Health News for Late June 2008

Cancer

Lung Cancer & Women

An article published on June 14 in The Lancet Oncology has found that smoking is strongly associated with lung cancer risk in both men and women. However, while women who smoke are no more likely than men who smoke to get lung cancer, women who are nonsmokers seem to have a higher risk of lung cancer than men who are nonsmokers. The findings were based on 279,214 men and 184,623 women from eight states, who were aged 50 to 71 at baseline in 1995 and 1996, and who were followed until 2003.

Treating Melanoma with Cloned Immune Cells

A paper published in the June 19 issue of The New England Journal of Medicine reports success in using a man's own cloned CD4+ T white blood cells to treat his metastatic melanoma. The cells, which were removed from the patient and multiplied in the lab, had been primed to attack a chemical found on the surface of melanoma cells. Two months after treatment with the cloned cells, scans showed the tumors had disappeared, and after two years, the man remained disease-free.

Lifestyle, Diet, & Prostate Cancer

An article published online on June 16 in Proceedings of the National Academy of Sciences looked at a group of 30 men with low-risk prostate cancer who had decided against conventional measures such as surgery and radiation or hormone therapy. Instead, the men were put on a three-month major lifestyle change regimen, which included eating a diet rich in fruits, vegetables, legumes, whole grains, and soy products, engaging in moderate exercise (e.g., walking 30 minutes daily), and an hour of daily stress management (e.g., meditation). After the three months, not only did the men lose weight and lower their blood pressure, but prostate biopsies showed they had experienced changes in activity in about 500 genes – including 48 that were turned on and 453 that were turned off.

Promising – and Accidental – Cancer Treatment?

Research published online on June 30 in Nature Biotechnology reports that a drug developed using nanotechnology and a fungus (Aspergillus fumigatus fresenius) discovered while a scientist was trying to grow endothelial cells in the lab may be effective against several forms of cancer. The drug, an angiogenesis inhibitor now known as lodamin, has proven successful in tests on mice with breast cancer, neuroblastoma, ovarian cancer, prostate cancer, glioblastoma, and uterine tumors. The drug is in pill form, without side effects.

Possible Clue to Cancer Spread

An article published in the July issue of The American Journal of Pathology suggests that fibrocytes, normal cells found in the blood that have a role in healing wounds, may also be allowing cancer to spread. While working with mice that were genetically engineered to lack the cell receptor CCR5 (which helps control the migration of cells through the body) and which also had melanoma, researchers noted that these mice had fewer metastatic tumors than normal mice with melanoma. They therefore began injecting the genetically engineered mice with different cells to see which resulted in more tumors. Those injected with fibrocytes started making matrix metallopeptidase 9, or MMP-9, an enzyme that is known to promote cancer. As explained in a June 30 news release, mice injected with just 60,000 fibrocytes had the rate of metastases nearly double – a big effect for a relatively small number of cells. However, as researcher Dr. Hendrik van Deventer pointed out, "This study shows it's possible for fibrocytes to form the premetastatic niche. But it stops short of proving they positively are the cells."

The Mediterranean Diet & Cutting Cancer Risk

We've heard before of the heart-healthy benefits of the Mediterranean diet. Now, findings published in the July issue of the British Journal of Cancer suggests that adopting just a couple of the elements of the Mediterranean diet (eating less red meat, and more peas, beans, and lentils) could cut cancer risk by 12% – and using more olive oil could cut the risk of cancer by 9%. The findings were based on 25,623 participants (10,582 men and 15,041 women) who were part of the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC) study.

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Babies & Kids

Asthma, Allergies, & Air Pollution

A study published in the June 15 issue of the American Journal of Respiratory and Critical Care Medicine followed approximately 3,000 children in Munich from birth to age six, and found strong positive associations between the distance to the nearest main road and asthmatic bronchitis, hay fever, eczema, and sensitization, and that a distance-dependent relationship could be identified, with the highest odds ratios for children living less than 50 meters (55 yards) from busy streets. A busy street was defined as one with 10,000+ cars using it each day.

Pain in Preemies

Research published online on June 24 in PLoS Medicine suggests that tools commonly used to assess pain in infants may not be accurate. Researchers measured cortical hemodynamic activity in infants undergoing heel sticks, and found that pain may be processed at the cortical level without producing detectable behavioral changes, which means that infants with low pain scores based on behavioral assessment tools may not in fact be pain free.

Pain in Babies & Children

Two studies in July 1 issue of the Canadian Medical Association Journal looked at the effectiveness of techniques to minimize pain in newborns and children undergoing invasive procedures. In one study, researchers looked at 120 newborns from diabetic mothers and 120 from nondiabetic mothers, and used the Premature Infant Pain Profile to assess pain during intramuscular injection of vitamin K, venipuncture for the newborn screening test, and the first three heel lances for glucose monitoring (newborns of diabetic mothers only). Each newborn received 2 ml of a 24% sucrose solution or placebo solution before all procedures. They found that sucrose reduced overall pain in newborns when administered before painful medical procedures during the first two days after birth. The observed difference in pain, however, was modest (16%) and did not meet their definition of a clinically important difference of 20%. However, when each procedure was individually assessed, sucrose was effective for reducing pain during venipuncture for the newborn screening test, but it was ineffective during intramuscular injection of vitamin K, and was ineffective for reducing pain in newborns of diabetic mothers during repeated heel-lances. In another study, researchers conducted a double-blind randomized controlled trial to test the effectiveness of vapocoolant sprays to provide transient skin anesthesia for children (aged six to 12) undergoing intravenous cannulation. They found that the spray quickly and effectively reduced pain due to the procedures in children and improved the success rate of cannulation. They therefore concluded, "It is an important option to reduce childhood procedural pain in emergency situations, especially when time precludes traditional interventions."

Moms' Junk Food Diet & Their Kids' Future Health

Research involving rats, which was published the July issue of The Journal of Physiology suggests that eating a poor diet when pregnant or nursing may cause long-term health damage to the child. Researchers found that when rat mothers were fed a "junk food diet rich in fat, sugar and salt," their offspring had high levels of fat in their bloodstream and around major organs even after adolescence, and that the offspring had an increased diabetes risk, even if they ate a healthy diet themselves. Interestingly, male offspring of the junk-food-eating mothers had higher levels of insulin and normal blood sugar, while the reverse was true of females, who also tended to be fatter.

More on Serotonin & SIDS

In late 2006, a news item was released that connected SIDS to brain stem abnormalities that impact the way the brain uses the neurotransmitter serotonin. Now, a report published on July 4 in Science has found that mice genetically engineered to have an overactive serotonin-regulating receptor, which reduced the amount of serotonin in the brains of these otherwise normal baby mice, had erratic episodes where their heart rate would drop and, five to 10 minutes later, their body temperature would drop. Also, more than half of the mice abruptly died before they were three months old – some dying in the midst of these erratic episodes, sometimes after. Researchers hope the findings may help pinpoint babies at high risk for SIDS.

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Minds, Brains, & Mental Health

Brains & Sexual Orientation

Research published online on June 16 in Proceedings of the National Academy of Sciences has found that gay men and straight women, and lesbian women and straight men, share some characteristics in common in the areas of the brain responsible for emotion, mood, and anxiety. They wrote, "The results cannot be primarily ascribed to learned effects, and they suggest a linkage to neurobiological entities." The findings were based on the brain scans of 90 volunteers.

Another Piece in the Alzheimer's Puzzle

Research published online on June 22 in Nature Medicine may have answered the question of whether the amyloid plaques found in the brains of patients with Alzheimer's caused the disease or were a by-product of the diseases process. Researchers tested cerebral cortex extracts from brains of individuals aged 65+ with Alzheimer's, other forms of dementia, and without dementia. The extracts, which contained soluble one-molecule (monomer), two-molecule (dimer), three-molecule (trimer) or larger aggregates of beta-amyloid, as well as insoluble plaque cores, were injected into normal rats or added to slices of normal mouse hippocampus. The soluble dimers induced certain key characteristics of Alzheimer's in the rats (e.g., they impaired memory function, specifically the memories of newly learned behaviors) and in the mouse hippocampal slices, the dimers reduced the density of dendrite spines by 47%. As stated in a June 23 news release from the National Institute on Aging, which helped fund the research, "The animal findings were consistent with what the researchers found when they examined the brain tissues of people who had been clinically diagnosed with Alzheimer's and those without dementia. They detected soluble dimers and some trimers of amyloid in the brains of patients with Alzheimer's, but none or very low levels in those free of the disorder. Some people free of the disorder, however, did have insoluble amyloid plaques in their brains."

IQ & Vascular Dementia Risk

A paper published online on June 25 in Neurology reports a connection between low IQ measures in childhood and vascular dementia risk (though not Alzheimer's risk) in old age. Researchers wrote, "This suggests its effect acts mainly through vascular pathology rather than brain vulnerability." The findings were based on a study of 172 people with dementia who had had an IQ test at age 11 in 1932, and compared them to people of the same age and gender, and from similar neighborhoods and backgrounds who did not have dementia.

Women, Men, & Dementia

An article published online on July 2 in Neurology, which used data from 911 participants in The 90+ Study, a population-based study of aging and dementia in people aged 90 and above, has found that prevalence of all-cause dementia doubled every five years after age 90 for women but not men. They also found that overall prevalence of all-cause dementia was higher in women (45%) than in men (28%), and that women – but not men – who had received higher education were much less likely to develop dementia than those with a lower level of education.

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Stoke

Cancer Drug May Help With Stroke Treatment

A paper published online on June 22 in Nature Medicine has found, in tests on mice, that the leukemia drug Gleevec (imatinib) may reduce complications and increase the effectiveness of a treatment for ischemic stroke. The clot-busting drug tPA, which may be used to treat this common form of stroke, can cause blood to leak into the brain, and it must be used within three hours of the start of the stroke. However, when combining tPA with Gleevec, the mice exhibited less leakage and less damage to the brain. And in giving Gleevec prior to tPA, researchers were able to delay administration of tPA hours past the usual three-hour cut-off. As a result, researchers concluded that Gleevec may help prevent blood vessel leakage associated with tPA and could extend the window of time in which it can be used.

Possible Ways to Determine Stroke Risk

A study published in the June 23 issue of Archives of Internal Medicine suggests that doctors who look for subtle problems (e.g., reduced reflexes, unstable posture, tremors, differences in hand strength) in healthy elderly patients could help determine their risk of stroke. The findings, which were based on 506 community-dwelling individuals (average age 71.9 years) who were free of neurological diseases at baseline, showed that the presence of multiple subtle neurological abnormalities were associated with cognitive and functional decline and independently predicted mortality and cerebrovascular events.

Silent Strokes

An article published online in Stroke, which looked at 2,040 individuals in the Framingham Offspring Study, and whose average age was 62, found that 10.7% of the individuals had had at least one silent cerebral infarction.

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Preventive Medicine

Coffee & Long-Term Health

A paper published in the June 17 issue of Annals of Internal Medicine followed 41,736 men and 86,214 women with no history of CVD or cancer at baseline for 18 and 24 years respectively. Researchers found that regular coffee consumption was not associated with an increased mortality rate in either men or women, and concluded that the possibility that coffee consumption provides a modest benefit on all-cause and CVD mortality needs to be further investigated. The study's participants were subjects in the Health Professionals Follow-up Study and the Nurses' Health Study.

More Praise for Vitamin D

An investigation published in the June 23 issue of Archives of Internal Medicine has found that vitamin D deficiency is independently associated with all-cause and cardiovascular mortality. The findings were based on 3,258 male and female patients (average age, 62 years) scheduled for coronary angiography at a single tertiary center between 1997 and 2000, and who were followed up for a median period of 7.7 years.

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Diabetes

Depression & Diabetes

A contribution entitled Examining a Bidirectional Association Between Depressive Symptoms and Diabetes published in the June 18 issue of The Journal of the American Medical Association suggests that not only can diabetes lead to depression, but depression can lead to diabetes. The authors stated, "These findings suggest that individuals with elevated depressive symptoms have a modest increased risk of developing type 2 diabetes during follow-up, independent of sociodemographic, economic, and metabolic factors. Although this association was no longer statistically significant after adjustment for lifestyle factors, point estimates were largely unchanged by adjustment, suggesting that the association between depressive symptoms and incident type 2 diabetes is not fully explained by lifestyle risk factors." The findings were based on approximately 7,000 male and female participants aged 45 to 84 in the Multi-Ethnic Study of Atherosclerosis.

New American Diabetes Numbers

A June 24 CDC press release states that diabetes now affects nearly 24 million people in the United States, or 8% of the population, an increase of more than three million people in about two years. An additional 57 million people are estimated to have pre-diabetes, which puts them at increased risk for diabetes. The release also states that almost 25% of those aged 60+ had diabetes in 2007, and that the rate of diagnosed diabetes was highest among Native Americans and Alaska Natives (16.5%). Among other groups, the rate among blacks was 11.8%; among Hispanics, 10.4%, which includes rates for Puerto Ricans (12.6%), Mexican Americans (11.9%), and Cubans (8.2%); among Asian Americans 7.5%, and among whites 6.6%.

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Miscellaneous

MDs Rate Insurance Companies

This week, the American Medical Association released its first National Health Insurer Report Card, which rated Medicare and seven companies: Aetna, Anthem Blue Cross and Blue Shield, CIGNA Corp., Coventry Health Care, Health Net Inc., Humana Inc., and UnitedHealthcare. Among the findings: doctors are spending as much as 14% of their total earnings trying to get accurate payment for their work. Among those surveyed, the AMA found that Medicare had the highest rate of contract compliance (98%) and UnitedHealthcare the lowest (approximately 62%).

Overcrowding, Understaffing, & MRSA

An article published in the July issue of The Lancet Infectious Diseases suggests that when overcrowded, understaffed hospitals try to deal with patient volume by shortening patient stays, it may help with spread of infectious organisms, such as MRSA. They wrote, "Overcrowding and understaffing lead to failure of MRSA control programmes via decreased health-care worker hand-hygiene compliance, increased movement of patients and staff between hospital wards, decreased levels of cohorting, and overburdening of screening and isolation facilities. In turn, a high MRSA incidence leads to increased inpatient length of stay and bed blocking, exacerbating overcrowding and leading to a vicious cycle characterised by further infection control failure."

Genes & Crohn's Disease

A paper published online on June 29 in Nature Genetics combined data from three Crohn's studies (3,230 cases and 4,829 controls) and carried out replication in 3,664 independent cases, and their results strongly confirmed 11 previously reported genetic loci and provided genome-wide significant evidence for 21 additional loci connected to Crohn's.

Treating Women's Hearts

A meta-analysis published in the July 2 issue of The Journal of the American Medical Association concluded that in the case of non-ST-segment elevation acute coronary syndromes, an invasive strategy has a comparable benefit in men and in high-risk women for reducing the composite end point of death, MI, or rehospitalization with acute coronary syndromes, and that there was evidence supporting new guidelines for a conservative strategy in the case of low-risk women.

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