Tag Archives: professor

Novel class of drugs for prostate cancers

In men with advanced prostate cancer, growth of cancer cells depends on androgen receptor signaling, which is driven by androgens, such as testosterone. To thwart tumor growth, most patients with advanced prostate cancer receive drugs that block the production of androgen or block the receptor where the androgen binds. Unfortunately, such treatments invariably fail and patients die of prostate cancer with their androgen receptor signaling still active and still promoting tumor growth. In the new study, available online at Nature Communications, a team of researchers led by Dr. …

Patient communication has room to grow, study shows

There's room - and need - for improvement in the discussions between doctor and patient that go into medical decision-making, according to research out on Monday. In four studies and a commentary published in JAMA Internal Medicine, the authors look at various aspects of doctors' dialogue with patients about prognoses, options and treatment preferences and find little consistency. And though not all patients want the responsibility of making treatment decisions, medical organizations have long promoted the idea of patient-centered care through shared decision-making, and the 2010 Affordable Care and Patient Protection Act that goes into effect next year incorporates the idea into law. What's more, “When physicians reach out and communicate to patients that their views are welcome, patients really like that a lot,” said Floyd Fowler, senior scientific advisor for the Informed Medical Decisions Foundation in Boston. But research in the past decade showed that U.S. patients with common medical conditions were not being adequately informed about their treatment options, so Fowler and his colleagues wanted to see if anything had changed recently. They surveyed 2,718 U.S. adults who were over 40 years old in 2011 and had seen a doctor for any of the five most commonly treated medical conditions - high blood pressure and cholesterol, prostate and breast cancer screenings and back and knee problems - during the previous two years. They found that doctors tended to discuss the pros and cons of surgeries, but not of cancer screenings or the choice of medication to treat high blood pressure or cholesterol. “Each decision has its own dynamic, and it's intriguing that the heart risk related discussions weren't very good,” said Fowler, the study's lead author. He added that doctors may view back and knee surgeries as more complicated treatments, which is why they were discussed in more detail. In a separate study of 207 kidney patients from two dialysis centers in Boston, researchers found that doctors rarely discussed very sick patients' prognoses or their eligibility for kidney transplants. Dialysis patients tend to have one- and five-year survival rates comparable to those of many cancer patients, Dr. Melissa Wachterman, a palliative care physician with the VA Boston Healthcare system, and her colleagues point out in their report. “Talking about prognosis is tough, but there are a lot of reasons why there is a benefit for patients to have this information if they want it,” Wachterman said. In their study, Wachterman's team interviewed 60 of the sickest dialysis patients and their doctors about expectations for the patients' survival and to what degree they had been discussed. The researchers found only two patients whose doctors may have discussed their prognosis with them, and that more than half of the doctors said they would refuse to discuss prognoses - even if patients asked. “I think we do a disservice to patients if we don't give them a sense that time could be short, because they have a lot that they want to do with the time they have left,” Wachterman said. In addition, the researchers found that while patients were good judges of whether or not they'd live another year, they tended to overestimate their long-term survival without their doctors' guidance. “I think - in the long term - having this kind of information can actually give people hope and the ability to plan,” Wachterman said. But not everyone may want to play an active role in their care, according to Dr. Mack Lipkin, a professor of medicine at the New York University School of Medicine and the Bellevue Hospital Center in New York City. “There are many people who want to be active participants in their care but there are also many people who prefer not to be so active,” said Lipkin, who wrote an editorial accompanying the new research. That's supported by a study of hospitalized patients, led by Hyo Jung Tak of University of Chicago, which found the vast majority wanted information on their illness and treatment options but more than 70 percent wanted doctors to make their medical decisions. Moreover, Tak's group found that patients who preferred to participate in decision-making were more expensive. They stayed, on average, an extra quarter day in the hospital and racked up $155 to $1,576 more in costs. Still, a study led by Dr. Harlan Krumholz, of Yale University School of Medicine in New Haven, Connecticut, surveyed 7,000 heart attack patients and found more than two-thirds preferred to play an active role in decision-making. A quarter of the respondents preferred to be the sole decision-maker. At the very least, Krumholz's report concludes, doctors “who aspire to provide patient-centered care” should ask patients about their decision-making preferences directly. Lipkin also said it's best to ask patients their preferences. “We think the first thing to do is ask the patient what they'd like to know, how they'd like to learn it and then tell them,” he said. Fowler added that patients who want to be a part of the decision process shouldn't be afraid to speak up, and he hopes they get used to sharing in the process as the Affordable Care Act emphasizes shared decision-making initiatives. “We're hoping these types of changes that are in the works really happen… and that when we repeat the study three or four years from now we'll start to see a difference. That would be great,” he said.source : http://www.foxnews.com/health/2013/05/28/patient-communication-has-room-to-grow-study-shows/

10 things you only ask Google

Click over to the history tab in your browser and scan what's there. We're going to bet there's at least one semi-embarrassing health question you've been trying to get to the bottom of, but would never breathe a word about to your doctor.  To help you save time (and face), we canvassed doctors across America about common embarrassing symptoms and guess what? None of them flinched. They also had some fascinating clues as to what might be causing them—and what you can do about it. Here, strange symptoms you'd rather not talk about—explained. Why do I pee when I run? “Exercise-induced incontinence is not uncommon in women, and it's usually caused by one of two factors: “1. Stress incontinence occurs when the pressure inside the abdomen exceeds the resistance at the neck of the bladder (for example: if the urethral sphincter muscle doesn't close with enough force). Running or other strenuous physical exercise could cause this increase in abdominal pressure and subsequent urinary leakage. (Sound familiar? See 11 Fixes For A Weak Bladder.) “2. The other main reason is bladder overactivity, where the muscles of the wall of the bladder squeeze when they should be relaxed (during bladder filling). This gives people a sense of urgency, and may cause them to leak urine. “If you're experiencing urine leakage with running or other physical exercise, I encourage you to seek help from a urologist or your primary health care provider.” —Dr. Tomas L. Griebling, professor and vice-chair of urology at the University of Kansas My thighs chafe when I walk. What's up? …

Infantile myofibromatosis: First drug targets in childhood genetic tumor disorder

IM is an inheritied disorder that develops in infancy or even in utero and tumors continue to present throughout life. The tumors do not metastasize, but can grow large enough to invade the tissue surrounding them causing physical limitations, disfiguration, bone destruction, intestitinal obstruction, and even death. …

Sugar water injections may help ease knee pain

Knee pain appears to decrease up to one year after “prolotherapy,” a series of sugar water injections at the site of the pain, according to a new study. Previous research on the therapy that suggested positive effects was plagued by flaws, but the new report may be more reliable, according to Dr. John D. Loeser, a pain specialist and professor emeritus at the University of Washington in Seattle. “This is a well-performed clinical trial that deals with many of the issues that have clouded prior reports of prolotherapy,” Loeser, who was not involved in the study and has spoken out against the practice in the past, told Reuters Health in an email. Knee osteoarthritis is common, especially among people over 65, but no single therapy has proven particularly beneficial. In prolotherapy, which costs $200 to $1000 per session and is not covered by Medicare, small amounts of solution are injected at multiple painful ligament and tendon locations in the knee over several sessions. The hope is that a new minor irritation will stimulate the body to repair both old damage and new. “The idea is to stimulate a local healing reaction,” lead author Dr. David Rabago, assistant professor at the University of Wisconsin in Madison, told Reuters Health. Rabago and his colleagues divided 90 people with knee osteoarthritis and between ages 40 and 76 years old into three groups: one got sugar-water prolotherapy injections, another got salt-water placebo injections, and the third was instructed in at-home exercise and received no injections. The first two groups got injections at least three times, sometimes more if they asked for it, over 17 weeks, and were followed for one year. The sugar water group reported better knee function, improving 16 points on a 100-point scale of osteoarthritis severity, compared to 5 points for saline and 7 points for the exercise group. The sugar water group also reported less frequent and less severe pain, improving 14 points on the same scale, at one year, while the salt water and exercise groups improved 7 points and 9 points, respectively. The study was small but not too small and included the right type of subjects: typical sufferers of knee osteoarthritis, researchers said. One of the things that has held back previous studies of prolotherapy is the difficulty of mimicking the injections for a placebo group without actually injecting them with something - that makes it difficult to tell what's causing the improvements, the sugar water itself or the needle stick, bleeding or stretching the tissue, which can all have effects. “The best one can do is ‘control' for those effects by testing an agent against a similar treatment and varying only one thing, which is what we did,” Rabago said. But since the salt water group and the exercise-only groups had similar results, the benefit was probably not a placebo response, Loeser said. “This study yields results that are more favorable than other carefully controlled studies of prolotherapy in other regions,” Loeser said. But there are a lot of questions to answer before this becomes widely adopted, he cautioned. “Certainly, additional studies are needed before one accepts prolotherapy as standard treatment for knee OA,” Loeser said. Researchers don't yet know how long the pain benefit will persist after one year. But Rabago said, “These results support its use as routine care for knee OA in patients who have not improved with more conservative measures.” Though he doesn't yet know how prolotherapy works, he added that he would recommend the treatment for a member of his own family.source : http://www.foxnews.com/health/2013/05/24/sugar-water-injections-may-help-ease-knee-pain/

Scientists discover how rapamycin slows cell growth

"Cells normally monitor the availability of nutrients and will slow down or accelerate their growth and division accordingly. A key monitor of nutrients is a protein called the Target of Rapamycin (TOR), but we do not know the details of how this protein feeds signals downstream to control growth" says Dr. Stephen Michnick, senior author and a University of Montreal biochemistry professor…

Biophysicists measure mechanism that determines fate of living cells

Cells in the human body do not function in isolation. Living cells rely on communication with their environment — neighboring cells and the surrounding matrix — to activate a wide range of cellular functions, including reproduction of new cells, differentiation of stem cells into distinct cell types, cell adhesion, and migration of white blood cells to fight bodily infections. This cellular communication occurs on the molecular level and it is reciprocal: a cell receives cues from and also transmits function-activating cues to its neighbors…

Lung cancer screening: CT scans more effective than X-rays

Screening for lung cancer using low-dose computed tomography (CT scans) rather than chest X-rays may be a more effective way of detecting the disease, Medscape Today reported. Researchers hope that these results, collected as part of the National Lung Screening Trial, will provide more detailed information about the benefits of various types of lung cancer screening available to patients and physicians. During the study, 26,309 participants received low-dose CT scans, and 26,035 participants underwent chest radiography to detect for signs of lung cancer. Among those who received CT scans, a total of 7,191 participants (27.3 percent) had a positive screening result, compared to 2,387 (9.2 percent) in the chest X-ray group. Overall, lung cancer was diagnosed in 292 participants (1.1 percent) in the CT group compared with 190 (0.7 percent) in the radiography group. Previously, experts had been concerned that the high level of false-positive screenings that occur during CT scans would lead to undue stress, unnecessary testing and high medical bills for patients, Medscape Today reported. However, the new report reveals that the majority of patients who had a positive result after their CT scan only underwent one additional diagnostic test. “In many of the previous analyses people have assumed that there would be three or four or five additional diagnostic tests for every positive screen, and this has ramifications for the cost effectiveness of screening,” study author Dr. William C. Black, professor of radiology at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., told Medscape Today. Black is hopeful that these results will provide a good frame of reference for other lung cancer screening programs. “If patients and their clinicians are trying to decide whether or not to get screened, they can always refer to these results. They will let patients know what they can expect, what are the likely outcomes, not just in terms of dying of lung cancer, which is only going to happen to a small percentage of people who get screened, but also in terms of the false positives and what happens afterwards,” Dr. Black told Medscape Today. People eligible for lung cancer screening include men and women, ages 55 to 74, who have a 30-pack-per year history of smoking, those who have quit smoking in the last 15 years and those who are medically fit for surgery. Click for more from Medscape Today.source : http://www.foxnews.com/health/2013/05/23/lung-cancer-screening-ct-scans-more-effective-than-x-rays/

Heat-related deaths may increase with climate change

Heat-related deaths in New York City's borough of Manhattan may rise about 20 percent over the next decade, according to a new study. Researchers at Columbia University in New York analyzed the relationship between daily temperatures and temperature-related deaths across all seasons between 1982 and 1999 in Manhattan, which comprises the most densely populated county in the United States. The findings were published online May 19 in the journal Nature Climate Change. Using projections from 16 global climate models, the scientists found that the number of heat-related deaths in the city could increase by 20 percent by the 2020s, and in some worst-case scenarios, could rise by 90 percent or more by the 2080s, said study co-author Patrick Kinney, an environmental scientist at the Mailman School of Public Health at Columbia University. [Top 10 Surprising Results of Global Warming] To make their estimates, Kinney and his colleagues used the 1980s as a baseline, during which about 370 Manhattan residents died yearly from overheating. With this figure as a reference, a 20 percent increase could mean 74 additional yearly heat-related fatalities in Manhattan by the 2020s. “What we found was that there could be some benefits, in terms of reduced fatalities in the wintertime because of warmer temperatures, but our analysis suggests that those benefits are outweighed by extra fatalities that will occur in the hotter times of the year,” Kinney said. Mercury rising Daily readings in Manhattan's Central Park demonstrate that average monthly temperatures have increased 3.6 degrees Fahrenheit (2 degrees Celsius) between 1901 and 2000. Last year was the warmest year on record in Manhattan, and projections predict rising temperatures over the next six decades, the researchers said. In 2011, 206 people died due to extreme heat in the United States. “The warming that's anticipated from climate change is happening throughout the year, so the months that are already hot like June, July and August are going to get hotter, but months that are more moderate, like May and September, may become uncomfortably hot or fatally hot,” Kinney explained. In their study, Kinney and his colleagues applied climate models to two scenarios: one that assumed rapid global population growth with limited efforts to control emissions, and another that assumed slower population growth combined with technological advances to decrease emissions by the year 2040. The researchers found that both projections pointed to increases in temperature-related fatalities. “It was a little surprising that no matter which climate model we used, and which scenario of greenhouse gases we used, they all consistently showed this effect of increasing fatality risk in the future,” Kinney said. More of the same And Manhattan is not alone, Kinney added. The trend toward more fatalities is also expected for other cities, particularly in the northern United States. “Climate models of future temperatures do vary a bit from place to place, but generally the story is pretty much the same,” Kinney said. The effects are not limited to cities, but heat waves are typically more severely felt in densely populated areas. This is because cities tend to concentrate heat, with buildings and pavement surfaces soaking up heat during the day and releasing it at night, the researchers said. “This serves as a reminder that heat events are one of the greatest hazards faced by urban populations around the globe,” study co-author Radley Horton, a climate scientist at Columbia University, said in a statement. The way of the future The researchers acknowledge uncertainties in their projections, including that heat's effects could be made better or worse with changing demographics, and how fatalities may be prevented with better infrastructure or public policies. Still, the findings suggest that cities and governments need to do more to address the potential dangers posed by heat waves, said Richard Keller, an associate professor of medical history and bioethics at the University of Wisconsin-Madison, who was not involved with the study. “We have needed to rethink the dangers of heat for years,” Keller said. “The Chicago heat wave of 1995, and especially the European heat wave of 2003 both caused catastrophic excess mortality.” Major federal programs provide heating assistance in the winter, but there is no concomitant program for cooling assistance in the summer, Keller said. Kinney said that to combat the effects of deadly heat waves, cities can open community cooling centers, plant trees or construct “green” roofs. The new findings demonstrate the importance of developing strategies to adapt to future higher temperatures. “Heat is a major and often underestimated killer,” Keller said. “While we evacuate in the face of hurricanes and floods, we tend to ignore extreme heat, with deadly consequences. The 2003 heat wave killed nearly 15,000 people in France alone eight times the mortality associated with Hurricane Katrina.” Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/05/23/heat-related-deaths-in-nyc-may-increase-with-climate-change/

Boosting body’s natural flu killers as way to offset virus mutation problem

Emergence of new influenza strains, such as the recent avian influenza (H5N1) and swine influenza (H1N1 2009), can lead to the emergence of severe pandemics that pose a major threat to the entire world population. Recently, the concern regarding the emergence of such a pandemic arose when a new and deadly avian influenza strain (H7N9) was discovered in China, causing the death of six people in only one month. The body’s immune system can fight influenza infection. Natural killer (NK) cells, which are an essential component of this system, can recognize and eliminate influenza-virus-infected cells and inhibit the spread of the virus in the respiratory system…