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Thursday, July 31, 2008

Public Smoking Bans Work Across the Board

After a ban on smoking in all enclosed public places was introduced in Scotland in March 2006, there was a 17 percent reduction in hospital admissions for acute coronary syndrome, says a new study that provides further proof that smoke-free laws provide health benefits.

Researchers found the number of admissions in the 10 months after the ban was 2,684, compared with 3,235 in the 10 months before the ban. Nonsmokers accounted for 67 percent of the decrease. There was a 14 percent reduction in admissions among smokers, a 19 percent reduction among former smokers, and a 21 percent reduction among people who'd never smoked.

The study also found that people who'd never smoked reported a decrease in their weekly amount of exposure to secondhand smoke.

While admissions for acute coronary syndrome decreased 17 percent in the 10 month's after the Scottish ban, there was a 4 percent reduction in England (which has no such legislation) during that same period. In the decade preceding the ban, Scotland had a mean annual decrease of 3 percent.

Previous studies have suggested that banning smoking in public places reduced hospital admissions for acute coronary syndrome, but it wasn't clear whether the reduction involved nonsmokers, smokers or both.

The new study was published in the July 31 issue of the New England Journal of Medicine.

Earlier this month, an International Agency for Cancer Research report said smoke-free policies are extremely effective at reducing smoking rates, exposure to secondhand smoke, and smoking-related heart disease.

Another study, published in the journal Circulation, found the number of acute coronary events dropped significantly among adults in Rome after Italy banned smoking in public places in 2005.

Wednesday, July 23, 2008

Scientists Discover a New Way to Fight Tooth Decay

Dental caries is an infectious disease that results in tooth decay and cavities if left untreated. It is one of the most common diseases around the world. With funding from USDA's Cooperative State Research, Education, and Extension Service (CSREES), a team of scientists in New York examined a group of compounds, called polyphenols, in grapes that could potentially fight the onset of tooth decay.

Streptococcus mutans, one of the primary microbial agents involved with tooth decay and cavity formation, produces a biofilm that covers the teeth. In creating the biofilm, it creates an acidic environment that breaks down the mineral structure of the tooth, producing points of weakness where the onset of disease can occur.

Hyun Koo and colleagues at the University of Rochester Medical Center (URMC) and the New York State Agricultural Experimental Station at Cornell University focused their analyses on red wine grapes and wine-derived byproducts due to their rich and diverse content of polyphenols and availability of the products for research. Previous studies show that polyphenolic compounds in the extracts of grape, apple, cranberry and cocoa act as a natural biological agent against S. mutans' ability to cause the disease.

Their work examined the chemical composition of polyphenolic compounds obtained from whole grape and pomace, a slightly fermented grape mash consisting primarily of skins and seeds. The phenolic compounds from the different wine grape varieties were tested against S. mutans to determine the most effective disruptive agent.

The scientists determined that all wine grape varieties contained high levels of polyphenolic extracts. The extracts, however, did not kill S. mutans. Instead, the extracts were effective at disrupting the bacteria's ability to form the acidic biofilms that cause dental caries. The phenolic extracts obtained from the pomace were slightly more effective than the whole grape in inhibiting acidic bacterial biofilm production.

Thursday, July 17, 2008

Cancer Survival Depends on Where You Live

Economic differences among countries, access to health care, and the availability of cancer treatments feed the disparities in survival, the report said.

"There is a very wide global range in the odds of survival after a cancer diagnosis," said lead researcher Michel Coleman, a professor of epidemiology at the London School of Hygiene and Tropical Medicine in Great Britain. "Some of the range is understandable on the basis of the relative wealth of these countries," he added.

The study also confirms the disparity in cancer survival among blacks and whites in the United States, Coleman said. "The differences are large across the U.S.A., and even in different metropolitan areas," he said.

Coleman believes the differences among countries -- and within regions of countries -- is directly related to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."

For the study, called the CONCORD study, Coleman's team collected data on 1.9 million cancer patients in 31 countries. Using cancer registries from each country, the researchers compared the five-year survival rates for breast, colon, rectal and prostate cancer.

The United States has the highest rates of survival for breast and prostate cancers, while Japan has the highest survival rates for colon and rectal cancers among men. France has the highest survival rates for colon and rectal cancer among women, the report found.

In addition, Canada and Australia also have very high survival rates for most cancers. The lowest rate of survival among both men and women was seen in Algeria.

In the United States, the lowest survival rates are in New York City, except for rectal cancer in women, where Wyoming scores worse. The best survival rate for cancer in the United States is in Hawaii, the researchers found.

Idaho also has a high survival rate for rectal cancer, and Seattle has the highest survival rate for prostate cancer.

But, there's a big disparity in cancer survival rates between whites and blacks in the United States, and it favors whites. The differences range from 7 percent for prostate cancer to 14 percent for breast cancer. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.

There's also a significant difference in cancer survival rates between the United States and Europe, with survival rates 10 percent and 34 percent higher in the United States for breast cancer and prostate cancer, respectively, the study found.

Friday, July 11, 2008

Breast-Conserving Surgery Leaves Many Cancer Patients Disappointed

A third of women who opt for breast-conserving cancer surgery say they now have an asymmetry between their breasts that greatly affects their quality of life, a new study says.

Women whose affected breast looked noticeably different after surgery were twice as likely to fear their cancer returning and to have symptoms of depression when compared with women whose breasts still appeared similar, according to the study by researchers at the University of Michigan Comprehensive Cancer Center.

Their findings are published in the July 10 issue of the Journal of Clinical Oncology.

"We found that one of the most important factors of postoperative quality of life and satisfaction was postoperative asymmetry or the aesthetic outcome that women experienced after their surgery," study author Dr. Jennifer Waljee, a resident in general surgery at the U-M Medical School, said in a university news release.

Many women diagnosed with breast cancer can choose between surgery that removes just the tumor and some surrounding tissue or a mastectomy, which removes the entire breast. Reconstructive surgery is possible after each type of operation.

"It's important for women to think about all of those issues at the time that they're making their surgical decision and realize that although breast-conserving surgery may or may not be less disfiguring than mastectomy, they're likely to experience some asymmetry afterwards that may impact their quality of life," Waljee said.

Surgeons usually discuss prior to the operation the types of aesthetic changes mastectomy patients will see after. The researchers believe the same level of counseling is not given those having breast-conserving surgery, leaving them with incorrect expectations of what their breast will look like after the operation.

"It's important for breast surgeons to have an open and honest dialog with their patients so that they understand patients' expectations before surgery and can better address postoperative recovery needs," Waljee said.