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"Eating barley or foods containing barley significantly reduced levels of two types of bad cholesterol associated with cardiovascular risk a St. Michaels Hospital research paper has found. Barley reduced both lowdensity lipoprotein or LDL and nonhighdensity lipoprotein or nonHDL by seven per cent. The review also indicated that barley had similar cholesterollowering effects as oats which is often the goto grain for health benefits. The research review published today in The European Journal of Clinical Nutrition included studies on clinical trials conducted in seven countries including Canada. It is the first study to look at the effects of barley and barley products on both LDL and nonHDL cholesterol in addition to apolipoprotein B or apoB a lipoprotein that carries bad cholesterol through the blood. Measuring nonHDL and apoB provides a more accurate assessment for cardiovascular risk as they account for the total bad cholesterol found in the blood. The findings are most important for populations at high risk for cardiovascular disease such as Type diabetics who have normal levels of LDL cholesterol but elevated levels of nonHDL or apo B said Dr. Vladimir Vuksan research scientist and associate director of the Risk Factor Modification Centre of St. Michaels. Barley has a lowering effect on the total bad cholesterol in these highrisk individuals but can also benefit people without high cholesterol. High cholesterol and diabetes are major risk factors for cardiovascular disease and stroke historically treated with medications. However Dr. Vuksans research and work focuses on how dietary and lifestyle changes can reduce these risk factors. Barleys positive effect on lowering cholesterol is welldocumented and has been included in the Canadian strategy for reducing cardiovascular risk said Dr. Vuksan. Health Canada the FDA and several health authorities worldwide have already approved health claims that barley lowers LDL cholesterol but this is the first review showing the effects on other harmful lipids. Despite its benefits Dr. Vuksan said barley is not as wellestablished as some other healthrecommended foods such as oats. Barley consumption by humans has fallen by per cent in the last years. Canada is one of the top five world producers of barley almost megatonnes per year but human consumption accounts for only two per cent of the crop yield with livestock making up the other per cent. After looking at the evidence we can also say that barley is comparably effective as oats in reducing overall risk of cardiovascular disease said Dr. Vuksan. Barley is higher in fibre has twice the protein and almost half the calories of oats which are important considerations for those with weight or dietary concerns. Dr. Vuksan said barley can be enjoyed in a variety of ways. He recommends trying to incorporate barley into existing recipes using it as a substitute for rice or even on its own just like oatmeal. About St. Michaels Hospital St. Michaels Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in academic disciplines. Critical care and trauma heart disease neurosurgery diabetes cancer care care of the homeless and global health are among the hospitals recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre which make up the Li Ka Shing Knowledge Institute research and education at St. Michaels Hospital are recognized and make an impact around the world. Founded in the hospital is fully affiliated with the University of Toronto."

"FROM a marketing perspective theres something alluring about being a beauty outsider. Just ask Allison Slater the vice president for retail marketing at Sephora about the new antiaging skin care line Algenist featuring a star ingredient alguronic acid that scientists in San Francisco say they stumbled upon while researching microalgae. Retailing for to Algenist moisturizers serum and eye balm are already available at Sephora.com and will go on sale in the companys stores this week. When we saw it we thought it was so unique such innovation something our clients could really understand Mrs. Slater said of the line. The whole story about this being an unexpected discovery. Mrs. Slater added that it made sense to her that alguronic acid a compound that protects microalgae cells according to Algenists maker Solazyme could also protect middleaged faces from environmental assault. Think about how algae can live anywhere live in the coldest of places or the harshest of places and think about translating that to skin care she said. Dermatologists might not wholeheartedly share Sephoras enthusiasm. But a surprising story about a products genesis can be just as important for generating sales as the products demonstrable efficacy. Consider Crme de la Mer which like Algenist contains sea matter and also involves an enterprising scientist an aerospace physicist trying to heal scars he suffered in a lab accident. Its a slightly different story said Nica Lewis the head consultant of beauty innovation at Mintel a market research firm. But its still brainy scientist comes up with cosmetic product. According to Jonathan Wolfson the chief executive of Solazyme the alternativeenergy company that makes Algenist the product came about after a fortuitous suggestion roughly six years ago by Arthur Grossman a microalgae expert whos now an adviser to the brand. At first Solazyme executives had a good chuckle about the idea of getting into skin care Mr. Wolfson said. I really never thought Id be standing in a store like this he told a gathering of reporters during a preview at Sephora Fifth Avenue amid shiny display cases of primer and volumizing mascara. It may seem novel for a nonbeauty company to get into skin care but these days it really isnt Mrs. Lewis said. There are ingredient suppliers that provide ingredients to health care food and drink industries and cosmetic companies she said. In Japan food and health care companies have found cosmetic applications for their ingredients so they are creating skin care brands. For example Frutarom http a flavoringredient house based in Israel makes Alguard a purified polysaccharide shield from a red microalgae that it says protects skin from daily assaults and reduces roughness as well as the look of fine lines. There are more than algaederived ingredients used in cosmetics worldwide Mrs. Lewis said. The patentpending alguronic acid in Algenist is a single purified highly bioactive compound said Tony Day the vice president for research and development at Solazyme and therefore delivers much higher activity to the skin than products using only a microalgae extract. Studies conducted by an independent lab and commissioned by Algenist none of which have been published in a peerreviewed journal showed alguronic acid increased cell regeneration and the synthesis of elastin which gives skin that snapback youthful quality. This testing also demonstrated that alguronic acid provided protection against cell damage induced by ultraviolet rays and inhibited the enzymes that break down elastin. After reviewing press materials and Solazymes page patent application Dr. David McDaniel a dermatologist and the director of the Institute of AntiAging Research http in Virginia Beach Va. said he was impressed by the invitro testing of alguronic acid. In the petri dish their data seems to show some substantial benefits to their active ingredient he said. But he cautioned that invitro testing does not demonstrate how a final formulation works off the shelf. Dr. Dana Sachs an associate professor of dermatology at the University of Michigan Ann Arbor wrote in an email after looking at Algenists dossier that the claims on cell regeneration and elastin synthesis are based on in vitro models which is hard to extrapolate to in vivo and again no statistical significance is presented so this is a weak claim. Dr. Day who has a doctorate in biochemistry said that statistical significance was found but not included in press materials. And according to the company a study of women showed that after days of using the Algenist serum they had a percent decrease in wrinkles httphealth.nytimes.comhealthguidessymptomswrinklesoverview.htmlinlinenytclassifier as shown by silicone replicas of their faces. Dr. Ellen Marmur the chief of the division of dermatologic and cosmetic surgery httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsplasticsurgeryindex.htmlinlinenytclassifier at Mount Sinai Medical Center in Manhattan did say Algenist could fairly claim that alguronic acid offers protection against ultraviolet damage to cells and that she might use the product as a nice sun protection on top of S.P.F. protection. Algenist literature touts alguronic acids superiority to hyaluronic acid retinol httphealth.nytimes.comhealthguidesnutritionvitaminaoverview.htmlinlinenytclassifier and vitamin C httphealth.nytimes.comhealthguidesnutritionvitamincoverview.htmlinlinenytclassifier among other antiaging ingredients in encouraging elastin synthesis and cell regeneration. But Dr. McDaniel who does research into using plantderived products to lengthen the life of cells says he thinks the comparative data must be viewed with caution because the studies that yielded it are challenging to do accurately hard to interpret and not necessarily predictive of final products. Soon consumers will judge whether Algenist products are a breakthrough. In an unusual move Sephora is introducing the line in locations in countries all at once in a rollout coordinated with QVC. It was a brand nobody has ever heard of said Allen Burke the senior adviser for beauty strategy and development at QVC. We want to give it a lot of visibility all at the same time. But Mr. Burke knows that marketing has its limits. It can be the most interesting story in the world he said. But if it doesnt deliver its not a business that we can do."

"Women who took fish oil during the last three months of pregnancy significantly lowered the risk that their children would develop asthma a study in Denmark has found. Among children whose mothers took fishoil capsules . percent had asthma by age compared with . percent whose mothers were given placebos. The difference nearly percentage points translates to a risk reduction of about percent. But in the study released on Wednesday http the researchers say they are not ready to recommend that pregnant women routinely take fish oil. Although the study found no adverse effects in the mothers or babies the doses were high . grams per day to times what most Americans consume from foods. Before doctors can make any recommendations the study should be replicated and fish oil should be tested earlier in pregnancy and at different doses Dr. Hans Bisgaard the leading author of the study said in an email. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood an independent research unit. Doctors are eager to find ways to prevent asthma a chronic disease that causes wheezing coughing and breathing trouble and that sends many families to the emergency room again and again. The incidence has more than doubled in developed countries in recent decades. More than six million children https_recent_data.htm in the United States have asthma according to the Centers for Disease Control and Prevention as do more than million http children and adults worldwide according to the Global Asthma Network. Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish. The results were published in The New England Journal of Medicine. The scientists bought fish oil from a company that makes it but they said the company had no role in the study. The research was paid for by the Danish government and private foundations. An editorial http in the same journal by an expert who was not part of the study praised the research saying it was well designed and carefully performed. The author of that editorial Dr. Christopher E. Ramsden from the National Institutes of Health said the findings would help doctors develop a precision medicine approach in which fishoil treatment could be tailored to women who are most likely to benefit. But Dr. Ramsden also said it was too soon to put the new findings into practice and he recommended further study. Previous research had suggested that fish oil might help prevent asthma. The idea is plausible because inflammation in the airways and lungs plays a major role in asthma and fatty acids in fish oil are thought to prevent inflammation. The richest sources in food include fish like herring sardines mackerel eel and salmon. Because the earlier studies suggesting a benefit from fish oil were not conclusive the Danish researchers decided to test the idea. They recruited women. Starting in their third trimester half the women took . grams of fish oil a day and half took placebo capsules of olive oil continuing until one week after birth. About a quarter of the mothers and a fifth of the fathers had asthma and they were evenly distributed between the fishoil and placebo groups. The capsules were an overthecounter product called Incromega TG a fish extract made by the British chemical company Croda Health Care. The extract contained the fatty acids eicosapentaenoic acid EPA and docosahexaenoic acid DHA. The researchers tracked the childrens health finding asthma less common in those whose mothers had taken the fish oil with the effect lasting at least through age the longest followup. By age the biggest difference had emerged from data on mothers who before treatment had the lowest levels of EPA and DHA in their blood. In that group only . percent of the children whose mothers took fish oil developed asthma compared with . percent whose mothers took the placebo a difference of . percentage points and a risk reduction of about percent. Low levels of EPA and DHA in the blood can be related to diet but also to genetics. The body normally converts another fatty acid found in plantbased foods to EPA and DHA. But some people about percent in the study carry a genetic variant that impairs their ability to make the conversion. The researchers found that children born to women with little EPA and DHA in their diets and to women with the genetic variant were among those most likely to benefit from exposure to fish oil in pregnancy. Dr. Bisgaard said that pending further study the best way to apply the findings would probably be to test women for the fattyacid levels in their blood and for the genetic variant to determine who might benefit from fish oil. He said that genetics could differ among different populations and that there might be ethnic variations in risk."

"Eczema is the most common skin disease worldwide. People suffering from it often deal with a lifetime of painful symptoms. A new clinical trial is testing a natural treatment that researchers hope will provide a longterm solution for those dealing with the dry itchy and painful skin that comes with chronic eczema. The trial uses a cream containing beneficial bacteria to fight harmful bacteria on the skin. While it may seem counterintuitive to treat bacteria with more bacteria experts say this approach seeks to restore the natural microbial balance of healthy skin. There are over species of bacteria that all live in balance on healthy skin some that even produce natural antibiotics. However we know that eczema patients lack the beneficial bacteria needed to kill Staph aureus harmful bacteria that can worsen eczema said Donald Leung MD head of the Division of Pediatric Allergy Immunology at National Jewish Health. To fight harmful bacteria researchers isolate beneficial bacteria from our skin and grow it in a lab. It is then applied to eczema patients skin as a lotion twice a day for a week. Bacterial DNA from patients skin is then analyzed in a lab to determine if the cream effectively reduced the amount of bad bacteria present. Ideally we want to eliminate all staph aureus from the skin of eczema patients said Leung. What the cream does is help the skin gain back its natural balance and create that barrier needed to keep it healthy. Researchers hope that using the bacteriainfused cream will offer a longterm solution where other treatments fall short. Powerful antibiotics are commonly prescribed for eczema but they kill good bacteria on patients skin along with the bad. Creams containing corticosteroids are also often prescribed to eczema patients but they come with harsh side effects and patients usually cant tolerate them for long periods of time. The worst symptom of eczema is the itching and the scratching and the more you scratch the more it spreads. It can be very painful said Cassandra Rodriguez who has struggled with eczema all her life. Cassandra has tried just about every cream and medication on the market and says when she learned about the clinical trial she was on board to give it a try. The trial coordinator explained that its like a probiotic for your skin said Rodriguez. You hear all these things about good bacteria for your gut so it seemed like a promising idea to apply that same concept to the skin. Cassandras son also has eczema and shes hoping this research will lead to an effective treatment so that he wont have to suffer with the pain and embarrassment of the disease for as long as she has. Hes little now but dealing with eczema as a teen and an adult is really difficult said Rodriguez. If there were something on the market that could help him and help everyone suffering with eczema every day that would be amazing. Experts say there is more research to be done but that the goal of the trial is to discover the best combination of bacteria to clear eczema from the skin and then make it available to patients as a prescription cream. The next steps involve testing those different combinations ensuring theyre safe and conducting a longer trial to see if the benefits of bacterial cream can truly provide a permanent solution for eczema patients. About National Jewish Health National Jewish Health is the leading respiratory hospital in the nation. Founded years ago as a nonprofit hospital National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of patients with respiratory cardiac immune and related disorders. Patients and families come to National Jewish Health from around the world to receive cuttingedge comprehensive and coordinated care. To learn more visit njhealth.org http"

"Most heart attacks strike with no warning but doctors now have a clearer picture than ever before of who is most likely to have one says Dr. Arthur Agatston a Miami cardiologist and author of the bestselling South Beach diet books. Agatston says relatively new imaging tests give realtime pictures showing whether plaque is building up in key blood vessels alerting doctor and patient to an increased risk of a potentially deadly heart attack. Unless you do the imaging you are really playing Russian roulette with your life he said. Agatston invented one of the imaging tests the coronary calcium scan which looks at plaque in the arteries leading to the heart. Plaque in these arteries is a red flag for a potential heart attack. Agatston does not make any money from the coronary calcium scan. The other imaging test Agatston recommends is an ultrasound of the carotid artery looking at plaque in the main blood vessel leading to the brain. Plaque in the carotid artery is a sign of increased risk for a heart attack and stroke. American Heart Association Learn and live http Both tests are noninvasive and outpatient although the calcium scan does expose the patient to the equivalent of several months of normal background radiation. Dr. Arthur Agatston consults with Judy Willner about her checkup in his Miami office. One large federally funded study found the coronary calcium score a better predictor of coronary events like a heart attack than the traditional Framingham Risk Score which considers age cigarette smoking blood pressure total cholesterol and HDL the good cholesterol. Agatston thinks the coronary calcium scan should be routinely scheduled at age like a colonoscopy or earlier for people with family histories of heart disease. Most hospitals now offer the imaging tests some at less than for both and they are often covered by insurance. Cardiologists now generally use the calcium scan only for patients considered at intermediate risk for heart disease determined by traditional measures such as cholesterol blood pressure lifestyle and family history. Highrisk patients already receive such aggressive treatment as cholesterollowering statin medication but many doctors dont think lowrisk patients need to incur the expense or small dose of radiation that comes with a coronary calcium scan. There is a large group in the middle called intermediate risk which may be as much as of the population said Dr. Erin Michos a cardiologist at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University A good candidate for a coronary calcium scan she says would be a yearold man with slightly elevated cholesterol and a father who had a heart attack. Do you put this yearold who has this family history on a statin medication with potential expense and side effects for the next four decades of his life or do you further refine how far at risk he is she asked. A calcium score would answer that question she says. Theres a third test Agatston likes a blood test that looks at a patients LDL or bad cholesterol. LDL particles come in different sizes and patients with a lot of smallparticle LDL are more likely to build up plaque in their blood vessels Agatston says. Alternately patients with large LDL particles do not tend to accumulate plaque. There are a lot of little old ladies in their s with very high cholesterol who have squeaky clean vessels. They have very large particles and they dont get into the vessel wall Agatston says. These new tests give patients a chance to make major changes in their diet and lifestyle and give doctors an opportunity to treat them with medication. One of the bestkept secrets in the country in medicine is the doctors who are practicing aggressive prevention are really seeing heart attacks and strokes disappear from their practices. Its doable Agatston says."

"The debate over coronary bypass surgery http versus stenting goes back decades. Studies have been inconclusive but doctors and patients have voted with their feet in favor of the lessinvasive procedure clearing clogged arteries and propping them open with tiny scaffolds called stents. U.S. doctors do at least two stenting procedures these days for every coronary bypass operation. Now the biggest collection of cases so far comes out in favor of surgery on the allimportant question of mortality. Four years after the procedure patients over who had coronary artery bypass surgeries called CABG or cabbages were almost percent less likely to die. Put another way percent of stented patients had died after four years compared with percent of surgery patients. Is that a big difference Well the studys lead author tells Shots that it might be enough to tip the balance a little bit but not overwhelmingly so. The National Heart Lung and Blood Institute which funded the study with new stimulus money from the American Recovery and Reinvestment Act is more bullish on the implications. We would hope a study as powerful as this one will inform decisionmakers to rethink the direction theyre going in the NHLBIs Dr. Michael Lauer httppublic.nhlbi.nih.govNewsroomhomeShowBio.aspxPID told Shots. He says its been worrying that so many doctors have been opting for stenting over surgery. Article continues after this message from our sponsor Study author Dr. William Weintraub http chief of cardiology at Christiana Care Health System in Newark Del. is presenting the data at the annual meeting of the American College of Cardiology in Chicago. The study also appears online http_home in the New England Journal of Medicine. It draws on data from more than patients across the nation who underwent CABG operations and nearly patients who had coronary stenting. They had blockages in either two or three coronary arteries but did not require emergency procedures. Although the prosurgery outcome is not a gamechanger Weintraub says it might cause some doctors and patients to consider surgery. And he says it supports those who now opt for CABGs. Its a very big deal to recommend coronary surgery to patients Weintraub says. I think doctors work very hard to weigh whats best for their patients. When doctors recommend surgery these data suggest that that decision is a good one. But Dr. Laura Mauri http_teamLaura_Mauri says in an accompanying editorial http_home that the new study cant settle any debates. Only studies that randomly assign comparable patients to surgery or stenting can do that. Mauri is an interventional cardiologist i.e. a specialist who does coronary stenting at Brigham and Womens Hospital inBoston. Weintraub notes its very difficult and expensive to do randomized studies on this question and to make the comparison groups truly comparable. And while such a study is being done the technology especially stenting technology changes. That can call into question the ultimate relevance of the findings. So the new data may be the best that doctors and patients in this situation can expect for the foreseeable future."

"A combination of two BristolMyers Squibb drugs that help the immune system fight melanoma led to significantly greater tumor shrinkage than treatment with one of the medicines according to a midstage study presented on Monday. The combination of Yervoy and the newer Opdivo also reduced the risk of disease progression by percent compared with Yervoy alone through months of followup in previously untreated patients with advanced melanoma researchers found. The overall response rate defined as tumors that shrank by at least percent was percent for the patients who received the combination versus percent among the who got Yervoy alone. Twentytwo percent of those combination patients had a complete response meaning no sign of tumor. There were no complete responses with Yervoy alone. The response rates and the depth of responses are quite impressive Dr. Stephen Hodi director of the Melanoma Center at DanaFarber Cancer Institute and colead author of the study said in an interview. The median time it took for Yervoy patients to see their cancer worsen was . months. But after months more than half of the combination group had yet to see their disease worsen. Overall survival data was not yet available. Longer followup will be helpful to see the durability of these responses and what happens to patients who had complete responses said Hodi who presented data from the Checkpoint study at the American Association for Cancer Research meeting in Philadelphia. The results were published in the New England Journal of Medicine. Yervoy also known as ipilimumab had been the first immunotherapy to extend survival in patients with advanced melanoma the deadliest skin cancer. It works by taking the brakes off the immune system to more efficiently attack cancer. Opdivo nivolumab belongs to a promising new class of drugs called PD inhibitors that block a mechanism tumors use to hide from the immune system. In a separate group of patients with a mutation of the BRAF gene involved in cancer cell growth the overall response rate was percent for the combination. The complete response rate was percent. That compared with percent overall response rate and no complete responses for Yervoy alone. The combination of the two drugs also led to far higher levels of side effects such as colitis and inflammation of lung tissue at percent versus percent for Yervoy alone. Patients were also more likely to stop taking the combination of drugs. Most of the patients who stopped for toxicity continued to benefit said Fouad Namouni Bristols head of development for Yervoy and Opdivo."

"In an analysis that set off a fierce debate over the health effects of salt researchers said on Wednesday they had found no evidence that small cuts to salt intake reduce the risk of developing heart disease or dying prematurely. A man holds sea salt harvested from a salt field in Sandspit about km miles southwest of Karachi June . REUTERSAkhtar Soomro In a systematic review published by The Cochrane Library British scientists found that while cutting salt consumption did appear to lead to slight reductions in blood pressure that was not translated into lower death or heart disease risk. The researchers said they suspected the trials conducted so far were not big enough to show any benefits to heart health and called for largescale studies to be carried out soon. With governments setting ever lower targets for salt intake and food manufacturers working to remove it from their products its really important that we do some large research trials to get a full understanding of the benefits and risks of reducing salt intake said Rod Taylor of Exeter University who led the review. The Cochrane review attracted sharp criticism from nutrition experts. Francesco Cappuccio head of the World Health Organizations collaborating center for nutrition at Warwick University said it was a surprisingly poor piece of work. This study does not change the priorities outlined worldwide for a population reduction in salt intake to prevent heart attacks and strokes the greatest killers in the world he said in an emailed comment. Simon Capewell a professor of Clinical Epidemiology at Liverpool University said the review was disappointing and inconclusive and did not change public health consensus that dietary salt raises blood pressure. Most experts are agreed that consuming too much salt is not good for you and that cutting salt intake can reduce hypertension in people with normal and high blood pressure. Many developed nations have governmentsanctioned guidelines calling on people to cut their salt or sodium intake for the sake of their longerterm health. The World Health Organization WHO lists reducing salt intake among its top best buys for reducing rates of chronic disease. In Britain the National Institute of Health and Clinical Guidance NICE has called for an acceleration of the reduction in salt in the general population from a maximum intake of gramsg a day for adults by to g by . U.S. guidelines recommend Americans consume less than . g of salt daily or . g for certain people who are more at risk for high blood pressure or heart disease. While previous trials have found there is a blood pressure benefit from cutting salt research has yet to show if that translates into better overall heart health in the wider population. High blood pressure or hypertension is a major risk factor for cardiovascular diseases the leading causes of death worldwide. Taylor said he thought it did not find any evidence of big benefits because the numbers of people studied and the salt intake reductions were relatively small. The people in the trials we analyzed only reduced their salt intake by a moderate amount so the effect on blood pressure and heart disease was not large he said. For this review Taylors team found seven studies that together included participants. This gave the researchers enough data to be able to start drawing conclusions they said. But even so the scientists think they would need to have data from at least people before they could expect to identify any clear health benefits. Elaine Rush a professor of nutrition at Auckland University of Technology in Australia said that putting a spotlight on single trials and generalizing dietary advice for a single nutrient such as salt was not helpful. What is helpful is for the food industry to reformulate products to reduce sodium and increase the nutrient quality of foods by using real ingredients she said in an emailed comment. SOURCE bit.lyqxF httpbit.lyqxF Cochrane Reviews July . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"For most of her life Fran Friedman struggled with compulsive eating. At years old she was foot and weighed pounds. Thats when she opted for bariatric surgery. The surgery http worked. Friedman who is now and lives in Los Angeles lost pounds. It was a miracle Friedman says not to feel hungry. It was the first time in my life that Ive ever lost a lot of weight and was able to maintain it. Friedman kept the weight off for almost years. But then to her dismay she started to gain it back. I thought I was cured she says. I thought I could eat like regular people. Shes not alone says Dr. Rabindra Watson http Assistant Clinical Professor at the University of California Los Angeles Division of Digestive Diseases. About one in three patients regain significant amounts of weight a few years after surgery to reduce the size of the stomach pouch. Bariatric surgery shrinks the stomach to about the size of an egg so people feel full from eating very little food. The problem is that over the years the stomach stretches and when that happens Watson says Patients are able to eat more at one sitting and they feel hungrier more often. At the same time hormonal changes that reduce the appetite and take effect immediately after the surgery begin to decline. Watson says we dont know for sure but its possible the body begins to adapt to those changes which is why the weight loss is reversed over time. For Fran Friedman it meant a pound weight gain and a bout of depression. The reality hits she says. Do I want to go back to where I was or do I want to maintain this level of quality of life So Friedman opted for a less invasive procedure to make her stomach smaller again. Its called Transoral Outlet Reduction httpgastro.ucla.edusite.cfmid or TORe for short. Its one of several procedures designed to help people maintain the benefits of bariatric surgery. This procedure involves inserting an endoscope through the mouth into the stomach while the patient is under anesthesia. It costs http to and insurance coverage varies. Article continues after this message from our sponsor If the stomach pouch has stretched new sutures are put in place to once again reduce the size of the stomach. After the surgery Watson says patients report feeling fuller and less hungry and they ultimately gain greater control over what they are eating. And research http conducted over the past decade suggests it works. There are no significant side effects to the surgery and patients can return to work the day after they have the procedure. For Friedman it did the trick. She has lost pounds since her second surgery. And now she says with the help of a support group she is recommitted to watching what she eats and how much she exercises. She wants to lose another pounds. And more importantly she wants to keep the weight off."

"Reiterating a recommendation last made in an influential U.S. panel of health experts is advocating that regular colon cancer screening begin at age and continue until at least age . However the U.S. Preventive Services Task Force stopped short of saying any one screening method was better than another. There are multiple screening options for colorectal cancer that reduce the risk of dying from the disease. We encourage people to choose the best option for them in consultation with their clinician former Task Force member Dr. Douglas Owens said Wednesday in a USPSTF news release. The panels reticence to choose one option over another may be at odds with the preference of many doctors who often advise colonoscopy as the gold standard test. Dr. Arun Swaminath is one of them. There is only one test colonoscopy that can both diagnose a polypcancer and remove or sample it at the same time said Swaminath who directs the inflammatory bowel disease program at Lenox Hill Hospital in New York City. This is key because a positive stool test plus stool DNA test such as Cologuard or a positive imaging test such as CT colonoscopy will still require a follow up colonoscopy to confirm and treat the problem he explained. For its part the American Cancer Society recommends colonoscopy screening once every years beginning at age or one of a number of other tests at more frequent intervals. In drafting its updated colon cancer screening guidelines the USPSTF reviewed data on several screening strategies. Besides colonoscopy these included flexible sigmoidoscopy an invasive procedure that penetrates less far than colonoscopy CT colonography a scan of the colon traditional fecal occult blood tests looking for blood in stool and the recently approved Cologuard DNAbased stool test. The panel said there were no comparison studies that suggested that any of the screening methods were any more effective than others. There are varying amounts of proof supporting the effectiveness of each and each method has its advantages and limitations the panelists said. And what about colon cancer screening for the elderly In its statement the panel said that for some adults ages to the benefits of screening are smaller and the potential for harm greater. However some people in this age group may benefit especially if they have never been screened before and are healthy enough to undergo treatment if cancer is found. For this older group the USPSTF recommends that decisions on screening be made during consultations between the patient and his or her doctor. All of the recommendations are specific to symptomfree people years of age or older with an average risk colorectal cancer the panel stressed. People with disorders or medical histories that raise their odds for colon cancer may need more rigorous screening the USPSTF said. The updated recommendation was published online June in the Journal of the American Medical Association. Evidence convincingly shows screening for colorectal cancer works but not enough people are taking advantage of this highly effective service said Owens a general internist at the Veterans Affairs Palo Alto Health Care System and a professor at Stanford University. The USPSTF notes that only onethird of eligible adults in the United States are screened for colon cancer and more need to take advantage of this effective method of prevention. Colorectal cancer remains the second leading cause of cancer death in the United States. This year about people in the country will be diagnosed with the disease and about will die from it. the panel said The USPSTF is an independent volunteer panel of experts that makes recommendations about the effectiveness of specific preventive health services. More information The U.S. Centers for Disease Control and Prevention has more on colon cancer screening http_infoscreeningindex.htm. SOURCES Arun Swaminath M.D. director inflammatory bowel disease program Lenox Hill Hospital New York City Journal of the American Medical Association and U.S. Preventive Services Task Force news releases June"

"For years research has shown that babies born by cesarean section are more likely to develop health problems. Now a groundbreaking study suggests that not all Csections are equally risky. The research looked at all fullterm firstborn births in Scotland over a year period and tracked the babies longterm health. It is one of the largest and longest studies to explore how planned Csections differ from other deliveries. Surprisingly the data showed more health problems among babies born by planned Csection than among those delivered by emergency Csection or vaginal birth even though the planned surgery is done under more controlled conditions. The finding suggests that the arduous experience of labor that exhausting sweaty utterly unpredictable yet often strangely exhilarating process may give children a healthy start even when its interrupted by a surgical birth. The new findings published in JAMA this month https are important because the number of babies born by Csection has increased tremendously. In the United States nearly one in three https babies are born by Csection. Cesarean births that had no medical indication increased to . percent of lowrisk women in up from . percent of such women in https Dr. Mairead Black the University of Aberdeen obstetrician who led the study said that as cesarean births had increased in Scotland and worldwide the researchers wondered what if anything children born by Csection are missing out on. Our thinking was If a baby is born naturally it comes into contact with bacteria from the mother which might help with immune system development Dr. Black said. Even attempted labor may provide some exposure to bacteria she said. But babies delivered by a planned Csection which is usually scheduled to take place well before the first pang of labor may miss out entirely. When you dont wait for labor to begin on its own you cut short all kinds of physiological changes and preparations for birth that are taking place toward the end of pregnancy said Carol Sakala the director of the nonprofit Childbirth Connection https programs at the National Partnership for Women Families. What is the effect of cutting off those processes so casually on such a large scale Studies have consistently found that children born by Csection are at higher risk for health problems like obesity httpsjournals.plos.orgplosonearticleid.journal.pone.and allergies https Csection birth has also been associated with a higher risk for Type httpslink.springer.comarticle.Fsz diabetes. The Scottish study took advantage of the small countrys rich trove of linked birth and medical databases to track the longterm health of babies. Nearly percent were born by planned Csection and percent were delivered by emergency surgery. The remaining were vaginal births. The researchers compared a range of health outcomes among the babies including asthma irritable bowel syndrome obesity Type diabetes early death and cancer. Over all the differences between a scheduled Csection and an emergency Csection were slight. However the data do begin to shed light on why babies born through vaginal birth may have fewer health risks than babies born by Csection. The biggest difference between babies born by scheduled and unscheduled Csection appeared in risk for Type diabetes. The results showed that babies born by planned Csection had a percent higher risk of Type diabetes compared with babies born by emergency Csection after adjusting for differences among the mothers. All of the babies born by Csection were slightly more likely to use an asthma inhaler at age . percent of planned Csection babies and . percent of unscheduled Csection babies wound up using an inhaler compared with . percent of vaginally born babies. Asthma hospitalization rates were also higher for babies born by planned Csection with a statistically significant increase of percent over vaginally born babies. Although all of the Csection babies were more likely to be obese at age the differences were not statistically significant after adjusting for differences among the mothers. There were no significant differences in cancer and irritable bowel disease among any of the types of births. No one knows exactly why labor may be protective but the spontaneous onset of labor prompts fluid to clear from a babys lungs said Dr. Aaron Caughey who helped draw up guidelines https for the American College of Obstetricians and Gynecologists that urged providers to let women spend more time in labor and avoid an unnecessary Csection. The step is just one of a cascade of physiological changes that take place in mother and baby during the labor process including surges in stress hormones and reproductive hormones like oxytocin that may help the fetus adapt during labor preserve blood flow to the organs and keep the baby alert and prepared for breastfeeding. During labor a newborn absorbs maternal microbes into its mouth and gastrointestinal tract said Dr. Josef Neu a neonatologist at the University of Florida who has written about Csection babies and the hygiene hypothesis. The theory is that maternal microbes train the infants immune system so it doesnt overreact or become destructive and precipitate autoimmune disorders like Type diabetes. Its an education process that says Calm down youre going to be seeing this antigen again you dont have to be so aggressive Dr. Neu said. Dr. Neu said the broadspectrum antibiotics prescribed to the mother before a surgical delivery were another concern the antibiotics can be transmitted to the baby through breast milk if not before birth decreasing the diversity of natural bacteria. The findings are a reminder that although Csections are appropriate in some circumstances they are a poor substitute for labor. Childbirth and labor are a physiological process that weve evolved to over millions of years Dr. Caughey said. Its been really welldesigned by evolution."

"Coronary artery disease is a condition in which a waxy substance called plaque builds up inside the arteries which supply oxygenrich blood to your heart. Eventually an area of plaque can rupture and cause a blood clot to form on the plaques surface. If the blockage isnt treated quickly the portion of heart muscle fed by the artery begins to die. This heart damage may go unrecognized and lead to severe or longlasting problems. Coronary artery bypass grafting CABG is a surgical procedure that improves blood flow to the heart by bypassing clogged arteries. CABG was once thought to be too risky for patients with the longterm effects of coronary artery disease left ventricular dysfunction when the left side of the heart is unable to pump normally and heart failure when the heart cant pump enough blood to meet the bodys needs. Early studies of the safety and effectiveness of CABG excluded most patients with these conditions. The procedure was typically used to relieve disabling angina or chest pain. A team led by Dr. Eric J. Velazquez of Duke University Medical Center conducted a year randomized controlled trial to investigate the effects of CABG on patients with coronary artery disease that shows sign of left ventricular dysfunction and heart failure. More than patients were included in the clinical trial. They were randomly assigned to receive either CABG plus medical treatment or medical treatment alone. The medical treatment included guidelinedirected medications and devices. Patients had followup evaluations every months for the first year and then every subsequent months. An extension study evaluated the year outcomes of the surgical intervention. Almost all the participants were included in the year followup results. The research was funded by NIHs National Heart Lung and Blood Institute NHLBI. Results were published online in the New England Journal of Medicine on April . Death from any cause occurred in patients in the CABG group and in patients receiving medical treatment alone. A total of patients in the CABG group and patients in the medical treatment group died from cardiovascular causes. In addition the bypass surgery was associated with an overall .year increase in median survival time . vs. . years. These results show that CABG improves survival for people with coronary artery disease left ventricular dysfunction and heart failure. The current year followup provides new important insights about patient subgroups that are more likely to benefit from CABG as compared to medical therapy alone explains NHLBI Director Dr. Gary H. Gibbons. As such we now have a solid evidence base to inform patient care and the future development of clinical practice recommendations. Related Links Who to Treat with Statins https Fending Off Cardiovascular Disease https Coronary Heart Disease http Coronary Heart Disease Risk Factors http Heart Disease in Women http What is Heart Surgery http Heart Failure http References CoronaryArtery Bypass Surgery in Patients with Ischemic Cardiomyopathy. https Velazquez EJ Lee KL Jones RH AlKhalidi HR Hill JA Panza JA Michler RE Bonow RO Doenst T Petrie MC Oh JK She L Moore VL DesvigneNickens P Sopko G Rouleau JL STICHES Investigators. N Engl J Med. Apr . Epub ahead of print. PMID . Funding NIHs National Heart Lung and Blood Institute NHLBI."

"A University of Manchester England engineering professor has invented a portable breast https scanner that could lead to more accurate tests for younger women without the need for Xrays. The scanner is based on radiofrequency technology which is able to quickly show malignant and benign tumors https when linked to a computer. It could be used in doctors offices. Radio Waves Radiofrequency or microwave technology for breast cancer https detection is not new but what Zhipeng Wu PhD from Manchesters School of Electrical and Electronic Engineering has achieved is the speed of results and portability. The patented realtime radiofrequency scanner uses computer tomography and works by using the same technology as a mobile phone but with only a tiny fraction of its power. Costs are reduced and the electronics fit into a case the size of a lunchbox. Continue Reading Below Current mammography https testing works well for detecting breast cancer https in women over with results of up to accuracy. The Manchester team says it is far less effective for younger women where the detection rate could be as low as for women under the age of . This group the team says accounts for of all breast cancer https cases. How It Works While mammography https works on breast https density radiofrequency looks at contrasts between normal and diseased breast tissues. The breast is placed in a scanner cup and an image appears on screen. Tumors or other abnormalities show up in red. Wu says in a news release The system we have is portable and as soon as you lie down you can get a scan its realtime. The realtime imaging minimizes the chance of missing a breast tumor during scanning. Wu says it will even work through a bra. Although there is still research to be done the system has great potential to bring a new way for breast cancer diagnosis https Reaction Carolyn Rogers clinical nurse specialist at Breast Cancer Care in the U.K. says in an emailed statement Evidence is needed to demonstrate the accuracy and uses of this device. The most effective screening tool for detecting breast cancer https is mammography and for women of all ages to remain breast aware reporting any changes to their doctor."

"A new form of cataract https surgery using a patients stem cells https has restored vision in babies for the first time and someday the technique may hold promise for millions of older Americans who undergo traditional cataract eye surgery https every year say scientists who developed the new procedure. Eye experts across the country who spoke with CBS News are alternately excited and cautious about the findings published Wednesday in the journal Nature. The procedure developed by researchers at the University of California San Diego and China is less invasive than traditional cataract treatment said the scientists. Cataracts are most common in older adults. As most people age an opaque film slowly forms over the lens the part of the eye that helps with focusing on images at various distances. It clouds vision and can lead to blindness. In cataract https surgery which has been around for several decades eye surgeons make an incision in the front of the eye and remove the lens from its supporting capsule. Then they replace it with an artificial lens. The new procedure described in Nature involves making a slim incision at the side of the lens capsule removing the entire lens yet preserving the empty capsule bag or scaffold. A certain kind of stem cell called endogenous stemprogenitor cells when left intact then begins to repopulate the damaged lens and essentially grow a new healthy lens. Study author Dr. Kang Zhang the chief of ophthalmic genetics at UC San Diegos Shiley Eye Institute told CBS News Unlike the current way of cataract surgery which destroys over half of lens stem cells and requires implantation of a plastic intranet ocular lens https we devised a new surgery to make a very small opening at the side of a cataractous lens bag remove the cataract inside allow the opening to heal and promote dormant lens stem cells to regrow an entirely new lens with vision. Pioneering surgery tested in babies The experimental procedure was done in infants who were born with a congenital cataract condition. By using a less invasive procedure Zhang and his colleagues report that they were able to leave the lens epithelial stem cells also called LECs intact. These LECs regenerated the eyes lens in the children eliminating the need for implants. The same technique was also successfully performed in animals. In little ones with congenital cataracts eye surgeons need to intervene early so that light can get to the brain and allow for normal healthy growth said Suraj Bhat associate professor of ophthalmology and director of the Vision Molecular Biology Laboratory at the UCLA Stein Eye Institute. Bhat was not involved in the new research but said its extremely exciting because it offers an alternative to an extraordinarily invasive procedure. In early childhood cataracts are very bad. We need light to enter into the eyes at a young age to get proper brain function otherwise information does not get transferred to the developing brain said Bhat. Traditional surgery can cause opacity in the line of a childs vision and because the eye is still growing it is difficult to provide good vision with eye glasses explained Julie T. Daniels from University College London Institute of Ophthalmology in an accompanying commentary in Nature. Many children also later go on to suffer from glaucoma. Daniels wrote that to correctly refract light onto the retina at the back of the eye the cornea and lens must remain transparent throughout life. Current treatments for the cornea and lens involve donor transplants or artificial implants but the procedures can be risky. She said the new procedure which coaxes stem cells to regenerate normal tissue in the body offers promise. The studys stem cell engineering has led to the regeneration of transparent lens tissue in children showing that the concept offers a potential therapeutic approach Daniels wrote. She noted a second study in Nature that used transplant tissue grown in the laboratory from stem cells to treat damaged corneas saying it also holds promise. Zhang said their results need to be validated in a large number of patients and with a longer followup period. Will it work in older eyes One major question remains to be answered Can it be applied to agerelated cataracts the leading cause of blindness According to the National Eye Institute about . million Americans suffer from cataracts. Between and the number of cataract cases in the U.S. went up by percent and its expected to continue to grow as the population ages. We are now planning a study to test this approach in this old patient population. In addition we are testing if this approach can be used in treating other leading causes of blindness such as macular degeneration and glaucoma said Zhang. He hopes the surgery will be available to the general population within four to five years. I would anticipate that it may be available after several independent studies with a large number of patients he said. Some other experts in the field saw great promise in the research. Everyones working on this. Stem cells are like the Holy Grail of vision research Dr. James Tsai M.D. president of the New York Eye and Ear Infirmary of Mount Sinai told CBS News. To me its very exciting data. They may be on to something. But he tempered the hope the study offers by noting that the lens regeneration work is also very controversial and could impact a multimilliondollar industry. This is potentially a new surgery. If you think about the implications in the long run lens implants may not be necessary he said. There are a lot of doctors who will want to see more data. He also pointed out that the study involved infants and that adults the most common cataract patients have a different regenerative capacity of lens epithelial stem cells. In the meantime Tsai said its hopeful news for some babies with congenital cataracts like the children who participated in the study. As a glaucoma specialist the way we do congenital cataracts theres a great risk these babies will develop glaucoma for a lifetime and maybe with this new surgery they wont have that glaucoma risk. Dr. Maria Valeria CantoSoler assistant professor of ophthalmology and director of the Retinal Degeneration Research Center at Johns Hopkins Wilmer Eye Institute said she was impressed by the research. The main excitement for me is the ability to regenerate an organ or a tissue within an organ said CantoSoler a retina specialist. From what I know Id say this is the first demonstration where you can use endogenous stem cells for replacing tissue within the eye. Its something we are all looking for. They have actually done it in humans. She said even without answers to the question of whether it will work in aging eyes it creates hope for children with congenital issues. If you can create it in children thats a big thing. You are giving sight back to little kids and that change their lives. Larger studies more eyes needed Dr. Kathryn Hatch an ophthalmologist at Massachusetts Eye and Ear in Boston told CBS News the procedure seems very exciting but more research is needed. Id need to see a larger study with more eyes and we need to see some reproducibility and see how long it would take for the lens if its able to regenerate what are the visual results. Because thats what patients really care about. Their vision. If it takes months to get to an outcome its not superior to the lens technologies we have now. Im not sure what the advantage is. Most patients dont even want to wait. They want to get back to work their life Hatch added. She also had questions about how the procedure was done with such a tiny incision. I dont understand how theyre doing the surgery with such a tiny hole without tearing the capsule. If we make a three millimeter incision in traditional cataract surgery thats really small in an adult. Cataract surgery is traditionally done by hand with a bent needle. Thats one of the most difficult steps to learn as a surgeon. One of most important steps to learn she said and there could be major eye damage if a surgery was compromised by a tear. She also noted that baby eye surgery is different from adults in that the infant cataract is much softer compared to an adults harder cataract. UCLAs Bhat noted another limitation in the study These are all genetic cataracts. This study wasnt long enough. They cataracts may come back he said but its also possible the genetic defect may not reappear. Hes said its unclear if the results will be mirrored in older cataract patients the same concern expressed by others in the field. Cell division is slower in older people Bhat said. The biggest problem as we grow older particularly beyond is cell division which keeps on decreasing. Our ability to make new cells is significantly lost. The process that these people are depending upon is tremendously dependent on cell division. Bhat said he also paused when he read the statement in the paper that claimed a percent success rate three months after surgery. I dont know them. I cant second guess them. Youve got to believe the written word."

"The first germs to colonize a newborn delivered vaginally come almost exclusively from its mother. But the first to reach an infant born by cesarean section come mostly from the environment particularly bacteria from inaccessible or lessscrubbed areas like lamps and walls and skin cells from everyone else in the delivery room. Photo The transfer of the maternal microbiome occurs naturally after a a vaginal birth. After a b Csection researchers transferred the neonatal microbiome from the mothers with a c gauze treatment.Credit Kim CaesarNature Publishing Group That difference some experts believe could influence a childs lifelong health. Now in the first study of its kind researchers on Monday confirmed that a mothers beneficial microbes can be transferred at least partially from her vagina to her baby after a Csection. The small proofofprinciple study suggests a new way to inoculate babies said Dr. Maria Gloria DominguezBello an associate professor of medicine at New York University and lead author of the report published on Monday in Nature Medicine. The study is extremely important said Dr. Jack Gilbert a microbial ecologist at Argonne National Laboratory who did not take part in the work. Just understanding that its possible is exciting. But it will take further studies following Csection babies for many years to know to what degree if any the method protects them from immune and metabolic problems he said. Some epidemiological studies have suggested that Csection babies may have an elevated risk for developing immune and metabolic disorders including Type diabetes httpsdiabetes.diabetesjournals.orgcontent.extract allergies asthma and obesity. Scientists have theorized that these children may be missing key bacteria known to play a large role in shaping the immune system from the moment of birth onward. To replace these microbes some parents have turned to a novel procedure called vaginal microbial transfer. A mothers vaginal fluids loaded with one such essential bacterium lactobacillus that helps digest human milk are collected before surgery and swabbed all over the infant a minute or two after birth. An infants first exposure to microbes may educate the early immune system to recognize friend from foe Dr. DominguezBello said. Friendly bacteria like lactobacilli are tolerated as being like oneself. Those from hospital ventilation vents or the like may be perceived as enemies and be attacked. These early microbial interactions may help set up an immune system that recognizes self from nonself for the rest of a persons life Dr. DominguezBello said. In the United States about one in three babies are delivered by Csection a rate that has risen dramatically in recent decades. Some hospitals perform the surgery on nearly seven in ten women delivering babies. An ideal Csection rate for lowrisk births should be no more than percent according to the World Health Organization. Dr. DominguezBellos study involved babies born at the University of Puerto Rico hospital in San Juan where she recently worked. Seven were born vaginally and by elective Csection. Of the latter four were swabbed with the mothers vaginal microbes and seven were not. Microbes were collected on a folded sterile piece of gauze that was dipped in a saline solution and inserted into each mothers vagina for one hour before surgery. As the operations began the gauze was pulled out and placed in a sterile collector. One to two minutes after the babies were delivered and put under a neonatal lamp researchers swabbed each infants lips face chest arms legs back genitals and anal region with the damp gauze. The procedure took seconds. Dr. DominguezBello and her colleagues then tracked the composition of microbes by taking more than oral skin and anal samples from the newborns as well as vaginal samples from the mothers over the first month after birth. For the first few days ambient skin bacteria from the delivery room predominated in the mouths and on the skin of Csection babies who were not swabbed Dr. DominguezBello said. But in terms of their bacterial colonies the infants swabbed with the microbes closely resembled vaginally delivered babies she found especially in the first week of life. They were all covered with lactobacilli. Gut bacteria in both Csection groups however were less abundant than that found in the vaginally delivered babies. Anal samples from the swabbed group oddly contained the highest abundance of bacteria usually found in the mouth. The results show the complexity of labor said Dr. Alexander Khoruts a microbial expert and associate professor of medicine at the University of Minnesota. It cannot be simplified to a neat effortless passage of the infant through the birth canal he said. As the month progressed the oral and skin microbes of all infants began to resemble normal adult patterns Dr. DominguezBello said. But fecal bacteria did not probably because of breast or formula feeding and the absence of solid foods. The transfer fell short of full vaginal birthlike colonization for two reasons Dr. DominguezBello said. Compared to infants who spent time squeezed inside the birth canal those who were swabbed got less exposure to their mothers microbes. And all infants delivered by Csection were exposed to antibiotics which also may have reduced the number and variety of bacteria colonizing them. A larger study of vaginal microbial transfer is underway at N.Y.U. Dr. DominguezBello said. Eightyfour mothers have participated so far. Infants delivered both by Csection and vaginally will be followed for one year to look for differences in the treated and untreated groups and to look for complications. Thus far the swabbing has proved entirely safe. The procedure is not yet recommended by professional medical societies said Dr. Sara Brubaker a specialist in maternal and fetal medicine at N.Y.U. Until more is known physicians are hesitant to participate. But it has hit the lay press she said. Patients come in and ask for it. They are doing it themselves. Dr. Brubaker is one of them. When her daughter was born three and a half months ago she arranged to have her baby swabbed."

"Cooling babies deprived of oxygen at birth perinatal asphyxia can reduce the number of children who develop epilepsy later in childhood according to a new study published in the journal Epilepsia. The study has been led by Marianne Thoresen Professor of Neonatal Neuroscience from the Bristol Medical School Translational Health Sciences at the University of Bristol. It is known that newborn babies who suffer perinatal asphyxia may develop permanent brain injury resulting in cerebral palsy or other conditions like epilepsy. Until recently to per cent of these patients would develop epilepsy and many need regular antiepileptic treatment. The patients cognitive performance life quality and life expectancy is also affected by having the condition. The research team has developed and delivered cooling treatment known as therapeutic hypothermia for newborns who suffer lack of oxygen during birth. For up to eight years the researchers followed infants who were born in the south west and who received cooling therapy at St Michaels Hospital Bristol part of University Hospitals Bristol NHS Foundation Trust. The study examined how many babies were diagnosed with epilepsy and how many are on regular antiepileptic drug treatment at two and four to eight years of age. The research found that babies born after who received the cooling treatment had much less epilepsy than before cooling treatment was introduced. At two years seven per cent of the children had an epilepsy diagnosis however far fewer only two per cent were on regular antiepileptic drugs. The study showed that more children had epilepsy when they reached the age of four to eight years with seven per cent on regular medication. However these are very low numbers needing antiepileptic treatment compared to before cooling treatment was introduced as standard of care. Before therapeutic hypothermia was introduced poor outcome meaning death or moderate or severe disability was around per cent per cent death and per cent surviving with disability. In this cohort born after the number of children with poor outcome is lower at per cent per cent death and per cent survived with disability. Also the severity of cerebral palsy is milder and seven out of ten are able to walk. Even if a lesser severity of perinatal asphyxia is accounted for cooling therapy has increased the number of healthy survivors and there are very few children with epilepsy needing drug treatment. Professor Marianne Thoresen said Even if we account for a lesser severity of perinatal asphyxia our research has shown that therapeutic hypothermia reduces the number of children who develop epilepsy later in childhood. Cooling treatment also reduces the number and severity of cerebral palsy and increases the number of patients who survive normally. The research was funded by Sparks UK University of Bristols Alumni Foundation The Laerdal Foundation for Acute Medicine Norway University of Oslo and a private donation. Paper Reduced infancy and childhood epilepsy following hypothermiatreated neonatal encephalopathy by Xun Liu Sally Jary Frances Cowan and Marianne Thoresen in Epilepsia"

"Having an optimistic outlook https on life may do more than just boost your mood. It may actually help you live longer according to new research from the Harvard T.H. Chan School of Public Health. The study published in the American Journal of Epidemiology found that women who were optimistic had a significantly lower risk of dying from several major diseases including cancer https heart disease https stroke https and respiratory disease https compared to other women whose outlook on life was less positive. Optimism in prior research has been shown to be related to better health behaviors and better health outcomes particularly in cardiovascular disease postdoctoral research fellow Kaitlin Hagan colead author of the study told CBS News. So in our study we wanted to expand that and look at allcause mortality https and be able to see whether optimism improves other health behaviors that then affects mortality or whether theres an independent effect of optimism on mortality. For the study the researchers analyzed data on from to on women who participated in the Nurses Health Study a longrunning research project tracking womens health via surveys every two years. To measure levels of optimism participants were asked to use a fivepoint scale to either agree or disagree with six statements such as In uncertain times I usually expect the best. The results showed that the most optimistic women those in the top percent had a nearly percent lower risk of dying from any of the diseases analyzed in the study when compared to the least optimistic participants in the lowest percent. Specifically the researchers found that the most optimistic women had a percent lower risk of dying from cancer. a percent lower risk of dying from heart disease. a percent lower risk of dying from stroke https a percent lower risk of dying from respiratory disease. The researchers controlled for a number of factors that could have had an impact on lifespan including marital status education level and other socioeconomic factors. While the study is observational and cannot prove a causeandeffect relationship between optimism and a longer life https the researchers have some theories for what might be behind the connection. Its a combination Hagan said. If youre more optimistic you tend to have healthier behaviors. Optimistic people are likely to have better diets theyre exercising more and theyre getting better sleep https However even after the researchers accounted for these factors the results still suggest that optimism itself is linked to a longer life https So it could be that optimism directly impacts our biological functioning Hagan said. Optimism is linked with lower inflammation and healthier biomarker levels and lipid levels https so there could be an independent effect on optimism. She said her team plans to focus more on the potential impact of optimism on biological functioning in future research. The authors point out that since the study was only done in women who were mainly white the results might not be generalizable to other populations. However they note there is no clear basis for believing that the effects of optimism on health differ by sex or race. Finally the researchers emphasize that while some people may think theyre just not optimistic it is something that is modifiable. They suggested a number of steps people can take to improve their level of optimism. One is called best possible self Eric Kim who also coled the study told CBS News. So you think about your different domains of life whether its your personal relationship your spouse your career your friendships and in each of those domains you think about the best possible outcome. Hagan had some suggestions too. Simple things like thinking about what youre grateful for every day or writing down what things make you happy or what things youre looking forward to can help someone to increase their optimism which can improve health outcomes as weve seen here she said."

"In a Canadian first a medical team has implanted a wireless device inside a heart failure patient permitting clinicians to monitor the patients cardiovascular status virtually and in realtime and proactively adjust treatment to prevent costly potentially unnecessary hospitalization. Heart failure is an epidemic that commonly leads to hospitalization says Dr. Heather Ross scientific lead at the Ted Rogers Centre for Heart Research and cardiologist Peter Munk Cardiac Centre University Health Network. Hospitalization is often necessary when patients start to retain fluid develop congestion and experience shortness of breath. This technology is a way to directly measure how much fluid is in a patient allowing us to intervene before they develop symptoms of congestion before they end up in hospital. This is a big gamechanger. Funded by the Ted Rogers Centre for Heart Research the device called CardioMEMS HF System was successfully implanted by interventional cardiologists at the Peter Munk Cardiac Centre in March . The system features a small butterflylike sensor that then sits inside the pulmonary artery of a heart failure patient. When the patient lies on an accompanying antennaequipped pillow device the sensor provides important data including the patients lung pressure readings to clinicians via a secure website. Never before have we had the ability to obtain a patients accurate lung pressure data while they are outside the hospital said Meredith Linghorne nurse practitioner Peter Munk Cardiac Centre. Traditionally weve relied on a patient describing symptoms and by then they may have already progressed to the point of hospitalization. With this device we can see warning signs days in advance and adjust treatment accordingly. The most rapidly rising cardiovascular disease in Canada heart failure affects close to one million Canadians and an estimated million people globally. In Canada heart failure patients stay an average of almost days for each hospital admission accounting for . million hospital stays a year. These patients live an average of . years after diagnosis and cost the Canadian healthcare system more than billion annually. About onequarter of these patients return to hospital within three months while approximately per cent return to hospital within six months. The CardioMEMS HF System is designed to monitor heart failure patients whose condition is serious but who are not so ill that the technology cannot improve their outcome. The first Canadian patient implanted with the heart monitor will be among patients within the Ted Rogers Centre for Heart Research at the Peter Munk Cardiac Centre to be fitted with the device over the next nine months. Produced by Abbott the CardioMEMS HF System is approved in the United States by the Food Drug Administration FDA and is currently awaiting approval by Health Canada. Video interview Dr. Heather Ross cardiologist and Meredith Linghorne nurse practitioner. https ABOUT THE TED ROGERS CENTRE FOR HEART RESEARCH The Ted Rogers Centre for Heart Research aims to develop new diagnoses treatments and tools to prevent and individually manage heart failure Canadas fastest growing cardiac disease. Enabled by an unprecedented gift of million from the Rogers family the Centre was jointly conceived by its three partner organizations the Hospital for Sick Children University Health Network and the University of Toronto. Together they committed an additional million toward the Centre representing a million investment in basic science translational and clinical research innovation and education in regenerative medicine genomics and the clinical care of children and adults. It is addressing heart failure across the lifespan. http trogersresearch ABOUT THE PETER MUNK CARDIAC CENTRE The Peter Munk Cardiac Centre is the premier cardiac centre in Canada. Since it opened in the Centre has saved and improved the lives of cardiac and vascular patients from around the world. Each year approximately patients receive innovative and compassionate care from multidisciplinary teams in the Peter Munk Cardiac Centre and the Centre trains more cardiologists cardiovascular surgeons and vascular surgeons than any other hospital in Canada. The Centre is based at the Toronto General Hospital and the Toronto Western Hospital members of University Health Network. http"

"Men may one day have a birthcontrol option other than the condom or vasectomy if early research on a new contraceptive gel pans out. Preliminary findings suggest that when applied to the skin the gel dramatically lowers sperm counts thus also lowering though not eliminating the risk for pregnancy. This is the first time that a combination of testosterone and a synthetic progestin called Nestorone has been tested as a gel that could be applied topically. Previous research involved administering the combination by injection or via a patch said study senior author Dr. Christina Wang a professor of medicine at Los Angeles Biomedical Research Institute. The combination contraceptive needs to undergo further testing before it is commercially available. Although men have sometimes received a bad rap for not being willing to assume responsibility for birth control Dr. Joseph Alukal an assistant professor of urology at NYU Langone Medical Center in New York City thinks this reputation may be somewhat undeserved. I think men would use it more than is realized said Alukal who was not involved in the new research. Plenty of guys are concerned about unwanted pregnancy almost as much as women. Unfortunately condoms and vasectomy have remained the only commercially available contraception options for men. The results of the study funded by the U.S. National Institutes of Child Health and Human Development were presented at the recent Endocrine Society annual meeting held in Houston. According to Wang the gel was applied in two spots the testosterone component on the arm and the progestin component on the abdomen. The gels were applied every day for six months. The study conducted in conjunction with the University of Washington involved men who were assigned to receive one of three types of gels one gel containing both testosterone plus a gel containing one of two doses of the synthetic progestin or a gel containing testosterone on its own plus a placebo gel with no progestin. Up to percent of the men who received the combination formulas saw their sperm concentrations plunge to less than million sperm per milliliter versus just percent of those receiving only testosterone. Normal sperm concentration is more than million sperm per milliliter according to the Mayo Clinics website. Up to percent of men receiving the drug combination in the study saw their concentrations drop to no sperm at all versus only percent of men taking testosterone alone. The testosteroneprogestin combination works by shutting off the hormones that control production of sperm in the testes Wang explained. One important and unanswered question is what the longterm side effects of this regimen might be. The answer said Wang is We just dont know. Thats apart from mildtomoderate acne or an increase in acne which was seen in about percent of participants. A new formulation currently being developed that contains half the amount of testosterone might decrease or eliminate that problem Wang speculated. Another question is how reversible this would be in terms of restoring sperm counts Alukal said. In addition to planning more studies on this combination protocol Wang is also in early phases of testing the male hormone dimethandrolone which is more potent than testosterone. Because the new study was presented at a medical meeting the data and conclusions should be viewed as preliminary until published in a peerreviewed journal. More information Theres more on contraception at the American College of Obstetricians and Gynecologists http_Patients. SOURCES Christina Wang M.D. professor of medicine Los Angeles Biomedical Research Institute Joseph P. Alukal M.D. assistant professor of urology NYU Langone Medical Center New York City presentation Endocrine Society annual meeting June Houston"

"GenomeDx Biosciences today announced that a study featured on the cover of Urology demonstrates that Decipher Prostate Cancer Classifier significantly influenced treatment recommendations following prostate surgery reducing disagreement between urologists and radiation oncologists and has the potential to enhance personalization of patient care. Decipher is a Medicarecovered genomic test capable of predicting tumor aggressiveness in men following prostate surgery. The study titled Impact of a Genomic Classifier of Metastatic Risk on Postprostatectomy Treatment Recommendations by Radiation Oncologists and Urologists http was published in this months issue of Urology. Conflicting treatment recommendations by different specialists looking at the same disease can be highly confusing for patients and is a problem for the health care system in general said Paul Nguyen M.D. of DanaFarberBrigham and Womens Cancer Center and Harvard Medical School. The Decipher tests tendency to make the two specialties more concordant in their treatment recommendations provides significant value toward standardizing care for patients. The study was designed to evaluate how the Decipher Prostate Cancer Classifier which predicts the risk of metastasis after prostatectomy would impact adjuvant treatment recommendations made by urologists and radiation oncologists. These two specialties often disagree on which patients should receive radiation therapy following surgery and when. Using clinical information alone observation rather than adjuvant radiation therapy was recommended in of decisions made by urologists and of decisions by radiation oncologists P .. The Decipher test results altered and of treatment recommendations made by urologists and radiation oncologists respectively. Decipher results indicating genomic high risk resulted in intensification of treatment whereas genomic low risk resulted in less aggressive recommendations. The Decipher results increased agreement in treatment recommendations between urologists and radiation oncologists as the odds of a recommendation for adjuvant treatment by urologists vs radiation oncologists increased from . CI .. to . CI .. after results of the Decipher test were made available. It is notable that while the Decipher test significantly influenced treatment decisions it did not increase the total number of people receiving adjuvant therapy suggesting that it helped ensure that the ones selected for adjuvant therapy are the ones most likely to benefit from it said Doug Dolginow M.D. chief executive officer of GenomeDx. As genomic tests like Decipher become used more routinely in urologic cancer patient care they will have a greater impact on treatment recommendations in clinical practice and allow for better personalization of therapy. The Decipher test used in this study has been previously described in multiple blinded independent validation studies in men at high risk of recurrence at the time of prostatectomy. Researchers found that of the clinically highrisk men would be reclassified as low risk based on the Decipher test and have only a . risk of metastasis at years after surgery. In addition the of the patients with the highest risk based on Decipher had a nearly fold higher risk of distant metastases by years. The test provided a more accurate and precise estimate of a patients risk of recurrence. Use of this test therefore has the potential to assist clinicians to better direct utilization of secondary therapy after surgery. About Decipher The Decipher Prostate Cancer Classifier is a highly validated and commercially available genomic test for men with intermediate and high risk prostate cancer. Decipher predicts cancer aggressiveness by looking for a unique genomic signature comprised of a validated series of biomarkers associated with metastatic disease. Adding truly unique information to the treatment decisionmaking process Decipher generates a risk result that is completely independent and distinct from PSA Gleason score and other clinical risk factors. Clinical studies from leading cancer centers published in over a dozen medical journals demonstrate that Decipher can accurately predict metastatic disease which men may benefit from radiation therapy following prostate surgery and can lead to significant costsavings for healthcare systems. Decipher was developed in partnership with the Mayo Clinic. Decipher is covered by Medicare and multiple private insurance plans in the US. Learn more at http and follow Decipher on Twitter DecipherTest http and on Facebook. About GenomeDx Biosciences GenomeDx Biosciences is focused on transforming cancer patient care by putting usable genomic information in the hands of patients and their physicians. GenomeDx is developing and commercializing Decipher a highly validated genomic test for predicting metastatic disease in men with prostate cancer. In partnership with leading medical centers the company has assembled the largest genomic catalogue of prostate cancer tumors in the world representing billions of data points and more than years of prostate cancer research expertise. Using advanced cloudbased bioinformatics GenomeDx mines the genomic data to develop proprietary tests that address key clinical questions in cancer patient management. GenomeDx has partnered to share genomic data with leading clinicianscientists worldwide to collaboratively enrich the knowledge and understanding of urologic cancers for the goal of improving global cancer patient care. GenomeDx is based in San Diego California and Vancouver British Columbia. Learn more at http and follow us on Twitter at Twitter GenomeDx http Facebook LinkedIn httpca.linkedin.comcompanygenomedxbiosciencesinc. and YouTube http Media Contact for GenomeDx Biosciences Ian Stone Canale Communications iancanalecomm.com mailtoiancanalecomm.com SOURCE GenomeDx Biosciences Related Links httpgenomedx.com"

"Hot flashes the bane of existence for many women during menopause can be reduced in frequency by almost half for about percent of women over eight weeks of acupuncture treatment according to scientists at Wake Forest Baptist Medical Center. In a study published in the Sept. issue of the journal Menopause scientists reported that about half the women in the study reduced the frequency of hot flashes while half did not. Women bothered by hot flashes and night sweats may want to give acupuncture a try as a relatively lowcost lowrisk treatment said Nancy Avis Ph.D. lead author of the study and professor of Public Health Sciences at Wake Forest School of Medicine a part of Wake Forest Baptist. Women will know pretty quickly if acupuncture will work for them. Women who had a reduction in their hot flashes saw a benefit beginning after about three to four weeks of weekly treatments. The National Institutes of Healthfunded study was designed to examine different patterns of responses to acupuncture. Participants included perimenopausal and postmenopausal women ages to who had on average at least four hot flashes or night sweats per day. Women were randomized to receive up to acupuncture treatments within six months or to a control group. Of the women who received acupuncture a small group of women . percent had an percent reduction in hot flashes by the eighth week of the study Avis said. Fortyseven percent of the study group reported a percent reduction over this same time frame. However percent showed only a minimal reduction of . percent in frequency of hot flashes while percent reported a percent increase in hot flashes. We had hoped to identify some of the characteristics of the women who benefitted from acupuncture but like so many treatments we could not really tell ahead of time who would benefit Avis said. Funding for the study was provided by grant RAT from the National Center for Complementary and Integrative Health at NIH. Coauthors include Beverly Levine Ph.D. Scott Isom M.S. and Timothy Morgan Ph.D. of Wake Forest Baptist and Remy R. Coeytaux M.D. Ph.D. of Duke University School of Medicine. Disclosure Coeytaux has a financial interest in an organization involved in recruiting study subjects and administering acupuncture treatments at one of the two study sites. His spouse is the primary shareholder of Chapel Hill Doctors which is an organization that was subcontracted by Wake Forest School of Medicine as a site for subject recruitment and treatment."

"Among a group of older women selfreported caffeine consumption of more than mg per day was associated with a percent reduction in the risk of incident dementia over years of followup. This level is equivalent to two to three oz cups of coffee per day five to six oz cups of black tea or seven to eight ounce cans of cola. The mounting evidence of caffeine consumption as a potentially protective factor against cognitive impairment is exciting given that caffeine is also an easily modifiable dietary factor with very few contraindications said Ira Driscoll PhD the studys lead author and a professor of psychology at the University of WisconsinMilwaukee. What is unique about this study is that we had an unprecedented opportunity to examine the relationships between caffeine intake and dementia incidence in a large and welldefined prospectivelystudied cohort of women. The findings come from participants in the Womens Health Initiative Memory Study which is funded by the National Heart Lung and Blood Institute. Driscoll and her research colleagues used data from communitydwelling postmenopausal women aged and older who reported some level of caffeine consumption. Intake was estimated from questions about coffee tea and cola beverage intake including frequency and serving size. In years or less of followup with annual assessments of cognitive function of these women received a diagnosis of probable dementia or some form of global cognitive impairment. Those who consumed above the median amount of caffeine for this group with an average intake of mg per day were diagnosed at a lower rate than those who fell below the median with an average intake of mg per day. The researchers adjusted for risk factors such as hormone therapy age race education body mass index sleep quality depression hypertension prior cardiovascular disease diabetes smoking and alcohol consumption. The paper Relationships Between Caffeine Intake and Risk for Probable Dementia or Global Cognitive Impairment The Womens Health Initiative Memory Study is available at httpbiomedgerontology.oxfordjournals.orgcontentearlygerona.glw Direct correspondence to Ira Driscoll PhD Department of Psychology University of WisconsinMilwaukee Garland Hall East Hartford Avenue Milwaukee WI Email driscoliuwm.edu mailtodriscoliuwm.edu Sharing on social media Find Oxford Journals online at OxfordJournals httpstwitter.comOxfordJournals"

"Bayer announced today that the U.S. Food and Drug Administration FDA approved Kyleena levonorgestrelreleasing intrauterine system . mg a progestincontaining intrauterine system IUS for the prevention of pregnancy for up to five years. Kyleena will be available by prescription only in October . Bayer is a global enterprise with core competencies in the Life Science fields of health care and agriculture. Data show that the use of effective longacting birth control methods including intrauterine devices or IUDs have helped to reduce unintended pregnancies in the United States but we still have a long way to go said Anita L. Nelson M.D. Professor and Chair Obstetrics and Gynecology at Western University of Health Sciences Pomona Calif. Kyleena is highly effective at preventing pregnancy and may be an appropriate choice for women who want a lowdose nondaily birth control method. Kyleena is a small flexible plastic Tshaped device containing . mg of a progestin hormone called levonorgestrel. Kyleena is placed by a healthcare provider during an inoffice visit and prevents pregnancy for up to five years but may be removed by a healthcare provider at any time. With the approval of Kyleena women have an important new birth control option that provides pregnancy prevention for up to five years said Dario Mirski M.D. Senior Vice President and Head of Medical Affairs for the Americas Bayer. Kyleena expands Bayers IUD portfolio and is part of our commitment to provide women and their healthcare providers with a variety of contraceptive choices to meet their individual needs. The use of longacting reversible contraception LARCs has increased nearly fivefold in the last decade. Because Kyleena slowly releases levonorgestrel into a womans uterus only small amounts of the hormone enter the blood. For the first to months a womans period may become irregular and the number of bleeding days may increase. Women may also have frequent spotting or light bleeding. Some women have heavy bleeding during this time. After using Kyleena for a while the number of bleeding and spotting days is likely to lessen. For some women periods will stop altogether. When Kyleena is removed menstrual periods should return. About the Clinical Trial for Kyleena The contraceptive efficacy of Kyleena was evaluated in a clinical trial that enrolled generally healthy women aged to of whom received Kyleena. Of these were nulliparous women women completed years of the study elected to enroll in an extension phase up to a total of years and completed years of use. The trial was a multicenter multinational randomized openlabel study conducted in countries in Europe Latin America the U.S. and Canada. Women less than six weeks postpartum with a history of ectopic pregnancy with clinically significant ovarian cysts or with HIV or otherwise at high risk for sexually transmitted infections were excluded. A total of were treated at U.S. sites and were at nonU.S. sites. The racial demographics of enrolled women who received Kyleena was Caucasian BlackAfrican American . Other . and Asian . indicated Hispanic ethnicity. The clinical trial had no upper or lower weight or BMI limit. The weight range was to kg mean weight . kg and mean BMI was . kgm range .. kgm. Of Kyleenatreated women discontinued the study treatment due to an adverse reaction . were lost to followup . withdrew for unspecified reasons . discontinued due to a protocol deviation . discontinued due to pregnancy and discontinued due to other reasons. The pregnancy rate calculated as the Pearl Index PI in women aged years was the primary efficacy endpoint used to assess contraceptive reliability. The PI was calculated based on day equivalent exposure cycles evaluable cycles excluded those in which backup contraception was used unless a pregnancy occurred in that cycle. The Year PI was based on pregnancies and the cumulative year pregnancy rate was based on pregnancies that occurred after the onset of treatment and within days after Kyleena removal or expulsion. Kyleena Clinical Trial Pearl Index Cumulative Year Kaplan Meier Rate Year Year Year Year Year Number of Evaluable day Cycles of Exposure Pregnancy Rate Confidence Interval . . . . . . . .. . . . . . . . . . About of women who desired pregnancy after study discontinuation and provided followup information conceived within months after removal of Kyleena. The most common adverse reactions occurring in users were vulvovaginitis ovarian cyst abdominal painpelvic pain headachemigraine acneseborrhea dysmenorrheauterine spasm breast painbreast discomfort and increased bleeding . In the combined studies discontinued prematurely due to an adverse reaction. The most common adverse reactions leading to discontinuation were increased bleeding . abdominal painpelvic pain . device expulsion . acneseborrhea . and dysmenorrheauterine spasm .. In the clinical trials serious adverse reactions occurring in more than a single subject included ectopic pregnancyruptured ectopic pregnancy subjects pelvic inflammatory disease subjects missed abortionincomplete spontaneous abortionspontaneous abortion subjects ovarian cyst subjects abdominal pain subjects depressionaffective disorder subjects and uterine perforationembedded device myometrial perforation subjects. Indication for Kyleena Kyleena levonorgestrelreleasing intrauterine system is a hormonereleasing IUD that prevents pregnancy for up to years. Important Safety Information for Kyleena If you have a pelvic infection get infections easily or have certain cancers dont use Kyleena. Less than of users get a serious pelvic infection called PID. If you have persistent pelvic or stomach pain or if Kyleena comes out tell your doctor. If Kyleena comes out use backup birth control. Kyleena may attach to or go through the uterus and cause other problems. Pregnancy while using Kyleena is uncommon but can be life threatening and may result in loss of pregnancy or fertility. Ovarian cysts may occur but usually disappear. Bleeding and spotting may increase in the first to months and remain irregular. Periods over time usually become shorter lighter or may stop. Kyleena does not protect against HIV or STDs. Only you and your healthcare provider can decide if Kyleena is right for you. Kyleena is available by prescription only. For important risk and use information about Kyleena please see the Full Prescribing Information httplabeling.bayerhealthcare.comhtmlproductspiKyleena_PI.pdf Bayer Science For A Better Life Bayer is a global enterprise with core competencies in the Life Science fields of health care and agriculture. Its products and services are designed to benefit people and improve their quality of life. At the same time the Group aims to create value through innovation growth and high earning power. Bayer is committed to the principles of sustainable development and to its social and ethical responsibilities as a corporate citizen. In fiscal the Group employed around people and had sales of EUR . billion. Capital expenditures amounted to EUR . billion RD expenses to EUR . billion. These figures include those for the hightech polymers business which was floated on the stock market as an independent company named Covestro on October . For more information go to http Bayer Bayer and the Bayer Cross are registered trademarks of Bayer. Kyleena is a trademark of Bayer. ForwardLooking Statement This news release may contain forwardlooking statements based on current assumptions and forecasts made by Bayer Group or subgroup management. Various known and unknown risks uncertainties and other factors could lead to material differences between the actual future results financial situation development or performance of the company and the estimates given here. These factors include those discussed in Bayers public reports which are available on the Bayer website at http The company assumes no liability whatsoever to update these forwardlooking statements or to conform them to future events or developments. Kyleena Prescribing Information September . Finer LB and Zolna MR Declines in unintended pregnancy in the United States New England Journal of Medicine httpnejm.orgdoifull.NEJMsa. Branum AM Jones J. Trends in longacting reversible contraception use among U.S. women aged . NCHS data brief no . Hyattsville MD National Center for Health Statistics. . Photo httpphotos.prnewswire.comprnh Logo httpphotos.prnewswire.comprnhNYLOGO SOURCE Bayer Related Links http"

"For years after it was administered growth hormone continued to reduce the risk of fractures and helped maintain bone density in postmenopausal women who had osteoporosis according to a new study published in the Endocrine Societys Journal of Clinical Endocrinology Metabolism. Osteoporosis http is a progressive condition that causes the bones to become weak and more likely to break. More than million American adults have osteoporosis and percent of the people being treated for the condition nationwide are women according to the Societys Endocrine Facts and Figures Report httpendocrinefacts.orghealthconditionsbonecalcium. Women are three times more likely to experience an osteoporosisrelated bone fracture in their lifetimes than men. Our study is the largest and longest controlled study of growth hormone treatment for osteoporosis in postmenopausal women to date said one of the studys authors Emily Krantz MD of Sdra lvsborgs Hospital in Bors Sweden. Years after treatment stopped women who were treated with growth hormone still experienced improved bone density and reduced fracture risk. During an monthlong randomized doubleblind trial postmenopausal women with osteoporosis received daily injections of either placebo a single unit of growth hormone or a .unit dose of growth hormone. The women were between the ages of and when they were recruited for the decadelong study. After months the women who received the placebo halted the injections. Women who received growth hormone continued to receive injections for another months. The researchers continued to follow up with the women for seven years after the growth hormone treatment was halted to monitor their bone density fractures and perception of their quality of life. The researchers compared the participants bone density and rate of fractures to those of a group of women who did not have osteoporosis. The controls were identified using the city census in Gothenburg Sweden. A decade after the study began the women who received the larger growth hormone dose still had higher bone mineral density levels than the participants who received the lower dose or the placebo. The rate of fractures in the treated women who had osteoporosis declined by percent during the yearlong study. More than half of the participants had fractured bones prior to the start of the study. In contrast the rate of fractures rose fourfold in the control group as some of those women were diagnosed with osteoporosis. The findings indicate the beneficial effects of growth hormone remained long after the treatment ceased Krantz said. Other authors of the study include Penelope Trimpou and Kerstin LandinWilhelmsen of Sahlgrenska University Hospital at the University of Gothenburg in Gothenburg Sweden. The study Effect of Growth Hormone Treatment on Fractures and Quality of Life in Osteoporosis A year Followup was published online at httppress.endocrine.orgdoi.jc. ahead of print. Founded in the Endocrine Society is the worlds oldest largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today the Endocrine Societys membership consists of over scientists physicians educators nurses and students in countries. Society members represent all basic applied and clinical interests in endocrinology. The Endocrine Society is based in Washington DC. To learn more about the Society and the field of endocrinology visit our site at http Follow us on Twitter at httpstwitter.comEndoMedia httpstwitter.com."

"A new type of stem cell treatment for people with type diabetes appears to help reeducate rogue immune system cells which allows cells in the pancreas to start producing insulin again. The treatment which combines a patients immune system cells with stem cells from a donors cord blood even worked in people with longstanding diabetes who were believed to have no insulinproducing ability. Although the treatment didnt wean anyone off insulin completely average blood sugar levels dropped significantly which would reduce the risk of longterm complications. Our study brings a new hope for people with type diabetes. If we can control the autoimmunity we may reverse the diabetes. We showed that the islets cells can start to work again said Dr. Yong Zhao an assistant professor in the section of endocrinology diabetes and metabolism at the University of Illinois at Chicago. This treatment could potentially be useful in other autoimmune diseases such as lupus and rheumatoid arthritis. Its quite remarkable that this approach based on the reeducation of immune cells might work so well. The concept is very intriguing and the treatment seems to be so simple and so safe said Dr. Luca Inverardi deputy director of translational research at the Diabetes Research Institute University of Miami School of Medicine. But hes also reasonably cautious he said. The followup is long up to weeks but its not long enough to declare victory against diabetes yet said Inverardi. Also he noted that the study involved only Chinese people and that type diabetes is a bit different in that population. He said hed like to see larger studies with a more diverse population followed for a longer time. Results of the study were published online Jan. in the journal BMC Medicine. Type diabetes an autoimmune disease occurs when the bodys immune system cells mistakenly attack the insulinproducing beta cells in the pancreas. Because their beta cells dont produce enough or any insulin people with type diabetes have to replace the lost insulin through injections to survive. Stopping that autoimmune attack appears to be crucial to any treatment that hopes to cure or reverse type diabetes. Zhaos team developed a completely new approach. They take blood from a patient and separate out the immune system cells lymphocytes. They briefly expose those cells to stem cells from umbilical cord blood from an unrelated infant and return the lymphocytes alone to the patients body. The researchers have dubbed this Stem Cell Educator Therapy because while exposed to the stem cells the lymphocytes seem to relearn how they should behave. The study participants who were to years old had had type diabetes for an average of nine years. Six had some residual beta cell function and six did not. Both groups were given stem cell educator therapy. The other three people served as the control group. The researchers measured Cpeptide a protein fragment thats a byproduct of insulin production and found that the educator therapy group had improved levels of Cpeptide at weeks. These levels continued to improve until weeks and remained stable through the followup at weeks. There were no changes in Cpeptide in the control group. The average daily dose of insulin dropped almost percent after weeks for the group with some beta cell function and percent in those with no beta cell function suggesting that the group with no beta cell function now produced insulin. That means if you stop the autoimmune reaction you may see beta cell regeneration or there might be other precursor cells in the pancreas. If these data are confirmed this is a very provocative and remarkable finding Inverardi said. The average hemoglobin AC level dropped . percent for those with residual beta cell function and . percent for those without beta cell function. AC levels measure average blood sugar levels over two to three months and people with type diabetes are advised to maintain AC levels below percent. A drop of percent in AC levels can reduce the risk of complications. This was an initial clinical trial designed to test for safety. Zhao said that in future trials he hopes that with additional treatments people might get off insulin altogether. But even if thats not possible the recovery of some beta cell function would be welcome news. In the absence of complete remission there are very sizable advantages to having some beta cell function Inverardi noted. Both experts said the treatment appears safe with no risk of rejection. No significant side effects were reported during the trial other than some arm soreness where blood was taken and returned. More information Learn more about type diabetes from the Nemours Foundations KidsHealth Web site httpkidshealth.orgparentmedicalendocrinetype.html. SOURCES Yong Zhao M.D. Ph.D. assistant professor section of endocrinology diabetes and metabolism department of medicine University of Illinois at Chicago Luca Inverardi M.D. deputy director of translational research at the Diabetes Research Institute University of Miami School of Medicine and research professor of medicine microbiology and immunology University of Miami Miller School of Medicine Jan. BMC Medicine online"

"New research finds that a minimally invasive surgical procedure to treat hernias results in less chronic pain and a faster recovery when compared to a traditional approach. One expert however said the older strategy may still be the best option in some cases. Its not onesizefitsall said Dr. L. Michael Brunt a professor at Washington University in St. Louis. One repair isnt appropriate for all circumstances. Hernias occur when part of an internal organ such as the intestines bulges out through muscle. At issue are the surgical approaches that physicians use when a patient suffers from a hernia in the groin. The procedures are designed to reduce the bulge of the hernia and make a patch so it doesnt protrude again. Its as if you had a leak in a tire thats ballooned out Brunt said. Youll patch it to prevent it from continuing to protrude. The study led by researchers at Erasmus Medical Center in Rotterdam the Netherlands examined two procedures. One procedure known as total extraperitoneal inguinal hernioplasty is performed under a general anesthetic and uses a laparoscopic approach through a small opening. It was developed in the s Brunt said. The other approach is older and is performed through a to .inch incision in the groin Brunt said. It can be done under local anesthesia. The study authors didnt examine a third approach known as patch and plug he said. In the study researchers randomly assigned hernia patients to one of the two surgical procedures. Almost all the patients were men and their average age was around . The researchers followed up with percent of the patients after an average period of five years. Hernias recurred in percent of laparoscopic and percent of the traditionalprocedure patients. Recurrences decreased to . percent and percent respectively if the procedures were performed by experienced surgeons. After five years percent of those who had the traditional procedure reported chronic pain compared to percent of the laparoscopic group. The study confirms what a lot of surgeons who do both procedures know already Brunt said. Theres less pain and a bit of a faster recovery from the laparoscopic procedure. Still the vast majority of patients do well regardless of the approach he said. Why use the traditional approach if the laparoscopic technique is better in some ways The traditional approach may be appropriate when its too risky to place patients under general anesthesia Brunt said such as in elderly patients and those with multiple health problems. Brunt said the costs of the two procedures are comparable although the laparoscopic procedure may cost more. The findings appear in the March issue of the Archives of Surgery. More information For more about hernias http try the U.S. National Library of Medicine. SOURCES L. Michael Brunt M.D. professor surgery Washington University School of Medicine St. Louis March Archives of Surgery"

"The inexpensive tests that look for hidden blood in a persons stool are effective for colon cancer screening a study out Tuesday confirms. The findings reported in the Canadian Medical Association Journal give some extra weight to fecal occult blood testing FOBT as a valid option for early detection of colon cancer. Experts generally recommend that people at average risk of colon cancer start screening tests for the disease at age . And they can pick from a number of tests that have all been found to cut the risk of dying from colon cancer. Along with stool tests done once a year at home the choices include two invasive procedures colonoscopy done every years and flexible sigmoidoscopy done every five years. The U.S. Preventive Services Task Force a federally supported expert panel recommends that people at average risk of colon cancer choose any of the three methods. FOBT detects hidden blood in the stool which can be a sign of colon cancer or precancerous growths called polyps. Positive results on the screen prompt a followup colonoscopy to investigate the source of the blood. Advances in the stool tests in recent years have made them more effective. A newer version called immunochemical FOBT iFOBT is supposed to zero in on colon growths better than an older version known as guaiac FOBT which often picked up bleeding originating in the upper digestive tract such as from a stomach ulcer. Immunochemical FOBT is now largely replacing the older test. But theres been surprisingly little evidence that it really is highly specific to colon cancer according to Dr. YiChia Lee of National Taiwan University Hospital one of the researchers on the new study. So for their study the researchers followed nearly adults who all volunteered to have iFOBT a colonoscopy and an upper endoscopy to check for problems in the upper digestive tract. They found that of people confirmed to have colon tumors after a colonoscopy all but one had also a positive iFOBT result. It means that almost every case with colon cancer can be identified by iFOBT Lee told Reuters Health in an email. It is a strong support to iFOBT as an effective screening tool. The researchers also found that iFOBT had specificity for colon cancer of close to percent meaning the test would accurately give a negative result to almost percent of people who did not have colon cancer. Of three study participants who were found to have cancers of the stomach or esophagus for instance none had a positive result on the iFOBT test. Like any screening test iFOBT does have a risk of falsepositive results which leads to unnecessary invasive testing in some people. In this study about percent of all participants had a falsepositive finding on the stool test. Among the risk factors for falsepositives the authors identified were the use of anticlotting drugs and low levels of the ironrich molecule hemoglobin in the blood. In practice a positive iFOBT result would be followed by colonoscopy in which a scope is used to investigate the interior of the colon. Whether used for firstline screening or as a followup colonoscopy has the advantage of allowing doctors to spot and remove precancerous growths called polyps which means the test can prevent cases of colon cancer. But as far as cutting the risk of death from colon cancer stool testing is similarly effective according to the U.S. Preventive Services Task Force. And its much cheaper iFOBT is more expensive than the older stool tests but it is still roughly . A screening colonoscopy averages around . The downside of iFOBT being specific to colon tumors is that it is not useful for catching cancers of the stomach or throat. Thats particularly important in Asia where those cancers are common. Lee said researchers there are looking into whether combining iFOBT with the older guaiac test is useful for catching cancers in the lower and upper digestive tract and whether adding a third stool test which looks for the ulcercausing bacteria H. pylori can help as well. Infection with H. pylori is associated with increased risks of stomach and throat cancers. In the U.S. cancers of the upper digestive tract are relatively uncommon. The average American has a one in chance of developing esophageal cancer while the risk of stomach cancer is one in . In contrast Americans lifetime risk of colon cancer is about one in according to the American Cancer Society. More than Americans died of the disease in . SOURCE bit.lymUOj httpbit.lymUOj Canadian Medical Association Journal online August . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Hormone replacement therapy in menopause is back and its come a long way. In the late s the treatment became standard for menopausal symptoms the hot flashes night sweats headaches incontinence and other problems that eventually strike almost all women. Most American women begin to experience menopause around age with some changes in their menstrual cycles earlier. Hormone treatment gives the body a smoother landing from menopause to postmenopause. But in when concerns were raised by a set of studies by the Womens Health Initiative of the National Institutes of Health showing hormones correlated with elevated breast cancer heart disease and stroke risk women and their doctors hit the brakes. For most women menopausal symptoms degrade quality of life for at least some amount of time maybe two years maybe as long as . Even after the Womens Health Initiative news broke some women couldnt face the changes without hormone treatment. Now doctors are once again saying they shouldnt have to. The difference For one thing the conclusions of the study have been discredited by subsequent studies. Many women in the Womens Health Initiative study were well past menopause were obese or were smokers and therefore already at risk of heart disease and stroke. For another the formulations used were less safe in their dosage mix of hormones and delivery method pills which travel through the liver and can cause clots. The sheer number of choices today and the need for a thorough initial health assessment make the decision on hormone therapy highly dependent on close communication between a woman and her doctor experts say. Getting educated Some women need higher doses some need lower doses. Once a woman is educated then she knows what to go in and ask for. If a doctor wont work with you then find another doctor says Dr. Marina Johnson a Dallas endocrinologist and pharmacist and author of Outliving Your Ovaries An Endocrinologist Weighs the Risks and Rewards of Treating Menopause With Hormone Replacement Therapy. Dr. Noushin A. Firouzbakht an obstetriciangynecologist at Texas Health Harris Methodist Hospital Fort Worth says that despite the alarm provoked by the Womens Health Initiative study much was learned especially about the ideal candidate for hormone replacement. New rule of thumb We also learned that we see fewer strokes and heart attacks from nonoral methods like a patch or a cream she says. The rule of thumb now is the lowest dose for the shortest amount of time. Its no longer that you need to stay away from hormone replacement therapy its that you need to use it wisely. That wisdom comes from a careful medical assessment and ongoing surveillance of blood pressure blood work breast changes side effects and effectiveness.Women whove had breast cancer cannot take hormone replacements. This requires a thorough exam and a thorough history and individualized care but women need to know Its not a death sentence or a dependence. Its an unfortunate thing that thats out there Firouzbakht says because women also need to know You dont have to suffer you dont have to have incontinence or vaginal prolapse or hot flashes. There is help available. Its a process but hormone replacement therapy is helping women have a better life in an era when they live longer. Johnson Firouzbakht and other experts will tell you that hormone therapy protects against heart disease a much more common killer of women than breast cancer as well as against dementia colon cancer osteoporosis and other health issues. The doctors emphasized not just the medical benefits but that the treatment can enable and boost a womans overall daytoday existence too. Too many women have been taught to accept suffering in this stage of life they say. Johnson notes that in her book she included chapters aimed at young women far from menopause in an effort to dispel that notion. There was a time when most women were just patted on the head and told Honey thats just what happens when you get old she says. But this is going to help you improve the quality of your life and prevent serious diseases. Why wouldnt you want to learn about it Bioidenticals Bioidentical hormones which come from plants are getting a lot of attention and add to the confusion about the treatment. Johnson who runs the Institute of Endocrinology and Preventive Medicine in Dallas says she only trusts the qualitycontrolled safetytested pharmaceutical bioidentical hormones that are made by drug companies and approved by the Food and Drug Administration. Bioidentical hormones are made from plants. Still commonly prescribed synthetic drugs are made from the urine of pregnant mares and although they are FDAapproved she considers them less effective and less safe. Johnson who runs the Institute of Endocrinology and Preventive Medicine in Dallas says she only trusts the qualitycontrolled safetytested formulations that are made by pharmaceutical companies and approved by the Food and Drug Administration whether the hormones come from plants or equine sources. Older still available drugs are made from the urine of pregnant mares. Firouzbakht prescribes pharmaceutical hormones and also works with a pharmacy she trusts to develop bioidentical hormone combinations for some patients. Such custom compounds are not FDAapproved. It doesnt matter what formulation of the hormones you are using its the surveillance of it all that is very important Firouzbakht says. We need to know about side effects unwanted adverse effects those risk factors dont go away with bioidentical hormones. When you have a good relationship with your gynecologist you will get what you need. Daphne Howland is a freelance writer in Portland Maine."

"Nobody looks forward to having a cavity drilled and filled by a dentist. Now theres an alternative an antimicrobial liquid that can be brushed on cavities to stop tooth decay painlessly. The liquid is called silver diamine fluoride or S.D.F. Its been used for decades in Japan but its been available in the United States under the brand name Advantage Arrest for just about a year. The Food and Drug Administration cleared silver diamine fluoride http for use as a tooth desensitizer for adults and older. But studies show it can halt the progression of cavities http and prevent them http and dentists are increasingly using it offlabel for those purposes. Knox Urschel had a liquid treatment silver diamine fluoride brushed on a decaying tooth. Studies have shown that the antimicrobial liquid can halt the progression of cavities and prevent them.CreditCaitlin OHara for The New York Times The upside the great one is you dont need to drill and you dont need an injection said Dr. Margherita Fontana a professor of cariology at the University of Michigan. Advertisement Silver diamine fluoride is already used in hundreds of dental offices. Medicaid patients in Oregon are receiving the treatment and at least dental schools have started teaching the next generation of pediatric dentists how to use it. Dr. Richard Niederman the chairman of the epidemiology and health promotion department at the New York University College of Dentistry said Being able to paint it on in seconds with no noise no drilling is better faster cheaper. I would encourage parents to ask for it he added. Its less trauma for the kid. The main downside is aesthetic Silver diamine fluoride blackens the brownish decay on a tooth. That may not matter on a back molar or a baby tooth that will fall out but some patients are likely to be deterred by the prospect of a dark spot on a visible tooth. Until more insurers cover it patients also have to cover the cost. Still its relatively inexpensive. Dr. Michelle Urschel an anesthesiologist was happy to pay to have Dr. Jeanette MacLean a pediatric dentist in Glendale Ariz. paint over a cavity that her son Knox had recently developed. Editors Picks A cavity that had to be drilled cost . The liquid was very affordable Dr. Urschel said. The noninvasive treatment may be ideal for the indigent nursing home residents and others who have trouble finding care. And many anxious dental patients want to dodge the drill. But the liquid may be especially useful for children. Nearly a quarter of to yearolds have cavities according to the Centers for Disease Control and Prevention httpwell.blogs.nytimes.comuntreateddentaldecayisfallingamongchildren. Some preschoolers with severe cavities must be treated in a hospital under general anesthesia http even though it may pose risks to the developing brain. S.D.F. gives us an opportunity to decrease the number of toddlers with cavities going to the O.R. said Dr. Arwa Owais an associate professor of pediatric dentistry at the University of Iowa httpsclinicaltrials.govctshowNCT. Dr. Laurence Hyacinthe a pediatric dentist in Harlem used silver diamine fluoride on eight uncooperative children whose parents wanted to delay a trip to the operating room. Dr. MacLean said People assume that parents will reject it because of poor aesthetics. But if it means preventing a child from having to be sedated or having their tooth drilled and filled there are many parents who choose S.D.F. she added. After Dr. MacLean treated Knox she gave him a sticker.CreditCaitlin OHara for The New York Times After Dr. MacLean treated Knox she gave him a sticker.CreditCaitlin OHara for The New York Times Alejandra Bujeiro was delighted that her yearold daughter Natalia didnt have to have two cavities filled in the back of her mouth. Instead Dr. Eyal Simchi https a pediatric dentist in Elmwood Park N.J. brushed silver diamine fluoride on the decay. Two front teeth however were drilled. Next time Ms. Bujeiro said shed opt for silver diamine fluoride. I would use it in baby teeth even if its in front she said. As for the discoloration You cant see it too much. Advertisement Silver diamine fluoride has another advantage over traditional treatment It kills the bacteria that cause decay. A second treatment applied six to months after the first markedly arrests cavities studies have shown. S.D.F. reduces the incidence of new caries and progression of current caries by about percent said Dr. Niederman who is updating an evidence review of silver diamine fluoride published in . Fillings by contrast do not cure an oral infection. Theres nothing that goes on in an operating room that treats the underlying problem said Dr. Peter Milgrom a professor of pediatric dentistry at the University of Washington who was instrumental in receiving F.D.A. clearance for silver diamine fluoride and has a financial stake in Advantage Arrest. Thats why some children must have dental treatment under anesthesia twice. Bacterial infections also cause acne but a dermatologist doesnt take a scalpel and cut off your pimples said Dr. Jason Hirsch a pediatric dentist in Royal Palm Beach Fla. Yet thats how dentistry has approached cavities. Dr. Hirsch has a Facebook page called SDF Action https where dentists can discuss individual cases. Knox getting a highfive from Dr. MacLean after being treated with silver diamine fluoride. The cost of the treatment . By comparison a filling would have run .CreditCaitlin OHara for The New York Times Knox getting a highfive from Dr. MacLean after being treated with silver diamine fluoride. The cost of the treatment . By comparison a filling would have run .CreditCaitlin OHara for The New York Times In January Oregon became the first state to reimburse Medicaid providers for treating cavities with silver diamine fluoride. Its a completely new paradigm that offers significant savings said Dr. Bruce W. Austin the dental director of the Oregon Health Authority http You need only a drop to treat five teeth and it comes out to pennies per tooth said Dr. Scott L. Tomar a University of Florida dentistry professor who treats some Medicaid patients. Toddlers in lowincome families sometimes have to wait a year for fillings in an operating room. The new alternative is a huge deal said Dr. Tomar the chairman of the oral health section https of the American Public Health Association. Advertisement Silver diamine fluoride also may help nursinghome residents who often experience severe cavities if their teeth arent routinely brushed httpwell.blogs.nytimes.cominnursinghomesanepidemicofpoordentalhygiene. Transporting and treating frail patients assuming they can afford to see a dentist can be difficult. But now some patients can be quickly treated where they live. Still silver diamine fluoride is no silver bullet. Patients with mouth sores or a silver allergy cant use it. Severe cavities huge holes that trap food and plaque still require fillings. At dental conferences Dr. Tomar and Dr. Fontana lecture about the treatment. They ask audiences if they are using it so far just a few hands go up."

"To the tantalizing delight of chocolate lovers everywhere a number of recent studies employing various methods have suggested that compounds in cocoa called flavanols could benefit cardiovascular health. Now a systematic review and metaanalysis of randomized controlled trials RCTs of cocoa consumption reveals some further pieces of supporting evidence. The metaanalysis in the Journal of Nutrition an assessment of the combined evidence from all RCTs focused on whether consumption of flavanolrich cocoa products was associated with improvements in specific circulating biomarkers of cardiometabolic health as compared to consuming placebos with negligible cocoa flavanol content. In all volunteers were involved in these trials. Our metaanalysis of RCTs characterizes how cocoa flavanols affect cardiometabolic biomarkers providing guidance in designing large definitive prevention trials against diabetes and cardiovascular disease in future work said corresponding author Dr. Simin Liu professor and director of the Center for Global Cardiometabolic Health at Brown University who worked with epidemiology graduate student and lead author Xiaochen Lin. We found that cocoa flavanol intake may reduce dyslipidemia elevated triglycerides insulin resistance and systemic inflammation which are all major subclinical risk factors for cardiometabolic diseases. Liu noted some limitations in the trials. All studies were small and of short duration not all of the biomarkers tracked in these studies changed for the better and none of the studies were designed to test directly whether cocoa flavanol consumption leads to reduced cases of heart attacks or type diabetes. But taking into account some of these heterogeneities across studies the teams metaanalysis summarizing data from trials found potential beneficial effects of flavanolrich cocoa on cardiometabolic health. There were smalltomodest but statistically significant improvements among those who ate flavanolrich cocoa product vs. those who did not. The greatest effects were seen among trial volunteers who ate between and milligrams of flavanols a day based on their cocoa consumption. They saw significant declines in blood glucose and insulin as well as another indicator of insulin resistance called HOMAIR. They also saw an increase in HDL or good cholesterol. Those consuming higher doses saw some of the insulin resistance benefits and a drop in triglycerides but not a significant increase in HDL. Those with lower doses of flavanols only saw a significant HDL benefit. In general Lin said where there were benefits they were evident for both women and men and didnt depend on what physical form the flavanolrich cocoa product was consumed in dark chocolate vs. a beverage for example. The treatment groups of the trials included in our metaanalysis are primarily dark chocolate a few were using cocoa powderbased beverages Lin said. Therefore the findings from the current study apparently shouldnt be generalized to different sorts of chocolate candies or white chocolates of which the content of sugarfood additives could be substantially higher than that of the dark chocolate. The authors therefore concluded Our study highlights the urgent need for large longterm RCTs that improve our understanding of how the shortterm benefits of cocoa flavanol intake on cardiometabolic biomarkers may be translated into clinical outcomes. In addition to Lin and Liu the studys other authors are Isabel Zhang Alina Li from Brown University JoAnn Manson Howard Sesso and Lu Wang from Brigham and Womens Hospital. The authors acknowledge funding from the National Institutes of Health including the National Heart Lung and Blood Institute the American Heart Association and Pfizer. Coauthors at Brigham and Womens also noted receiving funding from Mars Symbioscience a research segment of Mars Inc. which makes chocolate products."

"Today marks a significant step forward in the prevention and treatment of leprosy as the Infectious Disease Research Institute IDRI and American Leprosy Missions announce the start of a Phase clinical trial in humans for a promising leprosy vaccine candidate the first vaccine developed specifically for leprosy. Characterized by the World Health Organization as a neglected tropical disease leprosy also known as Hansens disease is one of the most ancient diseases known to humankind and is caused by the bacteria Mycobacterium leprae. Nearly a quarter of a million people worldwide have leprosy which causes disfiguration of the skin and mucous membranes as well as progressive and incurable nerve damage. While drug therapy exists for leprosy it must be taken for many months has many side effects and often is given too late to reverse the permanent damage caused by the bacterial infection. A viable vaccine to prevent andor treat leprosy is the next step in the effort to bring this disease to an end. Scientists at IDRI along with national and international collaborators including the National Hansens Disease Program and the National Institute of Allergy and Infectious Diseases NIAID part of the National Institutes of Health with financial support from American Leprosy Missions have developed a promising leprosy vaccine candidate designed to help treat leprosy and prevent exposed individuals from developing disease and the resulting disabilities. Based on data generated in preclinical studies the vaccine candidate called LepVax has progressed to Phase I clinical testing in the United States the first stage of safety testing in human volunteers. The clinical trial is focused on safety as well as evaluating the immune response to the vaccine. While previous attempts have used vaccines primarily developed for other diseases this is the first totally defined vaccine candidate developed specifically for leprosy using the latest technologies and offering no less than those exposed to leprosy deserve said Steven Reed Ph.D. IDRI President CEO Founder. The leprosy vaccine program at IDRI has benefited greatly from what weve learned in the development of tuberculosis vaccine candidates over the past two decades. Although the bacteria that cause tuberculosis and leprosy are related leprosy vaccine development posed great challenges. This vaccine represents a unique accomplishment requiring the most advanced technologies in molecular biology and immunology and American Leprosy Missions has been there from the beginning. IDRI scientists have also developed two vaccine candidates for tuberculosis both in clinical stages of development. We are thrilled that after years and an investment of over . million made possible by our faithful donors and partners a leprosyspecific vaccine is beginning a Phase I clinical trial says Bill Simmons President and CEO of American Leprosy Missions. We believe this may be the most exciting breakthrough in leprosy treatment since multidrug therapy the current treatment for leprosy was launched in the s. We look forward to this vaccine improving the health outcomes of people diagnosed with leprosy. And it may be that this vaccine can lead to interruption of the transmission of leprosy all together. What a tremendous legacy this would leave for millions of people worldwide. The vaccine was developed through significant efforts in screening and identifying M. leprae proteins that trigger an effective immune response. IDRI scientists then produced a fusion of four leprosy proteins which is combined with IDRIs proprietary immunestimulating adjuvant GLASE. With recent developments in vaccine technology IDRI scientists can now induce protective responses even after infection meaning it could be possible to prevent disease development in people already infected with the leprosy bacterium. This generation of a vaccine to prevent and possibly treat leprosy is the result of years of research. The development has been complicated by the fact that the organism that causes leprosy cannot be grown in culture in the laboratory Reed explained. This is a unique example of a vaccine produced by totally synthetic methods. Reed added that without the foresight and support of American Leprosy Missions there would be no leprosy vaccine candidate. The vision and support of American Leprosy Missions has been tremendous as weve worked with them throughout the years moving from our work in developing a leprosy diagnostic to our current focus on a successful leprosy vaccine he said. The progress weve had to date would not have been possible without American Leprosy Missions financial support and guidance. Early results from the Phase I study should be available in and the partners are currently exploring mechanisms to advance the vaccine through laterphase clinical trials should results from the Phase I study clinical trial NCT support further evaluation. The vaccine candidate will serve as part of an overall strategy to end leprosy which will require detection prevention and treatment. IDRI had developed technology to enable a rapid affordable pointofcare diagnostic test which was funded by NIAID grant numbers RAIA and RAI. In addition to IDRI and American Leprosy Missions a variety of partners are taking part in efforts to eliminate leprosy including Novartis and the Novartis Foundation. Reed along with scientists from a variety of scientific organizations recently published Innovative tools and approaches to end the transmission of Mycobacterium leprae in The Lancet Infectious Diseases outlining what is needed to achieve this goal. Together with scientific government and NGO partners the Novartis Foundation develops and implements strategies to help interrupt leprosy transmission while Novartis donates the treatment for leprosy free of charge. About IDRI As a nonprofit global health organization IDRI Infectious Disease Research Institute takes a comprehensive approach to combat infectious diseases combining the highquality science of a research organization with the product development capabilities of a biotech company to create new diagnostics drugs and vaccines. Founded in IDRI has employees headquartered in Seattle with nearly partnerscollaborators around the world. For more information visit http About American Leprosy Missions American Leprosy Missions based in Greenville South Carolina is the oldest and largest Christian organization in the United States dedicated to curing and caring for people affected by leprosy and related diseases. It funds projects and partners in countries across Africa Asia and the Americas. During its more than year history American Leprosy Missions has provided holistic care to four million people around the world including medical treatment and training Christian outreach community development and vaccine research. For more information visit http SOURCE Infectious Disease Research Institute Related Links http"

"A minimally invasive implant procedure is highly effective in reducing pain and disability for patients with sacroiliac joint SIJ dysfunction reports a clinical trial in the November issue of Neurosurgery http official journal of the Congress of Neurological Surgeons http published by Wolters Kluwer http The randomized controlled trial shows superior outcomes in patients undergoing minimally invasive sacroiliac joint SIJ fusion using triangular titanium implants compared to nonsurgical management according to the new research overseen by Dr. Daniel J. Cher of SIBONE Inc. in San Jose Calif. The study was sponsored by SIBONE manufacturer of the SIJ implants. Good Pain Relief and Other Outcomes with Implant Treatment for SIJ Dysfunction The study included patients with low back pain caused by confirmed SIJ dysfunction treated at US spine surgery clinics. The SIJ connects the central sacrum and lateral ilium bones of the pelvis. SIJ disruption or osteoarthritis is a common pain condition estimated to cause to percent of cases of chronic low back pain. Trial subjects had severe SIJ pain with an average pain score of on a topoint scale. Average pain duration was longer than six years and about twothirds of subjects were taking opioid narcotic medications. Many had previously received many nonsurgical SIJ treatments and many had a history of prior spinal surgery. Twothirds of subjects were randomly assigned to undergo minimally invasive SIJ fusion. In this procedure triangular titanium implants were placed through a small incision to stabilize and fuse the SIJ. Procedures were unilateral in most cases but some subjects underwent bilateral treatment. The remaining subjects received nonsurgical treatments such as physical therapy steroid injections andor radiofrequency ablation of sacral nerve root lateral branches. Pain and other outcomes were compared at baseline and at and months. At months subjects in the nonsurgical group had the option to cross over to the implant procedure. Based on reduction in pain and absence of complications at months treatment was rated successful in percent of subjects assigned to the SIJ implant procedure compared to percent with nonsurgical treatment. Average pain score decreased to in the surgical group versus in the nonsurgical group. Seventythree percent of subjects undergoing the implant procedure had clinically significant reduction in disability scores compared to just percent in the nonsurgical group. After one year subjects assigned to SIJ fusion still had significant reductions in pain and disability as well as improved quality of life. Thirtyfive subjects from the nonsurgical group opted to undergo the implant procedure with similarly good results. There were only a few complications related to the SIJ implant procedure. Sacroiliac joint dysfunction is a common cause of disabling pain in the lower back buttocks or groin. Many different surgical and nonsurgical treatments have been used for this condition despite a lack of highquality evidence for their effectiveness. The minimally invasive SIJ implant approach evaluated in this trial has been cleared by the US Food and Drug Administration. The study is the first randomized controlled trial to directly compare the results of surgical and nonsurgical treatment for SIJ dysfunction. The results show clinically and statistically important improvements in clinical outcomes for patients undergoing the SIJ implant procedure according to Dr. Cher and colleagues with profound differences between the surgical and nonsurgical groups. The implant procedure is minimally invasive has few complications and produces significant and lasting improvements in pain disability and quality of life. The authors note some important limitations of the trial including the lack of longterm outcomes in the nonsurgical group due to the high crossover rate. They plan further analyses including twoyear followup CT scans and a costeffectiveness comparison of SIJ fusion versus nonsurgical treatment. Click here to read Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction Month Outcomes. httpjournals.lww.comneurosurgeryFulltextRandomized_Controlled_Trial_of_Minimally_Invasive..aspx Article Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction Month Outcomes doi .NEU. About Neurosurgery Neurosurgery http the Official Journal of the Congress of Neurological Surgeons http is your most complete window to the contemporary field of neurosurgery. Members of the Congress and nonmember subscribers receive pages per year packed with the very latest science technology and medicine not to mention fulltext online access to the worlds most complete uptotheminute neurosurgery resource. For professionals aware of the rapid pace of developments in the field Neurosurgery is nothing short of indispensable. About Wolters Kluwer Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal business tax accounting finance audit risk compliance and healthcare rely on Wolters Kluwers market leading informationenabled tools and software solutions to manage their business efficiently deliver results to their clients and succeed in an ever more dynamic world. Wolters Kluwer reported annual revenues of . billion. The group serves customers in over countries and employs over people worldwide. The company is headquartered in Alphen aan den Rijn the Netherlands. Wolters Kluwer shares are listed on NYSE Euronext Amsterdam WKL and are included in the AEX and Euronext indices. Wolters Kluwer has a sponsored Level American Depositary Receipt program. The ADRs are traded on the overthecounter market in the U.S. WTKWY."

"A new study conducted at the University of California Davis found that two cups of mangos a day had beneficial effects on systolic blood pressure among healthy postmenopausal women. Mango consumption helped relax blood vessels in as little as two hours after intake. Additionally some of the participants showed favorable changes in the production of breath methane an indication of the potential influence on gut fermentation. This is the first study to demonstrate positive vascular effects of mango intake in humans said lead researcher Robert Hackman with the UC Davis Department of Nutrition. He presented the findings today at the American Society for Nutrition annual meeting Nutrition httpsmeeting.nutrition.org in Boston. Our results build on previous animal and cell studies that point to the potential benefits of mangos to promote health. Mangos contain a mix of polyphenols including mangiferin quercetin gallotannins and gallic acid that have been the focus of previous investigations exploring the potential healthprotecting properties of mangos. Li and colleagues believe the concentration of these bioactive compounds in mangos may be responsible for the favorable response. Methodology and Results In the study healthy postmenopausal women consumed grams cups of mango daily for days. The honey mango also referred to as Ataulfo was chosen for the study due to the high concentration of polyphenols in this popular variety. Following the days of mango consumption the study participants resumed their normal daily diet but eliminated mango intake for days. Measurements were taken during each visit including heart rate and blood pressure blood samples and breath samples which are increasingly used in nutrition studies to evaluate gut health status. At the start of the study blood pressure was not significantly different between the study visits. Yet once mango was consumed systolic blood pressure was significantly lower two hours after mango intake compared to baseline values. Pulse pressure was also significantly reduced two hours after eating mango. Systolic blood pressure the upper number in blood pressure readings indicates how much pressure your blood is exerting against your artery walls when the heart beats. Pulse pressure is the difference between systolic and diastolic bottom number in blood pressure readings. Pulse pressure can be used as an indicator of heart health. Breath levels of hydrogen and methane were measured which reflect the amount of these gases that were produced due to microbial fermentation in the intestinal tract. Some study participants produced hydrogen some produced methane and others produced both gases or neither of them. Six of the participants produced methane and of these six three shown significant reduction after consuming mango which is considered a favorable outcome for gut health. The researchers conclude that mangos may be a hearthealthy fruit that may help play a role in reducing the risk of cardiovascular disease. Longerterm studies involving other population groups are warranted. The research was supported in part by funds from the National Mango Board and USDA. Source Li X Vanness MA Holt RR Horn WF Keim NL Keen CL Hackman RM. Effects of two weeks of daily mango fruit intake on vascular function blood pressure and gut fermentation in healthy adult women. The FASEB Journal June ."

"The use of proton radiotherapy to treat the most common malignant brain tumor in children is as effective as standard photon xray radiation therapy while causing fewer longterm side effects such as hearing loss and cognitive disorders according to a study receiving online publication in Lancet Oncology. The paper from a team led by Massachusetts General Hospital MGH investigators describes patient outcomes an average of seven years after proton therapy for medulloblastoma a fastgrowing tumor that develops in the cerebellum at the base of the brain. Proton radiotherapy is still not widely available in the U.S. or around the world but it is increasingly recognized for its potential to reduce the side effects of treatment particularly in the pediatric population says Torunn Yock MD MCh MGH Department of Radiation Oncology lead and corresponding author of the report. At experienced centers proton therapy has a proven track record of treatment success and safety. In contrast to photon radiotherapy in which a dose of radiation is delivered all along the xray beam as it passes through a patients body in proton therapy the dose is precisely focused on the target area with little or no dose delivered to normal tissues in front of or behind the tumor. This feature has made proton therapy particularly attractive to treat tumors in or near the brain or eyes areas where the protection of nearby healthy tissues is particularly critical. While medulloblastoma can often be successfully treated with a combination of surgery chemotherapy and radiotherapy because of its location within the brain longterm side effects are common. These can include hearing loss which can be particularly problematic in young children problems with learning and memory and neuroendocrine disorders caused by irradiation of the pituitary gland and hypothalamus. Also commonly seen are problems affecting the heart lungs thyroid spine and reproductive organs all of which tend to be more serious in children treated at younger ages. While proton therapy may appear to be ideal for reducing these adverse effects no previous study had prospectively examined the longterm results of children treated for medulloblastoma with proton therapy. To investigate their hypothesis that proton therapy would reduce the incidence and severity of side effects without loss of treatment effectiveness the researchers enrolled children and adolescents ages to with an average age of around who received proton therapy for medulloblastoma at the MGH from to . All had previous surgery to remove as much of the tumor as possible and all received chemotherapy before during or after proton therapy. Study participants were tested for hearing a variety of cognitive functions levels of important hormones and height and weight at the outset of the study and at several followup visits for up to eight years. Of patients who enrolled died from their tumor during the study period and one from a traumatic brain injury. Significant hearing loss was seen in percent of patients three years after treatment and in percent at five years which compares with around percent reported in studies using photon radiotherapy. The cognitive effects of proton therapy primarily affecting verbal comprehension and processing speed were also less serious than what has been reported with photon radiotherapy and those effects were primarily seen in children who were under the age of when treated. The neuroendocrine effects of proton therapy deficits in any hormone level were seen in percent of participants seven years after treatment were similar to what has been reported with photon therapy. However no cardiac pulmonary gastrointestinal seizure or secondary tumor effects all of which have been reported in photon therapy studies were seen in the current studys participants. Survival rates and the incidence and type of tumor recurrence all were similar to what has been reported for photon radiotherapy. Our results indicate that proton therapy maintains excellent cure rates in pediatric medulloblastoma while reducing longterm side effects particularly in hearing and neurocognitive function and eliminating cardiac pulmonary gastrointestinal and reproductive effects says Yock who is an associate professor of Radiation Oncology at Harvard Medical School. While we are currently investigating quality of life differences between proton and photon treatment I truly believe that particularly for the youngest children the ability to offer them proton therapy can make a big difference in their lives. Nancy J. Tarbell MD MGH Radiation Oncology is senior author of the Lancet Oncology report. Additional coauthors are Elizabeth Weyman Bree Eaton MD and Shannon M MacDonald MD MGH Radiation Oncology Beow Yeap ScD MGH Department of Medicine David Ebb MD Beverly Lavally RN and Mary Huang MD MGH Pediatric Oncology Nicole Sherry MD MGH Pediatric Endocrinology Robin Jones MD MGH Pediatric Neurology Margaret Pulsifer PhD MGH Psychiatry Annah Abrams MD MGH Child Psychiatary and Karen Marcus MD Brigham and Womens Hospital Radiation Oncology. The study was funded in part by National Cancer Institute grant P CA. Massachusetts General Hospital http founded in is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospitalbased research program in the United States with an annual research budget of more than million and major research centers in AIDS cardiovascular research cancer computational and integrative biology cutaneous biology human genetics medical imaging neurodegenerative disorders regenerative medicine reproductive biology systems biology transplantation biology and photomedicine. In July MGH returned into the number one spot on the U.S. News World Report list of Americas Best Hospitals."

"Up to sixteen weeks of intermittent fasting without otherwise having to count calories helps fight obesity and other metabolic disorders. Such fasting already shows benefits after only six weeks. This is according to a study by KyoungHan Kim and Yun Hye Kim in the journal Cell Research which is published by Springer Nature. Intermittent fasting in mice helped to kickstart the animals metabolism and to burn fat by generating body heat. The research team was led by HoonKi Sung of The Hospital for Sick Children in Ontario Canada. Research has shown that our unhealthy eating habits and sedentary lifestyles are playing a major role in the development of lifestylerelated metabolic diseases such as diabetes heart disease and obesity. For this reason dietary interventions like intermittent fasting are gaining popularity to treat conditions such as obesity. The research team in this study wanted to better understand the reactions that interventions such as fasting trigger on a molecular level in the body. They exposed groups of mice to sixteen weeks of intermittent fasting. The recurring regimen saw the animals being fed for two days followed by one day without anything to eat. Their calorie intake was not adjusted otherwise. Four months later the mice in the fasting group weighed less than those in the control group who continued to eat the same volume of food. The lower body weight of the mice in the fasting group was not the only effect. The fasting regime helped lower fat buildup in the white fat by increasing the brownlike fat involved in burning energy and producing body heat of mice on the high fat diet. Their glucose and insulin systems also remained more stable. In a further experiment similar benefits were already seen after only six weeks of intermittent fasting. Through an analysis into the underlying biology involved the researchers found that such intermittent fasting tempers an immune reaction in fat cells. There are changes in certain gene pathways involved in the immune system and the bodys reaction to inflammation. A type of white blood cell known to play a role in fighting inflammation is triggered. Known as antiinflammatory macrophages these cells stimulate the fat cells to burn stored fats or lipids by generating heat. This happens during periods of intermittent fasting because there is an increase in vascular growth factor VEGF that help form blood vessels and activate antiinflammatory macrophage. Intermittent fasting without a reduction in calorie intake can be a preventative and therapeutic approach against obesity and metabolic disorders says KyoungHan Kim. Strikingly these fastingstimulated changes in the growth of vascular cells and subsequent immune alterations occur even after a single cycle of hour fasting and are completely reversed when mice start eating again adds Yun Hye Kim. Reference Kim KH. et al . Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGFmediated alternative activation of macrophage Cell Research DOI .cr.. Note KyoungHan Kims current affiliation is the University of Ottawa Heart Institute Canada"

"Allergan plc NYSE AGN httpstudio.financialcontent.comprnewsPageQuoteTickerAGN today announced that the CoolSculpting treatment is the first and only nonsurgical fat reduction technology to be FDAcleared for improved appearance of lax tissue in conjunction with submental fat or double chin treatments. CoolSculpting for the double chin is already clinically proven to reduce fat up to percent in the treated area after one treatment. Allergan is committed to advancing innovation for CoolSculpting to meet the needs of patients seeking noninvasive aesthetic treatments said David Nicholson Chief Research and Development Officer at Allergan. A American Society for Dermatologic Surgery ASDS survey revealed that percent of patients are bothered by excess fat under the chin. We are pleased this patient concern can successfully be addressed by CoolSculpting through a noninvasive approach and furthermore improve the appearance of lax tissue in the treated area. An week clinical study of CoolSculpting in submental fat treatment found that percent of patients showed improved appearance of lax tissue and percent of patients reported their chin looked more toned following treatment. In my own patients I have noticed the improved appearance of lax tissue when using the CoolMini applicator for the CoolSculpting system to treat the submental area said Jeffrey S. Dover MD FRCPC CoDirector of SkinCare Physicians of Chestnut Hill Mass. It is great to see the company invest to validate this and secure the FDA clearance. CoolSculpting is available through a network of CoolSculpting Centers worldwide. Dermatologists plastic surgeons and aesthetic specialists that offer CoolSculpting can be found at http References Data On File Allergan Inc. Safety and Efficacy of Cryolipolysis for NonInvasive Reduction of Submental Fat ASDS Consumer Survey Data on File Allergan Inc. Study to Evaluate NonInvasive Subcutaneous Fat Reduction in the Submental Area Using Cryolipolysis About the CoolSculpting Treatment CoolSculpting is a nonsurgical clinically proven treatment that selectively reduces unwanted fat using a patented cooling technology. Cleared by the FDA CoolSculpting works by gently cooling targeted fat cells in the body to induce a natural controlled elimination of fat cells without affecting surrounding tissue and the treated fat cells are gone for good. Millions of CoolSculpting treatments have been performed in more than countries. CoolSculpting is available through a network of CoolSculpting Centers worldwide. Dermatologists plastic surgeons and aesthetic specialists that offer CoolSculpting can be found at https_fG_GGkiRxEaLmhqmanWVMeVXRrTcVRxzskvI_VlsLjWXqMgLlzXlWI. In the U.S. the CoolSculpting procedure is FDAcleared for the treatment of visible fat bulges in the submental area thigh abdomen and flank along with bra fat back fat underneath the buttocks also known as banana roll and upper arm. It is also FDAcleared to affect the appearance of lax tissue with submental area treatments. During the procedure you may experience sensations of pulling tugging mild pinching intense cold tingling stinging aching and cramping at the treatment site. These sensations subside as the area becomes numb. Following the procedure typical side effects include temporary redness swelling blanching bruising firmness tingling stinging tenderness cramping aching itching or skin sensitivity and sensation of fullness in the back of the throat after submental area treatment. Rare side effects may also occur. The CoolSculpting procedure is not for everyone. You should not have the CoolSculpting procedure if you suffer from cryoglobulinemia cold agglutinin disease or paroxysmal cold hemoglobinuria. The CoolSculpting procedure is not a treatment for obesity. Please see full Important Safety Information http_Patient_Safety_Info_proof.pdf for additional information. Be sure to follow CoolSculpting on Facebook https Twitter https Pinterest https_syBwQunMraQE_fyaluRaYxVezzwZGYWSciNADysQauWYhgaYkG_sIwp_TzIAMmkVFxJreesSBlqtBs and YouTube https About Allergan plc Allergan plc NYSE AGN httpstudio.financialcontent.comprnewsPageQuoteTickerAGN headquartered in Dublin Ireland is a bold global pharmaceutical company and a leader in a new industry model Growth Pharma. Allergan is focused on developing manufacturing and commercializing branded pharmaceutical device biologic surgical and regenerative medicine products for patients around the world. Allergan markets a portfolio of leading brands and bestinclass products for the central nervous system eye care medical aesthetics and dermatology gastroenterology womens health urology and antiinfective therapeutic categories. Allergan is an industry leader in Open Science a model of research and development which defines our approach to identifying and developing gamechanging ideas and innovation for better patient care. With this approach Allergan has built one of the broadest development pipelines in the pharmaceutical industry with midtolate stage pipeline programs currently in development. Allergans success is powered by our more than global colleagues commitment to being Bold for Life. Together we build bridges power ideas act fast and drive results for our customers and patients around the world by always doing what is right. With commercial operations in approximately countries Allergan is committed to working with physicians healthcare providers and patients to deliver innovative and meaningful treatments that help people around the world live longer healthier lives every day. For more information visit Allergans website at http ForwardLooking Statement Statements contained in this press release that refer to future events or other nonhistorical facts are forwardlooking statements that reflect Allergans current perspective on existing trends and information as of the date of this release. Actual results may differ materially from Allergans current expectations depending upon a number of factors affecting Allergans business. These factors include among others the difficulty of predicting the timing or outcome of FDA approvals or actions if any the impact of competitive products and pricing market acceptance of and continued demand for Allergans products the impact of uncertainty around timing of generic entry related to key products including RESTASIS on our financial results uncertainty associated with financial projections projected cost reductions projected synergies restructurings increased costs and adverse tax consequences difficulties or delays in manufacturing and other risks and uncertainties detailed in Allergans periodic public filings with the Securities and Exchange Commission including but not limited to Allergans Annual Report on Form K for the year ended December and Allergans Quarterly Report on Form Q for the period ended September . Except as expressly required by law Allergan disclaims any intent or obligation to update these forwardlooking statements. ICA CONTACTS Allergan Investors Daphne Karydas Media Mark Marmur Marlo Rodman SOURCE Allergan plc Related Links http"

"Women who take hormone replacement therapy HRT to ease menopause symptoms like hot flashes and night sweats may be no more likely to die prematurely than women who dont take hormones a new study suggests. Many women have been reluctant to use hormones for menopause symptoms since when the federally funded Womens Health Initiative WHI study linked the treatments containing manmade versions of the female hormones estrogen and progestin to an increased risk of breast cancer heart attacks and strokes. The current study however looked at longerterm data from the WHI study and found no increased risk of death from all causes or from cancer or cardiovascular issues in particular associated with hormone use. Women seeking treatment for distressing hot flashes night sweats or other menopausal symptoms may find the mortality results reassuring said lead study author Dr. JoAnn Manson of Brigham and Womens Hospital and Harvard Medical School in Boston. Women go through menopause when they stop menstruating typically between ages and . As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterward women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia. For the study researchers looked at data on women ages to who joined two WHI trials between and and were followed through . One trial tested estrogen alone against a placebo or dummy pill while the other trial tested estrogen taken in combination with progestin. Women were years old on average when they joined the trials and had already gone through menopause. They took hormones or a placebo for five to seven years and were followed for a total of years altogether. During the study period women died. Death rates were similar at about percent among women who took hormones and women who didnt researchers report in JAMA. Younger women in the study appeared to have better survival odds with HRT. Over the initial five to seven years when women were randomly assigned to take hormones or a placebo death rates were about percent lower among women aged to when they took HRT than when they didnt. For women who started hormones in their s or s however there wasnt a meaningful difference in death rates according to whether they got the treatment or a placebo during the initial years of the study. After years including both the treatment period and a decade or more of followup womens age when they joined the study no longer appeared to significantly influence death rates. One limitation of the study is that the WHI didnt look at different dosages of hormone pills and the findings may be different for other dosages or different types of therapy such as gels or creams or skin patches. Still the current study should ease concerns raised by earlier results from the WHI trials that an increased risk of breast cancer or heart attacks might translate into higher longterm mortality rates said Dr. Melissa McNeil author of an accompanying editorial and a womens health researcher at the University of Pittsburgh. Taking a combination of estrogen and progestin is associated with an increased risk of breast cancer but advances in screening and treatment since the WHI started now mean these tumors are unlikely to be fatal McNeil said by email. With additional years of followup it also appears that the increased heart attack risk associated with HRT in the initial results from the WHI trials is limited to older women McNeil added. Hormone therapy has been in and out of favor first it was good for all menopausal women then it was dangerous for all women McNeil said. The takehome message now is that for the right patient hormone therapy is safe and effective. SOURCE bit.lyjkqUFE httpbit.lyjkqUFE and bit.lyjopiX httpbit.lyjopiX JAMA online September . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Lovers of Indian food give yourselves a second helping Daily consumption of a certain form of curcumin the substance that gives Indian curry its bright color improved memory and mood in people with mild agerelated memory loss according to the results of a study conducted by UCLA researchers. The research httpsdoi.org.j.jagp... published online Jan. in the American Journal of Geriatric Psychiatry examined the effects of an easily absorbed curcumin supplement on memory performance in people without dementia as well as curcumins potential impact on the microscopic plaques and tangles in the brains of people with Alzheimers disease. Found in turmeric curcumin has previously been shown to have antiinflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India where curcumin is a dietary staple have a lower prevalence of Alzheimers disease and better cognitive performance. Exactly how curcumin exerts its effects is not certain but it may be due to its ability to reduce brain inammation which has been linked to both Alzheimers disease and major depression said Dr. Gary Small director of geriatric psychiatry at UCLAs Longevity Center and of the geriatric psychiatry division at the Semel Institute for Neuroscience and Human Behavior at UCLA https and the studys first author. The doubleblind placebocontrolled study involved adults between the ages of and years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or milligrams of curcumin twice daily for months. All subjects received standardized cognitive assessments at the start of the study and at sixmonth intervals and monitoring of curcumin levels in their blood at the start of the study and after months. Thirty of the volunteers underwent positron emission tomography or PET scans to determine the levels of amyloid and tau in their brains at the start of the study and after months. The people who took curcumin experienced significant improvements in their memory and attention abilities while the subjects who received placebo did not Small said. In memory tests the people taking curcumin improved by percent over the months. Those taking curcumin also had mild improvements in mood and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos. The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions. Four people taking curcumin and two taking placebos experienced mild side effects such as abdominal pain and nausea. The researchers plan to conduct a followup study with a larger number of people. That study will include some people with mild depression so the scientists can explore whether curcumin also has antidepressant effects. The larger sample also would allow them to analyze whether curcumins memoryenhancing effects vary according to peoples genetic risk for Alzheimers their age or the extent of their cognitive problems. These results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years said Small UCLAs ParlowSolomon Professor on Aging. The papers authors in addition to Small are Prabha Siddarth Dr. Zhaoping Li Karen Miller Linda Ercoli Natacha Emerson Jacqueline Martinez KoonPong Wong Jie Liu Dr. David Merrill Dr. Stephen Chen Susanne Henning Nagichettiar Satyamurthy SungCheng Huang Dr. David Heber and Jorge Barrio all of UCLA. The study was supported by the Ahmanson Foundation the Marshall and Margherite McComb Foundation the McMahan Foundation Bob and Marion Wilson the Fran and Ray Stark Foundation Fund for Alzheimers Disease Research the U.S. Department of Energy and the National Institutes of Health. Theravalues Corp. provided the curcumin and placebos for the trial as well as funds for laboratory testing and for Smalls travel to present preliminary findings at the Alzheimers Association International Conference. SEE ORIGINAL STUDY http"

"Over the past few decades as breast cancer has increasingly been treated as a systemic disease the number of surgeries performed on the most serious cases has plummeted. With better drugs and radiation techniques available the proportion of women with Stage breast cancer who had surgery dropped from . percent in to . percent in according to a study published Wednesday in the journal JAMA Surgery. httphttparchsurg.jamanetwork.comarticle.aspxarticleid But the study raises an intriguing question about that approach. It shows that women who had surgery survived longer than those who didnt a median of months vs. months. When the researchers examined a small subset of the group those who survived years they found that . percent had chosen to have surgery while . percent had not. Maybe we need to revisit this question of surgery said Mary C. Schroeder an assistant professor in the College of Pharmacy at the University of Iowa and one of the authors of the study. It may not be right for all women but it may be better for some women than it was in . He had a .pound tumor and months to live. Heres how he survived https_story.html Previous research has reached the same conclusion but a significant problem with this study and others like it is that they rely on retrospective data looking back over any number of years said Michael S. Sabel the chief of surgical oncology at the University of Michigan who was not involved in the newly published study. In retrospective research its impossible to filter out the countless reasons that a woman and her doctor might have made the decision to treat the cancer with or without surgery leaving the conclusions unreliable for clinical decisionmaking he said. Its premature to suggest and its a difficult conversation to have with patients that removing the breast will help them live longer in the face of Stage disease Sabel said. Two small prospective studies have suggested no survival difference among women with Stage breast cancer who have surgery and those who dont he said. A large randomized prospective study currently being conducted by the Eastern Clinical Oncology Group httpecogacrin.org should produce the most reliable data on the subject to date he said. In a Stage case cancer cells have left the breast metastizing to bones or other organs which presents a more dire and immediate threat to a womans survival than the presence of the original tumor. Still there may be reasons to remove the cancer in the breast. Some evidence suggests that it may be influencing the womans immunological response to her cancer. Or it could be continuously seeding the spread of cancer to other parts of the body. In their study Schroeder Alexandra Thomas a professor at Iowas Carver College of Medicine and others looked at women from to who had Stage breast cancer at the time of their original diagnosis and did not receive radiation as part of their first course of therapy. Their median age was . Cancer trials are changing. That could mean faster access to better drugs https_story.html The researchers found that median survival for all of the women improved from to months as more sophisticated treatments and better imaging techniques developed over that time. As other research has shown African American women were overrepresented among women who have Stage breast cancer at the time they are first diagnosed. In interviews Schroeder and Thomas stressed that each decision about whether to have surgery is based on many factors that only a woman and her doctors can assess in particular how far the cancer has spread and how sick she is. But with better therapies to control the cancer systemically and improved imaging that finds eversmaller deposits of cancer in other parts of the body it may be time to see whether surgery also can help increase the length of survival times they said. Aggressive local therapy may benefit select women such as those with an already established potential for durable remission they wrote in their paper. That would include younger women whose cancers have not spread in great volume to other organs and who have certain kinds of cancers that respond better to drugs Lisa Newman medical director of the Henry Ford Health Systems International Center for the Study of Breast Cancer Subtypes said in an email. Newman was not involved in the study. Theoretically...patients with metastatic breast cancer might benefit from surgery to remove the cancerous breast tumor in combination with medical therapies as a more complete reduction of their total body cancer burden she added."

"New research published in Lancet Neurology and reported by CNN has found using a green tea extract decaffeinated in combination with cognitive training improves some measures of cognition and behavior in subjects with Down syndrome. Eightyseven volunteers aged to with Down syndrome were enrolled in the phase randomized controlled trial. The study was conducted at the IMIMHospital del Mar Medical Research Institute in Barcelona Spain. Participants were randomly assigned to take the decaffeinated green tea extract or placebo for one year. All subjects also underwent cognitive training during the month trial. After one year of treatment functional brain scans fMRI showed that epigallocatechingallate EGCGtreated subjects had improved neuronal connectivity in certain brain regions. Participants who took the green tea extract also scored significantly better on assessments of visual recognition memory inhibitory control and adaptive behavior compared with those who took the placebo. Its an important trial says Dr. Steven Hirsh director of clinical research for Life Extension in Fort Lauderdale Fla. The findings are very noteworthy and support further study in randomized controlled trials with larger sample sizes and durations. It is very encouraging that this catechin EGCG from green tea extract has the potential to benefit people with Down syndrome. Down syndrome is a genetic condition that affects about Americans. Individuals with Down syndrome have an extra full or partial copy of chromosome . The team of researchers led by Dr. Rafael de la Torre program director of IMIM Hospital del Mar Medical Research Institute and study coprincipal investigator and Dr. Mara Dierssen group leader at Center for Genomic Regulation Barcelona Spain and study coprincipal investigator proposed that EGCG might have conferred these benefits by inhibiting an enzyme called DYRKA which has been implicated in Down syndrome and neurodegenerative conditions including Alzheimer disease. The level of DYRKApositive cells is elevated in certain regions of Alzheimer disease patients brains and is roughly fold higher in the frontal cortex compared to normal brains. DYRKA is implicated in the formation of neurofibrillary tangles via tau hyperphosphorylation and amyloid plaques both of which are features of Alzheimer disease. Tea catechins may also modulate the damaging effects of amyloidbeta. Several animal studies have found that EGCG and related compounds from tea suppress amyloidbetainduced cognitive dysfunction and neurotoxicity. Other possible mechanisms by which EGCG may influence cognition include epigenetic regulation restoration of mitochondrial function and antioxidative functions. In an earlier pilot study supported by Life Extension Drs. de la Torre and Dierssens team showed that three months of EGCG treatment improved symptoms in individuals with Down syndrome and in mice with a Downsyndromelike condition characterized by overexpression of DYRKA. We are excited that the benefits observed in the early pilot and preclinical research extended to this larger trial says Luke G. Huber ND MBA vice president of product innovation and scientific development at Life Extension. This new research adds to the growing body of evidence that suggests compounds in green tea such as EGCG may support cognitive health. In acknowledging the novelty of their findings and calling for more research the Spanish research team noted that this study is the first wellpowered trial that shows improvement in adaptive behavior functional academics and brainrelated changes in young adults with Downs syndrome. However more research is needed to clarify the nature of the beneficial association between the EGCG and cognitive training intervention ie synergistic or additive. References . de la Torre R de Sola S Hernandez G et al. Safety and efficacy of cognitive training plus epigallocatechingallate in young adults with Downs syndrome TESDAD a doubleblind randomised placebocontrolled phase trial. The Lancet Neurology. . . Senthilingam M. Cable News Network CNN U. S. Edition online. Can green tea boost your brainpower and treat disease http Last updated . Accessed . . . CDC. Centers for Disease Control and Prevention. Birth Defects. Key Findings Prevalence of Down syndrome in the United States. http Last updated . Accessed . . . NDSS. What Is Down Syndrome http Accessed . . Stotani S Giordanetto F Medda F. DYRKA inhibition as potential treatment for Alzheimers disease. Future medicinal chemistry. . . Souchet B Latour A Gu Y et al. Molecular rescue of DYRKA overexpression in cystathionine beta synthasedeficient mouse brain by enriched environment combined with voluntary exercise. Journal of molecular neuroscience MN. . . Becker W Soppa U Tejedor FJ. DYRKA a potential drug target for multiple Down syndrome neuropathologies. CNS neurological disorders drug targets. . . Wegiel J Gong CX Hwang YW. The role of DYRKA in neurodegenerative diseases. The FEBS journal. . . Bhat RV Budd Haeberlein SL Avila J. Glycogen synthase kinase a drug target for CNS therapies. Journal of neurochemistry. . . Avila J Hernandez F. GSK inhibitors for Alzheimers disease. Expert review of neurotherapeutics. . . Jope RS Roh MS. Glycogen Synthase Kinase GSK in Psychiatric Diseases and Therapeutic Interventions. Current Drug Targets. . . Kim TI Lee YK Park SG et al. lTheanine an amino acid in green tea attenuates amyloidinduced cognitive dysfunction and neurotoxicity reduction in oxidative damage and inactivation of ERKp kinase and NFB pathways. Free Radical Biology and Medicine. . . RezaiZadeh K Arendash GW Hou H et al. Green tea epigallocatechingallate EGCG reduces amyloid mediated cognitive impairment and modulates tau pathology in Alzheimer transgenic mice. Brain research. . . Haque AM Hashimoto M Katakura M Hara Y Shido O. Green tea catechins prevent cognitive deficits caused by Abeta in rats. The Journal of nutritional biochemistry. . . De la Torre R De Sola S Pons M et al. Epigallocatechingallate a DYRKA inhibitor rescues cognitive deficits in Down syndrome mouse models and in humans. Molecular nutrition food research. . SOURCE Life Extension"

"Patients with newly diagnosed advanced lung cancer who received an immunotherapy drug plus standard chemotherapy lived significantly longer than those who got chemo alone according to a new study that is expected to change the way such patients are treated. The report was one of several highly anticipated studies on immunotherapy and lung cancer presented Monday at the annual meeting of the American Association for Cancer Research in Chicago. The studies simultaneously were published by the New England Journal of Medicine on a day that some experts called the Super Bowl of lung cancer immunotherapy. The reports underscore the increasingly important firstline role that immunotherapy https_story.htmlutm_term.afa which unleashes the immune system to destroy cancer cells is taking against the deadliest cancer. Immunotherapy is rapidly in combination with other treatments and on its own dramatically changing the standard of care for lung cancer said Leena Gandhi an oncologist at NYU Langone Health who led the study on the immunotherapychemotherapy combination called Keynote. Instead of chemo being the backbone on which to improve immunotherapy is now the backbone on which we build. Lung cancer is the secondmostcommon malignancy https_story.htmlutm_term.afaaf in the United States after breast cancer. The American Cancer Society estimates that people will be diagnosed with the disease this year and will die of it. Most patients diagnosed with advanced lung cancer disease that has spread beyond its original site initially receive chemotherapy which provides only marginal benefit. But the disease is so lethal that many patients dont survive long enough to try second or thirdline treatments so researchers are trying to develop and use more effective approaches earlier. The trial that grabbed much of the spotlight Monday is a randomized effectiveness study that involved more than untreated patients with advanced nonsquamous nonsmall cell lung cancer a common type of the disease. The patients did not have cancercausing mutations. One group was treated only with chemo while the other got an immunotherapy drug called Keytruda https_story.htmlutm_term.efec plus chemo. Some of the results had been released previously but not specific details.After a median followup time of . months Gandhi said the patients in the combination group were percent less likely to die compared with patients in the chemoonly arm. For the first time adding another drug has significantly impacted the longterm outlook for those patients she said. Scientists who werent involved in the study agreed that it was highly significant. H. Jack West an oncologist at Swedish Medical Center in Seattle said It is literally practicechanging immediately. Roy Herbst an oncologist at Yale Cancer Center said that most lung cancer patients now will be offered immunotherapy in some form much earlier than before. Still he said the approach was not a cure and there is a lot of room for improvement. The estimated proportion of patients in the combination therapy group who were alive and whose disease had not gotten worse at a year was about percent about double the proportion for the chemoonly group. Last May the Food and Drug Administration approved the Keytrudachemo combination based on an earlystage trial. But many doctors did not adopt it because the trial was small and didnt initially show a survival benefit Gandhi said. Experts said it was especially significant that the study showed that patients benefited from the Keytrudachemo combination regardless of the levels of a protein called PDL found on their cancer cells. Researchers already had known https_story.htmlnoredirectonutm_term.adea that patients with high levels of the protein were more likely to respond to immunotherapy. Last week in a related development Merck which makes Keytruda reported that a different trial showed that the medication prolonged survival even when used alone compared with chemo. Experts said they will have to see more details before they can determine whether the medication is better used alone or with chemo. In a second study published Monday researchers used two other immunotherapy medications Opdivo and Yervoy both made by BristolMyers Squibb to treat newly diagnosed patients with advanced nonsmall cell lung cancer with a high number of mutations in their tumors. The patients experienced a significantly longer period during which their disease did not worsen compared with people who received only chemotherapy said Memorial Sloan Kettering Cancer Center oncologist Matthew Hellmann who led the study. He said the results established the doubleimmunotherapy combination as a firstline treatment for patients with a high tumor mutational burden but that it was too early to know whether the treatment leads to longer survival. And he said the trial showed that tumor mutational burden is a reliable way to predict who will benefit from the medications. Another study published Monday used immunotherapy in a different way for patients with earlystage lung cancer. Researchers at Johns Hopkins and Memorial Sloan Kettering gave patients two doses of Opdivo the first a month before surgery the second two weeks before the operation to try to stimulate antitumor activity and reduce the risk of relapse. Nine of the patients who got Opdivo had a major pathologic response a sharp reduction in the number of cancer cells found in the tumors removed by surgery. Drew Pardoll director of Hopkins BloombergKimmel Institute for Cancer Immunotherapy said that it is too early to know whether the findings will translate into longer survival. But if future studies show that he added then immunotherapy might be used to augment or even replace chemo typically given before surgery."