Top Five Women’s Health Stories of 2007

Description

The Society for Women's Health Research announced its top five women’s health stories of 2007 today. The list covers advances of particular interest to women and new sex-specific treatments.




The Society for Women's Health Research announced its top five women’s health stories of 2007 today. The list covers advances of particular interest to women and new sex-specific treatments.

“The medical news in 2007 show how important it is that researchers continue to focus on women’s health and sex differences,” said Phyllis Greenberger, M.S.W, president and CEO of the Society for Women's Health Research, a Washington, D.C., based advocacy organization. “We applaud the Gynecologic Cancer Foundation for forging a national consensus on ovarian cancer symptoms. And we commend cardiologists working to answer questions about sex differences in heart disease. We look forward to more advances in 2008.”

The top women’s health stories of 2007 as determined by the Society for Women's Health Research are:

1. First Consensus on Ovarian Cancer Symptoms
The Gynecologic Cancer Foundation (GCF) announced in June the first national consensus on ovarian cancer symptoms. Ovarian cancer has been long considered a silent killer because of the perceived lack of warning signs. According to GCF, ovarian cancer is the fifth deadliest cancer among U.S. women killing 15,000 annually. There is a 90 percent cure rate when women are diagnosed in Stage I of the disease. The announcement and promotion of the consensus statement should lead to earlier diagnosis and earlier intervention for many women.

2. Technology Advances Aid Fight against Breast Cancer
The FDA approved in February a molecular test that determines the likelihood of breast cancer returning within five to 10 years after a woman’s initial cancer. In August, research was published noting that magnetic resonance imaging enables radiologists to better identify tumors missed by mammography and ultrasound in women at high-risk for breast cancer. These developments underscore the growing role advanced medical technology is playing in the fight against breast cancer.

3. Mounting Evidence of Sex Differences in Cardiovascular Disease
Women with heart disease are 50 percent more likely to die from it than men with the disease. More women than men suffer from small vessel heart disease. More women than men are having a stroke in middle life. Women have a poorer quality of life after a stroke than men. These are just a few of the headlines from 2007 that confirm great differences in cardiovascular disease between the sexes. Scientists are just now beginning to understand these differences and treatments to account for them have generally not yet been developed, underscoring the need for greater research support.

4. Improved Model Predicts Breast Cancer Risk in African-American Women
National Cancer Institute researchers have developed a new model for calculating invasive breast cancer risk that has been found to give better estimates of the number of breast cancers that would develop in African American women 50 to 79 years of age than an earlier model which was based primarily on data from white women. This is a great advance because earlier models likely underestimated breast cancer risk in African American women. As a result they might not have received counseling about actions they could take to reduce their risk. The new model, called the CARE model, was unveiled in November.

5. Young Girls’ Obesity Rates Rising
Four-year-old girls are six times more likely to have a body mass index (BMI) of 30 or more than they were 20 years ago, according to research published in April. A BMI of 30 and over is considered obese by the National Institutes of Health. The findings point to recent changes in children’s environment and lifestyles, which merits monitoring, further research and action, given the health risks associated with adulthood obesity such as increased risks for cardiovascular disease and type-2 diabetes. (Newswise)

Winter Is Here: Tips to Prevent Dry Skin 'Blues'

Medical Director Offers Time-Tested Suggestions to Prevent Dry Skin in Winter

DES PLAINES, Ill., Dec. 20, 2007 -- When the calendar says it's December, better start preparing for the "Dry Skin Season." Whether you suffer from dry skin only in winter or year-round, you can take some simple steps to keep your skin soft, healthy, and pain-free. "An ounce of prevention will help you beat the discomfort and pain caused by dry irritated skin," says Dr. Paul R. Kasdan, medical director of OurHealthNetwork.com

While every inch of our skin is affected by the cold outdoors and low humidity created indoors by heating furnaces, our hands and feet suffer the most. Natural oils produced by the glands in the skin help the skin retain moisture. But our hands and feet lack the oil glands that are present on all other skin surfaces. If our palms were covered by oil, just think of all of the things that would slip out of our hands! The same goes for the soles of our feet: we would slip and slide with every step!

Without this oil, the skin on the hands and feet suffer most when exposed to excessively cold outdoor temperatures, dry indoor heat, and wearing socks and gloves made of wool or other materials that can irritate the skin.

To help avoid winter weather's skin irritations, painful cracks, and unsightly appearances, Dr. Kasdan says, "Getting a head-start on winter's assault is the best thing you can do for your skin." Dr. Kasdan recommends starting the following good skin habits immediately:
-- Moisturize, moisturize, and moisturize again. This is especially true after bathing or hand-washing. Make sure you pat your skin "almost dry." While the skin is still damp, apply a moisturizer to hold the water in, and keep the skin from drying.

-- Add oil to your bath. The oil will soothe dry skin and help "lock in" moisture.

-- Exfoliate patches of dry skin as soon as they appear. This helps to prevent the skin from breaking down and cracking. For calluses and dry cuticles, something stronger may be needed. Callex Ointment is uniquely effective in thinning and softening calluses and cuticles.

-- Wear clothes - especially gloves and socks - made of natural and comfortable fibers. Cotton is more soothing to the skin than nylon, wool, and rubber. Cotton will help the skin keep natural fluids in, while absorbing excessive perspiration that can cause drying.
Dr. Kasdan believes most dry skin problems would disappear if everyone followed this advice. At http://www.OurHealthNetwork.com/news/DrySkinInWinter.asp, Dr. Kasdan shares the recipe for his favorite exfoliative scrub you can make yourself. For those who do not respond to "preventive measures," Dr. Kasdan also lists additional tips for caring for dry, cracked skin.

Spine Surgeon First to Use AxiaLIF Spine Surgery in Manhattan

Description

More than one million spine surgery procedures are performed annually, with medical costs to treat back pain approaching $24 billion per year. With age and injury, discs located between the vertebrae in the spine might eventually wear-down -- a process termed degenerative disc disease. Due to the lack of padding, vertebrae bones slip and rub together. This leads to excruciating and disabling pain, and may cause sciatica (leg pain) due to pressure on the sciatic nerve -- resulting in cramping, pain and numbness along the lower back and back of the thigh.





Each year, 40 to 60 percent of American adults suffer from chronic back pain. More than one million spine surgery procedures are performed annually, with medical costs to treat back pain approaching $24 billion per year.

With age and injury, discs located between the vertebrae in the spine might eventually wear-down -- a process termed degenerative disc disease. Due to the lack of padding, vertebrae bones slip and rub together. This leads to excruciating and disabling pain, and may cause sciatica (leg pain) due to pressure on the sciatic nerve -- resulting in cramping, pain and numbness along the lower back and back of the thigh.

Now, Dr. Roger Härtl, director of the spine program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of neurological surgery at Weill Cornell Medical College, is using a new and less-invasive procedure, developed by TranS1 Inc., to help patients recover faster and with a better quality of life. The procedure, called AxiaLIF, involves only a single small incision near the tailbone.

"AxiaLIF offers another option for minimally invasive procedures for spine-surgery and opens up avenues to give surgeons a new way to perform a procedure in a less invasive fashion," says Dr. Härtl, who is currently the only spine surgeon in Manhattan using the procedure.

To correct degenerative disc disease, spine surgeons fuse together two or more vertebrae and replace the worn disc -- naturally composed of mostly cartilage and various proteins -- with synthetic replacement material. However, the invasive nature of this surgery often leads to a long and painful recovery for the patient.

Now, using AxiaLIF, patients are usually released from the hospital within 24 hours following the surgery, and are able to return to their daily routines and work within two to three weeks.

The surgery takes only 45 to 60 minutes with minimal blood loss, compared to the traditional four-hour procedure. And because there is only a small incision, there is less pain for the patient, because the area has fewer pain receptors.

More traditional surgeries call for large incisions in the back or abdomen. These invasive techniques often require complicated dissection of muscles, nerves and even organs, so that the surgeon can navigate to the affected area. Additional vascular surgeons are called in to perform this part of the procedure, which can take hours, even before a spine surgeon begins.

Because of these invasive measures, patients are at a much higher risk for greater blood loss, and nerve and muscle injury, which means more time in recovery with physical therapists to get back to doing normal-day activities. There are also other concerns for patients.

In males, for instance, surgery in the abdomen risks damage to the nerves controlling sexual function, which may lead to premature ejaculation, explains Dr. Härtl. But risks like these are now avoidable.

"With the less invasive technique, I can do the same surgery, but access the area with less trauma to muscles, nerves and surrounding tissue," says Dr. Härtl.

To perform the surgery, a one-inch incision is made at the tailbone. Under X-ray guidance, Dr. Härtl locates and removes the damaged portion of the disc -- most often affected is the lumbar region, between the sacral (S1) and lumbar (L5) vertebrae -- and then injects synthetic material to rebuild the disc. A screw is then inserted to distract and stabilize the vertebrae, and, finally, the incision is closed. Dr. Härtl cautions that, depending on the injury, this surgery may not be right for each patient, but may be combined with other techniques to reach a better outcome.

The AxiaLIF procedure is estimated to be less costly than open surgeries. The main savings are in the dramatic decrease in operating-room time, length of stay, less need for post-surgical pain medication and more rapid rehabilitation.

"With this new surgery, spine surgeons can offer patients more options," says Dr. Härtl. "We used to have only one or two surgeries to choose from, but now we have a variety of techniques to tailor the treatment for each person."

For more information, patients may call (866) NYP-NEWS.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances -- from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. (Newswise)

Constipation Most Common Cause of Children's Abdominal Pain

Description

Acute and chronic constipation together accounted for nearly half of all cases of acute abdominal pain in children treated at one hospital. The study suggests that physicians should do a simple rectal examination for constipation when trying to determine the cause of abdominal pain in children.



A new study led by a University of Iowa researcher showed that acute and chronic constipation together accounted for nearly half of all cases of acute abdominal pain in children treated at one hospital.

The study also suggests that physicians should do a simple rectal examination for constipation when trying to determine the cause of abdominal pain in children. The findings, which were based on medical records of 962 children ages 4 to nearly 18, appear in the December issue of the Journal of Pediatrics.

Earlier studies have shown that constipation can contribute to abdominal pain in children, but no specific recommendations for diagnosing this contributing factor were made, said Vera Loening-Baucke, M.D., professor of pediatrics at the UI Roy J. and Lucille A. Carver College of Medicine and the study's lead investigator.

"Constipation can be overlooked as the cause of severe or intermittent abdominal pain, as a reporting of symptoms alone does not always establish that a child has constipation," she said. "Our study helps to show that constipation frequently causes acute abdominal pain and that a physician should not just ask the parent if the child is constipated because the parent may have not been able to see all the signs of this condition."

Constipation signs include fewer than three bowel movements per week, one or more episodes of stool incontinence per week, passing of stools so large that they obstruct the toilet, retentive posturing (withholding behavior) and painful defecation.

"The doctor should perform an abdominal examination and a rectal examination to see if the child is retaining stool," said Loening, who sees patients at UI Children's Hospital.

Loening said that some doctors shy away from the rectal examination, which involves digitally checking for impacted stool in the lower colon, because they believe it may cause a child mental or physical discomfort. However, the test can be performed safely and explained to children so that they understand its purpose.

"It's important for doctors to do a thorough evaluation for abdominal pain, as there are many causes. In addition to constipation, having a cold or sore throat can also cause abdominal pain, for example," Loening-Baucke said.

The study found that 83 (9 percent) of 962 children who had received at least one "well-child" visit during a six-month period in 2004 at UI Children's Hospital or UI Hospitals and Clinics reported acute abdominal pain at that visit or another clinic or emergency visit. Significantly more girls (12 percent of the 962) reported such pain, compared to only 5 percent of boys.

Of the 83 children with acute abdominal pain, 72 were seen in a primary care clinic and 11 were examined after hours in the emergency department. Together, acute constipation (lasting eight or fewer weeks) and chronic constipation (lasting eight or more weeks) accounted for 48 percent of the cases (40 children), making it the most common cause of the pain.

Only 2 percent of the children with pain had a surgical condition such as appendicitis. In addition, doctors could not determine causes for 19 percent of the patients with pain.

While most of the patients reviewed in the study were Caucasian, individuals from all other races were included.

In addition to Loening-Baucke, the study team included Alexander Swidsinski, M.D., Ph.D., a faculty member at Charite Hospital and Humdboldt University in Berlin, Germany. Loening-Baucke is now investigating the role of constipation in chronic abdominal pain.(Newswise)

For Heart-defect Babies, Busier Hospital = Lower Death Risk

Image Gallery

Dr. Jennifer Hirsch, pediatric cardiac surgeon at the University of Michigan Health System.


Description

Though the odds for infants with heart defects are much better now than they were even 10 years ago, a new study suggests a way to give them a better chance at survival: Get them to hospitals that are the most experienced at handling such cases. It’s the first national study of this issue, and lends support to the creation of regional congenital heart centers.



Each year, thousands of babies are born with severe heart defects that must be operated on within days or weeks of their birth. And though the odds for these infants are much better now than they were even 10 years ago, a new study suggests that there may be a way to give them an even better chance at living: Get them to the hospitals that are the most experienced at handling such cases.

In the first national study of this issue, a team of University of Michigan researchers found that infants with specific complex heart defects are much less likely to die before leaving the hospital if they are treated at the centers that treat the largest numbers of these patients. This relationship between hospital volume and mortality has been seen in adult heart operations, but the new study suggests it holds true for infants as well. The study is published online in the journal Pediatric Cardiology.

“A generation ago, we were just happy when these patients lived, but that’s not good enough anymore,” says lead author Jennifer Hirsch, M.D., a U-M pediatric cardiac surgeon and member of the Michigan Congenital Heart Center. “Although mortality rates are much lower, there is still a significant variation between centers. This study indicates that it may be time to selectively regionalize these patients’ care, to give them the best chance at a good outcome.”

Hirsch and her colleagues based their study on data from the 2003 Kids’ Inpatient Database, a national database sponsored by the Agency for Healthcare Research and Quality that includes information on children hospitalized in 36 states.

They analyzed data for two of the most severe congenital heart defects: transposition of the great arteries (TGA), in which the major blood vessels leading between the heart and lungs are switched, and hypoplastic left heart syndrome (HLHS), in which the left side of the heart does not develop properly.

Both defects are lethal if not treated within a few weeks of birth, with operations called the arterial switch operation for TGA and the Norwood procedure for HLHS. Infants may need additional operations later in life, but these initial open-heart procedures are critical for their survival.

The study shows that an infant’s risk of dying in the hospital during or after their operation varied greatly depending on the number of each procedure performed that year at the hospital where they were treated. Mortality rates ranged from more than 10 percent to less than 1 percent for the arterial switch operation, and from more than 35 percent to around 10 percent for the Norwood procedure.

“The relationship between hospital volume and risk of dying was significant across the spectrum for both defects, though in the case of arterial switch operations the difference dwindled among hospitals that performed about 15 or more in a year,” says Hirsch, a Lecturer in the Section of Cardiac Surgery at the U-M Medical School who performs operations at the U-M C.S. Mott Children’s Hospital. “For the Norwood, the trend to decreased mortality did not level off.”

The researchers chose the two conditions for their study not because the operations themselves vary in difficulty — both require skilled surgeons and operating room teams — but because of differences in the difficulty of pre- and post-surgical care. TGA care is considered somewhat less tricky than HLHS care. Even after the Norwood operation, babies with HLHS will still need at least two more operations in their first years of life to palliate their defect.

“All of the surgeons who operate on congenital heart defects are incredibly well trained,” says Hirsch, noting that pediatric cardiac surgeons must complete more than 10 years of surgical training after four years of college and four years of medical school to operate on the tiny hearts of infants and children. “It’s a matter of exposure to these complex cases not just for the surgeon, but also for the anesthesiologist, the surgical nurses and perfusionists, the intensive care unit staff, and the social workers and floor nurses who help prepare parents to take care of these children at home.”

The new results suggest that for these most rare and complex of cases, infants have the best outcomes when treated at hospitals whose teams are accustomed to caring for TGA and HLHS babies. The Michigan Congenital Heart Center, for example, handles more than 60 Norwood cases and 20 arterial switch cases each year, along with hundreds of other children with lesser defects.

Selectively regionalizing the care of these more severely ill infants, the researchers conclude, may be warranted based on the difference in mortality seen in the new study. But making sure that babies get to the most experienced centers in time for their operation will require commitments of resources and logistics, and a commitment by smaller congenital heart programs to refer the most complex patients early.

More research is also needed on the factors that influence a baby’s likelihood of dying after being discharged from the hospital following a Norwood procedure, but before he or she has the second- or third-stage operations for HLHS. Currently, this inter-stage mortality is estimated at 15 percent. The U-M has launched a new effort — the Michigan Congenital Heart Outcomes Research & Discovery program — that will allow researchers to collect and analyze much more detailed data about U-M congenital heart patients than ever before, to help answer these questions and more.

The newly published study differs in several major ways from previous studies that examined the relationship between in-hospital mortality and hospital volume for congenital heart patients. Other United States studies, performed in the 1990s when congenital heart operations and post-surgical care were still evolving at a rapid pace, used data for all heart conditions in one or two states.

Although these studies found a relationship between the number of infants treated and their risk of dying, the major thresholds were seen at the 100- to 200-patient level. Hirsch and her colleagues note that these studies included data from patients with much less severe heart defects, who had operations that carry a much lower risk of death during and after surgery.

“For the more routine congenital heart surgery, outcomes are excellent everywhere,” says Hirsch. “But when it comes to a child with a complex defect, it’s important to send him or her to a center of excellence. And the parents of these children are often so overwhelmed by their sudden situation, it will be important to develop the systems and support that will help them get to the right place.”

In addition to Hirsch, the paper’s authors are pediatric heart surgeon Richard G. Ohye, M.D., and James Gurney, Ph.D. and Janet Donohue, MPH of the U-M Child Health Evaluation and Research Unit. (Newswise)

More information on the Michigan Congenital Heart Center is at http://www.med.umich.edu/cvc/mchc.

Age-old Remedy Cuts Kids’ Coughs

Image Gallery

Photo by Neil Brake
Claire Hendry, 5, of Franklin, Tenn., watches as her mother pours a spoonful of honey before bedtime.

Description

According to experts at the Monroe Carell Jr. Children's Hospital at Vanderbilt, a recent study may have discovered an intriguing option to help quiet children's coughs.


According to experts at the Monroe Carell Jr. Children's Hospital at Vanderbilt, a recent study may have discovered an intriguing option to help quiet children's coughs.

The study, from Pennsylvania State University researcher, Ian Paul, M.D., showed that honey has some benefit in reducing cough symptoms.

Michael Warren, M.D., a clinical fellow in the Division of General Pediatrics, along with Division colleagues, reviewed the research and wrote an Evidence-Based Journal Club review which appeared alongside the Penn State study in the December issue of Archives of Pediatrics and Adolescent Medicine.

“Dr. Paul's study represents a welcome addition to the literature on cough medications in children,” said Warren.

“During the cough and cold season, pediatricians are bombarded with questions from parents who want to know what they can to do to relieve their child’s cold symptoms.”

Warren and his colleagues combed through the Penn State article and found it was well-designed and that the results could be considered reliable.

The results were that children who are given honey at bedtime had a 47.3 percent reduction in cough symptoms, while a honey-flavored syrup containing a common over-the-counter cough suppressant, dextromethorphan (DM), had just slightly more effect than no treatment at all.

“We found there are some lingering questions,” Warren said. “It is unclear whether the benefits of honey are variety-specific. This study used buckwheat honey; the authors note that darker honeys (such as buckwheat honey) consist of more phenolic compounds than other varieties and that the associated antioxidant effect might have contributed to the improvement seen in those children treated with this kind of honey.”

Upper respiratory infections are the most common complaint at pediatric offices this time of the year.

Since an FDA panel reviewed the safety and efficacy of over-the-counter cough medications earlier this year and determined they pose more risk than benefit to children under age 6, parents have been anxious to hear about other things to try.

“When children have a cold, everyone is miserable —the cough bothers the child, the child can't sleep, and the parents can't sleep.

“Parents are often desperate for the 'magic bullet' that will make the symptoms go away. Supportive care like nasal saline sprays/drops, bulb suctioning, cool mist humidifiers, fever-reducing medications, fluids, and rest are the mainstays of therapy for children with cough and cold symptoms,” Warren said.

At least, Warren says, this new research shows that when desperation sets in, it’s reasonable to try a teaspoon of honey.(Newswise)

Keeping New Year’s Resolutions

Description

Health-related New Year’s resolutions top the list of promises American adults make to themselves every year. An expert offers tips on how to succesfully keep resolutions.




Jennifer Wider, M.D.
Society for Women’s Health Research

As the New Year quickly approaches, vows to adopt a healthier lifestyle abound. Health-related New Year’s resolutions top the list of promises American adults make to themselves as the calendar turns every year.

For lots of women, taking on new habits and maintaining a healthy lifestyle may be difficult, especially during the holiday season into the New Year. During the holidays, when entertaining and visiting with extended families are custom, women often take on most of the added workload, which can add up to a lot of stress. Add promises to change old, unhealthy lifestyle habits into the mix and new behaviors may be difficult to uphold.

“Sometimes we take on too many changes and create too many goals all at one time,” explains Erica Wright, a licensed clinical social worker and psychotherapist who practices in New York City and Fairfield, Conn. “Instead of being able to maintain these new habits, we fail because we become overwhelmed.”

But keeping health-related New Year’s resolutions can make a big difference when it comes to long-term health. For women who are overweight or obese, shedding those extra pounds can be life saving. Obesity has been linked to an increase risk of heart disease, breast cancer and type 2 diabetes. Studies have shown that losing weight through diet and exercise can lower the risk of these and other diseases.

“Every year, it’s the same thing,” says Kate Reynolds, a thirty-five year old stay-at-home mom in Connecticut. “I vow to lose weight, but somehow it doesn’t happen.” Reynolds has tried a host of different options from diet programs to fitness classes at a local gym. “I start off strong in January but I get frustrated if I don’t achieve my desired weight loss.”

Reynolds isn’t alone. Many women complain that they are unable to keep their resolutions. “We fall into the rhythm of life and into our old patterns,” says Wright, “forgetting some of these major life goals.”

So what can we do to keep our healthy resolutions and avoid falling into the same pitfalls?

Wright suggests streamlining your resolutions: “Pick one thing versus taking on so many things. For example, quitting smoking is a massive life change that has so many health benefits to it, but choosing to lose weight on top of that is way too much to handle all at once.”

Enacting small and feasible changes may make it easier to incorporate into in already busy lifestyle. Focus on one change at a time. For example, if you want to exercise more, try to work that into your routine before taking on any more challenges. Even if you walk briskly to work, take the stairs instead of the elevator or get to the gym once a week, it can make a difference.

“Perhaps incorporate other goals throughout the year,” says Wright. “It doesn’t necessarily have to get done by January 1st.” (Newswise)

Another “Smart” Cancer Drug Can Have Toxic Effects on the Heart

Description

Another FDA-approved targeted cancer drug, sunitinib (SutentTM, Pfizer), may be associated with cardiac toxicity, report researchers at Children’s Hospital Boston, Dana-Farber Cancer Institute, and Thomas Jefferson University. Sunitinib is one of several new “smart” cancer drugs called tyrosine kinase inhibitors that targets specific signaling molecules inside cancer cells that aid cancer spread.

Another FDA-approved targeted cancer drug, sunitinib (SutentTM, Pfizer), may be associated with cardiac toxicity, report researchers at Children’s Hospital Boston, Dana-Farber Cancer Institute (Boston), and Thomas Jefferson University (Philadelphia). Their collaborative study, led by Ming Hui Chen, MD, MMSc, a cardiologist at Children’s who specializes in the cardiac health of cancer patients, appears in the December 15 issue of The Lancet, accompanied by an editorial.

Sunitinib is one of several new “smart” cancer drugs called tyrosine kinase inhibitors that targets specific signaling molecules inside cancer cells that aid cancer spread. Another “targeted” cancer therapy, imatinib (GleevecTM, Novartis Pharmaceuticals), was reported last year in Nature Medicine to be associated with heart failure in patients with chronic myelogenous leukemia.

Sunitinib was originally thought to be relatively free of cardiac side effects. However, a new retrospective analysis, focused on cardiovascular events, revealed a risk for heart failure, myocardial infarction and hypertension in 75 adult patients with imatinib-resistant, gastrointestinal stromal tumor (GIST) receiving multiple cycles of sunitinib in a phase I/II trial at Dana-Farber.

Of the 75, six (8 percent) developed symptoms consistent with moderate-to-severe congestive heart failure, and two had heart attacks. In all, eight (11 percent) had some kind of cardiovascular event while receiving sunitinib at FDA-approved or lower doses. Patients with preexisting coronary artery disease were more likely to develop cardiac problems. Nineteen percent of the 36 patients receiving the FDA-approved dose had decreases in left ventricular ejection fraction, a measure of the heart’s pumping ability.

In addition, 47 percent (35 of 75) developed hypertension. “Hypertension is a common side effect with certain cancer drugs, but the degree of hypertension – both the percentage of affected patients and the magnitude of increase in systolic blood-pressure – was notable,” says Chen, who is also affiliated with Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School.

Two patient biopsies revealed abnormalities in the heart cells’ mitochondria (the structures responsible for energy production). Further studies, led by Maria Rupnick, MD, of the Children’s Hospital Boston Vascular Biology Program, and Thomas Force, MD, from the Center for Translational Medicine and Division of Cardiology at Jefferson, examined heart-muscle cells from mice who had received the equivalent of a human dosage of sunitinib alone, and found direct evidence of cardiotoxicity.

“Early identification of cardiac side effects is an important part of keeping patients on life-saving cancer therapy over the long-term,” says Chen. “In this study, the cardiac dysfunction and hypertension were usually medically manageable. Most importantly, patients were most often able to resume sunitinib therapy following temporary withholding of drug, addition of cardiac medications and/or dose adjustment.”

“This sunitinib study highlights potential concerns with agents that are ‘multi-targeted,’ meaning they inhibit multiple factors involved in cancer progression,” adds Force, who led the study of imatinib patients published in Nature Medicine last year. “Some of these factors may also play important roles in maintenance of proper heart function, and their inhibition by cancer drugs could have adverse effects on the heart.”

“The most important element of this new work is the close, creative collaboration between our medical oncology and cardiology teams,” says George Demetri, MD, a co-author on the paper and director of the Ludwig Center at Dana-Farber Cancer Institute and Harvard Medical School. “As our molecular targeting involves more pathways, we can inform one another’s fields and identify side effects early by working together across traditional disciplinary boundaries.”

“We are hopeful,” Chen concludes, “that this type of multidisciplinary approach, from the patient’s bedside to the basic cell biology laboratory, will lead to further pharmaceutical advances that will make these ‘smart’ cancer drugs even smarter.”

Children’s has a long history of researching the cardiovascular effects of cancer drugs. In children, such side effects are especially important to manage so they can survive the cancer in good health well into adulthood. In 1991, for example, Children’s cardiologists published the seminal finding that doxorubicin therapy for childhood leukemia can lead to clinically important heart disease.

Supporters of the sunitinib cardiovascular study included the Department of Cardiology, Children’s Hospital Boston; the Translational Research Fund for Cancer and Cardiology at Children’s Hospital Boston; a Long-Term Survivorship Grant from the Dana-Farber Cancer Institute; the National Heart, Lung and Blood Institute; the Finnish Heart Foundation; and the American Heart Association.

Children’s Hospital Boston is home to the world’s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Children’s research community. Founded as a 20-bed hospital for children, Children’s Hospital Boston today is a 377-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children’s also is the primary pediatric teaching affiliate of Harvard Medical School.(Newswise)

Amazing Treatment Relieves Serious Back Pain

Amazing Treatment Relieves Serious Back Pain Without Dangerous Drugs, Injections or Surgery!

CHICAGO, Dec. 14, 2007- Non-surgical, spinal decompression is probably the last back pain treatment you will ever need. And you can forget about popping toxic pills, struggling through exercise programs ... and ... unnecessary and risky injections and surgery ... because with this amazing technology - for most people - they are a thing of the past.

Dr. Thea Flock is Chicagoland's most respected authority on relieving severe back and leg pain. Dr. Flock says, "I enable people to live longer using non-invasive techniques without the use of drugs, injections or surgery."

Dr. Flock has treated many Chicagoland residents offering them a solution to their severe low back and leg pain. Patients from Florida to California and as far away as Lima, Peru have sought out her treatment programs and have found relief.

Dr. Flock is a powerful, and educational interview. She will tell your audience:
-- Why most medications often fail
-- 8 causes of low back pain
-- The worst and best things you can do for low back
pain at home
-- 6 warning signs of severe back and leg pain that
everyone must know
-- How you can have diminished pain and increased
function in less than 5 weeks
-- How can Dr. Flock guarantee diminished pain
(No other doctor I know of is willing to make a guarantee)

Dr. Flock has been featured in many local newspapers and publications including the M.D. News. Flock lectures to many different groups educating people on severe low back pain and the treatments available. Dr. Flock offers a free report entitled "The Severe Back, Sciatica, and Disc Pain Guide" and her website, http://www.flockspinal.com is a great educational resource to learn more about severe back pain.

Flock states, "I am thrilled to be able to provide relief to my patients who haven't responded to other treatments. Often times these are patients who have given up hope of ever being pain free. I believe this treatment will become as common in the treatment of back pain as laser eye surgery has become as a treatment for nearsightedness."

For further information contact: Dr. Thea Flock, 630-771-9662

Are Muramyl Peptides the Magic Bullet in Probiotics?

Magazines like Time, Newsweek, and U.S. World and News are all buzzing about the latest health trend, probiotics. Researchers have found compelling evidence that these friendly bacteria are an important key to digestive and immune health, but Eastern Europeans have been savvy to the health benefits of probiotics, found in fermented foods such as yogurt, for centuries. While Western medicine is beginning to tout probiotic benefits, Russian scientists have been aware of these characteristics for decades, and took investigations further by deconstructing the friendly bacteria to study cell components.

In fact, Russian and Ukrainian researchers used special strains of probiotics as raw materials for high-powered immune-support supplements during the Cold War period up until the mid-1980s. Soviet Scientists, responding to directives from their government, found that cell pieces of specific strains of probiotics, or lactobacillus bacteria, had a powerful protective action against bio-warfare agents. The researchers also discovered the probiotic cell pieces helped protect cancer patients against the effects of radiation and chemotherapy, were safe, and had no side-effects.

The Russian scientists discovered one key to these results are muramyl peptides, part of the complex sugars that become available when probiotic cells are fractured in the "lysing" process, which digests the cell wall. Eastern European researchers have been using the lysing technique for several decades, but the laboratory technique is barely on biotech manufacturing radar in the U.S.

"Comparing a live probiotic and a lysed one, in terms of immune system support, is like comparing a match to a blowtorch," said Dr. Elin Ritchie of Taos, N.M. Dr. Ritchie has been using a lysed lactobacillus product, Del-Immune V, for the last five years in cases including colds and flu. Ritchie has also had success with cancer patients. "I have given the product to hundreds of patients. The product is safe and has no contra-indications with drugs or other supplements," she said. Dr. Ritchie added that teachers are the product's biggest fans, as it helps them avoid the worst of the winter crud.

Other doctors are using the lysed cell product as well. "I have been recommending this product (Del-Immune V) for many patients. When I began using it, I couldn't believe its effectiveness in a variety of immune issues," said Dr. Ted Hayashida of Gardiner, Calif.

Research shows the striking effects of lysed probiotics are due to muramyl peptides in the cell fragments. "European doctors went deeper to understand the healthy role of probiotics decades ago, and used the bacteria as a jumping-off point for a new bio-technology. In simple terms, muramyl peptides regulate the correlation between different branches of the human immune system. When probiotics are lysed, the muramyl peptides become bio-available. The muramyl peptides organize an immune response to foreign invaders and environmental pathogens," said Dr. Luba Shynkarenko, former dean of the Institute of Biotechnology, National Technical University, Kiev, Ukraine.

During the 1980s, Shynkarenko worked as a Soviet microbiologist, and saw her research on lysed probiotics develop into products used for everything from adjunctive cancer therapies to radiation protection after the Chernobyl accident. Now living in the Boulder, Colo., she said she would like to see deeper probiotic research in the West. Shynkarenko is not surprised to see Del-Immune V, the grandchild of her original research, gaining popularity among patients and doctors, even though it is a nutritional supplement. "Healthy flora bacteria are the answer to a multitude of health issues - discovery in the West has really just begun," she said. For information, visit http://www.delimmune.com.

Top Five: Tips for a Stress-free Holiday with Family

Description

Busy holiday preparations, driving or flying to faraway places for family gatherings and spending time in close quarters with extended family can add up to a tension-filled holiday. Patricia Daza, PhD, a psychologist with The Menninger Clinic’s Hope Program, offers tips to better enjoy the holidays with your family.


Busy holiday preparations, driving or flying to faraway places for family gatherings and spending time in close quarters with extended family can add up to a tension-filled holiday.

“Most people, regardless if they are family members or not, will begin having conflicts when they are with each other 24/7,” says Patricia Daza, PhD, a psychologist with The Menninger Clinic’s Hope Program. Dr. Daza offers the following tips to better enjoy the holidays with your family:

1. Plan ahead.
Recognize stress and arguments will arise and put a game plan in place for how you will handle it. Dr. Daza suggests repeating coping self-statements to yourself (I am a good cook, good mother, good father, etc.), deep breathing and praising yourself for the work you are doing to make the day go well.

2. Be realistic about the time you spend together.
Do you feel comfortable spending eight hours together or would you rather schedule dinner one night and meet up the next day to see a movie? “At times families are not aware of their limits with each other,” Dr. Daza says. “They would rather avoid the meeting altogether rather than spend small amounts of quality time with each other.”

3. Involve family in an activity.
When in the presence of their family members, many persons revert to established roles in the family they have outgrown, which can cause tension. Activities such as playing a board game or going for a walk together allow an opportunity for cooperation and fun versus arguing or discussing problems in the relationships.

4. Consider staying in a hotel when visiting family.
Staying in a hotel can give you some extra breathing room and is a good option if family members are visiting and you are pressed for space. To avoid hurt feelings, reassure family members that you still intend to spend time with them.

“It can also be helpful to talk to family members about hotels as a way to accommodate different family patterns,” Dr. Daza says. “Some family members are ‘early birds’ and get up early to work out or shower. Others may want the quiet to sleep late. Also discuss how hotels add to the vacation experience, for example, the benefits of having someone make your bed, having breakfast in bed or taking advantage of the massage services at the hotel.”

5. Treat yourself after the holidays.
Make a plan for “me time” when you return home--such as attending a yoga class, getting a massage, seeing a movie or participating in other enjoyable activity. Having something to look forward to will make any tough times with your family a little easier.


The Menninger Clinic is an international specialty psychiatric center, providing treatment, research and education. Founded in 1925 in Kansas, Menninger relocated to Houston in 2003 and is affiliated with Baylor College of Medicine and The Methodist Hospital. For 17 consecutive years, Menninger has been named among the leading psychiatric hospitals in U.S. News & World Report’s annual ranking of America’s Best Hospitals.

Parkinson's-Specific Exercise Plan Restoring Lives

Since the spring release of his new book and instructional DVD, Delay the Disease - Exercise and Parkinson's Disease, David Zid delights in the positive response from participants whose lives are enhanced thanks to following his daily fitness program. Participants worldwide are thrilled that their Parkinson's symptoms have been minimized. "It might be overly dramatic to say exercise saved my life, but it certainly saved the quality of my life," boasts program participant Kathy Cooper.

Zid, an ACE, APG certified trainer, designed the Parkinson's-specific program to exercise all parts of the body, focusing on balance, flexibility, strength and coordination. Nearly two years after being diagnosed, Kathy Cooper began the Delay the Disease exercise program. "I've noticed improvements in the way I walk and maintain my balance," explains Cooper. "I now take bigger steps and no longer seem to shuffle or limp. I smile 'normally' and my relaxed facial expression has improved."

Participants are enthusiastic about the practical nature of the routine. Emphasis is placed on activities of daily living that frequently become a challenge to those with Parkinson's, such as rising from a chair, moving about in crowds, and getting in and out of the car. "The program has really helped me stand up from a seated position by using the 'nose over toes' technique," reports program participant Jerry Timmons.

According to Zid, the most rewarding stories are the individuals who associate an improved mindset with the Delay the Disease fitness program. Though Cooper attributes multiple physical improvements since beginning the routine, "The biggest change is my mental outlook," she gloats. "My demeanor has improved so much that my overall reaction to this affliction has become almost dismissive. My small voice has been replaced with a stronger one and overall, I feel as good, or better, than my pre-afflicted self."

Parkinson's professionals and those affected by the disease are grateful for the simplicity, organization and comprehensiveness of the exercise manual and DVD. The program empowers the patient to participate in their healing and cope with the difficult Parkinson's diagnosis. Marjorie Johnston, a clinical exercise specialist in Naples, Florida, has been conducting Parkinson's fitness classes for over ten years and is responsible for reviewing exercise programs for recommendation to her Parkinson's association. "The Delay the Disease program is the first program that I feel I can enthusiastically recommend to my organization and participants. The exercise inventory is excellent." The National Parkinson's Foundation Center of Excellence at Indiana University recently used a portion of their funding for a bulk purchase of books and DVDs to distribute to their patients to encourage daily exercise.

Author David Zid leads a weekly class based on this fitness routine where Parkinson's participants discover fun, fitness and camaraderie. A portion of Delay the Disease proceeds is used to support Parkinson's research and development. The book and DVD are available for purchase at http://www.amazon.com or http://www.delaythedisease.com.