The bone-strengthening drug zoledronic acid (Zometa) reduces the spread of breast cancer by preventing chemotherapy-related bone loss, a new study suggests.
Tumor cells released from the primary breast cancer site often travel to the bone marrow and spread from there to other areas of the body. Chemotherapy speeds up bone turnover, which releases bone-derived growth factors that can promote tumor growth in breast cancer patients.
It's been suggested that zoledronic acid -- which reduces bone loss by slowing the activity of cells that destroy bone -- can make bone marrow a less inviting place for cancer cells.
The new phase 2 trial included 120 women undergoing chemotherapy for locally advanced breast cancer. Some of the patients received 4 milligrams of zoledronic acid every three weeks for one year starting with their first dose of chemotherapy, while others received no zoledronic acid.
Bone marrow samples were taken at the start of the study and again after three months and one year of treatment. At the start of the study, 45.7 percent of patients had detectable tumor cells in their bone marrow. After three months of treatment, women who received zoledronic acid and chemotherapy had fewer detectable tumor cells than those who received chemotherapy alone, according to Rebecca Aft, of the Washington University School of Medicine in St. Louis, and colleagues.
Among women who had no tumor cells in their bone marrow at the start of the study, 87 percent of those in the zoledronic acid group were free of tumor cells at three months, compared with 60 percent of those who received chemotherapy alone. One year after treatment, the rates were 40 percent and 33 percent, respectively, the study authors noted.
The researchers also found that zoledronic acid prevented chemotherapy-related bone loss. Among patients who had low bone mineral density at the start of the study, 44 percent of those who took zoledronic acid had normal bone density after one year and significant decreases in bone-turnover markers at three months and one year.
A new form of inhaled insulin appears to help people with diabetes who must use insulin, with fewer potential risks than an earlier form of inhaled insulin that is no longer on the market.
The new drug, Afrezza, which is awaiting approval from the U.S. Food and Drug Administration, works faster, keeps blood sugar levels at a closer to normal level and has less risk of causing low blood sugar levels (hypoglycemia) than currently available injectable insulins, researchers say. It also appears to have less risk of causing lung problems than its inhaled predecessor, Exubera.
"Afrezza is ultra-rapid-acting insulin, and clinical studies have shown us that it has the potential to change diabetes therapy, because in the body, Afrezza looks like the insulin that's normally in a person's body," said Andrea Leone-Bay, vice president of pharmaceutical development for MannKind Corp., manufacturer of Afreeza.
"Afrezza differs a lot from Exubera," she said, both in the way it's made and in the way it works.
Afrezza uses a novel technology called Technosphere, according to Leone-Bay. It's inhaled as a dry powder that dissolves in the lungs. The particles then pass through the lungs into the bloodstream and begin acting almost immediately. Afrezza's action peaks about 12 to 15 minutes after inhalation, instead of the 45 to 60 minutes it takes for Exubera to peak, she said.
That fast action helps to keep after-meal blood sugar levels lower, which is a goal for people with diabetes. And Afrezza is less likely to cause hypoglycemia, a common problem that occurs when insulin levels are higher than required for a meal.
The idea of an inhaled insulin appeals to diabetics who must use insulin every time they eat. Currently, the only way to get that insulin is through injection or an insulin pump that must be inserted in a new site under the skin every few days.
In 2006, the first inhaled insulin, Exubera, received FDA approval. However, the drug was pulled from the market in October 2007 by its manufacturer, Pfizer, because of disappointing sales. From the beginning, concerns surfaced about the effects the drug might have on the lungs. One study found a reduction in lung function for some, but of more concern was an increased risk of lung cancer associated with its use. This finding came after Exubera had been pulled from the market, and the sample size wasn't large enough to draw a definitive link between the drug and the increased risk of lung cancer.
Leone-Bay said that cancer studies have been conducted on Afrezza in rats. The rats got a much higher inhalation dose than humans would take, and the researchers didn't find an increase in lung cancer. She said these types of studies weren't done on Exubera.
"They have done the required safety studies and come out clean, but it's only been tested for six months, so long-term isn't known," said Sanjoy Dutta, director of the insulin initiative at the Juvenile Diabetes Research Foundation.
Dutta confirmed that Afrezza is fast-acting and less likely to cause low blood sugar. "Just as quickly as it has an onset of action, it also has a quick off mechanism. It doesn't stay around long enough to cause hypoglycemia," he said.
While Afrezza looks promising, it can't replace all injections for people with diabetes. Because it's fast-acting, it can't provide the long action of insulin known as basal insulin. It will only replace meal-time insulin.
Afrezza may have an impact on lung function, but Leone-Bay said once people stopped taking Afrezza, this effect went away. The company is conducting clinical trials to assess Afrezza in people with asthma.
Leone-Bay was to explain the Technosphere technology Tuesday at the American Chemical Society annual meeting in San Francisco. MannKind hopes the technology used in Afrezza might help deliver drugs that treat pain and osteoporosis, too.
People who suffer from chronic illness are more likely to be chronically offline: they use the Internet much less than in good health people, a new survey finds. The survey, conducted by the Pew Internet & American Life Project and the California HealthCare Foundation, and published online March 24, found that just 62 percent of adults surveyed who undergo from a chronic disease go online, compared to 81 percent of those who don't have a chronic disease.
Adults who have more than one chronic disease are yet less likely to go online: 68 percent of people with one constant disease do, compared with just 52 percent of those who have two or more chronic diseases.
The findings reflect general information about who uses the Internet and who doesn't. Those who don't go online are more expected to be older, black, less educated and have a lower income, the survey found.
However, the researchers noted that chronic illness compact the likelihood that a person will go online even after they familiar their statistics to account for the influence of these factors.
People with chronic disease even pay out less time than healthier people looking up information about health topics: 51 percent of the chronically ill participants reported doing so, compared to two-thirds of the others who were surveyed.
The results showed that there was one way that people with chronic disease stood out regarding Internet use: When statistics were adjusted to account for the authority of factors such as race and age, the researchers found that those with a chronic disease were more likely to write on a blog or contribute to discussions online.
People with damage to a neural center for emotions don't get angry at would-be criminals, study finds.
Your ability to judge wrongdoing and get angry at the perpetrator seems to be based in a part of the brain that regulates emotions, neuroscientists say.
Researchers at the Massachusetts Institute of Technology report that people who suffer from damage in this area of the brain, the ventromedial prefrontal cortex, don't react appropriately when they consider hypothetical situations in which one person unsuccessfully tries to kill another person. The researchers say people with the brain damage don't consider the perpetrator to be morally responsible for the actions.
"Were slowly chipping away at the structure of morality," said Liane Young, a postdoctoral associate in MITs Department of Brain and Cognitive Sciences and lead author of a new study, in a statement. "We're not the first to show that emotions matter for morality, but this is a more precise look at how emotions matter."
The researchers came to their conclusions after studying nine patients with damage to the brain region, which is located behind the eyes and is about the size of a plum.
The subjects were asked to react to hypothetical scenarios.
"They can process what people are thinking and their intentions, but they just don't respond emotionally to that information," Young said. "They can read about a murder attempt and judge it as morally permissible because no harm was done."
Study finds better survival rates a year after intensive care.
High blood pressure -- even above the level ordinarily regarded as dangerous -- is a good indicator of long-term survival for people admitted to an intensive care unit because of chest pains that indicate a major heart problem, Swedish researchers report.
Their study, which involved 119,151 people admitted to ICUs for chest pain between 1997 and 2007, found the best one-year survival rate among those who had a systolic pressure (the higher of the recommended 120/80 number) at or above 163, according to a report in the March 24/31 issue of the Journal of the American Medical Association. The study was conducted at Swedish hospitals by physicians at Linkoping University.
Survival was poorest for the one-quarter of people who had the lowest blood pressure readings, less than 128 systolic, the study found. Their one-year death rate was 40.3 percent higher than for those in the next category up, with a systolic pressure of 128 to 144.
Overall, as blood pressure levels rose, the one-year death rate declined. Compared with people with a systolic reading of 128 to 144, those with readings between 145 and 162 had a 15.2 percent lower death rate, and people in the highest category, with a systolic reading of 163 or greater, had a 21.7 percent lower death rate.
There have been hints of such an effect in previous studies, said Dr. Gregg C. Fonarow, a professor of medicine at the University of California, Los Angeles, who led one such study, which included people with acute heart failure.
That study did find improved survival associated with higher blood pressure, and other studies have found a similar effect during a hospital stay, "but this is the first study looking at one-year survival," Fonarow said.
Why should blood pressure normally regarded as dangerously high be beneficial? "It could be a marker for patients with better cardiovascular reserves," Fonarow said. "It suggests that those patients who can engender a very high response may have less severe disease or a more intact neuro-hormonal system."
But the results do not indicate that high blood pressure in such cases can be ignored, Fonarow said. "It should not be taken as saying that they don't need treatment," he said. "Patients who were treated for high blood pressure before release, with drugs such as ACE inhibitors and beta blockers that lower blood pressure, did better."
The study does show the need for worry about people in the ICU with lower blood pressures, Fonarow said. "It highlights that they are at much greater risk," he said. "Those hospitalized with blood pressure below 128 need to be followed more closely."
A study led by Dr. Kim A. Eagle, director of the Cardiovascular Center at the University of Michigan, predicted such an effect for people with acute coronary syndromes several years ago, Eagle said.
"We reasoned that a patient with very low pressure was in shock or at risk of being in shock, with very little in cardiovascular reserves," he said. "There is very little room for error in cardiac function."
Blood pressure can indicate how much cardiovascular reserve a person has, Eagle said. "If someone is in acute stress, having a heart attack, and can generate acute hypertension [high blood pressure], he is in good shape," he said.
The study raises the question of "how hard should we work at lowering blood pressure in such cases," Eagle said. "Probably it should be normalized, but we don't want to go beyond that. We don't want to put the patient into acute stress."
Dr. Manesh Patel, an assistant professor of medicine at Duke University, said that it's important to remember that the study looked at "a very special group."
"They're in a very high-risk situation," Patel said. "Blood pressure is a measure of how well your heart is squeezing. When you're in that situation, it's generally better to have a high blood pressure than not. High blood pressure is a surrogate for how much your heart is alive and squeezing."
When shedding pounds is an issue, combo treatment found to boost success.
Behavioral therapy with a focus on weight-counseling combined with the smoking-cessation medicine bupropion (Zyban) is more effective than standard counseling alone in helping women quit smoking, according to a new study.
The research, published March 22 in Archives of Internal Medicine, included 349 female smokers who were concerned about their weight. The women were randomly divided into four groups. One group participated in a cognitive behavioral therapy program focused on weight gain issues and took bupropion, and a second group had the same counseling but took a placebo. The third group took bupropion while undergoing counseling without a focus on weight gain, and the fourth group had standard counseling and took a placebo.
Overall, 31.8 percent of the women in the study had quit smoking at three months, 21.8 percent at six months, and 16.3 percent at one year. Among the women who received weight counseling, those who took bupropion were more likely than those taking a placebo to have quit at three months (40.6 percent versus 18.4 percent), six months (34 percent versus 11.5 percent) and one year (23.6 percent versus 8.1 percent).
The researchers, from the University of Pittsburgh Medical Center, also found that the women who took bupropion took longer to start smoking again after quitting -- a median of 266 days, compared with 46 days.
Among the women who received standard counseling, bupropion did not appear to improve quit rates or time to relapse.
"Future research should focus on possible mechanisms to explain the efficacy of this specialized counseling plus bupropion therapy and address issues related to the practicality of wider dissemination of the specialized counseling intervention for weight-concerned women smokers," the researchers concluded.
The drug maker GlaxoSmithKline provided the drugs and placebos used in the study.
Two major studies confirm the current medical consensus that moderate drinking appears to be good for the heart but heavy drinking is bad for health in general.
"This would not change our current guidelines, which provide an upper limit and not a lower limit, no more than two drinks a day for men and no more than one drink a day for women," said Dr. Kenneth J. Mukamal, an associate professor of medicine at Harvard Medical School and an internist at Beth Israel Deaconess Medical Center. He is lead author of one of the reports published online March 23 in the Journal of the American College of Cardiology.
The new study, using data from nine National Health Interview Surveys done between 1987 and 2000, is more thorough than previous reports and provides "some of the strongest evidence to date" of a link between moderate drinking and a lower risk of cardiovascular disease, Mukamal said.
Specifically, the study tries to separate out the health effects of people who list themselves as abstainers, some of whom have never touched the stuff and others who were heavy drinkers but gave it up because of possible damage to their health.
"Some studies have done better than others at that, but this is by far the largest effort to do it," Mukamal said. "We have data on more than 2 million person-years, appropriately weighted so that it is representative of Americans over the last 20 years."
The study looked specifically at deaths from cardiovascular conditions such as heart attack and stroke. It found a lower rate of such deaths in light and moderate drinkers than among people who never drank or quit. The type of alcoholic beverage -- beer, wine, liquor -- made no difference.
"Indeed, the lowest rate of cardiovascular mortality was among those who drink moderately," Mukamal said. "That benefit is clearly eliminated in people who drank above that level."
The results "dovetail nicely" with those of previous reports, but "they are not likely to lead to any recommendation to drink alcohol," Mukamal said, since drinking can have adverse effects on organs outside the cardiovascular system.
A second report in the same issue of the journal by Italian doctors and epidemiologists at Catholic University, in Campobasso, looked at the relationship between alcohol consumption and death rates in eight studies that included more than 29,000 drinkers and nondrinkers who had cardiovascular disease.
Moderate alcohol intake had a protective effect for those people, the report said. It found the maximum reduction in risk of death from all causes among those whose alcohol intake ranged from 5 to 10 grams a day. (A typical drink is usually defined as containing 13.7 grams of alcohol.)
For cardiovascular deaths alone, the maximum protective effect -- a 22 percent reduction -- was found for a daily intake of 25 grams of alcohol. The death rate went up with higher daily alcohol intake levels.
Their bottom line: "In patients with cardiovascular disease, light to moderate alcohol consumption (5 to 25 grams per day), was significantly associated with a lower incidence of cardiovascular and all-cause mortality."
But it's important to remember that advice about drinking should be made on the basis of a person's specific risk factors, said Dr. Arthur L. Klatsky, a senior consultant in cardiology at the Kaiser Permanent Health Plan in California, who wrote an accompanying editorial.
For example, there is no net benefit of moderate drinking for young women, since it increases the risk of breast cancer, Klatsky said, but the cardiovascular benefits for middle-aged men and women are there.
"Advice about this has to be given on an individual basis," he said
Blood vessel function rapidly recuperates after smokers kick the habit, leading to a reduced risk of heart disease and heart attack, new research shows
The study included more than 1,500 people taking part in a clinical trial to help them quit smoking. Before and one year after the participants stopped smoking, doctors used ultrasound to measure the patients' flow-mediated dilation (FMD), a gauge of the health of the brachial artery, the main artery of the upper arm.
The ability of the brachial artery to relax is closely related to the ability of the heart arteries to relax, and predicts risk for future heart and blood vessel disease, explained the University of Wisconsin researchers.
They compared the FMD readings from patients who successfully quit with those who quit and then resumed smoking.
Individuals who quit smoking had improved blood vessel function, even though they gained weight, which is a common side effect of smoking cessation," study author Dr. James Stein, an associate professor of medicine at UW School of Medicine and Public Health, said in a university news release. "This confirms that quitting smoking is good for your blood vessels and reduces risk for heart attacks and cardiovascular disease.
FMD improved by as much as 1 percent among patients who had quit smoking for a full year. That's a significant improvement, according to Stein.
It's statistically significant, but more important, it's also clinically relevant," he said. "A 1 percent change in FMD is associated with an approximately 14 percent lower rate of cardiovascular disease events. That means patients who permanently quit smoking are less likely to have a heart attack and heart disease.
The study was presented this week at the American College of Cardiology annual meeting in Atlanta and published simultaneously in the Journal of the American College of Cardiology.
Cardiovascular disease is the cause of about one-third of smoking-related premature deaths in the United States.
Women who suffer a heart attack are more likely to survive if they receive the same invasive treatments as men do, a new study suggests.
French researchers looked at more than 3,000 patients admitted to the hospital for heart attack and found that women were 57 percent less likely than men to undergo angiography, a procedure that identifies blocked arteries. Among patients with an especially serious form of heart attack called ST-elevation myocardial infarction, men were 72 percent more likely to receive clot-busting drugs and 24 percent more likely to undergo angioplasty, a procedure to reopen a blocked artery.
In addition, the study authors noted, women were more likely than men to die during their initial hospital stay (9.7 percent versus 5 percent) and within a month of having a heart attack (12.4 percent versus 7 percent).
However, when the researchers used a special statistical model to match patients by baseline clinical characteristics and treatments, death rates were similar among women and men.
"This suggests that we could reduce mortality in female patients by using more invasive procedures. When there are no clear contraindications, women should be treated with all recommended strategies, including invasive strategies," Dr. Francois Schiele, professor of cardiology and cardiology chief at the University Hospital of Besancon, said in a news release from the American College of Cardiology.
The study was to be presented Tuesday at the American College of Cardiology's annual scientific session in Atlanta.
Eyes are a very important part of one’s body and taking care of the eyes is equally important as taking care of one’s body. The eyes of human being are one of the beautiful gifts given by the god and which is very necessary element of our body parts. Eyes afford us view, lacking of which life would have lost lots of significance. Eyes are rapidly in contact with external environment because of which many eye problems can arise.
There are lots of eye problems that can occur and the problems list is eternal. But we can try to take certain enough steps to protect our eyes. Apart from consulting the doctor on a regular basis for routine checkup one should take care of the eyes himself. It may include washing of eyes on a regular basis and also wearing UV protected sun glasses while going out in the sun.
Eyes are the most vulnerable part for catching any kind of infection or disorder. Thus a regular checkup is actually fact very important. Any eye doctor may suggest a patient to go for definite special tests in order to check that are there any signs or indications of eye diseases &disorders. The diseases & disorders may comprise cataract or conjunctivitis, dryness in eyes or glaucoma, tumors of parts of eyes & even partial or complete blindness.
It is really essential for a person to have a healthy diet. This is so because the deficiency of vitamins and minerals can lead to different eye problems. The deficiency of vitamin A may lead anyone to night blindness. Actually, more than 90 % of people who suffer from night blindness may also suffer from other problems as well. Anyone may even become Diabetic as a later result of night blindness.
* Smoking may cause major harm to the eyes & it may even lead to complete blindness. Smoking may reason Macular degeneration that leads to the blind spot.
* A person may come across other problems which may occur to the eyes which may occur due to an accident.
Eating plenty of potassium-rich foods such as leafy greens, potatoes and bananas may reduce the risk of stroke and coronary artery disease, according to Italian researchers.
The new analysis was based on 10 studies published between 1966 and 2009 that included almost 280,000 adults. During follow-ups that ranged from five to 19 years, there were over 5,500 strokes and almost 3,100 coronary heart disease events, the investigators found.
Higher potassium intake was associated with a 19 percent lower risk of stroke and an 8 percent lower risk of coronary heart disease. The findings support global recommendations for people to increase their consumption of potassium-rich foods in order to prevent vascular disease, said Dr. Pasquale Strazzullo, of the University of Naples, and colleagues.
Other foods high in potassium include soybeans, apricots, avocados, plain non-fat yogurt, prune juice, and dried beans and peas.
The findings were presented Wednesday at the American Heart Association's Nutrition, Physical Activity and Metabolism conference in San Francisco.
Another study presented at the meeting found that a diet high in raw fruits and vegetables may help protect against stroke.
In that study, the researchers examined the incidence of stroke among more than 20,000 men and women, aged 20 to 65, who were free of cardiovascular disease at the start of the study. During 10 years of follow-up, there were 233 strokes among the participants.
After they adjusted for a number of factors, the researchers found that people with a high intake (more than 262 grams per day) of raw fruits and vegetables were 36 percent less likely to suffer a stroke than those with a low intake (less than 92 grams per day) of raw fruits and vegetables.
However, there was no association between stroke risk and a high intake (more than 233 grams per day) or low intake (less than 113 grams per day) of processed fruits and vegetables, said Linda Oude Griep of Wageningen University, the Netherlands.
After 10 sessions, anxiety, depression and stress lessened, researchers say.
Psychotherapy helps cut the incidence of psychological woes in patients with lupus who contain high levels of daily stress, a new study finds.
The treatment also helps these patients improve and maintain their quality of life, according to a new Spanish study.
The research incorporated 45 patients randomly assigned to a control group or to a therapy group. Each acknowledged 10 weekly sessions of cognitive behavioral therapy (CBT).
By the end of the study, the patients in the therapy group had significantly reduced levels of depression, anxiety and daily stress -- along with considerable improvement in quality of life -- compared to those in the control group.
However, the patients in the therapy group didn't show any significant reduction in lupus disease activity, said the Spanish researchers.
The study was led by N. Navarrete-Navarrete of the University Hospital Virgen de Las Nieves, and was recently published in the journal Psychotherapy and Psychosomatics.
