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December 23, 2005
Test For Patients With Colorectal Cancer
Until now, the UGT1A1 test has only been available to patients enrolled in studies at the University of Chicago. Third Wave had received FDA approval for its UGT1A1 test kit in August, but the test had still not been made available to patients.
Through this licensing agreement, Mayo Clinic's reference laboratory, Mayo Medical Laboratories (MML), will make the test available to patients nationwide, starting this month.
The UGT1A1 test was developed and patented by Mark J. Ratain, MD, the Leon O. Jacobson Professor of Medicine and Chairman of the Committee on Clinical Pharmacology and Pharmacogenomics at the University of Chicago, and his colleagues. It gives doctors advance knowledge of an individual's risk for toxicity from irinotecan by revealing whether patients have one of two common versions of a gene that encodes for a protein involved in the metabolism of irinotecan.
"Eventhough most patients tolerate the drug quite well, some patients are genetically predisposed to severe side effects from irinotecan therapy," said Ratain. "The UGT1A1 test enables us to know in advance which patients are at risk. Those patients could be given reduced doses of irinotecan or other chemotherapy drugs".
This kind of customized dosing based on a person's genetic makeup is known as pharmacogenomics and is at the forefront of 21st century medicine. The UGT1A1 test is part of a growing list of pharmacogenomic tests designed to help physicians personalize therapy options.........
December 23, 2005
How Brain Replenishes Memory-making Molecules
Image credit: Credit: Pamela England, UCSFNew research on living neurons has clarified how the brain refreshes the supply of molecules it needs to make new memories.
The discovery by researchers at UCSF is reported today in the December 22 issue of the journal Neuron and is featured on the journal's cover.
Memory formation is thought to involve a strengthening of the communication between neurons in the part of the brain known as the hippocampus. Scientists know that this increased communication results from a surge in the number of receptors on one neuron that is available to bind to the neurotransmitter glutamate released from another neuron. The two neurons meet at a synapse.
But how and from where the brain gains fresh supplies of these crucial receptors has remained unclear. Known as AMPA receptors, they are essential for the rapid connections made between nerves during learning.
The researchers sought to answer this question by studying the basal trafficking of receptors -- the normal process by which receptors are replaced from fresh stores that are synthesized and located inside the cell. Focusing on live neurons cultured from rats, they discovered clear evidence to dispel the prevailing view that receptors at the synapse are constantly being replaced by stores inside the cell. Rather, the researchers found that the synaptic receptors are relatively stable, lasting about 16 hours before they are replaced.
The study also supports an unsuspected route by which new receptors make their way to the synapse: Fresh AMPA receptors appear to be placed on the cell surface at the cell body and then migrate along the arms or dendrites of the cell to synapses, rather than moving within the cell to the synapse as had been thought.
The researchers suspect the trafficking process their research revealed also occurs during learning and memory formation, but at a much faster rate. The study may provide insight into how to treat memory disorders, said Pam England, PhD, assistant professor of pharmaceutical chemistry at UCSF and senior author on the study.........
December 22, 2005
Troubling Behavior In Medical School And Practice
Published this week in The New England Journal of Medicine, the study is the work of a team of scientists including Susan Rattner, M.D., and J. Jon Veloski, MS, both of Thomas Jefferson University. The effort was led by Maxine Papadakis, M.D., of the University of California-San Francisco School of Medicine.
"Unprofessional behavior among students was defined as including irresponsibility, diminished capacity for self-improvement, poor initiative and impaired interpersonal relationships," said Dr. Rattner, clinical associate professor of Medicine and Senior Associate Dean for Undergraduate Medical Education at Jefferson.
These students were nearly nine times more likely than their colleagues to be disciplined when they became practicing physicians.
Emphasizing that this is "a rare problem affecting only a very small group of practicing physicians," Dr. Rattner nonetheless concluded that "because professionalism is a fundamental core value in the practice of medicine, it must be taught and modeled in all of our educational and clinical activities. It is imperative that technical standards for admission to medical school and outcome objectives for graduation address professional behavior."
The study recommends standardized methods be implemented for both assessing the personal qualities of medical school applicants and predicting their performance as doctors.........
December 22, 2005
Holiday Safety Tips
Think twice before gathering around the holiday fire.
Gas fireplaces are popular but children can easily burn their hands and fingers from contact with the glass barrier at the front of the gas fireplace. The fireplace glass can heat up to over 200 ° C (400 ° F) in about six minutes and takes an average of 45 minutes for the fireplace to cool to a safe temperature after a burning fire has been extinguished. Burns happen when toddlers fall towards the gas fireplace barrier or touch the glass for balance or out of curiosity. Safety gates should be installed to keep your child at a safe distance at all times. Consider not using the fireplace if you have young children, using it only after your children have gone to sleep, or turn the unit off completely, including the pilot flame, whenever the unit is not in use.
Make sure all holiday lights and electrical cords are in good repair and out of children's reach.
Each year, doctors at SickKids see children who have suffered electrical burns from touching hot bulbs or putting them into their mouths. Others have bitten electrical cords and mandatory plastic surgery.
New TV for Christmas? Be careful where you place it.
Each year, 100 children are injured when TV sets topple on them. In the majority of cases , the television was on a simple stand or cart, while others were on wall units, .
shelving or dressers. To prevent injuries, keep your television on low, sturdy furniture and push it as far back on the furniture as possible. Keep your TV cords behind the furniture, where children cannot reach them. When possible, use anchors, angle-braces, or furniture straps to secure furniture to the wall.........
December 22, 2005
How Air Pollution
In a well-designed mouse study, where animals breathed air as polluted as the air in New York City, the researchers pinpointed specific mechanisms and showed that air pollution can be particularly damaging when coupled with a high-fat diet, according to new research published in the December 21 issue of JAMA.
"We established a causal link between air pollution and atherosclerosis," says Lung Chi Chen, Ph.D., Associate Professor of Environmental Medicine at NYU School of Medicine and a lead author of the study. Atherosclerosis-the hardening, narrowing, and clogging of the arteries-is an important component of cardiovascular disease.
The study, done in collaboration with the Mount Sinai School of Medicine and University of Michigan, looked at the effects of airborne particles measuring less than 2.5 microns, referred to as PM2.5, the size linked most strongly with cardiovascular disease. The emissions arise primarily from power plants and vehicle exhaust. The US Environmental Protection Agency (EPA) has regulated PM2.5 since 1997, limiting each person's average exposure per year to no more than 15 micrograms per cubic meter. These tiny particles of dust, soot, and smoke lead to an estimated 60,000 premature deaths every year in the United States.
Dr. Chen and his colleagues divided 28 mice, which were genetically prone to developing cardiovascular disease, into two groups eating either normal or high-fat diets. For the next six months, half of the mice in each feeding group breathed doses of either particle-free filtered air or concentrated air containing PM2.5 at levels that averaged out to 15.2 micrograms per cubic meter. This amount is within the range of annual EPA limits and equivalent to air quality in urban areas such as New York City.........
December 21, 2005
Resolved to Lose Weight in 2006?
Neal Barnard, M.DWith 2006 quickly approaching, losing weight is on the minds of a number of people considering a New Year's resolution. Doctors with the Physicians Committee for Responsible Medicine (PCRM) suggest a new approach to weight loss based on a recent study showing that a low-fat vegan diet is an effective way to shed unwanted pounds.
PCRM's weight-loss study, published in September in The American Journal of Medicine, showed that a low-fat, plant-based diet is more effective at helping women lose weight and improve insulin sensitivity than an omnivorous diet.
"The study participants following the vegan diet enjoyed unlimited servings of fruits, vegetables, whole grains, and other healthful foods that enabled them to lose weight without feeling hungry," says Dr. Neal Barnard, the study's lead author. "Anyone who wants to make healthy changes in the New Year will do well to try a plant-based diet".
Other scientific studies support the obesity-fighting power of plant-based diets. In a recent study of more than 55,000 Swedish women, Tufts University researcher P. Kirstin Newby and her colleagues found that 40 percent of meat-eaters were overweight or obese while only 25 to 29 percent of vegetarians and vegans were. Worldwide, vegetarian populations experience lower rates of heart disease, diabetes, and high blood pressure.
The simplicity of a vegan diet appeals to people busy with work and family, and a number of familiar recipes are easy to adapt. At least four studies published in peer-reviewed journals show that patients give the low-fat vegetarian diet a high rating in terms of acceptability, and that the transition only takes about three weeks or less.........
December 21, 2005
It's never too late to quit smoking
According to the American Cancer Society, smoking is the most preventable cause of death in the United States, accounting for 440,000 deaths, or nearly one of every five deaths, each year. It also causes more than 80 percent of all lung cancers and increases the risk for a number of other types of cancer, including oral, throat pancreatic, uterine, bladder, and kidney cancers.
"Our most effective tool for treating lung cancer is to prevent it from ever happening," explains Bruce E. Johnson, MD, director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute in Boston.
Johnson emphasizes that it is never too late to quit. People who stop and remain a nonsmoker for at least 10 to 20 years can cut their risk of developing lung cancer in half. Even those who quit smoking in their 60s, 70s, and 80s benefit by reducing their risk of dying from a heart attack or from developing lung or head and neck cancer, says Johnson.
Johnson offers the following tips to help people to quit smoking:
First, commit to quit
Tell friends and family
December 21, 2005
Marine Bacteria Compound For Multiple Myeloma
Dharminder Chauhan, PhDAn anti-cancer compound derived from bacteria dwelling in ocean-bottom sediments appears in laboratory tests to be a potent killer of drug-resistant multiple myeloma cells, and potentially with less toxicity than current therapys, report Dana-Farber Cancer Institute scientists in the recent issue of Cancer Cell.
The experimental compound, NPI-0052, has been found to block or inhibit cancer cells' proteasomes from working effectively. The proteasome work as a cell's "garbage disposal," chewing up and disposing of old, unwanted proteins. With their proteasome jammed, cells die from the backup of damaged proteins.
"Proteasome inhibition is a key therapeutic target and bortezomib (Velcade™) was the first in a new class of compounds in multiple myeloma. NPI-0052 is a novel proteasome inhibitor with a chemical structure and action that is distinct from bortezomib, and has the promise of being even more effective for patients," says Kenneth Anderson, MD, director of the Jerome Lipper Multiple Myeloma Center at Dana-Farber, and senior author of the report.
The compound will be moved into Phase I clinical trials in early 2006, say officials of Nereus Pharmaceuticals in San Diego, the developer of NPI-0052. The compound will be tested as a single agent and subsequently in combination with other therapys.
Multiple myeloma is a currently incurable cancer of the bone marrow that causes a plunge in the production of vital red and white blood cells. Eventhough relatively rare, it is the second most common type of blood cancer and accounts for 11,000 deaths annually in the United States. Bortezomib, approved by the Food and Drug Administration in 2003 for relapsed myeloma patients and subsequently for patients who have received at least one previous therapy, demonstrated in clinical trials that it extended the time to disease progression and also improved survival.........
December 21, 2005
Genes Related To Alcoholism
The study, published in the January issue of the journal Alcoholism: Clinical and Experimental Research, offers evidence that the interaction between smoking and alcohol consumption may partly be due to overlapping genetic risk factors.
The results also provide further confirmation that alcoholism is a complex behavior drawing from both environmental and genetic factors.
"Since we know that people who drink often smoke and that smokers often drink, we thought it reasonable to collect some information about the drinking behavior in these families," said lead study author Dr. Kirk C. Wilhelmsen, associate professor in the departments of genetics and neurology at the University of North Carolina at Chapel Hill's School of Medicine.
He also is a member of the Carolina Center for Genome Sciences, the Bowles Center for Alcohol Studies and the UNC Lineberger Comprehensive Cancer Center.
The research team studied 158 families that had at least two first-degree relatives who had smoked 100 or more cigarettes in their lifetime. These included any combination of parents, siblings and offspring who had smoked.
A detailed questionnaire was used to search for alcohol-related behavioral traits, or phenotypes, shared within each family. Questions concerned the quantity of alcohol consumed, such as the number of alcohol drinks per month for six consecutive months and the number of alcohol of drinks consumed in a typical week and typical day.
DNA from blood samples taken from each family participant was analyzed for particular genetic variations. "We looked for excess chromosome sharing of regions that had genes that affect patterns of drinking behavior," Wilhelmsen said.........
December 21, 2005
Happiness May Lead To Success Via Positive Emotions
From a review of 225 studies in the current issue of Psychological Bulletin, published by the American Psychological Association (APA), lead author Sonja Lyubomirsky, Ph.D., of the University of California, Riverside found that chronically happy people are in general more successful across a number of life domains than less happy people and their happiness is in large part a consequence of their positive emotions rather than vice versa. Happy people are more likely to achieve favorable life circumstances, said Dr. Lyubomirsky, and "this may be because happy people frequently experience positive moods and these positive moods prompt them to be more likely to work actively toward new goals and build new resources. When people feel happy, they tend to feel confident, optimistic, and energetic and others find them likable and sociable. Happy people are thus able to benefit from these perceptions.
Lyubomirsky and co-authors Laura King, Ph.D., of University of Missouri, Columbia and Ed Diener, Ph.D., of the University of Illinois at Urbana-Champaign and The Gallup Organization examined studies involving three different types of evidence - cross-sectional, longitudinal and experimental designs - to determine how happiness and positive affect are related to culturally-valued success.
The authors chose to use these different types of evidence to bolster their confidence in establishing cause-and-effect relationships among happiness, positive affect, and success. Cross-sectional studies compare different groups of people and answer questions like, "Are happy people more successful than unhappy people? and "Does long-term happiness and short term positive affect co-occur with desirable behaviors? Longitudinal studies examine groups of people over a period of time and address questions like, "Does happiness precede success? and "Does positive affect pave the way for success-like behaviors? Finally, experimental studies manipulate variables to test whether an outcome will occur under controlled conditions and answer questions like, "Does positive affect lead to success-oriented behaviors?........
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