Health: June 2008

Saturday, June 14, 2008

Emory University study of syphilis bacteria yields valuable diagnostic tool

Variations in a gene within the family of bacteria that causes syphilis may hold clinical, epidemiological and evolutionary significance, researchers at Emory University in Atlanta have found.
The researchers' study results describe how sequence variations they identified in the acidic repeat protein (ARP) gene allow straightforward differentiation of venereal syphilis from non-venereal Treponema pallidum subspecies. The study was published online in the journal FEMS Immunology and Medical Microbiology June 12 (http://www.blackwell-synergy.com/doi/abs/10.1111/j.1574-695X.2008.00427.x).
"This finding can lead to improved diagnoses of cases, enabling doctors to prescribe the right treatment, and public health workers to determine the best prevention strategies," says Kristin Harper, who led the research team as a Howard Hughes Medical Institute pre-doctoral fellow in EmoryÕs Population Biology, Ecology and Evolution program.
The family of Treponema bacteria causes venereal syphilis and the non-venereal diseases of yaws and bejel, which are transmitted through skin-to-skin or oral contact. Public health workers in parts of Africa have reported difficulty in distinguishing yaws from syphilis in children, leaving open the question of whether the child may have contracted a venereal disease Ð either congenitally or through sexual abuse.
"As yaws eradication efforts near their goal, and case diagnosis becomes more difficult due to the relative rarity of yaws, a molecular means of determining whether the infection is venereal or non-venereal becomes essential," Harper says.
The analysis of the repeat region of the ARP gene in 32 strains of pathogenic Treponema showed that the sexually transmitted strains contained multiple types of repeat motifs, while the non-venereal subspecies contained only one type of motif.
In addition, the researchers found the presence of multiple, but distinct, repeat motifs in the two types of sexually transmitted Treponema examined, suggesting that a diverse repertoire of repeat motifs has evolved at least two times in association with sexual transmission.
"The kind of changes we found in the ARP gene are consistent with rapid evolution," Harper said. "This scenario lends further support to several prominent theories about the origin of syphilis, including that the pathogen arose with the return of Columbus from the New World."
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Harper was assisted in her research by Paolo Ocampo of Emory's School of Medicine; George Armelagos, chair of Emory's Department of Anthropology; and scientists at the Centers for Disease Control and Prevention. Previously, Harper headed up the most comprehensive comparative genetic analysis ever conducted on Treponema bacteria. The results were published in January by the Public Library of Science's Journal of Neglected Tropical Diseases.
Harper is currently researching an outbreak of treponemal disease among baboons in Tanzania, which could provide another important genetic clue to how the disease is transmitted in humans.
Emory University is known for its demanding academics, outstanding undergraduate experience, highly ranked professional schools and state-of-the-art research facilities. Perennially ranked as one of the country's top 20 national universities by U.S. News & World Report, Emory encompasses nine academic divisions as well as the Carlos Museum, The Carter Center, the Yerkes National Primate Research Center and Emory Healthcare, GeorgiaÕs largest and most comprehensive health care system. To access News@Emory RSS feeds, go to: http://news.emory.edu/Releases/RSSFeeds1124313225.html.

Research Australia : Precision blood pressure measurement to improve heart health

A University of Queensland researcher is trialling new, cutting-edge technology for measuring blood pressure and the health of the heart. The study, led by Dr James Sharman from the School of Medicine, aims to determine the effectiveness of measuring central blood pressure. This will help guide treatment management decisions of patients with high blood pressure (hypertension), a condition that affects nearly 30 per cent of the Australian population.
"We are very excited about this study as it could provide the framework for a better way to treat hypertension. It has been designed to ensure that all people enrolled receive optimal care," Dr Sharman said. Dr Sharman said it was now well recognised that traditional measures of blood pressure, using a cuff around the upper arm, did not provide a complete understanding of the true pressures that could be experienced by the heart and other vital organs. This deficit could have major implications for the appropriate diagnosis and treatment of people with hypertension. The new technology involves a quick, non-invasive test that measures central blood pressure by recording the pulse at the wrist. "We also give each person advice on the best way to work with their usual doctor to ensure continued benefit after the trial has finished. We feel that this study truly represents a win-win situation for the patient and their doctor," Dr Sharman said. Men and women aged between 18 and 75 years, who have been diagnosed with hypertension and are taking at least 1, but no more than 3, medications for hypertension are invited to participate.
The study is over 12 months and participants will be asked to visit the Princess Alexandra Hospital every 3 months. Each participant will receive a comprehensive scan of the structure and function of their heart.
Blood pressure will be monitored by doctors who specialise in hypertension. Participants (and their doctors) will receive all clinical information.
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For more information contact Deborah Gilroy on 3240 6614
Media: Dr Jim Sharman (07 3240 6438 or j.sharman@uq.edu.au)or Brooke Hargraves at UQ Communications (0448 235 303 / s4100883@student.uq.edu.au).

European Society of Cardiology : The EUROACTION trial

The EUROACTION trial:A comprehensive approach to cardiovascular prevention
The single largest research project ever to be undertaken by the European Society of Cardiology1 (ESC), EUROACTION, showed that a multidisciplinary, family based and nurse coordinated programme made a real difference in improving lifestyle and reducing cardiovascular risk among coronary patients and people with a high risk2 of developing Cardiovascular Disease (CVD). EUROACTION implicated six pairs of hospitals and six pairs of general practices in eight European countries3. The trial involved over 10 000 coronary and high risk patients and lasted 3 years.
"EUROACTION is a landmark study showing that preventive goals can be achieved and are sustainable in everyday clinical practice" explains Prof Kim Fox, President of the ESC. "This study provides practical support to initiatives such as the European Heart Health Charter, promoted by the ESC together with the European Commission and the European Heart Network, in order to raise awareness of CVD prevention goals throughout Europe. It also demonstrates the European Society of Cardiology's commitment to prevention".
The ESC regularly updates its European Guidelines on CVD Prevention4, the latest version was published in 2007.
Previous studies conducted by the ESC –Euroaspire I, II and III5- showed that CVD prevention in routine clinical practice was inadequate, with only a third of patients attending cardiac rehabilitation programmes and a high percentage not achieving weight, blood pressure and lipid targets. Researchers discovered that individuals left to themselves find it hard to adhere to recommended lifestyle changes and prescribed treatments. These include smoking cessation, changes in diet, increasing physical activity, controlling central obesity, blood pressure, cholesterol and glucose.
"Changing lifestyle behaviour -especially giving up smoking and loss of weight- is very hard to achieve" explains Catriona Jennings, Research Nurse Co-ordinator from the National Heart and Lung Institute, UK. "On their own, patients struggle and don't do well changing habits. Providing support and follow-up by dieticians, nurses and physiotherapists, made a big difference in helping patients reach their goals. Our team used behavioural techniques and expert advice to address individuals' particular problems and personal challenges as they tried to follow prescribed treatment. The second key element was involving spouses: reducing weight or giving up smoking are difficult to accomplish if families do not feel concerned. Including them in the programme meant that the patient was not alone in trying to adopt a wholesome way of life, particularly changing eating habits. EUROACTION helped both patients and their families benefit from healthier lifestyles."
Thanks to EUROACTION a large majority of coronary and high risk patients, and their families, were recruited to a comprehensive preventive cardiology programme. EUROACTION patients reduced their consumption of saturated fat: three quarters of patients and their partners achieved the recommended fruit and vegetable consumption, compared to just over a third of usual care patients and twice as many met the recommended weekly intake of oily fish. Partners of EUROACTION patients showed the same trend of change for diet. Over half of patients stopped smoking and remained non-smokers after one year.
Physical activity targets of 30-45 minutes of exercise four to five items per week were achieved by twice as many EUROACTION patients as compared to usual care patients, and partners of EUROACTION patients also increased their physical activity.
Improvements in prescription of cardio protective therapies (ACE inhibitors and statins) were also observed in EUROACTION.
"Helping patients to make healthy lifestyle changes and take medicines poses considerable challenges for cardiology and general practice. EUROACTION shows that support from a multidisciplinary health care team and family involvement makes a real difference" explains Prof David Wood, FESC, Imperial College London, who coordinated the study. "EUROACTION showed that we can achieve lifestyle and risk factor targets in a large majority of patients. We now have to work towards establishing preventive cardiology programmes which are accessible by all coronary and high risk patients across Europe. Cardiovascular disease is the main cause of death in Europe. EUROACTION shows us a practical way of reducing the burden of heart disease and stroke."
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The conclusions of this study will be published by The Lancet this week and can also be found on the ESC website.
Notes:
European Society of Cardiology recommendations for CVD Prevention:
Stop smoking
Make healthy food choices (eat more fruits and vegetables, whole grain cereals, oily fish and omega-3 fatty acids)
Be physically active ( at least 30 mn per day)
Achieve a body-mass index (BMI) of less than 25 kg/m
Keep a blood pressure of lower than 140/90 mm Hg
A cholesterol concentration of less than 5.0 mmol/L
A LDL cholesterol concentration of less than 3.0 mmol/L
Control blood glucose
Use appropriate prophylactic drugs when necessary
Screen close relatives of patients with premature cardiovascular disease
1 www.escardio.org 2 www.escardio.org/knowledge/decision_tools/heartscore 3 Denmark, France, Italy, Netherlands, Poland, Spain, Sweden, UK 4 www.escardio.org/NR/rdonlyres/2A4EF76B-D3AD-4313-B8BF-7D0BCC405CB8/0/guidelines_CVD_Prev_ES_FT_2007.pdf 5 www.escardio.org/initiatives/prevention/prevention-initiatives/euroaspireiii.htm
EUROACTION is an ESC initiative, funded by an unrestricted educational grant from AstraZeneca.

BMJ-British Medical Journal Research : Less hype and more research needed into new 'superbug,' say experts

Recent tabloid hype over the "newly emerging superbug", Stenotrophomonas maltophilia, is misplaced, say experts in this week's issue of the BMJ.
Headlines about S maltophilia including "no antibiotics can stop it" and "rising death toll in hospitals" are unfounded, write Georgia Duckworth and Alan Johnson, from the Health Protection Agency's Centre for Infections in London. In fact, they say, S maltophilia infections are relatively rare compared to infections caused by other species of viruses and bacteria such as Staphylococcus aureus (MRSA).
Despite recent concerns, S maltophilia accounts for less than 1% of all bloodstream infections in England and Wales. Data from the Health Protection Agency in 2007 shows that in England, 4918 cases of bloodstream infection were caused by MRSA compared with 671 by S maltophilia, while Clostridium difficle caused over 50 000 cases of gastrointestinal infections.
Indeed, S maltophilia infections are uncommon in previously healthy patients, are not easily spread, and are usually treatable, say the authors, in contrast to MRSA and C difficile which can be difficult to treat and have epidemic potential.
The authors suggest that the organism is, in reality, more deserving of the 'opportunist' rather than the 'superbug' label.
They point out that because it is relatively uncommon and treatable, it is unlikely that large scale interventions will be aimed specifically at S maltophilia, but interventions such as improved hospital hygiene and antibiotic stewardship will help prevent its spread and the emergence of multi-resistance.
"We hope that this new knowledge of the organism's biology will help allay these [recent] concerns by being used to improve diagnostic tests, identify new drug targets, or even develop a vaccine", conclude the authors.
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European Science Foundation : EuroDYNA takes lid off the genome

European researchers have made significant progress unravelling how genes are governed and why this sometimes goes wrong in disease. The key lies in the dynamic ever-changing structure of the chromatin, which is the underlying complex of protein and DNA making up the chromosomes in which almost all genes are housed within the genome. The way this structure changes and responds to external signalling molecules within the cell determines how and when genes are expressed and also the mechanisms used to repair DNA damaged by a variety of internal and external insults, such as ultra violet radiation and free radical by-products of metabolism.
Understanding the structure of chromatin and its interactions with proteins and RNA within the cell was the goal of the European Science Foundation's (ESF) EuroDYNA programme, which held its last conference at the Wellcome Trust Conference Centre near Cambridge in May 2008. The study of genome structure involves interaction between various disciplines including cell biology, molecular physics, biomechanics and bioinformatics, as well as access to a wide range of expensive equipment such as electron microscopes, supercomputers, and scanners for simultaneous profiling of RNA expression across the whole genome. EuroDYNA helped broker these collaborations and enable projects to develop the critical mass needed to make real progress.
The expression of genes involves an apparatus comprised mostly of proteins for reading the DNA, leading to production of RNA. This RNA in turn is either transported within the cell to the protein factory called the ribosome, where the code is translated into proteins, or else it interacts with other genes to control their expression in turn. These processes are intimately related to the constantly changing physical and chemical structure of the chromatin. Furthermore the overall state of the genome evolves during the life cycle of the cell, leading to its duplication if and when the cell eventually divides. All these inter-related processes need to be understood in order to unravel the complex network of mechanisms controlling gene expression.
One of the big fundamental questions tackled within EuroDYNA concerned the detailed structure of how the DNA double helix is folded in the nucleus of higher organisms. Although the double helix structure was discovered by Crick and Watson in 1953, the way it folds and stretches such that it fits in the cell nucleus is only now becoming clear, as is its relevance both for cell replication and gene expression. At the EuroDYNA conference, John van Noort from Leiden University in the Netherlands reported that the DNA molecule, which in humans and most mammals is about two metres in length but only 2 nanometres in diameter, is coiled up like a spring in a solenoid structure. In such a folded structure it behaves according to the well known Hooke's law, stating that up to a certain point the extension is proportional to the force applied. It turns out chromatin is a very elastic molecular complex, capable of stretching to three times its normal rest length without breaking, according to van Noort. Even more remarkably – and here it differs from a familiar metal spring - even if stretched beyond three times its rest length, the chromatin solenoid is capable of repairing itself and regaining its former shape and elasticity.
Indeed the ability of DNA to repair itself is essential for the long term survival of the cell and ultimately of the whole organism. DNA damage occurs not just from factors outside the cell nucleus, but also during the process of cell division (mitosis). The overall objective is to hand down the correct genetic code to the daughter cells during mitosis, a process so important that a number of surveillance and repair systems have been put in place to ensure its completion. One of those systems is called PRR (Post Replicative Repair) and it is highly conserved among all organisms, from bacteria to eukarya. PRR was discovered in the 1970s, but here again the detailed mechanisms are only now being elicited. At the EuroDYNA conference, Simone Sabbioneda from the University of Sussex presented new findings about one of the key PRR mechanisms called Translesion DNA Synthesis (TLS). This project, like some of the others, involved direct observation of processes as they take place in living cells, in this case using a technique called Fluorescence Recovery after Photobleaching. This comprises an optical microscope combined with a probe to observe the radiation emitted (the fluorescence) by molecules within a cell in response to a laser source. Such work is yielding important clues on how the PRR pathways work, hoping to help in the long term campaign to find novel, more specific, treatments for cancer, without the side effects of current therapies based on surgery, radiotherapy, or chemotherapy.
One EuroDYNA project however yielded a more immediate insight into a treatment already used to alleviate the symptoms of another important disease, MS (multiple sclerosis). Pavel Kovarik from the University of Vienna's Department of Microbiology and Immunology noted that the only compound capable of alleviating MS symptoms was the protein interferon beta. This resembles the interferon produced naturally by the body in response to infection, but until now it has not been known how it relieves symptoms for MS sufferers. However Kovarik and colleagues have shown that interferon works by upregulating (increasing production of) members of the protein family Tristetraprolin (TTP), which have an anti-inflammatory affect by in turn inhibiting production of pro-inflammatory agents. "We have demonstrated a novel function for interferon," said Kovarik. By understanding how it works, there is the potential for delivering interferon beta more effectively for treating MS.
There were other projects within EuroDYNA with great therapeutic potential, many of which will continue, but which would benefit greatly from an extension to this highly successful programme.

European League Against Rheumatism : Oily fish can protect against RA, but smoking and psychosocial stress increase its risk

Results from the EIRA study
Paris, France, Friday 13 June 2008: New data presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France, show that intake of oily fish is associated with a reduced risk of developing rheumatoid arthritis (RA), whereas psychosocial work stress and smoking can increase the risk of developing the condition. The findings, all taken from a large population-based case-control study in Sweden called EIRA (Epidemiological Investigation of Rheumatoid Arthritis), shed light on the important role of environmental and social factors in the development of RA.
Intake of Oily Fish
For the first time, the intake of oily fish has been demonstrated to have a protective effect against the development of RA, reducing an individual's risk by 20-30%. Studying 1,899 subjects with a confirmed diagnosis of RA (fulfilling ACR criteria) and 2,145 controls (randomly selected and matched for age, sex and residential area), investigators concluded that the odds ratio (OR) for developing RA was 0.8 (0.7-1.0) for those who consumed oily fish 1-7 times per week or 1-3 times per month, compared with those who never, or seldom consumed oily fish. Interestingly, no significant association with RA risk was observed for consumption of fish oil supplements.
Smoking Dosage
Tobacco smoking is an established risk factor for RA, but the investigators found that there is a dose dependency for the level of smoking (i.e. the number of cigarettes smoked across a given period) on the odds ratio of developing anti-citrulline (anti-CCP) positive RA. The highest odds ratios were seen in those carrying a risk variant of the susceptibility gene PTPN22. In the study, 1,240 cases and 798 controls were identified as smokers from a total group of 1,419 cases and 1,674 controls via an extensive questionnaire regarding lifestyle factors, including smoking habits.
These subjects were then classified into three different groups according to the number of pack years smoked - less then 10, 10-20 or more than 20 pack years (where one pack-year is equivalent to having smoked one pack per day for one year) and genotyped to determine the presence of the PTPN22 risk allele.
Psychosocial Stress at Work
Psychosocial stress at work, defined as low decision latitude (or low level of control) was found to be associated with a higher risk for RA. Collected via a validated questionnaire, this was demonstrated in both self-reported data (OR=1.6 (95% CI 1.2-2.2)) and JEM (job exposure matrix)-derived data (OR=1.3 (95% CI 1.0-1.7)). These results were only marginally changed when the investigators adjusted the odds ratios for social class and smoking for the 1,221 cases and 1,454 controls who participated in the study.
Mrs Annmarie Wesley of the Institute of Environmental Medicine, Stockholm, Sweden, EIRA investigator and lead author of the oily fish intake study, commented: "The findings from these studies add to an increasing body of evidence to support the assertion that lifestyle modifications can have a significant impact on an individual's risk for developing RA, one of the most common autoimmune diseases, affecting approximately 1% of adults worldwide. We hope that the data will contribute to the growing understanding of the aetiology of RA and, ultimately, its treatment and prevention"
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For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress press office on:
Email: eularpressoffice@uk.cohnwolfe.com
Rory Berrie: Onsite tel: +44 (0) 7789 270 392 Camilla Dormer: Onsite tel: +44 (0) 7876 190 439
Abstract numbers: FRI0034, FRI0054 and SAT0129AHP
About EULAR
The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations.
The aims of EULAR are to reduce the burden of rheumatic diseases on the individual and society and to improve the treatment, prevention and rehabilitation of musculoskeletal diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with musculoskeletal diseases by the governing bodies in Europe.
Diseases of bones and joints, such as rheumatoid arthritis and osteoarthritis cause disability in 4 - 5 % of the adult population and are predicted to rise as people live longer.
As new treatments emerge and cellular mechanisms are discovered, EULAR 2008 brings together more than 12,000 experts - scientists, clinicians, healthcare workers, pharmaceutical companies and patients - to share their knowledge in a global endeavour to challenge the pain and disability caused by musculo-skeletal disorders.
To find out more information about the activities of EULAR, visit: www.eular.org

University of Rochester Medical Center : Salmonella: Trickier than we imagined

Salmonella is serving up a surprise not only for tomato lovers around the country but also for scientists who study the rod-shaped bacterium that causes misery for millions of people.
In research published June 4 in the online journal PloS One, researchers say they've identified a molecular trick that may explain part of the bacteria's fierceness. A team from the University of Rochester Medical Center has identified a protein that allows the bacteria to maintain a low profile in the body, giving the bacteria crucial time to quietly gain a foothold in an organism before the immune system is roused to fight the invader.
"Inflammation immediately after a bacterial infection occurs helps the body fight off bugs like Salmonella quickly," said Jun Sun, Ph.D., the leader of the team and assistant professor of Gastroenterology and Hepatology. "But it may be that Salmonella is especially equipped with tools to allow it to evade the immune system early on, growing quietly and then really making the host quite ill. Salmonella is trickier than we imagined."
Sun's team found that a virulence protein known as AvrA dampens the inflammatory response. That helps the bacteria avoid the wrath of the immune system and gives the infection crucial time to grow and develop before it needs to expend energy to fight off immune cells like neutrophils, which would attack the intruder more quickly if the bacteria attacked the body in a more clear-cut fashion.
"AvrA allows Salmonella to make peace with you, buying the bacteria a little time to survive in the body," said Sun. "That's bad news for the body, because then the bacteria spreads. AvrA allows the bacteria to do harm in the body without the body realizing it. Bacteria have been evolving for millions of years. That gives them some tricks that perhaps we don't understand yet."
AvrA is one of several proteins in Salmonella that affect cells in the wall of the intestines and stomach known as epithelial cells. These cells link up tightly together thanks to molecules known as tight junction proteins, which form an elaborate barrier to keep molecules and substances in or out of the colon. The bacterium employs several proteins enabling it to loosen these junctions, effectively breaking up the barrier and making the body vulnerable to the infection.
While several of Salmonella's proteins allow it to loosen up and punch through this latticework, Sun's team unexpectedly found that AvrA allows the bacteria to maintain these tight junctions. This ability reduces the body's inflammatory response and allows the bacteria to avoid detection by the immune system for some time, enabling the bacteria to survive in the host. The severe symptoms of infection, including nausea, vomiting, diarrhea, and abdominal cramps, typically hit anywhere from 8 to 72 hours after initial exposure to the bug.
"It's a surprising finding, which is why we've repeated our studies many times and done tests in different experimental models," said Sun, whose team studied the phenomenon in the laboratory, in mice, and in cultured human cells.
AvrA is one of several virulence proteins that Salmonella has at its disposal, using syringe-like molecular machinery to shoot toxins and proteins into cells just seconds after its first encounter with a cell in the small or large intestine. The protein is especially adept at functioning in low-acid locales like the gut and bears close resemblance to a virulence protein known as YopJ that is active in Yersinia – the bug that caused the Black Plague.
Sun is one of several scientists who have shown that AvrA reduces inflammation in the body, acting to some degree like new arthritis medications by reducing the activity of an inflammatory molecule known as NF-Kappa B.
There are thousands of types of the bug. Sun studied Salmonella Typhimurium, one of the two most common types; that bacterium and Salmonella enteritidis together cause more than half the Salmonella illnesses seen in people. While the current outbreak in tomato involves a much more rare form, Salmonella saintpaul, Sun says that the AvrA gene is in more than 80 percent of Salmonella types overall, including the "saintpaul" variety.
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Just last month, Sun was honored for her research on Salmonella at Digestive Disease Week in San Diego. Last year she spoke about AvrA at a plenary lecture of the American Gastroenterological Association.
Other researchers working on the project, which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, include Anne Liao, Yun Zhao, and Yinglin Xia of the University of Rochester; Elaine Petrof of Queen's University in Kingston, Ontario; and Erika Claud of the University of Chicago.

University of Minnesota research : Drug commonly used for alcoholism curbs urges of pathological gamblers

MINNEAPOLIS / ST. PAUL (June 13, 2008) – A drug commonly used to treat alcohol addiction has a similar effect on pathological gamblers – it curbs the urge to gamble and participate in gambling-related behavior, according to a new research at the University of Minnesota.
Seventy-seven people participated in the double-blind, placebo controlled study. Fifty-eight men and women took 50, 100, or 150 milligrams of naltrexone every day for 18 weeks. Forty percent of the 49 participants who took the drug and completed the study, quit gambling for at least one month. Their urge to gamble also significantly dropped in intensity and frequency. The other 19 participants took a placebo. But, only 10.5 percent of those who took the placebo were able to abstain from gambling. Study participants were aged 18 to 75 and reported gambling for 6 to 32 hours each week.
Dosage did not have an impact on the results, naltrexone was generally well tolerated, and men and women reported similar results.
"This is good news for people who have a gambling problem," said Jon Grant, M.D., J.D., M.P.H., a University of Minnesota associate professor of psychiatry and principal investigator of the study. "This is the first time people have a proven medication that can help them get their behavior under control."
The research is published in the June issue of the Journal of Clinical Psychiatry.
Compulsive gamblers are unable to control their behavior, and the habit often becomes a detriment in their lives, Grant said. He estimates between 1 to 3 percent of the population has a gambling problem.
While the drug is not a cure for gambling, Grant said it offers hope to many who are suffering from addiction. He also said the drug would most likely work best in combination with individual therapy.
"Medication can be helpful, but people with gambling addiction often have multiple other issues that should be addressed through therapy," he said.
Naltrexone is sold under the brand names Revia and Depade. An extended-release formulation is sold under the name Vivitrol.
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The research was funded by the National Institute of Mental Health. Grant has served as a consultant to Pfizer and has received grant/research support from GlaxoSmith Kline and Forest.

European Space Agency research : Even the Antarctic winter cannot protect Wilkins Ice Shelf

Even the Antarctic winter cannot protect Wilkins Ice Shelf

13 June 2008Wilkins Ice Shelf has experienced further break-up with an area of about 160 km² breaking off from 30 May to 31 May 2008. ESA’s Envisat satellite captured the event – the first ever-documented episode to occur in winter. Wilkins Ice Shelf, a broad plate of floating ice south of South America on the Antarctic Peninsula, is connected to two islands, Charcot and Latady. In February 2008, an area of about 400 km² broke off from the ice shelf, narrowing the connection down to a 6 km strip; this latest event in May has further reduced the strip to just 2.7 km.
This animation, comprised of images acquired by Envisat’s Advanced Synthetic Aperture Radar (ASAR) between 30 May and 9 June, highlights the rapidly dwindling strip of ice that is protecting thousands of kilometres of the ice shelf from further break-up.
According to Dr Matthias Braun from the Center for Remote Sensing of Land Surfaces, Bonn University, and Dr Angelika Humbert from the Institute of Geophysics, Münster University, who have been investigating the dynamics of Wilkins Ice Shelf for months, this break-up has not yet finished. "The remaining plate has an arched fracture at its narrowest position, making it very likely that the connection will break completely in the coming days," Braun and Humbert said.
Braun and Humbert are monitoring the ice sheet daily via Envisat acquisitions as part of their contribution to the International Polar Year (IPY) 2007-2008, a large worldwide science programme focused on the Arctic and Antarctic.

Previous break-up of Wilkins Ice ShelfThe ASAR images used to compile these animations were acquired as part of ESA’s support to IPY. ESA is helping scientists during IPY to collect an increasing amount of satellite information, particularly to understand recent and current distributions and variations in snow and ice and changes in the global ice sheets.
ESA is also co-leading a large IPY project – the Global Interagency IPY Polar Snapshot Year (GIIPSY) – with the Byrd Polar Research Centre. The goal of GIIPSY is to make the most efficient use of Earth-observing satellites to capture essential snapshots that will serve as benchmarks for gauging past and future changes in the environment of the polar regions.
ASAR is extremely useful for tracking changes in ice sheets because it is able to see through clouds and darkness – conditions often found in polar regions. Long-term satellite monitoring over Antarctica is important because it provides authoritative evidence of trends and allows scientists to make predictions. Ice shelves on the Antarctic Peninsula are important indicators for on-going climate change because they are sandwiched by extraordinarily raising surface air temperatures and a warming ocean.
The Antarctic Peninsula has experienced extraordinary warming in the past 50 years of 2.5°C, Braun and Humbert explained. In the past 20 years, seven ice shelves along the peninsula have retreated or disintegrated, including the most spectacular break-up of the Larsen B Ice Shelf in 2002, which Envisat captured within days of its launch.

Tuesday, June 10, 2008

American Academy of Sleep Medicine Find Treatment at an AASM accredited sleep center improves long-term CPAP compliance

WESTCHESTER, Ill. – Obstructive sleep apnea (OSA) patients are more likely to comply with continuous positive airway pressure (CPAP) for longer periods of time if they receive their treatment from a sleep center accredited by the American Academy of Sleep Medicine (AASM), according to a research abstract that will be presented on Tuesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
The study, authored by Siva Ramachandran, MD, focused on 55 consecutive patients in an AASM accredited sleep center with OSA whose CPAP compliance was less than four hours at their one-month follow-up visit. All subjects were evaluated and counseled by a board certified sleep specialist and a certified respiratory therapist and were educated about OSA. CPAP desensitization and mask fittings were conducted within the center, if indicated, and patients had access to specialized CPAP clinics. All patients were offered follow up with their downloadable compliance card and had open access to their sleep specialist by telephone, e-mail or by clinic visits. There was close collaboration with center staff and DME providers in specialized multidisciplinary CPAP clinics. Patients also had access to a 24 hour CPAP hot line into the center with close tracking of problems within 24 hours. In some patients referring physicians actively collaborated with center physicians to advance optimal use of CPAP.
According to the results, 34 patients (61 percent) were compliant and were followed up for six months. CPAP compliance improved in these patients and more patients availed of mask changes and desensitization in the compliant group. Older age was related to increasing compliance.
“This study was unique as it targeted patients with high risk for CPAP failure, in a community setting with resources identified within the center, and was developed in a longitudinal model of patient care,” said Dr. Ramachandran. “Access to specialized services with close follow-up in an AASM accredited center improves long term CPAP compliance in patients with high risk of CPAP failure. Patients in the older age group are particularly responsive to multimodal CPAP rescue services and are a model for development in sleep centers.”
OSA is a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. It is estimated that four percent of men and two percent of women have OSA, and millions more remain undiagnosed.
On average, most adults need seven to eight hours of nightly sleep to feel alert and well-rested.
The AASM offers the following tips on how to get a good night’s sleep:
Follow a consistent bedtime routine.
Establish a relaxing setting at bedtime.
Get a full night’s sleep every night.
Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
Do not go to bed hungry, but don’t eat a big meal before bedtime either.
Avoid any rigorous exercise within six hours of your bedtime.
Make your bedroom quiet, dark and a little bit cool.
Get up at the same time every morning.
First introduced as a treatment option for sleep apnea in 1981, continuous positive airway pressure (CPAP) is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.
CPAP Central (www.SleepEducation.com/CPAPCentral), a Web site created by the AASM, provides the public with comprehensive, accurate and reliable information about CPAP. CPAP Central includes expanded information about OSA and CPAP, including how OSA is diagnosed, the function of CPAP, the benefits of CPAP and an overview of what to expect when beginning CPAP, the position of experts on CPAP, and tools for success. CPAP Central also features an interactive slide set that educates the public about the warning signs of OSA.
Those who think they might have OSA, or another sleep disorder, are urged to consult with their primary care physician or a sleep specialist.
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The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.
SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Health Insurance Survey : Insured but poorly protected: 25 million adults are underinsured

Number up 60 percent in 4 years; rate of underinsured triples for middle and higher income families; underinsured go without needed care and face medical debt
New York, NY, June 10th, 2008—The number of underinsured adults—those with health insurance all year, but also very high medical expenses relative to their incomes—rose by 60 percent between 2003 and 2007, from 16 million to more than 25 million, according to a new Commonwealth Fund study released today as a Health Affairs Web Exclusive. Middle and higher income families were hit the hardest by the steep increase: underinsured rates nearly tripled for those with incomes above 200 percent of the federal poverty level, which is an annual income of $40,000 or higher for a family.
In "How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007," Commonwealth Fund authors Cathy Schoen, Sara Collins, Jennifer Kriss and Michelle Doty use 2007 national survey data to provide a national estimate of the number of adults who are underinsured, updating a 2003 study. The analysis finds that 25.2 million insured adults ages 19-64 were underinsured based on their out-of-pocket health care costs relative to their incomes. Underinsured rates have now reached double-digit levels for families with incomes in the 200-400 percent of poverty range, solidly in the middle class.
"We are seeing the sharp increase in the underinsured because the insured are facing higher cost-shares and limits in insurance benefits—premiums are up but people are buying less protection," said lead author and Commonwealth Fund Senior Vice President Cathy Schoen. "Today you can have health insurance and still go bankrupt if you get sick. This puts individuals, families, and the nation's health and economic security at risk."
Including those who had any time without insurance during the year, the study estimates that more than two of five (42%) adults ages 19-64, or 75 million people, were either uninsured during the year or underinsured during the year as of 2007, up from one-third in 2003. The study identified the underinsured using medical cost exposure relative to income. The underinsured included those insured all year who spent 10 percent or more of their income on out-of-pocket medical expenses or 5 percent of income if low-income (under 200% of federal poverty level), or who had per person deductibles equal to 5 percent or more of family annual income.
Underinsured Experiences Often Mirror Those of Uninsured
The study found that despite the fact that the underinsured have health insurance all year long, they are at high risk of access problems and financial stress—with experiences often similar to the uninsured. Both underinsured and uninsured adults were significantly more likely to go without needed health care and to struggle with medical bills than people with adequate health insurance.
Half of the underinsured (53%) and two thirds of the uninsured (68%) went without needed care because of cost, including not seeing a doctor when sick, not filling prescriptions, and not getting recommended diagnostic tests or treatments. By contrast, only 31 percent of the insured report going without such care.
The underinsured were almost as likely as the uninsured to face financial stress related to medical bills. Nearly half (45%) of the underinsured reported difficulty paying bills, being contacted by collection agencies for unpaid bills or changing their way of life to pay their medical bills as did half of the uninsured (51%). By contrast only 21 percent of the insured reported financial stress related to medical bills.
Insurance Characteristics
Underinsured adults were more likely than adults with more adequate insurance to have insurance plans with limits on the amount a plan would pay or on visits. And, underinsured adults were much more likely to have high deductibles—one quarter had annual deductibles of $1,000 or more.
Despite these limited benefits, the underinsured faced premium levels that were similar to those paid by adults with more adequate health insurance. Premiums were often very high relative to incomes, adding to financial stress.
Policy Implications
The authors conclude that benefit designs that reduce cost-sharing for high-value, cost-effective care and lower cost-sharing for families with low and modest incomes will be necessary to achieve quality care and better health outcomes rather than just coverage.
"The United States needs to move in new directions," said Commonwealth Fund President Karen Davis. "Middle and low income families are struggling through tough economic times and we need to extend affordable, effective health insurance to all. Shifting costs to patients is not an equitable or effective solution to rising costs. It's time for serious consideration of changes in the way we pay for and deliver health services—reforms that show much greater potential for gains in quality and efficiency."
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Methodology
Study data come from The Commonwealth Fund 2007 Biennial Health Insurance Survey, a nationally representative survey of 3,501 adults living in the continental United States, including 2,616 adults ages 19-64. The survey was conducted by Princeton Survey Research Associates International. Interviews were conducted from June through October, 2007.
After the embargo lifts, the article by Schoen and coauthors will be available online at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.4.w298 and through a link on the Fund's web site at: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=688615
The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system.
Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print, with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.

Teenage Cancer Trust TResearch : Managing symptoms by mobile phone may revolutionize cancer care for young people

London, UK: Researchers are harnessing the powers of digital communications technology to help young cancer patients at home manage the side-effects caused by chemotherapy.
They have given the teenagers and young adults specially adapted mobile phones on which the patients can record and send details of all their symptoms to the medical professionals managing their care. The phones are capable of giving basic advice about the most common symptoms, and if the symptoms are serious enough, the phone triggers an alert at the hospital so that specially trained cancer nurses can ring the patient and, if necessary, ask him or her to come into hospital.
Dr Faith Gibson told Teenage Cancer Trust's Fifth International Conference on Teenage and Young Adult Cancer Medicine today (Tuesday) that the Advanced Symptom Management System for Young People (ASyMS©-YG) seemed capable of transforming the way young people with cancer were cared for.
"Chemotherapy for cancer can cause many unpleasant, distressing and sometimes life-threatening side-effects, which can have a huge impact on a young person's life," said Dr Gibson, a senior lecturer in children's cancer nursing research at the Institute of Child Health (London, UK). "The Advanced Symptom Management System for Young People that we are developing could revolutionise their care, giving them support and confidence in being able to manage their symptoms, as well as giving medical teams valuable information on a day-to-day basis about the way the patient has reacted to their treatment. I think this is a really exciting development and it could make a real difference in clinical care."
The ASyMS©-YG [1] involves young people reporting their symptoms each day after having chemotherapy by completing a questionnaire on the mobile phone, which is similar to a PDA (personal digital assistant) or Blackberry. It has a touch screen and stylus. The questionnaire includes questions about how they are feeling, what their temperature is, what symptoms they have and it includes a body outline so that the patient can indicate where the pain is. The language used is teenage-friendly and the whole system has been developed with the help of young patients.
The symptom reports are sent to a central server and nurses at the hospital can view them on a web page. The patient can also view their symptoms on the phone in the form of graphs, which show how their symptoms have changed over time. Once they have reported symptoms, the young person automatically receives a text message giving them advice about what to do. In the latest phase of development, the patient can click on a button that immediately gives them advice about management of the most common symptoms such as constipation, diarrhoea, sickness etc. If the symptoms are severe or getting worse, a nurse is automatically paged to contact the patient at home to offer advice and support.
Dr Gibson said that during the first stages of development, young people were very positive about the system. "They could really see the benefits and really liked it. When we were recruiting for the phase three trial, the young people who were randomised not to receive the phone were disappointed that they would not be able to use it." So far, it has been tested in teenagers aged 13-18 with lymphoma, soft tissue sarcoma and bone tumours, but the researchers hope to extend it to different groups, such as patients with leukaemia.
Teenagers said that it was useful because it gave them a record of their symptoms to talk about when they attended clinic: "Sometimes you may forget what symptoms you had three weeks ago," said one. It also saved them from having to continuously repeat their symptoms to different people at different times, and it meant that the patients knew that the doctors and nurses knew exactly what they were going through.
Parents commented on the system's potential to provide support and reassurance for families and the usefulness of having a record of symptoms. "I think this is a fantastic idea, it would give teenagers more control over their symptoms and what to do about them," said a mother.
Medical professionals agreed with patients and parents and said they thought it would help to improve their knowledge and understanding about young people's symptoms and that it could aid communication between the health professionals and patients. "It would give us a better understanding of what is actually happening when they are at home," said one. Dr Gibson said: "Health professionals said that the system gave the young people some independence and control back into managing their own life."
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The system has been funded up to this stage by Teenage Cancer Trust, with additional support from CLIC Sargent, and has just received further funding from Teenage Cancer Trust so that work can continue into the fourth stage involving 150 young people at six centres in the UK: the Royal Marsden and University College Hospital in London, the Christie Hospital (Manchester), St James's Hospital (Leeds) and two more still to be confirmed. The study, with a new improved version of the system, is due to start in September and will run for 30 months. After that, Dr Gibson hopes that it will be rolled out across the country so that every young cancer patient can benefit from it.
Note:
[1] The intellectual property rights to ASyMS©-YG belong to the University of Stirling (UK).

Teenage Cancer Trust :Experts highlight gaps in knowledge on caring for survivors of teenage and young adult cancers

London, UK: Over 95% of patients with testicular cancer are cured nowadays, but this success has produced a new problem for cancer survivors, the medical profession and national governments, a cancer expert will tell Teenage Cancer Trust's Fifth International Conference on Teenage and Young Adult Cancer Medicine, which is meeting in London on Monday and Tuesday (June 9 and 10).
Dr Craig Nichols, director of program development and director of the germ cell tumor and lymphoma program at the Providence Cancer Center (Oregon, USA) will tell the conference: "Patients with testicular cancer, and, indeed, several other of the more treatable cancers, have great expectations of a cure, but this also imparts an additional responsibility of ensuring that the medical and social consequences of the disease and the cure have a minimum impact.
"We are returning an extra 50-60 years of life to teenagers and young adults who have been treated successfully for cancer. This shifts the emphasis from 'can we cure this disease?' to 'can we retain this near perfect cure rate as well as reducing the short and long term side effects of treatment, minimising the fertility consequences of therapy, reducing the long term risk of a second cancer and metabolic syndrome, and developing pre-emptive strategies for managing psychosocial consequences of cancer and cancer treatment at a young age?'.
"The medical profession and national governments need to develop strategies for meeting this challenge. They need to recognise that care cannot just stop when the patient is cured of the cancer, and that there is a huge cost still to be faced in terms of long-term care and support and in terms of collateral damage. Maximising the chances for good health for the next 50 years of life has very calculable social benefits, and people are beginning to realise this now. This is a fundamental shift."
Nearly three-quarters of children with cancer survive into adulthood, but a north American study has shown that, 30 years after diagnosis, 42% are affected by severe disease or a life-threatening condition, or have died. In the UK, there are approximately 30,000 survivors of cancer diagnosed before the age of 15, and given that cancer is more common between the ages of 15-24 than in childhood and assuming cure rates are similar to those for children, there are probably over 30,000 survivors of cancer diagnosed when they were aged between 15-24.
Dr Nichols will explain that cancer patients face a double whammy: "There are two aspects: the burden of the disease and the burden of treatment. Each makes a long-term contribution to the patient's quality of life."
Problems for cancer survivors include: the increased risk of a second cancer arising either from the first cancer or from its treatment, infertility caused by chemotherapy and radiotherapy, hypertension, kidney problems, the metabolic syndrome (a collection of disorders such as obesity, high cholesterol levels, high blood pressure and insulin resistance) and hormonal disorders. Survivors of testicular cancer may have life-long problems with low sperm counts, low testosterone levels and poor semen quality. Patients who have survived cancer as children, teenagers or young adults often have psychosocial problems as well.
"We are beginning to learn more about the psychosocial consequences such as body image, employment and sexual health," says Dr Nichols. "There's a higher incidence of lower performance in life generally among cancer survivors. They have undergone a big life disruption at a formative time in their lives. There needs to be recognition of this so that we can try to identify problems and risks early on and be pre-emptive in our use of psychosocial interventions and use of medications."
Traditionally, paediatricians have tended to drive initiatives on caring for cancer survivors because they recognised the problem some time ago. In the USA, the challenge is being met by the establishment of Adolescent and Young Adult Clinics and Specialised Survivorship Clinics under the auspices of the National Cancer Institute. In the UK, the government's recently published Cancer Reform Strategy announced the setting up of a new National Cancer Survivorship Initiative to consider a range of approaches to caring for cancer survivors.
Simon Davies, chief executive of Teenage Cancer Trust, says: "We know that this is a major issue that affects a lot of our patients and is increasingly going up the national agenda. I have just been invited to join the National Health Improvement Agency's working group on improving services to survivors of childhood cancers. I am also a member of the National Cancer Research Institute's Teenage and Young Adult Clinical Studies Development Group. One of their three strands of work is survivorship led by Professor Mike Hawkins."
Speaking before the conference started, Prof Mike Hawkins, director of the Centre for Childhood Cancer Survivor Studies at the University of Birmingham (UK) agrees that survivorship following cancer in childhood, teenage or young adult years is becoming an increasingly important area in the UK and it has been highlighted by the cancer czar, Professor Mike Richards. Prof Hawkins and his colleagues plan to follow-up approximately 25,000 survivors of cancer diagnosed between the ages of 15-24 between 1970-2000 in order to discover the specific problems this age group face.
He identifies three key areas where there need to be improvements:
the establishment of standardised guidelines for following up TYA cancer survivors;
extending the evidence base for guidelines on long-term follow-up;
providing every survivor with a "patient passport" on their discharge from hospital, which would contain a summary of all their treatments and the implications for any future medical treatments.
Some of these things are happening already, but in a fragmented way, with some guidelines in existence and some centres issuing patient passports. But Prof Hawkins believes it needs to happen in a much more organised and standardised way, and, at present, there is a big gap in knowledge about the 15-24-year-old age group.
"For teenagers and young adults we really need to extend the evidence base. There's still a huge area of ignorance in relation to the consequences of treatment in the late teenage and young adult years. We hope to address this through the NCRI group that I chair.
"In the interim, we have got to use what we know from survivors of childhood cancers. However, we are much more ahead of the game for children up to the age of 15 than we are for the generality of cancer survivors," he concludes.
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Note:
See the press release on Dan Savage for an account of what it is like to be a cancer survivor.

Teenage Cancer Trust : 'Cancer was one of the best things to happen to me... but I worry about the future'

London, UK: For Dan Savage, surviving testicular cancer has been a spur to him making the most of his life and taking more adventurous decisions, and he says, that in retrospect, it was probably one of the best things that has happened to him. But as he approaches the end of his fifth year in remission from the disease, when he will be signed off as "cured" by the medical profession, he worries that from now on he will have no regular medical checks that might pick up early signs of the cancer returning. It will be down to him to contact the cancer clinic if he is worried about any new symptoms.
Dan, aged 25, is now an award-winning artist. He has set up his own studio in York (UK) and specialises in creating glass artwork for architectural spaces. He is also an ambassador for Teenage Cancer Trust and will be speaking at the charity's Fifth International Conference on Teenage and Young Adult Cancer Medicine on Tuesday.
Dan was 20 and studying art at Lancaster University when he discovered a lump the size of half a pea in his right testicle. After having surgery at Lancaster he was transferred to St James's hospital in Leeds for chemotherapy.
"The chemotherapy was largely precautionary. The outward appearance of the tumour suggested it had been caught early, but when they dissected it, they found it was quite developed, just on the brink of spreading and they didn't want to take that risk. Also they found that I had the most aggressive form of testicular cancer, teratoma," says Dan.
Dan feels he got off fairly lightly, although the chemotherapy made him very sick and he lost his hair. Looking back now, he says: "Having cancer, for me, was one of the best things to happen. It gave me a real drive to succeed and make the most of my life. I know, from speaking to other cancer survivors, that many of them agree. I have gained more confidence. Starting up my own business isn't necessarily what I would have done prior to having cancer." Cancer didn't stop his studies: he went back to university, completed his degree and went on to do a Masters degree in Glass. He has also married his long-term girlfriend.
Dan has not suffered any particular problems following his treatment, although he finds he is more susceptible to common colds and other illnesses that are going around.
"I'm much more aware now of my own body and if anything is slightly out of kilter, I'm probably a lot more paranoid about it," he says. "On a day-to-day basis I'm fairly relaxed, but if I have an ache or pain I start to worry.
"One thing I am getting a bit worried about is that I'm coming up to five years in remission, and will be signed off by the doctors in June. Thereafter it's up to me. People say I'm cured but I don't see it like that. Something could crop up. It worries me that I won't have any more medical checks. I know that if I find anything that's odd I can go straight back to the clinic rather than the GP, which is good because the GP route was a bit of a nightmare. So that is reassuring. But I get reassurance from having regular checks, from having a blood test and even if I don't hear anything after the blood test has been taken, I still know someone has seen it and it's OK. I would prefer to keep the checks going for longer."
Before his chemotherapy the doctors talked to him about fertility and he had sperm samples frozen. The samples were good quality, but, as he was young, fit and healthy (apart from the cancer), he knows he has a good chance of his fertility returning to normal levels, although he hasn't re-visited the fertility clinic to check yet.
Dan says he has become very health conscious in terms of fitness levels and diet. "I drink a lot of green tea!"
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Note:
This press release is intended as a case study to accompany the press release on the problems cancer survivors face, quoting Dr Craig Nichols and Professor Mike Hawkins.

Elsevier Health Sciences : Golf cart injuries on the rise

San Diego, June 10, 2008 – As golf carts are used in more settings off the golf course, the number of injuries is rising. According to an article in the July 2008 issue of the American Journal of Preventive Medicine, from 1990 until 2006, the injury rate rose more than 130 percent. During this period, nearly 150,000 golf cart-related injuries were recorded in people as young as 2 months and as old as 96 years.
Golf carts have become much faster and more powerful - some can reach 25 mph and travel over 40 miles on a single battery charge. Golf carts are now routinely used for transportation purposes at sporting events, hospitals, airports, national parks, college campuses, businesses and military bases. In many gated and retirement communities, golf carts have become the primary means of transportation. Most golf carts are not subject to federal regulation, and state and local regulations for golf carts vary widely by region.
The number of golf cart–related injuries increased steadily and significantly over the study period, from an estimated 5772 cases in 1990 to an estimated 13,411 cases in 2006, an increase of 132%. For cases in which the location of the injury was documented, the majority (70.3%) occurred at a sports or recreational facility. Injuries that occurred on the street, however, more often resulted in concussions and were more likely to require hospitalization than injuries that occurred in other locations.
Falling or jumping from a golf cart was the most common cause of injury for both adults and children (38.3%). However, children were at greater risk than adults for falls from a golf cart. Injuries caused by falls were more than twice as likely to result in injury to the head or neck, and more than six times more likely to result in concussion than injuries due to other causes.
According to investigator Lara B. McKenzie, Nationwide Children's Hospital, Center for Injury Research and Policy, Columbus, OH, "Because golf carts are not designed for the safe transportation of children, their use for transporting children should be strongly discouraged….In addition, private and public facilities that allow golf cart use can help prevent cart–related injuries by requiring driver's licenses and safety/operations training, establishing safety policies and considering golf cart safety in the design of pathways and landscapes. Given the large increase in golf cart–related injuries over the study period, greater efforts are needed to prevent these injuries, especially among children."
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The article is "Golf Cart–Related Injuries in the U.S." by Daniel S. Watson, BS, Tracy J. Mehan, MA, Gary A. Smith, MD, DrPH, and Lara B. McKenzie, PhD, MA. It appears in the American Journal of Preventive Medicine, Volume 35, Issue 1 (July 2008) published by Elsevier.

Research Australia : QBI neuroscientists make Alzheimer's disease advance

Queensland Brain Institute (QBI) neuroscientists at UQ have discovered a new way to reduce neuronal loss in the brain of a person with Alzheimer's disease.
Memory loss in people with Alzheimer's disease can be attributed to several factors.
These include a build-up of the neuro-toxin Amyloid beta – the major component of amyloid plaques found in patients with Alzheimer's – and corresponding degeneration of a specific population of nerve cells in the basal forebrain.
QBI neuroscientist Dr Elizabeth Coulson's research was recently published in the Journal of Neuroscience.
She said the research had established that the molecule known as p75 neurotrophin receptor was necessary for the Amyloid beta to cause nerve cell degeneration in the basal forebrain.
During her research, Dr Coulson's team found – both in cultured cells and in an animal model of Alzheimer's disease – that it was possible to completely prevent Amyloid beta toxicity by removing the p75 cell death receptor.
"Discovering how Amyloid beta triggers neuronal degeneration has been a question bugging neuroscientists for decades, and we have identified an important piece of the puzzle," Dr Coulson said.
These results provide a novel mechanism to explain the early and characteristic loss of brain cells that occurs in Alzheimer's disease – which are known to be important for memory formation.
Dr Coulson already has patented molecules that can block p75 and is ready to begin testing them in animal models of Alzheimer's disease.
"If such therapy is successful, it probably wouldn't cure this multifaceted disease," Dr Coulson said.
"But it would be a significant improvement on what is currently available for Alzheimer's disease patients."
The World Health Organisation predicts that by 2040, neurodegenerative conditions will become the world's leading cause of death, overtaking cancer.
Alzheimer's disease is the most common dementia affecting 10 per cent of people over 65 and 40 per cent over 80 years of age.
Significant advances in determining the molecular regulation of nerve cell function and survival have major impact on our understanding of more complex areas such as behaviour, cognition, aging and neurological diseases.
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Established in 2003, QBI is dedicated to understanding the molecular basis of brain function and applying this knowledge to the development of new therapeutics to treat brain and mental health disorders.
QBI was formed as part of the Queensland Government's Smart State Initiative with the generous support of the Atlantic Philanthropies.
An abstract of the Dr Coulson's scientific paper "Beta-amyloid(1-42) induces neuronal death through the p75 neurotrophin receptor" is available.

Monday, June 9, 2008

Thomas Jefferson University Study finds Chinese food good for your heart

Chinese red yeast rice reduces repeat heart attacks/mortality rates
(PHILADELPHIA) – A clinical study on patients who have suffered a heart attack found that a partially purified extract of Chinese red yeast rice, Xuezhikang (XZK), reduced the risk of repeat heart attacks by 45%, revascularization (bypass surgery/angioplasty), cardiovascular mortality and total mortality by one-third and cancer mortality by two-thirds. The multicenter, randomized, double-blind study, was conducted on almost 5,000 patients, ranging in age from 18-70 over a five-year period at over 60 hospitals in the People's Republic of China. Corresponding author David M. Capuzzi, M.D., Ph.D, director of the Cardiovascular Disease Prevention Program at Jefferson's Myrna Brind Center of Integrative Medicine and Zonliang Lu, M.D., Ph.D, from the Fuwai Hospital at the Chinese Academy of Medical Science report their findings in the June 15th edition of the American Journal of Cardiology.
"It's very exciting because this is a natural product and had very few adverse side effects including no abnormal blood changes," said Capuzzi. "People in the Far East have been taking Chinese red yeast rice as food for thousands of years, but no one has ever studied it clinically in a double-blind manner with a purified product against a placebo group until now and we are pleased with the results. However, people in the United States should know that the commercially available over-the-counter supplement found in your average health food store is not what was studied here. Those over-the-counter supplements are not regulated, so exact amounts of active ingredient are unknown and their efficacy has not been studied yet."
The study looked at patients who had suffered a heart attack in the previous year. Study participants were given two-300-milligram XZK capsules or a placebo and tracked over a five-year period. The XZK capsules contained a combination of lovastatin, lovastatin hydroxyl acid, ergosterol and other components.
"I think it is surprising that a natural product like XZK would have this great an effect," said Capuzzi. "If further testing and study prove true, my hope is that XZK becomes an important therapeutic agent to treat cardiovascular disorders and in the prevention of disease whether someone has had a heart attack or not. But it is important to recognize the fact we do not know exactly how Chinese red yeast rice works. The exact ingredients from the XZK capsules have not been isolated and studied yet. Still the results were so profound, even out performing statins prescribed in numerous western populations, that further study should certainly be investigated."
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The study was sponsored by Beijing Peking University WBL Biotech Co. Ltd (WPU), in Beijing, People's Republic of China. Dr. Capuzzi has no financial interest in this company.

Thomas Jefferson University Study finds Chinese food good for your heart

American Academy of Sleep Medicine : Poor sleep a problem in long-term breast cancer survivors

WESTCHESTER, Ill. – A research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds that poor sleep is a problem in long-term breast cancer survivors.
The study, authored by Julie L. Elam, of Indiana University, was based on 246 breast cancer survivors with an average age of 48 years. Seventy-six percent of the participants were Caucasian, 73 percent employed, 73 percent married or partnered, 70 percent postmenopausal, 58 percent with a college education, and 43 percent with at least one concurrent medical problem. The women were an average of 5.62 years post-treatment.
According to the results, 65 percent of breast cancer survivors scored at or above the cut-off for poor sleep. Breast cancer survivors in the minority, those with hot flashes, with high physical functioning, and high depressive symptoms were more likely to have poor scores on the Pittsburgh Sleep Quality Index, self-rated questionnaire that assesses sleep quality and disturbances over a one-month time interval.
“This study provided new information about predictors of poor sleep in long-term breast cancer survivors,” said Elam. “The purpose of the study was to examine a comprehensive list of physiological, psychological, and environmental factors that contribute to poor sleep for this population. The findings indicated that sleep disturbances were problematic in long-term survivors with physiological and psychological predictors of poor sleep.”
Sleep plays a vital role in promoting a woman’s health and well being. Getting the required amount of sleep is likely to enhance a woman’s overall quality of life. Yet, women face many potential barriers – such as life events, depression, illness, and medication use – that can disrupt and disturb her sleep. Overcoming these challenges can help her enjoy the daily benefits of feeling alert and well rested.
It is recommended that women get between seven and eight hours of nightly sleep.
The American Academy of Sleep Medicine (AASM) offers the following tips for women on how to get a good night’s sleep:
Follow a consistent bedtime routine.
Establish a relaxing setting at bedtime.
Get a full night’s sleep every night.
Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
Do not bring your worries to bed with you.
Do not go to bed hungry, but don’t eat a big meal before bedtime either.
Avoid any rigorous exercise within six hours of your bedtime.
Make your bedroom quiet, dark and a little bit cool.
Get up at the same time every morning.
Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.
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The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.
SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

American Cancer Society research find Family history and screening for colorectal cancer

A new study indicates that African Americans with a family history of colorectal cancer are less likely to be screened than African Americans at average risk for the disease. There is also some evidence to indicate that AA with a family history are less likely to be screened than their white counterparts. The study is published in the July 15, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.
African Americans have the highest colorectal cancer (CRC) incidence and death rates of all racial groups in the United States. The reason for this is thought to be multifactorial but remains poorly understood. Overall, African Americans have low rates of colorectal cancer screening compared to most other racial groups. Early detection is especially important for those with family histories of CRC who are at higher risk of developing the disease. Factors associated with CRC screening are not well understood for African Americans, both those with and without family histories of CRC.
To investigate the factors associated with risk-appropriate CRC screening, Kathleen Griffith, Ph.D., CRNP, of the Johns Hopkins University School of Nursing and colleagues at the University of Maryland Baltimore analyzed data from the 2002 Maryland Cancer Survey, a telephone survey of more than 5,000 Maryland residents, performed under the Maryland Cigarette Restitution Fund Program, to identify predictors of screening among African Americans.
The researchers' analyses revealed that for African Americans, regardless of family history, a health care provider's recommendation for colorectal cancer screening was strongly correlated with a higher likelihood of screening. Furthermore, individuals who were more physically active were also more likely to have been screened for colorectal cancer. Surprisingly, though, having a family history of colorectal cancer did not predict a higher likelihood of screening. In fact, the researchers found that African Americans with a family history were less likely to have received risk-appropriate screening than those without a family history. Family history of colorectal cancer is often associated with increased rates of screening in whites.
The authors say it is difficult to explain why a perception of increased risk, which is significantly higher in African Americans with a family history of CRC than in those without, did not translate into screening. Their findings suggest that other unknown or unmeasured factors may play a role is screening decisions. Additional studies to determine what those factors might be could lead to culturally tailored interventions designed to increase screening rates, which in turn could ultimately improve early detection and reduce colorectal cancer deaths in African Americans. "This study suggests that African Americans would benefit from a primary care approach that evaluates their risk factors for colorectal cancer, and provides corresponding recommendations for appropriate screening tests," the authors write.
Regular colorectal cancer screening is one of the most powerful weapons in preventing colorectal cancer. It can, in many cases, prevent colorectal cancer altogether. Experts estimate adherence to national screening guidelines could prevent up to eight in ten deaths from the disease. The American Cancer Society recommends that people at average risk begin screening for colorectal cancer at age 50. Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, as well as the third leading cause of cancer-related death among both men and women in the United States.
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Article: "Influence of family history and preventive health behaviors on colorectal cancer screening in African Americans." Kathleen A. Griffith, Deborah B. McGuire, Renee Royak-Schaler, Keith O. Plowden, and Eileen K. Steinberger. CANCER; Published Online: June 9, 2008 (DOI: 10.1002/cncr.23550); Print Issue Date: July 15, 2008.
Contact: Lynn Schultz-Writsel, Johns Hopkins University School of Nursing. 410-955-7552 or lwritsel@jhmi.edu.

American Cancer Society research find Family history and screening for colorectal cancer

American Academy of Sleep Medicine : Students with a delayed school start time sleep longer, report less daytime sleepiness

WESTCHESTER, Ill. – High school students with a delayed school start time are more likely to take advantage of the extra time in bed, and less likely to report daytime sleepiness, according to a research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
The study, authored by Zaw W. Htwe, MD, of Norwalk Hospital’s Sleep Disorders Center in Norwalk, Conn., focused on 259 high school students who completed the condensed School Sleep Habits Questionnaire. Prior to the delay, students reported sleeping a mean of 422 minutes (7.03 hours) per school night, with a mean bed-time of 10:52 p.m. and a mean wake-up time as 6:12 a.m.
According to the results, after a 40-minute delay in the school start time from 7:35 a.m. to 8:15 a.m., students slept significantly longer on school nights. Total sleep time on school nights increased 33 minutes, which was due mainly to a later rise time. These changes were consistent across all age groups. Students’ bedtime on school nights was marginally later, and weekend night sleep time decreased slightly. More students reported “no problem” with sleepiness after the schedule change.
“Following a 40-minute delay in start time, the students utilized 83 percent of the extra time for sleep. This increase in sleep time came as a result of being able to ‘sleep in’ to 6:53 a.m., with little delay in their reported school night bedtime. This study demonstrates that students given the opportunity to sleep longer, will, rather than extend their wake activities on school nights,” said Mary B. O'Malley, MD, PhD, corresponding author of the study.
It is recommended that adolescents get nine hours of nightly sleep.
The American Academy of Sleep Medicine (AASM) offers the following tips to adolescents on how to get a good night’s sleep:
Follow a consistent bedtime routine.
Establish a relaxing setting at bedtime.
Get a full night’s sleep every night.
Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
Do not stay up all hours of the night to “cram” for an exam, do homework, etc. If after-school activities are proving to be too time-consuming, consider cutting back on these activities.
Keep computers and TVs out of the bedroom.
Do not go to bed hungry, but don’t eat a big meal before bedtime either.
Avoid any rigorous exercise within six hours of your bedtime.
Make your bedroom quiet, dark and a little bit cool.
Get up at the same time every morning.
Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.
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More information about “teens and sleep”, including a new questionnaire that assesses the level of sleepiness in adolescents, is available from the AASM at: http://www.SleepEducation.com/Topic.aspx?id=71.
The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.
SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

American Academy of Sleep Medicine : Children with high risk for a sleep-related breathing disorder are more likely to have anxiety

WESTCHESTER, Ill. – Children with high risk for a sleep-related breathing disorder (SRBD) are more likely to have anxiety, according to a research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
The study, authored by Shalini Paruthi, MD, of the University of Michigan, focused on 341 families with a child in second through fifth grade, who were surveyed about SRBD symptoms as well as behavior. Parents completed two well-validated instruments: the SRBD subscale of the Pediatric Sleep Questionnaire and the Conners’ Parent Rating Scale.
According to the results, children with a high risk for an SRBD, compared to those without, were more likely to have anxiety. This relationship was independent of hyperactivity, which is known to be associated with both SRBD and anxiety.
“SRBD is a common condition in children, and is frequently associated with cognitive and behavioral morbidities such as hyperactivity,” said Dr. Paruthi. “Anxiety in children is often multifactorial and can be associated with other disorders, including ADHD. As ADHD has been associated with SRBD, our results showed that treatment of an SRBD has been shown to improve behavior and cognitive function in children diagnosed with ADHD, and may translate into treatment options for school age children with anxiety. More research is needed to further explore this relationship between SRBD and anxiety.”
The most common category of SRBD is obstructive sleep apnea (OSA), which causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs.
OSA occurs in about two percent of young children. It can develop in children at any age, but it is most common in preschoolers. OSA often occurs between the ages of three and six years when the tonsils and adenoids are large compared to the throat. OSA appears to occur at the same rate in young boys and girls. How often it occurs in infants and teens is unknown. OSA also is common in children who are obese.
OSA is more likely to occur in a child who has a family member with OSA.
Most children with OSA have a history of snoring. It tends to be loud and may include obvious pauses in breathing and gasps for breath. Sometimes the snoring involves a continuous, partial obstruction without any obvious pauses or arousals. The child’s body may move in response to the pauses in breathing.
Symptoms of OSA tend to appear in the first few years of life. But OSA often remains undiagnosed until many years later. In early childhood OSA can slow a child’s growth rate. Following treatment for OSA children tend to show gains in both height and weight. Untreated OSA also can lead to high blood pressure.
It is recommended that school-aged children get between 10-11 hours of nightly sleep.
The American Academy of Sleep Medicine (AASM) offers some tips to help your child sleep better:
Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
Establish a relaxing setting at bedtime.
Interact with your child at bedtime. Don’t let the TV, computer or video games take your place.
Keep your children from TV programs, movies, and video games that are not right for their age.
Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.
It is important to make sure that your child gets enough sleep and sleeps well. The value of sleep can be measured by your child’s smiling face, happy nature and natural energy. A tired child may have development or behavior problems. A child’s sleep problems can also cause unnecessary stress for you and the other members of your family.
Parents who suspect that their child might be suffering from a sleep disorder are encouraged to consult with their child’s pediatrician or a sleep specialist.
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The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.
SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

American Academy of Sleep Medicine : Women worrying about cancer are more likely to experience sleep disturbances

WESTCHESTER, Ill. – A significant number of women worrying about cancer may be experiencing sleep disturbances, even without a breast cancer diagnosis, according to a research abstract that will be presented by Amita Dharawat, MD, on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).
This collaborative study, from the Brooklyn Health Disparities Center at SUNY Downstate Medical Center and Long Island University in Brooklyn, New York, focused on 1,038 community-based residents, between 50 and 70 years of age; none of whom had a history of a physician-diagnosed cancer. Sleep complaint was defined as a report of either difficulty initiating sleep, maintaining sleep, or early morning awakening.
According to the results, 65 percent of the women reported that they worried about developing breast cancer, and 49 percent reported a sleep complaint. Twenty-seven percent indicated that cancer worry affected their mood, while 25 percent indicated that it affected their daily activity. The odds of reporting sleep complaints for women who worry about cancer were nearly 50 percent greater than odds for women who reported no cancer worry, independent of several confounders.
“This is a unique and important finding because sleep-related complaints have never been studied in women who worry about cancer, without a diagnosis, and it provides practitioners with knowledge with regards to identifying and targeting women who report sleep-related complaints with cognitive behavioral therapy,” said Dr. Dharawat, who is a second year medical resident, working with Dr. Girardin Jean-Louis on an NIH funded ‘Women’s Health Project’.
Cognitive behavioral therapy (CBT) helps eliminate negative images and thoughts that compromise one’s ability to sleep well. It helps develop habits that promote a healthy pattern of sleep. CBT is most often used for people who suffer from insomnia.
Sleep plays a vital role in promoting women’s health and well being. Getting the required amount of sleep is likely to enhance women’s overall quality of life. Yet, they face many potential barriers – such as life events, depression, illness, and medication use – that often disrupt their sleep patterns. Overcoming these challenges can help women enjoy the daily benefits of feeling alert and well rested.
It is recommended that women get between seven and eight hours of nightly sleep.
The American Academy of Sleep Medicine (AASM) offers the following tips for women on how to get a good night’s sleep:
Follow a consistent bedtime routine.
Establish a relaxing setting at bedtime.
Get a full night’s sleep every night.
Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
Do not bring your worries to bed with you.
Do not go to bed hungry, but don’t eat a big meal before bedtime either.
Avoid any rigorous exercise within six hours of your bedtime.
Make your bedroom quiet, dark and a little bit cool.
Get up at the same time every morning.
Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.
###
More information about “women and sleep” is available from the AASM at http://www.SleepEducation.com/Topic.aspx?id=67.
The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.
SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Health Headline

Saturday, June 14, 2008

Emory University study of syphilis bacteria yields valuable diagnostic tool

Research Australia : Precision blood pressure measurement to improve heart health

European Society of Cardiology : The EUROACTION trial

BMJ-British Medical Journal Research : Less hype and more research needed into new 'superbug,' say experts

European Science Foundation : EuroDYNA takes lid off the genome

European League Against Rheumatism : Oily fish can protect against RA, but smoking and psychosocial stress increase its risk

University of Rochester Medical Center : Salmonella: Trickier than we imagined

University of Minnesota research : Drug commonly used for alcoholism curbs urges of pathological gamblers

European Space Agency research : Even the Antarctic winter cannot protect Wilkins Ice Shelf

Tuesday, June 10, 2008

American Academy of Sleep Medicine Find Treatment at an AASM accredited sleep center improves long-term CPAP compliance

Health Insurance Survey : Insured but poorly protected: 25 million adults are underinsured

Teenage Cancer Trust TResearch : Managing symptoms by mobile phone may revolutionize cancer care for young people

Teenage Cancer Trust :Experts highlight gaps in knowledge on caring for survivors of teenage and young adult cancers

Teenage Cancer Trust : 'Cancer was one of the best things to happen to me... but I worry about the future'

Elsevier Health Sciences : Golf cart injuries on the rise

Research Australia : QBI neuroscientists make Alzheimer's disease advance

Monday, June 9, 2008

Thomas Jefferson University Study finds Chinese food good for your heart

Thomas Jefferson University Study finds Chinese food good for your heart

American Academy of Sleep Medicine : Poor sleep a problem in long-term breast cancer survivors

American Cancer Society research find Family history and screening for colorectal cancer

American Cancer Society research find Family history and screening for colorectal cancer

American Academy of Sleep Medicine : Students with a delayed school start time sleep longer, report less daytime sleepiness

American Academy of Sleep Medicine : Children with high risk for a sleep-related breathing disorder are more likely to have anxiety

American Academy of Sleep Medicine : Women worrying about cancer are more likely to experience sleep disturbances

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