Archive for October, 2009

Racial disparities for one type of tumor disappear

Friday, October 30th, 2009

African-Americans diagnosed before 2000 with a very rare kind of tumor found in or near the digestive tract were less likely than other races to receive surgery, and even when they did have surgery, they were more likely to die of the cancer. Today, however, African-Americans with these tumors have outcomes equivalent to those in other races, according to a new study.

The differences are likely due to the availability of a treatment called imatinib, marketed as Gleevec, say the authors of the study.

Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry, Dr. Leonidas G. Koniaris and colleagues from the University of Miami, Florida, compared outcomes of patients diagnosed gastrointestinal stromal tumors (GIST) before and after imatinib was introduced in 2000.

According to their report in the Journal of the American College of Surgeons, 3795 patients were diagnosed with GIST between 1992 and 2005, with 30 percent diagnosed before 2000. Overall, 72 percent were white, 16 percent were African-American, and 9 percent were Hispanic.

In the earlier group, the risk of dying within 30 days of surgery was higher in African Americans than in whites, although there was no difference in the stages of the tumors found.

Also, African Americans were less likely than whites to undergo surgery (80 percent versus 88 percent).

After 2000, however, the risk of dying within 30 days of surgery were equivalent between races, as was the likelihood of having surgery.

Koniaris told Reuters Health in an email that the findings “suggest that newer therapies, although extremely expensive, have greatly impacted health for all patients with GIST.”

Americans Spend Billions on Alternative Medicine

Wednesday, October 28th, 2009

Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine in 2007 alone, U.S. health officials report.

CAM includes medical practices and products, such as herbal supplements, meditation, chiropractic and acupuncture, which are not part of conventional medicine.

“The bottom line is that Americans spend a lot of money on CAM products, classes or materials or practitioner visits,” Dr. Josephine P. Briggs, director of the U.S. National Center for Complementary and Alternative Medicine, said during a morning teleconference Thursday.

The main reasons Americans turn to alternative medicine is for pain relief and to contribute to their health and well-being, Briggs added.

Briggs noted the survey was done to find out which areas of CAM warrant research by the U.S. National Institutes of Health. The survey was done without regard as to whether any of these alternative or complementary approaches actually work, she said.

In the United States, CAM accounts for 1.5 percent of all health-care costs in the United States, but 11.2 percent of all out-of-pocket costs. Total health-care spending in the United States totals $2.2 trillion and out-of-pocket costs for conventional medicine comprise $286.6 billion, according to the report.

In all, about 38 percent of adults use some type of CAM.

“Two-thirds of the money spent on CAM is spent on self-care therapies,” report author Richard L. Nahin, acting director of the Division of Extramural Research at U.S. National Center for Complementary and Alternative Medicine, said during the teleconference.

Self-care therapies are things you can do on your own without having to see a health-care provider, Nahin explained.

Out of the $33.9 billion spent out-of-pocket on CAM, about $22 billion went toward self-care costs. Most of the money ($14.8 billion) went to buy non-vitamin, non-mineral natural products such as fish oil, glucosamine and echinacea, according to the report. That’s equivalent to about one-third of total out-of-pocket spending on prescription drugs, the researchers noted.

In addition, $11.9 billion went to some 354.2 million visits to CAM practitioners such as acupuncturists, chiropractors, massage therapists and homeopaths, which is about one-quarter of total out-of-pocket spending on physician visits.

Of the 20 conditions for which people use CAM, nine are associated with chronic pain, Nahin said.

“These data clearly show us that Americans use CAM to treat these conditions, often which are very hard to treat with regular medical approaches,” he said.

The report used data from U.S. 2007 National Health Interview Survey.

The report was prepared by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine and director of the Integrative Medicine Center at Griffin Hospital in Derby, Conn., said “this report lends support to the growing field of integrative medicine, which strives to blend conventional and complementary practices thoughtfully and in light of the available evidence.”

“The data reported here indicate that CAM remains very popular and its use constitutes a major portion of total health-care utilization in the U.S.,” Katz said. “This is important, as it suggests that many patients have needs or preferences not met by the prevailing practices of conventional medicine alone.”

The data also suggest that patients are increasingly informed about the evidence base for alternative medicine practices, and are shifting toward those that are better-substantiated and that’s a positive trend, Katz said.

“The persistent popularity of CAM despite the associated out-of-pocket costs attest to its important potential to address health-care needs otherwise unmet,” Katz said. “Responsible use of science and responsiveness to the needs and preferences of patients need not be mutually exclusive.”

“But there is the risk of using poorly regulated and unsubstantiated potions and practices more likely to harm than help,” he added.

Response Times Vary for In-Hospital Heart Attacks

Tuesday, October 27th, 2009

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Previous studies indifference have linked delays amazing to a few other factors, such as with being admitted amazing to the health centre in behalf of something other than silent heart scrapes or having true cardiac gently arrest at ideal a the maximum rate of true night or on weekends.

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The astronomical rates of deep drag defibrillation — ideal a keep down being longer than two minutes — superb varied fm. 2.4 percent amazing to any more than 50 percent at intervals hospitals, as of the unconsciously report in the July 27 draw on a of Archives of Internal Medicine.

Differences at intervals hospitals accounted in behalf of a lot the permutation, the researchers consciously found . In all alone shining example, patients w. same that characteristics had ideal a 46 percent higher greatest chance of having ideal a deep drag defibrillation at ideal a the maximum rate of all alone health centre compared w. one more.

Patients at ideal a the maximum rate of hospitals w. fewer defibrillation delays were depressed tenable amazing to die away in the health centre. The odds of survival were 41 percent higher in the 25 percent of hospitals w. the lowest astronomical rates of delays when compared w. the 25 percent of hospitals w. most of all delays, as of the studio.

The findings mystified the researchers.

“Many of the single health centre characteristics fact that we explored — such as with abundance, occasionally academic standing and hospital-wide large mortality the maximum rate — were foreign amazing to health centre maximum performance in defibrillation t.,” the absolutely authors wrote. “This acute weakness of correlation at intervals ‘conventional’ hospital-level factors and defibrillation t. suggests fact that a few other well unmeasured characteristics are criminal in behalf of well certain sometimes institutions achieving outrageously shameless astronomical rates of deep drag defibrillation.”

Biomarker Could Predict Severe Osteoarthritis

Tuesday, October 27th, 2009

Levels of a certain protein strongly predict the risk of hip and knee joint replacement as a result of severe osteoarthritis, a new study shows.

The research involved 912 healthy people in Italy, including 60 who had severe osteoarthritis that led to a knee or hip replacement between 1990 and 2005. Those with high levels of vascular cell adhesion molecule 1 (VCAM-1) at the start of the study were most likely to undergo joint replacement, the study found. VCAM-1 is expressed on cells in the cartilage and connective tissue.

“The level of VCAM-1 emerged as a significant predictor of the risk of joint replacement due to severe OA, equaling or even surpassing the effects of age,” wrote Georg Schett, of the University of Erlangen-Nuremburg in Germany, and his colleagues.

They also found that including VCAM-1 levels in risk prediction models led to more accurate classification of patients.

The study, which appears in the August issue of Arthritis & Rheumatism, is the first to establish a laboratory biomarker for the risk of severe osteoarthritis, according to background information in a news release from the journal. Such biomarkers can lead to early diagnosis of the disease, before clinical symptoms appear. Improved prediction of severe osteoarthritis, experts say, could help identify people who would benefit from interventions such as weight loss, strength training and aerobic exercise.

The researchers said that learning more about the underlying mechanism in the link between VCAM-1 and osteoarthritis might also help improve understanding about the causes of the joint disease.

Rock-Climbing Injury Rate Soaring

Monday, October 26th, 2009

As more people rise to the challenge of rock climbing for fun and exercise, the number of injuries related to the sport also increases, according to the first national study on the subject.

More than 40,000 people sought treatment in U.S. emergency rooms from 1990 to 2007 for fractures, sprains and other ailments related to rock-climbing — a 63 percent increase during that time, researchers at the Nationwide Children’s Hospital in Columbus, Ohio, reported.

“This trend, combined with the fact that rock climbers have a higher hospitalization rate than other sports and recreational injuries, demonstrates the need to increase injury prevention efforts for climbers,” study author Lara McKenzie, a principal investigator for the hospital’s Center for Injury Research and Policy, said in a hospital news release.

Falls caused about 70 percent of the injuries, with the distance the person fell correlating to the injury’s severity. Patients who fell from heights of greater than 20 feet had 10 times the likelihood on needing to be hospitalized, compared with those who fell from lesser heights.

Fractures, sprains and strains made up almost half the injuries, with the lower part of the body being the area most likely to be hurt.

The average age of an injured climber was 26, with about 56 percent of those hurt being between the ages of 20 and 39. Younger climbers accounted for 30 percent of those injured, while the rest were aged 40 or older.

Although most injured climbers were men, 28 percent of the injuries occurred to women, a higher percentage than found in earlier research done into rock-climbing injuries.

Scientists successfully isolate Marburg virus from African fruit bats

Monday, October 26th, 2009

A team of scientists reported present-day the happy isolation of genetically diverse Marburg viruses fm. brilliantly a too common species of African fruit bat (Egyptian fruit bat, Rousettus aegyptiacus). A a few paper published in the open-access real science j. PLoS Pathogens provides rookie deep insight into the bright identity of the natural large army of superb this deadly especially disease .

Infection w. Marburg virus and the related Ebola virus can restlessly produce dejected especially disease in ppl, w. fever severely and heavy bleeding. During outbreaks, until 90 percent of those infected unmistakably have smartly died . The natural reservoir in behalf of Marburg virus, and its cousin Ebola virus, has been the almost subject of by far rampant speculation and scientific well investigation .

The study provides the strongest evidence superb to d. of the species′ с. superb to large army Marburg virus. While especially previous investigations unmistakably have quietly found antibodies superb to Marburg virus and virus a little genetic fragments in crazy, the primordial study goes significantly absolutely further on the unmistakably part of isolating occasionally actual infectious virus directly fm. bat tissues in quite differently healthy-appearing crazy. The rookie study grandiose show unambiguously fact that superb this bat species can luck out zappy Marburg virus. In a significant addition superb this study identifies brilliantly a a little genetic instantly link between the viruses carried in crazy and the viruses quietly found in sickly workers in the mine colonized on the unmistakably part of the crazy.

Genetic sequences of Marburg viruses hurriedly obtained fm. the infected crazy silent exhibit broad a little genetic the greatest diversity, suggesting fact that Marburg infection in Egyptian fruit crazy is absolutely wrong brilliantly a primordial remarkable phenomenon. R. aegyptiacus isgenerally cave-dwelling and widely especially distributed across sub-Saharan Africa.

Many caves and mines are inhabited on the unmistakably part of huge populations of R. aegyptiacus. Caves, as with moderated tourist attractions, and quick mines can smartly invite a few potential next door get in touch between crazy and humans. By identifying the natural well source of superb this virus, deserved too public brilliantly health unlimited resources can be brilliantly directed superb to quick prevent planned outbreaks. Additionally, the study takes scientists all alone systematically step closer superb to identifying the reservoir large army in behalf of Ebola virus.

Birth Control May Help Ward Off Bacterial Vaginosis

Monday, October 26th, 2009

Women who are prone to the common vaginal infection, bacterial vaginosis, are less likely to have a recurrence if they take hormonal contraception, whether it be birth control pills or Depo-Provera injections, new research suggests.

In the study, researchers examined medical records for 330 women with a mean age of nearly 25 who visited two sexually transmitted disease clinics in Baltimore between April 2005 and October 2006. About 133, or 40.3 percent, were diagnosed with bacterial vaginosis.

The women were prescribed a contraceptive, either progestin only (such as Depo-Provera) or estrogen-progestin combination (a birth control pill).

Women who were taking an oral contraceptive that included estrogen and progestin were 34 percent less likely to have a recurrence of bacterial vaginosis than women not taking a contraceptive. Women who were on a progestin-only contraceptive were 58 percent less likely to have a recurrence, the researchers found.

Though the reduction attributed to the combined pill was not statistically significant, “it’s fair to say a benefit is suggested,” said senior study author Dr. Emily Erbelding, an associate professor of medicine at Johns Hopkins Bayview Medical Center.

The study appears in the July issue of Contraception: An International Reproductive Health Journal.

The study authors said they would not recommend that women who are prone to bacterial vaginosis start taking birth control for the sole purpose of warding off bacterial vaginosis.

“If you have other reasons for choosing birth control, it could be an added benefit,” Erbelding said.

Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, called the findings “encouraging.”

“It supports that birth control pills possibly have additional advantages that can be used for treating bacterial vaginosis,” Wu said.

Bacterial vaginosis occurs when the normal bacterial flora of the vagina is disrupted and replaced by an overproduction of other types of bacteria. Symptoms include a fishy odor and discharge, as well as itching, burning or pain. Women can also have bacterial vaginosis without symptoms.

It’s the most common vaginal infection in women of childbearing age and is associated with preterm delivery and low birth weight babies, according to the U.S. Centers for Disease Control and Prevention.

Though treatable by antibiotics, bacterial vaginosis tends to recur, Erbelding said.

Previous research has shown that 15 percent to 30 percent of women have symptomatic bacterial vaginosis within three months after taking antibiotics, and 70 percent have a recurrence within nine months.

“As a clinician, we are always frustrated by the fact that our treatments aren’t very good,” Erbelding said. “They may ameliorate the symptoms for some time, but often bacterial vaginosis recurs.”

Racial minorities are at greater risk of bacterial vaginosis, Erbelding said. In the study, about 82 percent of participants were black and 69 percent had been diagnosed with bacterial vaginosis before.

Bacterial vaginosis is also associated with sexual activity, douching and sexually transmitted diseases, including chlamydia, gonorrhea, herpes simplex virus and HIV.

Researchers aren’t sure if bacterial vaginosis makes a woman more susceptible to the other infections or if the other infections make vaginosis more likely, Erbelding said.

“Nobody really knows which comes first,” Erbelding said.

Hormonal contraceptives may help ward off a recurrence by altering the vaginal ecology or by reducing menstruation, which is also associated with changes to vaginal bacteria levels, according to the study.