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Wednesday, August 27, 2008

Nuts, Seeds, Popcorn Don't Boost Diverticulosis Risk

People with diverticular disease, a common digestive disorder, are typically told to avoid eating popcorn, nuts, seeds and corn so they don't get painful attacks.

But, a new study calls into question that conventional wisdom. The study of more than 47,000 men found that eating those foods did not seem to increase the risk of diverticulosis or diverticular complications.

"We found, contrary to current recommendations, that actually, consumption of these foods did not increase the risk of diverticulitis or diverticular bleeding and didn't appear to increase the risk of developing diverticulosis or its complications," said study lead author Dr. Lisa Strate, an assistant professor of medicine at the University of Washington School of Medicine, in Seattle.

The findings are published in the Aug. 27 issue of the Journal of the American Medical Association.

Diverticular disease affects the colon, the part of the large intestine that discards waste. Diverticulosis occurs when pouches -- called diverticula -- form in the colon. Stool or bacteria can lodge in the pouches. Diverticulitis occurs when the pouches get inflamed; symptoms can include bleeding, infection or a blockage of the digestive system.

One third of U.S. adults have diverticulosis by age 60, although most do not experience serious problems. By age 85, two-thirds of people have come down with the condition, according to the U.S. National Institutes of Health.

The exact cause isn't known, although many experts blame a low-fiber diet. Muscle strain during defecation may cause the pouches to form.

The advice to avoid nuts, seeds, popcorn and corn comes from the belief that these foods may be more likely to become lodged within the pouches. But there's been no proof demonstrating such a link.

And Strate's study failed to find a link, either. Evaluating data from the long-running Health Professionals Follow-up Study, a cohort of men followed from 1986 to 2004, she and her colleagues looked at medical records every two years and dietary information for every four years. The men ranged in age from 40 to 75.

At the study start, all were free of diverticulosis or complications. Eighteen years later, 801 had experienced diverticulitis, and 383 had diverticular bleeding.

When the study authors compared men with the highest intake of foods such as nuts with those with the lowest, they found that those who ate the most nuts were actually 20 percent less likely to get diverticulitis than those who ate the least. And those men who ate the most popcorn were 28 percent less likely to get diverticulitis than those eating the least.

No association was found for corn.

Strate thinks the longstanding dietary recommendations should be reconsidered, but she cautioned that hers was just one study. She believes the findings would probably apply to women, too.

Dr. Anthony Starpoli, an attending gastroenterologist at Lenox Hill Hospital in New York City, who is familiar with the new findings, said that even though the study numbers were large, the results may not apply to everyone. "There are probably going to be a subset of people where perhaps a more restrictive diet does benefit them," he said.

Starpoli said that, while the recommendation to avoid nuts, popcorn and seeds isn't based on scientific studies, there are people who do experience distress when they eat those foods.

"If you are a patient with known diverticular disease, and you have had the experience of eating seeds, nuts and popcorn and developed diverticular pain as assessed by your doctor, you should probably not have those foods."

Tuesday, August 19, 2008

Mathematical Model Helps Predict Cancer Tumor Size

A mathematical model to find blood biomarkers that can help doctors estimate the size of cancer tumors has been developed by researchers at Stanford University.

The team says its work may help guide development of new tests to improve early detection of cancer. Currently, there's no reliable method of using the results of blood-screening tests to gauge tumor size.

The Stanford researchers developed their mathematical model using two common blood biomarkers: prostate specific antigen (PSA), which is often elevated in prostate cancer, and CA125, used as a marker for follow-up therapy in ovarian cancer patients.

Using this model, the researchers found that the minimum tumor sizes predicted by their calculations were close to what was actually seen in clinical practice.

"We're pretty happy that we came up with rather realistic tumor sizes. Although this is a very basic model, it should give researchers a tool to use when deciding if a particular secreted protein would be a good biomarker," radiologist Dr. Amelie Lutz said in a Stanford news release.

"Early cancer detection is a very challenging but important goal for the cancer field. This modeling work enables a very deep understanding of the problems that will have to be solved for blood-based cancer biomarkers to be successful in this effort," study senior author Dr. Sanjiv Sam Gambhir, a professor of radiology, said in the news release.

Monday, August 11, 2008

Arm swelling after breast cancer surgery common

Lymphedema is a public health issue "deserving greater attention," doctors from Australia wrote in a recently published paper.

Among 287 women with breast cancer, 190 took part in all assessments during 18 months of followup after surgery and arm swelling developed in 62 (33 percent) of them during that time, Dr. Sandra C. Hayes and colleagues from Queensland University of Technology in Kelvin Grove found.

Roughly 60 percent of these women had fleeting symptoms, whereby the lymphedema dissipated with or without treatment. However, 40 percent of women experienced long-term arm swelling lasting more than 3 months, with or without intermittent periods of relief.

Women with lymphedema, Hayes told Reuters Health, "were twice as likely to have poorer upper-body function when compared with women who had not developed arm swelling. Poor upper body function is associated with reduced quality of life," she noted.

More extensive breast surgery increased the odds of lymphedema six-fold and having more than 20 cancerous lymph nodes removed increased odds four-fold.

Hayes noted that two identified risk factors for arm swelling post-surgery -- insufficient physical activity and not using the affected arm -- "are amenable to interventions and should be investigated for their preventive and therapeutic effects among women after treatment for breast cancer."

"It was found that use of the treated side likely decreases risk of developing lymphedema," Hayes said.

Thursday, August 7, 2008

Brain Pathway Yields Clues to Cigarette Addiction

New insight into how the brain processes the rewarding and addictive properties of nicotine sheds light on why some people seem to become addicted once they have their first cigarette, say Canadian researchers.

"Nicotine interacts with a variety of neurochemical pathways within the brain to produce its rewarding and addictive effects. However, during the early phase of tobacco exposure, many individuals find nicotine highly unpleasant and aversive, whereas others may become rapidly dependent on nicotine and find it highly rewarding. We wanted to explore that difference," study leader Steven Laviolette, of the department of anatomy and cell biology at the Schulich School of Medicine & Dentistry, University of Western Ontario, said in a university news release.

One brain pathway in particular uses the neurotransmitter dopamine to transmit signals related to nicotine's rewarding properties, the researchers noted. This pathway -- the mesolimbic dopamine system -- also plays a role in addiction to a number of other substances, such as alcohol and cocaine.

"While much progress has been made in understanding how the brain processes the rewarding effects of nicotine after the dependence is established, very little is known about how the mesolimbic dopamine system may control the initial vulnerability to nicotine; that is, why do some individuals become quickly addicted to nicotine while others do not, and in some cases, even find nicotine to be highly aversive," Laviolette said.

He and his colleagues identified the specific dopamine receptor subtype that controls the brain's initial sensitivity to nicotine's rewarding and addictive properties. In addition, the researchers were able to manipulate these receptors to control whether nicotine is processed as rewarding or unpleasant.

The findings could lead to new therapies to prevent nicotine addiction and to treat nicotine withdrawal when smokers try to kick the habit.

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.