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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."

"Researchers have discovered a new class of drug that has the potential to help cancer patients who no longer respond to existing therapies. The drug may not become available to patients for a number of years yet but researchers believe that if clinical trials are successful it could be used to tackle a variety of treatmentresistant cancers. Patients with breast cancer for example frequently become resistant to existing hormonebased treatments leading to the disease becoming fatal. In a bid to come up with new forms of treatment that work in a distinct way from established ones chemists biologists and clinicians at Imperial College London collaborated on creating a new drug the properties of which are reported in the journal Molecular Cancer Therapeutics. The team of scientists at Imperial was funded by Cancer Research UK. The drug was then developed by Imperial in collaboration with Emory University in the USA. Early labbased tests of ICEC were successful in targeting resistant breast cancers and indicated minimal side effects. ICEC was then licenced to Carrick Therapeutics who developed it into a molecule named CT which they have taken to earlystage clinical trials in less than two years. The first patient was given the drug in November as part of Carricks a Phase I clinical trial to assess its safety and how well it can be tolerated. The trial is still ongoing so results are not available yet. Professor Charles Coombes from the Department of Surgery Cancer said Treatmentresistant tumours represent a significant threat for patients as once a cancer stops responding to treatments there is increasingly little clinicians can do. Drugs such as these could help to shift the balance back in favour of the patients potentially providing a new option to patients for who existing treatments no longer work. Professor Tony Barrett from the Department of Chemistry said This work is the result of extensive collaboration between chemists biologists and clinicians which has helped to bring a new treatment from discovery to clinical testing in record time streamlining the process. The drug targets an enzyme called CDK involved in directing cells through their lifecycle which consists of growth DNA replication and cell division. CDK is also involved in the process of transcription a vital step in gene expression the creation of proteins to carry out cell functions. Particular cancers such as treatmentresistant breast cancers have a unique dependence on transcription meaning targeting CDK may be particularly effective. By inhibiting transcription ICEC shuts down the ability of the cancer to spread. As well as breast cancers cancers such as acute myeloid leukaemia and smallcell lung cancer are particularly transcriptiondependent so ICEC may work well for these too especially where they have become resistant to other treatments. The discovery of the drug was spurred by an initial meeting between Professor Anthony Barrett from the Department of Chemistry and oncologist Professor Charles Coombes from the Department of Surgery Cancer. Professor Simak Ali also from the Department of Surgery Cancer was working on understanding the action of CDK in treatmentresistant breast cancer. Professors Coombes and Ali suggested CDK as a drug target leading the collaboration to attempt to design a molecule that would inhibit its action. From early attempts a large collaborative team was eventually founded for drug discovery from bench to bedside directed by Dr Matthew Fuchter in the Department of Chemistry. Possible compounds for CDK inhibition were modelled using computational drug design aided by collaboration with Emory University. Ultimately a candidate molecule called ICEC suppressed tumour growth in a wide range of cancer types in lab tests. In addition laboratory studies showed ICEC worked better in combination with traditional hormone therapies for estrogen receptor positive breast cancer cells which have not yet become resistant. It is this molecule in oral pill form that was taken forward by Carrick as CT and is currently in Phase I clinical trials. If the Phase I trial proves successful the compound must pass further stages of trial over the next few years before it becomes available to patients. Early funding for the study came from the Engineering and Physical Sciences Research Council EPSRC and a major contribution of wholeproject funding was from Cancer Research UK. Licensing of the technology to Carrick Therapeutics was led by Cancer Research UKs Commercial Partnerships Team and Imperial Innovations the Technology Transfer Office of Imperial with support from Emory University. Dr Iain Foulkes Cancer Research UKs executive director of research and innovation said Its exciting to see how Cancer Research UKs partnerships with both academia and industry are bringing urgently needed new tests and treatments to patients. Drug resistance continues to be a major challenge across many cancer types so its vital that we explore new ways to tackle tumours that have stopped responding to standard therapies. We hope that this promising new class of drug will offer more options to patients who have few left available to them and help more people survive their cancer."

"While prenatal testing is widely used for pregnant women at risk of having babies with chromosome disorders https such as Down syndrome https new research shows certain types of tests may also reveal markers of cancer https in mothers. When Marin Mejia was pregnant with her son Owen one such blood test that picks up DNA from mother and baby came back showing abnormal results. Further testing showed the baby was healthy. But doctors told Mejia they needed to investigate what caused the irregular finding. At the time she was and had experienced bleeding she blamed on hemorrhoids. More testing showed she had anal cancer https Recent research from Tufts Medical Center found evidence that these prenatal tests can detect cancers https in pregnant women. The study funded by Illumina a maker of one noninvasive prenatal test looked at eight women with abnormal test results. The findings are published in the Journal of the American Medical Association httpjama.jamanetwork.comarticle.aspxarticleid. If there is cancer the tumor is shedding DNA into the mothers blood as well and that is what is accounting for this imbalance study author Dr. Diana Bianchi who serves on an advisory panel for the company told CBS News. Mejias cancer was advanced and it spread to her lymph nodes and lungs. Doctors delivered Owen at weeks so she could begin chemotherapy and radiation. I am thankful for every minute I get to spend with them she said. I refuse to believe that theres going to be any other outcome than its all going to be okay because the alternative is unfortunately not something I want to think about. Recent tests show the cancerous nodules in Mejias lungs are shrinking and she hopes for more good news after scans later this summer."

"Acupuncture may be an effective way to treat older children struggling with a certain form of lazy eye new research from China suggests although experts say more studies are needed. Lazy eye amblyopia is essentially a state of miscommunication between the brain and the eyes resulting in the favoring of one eye over the other according to the National Eye Institute. The study authors noted that anywhere from less than percent to percent of people worldwide are affected with the condition. Of those between one third and one half have a type of lazy eye known as anisometropia which is caused by a difference in the degree of nearsightedness or farsightedness between the two eyes. Standard treatment for children involves eyeglasses or contact lens designed to correct focus issues. However while this approach is often successful in younger children between the ages of and it is successful among only about a third of older children between the ages of and . For the latter group doctors will often place a patch over the good eye temporarily in addition to eyeglasses and treatment success is typically achieved in twothirds of cases. Children however often have trouble adhering to patch therapy the treatment can bring emotional issues for some and a reverse form of lazy eye can also take root the researchers said. Study author Dr. Dennis S.C. Lam from the department of ophthalmology and visual sciences and Institute of Chinese Medicine at the Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong and his colleagues report their observations in the December issue of the Archives of Ophthalmology. In the search for a better option than patch therapy Lam and his associates set out to explore the potential benefits of acupuncture noting that it has been used to treat dry eye and myopia. Between and Lam and his colleagues recruited children between the ages of and who had been diagnosed with anisometropia. About half the children were treated five times a week with acupuncture targeting five specific acupuncture needle insertion points located at the top of the head and the eyebrow region as well as the legs and hands. The other half were given two hours a day of patch therapy combined with a minimum of one hour per day of nearvision exercises such as reading. After about four months of treatment the research team found that overall visual acuity improved markedly more among the acupuncture group relative to the patch group. In fact they noted that while lazy eye was successfully treated in nearly percent of the acupuncture patients that figure dropped to less than percent among the patch patients. Neither treatment prompted significant side effects the authors said. The team nonetheless pointed out that their studys tracking period was relatively short and that acupuncture is a complicated system that may lend itself to different success rates depending on the skills of the particular acupuncturist. And while theorizing that the apparent success of this alternative approach may have something to do with stimulating blood flow retinal nerve growth and visual cortex activity the authors acknowledged that the exact mechanism by which it works remains poorly understood. Dr. Richard Bensinger a Seattlebased ophthalmologist and spokesman for the American Academy of Ophthalmology said that the finding is certainly suggestive and worth following up. This is kind of cool he said. But I will say that I dont know of any study looking at acupuncture and vision. There are studies based on symptomatic things such as pain and I think theres pretty good evidence that it does have benefit in that respect. But for vision therapy this is the first Ive heard of it and I dont know that anyone has ever tried this before. So this is like a teaser. Of course people in those parts of the country like where I live where theres fairly wide acceptance of alternative medicine might receive this type of treatment better than others Bensinger cautioned. And no question patients will gravitate towards treatments that are covered by their insurance even if its not the best treatment. And as an alternative approach this may not be covered. But if it works he added people will certainly be excited although it certainly needs further testing and further studies to decide if its really beneficial or not. For his part Dr. Stanley Chang chairman of the ophthalmology department at Columbia University in New York City did not seem to hold out much promise for acupunctures potential as an alternative lazy eye therapy. Acupuncture I think definitely works for pain amelioration but Im not sure it works for some of these other things he cautioned. Theyve tried it for the treatment of myopia and glaucoma without much success. And so although there havent been any really good trials comparing acupuncture with conventional therapies my guess is that its probably not going to do much for the treatment of lazy eye. However I think its worth considering or trying Chang added because nothing else seems to work very well for patients of that age including patch therapy. But what will need is a very carefully controlled study that accounts for all the variables that might have an impact on the outcome of this approach. More information For more on amblyopia visit the National Eye Institute http SOURCES Dennis S.C. Lam M.D. department of ophthalmology and visual sciences and Institute of Chinese Medicine Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong Richard Bensinger M.D. Seattle ophthalmologist and spokesman American Academy of Ophthalmology December Archives of of Ophthalmology."

"It takes up to years and billion for a new drug to make it through testing and earn approval from the U.S. Food and Drug Administration FDA. Before researchers try a compound on humans its tested at labs in petri dishes and on animals such as mice and monkeys. More often than not these studies produce mixed data that dont tell researchers much about whether it is safe and effective for humans. For some time scientists have been searching for ways to cut down on the cost and failure rate of drug testing. Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University have developed a beautiful solution httpwyss.harvard.eduviewpage OrgansOnChips. The clear and flexible polymer microchips are lined with human cells. Each one represents a different human organ system such as lungs heart and intestines. The institutes goal is to create different organ systems that can be joined together by blood vessel channels to simulate human physiology on a microscale and provide a cheaper more reliable way to test new drugs. The sophisticated architecture of these organsonchipswhich are about the size of a thumb drivehas also earned the Wyss Institute recognition in the art world with a Design of the Year award from the Design Museum and placement in the Museum of Modern Arts permanent collection. The real power of this approach is that you have a window to the inner workings of life says Don Ingber founding director of the Wyss Institute and a professor of Vascular Biology and of Bioengineering at Harvard University. Anything you can ask at the molecular level we could do in our chips. In the team built and tested its first organoid chip to mimic the mechanical function of human lungs. It contains tiny channels separated by a porous membrane to create two distinct hollow passagewaysone lined with human lung cells and the other with capillary blood vessel cells. Air is suctioned through the side channels to emulate breathing. Ingber and his team introduced bacteria into the chips lung channel and white blood cells into the capillary channel. They observed that the white blood cells permeated the membrane and attacked the bacteria in the lung cell channelexactly what would happen in human lungs fighting off an infection. In another experiment the team at Wyss filled a chips lung cell channel with interleukin a chemotherapy drug known to cause pulmonary edema an accumulation of fluid in the lungs. When air entered the lung cell channel the channel filled with fluid and then blood clotsexactly what happens in the lungs of patients who develop this lifethreatening condition. This proved the chips could provide real world information to scientists studying the effects of new drug compounds. The project has received support from the National Institutes of Health and the FDA. The Defense Advanced Research Projects Agency also recently awarded the institute a million grant to create chips representing nearly all systems in the body. Ingber says some scientists are interested in using the chips to conduct research that would be unethical if performed on people such as studying the effects of gamma radiation on the human body. Of course the chips have limitations. We cant mimic consciousness we cant mimic compression on a joint says Ingber. Danilo Tagle associate director for special initiatives at the National Center for Advancing Translational Sciences a division of the NIH is spearheading a similar organonchip project. He suspects that in the beginning the chips will be used to complement and supplement animal studies but will eventually become routine practice. The chips will also provide researchers with information on dosing at a much earlier stage in drug studiesparticularly helpful because animals metabolize chemical substances at a different rate than humans. You can go forward with a candidate drug with greater assurance and confidence that it will have the desired effect on humans says Tagle. Biology is very complex. Incorporating the chips into drug testing could save millions of dollars and years of time on research. Some companies are already trying out the concept. Janssen Pharmaceuticals Company a subsidiary of Johnson Johnson is using a version of the chips to understand how blood clots in the lungs. The information is essential to reduce the risk for this side effect of oncology drugs. Though there still arent enough data to prove the chips are reliable enough to put rodents out of a job Ingber says its only a matter of time they hope to have them tested and ready for market in two years. The FDA has been very supportive he says. Theyve told us if they are as good as animals that they would consider accepting data provided by a drug company from one of these models rather than an animal model."

"More evidence is emerging that women who take calcium supplements to prevent bone deterioration may in fact be risking their heart health. But even when added to previous studies with similar findings the new conclusions dont necessarily mark a death knell for calcium supplements say the authors of a study released online April in the BMJ. There is a lack of consensus at the present time as to what recommendations should be regarding the use of calcium supplements said study senior author Dr. Ian Reid who fully expected that the new results will have a significant impact on recommendations. Our own recommendation is to critically review the use of calcium supplements since the data in this paper suggests that they do more harm than good added Reid who is professor of medicine and endocrinology at the University of Auckland in New Zealand. The cautious way forward seems to be to encourage people to obtain their calcium from the diet rather than from supplements since food calcium has not been shown to carry this increased risk of heart disease Reid added. A recent metaanalysis done by the same group of researchers found a to percent increased risk of heart attacks in women taking calcium without vitamin D. Many older women take calcium supplements with or without vitamin D to keep their bones strong especially since that has long been standard medical advice. In addition the mammoth U.S.government funded Womens Health Initiative WHI earlier found no negative link between calcium and heart health. But as the current authors point out more than half of the women in that study were already taking their own calcium supplements on top of what they had been prescribed for the trial which may have clouded the results. For this analysis the authors looked only at the women in the WHI who had not been taking personal calcium supplements before entering the trial. In this case women who were randomized to take calcium and vitamin D as part of the study protocol had a modest to percent increased risk of cardiovascular problems particularly heart attacks. Women in the control arm had no change in risk. The case against calcium became stronger when researchers added in data from other unpublished trials involving almost women. Now the increased risk for heart attack was to percent and for a stroke to percent. While the authors speculate that an increased risk could be biologically plausible given that calcium is connected with hardening of the arteries another expert thinks not. While calcium does tend to be a marker of inflammation explained Dr. Philip Houck assistant professor of internal medicine at Texas AM Health Science Center College of Medicine lesions with calcium are actually more stable so theres less of a chance of having a heart attack than in vessels that are less calcified. Moreover the results may have been statistically significant but that doesnt mean theyre clinically significant he added. If women have good reason to take calcium because their bones are thin then they should not be afraid of taking the calcium said Houck who is also a cardiologist with Scott White in Temple Texas. Dr. Susan V. Bukata associate professor of orthopaedic surgery at the University of Rochester Medical Center said that the study really doesnt provide enough information to make a definitive conclusion. Nevertheless accumulating evidence has her urging patients to get their calcium from their diet rather than reflexively telling them to take milligrams of calcium a day. With diet plus a supplement combined women should be getting to milligrams a day she said. And in an accompanying journal editorial medical professors Dr. Bo Abrahamsen and Dr. Opinder Sahota wrote that due to study limitations it is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. Clearly further studies are needed and the debate remains ongoing. More information The National Osteoporosis Foundation has more on osteoporosis http SOURCES Ian Reid M.D. professor medicine and endocrinology University of Auckland New Zealand Susan V. Bukata M.D. associate professor orthopaedic surgery University of Rochester Medical Center Rochester N.Y. Philip Houck M.D. assistant professor internal medicine Texas AM Health Science Center College of Medicine and cardiologist Scott White Temple Texas April BMJ online"

"Scientists at Newcastle University believe a drug commonly prescribed for Type diabetes could be routinely taken by Type diabetic patients to slow the development or delay heart disease. Metformin is an inexpensive treatment that is often used for Type diabetes to lower blood sugar levels by reducing glucose production in the liver. The drug is not regularly given to patients with Type diabetes. However for the first time a clinical trial has revealed metformin can promote a patients ability to repair their own damaged blood vessels by increasing vascular stem cells. Heart disease is the leading cause of illness in diabetic patients accounting for more than half of all fatalities. Metformin may be used to lower Type diabetic patients risk of developing this complication. Findings of the clinical trial are published today in the journal Cardiovascular Diabetology. This follows previous laboratory work at Newcastle University which explored the mechanism behind metformin. Dr Jolanta Weaver Senior Lecturer in Diabetes Medicine at Newcastle University and Honorary Consultant Diabetologist at Queen Elizabeth Hospital Gateshead led both studies. She believes this new research is a major development in understanding the best ways to further improve treatment in Type diabetes. Dr Weaver said As the outcomes of heart disease is worse in diabetic versus nondiabetic patients there is a need to identify additional treatment options. Metformin could routinely be used by patients with Type diabetes to help lower their chances of developing heart disease by increasing a repair mechanism created by vascular stem cells released from the bone marrow. Our research is an exciting step forward as it may have positive clinical implications for patients with increased risk of cardiovascular disease by improving their treatment options. For the first time this study has shown metformin has additional benefit beyond improving diabetes control when given to patients with relatively well controlled Type diabetes. We have established the drug increases patients own vascular stem cells which will help delay or slowdown heart disease. Our findings also show that the cells associated with damaged blood vessels were reduced confirming that the repair of blood vessels was taking place in our patients. Researchers studied a treatment group of people aged who had Type diabetes for up to years and had no evidence of heart disease. Patients were given metformin at a dose they could tolerate between one to three tablets a day for eight weeks. Participants were advised to adjust their insulin to keep blood glucose levels safe. Scientists measured patients stem cells directly in the blood and also grew stem cells in a test tube observing how they behaved. Another cell type was also counted to assess damaged blood vessels. The participants were matched with nine patients within the same age bracket who took standard insulin treatment and healthy nondiabetic people aged . Experts found that the stem cells of patients who took metformin were able to promote the repair of the blood vessels and there was an improvement in how vascular stem cells worked. Type diabetes is a lifelong autoimmune condition that develops when the pancreas does not produce any insulin causing a persons blood sugar level to become too high. It is estimated around people in the UK have the condition. Dr Weaver said We have shown that all our patients in the study had their insulin doses reduced after taking metformin and have not suffered any serious adverse effect. Patients with Type diabetes may wish to consider discussing with their GP the possibility of adding metformin even at a very low dose to the insulin that they are taking. However care needs to be taken to adjust insulin dose to prevent too low glucose levels. A pilot study was funded by Diabetes Research and Wellness Foundation and the extended study was financially supported by the Diabetes Research Fund in Gateshead. Dr Eleanor Kennedy Research Manager at Diabetes Research and Wellness Foundation said The Diabetes Research and Wellness Foundation is delighted to have funded the initial pilot study that led Dr Weaver and her colleagues to conduct this small clinical trial. The results which indicate that metformin a drug commonly used in the treatment of Type diabetes could also have a powerful effect in people with Type diabetes is unexpected. We hope that these results can lead to a much larger clinical trial. Case study Quantity surveyor Alex Laws was part of the Newcastle University clinical trial and is delighted with the results of the study. The yearold of Gateshead was diagnosed with Type diabetes at the age of just seven and has good control of her condition. She was enrolled on the clinical trial in the summer of . Alex said I was keen to be part of the clinical trial as I know how important research is into helping people with the condition I previously worked in the medical research field. People with Type diabetes can suffer from a number of complications especially in the longterm so its important as much as possible is done to limit serious problems. Heart disease is a concern for people with Type diabetes so any treatment that can help with this and give an advantage to the patient is a good thing. Reference Metformin improves circulating endothelial cells and endothelial progenitor cells in Type diabetes MERIT Study Fahad W Ahmed Rachel Rider Michael Glanville Kilimangalam Narayanan Salman Razvi and Jolanta U Weaver. Cardiovascular Diabetology. DOI .s"

"A minimally invasive treatment can help restore fertility in women with uterine fibroids according to a new study published online in the journal Radiology. Uterine fibroids abnormal masses of fiber and muscle tissue in the wall of the uterus are considered one of the most common causes of infertility and complications related to pregnancy. Previous research has found that one out of every four women with fibroids has problems related to fertility. The standard treatment option for such women is myomectomy or surgical removal of the fibroids. However myomectomy is not always possible or effective and can result in major complications including hysterectomy according to study coauthor Joo Martins Pisco M.D. Ph.D. from the Department of Interventional Radiology at Saint Louis Hospital in Lisbon Portugal. Uterine fibroid embolization UFE is a less invasive option that involves injection of an embolic agent typically made up of very small beads into the uterine arteries to block the blood supply to the uterus and fibroids. As the fibroids die and begin to shrink the uterus fully recovers. UFE can be performed in patients with a prior myomectomy or in vitro fertilization IVF. Despite its less invasive nature UFE has yet to be fully embraced in the medical community as a fertilitypreserving treatment for women with symptomatic fibroids due to concerns that the procedure may cause inadequate blood flow to the endometrium or lining of the uterus and the ovaries. For the new study Dr. Pisco and colleagues assessed pregnancy rates in women with uterine fibroids who were unable to conceive and who underwent either conventional or partial UFE. In conventional UFE all uterine artery branches are embolized. However the partial procedure requires treatment of only the small vessels to the fibroids leaving the corresponding larger vessels unaffected. Partial UFE may help reduce the risks of infertility associated with conventional UFE. After an average followup of almost six years of the women or . percent had become pregnant one or more times and gave birth to a total of babies. It was the first pregnancy for more than percent of the women who gave birth. The procedures had a clinical success rate of approximately percent for fibroidrelated symptoms. Complication rates were . percent for partial UFE and . percent for conventional UFE. The procedure was repeated in patients whose fibroids had not been fully treated as shown by MRI and of those patients subsequently got pregnant. Our findings show that UFE is a fertilityrestoring procedure in women with uterine fibroids who wish to conceive and pregnancy following UFE appears to be safe with low morbidity Dr. Pisco said. Women who had been unable to conceive had normal pregnancies after UFE and similar complication rates as the general population in spite of being in a highrisk group. Dr. Pisco suggested that UFE may become the firstline treatment for women with fibroids who wish to conceive particularly for those with numerous or very large fibroids. Such patients have a fibroid recurrence rate of more than percent after myomectomy making UFE an important option. The researchers are continuing the treatments and compiling data. Since the time of writing there were additional pregnancies. In our study there are now almost newborns following UFE Dr. Pisco said. Our next step will be a randomized study comparing the results of partial and conventional UFE. Spontaneous Pregnancy with a Live Birth after Conventional and Partial Uterine Fibroid Embolization. Collaborating with Dr. Pisco were Marisa Duarte M.D. Tiago Bilhim M.D. Ph.D. Jorge Branco M.D. Ph.D. Fernando Cirurgio M.D. Marcela Forjaz M.D. Lcia Fernandes M.D. Jos Pereira M.D. Nuno Costa M.D. Joana B. M. Pisco M.D. and Antnio G. Oliveira M.D. Ph.D. Radiology is edited by Herbert Y. Kressel M.D. Harvard Medical School Boston Mass. and owned and published by the Radiological Society of North America Inc. httppubs.rsna.orgjournalradiology RSNA is an association of over radiologists radiation oncologists medical physicists and related scientists promoting excellence in patient care and health care delivery through education research and technologic innovation. The Society is based in Oak Brook Ill. RSNA.org httpRSNA.org For patientfriendly information on uterine fibroid embolization visit RadiologyInfo.org httpRadiologyInfo.org."

"The race to develop a safe and effective vaccine against the Zika virus got one step closer Thursday when a team of researchers reported positive results in the latest round of testing in monkeys. Three experimental vaccines being developed by researchers at Harvards Beth Israel Hospital and the Walter Reed Army Institute of Research had already shown promise in mice but monkeys are a much better model of how the medicines will work in humans. All three of the vaccines were found to be safe and protected the monkeys against infection with the virus according to the report published in Science. The urgency for a vaccine to protect against Zika infection has intensified as the virus spreads rapidly across Latin America and the Caribbean. This week an unprecedented travel advisory was given for southern Florida after more than a dozen people were diagnosed with Zika after being bitten by homegrown mosquitoes. Zika virus is most dangerous to pregnant women because it can cause severe birth defects in babies if they are infected in the womb. Right now just one of those three vaccines will be progressing to clinical trials. That vaccine dubbed ZPIV for purified inactivated Zika virus uses a more traditional vaccine approach and depends on dead virus particles. Striking results To develop the vaccine researchers kill the virus with chemicals leaving behind harmless proteins that the body can learn to recognize as foreign invaders. Using those proteins as targets the immune system can then produce antibodies to latch onto live virus particles and destroy them. This kind of vaccine is much safer than ones that depend on live virus particles to foster immunity. The researchers gave monkeys an initial dose of ZPIV and then a booster four weeks later. Then the monkeys were exposed to active forms of the virus. In tests afterwards the monkeys showed antibodies against Zika and no detectable virus in their blood or urine meaning that the protection from the vaccine was complete. Monkeys that got a sham vaccine developed no antibodies. The results were striking said study coauthor Dr. Dan Barouch a professor of medicine at Beth Israel Deaconess Medical Center and Harvard Medical School. The findings published today substantially increase our optimism for the potential for the development of a Zika vaccine for humans. Beyond that this is a promising vaccine candidate that can be easily produced in large quantities said coauthor Col. Nelson Michael an Army doctor who specializes in flaviviruses such as Zika and dengue. Testing in people by October To continue the development of the vaccine the researchers will be partnering up with the largest pharmaceutical company solely devoted to vaccines Sanofi Pasteur. The researchers hope to test the vaccine in people by October Barouch said. The two other experimental vaccines described in the new report also sparked an immune response in monkeys. Both of these vaccines depend on new technology in which scientists learn the exact DNA of proteins on the surface of the virus and then create copies to be put in a vaccine. One vaccine had just the manmade proteins in it the other wrapped a common cold virus around the proteins. The proteincold virus vaccine was especially effective sparking a significant immune response after just one dose. Cautiously optimistic Another experimental vaccine developed by researchers at the National Institutes of Health is a bit further along. Trials of that vaccine in people which is also based on manmade copies of virus proteins began on August when the first study volunteer was given a vaccination through a needle free injector said Dr. Anthony Fauci head of the National Institute for Allergy and Infectious Diseases. Results are expected by December and if they are promising a bigger phase II trial will be launched in Zika endemic countries That puts the project ahead of schedule since the original launch of the phase I trials was expected to start in September Fauci said. Still with many years of experience in vaccine development behind him Fauci said youre never overconfident of the clinical results. But we are optimistic that this new DNA Zika is a viable platform Fauci said. So were cautiously optimistic. And if problems turn up there are the three potential vaccine described in the new study. Its always good to have multiple different vaccine candidates in both clinical and preclinical testing Barouch said. That increases the chance that we will have at least one if not more than one that works in the end."

"A new study finds young children with mild persistent asthma can tolerate acetaminophen without the worsening of asthma when compared with ibuprofen use. The study funded by the National Heart Lung and Blood Institutes NHLBI asthma network AsthmaNet appears in the August issue of the New England Journal of Medicine. Previous observational studies had suggested that acetaminophen use was associated with asthma symptoms says Kristie Ross MD MS Clinical Director Division of Pediatric Pulmonology AllergyImmunology and Sleep Medicine at University Hospitals Rainbow Babies Childrens Hospital UH Rainbow and coauthor on the study. Results from this randomized controlled study showed that in young children with mild asthma acetaminophen used as needed was not associated with increased asthma flares or more asthma symptoms. These findings can help us reassure parents of young children with asthma that they can continue to use acetaminophen on an as needed basis and as directed to treat pain and fever without concern that it will worsen asthma symptoms. Dr. Ross who is also an Associate Professor of Pediatrics at Case Western Reserve University School of Medicine was joined by UH Rainbow colleagues and study coauthors James Chmiel MD MPH Professor of Pediatrics and Ross Myers MD Assistant Professor of Pediatrics. To assess the impact of acetaminophen use on childrens asthma AsthmaNet investigators studied children aged to years old who had mild persistent asthma defined as symptoms on more than days out of a week but not daily. All children required daily inhaled treatments to manage their asthma. During the study caregivers used either acetaminophen commonly known as Tylenol or ibuprofen Advil Motrin whenever a child needed pain relief or had a fever. None of the study investigators children or caregivers knew which study drug each child was receiving. The study did not detect any worsening of asthma in the children treated with acetaminophen compared with those receiving ibuprofen. This was measured by asthma exacerbation rate the number of days of asthma control the need for rescue medications and unscheduled medical visits for asthma. They also did not find any significant differences in safety between the two drugs. AsthmaNet is a nationwide clinical research network created by the NHLBI in . The purpose of AsthmaNet is to develop and conduct multiple clinical trials that explore new approaches in treating asthma from childhood through adulthood. AsthmaNet studies are currently being conducted in states. In the United States more than million people are known to have asthma. The Division of Pediatric Pulmonology and AllergyImmunology at UH Rainbow is currently recruiting for a number of asthmarelated clinical trials. If you are interested in enrolling in a study or learning more about the opportunities please visit http About University Hospitals Rainbow Babies Childrens Hospital Internationally renowned UH Rainbow Babies Childrens Hospital is a fullservice childrens hospital and pediatric academic medical center with experts in medical divisions and surgical specialties who offer nationally ranked care not available at other institutions in the region including a center dedicated to adolescent and young adult cancer treatment and Northeast Ohios only singlesite provider of advanced maternal fetal medicine and neonatology services. As the primary pediatric affiliate of Case Western Reserve University School of Medicine and the only Level I Pediatric Trauma Center in the region UH Rainbow Babies Childrens Hospital offers access to novel therapies advanced technologies and clinical discoveries long before they are available nationwide. Rainbow pediatric specialists all of whom also serve on the faculty at the School of Medicine are engaged in todays most advanced clinical research and are widely regarded as the best in the nation and in some specialties the best in the world. Learn more at Rainbow.org. About Case Western Reserve University Case Western Reserve University is one of the countrys leading private research institutions. Located in Cleveland we offer a unique combination of forwardthinking educational opportunities in an inspiring cultural setting. Our leadingedge faculty engage in teaching and research in a collaborative handson environment. Our nationally recognized programs include arts and sciences dental medicine engineering law management medicine nursing and social work. About undergraduate and graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible. About the National Heart Lung and Blood Institute NHLBI NHLBI plans conducts and supports research related to the causes prevention diagnosis and treatment of heart blood vessel lung and blood diseases and sleep disorders. The Institute also administers national health education campaigns on women and heart disease healthy weight for children and other topics. NHLBI press releases and other materials are available online at http About the National Institutes of Health NIH NIH the nations medical research agency includes Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic clinical and translational medical research and is investigating the causes treatments and cures for both common and rare diseases. For more information about NIH and its programs visit http"

"A new insomnia drug helped people get a bit more shuteye in a lab study researchers report. The drug known as suvorexant is being developed by Merck Research Laboratories which funded and conducted the study. The medication is not available yet but the U.S. Food and Drug Administration is reviewing it for possible approval the researchers said. In the United States about percent of people say they have chronic insomnia according to the U.S. Centers for Disease Control and Prevention. There are sleep aids on the market but they do not work for everyone and they can have side effects that include sleepwalking daytime drowsiness and confusion. Suvorexant works differently from those drugs zeroing in on specific brain chemicals involved in the ability to sleep explained study author Dr. William Herring executive director of clinical research at Merck. The study published online Nov. and in the Dec. print issue of the journal Neurology included healthy adults with primary insomnia which means it wasnt caused by an underlying physical or mental health problem. All of the patients spent four weeks on one of four doses of suvorexant and another four weeks on placebo pills. They had their sleep monitored in a sleep lab on their first night with each treatment and then came back again after four weeks. Overall Herrings team found people slept better with the drug although the improvement was not dramatic. At the outset when patients spent eight hours in bed they were typically asleep for percent of that time. One day on suvorexant boosted that by anywhere from percent to percent relative to the placebo. Between and fewer minutes were spent awake during those sleep periods. There was still a benefit four weeks later. One expert pointed out however that the benefit was small. The amount of additional sleep was not tremendous said Dr. Carl Bazil director of the division of epilepsy and sleep at New YorkPresbyterian HospitalColumbia University Medical Center. The effect was essentially comparable to what has been seen with other sleep medications said Bazil who was not involved in the research. But he said suvorexant is seen as a potentially important development in the world of sleep medicine because the drug blocks specific brain chemicals called orexins which help keep people awake. Standard sleep medications work more widely throughout the brain Bazil explained which is why they can have a host of side effects. The way suvorexant works makes a lot of sense Bazil said. The hope is that it will help some people who havent responded to other drugs and have fewer side effects. Its promising news Bazil added that there were no serious side effects in this study. The most common side effects were sleepiness reported by about percent of patients on the two higher doses of suvorexant headache reported by about percent dizziness and abnormal dreams percent. There are still many questions including whether the drug would benefit people with insomnia due to a health condition which doctors call secondary insomnia. The study also excluded adults aged or older an age group commonly affected by insomnia. But Herring said seniors were part of a larger month trial and Merck has submitted those results to the FDA. Another sleep specialist said the findings show some potential benefit from suvorexant but he cautioned insomnia sufferers against relying completely on any drug. Medication can be important said Dr. William Kohler who directs the Florida Sleep Institute in Spring Hill. But in the long run the best methods for treating insomnia are behavioral techniques. Kohler said cognitive behavioral therapy where people learn to change the thoughts and habits that affect their sleep quality is a proven way to manage insomnia. For most people he said medication should be a temporary treatment behavior change is the longterm fix. Bazil agreed I look at most people with insomnia as someone who developed bad sleep habits. A drug ideally used for a short time may help encourage sleep and get people on the right track Bazil said. But those bad sleep habits youve got to address them too he added. The problem Kohler noted is that we dont want to make behavior changes. We want to pop a pill. More information Learn more about insomnia and good sleep habits from the National Sleep Foundation http SOURCES Carl Bazil M.D. Ph.D. director division of epilepsy and sleep New YorkPresbyterian HospitalColumbia University Medical Center New York City William Kohler M.D. medical director Florida Sleep Institute Spring Hill Fla. William Herring M.D. Ph.D. Merck Sharp Dohme Corp. Whitehouse Station N.J. Dec. Neurology"

"The window for helping certain stroke httpabcnews.go.comtopicslifestylehealthhearthealth.htm patients with a potentially lifesaving blood clot removal surgical treatment may be longer than previously thought according to a study published today httpjama.jamanetwork.comarticle.aspxarticleid in the Journal of the American Medical Association. Traditionally stroke is treated with medications that stabilize or diminish blood clots in the brain. In select patients surgical intervention to remove the clot may be possible to mitigate effects of the stroke. Currently the American Stroke Association advises that blood clot removal for some patients an emergency procedure called endovascular thrombectomy recently developed and increasingly used in addition to medical therapies should be done within six hours after stroke symptoms httpabcnews.go.comtopicslifestylehealthstrokesymptoms.htm to lower the amount of disability patients will face later. But this analysis showed that the time for treatment could be slightly longer up to . hours. This study could affect the current guidelines on treating stroke patients according to Dr. Cathy Sila Director of the Comprehensive Stroke Center at University Hospitals Cleveland Medical Center. She said there is compelling rationale to move that window a little bit. As a result of having lost blood flow to the brain for an extended time stroke victims often suffer physical disabilities and lose varying degrees of their independence. They often require longerterm care and therapies. Longterm disability of stroke is more expensive than cost of hospitalization Sila told ABC News today. What Does the Future Hold for Youngest Double Hand Transplant Patient httpabcnews.go.comHealthfutureyoungestrecipientgroundbreakingdualhandtransplantstoryid Fighting Zika With GMO Mosquitoes Could Be the Future of Mosquito Control httpabcnews.go.comHealthfightingzikausbattlegmomosquitoesstoryid Authors from multiple institutions including the University of Calgary pooled data from five studies on stroke treatments to see if providing endovascular thrombectomy in addition to standard medical treatment past six hours would help patients. They analyzed those studies for patients who have had large blood vessel strokes seeking to understand how much of an effect blood clot removal surgery performed after six hours would have on their longerterm recovery. They used a benchmark of three months after the stroke to assess patients level of disability. In total patients were enrolled in the five trials studied. The researchers examined clinical data and brain imaging in addition to the patients physical function. They found that the patients who received standard medical therapy along with an endovascular thrombectomy up to . hours after developing stroke symptoms were less likely than patients who were treated with only medications to report disability three months later. When they examined the patients three months after the stroke each hour delay in receiving the treatment corresponded in worse outcomes for the patients including more severe disability and less functional independence. This meant that even the patients who received the treatment outside of the generally accepted hours cut off up to the . hours point tended to report less disability during their recovery. However if people received the treatment after . hours from onset of symptoms there was no statistical improvement. Dr. Mayank Goyal a coauthor of the study and professor of Radiology University of Calgary said he hopes the study will help raise awareness about the importance of getting prompt treatment for a stroke and having an efficient system to provide this procedure. Time is brain Goyal told ABC News. The faster we can reestablish blood flow to brain the higher the likelihood of the patients having a good outcome and going back to independent living. Sila said further study is needed to find out if these kinds of procedures could benefit people even after the . hours from symptom onset. She pointed out that these studies are important since they can help change guidelines and push insurance companies httpabcnews.go.comtopicsbusinessinsurancecompanies.htm to cover the procedure for more patients. We need to have this kind of data so third party payers would have it to base costs on she said. Dr. Lei Lynn is an internal medicine resident at George Washington University Hospital and a resident in the ABC News Medical Unit."

"An experimental gene therapy that turns a patients own blood cells into cancer killers worked in a major study with more than onethird of very sick lymphoma patients showing no sign of disease six months after a single treatment its maker said Tuesday. In all percent of patients had their cancer shrink at least by half at some point in the study. Its sponsor Californiabased Kite Pharma is racing Novartis AG to become the first to win approval of the treatment called CART cell therapy in the U.S. It could become the nations first approved gene therapy. A hopeful sign the number in complete remission at six months percent is barely changed from partial results released after three months suggesting this onetime treatment might give lasting benefits for those who do respond well. This seems extraordinary ... extremely encouraging said one independent expert Dr. Roy Herbst cancer medicines chief at the Yale Cancer Center. The worry has been how long Kites treatment would last and its side effects which he said seem manageable in the study. Followup beyond six months is still needed to see if the benefit wanes Herbst said but added this certainly is something I would want to have available. The therapy is not without risk. Three of the patients in the study died of causes unrelated to worsening of their cancer and two of those deaths were deemed due to the treatment. It was developed at the governments National Cancer Institute and then licensed to Kite. The Leukemia and Lymphoma Society helped sponsor the study. Results were released by the company and have not been published or reviewed by other experts. Full results will be presented at the American Association for Cancer Research conference in April. The company plans to seek approval from the U.S. Food and Drug Administration by the end of March and in Europe later this year. The treatment involves filtering a patients blood to remove key immune system soldiers called Tcells altering them in the lab to contain a gene that targets cancer and giving them back intravenously. Doctors call it a living drug permanently altered cells that multiply in the body into an army to fight the disease. Patients in the study had one of three types of nonHodgkin lymphoma a blood cancer and had failed all other treatments. Median survival for such patients has been about six months. Kite study patients seem to be living longer but median survival isnt yet known. With nearly nine months of followup more than half are still alive. Six months after treatment percent still had a partial response cancer shrunk at least in half and percent were in complete remission no sign of disease. The numbers are fantastic said Dr. Fred Locke a blood cancer expert at Moffitt Cancer Center in Tampa who coled the study and has been a paid adviser to Kite. These are heavily treated patients who have no other options. One of his patients yearold Dimas Padilla of Orlando was driving when he got a call saying his cancer was worsening chemotherapy was no longer working and there was no match to enable a second try at a stem cell transplant. I actually needed to park ... I was thinking how am I going to tell this to my mother my wife my children he said. But after CART therapy last August he saw his tumors shrink like ice cubes and is now in complete remission. They were able to save my life Padilla said. Of the study participants percent developed a dangerous condition where the immune system overreacts in fighting the cancer but that rate is lower than in some other tests of CART therapy. The rate fell during the study as doctors got better at detecting and treating it sooner. Roughly a third of patients developed anemia or other bloodcountrelated problems which Locke said were easily treated. And percent had neurological problems such as sleepiness confusion tremor or difficulty speaking but these typically lasted just a few days Locke said. Its a safe treatment certainly a lot safer than having progressive lymphoma and comparable to combination chemotherapy in terms of side effects said the cancer institutes Dr. Steven Rosenberg who had no role in Kites study. The first lymphoma patient Rosenberg treated this way a Florida man is still in remission seven years later. There were no cases of swelling and fluid in the brain in this or any other study testing Kites treatment company officials said. That contrasts with Juno Therapeutics which has had a CART study put on hold twice after five patient deaths due to this problem. Company officials would not say what the treatment might cost but other types of immune system therapies have been very expensive. Its also being tested for some other types of blood cancer."

"A twoyear multicenter clinical study with patients with class IIIIV refractory angina randomized to low and high dose CD cells or placebo has revealed that patients who received either a high or low dose of CD a member of a family of proteins that have an impact on vascularassociated tissue cells had a significant reduction in angina frequency over patients who received placebo. The patients who were unresponsive to other treatments were considered to have no other options refractory. The researchers used intramyocardial delivery into the ischemic zone after D mapping to register both electrical and mechanical activities of the left ventricle. Outcomes from the ACTCMI study a twoyear phase II randomized doubleblind placebocontrolled clinical trial will be published in an upcoming cardiac issue of Cell Transplantation http There are an increasing number of patients with advanced coronary artery disease that are not amenable to surgical or percutaneous revascularization said study coauthor Dr. Timothy D. Henry of the CedarsSinai Heart Institute. These patients frequently have symptoms after having had standard therapies and are left with limited treatment options. Encouraging early clinical trials suggest that cell therapy is an attractive treatment option for these patients especially trials in which subjects were transplanted with autologous selfdonated CD cells. CD cells drew the attention of researchers for possible therapeutic testing because recent studies pointed to the importance of CD cell content in the bone marrow of patients with risk factors for coronary artery disease in predicting not only baseline but also future exercise capacity. According to the researchers the study demonstrated that CD cells have the ability to restore the microcirculation and improve myocardial tissue perfusion. All of the patients participating in the ACTCMI study saw significant improvement in both angina frequency and exercise at months and a trend toward decreasing major cardiac events. There was also a reduction in angina in the placebo group at six months but the effect was less prominent at and months reported the researchers. In addition there was a significant reduction in the time to first hospitalization in celltreated patients with a trend toward reduction in mortality as well. The results of our study are even more provocative given that the outcomes represent the effect of a single treatment wrote the researchers. Recent reports suggest that in patients with recurring symptoms repeated cell administration may replicate the initial positive results. The researchers concluded that for no option patients with class IIIIV angina refractory that was unresponsive to conventional medical therapy and who were not candidates for revascularization injection of CD cells resulted in persistent improvement in angina at two years posttreatment. Contact Timothy D. Henry S. San Clemente Blvd. Suite A Los Angeles CA. Email henrytcshs.org mailtohenrytcshs.org Tel Fax Citation Henry TD Schaer GL Traverse JH Povisc TJ Davidson C Lee JS Costa MA Bass T Mendelsohn F Fortuin FD Pepine CJ Patel AN Riedel N Junge C Hunt A Kereiakes DJ White C Harrington RA Schatz RA Losordo DW the ACTCMI Investigators. Autologous CD Cell Therapy for Refractory Angina year Outcomes from the ACTCMI StudyCell Transplant. Appeared or available online May This study scheduled to be published later this year in a special cardiovascular issue of Cell Transplantation is currently freely available online as an unedited early epub at http_Henry_et_al The CoEditorsinChief for CELL TRANSPLANTATION are at the Department of Neurosurgery and Brain Repair Morsani College of Medicine University of South Florida Tampa FL USA and the Center for Neuropsychiatry China Medical University Hospital TaiChung Taiwan. Contact Paul R. Sanberg at psanberghealth.usf.edu mailtopsanberghealth.usf.edu ShinnZong Lin at shinnzongyahoo.com.tw mailtoshinnzongyahoo.com.tw or Associate Editor Samantha Portis at celltransplantationgmail.com mailtocelltransplantationgmail.com"

"A minimally invasive procedure in which pulses of energy from a probe are applied directly to nerve roots near the spine is safe and effective in people with acute lower back pain that has not responded to conservative treatment according to a study being presented today at the annual meeting of the Radiological Society of North America RSNA. Lumbar disk herniation is a common often debilitating condition that affects the disks that act as cushions between the vertebrae of the lower spine. Herniation occurs where the jellylike material in the center of the disk bulges through a tear in the disks tough exterior layer and puts pressure on the roots of the nerves. Herniated disks are often the source of sciatica or pain that radiates downward from the lower back into the leg. Conservative treatment options for herniated disks range from overthecounter pain medications to injections of corticosteroids directly into the affected area of the spine. Those who dont respond may require surgery. In some cases the entire disk must be removed and the vertebra fused together for stability. An alternative technique CTguided pulsed radiofrequency pRF applies energy through an electrode under CT guidance to the portion of the nerve responsible for sending pain signals. Pulsed radiofrequency creates a nerve modulation significantly reducing inflammation and its associated symptoms said study senior author Alessandro Napoli M.D. Ph.D. professor of interventional radiology at Sapienza University of Rome in Italy. Dr. Napoli and colleagues studied the approach in patients with back pain from lumbar disk herniation that had not responded to prolonged conservative treatment. In patients the pRF treatment was delivered directly under CT guidance to the root of the nerve. The treatment was applied for minutes. For comparison a group of patients received one to three sessions of CTguided steroid injection on the same anatomical target with no pRF. The oneyear outcomes demonstrated that CTguided pRF was superior to the injectiononly strategy. Patients who received pRF saw greater overall improvement in pain and disability scores during the first year. Relief of leg pain was faster in patients assigned to pRF and they also reported a faster rate of perceived recovery. The probability of perceived recovery after one year of followup was percent in the pRF group compared with percent in the injection only group. Given our study results we offer pulsed radiofrequency to patients with herniated disk and sciatic nerve compression whose symptoms do not benefit from conservative therapy Dr. Napoli said. The results of the study are superior to those typically reported for usual care strategies and injections and may help a substantial number of patients with sciatic disk compression to avoid surgery Dr. Napoli added. The use of pRF also could improve outcomes for patients set to receive corticosteroid injections. We learned that when pulsed radiofrequency is followed by steroid injection the result is longer lasting and more efficacious than injection only Dr. Napoli said. The effect of pulsed radiofrequency is fast and without adverse events. Today therapy for spine disorders allows for definitive treatment of symptoms and conditions using different techniques and technologies. Of the different therapies available pulsed radiofrequency is among the least invasive Dr. Napoli said. Treatment lasts minutes and one session was enough in a large number of treated patients. Coauthors are Roberto Scipione M.D. Fabrizio Andrani M.D. Susan Dababou Cristina Marrocchio Michele Anzidei M.D. and Carlo Catalano M.D. Note Copies of RSNA news releases and electronic images will be available online at RSNA.orgpress httpspress.rsna.orgtimssnetmediarsnanewsroom.cfm beginning Monday Nov. . RSNA is an association of over radiologists radiation oncologists medical physicists and related scientists promoting excellence in patient care and health care delivery through education research and technologic innovation. The Society is based in Oak Brook Ill. RSNA.org https Editors note The data in these releases may differ from those in the published abstract and those actually presented at the meeting as researchers continue to update their data right up until the meeting. To ensure you are using the most uptodate information please contact us. For patientfriendly information on imageguided therapies visit RadiologyInfo.org https"

"An analysis of multicenter randomized controlled clinical trial found osteopathic manipulative treatment OMT for pneumonia reduced length of hospital stay in adults to years old and lowered inhospital mortality rates for patients and older. The study results published in The Journal of the American Osteopathic Association. The study analyzed patients ages or older who were randomly assigned to three groups either receiving OMT a light touch or conventional care only. Differences between treatment groups were evaluated for subgroups of participants based on their age Pneumonia Severity Index and type of pneumonia. The data were analyzed by intentiontotreat analysis of all participants and by perprotocol analysis of participants who finished the study without missing any protocol treatments. Key findings by perprotocol analysis of the younger subgroup found that OMT decreased hospital stay by . days compared to those who received conventional care only. By intentiontotreat analysis of the older subgroup inhospital mortality rates were percent lower to the conventionalcare only group. OMT also reduced the inhospital mortality rates of those with the highest severity of illness. Osteopathic manipulative therapy was developed in the preantibiotic era specifically for the management of pneumonia. While antibiotic therapy is the current standard of care the emergence of resistant bacteria is a global threat and provides an incentive to explore adjunct treatments that can improve their efficacy said James Bailey DO assistant professor in physical medicine and rehabilitation at Rowan University School of Osteopathic Medicine. This study should encourage physicians to use their osteopathic techniques when treating older patients with pneumonia. Pneumonia is a leading cause of death for elderly patients with over percent of pneumoniarelated deaths among those and older. Previous studies have also shown that OMT can improve the efficacy of antibiotics in pneumonia patients. Osteopathic manipulative techniques can help treat structural and tissue abnormalities relieve joint restriction and misalignment restore muscle and tissue balance and promote the overall movement blood flow throughout the body. When appropriate it can complement and in some cases replace medications or surgery. Disclosures The basis for this analysis The Multicenter Osteopathic Pneumonia Study in the Elderly MOPSE clinical trial was funded by a consortium of foundations including the Foundation for Osteopathic Health Services. Please see the study for full details. About the Journal of the American Osteopathic Association The Journal of the American Osteopathic Association JAOA is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein DO it is the premier scholarly peerreviewed publication of the osteopathic medical profession. The JAOAs mission is to advance medicine through the publication of peerreviewed osteopathic research."

"Drinking a glass of beet juice may have an immediate impact on lowering blood pressure https according to a new study. The study shows that within hours of drinking it beet juice lowered systolic blood pressure the top number in a blood pressure reading by an average of points among a small group of healthy men https Researchers say that drop may seem small but on a public health level a reduction like that would equate to a reduction in deaths due to heart disease https Its promising that we can see an effect from a single dose says researcher Leah Coles PhD a research fellow at the Baker IDI Heart https and Diabetes https Institute in Melbourne Australia. That effect might be even greater over the long term if they are drinking it day upon day. Beetroot Benefits Previous studies have shown that beet juice also known as beetroot juice can lower blood pressure in a laboratory setting. But researchers say this is the first study to look at the effects of adding beet juice to a heathy persons diet without making any other diet or lifestyle changes. The results appear in Nutrition https Journal. In the study men and women drank either . ounces of a beet juice beverage consisting of about threefourths beet juice and onefourth apple juice or a placebo https juice. They were then monitored for hours. The same procedure was repeated two weeks later with those who drank the placebo on the first round receiving beetroot juice on the second. Among both men and women the results showed a trend to lower systolic blood https pressure six hours after drinking the beet juice. But when researchers limited their analysis to men only they found a significant reduction of about . points among those who drank the beetroot juice. Previous studies have also suggested that beetroots blood https effects may not be as strong in women. In this case Coles says it may be partially explained by the fact that the women in the study tended to be older and many were on prescription medications https such as oral contraceptives https Nitrates Behind Blood Pressure Effect Experts say its the high concentration of nitrates in beets that are responsible for the benefits. In a lengthy biological process nitrates from dietary sources like beets and leafy green vegetables are converted to nitric oxide within the body. The nitric oxide then relaxes blood vessels and dilates them which helps the blood flow more easily and lowers blood pressure. Whether from foods or from juice you are seeing a consistent effect of nitrates in lowering blood pressure says registered dietitian Norman Hord PhD MPH an associate professor at College of Public Health and Human Sciences at Oregon State University in Corvallis Ore. Its probably the most potent bloodpressurelowering component of the diet. Hord says previous studies have found more impressive reductions in blood pressure of up to points when researchers measured blood pressure within three hours of drinking beet juice. Although more research is needed to better understand the longterm effects of nitrates on blood pressure Hord says eating a diet rich in nitrates from natural sources like beets and leafy green vegetables is good advice. Its an approach to eating thats similar to the DASH Dietary Approaches to Stop Hypertension https diet which has been proven to lower blood pressure. The DASH diet https emphasizes eating more fruits vegetables and lowfat dairy foods along with whole grains fish poultry and nuts while limiting saturated fat https and cholesterol https These food patterns have been shown to lower blood pressure Hord says. Research now shows nitrates are probably responsible for at least part of that effect."

"A onetime treatment with Luxturna the first US Food and Drug Administrationapproved gene therapy for an inherited disorder will cost per eye. Spark Therapeutics Inc. the Philadelphiabased maker of voretigene neparvovec announced Wednesday in a statement httpir.sparktx.comnewsreleasesnewsreleasedetailssparktherapeuticsannouncesfirsttheirkindprogramsimprove that it reached an agreement in principle with Harvard Pilgrim and affiliates of Express Scripts to make the onetime treatment available to patients with a rare genetic defect that often leads to blindness. The mutation affects both eyes usually at the same pace so most patients would need treatment for both eyes a Spark Therapeutics spokeswoman said. In some cases the gene therapy will be available under an outcomesbased rebate arrangement. The company also stated that its proposal to the Centers for Medicare and Medicaid Services the government program that covers about million Americans would allow installment payments for the drug. For a onetime therapy like Luxturna a nontraditional payment and distribution model is necessary to ensure needs of all parties patients payers and providers are addressed said Jennifer Luddy a spokeswoman for Express Scripts. At least one patient advocate disagrees. The new payment models announced today are merely a way to disguise a price that is simply too high David Mitchell president and founder of Patients For Affordable Drugs said in a statement https Spark Therapeutics is charging as much for Luxturna as they think they can get away with. Spark Therapeutics CEO Jeff Marrazzo coauthored a recent blog post in the journal Health Affairs https that said the current payment system accustomed to ongoing treatment of chronic diseases creates significant challenges for gene therapies and other treatments. Onetimeonly treatments for rare genetic disorders are still unique he noted. The drug is intended for patients with retinal dystrophy due to a mutation of the RPE gene. This rare genetic defect causes severe visual impairment beginning in infancy and can eventually lead to blindness. The company believes the total population in the US Europe and select additional markets in the Americas and AsiaPacific is up to approximately individuals who have the mutation targeted by Luxturna explained Monique da Silva a spokeswoman for Spark Therapeutics. The drug will be available in the United States in early spring with an estimated to people in the US standing to benefit from this treatment according to Spark. Luxturna is only the third gene therapy approved for use in the United States two others were also approved in . This is the first to correct an inherited genetic mutation. Luxturna is a liquid that is injected directly into the eye with a microscopic needle during a surgical procedure. The drug supplies a third gene a normal RPE gene to cells in the retina a layer of tissue lining the back of the eye. This third version of the gene does not remove or replace the two mutated genes causing the disease which remain inside the cells. However the normal gene delivered by the treatment is able to function within the retinal cells and correct vision problems. In the phase clinical trial out of participants who received the gene therapy demonstrated a gain in functional vision as assessed by a mobility test performed in a maze according to the company. Risks of the treatment include cataracts elevated eye pressure retinal tears and holes and inflammation. The companys offer of unusual payer models including rebates and installment payments will help ensure patients individual financial situation does not hinder access to treatment da Silva said. New technologies such as gene and cell therapies hold out the potential to transform medicine FDA Commissioner Dr. Scott Gottlieb said in a statement https announcing the August approval of Kymriah considered to be the first gene therapy to be approved for the US market. Follow CNN Health on Facebook and Twitter See the latest news and share your comments with CNN Health on Facebook https and Twitter httpstwitter.comcnnhealth. Kymriah is a leukemia treatment made by pharmaceutical giant Novartis. Similar to Luxturna Kymriah is a onetime treatment and its price tag is . However Novartis said this price will not be charged to patients who do not respond within a month of treatment."

"An experimental treatment that involves spinal injections of ozone gas and steroids relieved pain https in over twothirds of people with back problems related to a herniated disc. This condition occurs when the cushions or discs that serve as shock absorbers for the spine become inflamed and bulge or break open. When inflamed discs press against nearby nerves. People with this condition can experience pain numbness and weakness in the back buttocks and legs. None of the people in this study had been helped by other nonsurgical therapies and supporters say the new therapy could become a standard treatment for such patients. But a back pain https specialist who spoke to WebMD says that further research is needed. In the study people reported no pain at six months. About another third reported less frequent episodes of low back pain maybe once a day says researcher Thomas Lehnert MD an assistant professor of radiology at Frankfurt University in Germany. Another reported only a little improvement with pain persisting. And had no improvement or their pain got worse. A few patients resorted to back surgery. Continue Reading Below you might like Still ozone therapy could even help many patients with unrelenting back pain to avoid surgery Lehnert tells WebMD. Before the treatment patients had tried everything without success and were considering an operation he says. Studies suggest that ozone therapy works by reducing inflammation shrinking herniated discs and relieving pressure on the nerves bringing pain signals to the brain https The steroid further reduces inflammation. Lehnert presented the findings here at the annual meeting of the Radiological Society of North America. Pain From Herniated Disc As many as of adults in the U.S. suffer from lower back pain https_assetscontrolled_contenthealthwisemajorLow_Back_PainTopic_Overview.xml at some point in their lives and for many the cause is a herniated disc. About of people with herniated discrelated pain will improve within two months without surgical treatment. Of those who dont improve only will need surgery. The vast majority improve with physical therapy steroid injections chiropractic https_assetscontrolled_contenthealthwisespecialChiropracticTopic_Overview.xml treatment etc. says A. Nick Shamie MD of UCLA Spine Center a spokesman for the American Academy of Orthopaedic Surgeons. Its possible ozone treatment will someday be one of those options Shamie tells WebMD. But because so many people with pain from herniated discs get better on their own it is hard to prove that treatments like ozone therapy actually work he says. And in this study its unknown whether it was ozone the steroids or a combination of the two that helped patients he says. Theres no way to be sure Lehnert says. A headtohead comparison of treatments is planned to answer that question. Ozone Therapy for Back Pain Ozone therapy was developed In Italy. Its been used to treat thousands of lower back pain patients mainly in Europe in recent years. Lehnert says he added the steroid to reduce inflammation because of the pain is due to inflammation in the herniated area. Using computer imaging for guidance the doctor guides the needle used to deliver the ozonesteroid treatment directly into the herniated disc. Patients require no more than a local anesthetic. While patients in the study only got one injection more may be needed he says. Importantly imaging studies showed patients disc volumes shrunk by to in the study. If you reduce the volume it wont be pushing against the nerve causing pain Lehnert says. There were no serious complications and no one had an allergic reaction https_assetscontrolled_contenthealthwisesymptomAllergic_ReactionTopic_Overview.xml. Some people complained of pain around the area in the back where the needle was injected it went away after a few days. In other studies there have been reports of increased pain and bleeding in the eyes Lehnert says. Jeffrey Peterson MD professor of radiology at the Mayo Clinic in Jacksonville Fla. says the technique is promising. Were already using similar procedures for steroid injections says Peterson who moderated the session at which the findings were presented. Whats different here is the medical ozone. These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the peer review process in which outside experts scrutinize the data prior to publication in a medical journal."

"Bayer Healthcare said on Wednesday the U.S. Food and Drug Administration approved using transvaginal ultrasound as an alternate test to confirm if the companys Essure permanent birth control device has been placed properly. Essure is a small metal coil inserted into womans fallopian tubes. But since its approval in women using the device have sent the FDA more than complaints ranging from pain and menstrual problems to pregnancies and even deaths. Some of the complaints related to the placement of the device. In a transvaginal ultrasound TVU sound waves emitted from a probe placed in vagina help a physician check if Essure has been placed properly. This test is an alternative to the generallyprescribed modified hysterosalpingogram HSG test in which an xray of the uterus and fallopian tubes is used to check for proper device placement. A woman using Essure must do a test to confirm that the device is properly placed within three months of the procedure and until she receives a confirmation from her doctor she must use alternate birth control methods Bayer said in a statement on Wednesday. All physicians who offer Essure are expected to be trained to perform the TVU confirmation test by mid the company said. The training will start in September the same month the FDA will hold a public panel meeting to discuss the safety and effectiveness of Essure. Reporting by Anjali Rao Koppala in Bengaluru Editing by Savio DSouza Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Following a concussion or mild traumatic brain injury TBI patients may suffer from light sensitivity or photophobia making it challenging to return to normal activities. The sensitivity may also trigger or exacerbate headaches. While sunglasses can provide some relief from photophobia wearing them all the time is not always a practical solution nor is it pleasant for patients to live in a dark room for days at a time. A new study from the University of Cincinnati UC published online this week in the Journal of Athletic Training httpnatajournals.orgdoipdf... assessed the use of colored lenses in postconcussion patients and found wearing certain colortinted sunglasses may be a good alternative to dark sunglasses. While sunglasses can provide some relief they are not very practical indoors or in low light environments says Joe Clark PhD professor in the Department of Neurology and Rehabilitation Medicine at the UC College of Medicine and lead author of the study. What is needed is a light mitigation strategy that can be readily employed indoors which can optimize relief in those who suffer from photophobia or light sensitivity. Clark and researchers at the College of Medicine assessed visual symptoms of concussion patients and used frames with varying colored lenses to find out if certain hues provided relief from photophobia. We found that percent of patients reporting photophobia had relief of the symptoms with one or more colors blue green red and purplewith no reported adverse events Clark says. Sensitivity to light can be common and impact activities of daily life suggesting that light mitigation might improve quality of life in many of these patients. Photophobia is a common symptom for patients following traumatic brain injury. Our goal in this study was to provide medical staff like athletic trainers with a method and means to assess and subsequently provide relief to an athlete who may be experiencing symptoms of photophobia Clark adds. The goal is to help the concussion patient feel better as the brain heals. We compare the colored glasses to being like a brace or cast but for the brain he says. It is temporary but prevents further injury or pain. At least . million people in the United States sustain a concussion or traumatic brain injury every year many not for the first time. As with many other health conditions the presentation of concussion symptoms can vary greatlywhile some individuals exhibit very little to no change in functionality and may report no symptoms at all others may report confusion headache decreased balance and vision disturbances including blurry vision trouble focusing and sensitivity to light. Photophobia is so common that many neurosurgical intensive care units consider it standard operating procedure to keep lights dimmed in rooms containing TBI patients says Clark. In addition to trying coloredlens sunglasses the article suggests other ways to mitigate photophobia including wearing a widebrimmed hat when outdoors adjusting digital screen and device settings to an appropriate hue and brightness or purchasing filters for screens. However the researchers noted they do not recommend wearing colored glasses while driving. Certain colors make seeing stop lights or emergency vehicle lights difficult. We believe that an athletic trainer in consultation with team physicians may find it useful to apply this photophobia assessment and recommend colored glasses to his or her athlete Clark says. The use of the colored glasses in the high school college or other setting can allow a person to engage in some medically approved activities while minimizing the risk of symptom exacerbation. We believe the use of the colored glasses that provide photophobia mitigation has added benefits superior to dark sunglasses especially for indoor lighting. Additional researchers on the study include Jon Divine MD a professor in the Department of Orthopaedic Surgery at the UC College of Medicine and head team physician for University of Cincinnati Athletics. There was no funding used for this study."

"Researchers at Johns Hopkins Medicine have identified in live human brains new radioactive tracer molecules that bind to and light up tau tangles a protein associated with a number of neurodegenerative diseases including Alzheimers disease and other related dementias. Two studies will be published backtoback in the December issue of Journal of Nuclear Medicineone as featured article of the monthdescribing testing of three candidate molecules in patients with Alzheimers disease as well as the use of one molecule to measure the accumulation of tau proteins. One of the greatest public health challenges is Alzheimers disease for which there currently is no cure and no definitive diagnostic until autopsy says Dean Wong M.D. Ph.D. https professor of radiology and radiological sciences psychiatry and behavioral sciences neurology and neuroscience and director of the Section of High Resolution Brain PET Imaging Division of Nuclear Medicine at the Johns Hopkins University School of Medicine. We have been working hard to identify new radiopharmaceuticals that can help speed the discoveries of diagnostics and treatments for these devastating neurodegenerative disorders. Alzheimers disease is characterized in the brain by the appearance of two abnormal protein structures amyloid plaques and tangled fibers made up of a protein called tau. One of the biggest challenges in studying Alzheimers disease thus far according to Wong is the inability to watch these socalled neurofibrillary tangles develop in real time. As part of a longer term project funded by F. HoffmanLa Roche the team previously tested a collection of approximately potential tracer molecules and identified six promising tracers eventually narrowing them down to three to be made and tested as candidate Tau PET radiopharmaceuticals. These three most promising tracers were previously tested in nonhuman primates and the results looked promising enough to test in people. The researchers recruited a total of patients with Alzheimers disease seven younger healthy controls ages years old and five older healthy controls age or older for brainonly PET scans. An additional six older healthy controls were recruited for fullbody scanning. The study was divided into three parts. In the first part each person was injected with two of the three randomly designated tracers on separate visits prior to receiving a brain PET scan with subsequent evaluation to determine which molecule performed best. In the second part of the study researchers tested the optimal tracer called F RO with additional brain imaging in five patients with Alzheimers and five older controls with followup of previously seen patients to evaluate the potential progression of tau protein tangling after an average span of approximately months. The third part of the study examined six older controls undergoing wholebody scanning. In total the researchers looked at different regions in the brain to evaluate how well the tracers were taken up by the brain how well they penetrated through the tissue and how specifically they bound to the tau protein rather than just sticking indiscriminately to anything. Regions of the brain that typically contain accumulated tau protein include the temporal lobe parietal lobe and occipital lobe among others grey matter in the cerebellum is thought to contain low or no tau in patients with Alzheimers. They found that healthy brains retained little to no tracer whereas the brains of those with Alzheimers showed tau to be in regions of the brain consistent with previously reported postmortem data on filamentous tangles. In the second paper the team examined the detailed quantification of tau binding via F RO in patients with Alzheimers disease five young cognitively normal controls and five older cognitively normal controls. They verified that detailed quantification of the tested and retested tracer in those five patients with Alzheimers and five older controls generated good and reproducible results. According to Wong this body of work reveals that as compared with the currently used Tau tracer F AV the new tracer F RO does not bind randomly to other tissue offering greater clarity into quantification of potential tau burden within the human brain. It really takes a village to make progress in biomedical research and this project was no exception with the involvement of the PET team at Hopkins a CRO who helped recruit healthy subjects colleagues in psychiatry and behavioral sciences colleagues at the National Institute of Aging and neuroscience imaging experts at Roche says Wong. This is a true example of crossdisciplinary collaboration and Im honored to have such great collaborators. This study was made available online in May ahead of peerreview and publication. It was published in the December issue of the journal. Authors of the first Journal of Nuclear Medicine featured paper Characterization of Novel Tau Radiopharmaceuticals CRO CRO and FRO in Healthy Controls and in Alzheimer Subjects httpjnm.snmjournals.orgcontent include Dean F. Wong Hiroto Kuwabara Paul B. Rosenberg Esther Oh Constantine G. Lyketsos Noble George Lorena Gapasin Kelly Kitzmiller Josh Roberts Ayon Nandi James Brasic Chakradhar Mishra Abhay Moghekar Anil Mathur Marilyn Albert and Robert F. Dannals of The Johns Hopkins University Baltimore Maryland Robert A. Comley Susanne Ostrowitzki Cristina Vozzi Frank Boess Michael Honer Luca Gobbi Gregory Klein Jeff Sevigny and Edilio Borroni Pharma Research and Early Development HoffmannLa Roche Basel Switzerland and Susan M. Resnick and Madhav Thambisetty Lab of Behavior and Neuroscience NIHs National Institute on Aging Intramural Research Program Baltimore Maryland. This study was funded by an F. HoffmannLa Roche Ltd. contract to The Johns Hopkins University. Susan Resnick and Madhav Thambisetty are employees of the NIH National Institute on Aging. The authors report no other relevant potential conflict of interest."

"When roasted at degrees coffee beans are sometimes described as rich and fullbodied. But for the fullbodied person who is not so rich unroasted coffee beans green as the day they were picked may hold the key to cheap and effective weight loss new research suggests. In a study presented Tuesday at the American Chemical Societys spring national meeting in San Diego overweight young adults took by turns a low dose of green coffee bean extract a high dose of the supplement and a placebo. Though the study was small the results were striking Subjects lost an average of . pounds in weeks and reduced their overall body weight by .. If green coffee extract were a medication seeking approval from the Food and Drug Administration these results would make it a viable candidate more than of subjects lost more than of their body weight and weight loss appeared to be greater while subjects were taking the pills than when they were on the placebo. But as a dietary supplement green coffee extract does not require the FDAs blessing. In fact it is already available as a naturopathic medicine and antioxidant. Joe Vinson the University of Scranton chemist who conducted the pilot study said the findings should pave the way for more rigorous research on coffee bean extracts effects. A larger trial involving people is being planned. Vinson whose research focuses on plant polyphenols and their effects on human health said it appears that green coffee bean extract may work by reducing the absorption of fat and glucose in the gut it may also reduce insulin levels which would improve metabolic function. There were no signs of ill effects on any subjects Vinson reported Tuesday. The study used a crossover design which allowed each subject to serve as his or her own comparison group. For six weeks volunteers swallowed capsules three times a day ingesting either or milligrams of green coffee extract a day or taking a placebo. After a twoweek break they moved roundrobin style to another arm of the trial. Subjects did not change their calorie intake over the course of the trial. But the more extract they consumed the more weight and fat they lost. Altogether they reduced their body fat by on average. Of the volunteers six wound up with a body mass index in the healthful range. One downside is that the extract is extremely bitter. It would be difficult to take without a lot of water Vinson reported. At roughly per month however green coffee extract is much less expensive than any of the weightloss medications available over the counter or by prescription. The trial was conducted in India and paid for by Applied Food Sciences Inc. of Austin Tex. a manufacturer of green coffee bean extract. The pilot study drew strong cautions from several scientists who werent involved in the research. This is certainly a provocative study said Dr. Gerald Weissmann a physician and biochemist at New York University. But he said nutrition experts would want assurances that green coffee beans do not cause malabsorption within the human gut a condition that would lead to weight loss as well as malnutrition heart arrhythmias and other problems because vitamins and minerals are not passing through the intestine. Dr. Arthur Grollman a pharmacologist at the State University of New York at Stony Brook said coffee beans contain about different chemicals some with positive and others with negative effects on human health. Though Vinson identified polyphenols and chlorogenic acid as the agents that appear to promote weight loss Grollman said that claim needed further study. In the meantime he said consuming an extract that contains both good and bad chemicals in dense concentration seems an unwise thing to do."

"Researchers have identified two new biological markers of cystic fibrosis CF a genetic disease which affects children and young adults leaving them with lifelong health complications including digestive problems and persistent lung infections. The findings published in the journal ACS Central Science shed new light on the underlying mechanisms of CF and could lead to improved prognosis and better therapies for a disease which is quite variable affecting different children in different ways say researchers. There are chemical signatures in sweat that tell us an infant has CF says Philip BritzMcKibbin lead author of the study and a professor in the Department of Chemistry and Chemical Biology at McMaster University. We set out to discover whether there were chemical indicators detected in sweat that could complement the gold standard for CF diagnosis the sweat chloride test. The test is commonly used in universal newborn diseasescreening programs and measures the concentrations of salt. Elevated sweat chloride confirms that an infant actually has CF. But there are some obstacles that complicate clinical decisionmaking explains BritzMcKibbin because sweat chloride can result in ambiguous diagnoses in some borderline cases and does not reveal how the disease might progress for individual patients. Sweat contains lots of information related to human health that researchers have not fully analyzed and we found some unexpected chemicals associated with CF he says. Using a specialized technique developed at McMaster scientists collected and analyzed sweat samples from infants in CF clinics at the McMaster Childrens Hospital and the Hospital for Sick Children in Toronto. They identified several unknown chemicals beyond chloride that were consistently associated with babies who had CF including two different drug and environmental compounds the infants secreted in sweat at much lower concentration levels. Testing for these biomarkers could be done in cases in which the chloride sweat test result is unclear say researchers. The biomarkers also point to other underlying mechanisms that contribute to the progression of CF and could lead to better therapeutic interventions earlier in life. The easier it is to detect CF the earlier it can be diagnosed and the better peoples chances are at living a longer healthier life says Joanna Valsamis Chief Healthcare Research and Advocacy Officer at Cystic Fibrosis Canada. CF Canada invests heavily in research that aims to improve the lives of people living with CF and findings such as those from Dr. BritzMcKibbin are crucial to our understanding of the disease. In Canada one in every children are diagnosed with CF. But life expectancy rates have risen dramatically in recent decades with the median age of survival now over years due to better treatments to improve lung function better nutrition and lung transplants. Further benefits are expected with the advent of newborn screening programs that have resulted in early detection. The research was funded in part by Cystic Fibrosis Canada. Since CF Canada has invested more than million in leading CF research and care."

"A portable device common in optometrists offices may hold the key to faster diagnosis of schizophrenia predicting relapse and symptom severity and assessing treatment effectiveness a Rutgers University study finds. In the study published in the May issue of the Journal of Abnormal Psychology researchers used RETeval a handheld device developed to record electrical activity from the retina to replicate and extend prior studies showing that people with schizophrenia had abnormal electrical activity in the retina. This was the first time a portable device was used for these tests. The results show the device accurately indicated reduced electrical activity in the retina in multiple cell layers in the participants who had schizophrenia including in cell types that had not been studied before in this disorder. Schizophrenia is a devastating disorder probably the most disabling disorder long term. Although we know quite a bit about it its still not that well understood said Steven Silverstein professor of psychiatry at Rutgers Robert Wood Johnson Medical School and director of research at Rutgers University Behavioral Health Care UBHC who designed the study. Our study should help generate further research into developing a test that clinicians like psychologists psychiatrists or nurses can use in their offices to diagnose treat and monitor the condition of people with schizophrenia. Looking at biomarkers in the eye as a way to understand psychiatric disorders is a new field of study. Since the retina is part of the nervous system what is happening in the retina is likely reflective of what is occurring in the brain Silverstein said. For example we know that certain changes in the retina like thinning tissue due to cell loss or weakening electrical activity occur alongside loss of brain tissue and reduced brain activity in patients with neurological disorders like multiple sclerosis and Parkinsons disease. We and other researchers are now investigating whether retinal changes are related to brain structure and function changes in schizophrenia. In the justpublished study the researchers evaluated participants with schizophrenia and with no diagnosed psychiatric disorder. In the test the participants closed one eye and placed the other against the RETeval device which flashed to white or colored lights of various intensity against a white or colored background. A tiny skin electrode was placed on the skin under the eye to record the retinas electrical activity. The participants were tested in normal light and after sitting in the dark for minutes to assess activity in different types of retinal cells. Most individual tests were completed within two minutes. Since many of our participants were experiencing severe psychiatric symptoms such as hallucinations and delusions we wanted to use a test that was as noninvasive and quick as possible Silverstein said. While the portable device clearly distinguished people with schizophrenia from those without a psychiatric diagnosis its too soon to call this a diagnostic tool said lead author Docia Demmin a graduate assistant in UBHCs Division of Schizophrenia Research and a doctoral student in Rutgers Department of Psychology. However since every prior study has found that people with schizophrenia exhibit reduced retinal wave forms and slowed retinal responses our research shows that we closing in on an accurate test that is faster less invasive inexpensive and more accessible to patients."

"People who eat vegetables fruit and whole grains may have lower rates of depression over time according to a preliminary study released today that will be presented at the American Academy of Neurologys th Annual Meeting in Los Angeles April to . The study found that people whose diets adhered more closely to the Dietary Approaches to Stop Hypertension DASH diet were less likely to develop depression than people who did not closely follow the diet. In addition to fruit and vegetables the DASH diet recommends fatfree or lowfat dairy products and limits foods that are high in saturated fats and sugar. Studies have shown health benefits such as lowering high blood pressure and bad cholesterol LDL along with lowering body weight. Depression is common in older adults and more frequent in people with memory problems vascular risk factors such as high blood pressure or high cholesterol or people who have had a stroke said study author Laurel Cherian MD of Rush University Medical Center in Chicago and a member of the American Academy of Neurology. Making a lifestyle change such as changing your diet is often preferred over taking medications so we wanted to see if diet could be an effective way to reduce the risk of depression. For the study participants with an average age of were evaluated yearly for an average of sixandahalf years. They were monitored for symptoms of depression such as being bothered by things that usually didnt affect them and feeling hopeless about the future. They also filled out questionnaires about how often they ate various foods and the researchers looked at how closely the participants diets followed diets such as the DASH diet Mediterranean diet and the traditional Western diet. Participants were divided into three groups based on how closely they adhered to the diets. People in the two groups that followed the DASH diet most closely were less likely to develop depression than people in the group that did not follow the diet closely. The odds of becoming depressed over time was percent lower among the top group of DASH adherers versus the lowest group. On the other hand the more closely people followed a Western dieta diet that is high in saturated fats and red meats and low in fruits and vegetablesthe more likely they were to develop depression. Cherian noted that the study does not prove that the DASH diet leads to a reduced risk of depression it only shows an association. Future studies are now needed to confirm these results and to determine the best nutritional components of the DASH diet to prevent depression later in life and to best help people keep their brains healthy said Cherian. Register now for the AAN Annual Meeting Press Room in Los Angeles April https Media Contacts Renee Tessman rtessmanaan.com mailtortessmanaan.com Michelle Uher muheraan.com mailtomuheraan.com The study was supported by the National Institute on Aging. Learn more about brain health at http The American Academy of Neurology is the worlds largest association of neurologists and neuroscience professionals with over members. The AAN is dedicated to promoting the highest quality patientcentered neurologic care. A neurologist is a doctor with specialized training in diagnosing treating and managing disorders of the brain and nervous system such as Alzheimers disease stroke migraine multiple sclerosis concussion Parkinsons disease and epilepsy. For more information about the American Academy of Neurology visit http or find us on Facebook Twitter Google LinkedIn and YouTube."

"The new blood thinner Xarelto appears to lower the chances of potentially fatal blood clots in highrisk heart patients a U.S. Food and Drug Administration review has found. The review came in briefing documents that were filed Monday in advance of an FDA advisory panel meeting Wednesday at which the panel is to vote on whether to recommend approval of Xarelto for treating people with acute coronary syndrome a group of conditions brought on by sudden reduced blood flow to the heart. The FDA is not required to follow the advice of its expert panels but the agency typically does. A final decision is expected by the end of June according to the documents. Xarelto rivaroxaban is one of a new class of blood thinners that have been developed to overcome some of the problems that exist with the standard treatment warfarin Coumadin which requires constant dose monitoring. Warfarins effectiveness also can be altered by certain foods and other medications. Xarelto already is approved for use by those with atrial fibrillation irregular heartbeat and by people who are having hip or kneereplacement surgery. In the FDA briefing documents an agency reviewer recommended approving the drug for treatment of acute coronary syndrome mostly because trial data showed there was a reduction in cardiovascular death even though there was also an increased risk of potentially fatal bleeding. However what is not reflected in the sponsors analysis are minor bleeding events FDA reviewer Dr. Karen Hicks wrote in the briefing documents. While it is true that these bleeding events typically do not lead to death or irreversible harm these events may represent the biggest problem for both patients and health care providers if rivaroxaban is approved. While reductions in cardiovascular death still trump these bleeding events if rivaroxaban is approved we should expect a number of bleeding events that will require medical attention Hicks wrote. Carefully selecting patients for rivaroxaban therapy will be necessary to mitigate these bleeding risks. In research presented at the American Stroke Associations International Stroke Conference in New Orleans last February Australian doctors followed more than people who took either Xarelto or warfarin for a median of two years. Of those patients had bleeding in the brain. People who took Xarelto and suffered from the most common type of atrial fibrillation and didnt have heart valve damage were about onethird less likely to experience bleeding in the brain than those who took warfarin the investigators found. More information The U.S. National Institute of Neurological Disorders and Stroke has more about stroke. SOURCES May briefing documents U.S. Food and Drug Administration February news release American Stroke Association"

"In a bid to make cancer immunotherapy more effective researchers report they have succeeded in halting the progress of aggressive melanoma in its tracks at least briefly in seven patients treated with an army of cloned cancerfighting immune cells. In one of those patients the treatment resulted in complete remission of his metastatic melanoma and evidence that his immune system stands ready to fight any return of the cancer after three years. The study published Monday in the Proceedings of the National Academies of Science contributes to hopes that a tumorfighting strategy called immunotherapy can slow halt or even reverse the growth of a range of cancers and do so with fewer dangerous side effects. Immunotherapy is one of medicines most promising and most problematic approaches to cancer treatment. It aims to charge up the patients immune system to attack cancer cells and halt their outofcontrol growth. The approach outlined in the new study by researchers from the Fred Hutchinson Cancer Research Center in Seattle identifies several ways to make it better said Dr. Cassian Yee the studys senior author. The key is to identify specific cancerfighting cells already circulating in the blood of patients and make thousands of copies of them in the lab. This type of adoptive immunotherapy could be effective against a wide range of cancers Yee said. His research group is making plans to try the technique on patients with advanced ovarian cancer and sarcomas rare tumors that arise from connective tissue in bones and muscle. Several independent researchers said the study results were promising. But they also noted that the trial involved only patients and said the therapy was less effective than in other published trials. Someday cellbased therapy will be mainstream in cancer therapy said Dr. Jeff Miller of the University of Minnesotas cell therapy core laboratory. Each article that shows clinical activity is giving us a piece of the puzzle that will make it safer and more effective he said. Immunotherapy usually starts with clinicians harvesting immune system cells called T cells that have attached themselves to a tumor in an effort to attack. They then coax the cells to multiply either in the lab or in the body and let them loose in the bloodstream so they can attack cancer wherever they find it. Yees team tried to do this more precisely. The researchers hoped that by choosing T cells more selectively and cloning only those judged most likely to vanquish their foe the treatment would be more effective. Sorting through the bodys vast and diverse population of T cells to select just the right ones is a painstaking process. But Yee bet that the extra effort would pay off with better results and fewer side effects. Researchers drew blood from patients and scoured it to find the rare type of immune cell a melanomaspecific cytotoxic T lymphocyte cell that specifically homes in on proteins expressed by the cancer. Then they put their harvest as few as a few hundred cells into a test tube and cloned them creating millions. The last step was to infuse the resulting army of cancerfighting clones back into the patient. In six of the patients in the trial the melanoma stopped progressing for to weeks. Another patient was declared in remission because his cancer ceased to spread and after several months disappeared altogether. Three years later researchers continue to detect the presence of the cloned cells they infused into the patient yearold high school history teacher Gardiner Vinnedge of North Bend Wash. For six years Vinnedge endured painful rounds of chemotherapy only to have his melanoma return. The immunotherapy allowed him to return to work three weeks after treatments began. The only side effect he said was a raging rash that lasted for three days. My back my legs were just covered with a hot red rash Vinnedge said. It meant the treatment was working the war was on between my T cells and the melanin in my skin. Now he says he is optimistic he may live to see retirement age though hes not sure hell ever stop teaching. For immunotherapy to work the manufactured T cells must survive for the months it takes to reach a tumor and dismantle it as well as to round up migrating cancer cells and kill them. Currently the T cells have limited staying power and often die off before their work is done. Doctors give them a boost by administering a growth factor called interleukin. But at high doses it can cause dangerously low blood pressure breathing problems kidney failure and heart arrhythmias. Yees group showed that by choosing T cells more selectively patients can get by with much lower doses of interleukin making the treatment less toxic. The researchers also discovered another way to reduce their dependence on interleukin by selecting the most youthful T cells which survived the longest when infused into patients. Dr. Patrick Hwu of the MD Anderson Cancer Center in Houston said the study adds to the wealth of what we know about using the bodys immune system to fight cancer. But immunotherapy pioneer Dr. Steven A. Rosenberg was highly critical of the methods and results. Cloned cells dont work said Rosenberg who heads the National Cancer Institutes tumor immunology section. In larger immunotherapy trials that used cultured cancerfighting immune cells taken from patients tumors Rosenberg and his colleagues achieved durable and complete regression in as many as as patients with advanced metastatic melanoma. These results he said are inferior."

"A pill that combines three blood pressurelowering drugs improves peoples chances of lowering their high blood pressure researchers report. The pill contains low doses of the three medications telmisartan amlodipine and chlorthalidone. The finding stems from a study of people who averaged years old. All had high blood pressure. Among those who took the socalled triple pill for six months percent had achieved their blood pressure targets compared with percent of those who received their usual care. Usual care meant taking whatever blood pressure medicine their doctor prescribed. The rate of side effects was no greater among those who took the threeinone pill than among the usual care group. Based on our findings we conclude that this new method of using blood pressurelowering drugs was more effective and just as safe as current approaches lead author Ruth Webster said in a news release from the American College of Cardiology. Shes a researcher with the George Institute for Global Health at the University of New South Wales in Sydney Australia. The study was presented Monday at the annual meeting of the American College of Cardiology in Orlando Fla. The findings should be considered preliminary because research presented at meetings has not undergone the rigorous scrutiny given to research published in medical journals. The most urgent need for innovative strategies to control blood pressure is in low and middleincome countries Webster said. The triple pill approach is an opportunity to leapfrog over traditional approaches to care and adopt an innovative approach that has been shown to be effective. High blood pressure increases the risk for heart attack stroke and kidney problems. A control rate of percent would be a considerable improvement even in highincome settings Webster said. Most hypertension guidelines in these countries do not recommend combination bloodpressurelowering therapy for initial treatment in all people. The findings she said should prompt reconsideration of recommendations around the use of combination therapy. More information The U.S. Food and Drug Administration has more on high blood pressure medications https SOURCE American College of Cardiology news release March"

"In a bold new approach ultimately aimed at trying to cure AIDS scientists used genetic engineering in six patients to develop blood cells that are resistant to HIV the virus that causes the disease. Its far too early to know if this scientific first will prove to be a cure or even a new treatment. The research was only meant to show that so far it seems feasible and safe. The concept was based on the astonishing case of an AIDS patient who seems to be cured after getting blood cells from a donor with natural immunity to HIV nearly four years ago in Berlin. Researchers are seeking a more practical way to achieve similar immunity using patients own blood cells. The results announced Monday at a conference in Boston left experts cautiously excited. For the first time people are beginning to think about a cure as a real possibility said Dr. John Zaia head of the government panel that oversees gene therapy experiments. Even if the new approach doesnt get rid of HIV completely it may repair patients immune systems enough that they can control the virus and not need AIDS medicines what is called a functional cure he said. Carl Dieffenbach AIDS chief at the National Institute of Allergy and Infectious Diseases agreed. Were hopeful that this is sufficient to give the level of immune reconstitution similar to what was seen with the patient from Germany he said. This is the first time researchers have permanently deleted a human gene and infused the altered cells back into patients. Other gene therapy attempts tried to add a gene or muffle the activity of one and have not worked against HIV. The virus can damage the immune system for years before people develop symptoms and are said to have AIDS acquired immune deficiency syndrome. The virus targets special immune system soldiers called Tcells. It usually enters these cells through a protein receptor or docking station called CCR. Some people about percent of whites fewer of minorities lack both copies of the CCR gene and are naturally resistant to HIV. One such person donated blood stem cells in to an American man living in Berlin who had leukemia and HIV. The cell transplant appears to have cured both problems but finding such donors for everyone with HIV is impossible and transplants are medically risky. So scientists wondered Could a patients own cells be used to knock out the CCR gene and create resistance to HIV A California biotechnology company Sangamo SANGuhmoh BioSciences Inc. makes a treatment that can cut DNA at precise locations and permanently edit out a gene. Dr. Jacob Lalezari director of Quest Clinical Research of San Francisco led the first test of this with the company and colleagues at the University of California in San Francisco and Los Angeles. He warned that it would be way overstated to suggest that the results so far are a possible cure. Its an overreach of the data. There are a lot of people out there with hopes and dreams around the Cword so caution is needed. In the study six men with HIV had their blood filtered to remove a small percentage of their Tcells. The genesnipping compound was added in the lab and about onefourth of the cells were successfully modified. The cells were mixed with growth factors to make them multiply and then infused back into the patients. Three men received about . billion modified cells. Three others received about billion. Three months later five men had three times the number of modified cells expected. As much as percent of their total Tcells appear to be the new type resistant to HIV Lalezari said. The sixth man also had modified cells but fewer than expected. In all six patients the antiHIV cells were thriving nearly a year after infusion even in tissues that can hide HIV when it cant be detected in blood. The cells are engrafting theyre staying in the bloodstream theyre expanding over time said Lalezari who has no personal financial ties to Sangamo the studys sponsor. The only side effect was two days of flulike symptoms. It will take longer to determine safety but several AIDS experts said they were encouraged so far. It is a huge step and a first for the field of genetics said John Rossi a researcher at City of Hope in Duarte Calif. where he and Zaia plan another study to test Sangamos approach. The idea is if you take away cells the virus can infect you can cure the disease. On Wednesday Dr. Carl June a gene therapy expert at the University of Pennsylvania will report partial results from a second federally funded study of people testing Sangamos product. He treated his first patient with it in July . Many questions remain People born without the CCR gene are generally healthy but will deleting it have unforeseen consequences Will HIV find another way into cells Certain types of the virus can use a second protein receptor though this is less common and usually when AIDS is advanced. Sangamo is testing a similar approach aimed at that protein too. How long will the modified cells last Will more be needed every few years Could doctors just infuse Sangamos product rather than removing cells and modifying them in the lab What might this cost Sangamo spokeswoman Liz Wolffe said its too early in testing to guess but it would be a premierpriced therapy in the neighborhood of Dendreon Corp.s new prostate cancer immune therapy Provenge . Yet AIDS drugs can cost a year so this could still be costeffective especially if its a cure. Jay Johnson who works for Action AIDS an advocacy and service organization in Philadelphia had the treatment there in September. My results are excellent he said. The overall goal is to not have to take medication and then hopefully lead maybe to a cure. Matt Sharp of suburban San Francisco also had the treatment in September. I would trade anything to not have to take a handful of medications every day for the rest of my life and suffer all the consequences and side effects he said. I may not live long enough to see the cure but I always hoped for a chance. Online AIDS informationhttp andhttp"

"Orlando Fla Researchers at Orlando Health have developed a blood test that can detect even the most subtle signs of a concussion in children correctly identifying the presence of traumatic brain injuries percent of the time in a recent study. This could ultimately change the way we diagnose concussions not only in children but in anyone who sustains a head injury said Linda Papa MD MSC an emergency medicine physician and NIH funded researcher at Orlando Health and lead author of the study. We have so many diagnostic blood tests for different parts of the body like the heart liver and kidneys but theres never been a reliable blood test to identify trauma in the brain. We think this test could change that she said. In a new study published in the journal Academic Emergency Medicine Papa and her team recently performed CT scans on children and compared the results of those scans with results from the blood test she developed. As expected the high definition imagery from the CT scans was able to identify which patients had suffered visible traumatic brain injuries. Moreover the study showed that the blood test detected symptoms of concussions even when brain injuries were not visible on the CT scan. The team then tested blood serum from the same patients which was taken less than hours after their injuries. With our blood test we were able to identify the presence of brain injuries percent of the time said Papa. This simple blood test was nearly as accurate as a stateoftheart CT scan. Even more impressive the blood test also gave doctors an indication of how severe the brain injury was. We were looking at different types of brain lesions detected by the CT scans ranging from mild to serious injuries and found that the biomarker we tested for actually corresponded to the injuries. Levels of the biomarker were lower in mild cases and were much more elevated in severe case said Papa. The biomarker this particular blood test looks for is known as glial fibrillary acidic protein GFAP. These proteins are found in glial cells which surround neurons in the brain. When theres an injury to the brain cells the GFAP are released. What makes them unique is that they pass the bloodbrain barrier and enter the bloodstream which makes them easy to detect with this particular test. Currently almost all concussions in children are diagnosed only by symptoms which are either observed like vomiting or balance problems or symptoms that are reported by the child like headaches blurred vision or feeling groggy. Neither scenario gives doctors an objective indication of the severity of the injury. CT scans can provide a more definitive profile of the injury however they are expensive and are associated with radiation exposure said Papa. You really want to minimize the amount of CTs you do to your patients especially children who are a lot more sensitive to radiation and the side effects that can come with it. If there was a simple diagnostic tool like a blood test that can tell us quickly and accurately if a brain injury has occurred and how severe it might be that would be ideal said Papa. Thats what we are striving for with this project. In fact Papa envisions the development of mobile devices that could diagnose concussions on the spot much like the devices diabetics use to test their blood with a simple finger prick and a drop of blood. The idea is to get a pointofcare test that could be used on the field to help the coaches the trainers and the athletic directors make a decision then and there about whether the child should go back to play said Papa. Its estimated nearly a quarter of a million children a year are treated in hospitals for traumatic brain injuries like concussions that occur while playing sports. Thats an average of nearly children a every day. If we could find a simple test that takes the guess work out of diagnosing these kids that would completely change the way we approach concussions and would certainly give parents greater peace of mind said Papa. Researchers plan to do more studies with the blood test but they hope it will be commercially available within the next years."

"A new study claims that consuming one avocado a day as part of a moderatefat diet could help lower bad cholesterol among people who are overweight or obese. Consuming one avocado a day alongside a moderatefat diet was found to lower bad cholesterol among overweight and obese individuals. The researchers including senior author Penny M. KrisEtherton PhD distinguished professor of nutrition https at Pennsylvania State University publish their findings in the Journal of the American Heart Association. It is well known that avocados are high in fat but the majority of an avocados fat is monounsaturated which is deemed a good type of fat. It is known that monounsaturated fats can help lower levels of bad cholesterol https reducing the risk of heart attack https and stroke https For their study KrisEtherton and colleagues set out to assess how avocado consumption by replacing saturated fatty acids or bad fats affected risk factors associated with cardiovascular diseases. The team recruited healthy participants aged years who were either obese or overweight. Every participant was required to follow each of three cholesterollowering diets for weeks. The diets consisted of a lowerfat diet without avocado a moderatefat diet without avocado or a moderatefat diet with one Hass avocado a day. Prior to starting each diet subjects ate what the researchers deem an average American diet which was made up of of calories https from fat from protein while around half of calories were from carbohydrates https From both of the moderatefat diets participants gained of calories from fat of which were from monounsaturated fatty acids MUFAs. The lowerfat diet provided participants with of calories from fat of which was from MUFAs. Moderatefat diet with one avocado a day lowered bad cholesterol by . mgdL The researchers found that participants levels of lowdensity lipoprotein LDL referred to as the bad cholesterol were an average of . milligrams per deciliter mgdL lower after following the lowerfat diet without an avocado and . mgdL lower after following the moderatefat diet without an avocado compared with their baseline average. However after participants followed the moderatefat diet with one avocado a day their LDL levels were found to be an average of . mgdL lower than their baseline average. What is more the team found that a number of additional blood measurements such as total cholesterol small dense LDL triglycerides and nonHDL highdensity lipoprotein were better after participants followed the moderatefat diet with one avocado a day compared with the other two diets. Although these findings demonstrate that an avocado a day alongside a moderatefat diet has the potential to reduce bad cholesterol the team notes that their research was a controlled feeding study. That is not the realworld says KrisEtherton so it is a proofofconcept investigation. Still the team believes their findings indicate that people should consider replacing saturated fatty acids in their diet with healthier fats from avocados and other sources. KrisEtherton adds We need to focus on getting people to eat a hearthealthy diet that includes avocados and other nutrientrich food sources of better fats. In the United States avocados are not a mainstream food yet and they can be expensive especially at certain times of the year. Also most people do not really know how to incorporate them in their diet except for making guacamole. But guacamole is typically eaten with corn chips which are high in calories and sodium. Avocados however can also be eaten with salads vegetables sandwiches lean protein foods like chicken or fish or even whole. It should be noted that this research was supported by the Hass Avocado Board but the researchers say the organization played no other role in the study. In January Medical News Today reported on a study suggesting that consuming half an avocado with lunch each day may satisfy hunger in overweight individuals and help with weight management https Our Knowledge Center article on the health benefits of avocado https reveals some of the other ways the food may be good for us as well as the potential risks of avocado consumption."

"A new blood https test may help pregnant https women who are at high risk for having a baby https with Down syndrome https avoid more invasive tests such as amniocentesis https and chronic villus sampling CVS. The blood https test analyzes components of genetic material from both the pregnant woman and her fetus https that is present in the mothers blood. It could help avoid up to of these screening procedures according to the study which appears in BMJ. While amniocentesis https and CVS can help definitively determine if an unborn baby has Down syndrome or trisomy these tests do carry a risk of miscarriage https and some women are unwilling to take this risk. These tests also screen for other less common fetal abnormalities and birth defects https such as trisomy and trisomy https Accuracy of Blood Test The new blood test would be used if a woman was considered at high risk for having a child with Down syndrome based on her age or other factors. The sequencing test could be used to rule out trisomy among highrisk pregnancies before proceeding to invasive diagnostic testing to reduce the number of cases requiring amniocentesis or CVS conclude study authors who were led by Dennis Lo of the Chinese University of Hong Kong in China. The new study included pregnant women who were at high risk for having a child with Down syndrome. Of these women were determined to be pregnant with a child with Down syndrome. There were no falsenegative results with the new test suggesting it can help avoid of followup invasive tests in women whose test shows that their baby does not have Down syndrome. In a year or two this test may be available but it wont replace existing technologies it will nudge its way into our armamentarium of available methodologies says Mark I. Evans MD director of Comprehensive Genetics in New York City and an obstetrician https at Mount Sinai School of Medicine also in New York City. Not Ready for Prime Time The bad news is that prenatal diagnosis is not just about Down syndrome he says. Down syndrome represents about of what we find and this new test can help with that but it may also give women a false sense of reassurance. Still he adds its an important step forward. The technology is likely prohibitively expensive and timeconsuming at this point he says. Its not ready for prime time but researchers are actively working on methods to increase its efficiency he says. Patients are very concerned about loss rates with aminocentesis and CVS and want reassurance about their pregnancies so we are always looking for a better test says Jennifer Wu an obstetriciangynecologist Lenox Hill Hospital in New York City. This test looks very promising but it is also very expensive While there are risks attached to amniocentesis and CVS screens these are minimized when the test is performed by a skilled obstetrician she says. The new test looks very promising says Cathy Sullivan a genetic counselor at the University of Texas Health Sciences Center in Houston. We are not quite there yet but it may become a real possibility for finding out real information without having to risk a pregnancy. For example If this comes back negative you dont need an amniocentesis but if it comes back positive we would probably still do an amniocentesis to confirm the results she says. While the new screen only looks for Down syndrome Sullivan says that some of the other trisomy birth defects can be more easily identified on an ultrasound https exam. Many babies with Down syndrome appear normal on an ultrasound she says. Joyce Fox MD the chief of medical genetics at Cohen Childrens Medical Center in New Hyde Park N.Y. definitely sees a role for a test such as the one described in the new study. For now the test just looks for Down syndrome but technology will advance to the point where noninvasive testing will encompass more of the less common genetic anomalies she says. For women who are concerned about losing a pregnancy as a result of an invasive test this is an excellent addition to our armamentarium of screening she says. It is not a diagnostic test for Down syndrome she says. It can help women put some of the information from other tests into context."

"A new pill may help in the fight with cystic fibrosis. A study funded in part by Vertex Pharmaceuticals http the drug ivacaftor pronounced eye va kaf tor caused patients with a specific type of cystic fibrosis to improve lung function gain weight and fight other aspects of the disease. This is the first time that we have a therapy that is directed at the cause of cystic fibrosis says Dr. Michael Konstan httpcf.case.eduKonstan.html the chair of the Department of Pediatrics at Rainbow Babies and Childrens Hospital http Cleveland and one of the authors of the study. There is no cure for this disease and existing treatments just help alleviate some of the symptoms. This is a big deal says Robert Beall http the president and CEO of the Cystic Fibrosis Foundation http The fact is it is obviously going to make a very big difference in the lives of patients. Cystic fibrosis is a genetic disease that causes problems with the balance of salt going in and out of cells. A sticky mucus clogs organs particularly the lungs and liver. It can also cause digestive problems. About new cases are diagnosed each year according to the Cystic Fibrosis Foundation and the average person with the disease dies before age . Ivacaftor works for people with the GD mutation of cystic fibrosis. Konstan says that only about of the people with the disease have this specific mutation. It really is a major milestone in the treatment of cystic fibrosis he says. Even thought it only affects a small percentage of patients the hope is there that we can finally do something about this disease. The study published in the New England Journal of Medicine http looked at people who got the drug. Those taking ivacaftor saw improvements within two weeks which continued for the nearly yearlong trial. Drug recipients could blow out more than more air from their lungs compared with patients who were not taking the drug and were about half as likely to have a pulmonary exacerbation or a worsening of their lung disease that often requires hospitalization. On average patients taking the drug grew more and put on more weight than the placebo group according to the study and had lower sweat chloride an indicator of the disease. Beall says the improved lung function helped patients double their ability to walk and one patient even started going the gym for the first time. We have an incredible proof of concept Beall says. He points to other research under way with ivacaftor combined with another drug that could help people with the most common mutation of cystic fibrosis. That trial is ongoing and the treatment is at least four or five years away from approval but if it works Beall says it could help of the people with cystic fibrosis. In an editorial accompanying the study Dr. Pamela Davis httpcasemed.case.eduaboutbrief_bio.cfmdirectory_id of Case Western University paraphrased Winston Churchill This study is also a great victory in the war against genetic diseases and marks the end of the beginning for the treatment of the cystic fibrosis defect. Ivacaftor has been submitted to the FDA for approval and could be available next year according to Konstan. When it goes on sale it will be sold under the brand name Kalydeco pronounced kuhLYEdehkoh."

"People who are diagnosed with prediabetes can delay or prevent the disease if they change their lifestyle and lose a significant amount of weight. But heres the challenge How can people be motivated to eat healthier and move more Increasingly the answer might include digital medicine. Just telling people to do things doesnt work says Sean Duffy CEO of Omada Health https If it were easy there wouldnt be more than million adults https in the U.S. with prediabetes. Omada has rolled out a digital program delivered on smartphones and other devices that incorporates all the ingredients known to help people overhaul their habits. It includes ecoaching peer support education diet and exercise tracking and electronic nudging. Forget to weigh in or track your meals Youll get texts or emails reminding you to do it. Week by week we have lessons on different themes Duffy explains. Theyre interactive and theres little games to keep it dynamic. Participants are matched with a group of peers online and theyre led by a coach who they can text or email back and forth with. We call it the symphony effect Duffy says because there are multiple methods working together to help participants stay on track. Getting started Sometimes fear is a good motivator for losing weight. Don Speranza is in his late s and lives on a farm along the Columbia River in Washington state where he runs a bed and breakfast with his wife. Hes also the chef at the inn. Im immersed in food all day Speranza says. Article continues after this message from our sponsor Last year he received an email from his doctor at Kaiser Permanente with some test results. It was like a gut punch Speranza says. Based on his weight which had been crept up to pounds and the results of his bloodwork to test his glucose he was diagnosed with prediabetes. This means his blood sugar level was elevated but not yet high enough to be diagnosed with the condition. It was a real cometoJesus moment Speranza recalls. He knew that diabetes increased the risk of heart disease and can lead to many other complications including vision loss and amputations. When he signed up for the Omada program the first thing he received was a scale. He began to weigh himself daily. He also began to track what he was eating. Each day hed log his weight and meals and upload the data to a dashboard. His coach could see the data too and give him advice and encouragement. Oh my coach Speranza says. I cant sing her praises enough she was so responsive. Even though they never met in person they bonded. He took her advice and suggestions. He realized for instance that he ate too much of the wrong things. Homemade breads and croissants pasta and pizza Speranza ticks off the list of baked treats with a mix of reverence and resolve in his voice. Speranza realized he had to change his relationship with these foods. Temporarily he cut out all these refined carbohydrates. He had to train himself to resist all the treats he bakes for his guests. Instead he began to fill his plate with more protein vegetables and healthy fats. He raises animals on his organic farm so he eats pastured meats and a lot of salmon. Week by week Id make one or two little changes at a time Speranza says. It was a game changer. The weight began to fall off and he started to move more. His coach nudged him to switch up his morning routine. He says he was accustomed to sitting each morning for an hour or so just drinking coffee. Now Ill start the coffee he says but before he drinks it Ill go outside and walk. He tracks his movement withe a wearable electronic device. He began with steps logged during his morning walk but has now increased his steps significantly. And he rides a stationary bike too. Now I can almost keep up with my wife Speranza says with a laugh. Since last May he has lost about pounds to be exact but it fluctuates a bit and his blood sugar has returned to the normal range. He no longer has prediabetes. I feel so much better Speranza says. As a baker he buys flour in pound sacks. Now when I look at the sacks Im aghast to think thats what I was carrying around. Success is not automatic Not every Omada Health participant makes the progress theyre aiming for. After all pulling off these changes is difficult Im still on the journey to get to more optimal health says Lonny Northrup who lives in Utah. He lost weight while participating in the program but when he hit a plateau in his weight loss he felt stuck and he says he didnt get the personal support he would have liked from the program. For many days in a row I got an email saying Hey we noticed you didnt step on the scale he says. For some reason that didnt get escalated to the coach. So he says that was a disappointment. Overall he says he would recommend the Omada Health program to a friend. I got really good specific recommendations that worked for me and my lifestyle Northrup says. And he says the convenience of having the program delivered on a smartphone was key too. There is some evidence that these kinds of programs are working. A recent pilot study with Utahbased Intermountain Healthcare httpsintermountainhealthcare.org that included about people all of whom were at high risk of Type diabetes found that percent of the participants completed the Omada program and lost at least percent of their body weight. And about in participants lost percent of their body weight or more. Thats promising because theres evidence that a percent body weight loss cuts the risk https of developing diabetes by about percent. This is one of the most exciting things says Mark Greenwood a physician with Intermountain. Omada Health is not the only player in this space. The Centers for Disease Control and Prevention recognizes httpsnccd.cdc.govDDT_DPRPCity.aspxSTATEOTHCITYOTH many diabetes prevention lifestyle change programs delivered both inperson and online including Vida https which bills itself as a health transformation team that is data and techdriven. Additionally traditional players in the weight loss space such as Weight Watchers now offer some similar incentives https such as personal coaching. Greenwood says hed like to see many more patients try diabetes prevention programs. And he says hes pleased with the results of the pilot study of Omadas program. The data really does confirm that when you give people tools and help instead of just preaching to them it really does help."

"I love my local YMCA for many reasons beyond my daily swim. Top of the list the friendships and conversations in the locker room that are frequent sources of valuable information connections and motivation. For example I recently overheard a discussion about Y members and friends of members who had experienced devastating attacks of shingles including one woman who nearly lost an eye and another who was left with unrelenting nerve pain. That was the push I needed to end my procrastination about getting the new shingles vaccine Shingrix which was approved by the Food and Drug Administration last October after studies involving people showed it to be far more effective at preventing this disease than the first shingles vaccine Zostavax which I had had a decade earlier. The Centers for Disease Control and Prevention recommends that people and older https including those previously immunized with Zostavax should now get the Shingrix vaccine. The process was surprisingly simple and less costly than I had anticipated https list price is for the twopart shot without insurance. All I needed was a prescription from my doctor. I took it to my local pharmacy where a staff pharmacist administered the vaccine. Ill get the second part the same way in May. My Medicare Part D insurance covered it with a copay for each part. The cost may be higher if the vaccine is administered in a doctors office so check first. Many millions of Americans especially those older than are susceptible to an eventual attack of shingles https caused by the very same virus that causes chickenpox. Once this virus varicella zoster infects a person it lies dormant for decades in nerve roots ready to pounce when the immune system is weakened say by stress medication trauma or disease. Onethird of Americans eventually get shingles but the risk rises with age and by age half of adults will have had at least one outbreak of shingles. Before the introduction of the chickenpox vaccine in in the United States some four million cases of chickenpox mostly in children occurred annually. While you may not remember whether you had chickenpox as a child chances are you did if you were never vaccinated against it. The chickenpox vaccine https is usually given in two doses with the first dose recommended at age to months and the second at age to . Those and older who were never vaccinated or had chickenpox should get two shots at least four weeks apart. Studies have indicated that more than percent of Americans aged and older have had chickenpox even if they dont remember it according to Dr. Rosanne M. Leipzig geriatrician at the Icahn School of Medicine at Mount Sinai in New York. The Centers for Disease Control and Prevention recommends that people and older get the new shingles vaccine whether or not they remember having had chickenpox as a child. Those who never had chickenpox but did get the vaccine for it may also be susceptible to shingles because the vaccine contains a weakened live virus. However the risk of shingles for those who had the chickenpox vaccine is much lower than for people who had the natural infection. If you are uncertain about your disease or vaccine history you can get a blood test to check for immunity to chickenpox though the result does not distinguish between protection via the disease or the vaccine. Thus if the result is positive Dr. Leipzig says youd be wise to get the shingles vaccine because you could be harboring the live virus. Lest you have doubts about the value of this vaccine consider the effects of shingles. It is a painful infection of a single sensory nerve on one side of the body that can occur almost anywhere but most commonly involves the torso or face. Initial symptoms of tingling or burning pain within days develop into a red bumpy rash and very painful blisters. The blisters heal in a week or two to form crusty scabs that eventually fall off. But for about percent of people shingles does not end there. Instead it leaves them with deep searing nerve pain a condition called postherpetic neuralgia or PHN that can last for months or years and has no treatment or cure. More than half the cases of PHN affect people over . Other possible complications of shingles include pneumonia hearing problems blindness and encephalitis. Thats not all. Although most people get shingles only once it can happen again especially if you have a weakened immune system which most everyone does with advancing age. If youre lucky you may detect the onset of shingles before the rash appears. Years ago when I went to bed with what had been a daylong gnawing irritation on one side of my back I awakened in the middle of the night with the thought I have shingles. First thing in the morning I got a prescription for the antiviral drug acyclovir which halted progress of the disease. Not willing to trust my luck a second time I got the new vaccine. Heres how it compares to its predecessor Zostavax which over all reduces the risk of shingles by percent and of PHN by percent. According to the C.D.C. Shingrix can protect percent of people in their s and s and percent of those in their s and s. It also reduces the risk of PHN by percent and it appears to be longer lasting than Zostavax which starts to lose its protection after three years. What makes Shingrix so much better is the inclusion of a substance called an adjuvant that boosts the bodys immune response to the vaccine. Another difference is that Zostavax contains a live weakened virus making it unsuitable for people with poor immunity whereas Shingrix contains a nonliving virus particle and may eventually be approved for those with compromised immunity who are especially susceptible to a severe case of shingles. I should tell you that the new vaccine is not exactly a walk in the park. The shot itself is painful and can cause a sore arm for a day or two. Some people develop immunerelated side effects like headache fever or an upset stomach that last less than three days according to the manufacturer GlaxoSmithKline. My only reaction beyond local soreness was an acid stomach for a day or two."

"A daily aspirin to prevent cancer Maybe. A British study http offers compelling though not clinching evidence that the humble aspirin tablet can prevent death from a variety of cancers if you take the medicine long enough in middle age. Even a baby aspirin might be enough. Dont start popping aspirin every morning to fight tumors without talking to your doctor though. Yes scientists have already published strong evidence http suggesting aspirin can cut bowel cancer and deaths. The painkillers antiinflammatory properties and effects in damping down precancerous polyps may be involved. And the latest study published in The Lancet suggests aspirin could provide protection against a wide variety of tumors. They range from pancreatic cancer to the type of lung cancer that strikes nonsmokers httplungcancer.about.comodwhatislungcanceralungcancernonsmokers.htm. For some of these cancers the reduction in death was remarkable. Twenty years after people had started taking aspirin regularly and kept it up for at least five years their deaths from esophageal cancer httpheartburn.about.comcsarticlesaesophaguscancer.htm were reduced by percent compared to study subjects who got a placebo. Deaths from adenomatous lung cancer were cut percent those from colorectal cancer percent and those from prostate cancer percent. Still none of the big guns in cancer and prevention the National Cancer Institute the American Cancer Society or the U.S. Preventive Services Task Force are ready to advise healthy people to start taking aspirin to prevent cancer. But the latest batch of evidence deserves a closer look. It encompasses eight earlier studies that compared cancer deaths among more than people randomly assigned to get aspirin of different doses or placebo. And the researchers were able to gather more information about cancer deaths for up to years after those studies ended about nearly people. Article continues after this message from our sponsor For cancer prevention experts the British study is provocative and significant. This is definitely the first time that research has shown that longterm aspirin use can reduce the risk of deaths due to cancer Dr. Asad Umar of the National Cancer Institutes division of cancer prevention tells Shots. In fact Umar says no drug has been shown before now to prevent cancer deaths. This is definitely hypothesisgenerating for future studies Umar says. Massachusetts General Hospitals Dr. Andrew Chan http who studies the effect of aspirin on gastrointestinal cancers says the new study will feed a growing sense among experts that there is likely some potential anticancer effect of aspirin. Dr. Peter Rothwell an Oxford University neurologist who led the study tells Shots that aspirins effect on cancer is quite a lot bigger than its benefit in preventing heart attacks and strokes the reason millions of Americans already swallow a baby aspirin every day. So I think in the fullness of time preventing cancer will be seen to be the main reason for taking aspirin in healthy individuals Rothwell says. He started taking a daily dose of aspirin a couple of years ago as the results of his study emerged. It was looking as though there was something going on and I thought it was a sufficiently large benefit to be worth doing something about says the yearold researcher. Rothwell says the sensible time to start taking aspirin would be before the risk of cancer starts to rise at about . He says prophylactic aspirin is worth thinking about for people with a family history of early cancers. But aspirin carries risks. The biggest is stomach bleeding although it also raises the risk of brain hemorrhage. Daily aspirin doubles a persons gastrointestinal bleeding risk to about in every people a year. But Rothwell says this bleeding hazard is drowned out by the cancer benefit. Prof. Peter Elwood of the University of Cardiff who wasnt involved in the new study agrees. Theres a small risk of any of us having a gastric bleed Ellwood said at a Lancet press conference Monday. But when you inspect the datayou find that the mortality from the bleed is not increased. In other words aspirin seems to be increasing the lessserious bleeds he said. To be sure the U.S. Preventive Services Task Forces currently recommends against http taking aspirin to prevent colorectal cancer the type of cancer for which there is the largest body of scientific work. The benefits of daily lowdose aspirin can exceed the risks for many middleaged and older people when it comes to preventing heart attacks and strokes the task force says http So for those already taking prophylactic aspirin for this reason the possible anticancer effects are just icing on the cake. Other healthy people interested in taking aspirin to prevent cancer should consult their doctors experts say and possibly await further evidence. A final word about dose The new study didnt find any additional anticancer benefit for aspirin doses above milligrams a day the British dose for a baby aspirin. In the United States a baby aspirin weighs in at milligrams. However experts say more information is needed on the optimum dose for cancer prevention. Theres a little controversy about whether a baby aspirin dose is enough says Harvards Chan. We think that probably a standard adult aspirin dose of milligrams is more likely to be effective."

"The American Heart Association httpabcnews.go.comtopicslifestylehealthamericanheartassociation.htm has changed the definition of hypertension for the first time in years moving the number from the old standard of to the newly revised . The change is outlined in the American Heart Association Hypertension Practice Guidelines an extensive report by experts without relevant ties to the pharmaceutical industry. The changes are expected to drastically impact adult Americans revising the hypertension threshold downward will increase the percent of U.S. adults living with high blood pressure httpabcnews.go.comtopicslifestylehealthhighbloodpressure.htm from percent to percent nearly half of the adult population. It will also disproportionately affect younger people by tripling the number of men under and doubling the number of women under with the diagnosis. American Heart Association The American Heart Association has changed the definition of hypertension for the first time in years moving the number from mm Hg to mm Hg. more httpsabcnews.go.comHealthmillionamericanshighbloodpressureguidelinesstoryid The new guidelines reflect years of research which have shown that people within the new range of blood pressure defined as hypertension have doubled their risk of cardiovascular problems in the future such as heart attacks or strokes. As such health care professionals should be identifying these patients and helping to initiate interventions to bring down blood pressure. How to lower your blood pressure without medication httpabcnews.go.comHealthlowerbloodpressuremedicationstoryid While the new guidelines significantly increase the number of Americans with a diagnosis of hypertension they do not suggest a proportionate increase in treating with medication. The number of Americans with hypertension who are recommended for medical treatment would increase by only . million adults or percent more than were previously recommended. Medication will be recommended for patients with previous cardiovascular events such as heart attack httpabcnews.go.comtopicslifestylehealthhearthealth.htm or significant cardiovascular risk factors httpabcnews.go.comtopicslifestylehealthriskfactors.htm determined by factors such as age blood tests and having other medical conditions that increase risk of heart attack. The study authors recommend lifestyle changes including exercise httpabcnews.go.comtopicslifestylehealthcardiovascularexercise.htm diet modifications and weight loss httpabcnews.go.comtopicslifestylehealthdietandweightloss.htm as the first step to reducing high blood pressure. Getty Images The American Heart Association has changed the definition of hypertension for the first time in years moving the number from mm Hg to mm Hg. more httpsabcnews.go.comHealthmillionamericanshighbloodpressureguidelinesstoryid Doctors in the guidelines stress the importance of using two separate blood pressure readings on two different occasions to diagnose hypertension. They recommend that those with hypertension use approved blood pressure monitors at home. Writing down these readings at home can help tell the difference between people with truly abnormal blood pressure and those with whitecoat syndrome with high blood pressure only under stress like at the doctors office. High blood pressure increases the risk of cardiac problems and strokes and is sometimes called the silent killer because so many adults live with high blood pressure and dont know it. To help understand the new hypertension guidelines and how they affect managing your health see your healthcare professional."

"The cancer drug that former president Jimmy Carter says made his melanoma seemingly disappear has helped about percent of similar patients survive for as long as three years oncologists said Wednesday. The drug called Keytruda takes a new approach to treating cancer by stopping tumor cells from cloaking themselves against the normal healthy immune system response. New data about to be released to a meeting of cancer specialists shows that percent of the patients who have been taking the drug are still alive three years later. That compares to about percent of patients given the standard therapy interleukin the American Society for Clinical Oncology ASCO says. That means percent of patients are not living that long but its still far more than the usual month survival with advanced melanoma. It is definitely a huge benefit over what we have seen in the past said ASCO president Dr. Julie Vose a specialist in blood cancers at the University of Nebraska Medical Center. For some of those patients it is likely that their cancer never will come back. Melanoma is the deadliest form of skin cancer. It will be diagnosed in more than Americans this year according to the American Cancer Society and it will kill . Rates are rising in part because tanning became fashionable. Melanoma is easy to cure when caught early but it is often hard to tell if a mole or freckle has turned cancerous. Carter for example was only diagnosed http the tumors had spread to his brain last fall. Thats Stage IV cancer and its almost always deadly at that stage. But Carter has remained well enough to continue teaching his weekly Sunday school classes and said this past Sunday hed just traveled to London. He says theres no trace of his cancer now. In the past patients with this type of melanoma he has metastases to the brain you dont even see responses to therapy Vose told NBC News. This is something really different than what we have seen in the past. Other people are having similar experiences. For the trial Caroline Robert of Gustave Roussy and ParisSud University in France and colleagues treated patients with advanced melanoma. These are patients whose disease cannot be surgically removed cannot be cured by surgery and usually the majority of these patients have disease that involved vital organs said Dr. Stephen Hodi a melanoma specialist at the DanaFarber Cancer Institute who worked on the study. Seventyfive percent of them had already been given other cancer treatments including Yervoy known generically as ipilimumab. On average the patients lived two years and percent of them are still alive three years later. About percent of these patients have whats called a complete remission meaning there is no trace of their tumors. That doesnt mean a cure its too soon to say that but it does mean months or years of cancerfree life that they otherwise could not have hoped for. And of the patients or percent have stopped taking the drug after their tumors went away. Virtually all of them are still in remission. This is huge in the melanoma community said Tim Turnham executive director of the Melanoma Research Foundation. Its difficult to know at what point you call it a cure. For the patient though it means they are cancerfree and for some of those patients it is likely that their cancer never will come back Turnham told NBC News. When this study was started the average life expectancy of someone with advanced melanoma was months and now were seeing that a large percentage of people are living at least three years. Keytruda known generically as pembrolizumab http targets the activity of genes called PD antiprogrammeddeathreceptor and PDL. The interaction between the two genes lets some tumors escape detection and destruction by immune system cells. PD stops immune cells from attacking normal healthy cells by mistake. Tumor cells make PDL turn on PD when immune cells approach. Keytruda an engineered immune protein called a monoclonal antibody disrupts this signal and lets the immune cells attack the tumor cell. The drug works far better in patients whose tumors express more PD meaning they have a lot of PD activity so the drug will optimally be used jointly with a test for PD. There are sideeffects including fatigue itchiness and rash. It was bad enough for percent of patients that they stopped taking it. In a matter of a few years these therapies have truly transformed the outlook for patients with melanoma and many other hardtotreat cancers. The Food and Drug Administration gave Keytruda accelerated approval for melanoma i http . Its got breakthrough therapy designation for Hodgkins lymphoma and colon cancer and got accelerated approval for lung cancer. In a matter of a few years these therapies have truly transformed the outlook for patients with melanoma and many other hardtotreat cancers said Dr. Don Dizon an oncologist at Massachusetts General Hospital and a spokesman for ASCO. Keytrudas being tested in other cancer types now. Earlier Wednesday the FDA gave accelerated approval to a drug that works in a similar way. It approved Tecentriq known generically as atezolizumab for use in patients with advanced bladder cancer. Like Keytruda Tecentriq is a monoclonal antibody. It goes straight to PDL so its target is slightly different. FDAs approval was made on the basis of a trial that showed percent of patients with advanced bladder cancer who had high levels of PDL activity saw their tumors disappear compared to . percent of patients on other treatments. Another percent had a partial response meaning their tumors shrank a little compared to . percent on standard treatment. The drugs must be infused and they are pricey. Keytruda costs about a month or a year."

"Regularly consumption of food and drink rich in substances called flavonoids such as berries apples tea and red wine can lower a mans risk of developing Parkinsons disease by percent new research suggests. For women however a reduction in risk was only seen when they ate at least several servings of berries a week according to the study. Men also had a risk reduction from frequently eating berries. For total flavonoids the beneficial result was only in men. But berries are protective in both men and women said the studys lead author Dr. Xiang Gao a research scientist at the Harvard School of Public Health and an associate epidemiologist at Harvard Medical School and Brigham and Womens Hospital in Boston. Berries could be a neuroprotective agent. People can include berries in their regular diet. There are no harmful effects from berry consumption and they lower the risk of hypertension too Gao added. Results of the study are published online April in the journal Neurology. Parkinsons disease is a degenerative condition that affects the central nervous system. It causes movement disorders such as tremors rigidity and balance problems. About Americans have Parkinsons disease according to the National Institute of Neurological Disorders and Stroke. Flavonoids are substances found in plant foods that help prevent damage to the bodys cells known as oxidative damage. Anthocyanins are a type of flavonoid plentiful in such berries as strawberries and blueberries. For the study the researchers reviewed nutrition and health data from almost men enrolled in the Health Professional FollowUp Study and more than women participating in the Nurses Health Study. The researchers looked at dietary intake of five major flavonoid sources tea berries apples orange juice and red wine. Over to years of followup people developed Parkinsons disease men and women. When researchers compared those who ate the most flavonoids with those who ate the least they found that only men saw a statistically significant benefit lowering their risk of Parkinsons by percent. Gao said it wasnt clear why only men benefited from the extra flavonoid intake but he noted that other studies have also found differences between men and women. Gao said its not clear if theres a biological mechanism causing these differences or another factor. But when the researchers looked at the dietary compounds individually it was clear that berries could benefit both men and women lowering the risk of Parkinsons disease by about percent for those who had at least two servings of berries a week. Gao said that anthocyanins protect the cells from oxidative damage and they also have an antiinflammatory effect which may be how berries help to reduce Parkinsons risk. The study findings should be interpreted cautiously because the participants were mostly white professionals and the results might not apply to other ethnic groups. Also recollections of dietary intake may be faulty and its possible that other properties of fruits and vegetables might have influenced the results the authors said. Dr. Michael Okun medical director of the National Parkinson Foundation said It is exciting to see research emerging about modifiable dietary issues that may affect the risk of getting diseases such as Parkinsons. But he added its important for people to realize that this research isnt applicable to people who already have the disease. He also said it will be important to confirm these findings in other studies and learn the mechanism of how berries and other flavonoids appear to offer some protection against Parkinsons disease. More information Learn more about Parkinsons disease from the National Institute of Neurological Disorders and Stroke http_diseasedetail_parkinsons_disease.htm. SOURCES Xiang Gao M.D. Ph.D. research scientist Harvard School of Public Health assistant professor of medicine and associate epidemiologist Harvard Medical School and Brigham and Womens Hospital Boston Michael Okun M.D. medical director National Parkinson Foundation April Neurology online"

"Eighteen years ago math teacher Susan Tesone went from having perfect vision to being so visually impaired she wasnt able to drive in just four weeks. Tesone who is now was diagnosed with Lebers hereditary optic neuropathy which is a genetic disease that rapidly clouds a patients central vision. Tesone whose brother has the condition as well told FoxNews.com that she sees through a dense fog. Its not as though there is a big black spot. Your peripheral vision begins to take over she said adding I get a whole image of a whole room for example but what I dont have is clarity. Tesone didnt allow the diagnosis to alter her life plans and though she was saddened by the news she was determined to live a successful and fulfilling life. You have to decide what accommodations youre going to make for yourself in your home life and work life and figure them out she said. Tesone began to utilize different tools from talking computers to magnifiers that project images on to a large screen. These large and bulky gadgets served as a modest improvement to her life but it was her husband who found an item that she said makes her life much more efficient. Her husband a computer programmer was attending a conference and heard about a device called the OrCam which helps those who are visually impaired. He was able to get one for his wife so she can be part of the beta testing. OrCam is a portable intuitive smart camera that someone wears on their glasses Bryan Wolynski an optometrist who promotes OrCam to doctors and trains patients on how to use the device told FoxNews.com. It fits on their own right side temple of their glasses takes a picture and then speaks to the wearer what it sees he said. The camera which is about the size of a lighter is connected by a wire to a power pack that can fit in a pocket or purse. It is activated when a patient points at a subject or presses a button on the power pack. The camera takes a picture and instantaneously reads what it sees. OrCam can read print on a newspaper or a piece of mail. It also can be trained to recognize a persons face or any household object. OrCam costs but Wolynski believes the outcome worth the price. I have seen a person cry when being able to read for the first time in many years he said. Another ophthalmologist Dr. Marc Werner also believes that OrCam is a useful device but he said there are some drawbacks. It doesnt always get every word exactly correctly so if youre reading a long book it may not be the best way to do it he said adding but certainly there is nothing out there as far as I know that lets you read a newspaper or get the gist of the story even if its going to miss a few words or a few concepts its still far better than whats out there right now. Tesone agrees because of how much more efficient her life is now both at work and at home. Reading one piece of paper on a magnifier could take her sometimes up to minutes because she almost had to read letter by letter. Now the OrCam takes about seconds to read scan and dictate the letter back to her. I have time at home with my children because I could just read something and be done. Its just so amazing to be able to do Tesone said. For more information about OrCam click here http"

"A small preliminary study finds that ginger root supplements seem to reduce inflammation in the intestines a potential sign that the pills might reduce the risk of colon cancer. However more study needs to be done and the researchers arent yet recommending that people head to the supplements aisle or start gobbling up more ginger at meal times. If you want to add ginger to part of a healthy diet thats great. But you cant make any conclusions about definite health benefits based on the study findings said lead author Suzanna M. Zick a naturopathic physician and research associate professor at University of Michigan Medical Center Ann Arbor. The study funded by the U.S. National Cancer Institute was published online Oct. in Cancer Prevention Research. Ginger an herb is found in supplements and in many foods such as ginger snaps and Asian dishes. Research has supported its use to treat stomach problems such as nausea and vomiting the U.S. National Library of Medicine says its likely safe although some people may develop mild side effects. Previous research in animals has suggested that ginger can reduce inflammation but isnt potentially toxic to the stomach like aspirin Zick noted. And scientists have linked chronic inflammation in the gut to colon cancer suggesting that easing this inflammation could reduce the risk of the disease. In the new study Zicks team randomly assigned people to take pills containing grams of ground ginger root extract or a dummy placebo pill each day for days. They measured the level of inflammation in the participants intestines before and after the test period. The amount of ginger in the pills is equivalent to grams of raw ginger root the authors said. That is probably well beyond what most people would eat in their regular diet Zick noted. As for cost she said that a months supply of similar ginger supplements typically runs about to . The researchers found that the level of inflammation in the subjects who took the ginger pills fell by an average of percent while staying about the same in those who took the placebo. If more funding becomes available the researchers hope to launch a larger study Zick said. But for now she said if you want to embrace ginger because you like the taste go ahead but theres no solid evidence that it prevents colon cancer. Dr. Andrew Chan an assistant professor of medicine at Harvard Medical School and a gastroenterologist at Massachusetts General Hospital Boston said the findings are promising because they hint at how ginger may prevent colon cancer. Its already clear that people with inflammatory conditions such as inflammatory bowel disease are at higher risk of colon cancer he noted. We know there are antiinflammatory drugs like aspirin that appear to have anticancer properties. And we know there are certain basic mechanisms which seem to be common to both inflammation and cancer he said. Still Chan said its much too early to tell whether ginger has anticancer properties. More information Theres more on ginger at the U.S. National Library of Medicine http SOURCES Suzanna M. Zick N.D. M.P.H. research associate professor University of Michigan Medical Center Ann Arbor Andrew Chan M.D. assistant professor of medicine Harvard Medical School and gastroenterologist Massachusetts General Hospital Boston Oct. online Cancer Prevention Research"

"Each year nearly three times as many Americans die from suicide as from homicide. More Americans kill themselves than die from breast cancer. As Dr.Thomas Insel http longtime head of the National Institute of Mental Health prepared to step down from his job in October he cited the lack of progress in reducing the number of suicides as his biggest disappointment. While the homicide rate in the U.S. has dropped percent since the early s the suicide rate is higher than it was a decade ago. That to me is unacceptable Insel says. It hasnt been for lack of trying. The U.S. has a national suicide hotline http and there are suicide prevention programs in every state. Theres screening educational programs and midnight walks to raise awareness. Yet over the past decade or so the national suicide rate has increased. In the suicide rate was . per people. In it was .. An effort that began in Detroit in to treat the most common cause of suicide depression is offering hope. With a relentless focus on finding and treating people with depression the Henry Ford Health System http has cut the suicide rate among the people in its insurance plan dramatically. The story of the health systems success is a story of persistence confidence hope and a strict adherence to a very specific approach. That approach saved the life of a woman who prefers to be known only by her first name Lynn. She agreed to share her medical history on the condition that we not use her full name to protect her privacy. Lynn whos now in her mids has had bipolar disorder http also known as manicdepressive illness for nearly years. The depressive part of her illness is like the pain of having a cancer she says. About years ago she started getting irresistible urges to take her own life and she started making serious attempts at times almost monthly. When I was in the depths of depression I was being pulled and sucked into this black tunnel she says. I was desperately trying to grab onto something to stop from being sucked in. Sometimes she couldnt find anything to hang on to. Those are the times when I finally let go and attempted suicide she says. The program that saved Lynn almost didnt get off the ground. Fifteen years ago suicide prevention care at Henry Ford like in many places was mostly reactive. When patients came in talking about suicide health providers took notice. But little was done to find people before they reached that point. Some of the health providers in the psychiatric division decided they could do better. So they applied to a foundation for a grant to provide something they called perfect depression care for the patients in the health system. The goal zero suicides. The mental health division failed to win the grant but the health system went ahead with the proposed changes anyway. The plan it developed is intensive and thorough an almost cookbook approach. Primary care doctors screen every patient with two questions How often have you felt down in the past two weeks And how often have you felt little pleasure in doing things A high score leads to more questions about sleep disturbances changes in appetite thoughts of hurting oneself. All patients are questioned on every visit. If the health providers recognize a mental health problem patients are assigned to appropriate care cognitive behavioral therapy drugs group counseling or hospitalization if necessary. On each patients medical record providers have to attest to having done the screening and they record plans for any needed care. Therapists involve patients families and ask them to remove guns or other means of suicide from their homes. Clerks are trained to make sure that patients who need followup care dont leave without an appointment. Patients themselves come up with safety plans. Lynn has two copies one by her nightstand and one in her kitchen. Each lists things she can do when she feels depression coming on. She could sit on her balcony or do some drawing or painting. The list includes her therapists phone numbers. And theres a reminder that the feeling will pass it has before. Before the zero suicide plan went into effect says psychiatrist Doree Ann Espiritu http acting head of the zero suicide program at Henry Ford you might make a contract with a patient where the patient agrees not to commit suicide. Studies show it doesnt work very well she says. Today providers are trained to be comfortable asking their patients about suicidal thoughts. There is a fear among clinicians that if you ask questions about suicide you are giving the patient an idea that this could be an option says Espiritu and if you ask about guns or pills that you are giving them some hints on how they can carry out a plan. The Henry Ford therapists are trained to break that barrier. For Lynn the key was persistence her therapists and her own. I recall one time with my psychiatrist who kept trying to encourage me and help me find ways of coping and I can remember saying I dont believe theres hope I dont see it I dont feel it I need you to hold on to that for me because its not there she recalls. Her therapists never gave up. There is no question that the message I got from Day is that they knew they could help me and they would help me Lynn says. Over the years shes been in group therapy day treatment and when things got bad the emergency room. The Henry Ford approach is catching on. A stream of visitors from U.S. health insurers and from the United Kingdom have made site visits. The Suicide Prevention Resource Center http has run two zero suicide training academies for teams from health care systems based on the Henry Ford principles. Other health systems have adapted the plan including Group Health Cooperative https Seattle and the behavioral health provider Centerstone https in Tennessee. Espiritu started work at Henry Ford just as the program was starting and she remembers the initial staff meetings There was a lot of How can you do this How can you aim for zero How can you expect your clinicians to be perfect and follow this protocol Some people didnt think it could be done she says or even attempted. Still the health system went ahead and the rewards were nearly immediate. Henry Ford epidemiologist Brian Ahmedani http the numbers. In for those being actively treated for a mental health problem or substance abuse we had a rate of zero per hundred thousand he says. Its crept up to per per year but thats still percent lower than it was when the program began. The rate is five per in the organizations general population which is well below the national average and has remained steady despite an increasing rate of suicide statewide. Theres reason to think a fullbore effort to treat depression could reduce health costs because untreated depression is associated with higher medical bills for chronic illnesses such as diabetes and hypertension. But there are training costs involved and the Henry Ford system has had to keep its staffing up to be able to provide care for people who need it. Officials at Henry Ford say they havent analyzed the costs. But Centerstone https has. The behavioral health provider in Nashville implemented the Henry Ford approach for nearly patients whod already made a suicide attempt. Reductions in emergency room visits and hospitalizations over the course of a year resulted in savings of more than . Why push for zero rather than just a reduction Because if you say were OK with five a year one of those might be your brother or your friend says Espiritu. We aim for zero because it reminds all of us of what we would want for ourselves. Maybe it is not possible she says. But it is a goal. And as for Lynn she doesnt consider herself cured. She says with the treatment shes received at Henry Ford shes learned to live even thrive with bipolar disease. And shes alive. That she says makes her a big success story."

"Postmenopausal estrogenbased hormone therapy lasting longer than ten years was associated with a decreased risk of Alzheimers disease in a large study carried out at the University of Eastern Finland. The protective effect of hormone therapy may depend on its timing it may have cognitive benefits if initiated at the time of menopause when neurons are still healthy and responsive says Bushra Imtiaz MD MPH who presented the results in her doctoral thesis. The study explored the association between postmenopausal hormone replacement therapy Alzheimers disease dementia and cognition in two nationwide casecontrol studies and two longitudinal cohort studies. The largest study comprised approximately Finnish women and the followup time in different studies was up to years. Menopause may explain womens higher dementia risk Alzheimers disease is the most common cause of dementia and two out of three Alzheimers cases are women. One possible explanation for womens higher dementia risk is the postmenopausal depletion of sex steroid hormones estrogen and progesterone. Estrogen receptors are present throughout the body including brain areas primarily affected in Alzheimers disease. In in vitro and animal studies estrogen has showed neuroprotective effects. However studies on humans have yielded inconsistent results on the association between postmenopausal estrogenbased hormone replacement therapy and dementia risk. Hormonal therapy may protect cognition if started at the onset of menopause In the present study longterm use of hormonal replacement therapy was associated with a better performance in certain cognitive domains global cognition and episodic memory and a lower risk of Alzheimers disease. Shortterm use was not significantly linked to dementia risk but in one cohort dementia risk was higher among shortterm users who had started hormone therapy in the late postmenopausal period. The results were adjusted for various lifestyle socioeconomic and demographic variables. In the light of these findings hormonal replacement therapy may have a beneficial effect on cognition if started early around the time of menopause. The protective effect of hormonal therapy may depend on the health status of neurons at baseline and may be lost if therapy starts years after menopause Dr Imtiaz concludes. The study also showed that the postmenopausal removal of ovaries uterus or both was not significantly linked to the risk of Alzheimers disease irrespective of the indication of surgery or hormone therapy use. The research data was from the MEDALZ Medication use and Alzheimers disease OSTPRE Kuopio Osteoporosis Risk Factor and Prevention Study and CAIDE Cardiovascular Risk Factors Aging and Dementia studies. The newest results were published recently in Neurology and Maturitas and the earlier results in the Journal of Alzheimers disease. Bushra Imtiazs doctoral thesis Hormone therapy and the risk of dementia cognitive decline and Alzheimers disease is available for download at httpepublications.uef.fipuburn_isbn_index_en.html For further information please contact Bushra Imtiaz MD MPH University of Eastern Finland Neurology bushra.imtiazuef.fi mailtobushra.imtiazuef.fi or bushraaligmail.com mailtobushraaligmail.com AnnaMaija Tolppanen Academy Research Fellow Associate Professor University of Eastern Finland School of Pharmacy tel. annamaija.tolppanenuef.fi mailtoannamaija.tolppanenuef.fi Recent publications Postmenopausal hormone therapy and Alzheimers disease a prospective cohort study. Bushra Imtiaz Marjo Tuppurainen Toni Rikkonen Miia Kivipelto Hilkka Soininen Heikki Krger AnnaMaija Tolppanen. Neurology published online February . doi .WNL. Risk of Alzheimers disease among users of postmenopausal hormone therapy a nationwide casecontrol study. Bushra Imtiaz Heidi Taipale Antti Tanskanen Miia Tiihonen Miia Kivipelto AnnaMari Heikkinen Jari Tiihonen Hilkka Soininen Sirpa Hartikainen AnnaMaija Tolppanen. Maturitas published online January . httpdx.doi.org.j.maturitas..."

"Army veteran Vivian Cooke has long struggled with debilitating depression https She has tried alternative therapies and medication to cope with her symptoms. It wasnt effective. Some side effects would be headaches or stomachache she told CBS News. Then three years ago she decided to try something different after hearing about a study testing Botox to treat depression. While Botox is commonly used for cosmetic purposes doctors say the reasoning behind the treatment for depression may not be what you expect. We dont believe it has anything to do with looks says researcher Dr. Eric Finzi of Chevy Chase Cosmetic Center. Rather he says its because facial expressions are part of the circuit of the brain related to mood. Fear anger and sadness all go through this muscle Finzi told CBS News pointing out the area between the eyebrows where frown lines appear. So Botox basically inhibits the muscle and calms it down so it becomes more difficult to feel those negative emotions. The makers of Botox recently announced plans for the final phase of testing it as a treatment for depression. Finzi notes previous studies show between to percent of patients may benefit from the treatment. Our hope is eventually it will form a place as one of the tools to treat depression https he said. Botox is a prescription drug that blocks nerve signals to muscles in the injection area. Its effects are temporary and typically wear off after three months. Botox is currently FDA approved for cosmetic use to lessen frown lines and for medical use to treat a number of conditions including chronic migraines bladder incontinence excessive underarm perspiration and certain types of neck pain and eye issues. Costs vary widely but the American Society for Aesthetic Plastic Surgery http said the average price for a Botox treatment in was . Researchers are also studying whether Botox can treat social anxiety https and bipolar disorder https As for Cooke she said she noticed a change in her depression almost immediately. I found overall my mood was better on a daytoday basis she said. I had less problems with depression. Even though the study she took part in is now over she said she will continue to get Botox injections."

"The latest in a series of studies led by researchers at Johns Hopkins Medicine shows that addition of a widely available noninvasive imaging test called mTcsestamibi SPECTCT to CT or MRI increases the accuracy of kidney tumor classification. The research team reports that the potential improvement in diagnostic accuracy will spare thousands of patients each year in the United States alone from having to undergo unnecessary surgery. In a recent report on ongoing work to improve kidney tumor classification published in the April issue of the journal Clinical Nuclear Medicine the team reports that the sestamibi SPECTCT testshort for mTcsestamibi singlephoton emission computed tomographycomputed tomographyCT adds additional diagnostic information in conjunction with conventional CTs and MRI and improves physicians ability to differentiate between benign and malignant kidney tumors. Sestamibi SPECTCT lets radiologists and urologists see the most common benign kidney tumor something CT and MRI have not succeeded in doing alone says Mohamad E. Allaf M.D. http MEA Endowed Professor of Urology at the Johns Hopkins University School of Medicine. This noninvasive scan may prevent patients with a potentially benign kidney tumor from having to undergo a surgery to remove the tumor or potentially the entire kidney along with its associated risks and high costs. At Johns Hopkins use of this test has already spared a number of our patients from unnecessary surgery and unnecessary removal of a kidney that would require them to be on dialysis. These results are hugely encouraging but we need to do more studies. For this study patients who were diagnosed with a kidney tumor on conventional CT or MRI were imaged with sestamibi SPECTCT at Johns Hopkins prior to surgery. Radiologists who were not allowed to talk to each other or know the results of the surgeries graded the conventional and sestamibi SPECTCT images benign or malignant using a point scale definitely benign definitely cancerous. Following surgery similarly blinded pathologists analyzed the tumors without knowing the radiologists imaging results. Pathology results of surgically removed tumors showed that of the were benign. The remaining were classified as a variety of other tumor types including malignant renal cell carcinomas. Reviewing sestamibi SPECTCT scan results in conjunction with CT or MRI changed the initial rating levels from cancerous score toward benign score and in cases and changed reviewers score from likely cancerous score to definitely cancerous score in cases or about percent of all cases. The addition of sestamibi SPECTCT increased the reviewers diagnostic certainty in of the patients or in nearly percent of all cases. Overall the investigators said adding sestamibi SPECTCT helped identify of benign tumors and conventional imaging with added sestamibi SPECTCT outperformed conventional imaging alone as measured by a statistical analysis that measures tradeoffs between sensitivity and specificity. On this measure a value of . indicates that a diagnostic test is no better than chance. Conventional imaging combined with sestamibi SPECTCT had a value of . while conventional imaging alone had a value of .. Even for patients whose tumors were not reclassified the addition of sestamibi SPECTCT increased physicians ability to more confidently classify malignant tumors which reduces the risk of misdiagnosis and unnecessary surgery for all patients the researchers say. Radiologists and urologists have been frustrated for decades by the inability of conventional imaging tests such as CT and MRI to distinguish benign from malignant kidney tumors. At Johns Hopkins multispecialty teams work together to determine the best care for patients and as partners on research innovations and quality improvement initiatives. This collaborative venue enabled two thenresidents Drs. Michael Gorin and Steven Rowe from different departments and specialties to design a clinical trial based on a few reports in the literature suggesting a potential role for sestamibi SPECTCT in this diagnostic conundrum and their hypothesis proved correct says Mehrbod Som Javadi MD assistant professor of radiology at Johns Hopkins University School of Medicine and the senior author on the paper. Pamela T. Johnson MD http associate professor of radiology at the Johns Hopkins University School of Medicine notes these types of advances are critical to our precision medicine initiative Hopkins inHealth httphopkinsinhealth.jhu.edu designed for individualized patient management and to our mission of highvalue health care http_instituteimprovement_projectshighvaluehealthcare where the highest quality care is safely delivered at the lowest personal and financial cost to the patient. As radiologists we have struggled to find noninvasive ways to better classify patients and spare unnecessary surgery but this has not been easy says Steven P. Rowe M.D. Ph.D. http one of the two former residents who developed this approach and now assistant professor of radiology and radiological science at the Johns Hopkins University School of Medicine. Sestamibi SPECTCT offers an inexpensive and widely available means of better characterizing kidney tumors and the identical test is now being performed as part of a large trial in Sweden for which the first results have just recently been published and appear to confirm our conclusions. Although further study is needed to validate the accuracy of sestamibi SPECTCT this test appears to be a less expensive faster noninvasive alternative to surgery says Michael A. Gorin M.D. the other resident involved in developing this approach and now chief resident with The James Buchanan Brady Urological Institute of the Johns Hopkins University School of Medicine. In the absence of diagnostic certainty surgeons tend to remove kidney tumors in an abundance of caution leading to an estimated surgically removed benign kidney tumors each year in the United States. Other authors on this paper include Sara Sheikhbahaei Christopher S. Jones Kristin K. Porter Alex S. Baras Phillip M. Pierorazio Mark W. Ball Lilja B. Solnes Jonathan I. Epstein and Mehrbod S. Javadi all of the Johns Hopkins University School of Medicine and Takahiro Higuchi of Wurzburg University in Germany. SEE ORIGINAL STUDY https"

"Note A media teleconference with researchers and patients from Johns Hopkins and New York University will be held on Wednesday Nov. from a.m. to p.m. ET. To participate U.S.based media may call international media should dial . The access code is . Phone lines open at a.m. and all media should place speakers on mute unless posing a question. Reporters wishing to ask a question should email their name and outlet to david.marchnyumc.org mailtodavid.marchnyumc.org during the briefing so they may be placed in a queue the moderator will call on individual media members to ask a question in the order names and outlets were received. In a small doubleblind study Johns Hopkins researchers report that a substantial majority of people suffering cancerrelated anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin the active compound in hallucinogenic magic mushrooms. The researchers cautioned that the drug was given in tightly controlled conditions in the presence of two clinically trained monitors and said they do not recommend use of the compound outside of such a research or patient care setting. The Johns Hopkins team released its study results involving adult patients concurrently with researchers from New York University Langone Medical Center who conducted a similarly designed study on participants. Both studies are published in the Journal of Psychopharmacology on Dec. . The Johns Hopkins group reported that psilocybin decreased clinician and patientrated depressed mood anxiety and death anxiety and increased quality of life life meaning and optimism. Six months after the final session of treatment about percent of participants continued to show clinically significant decreases in depressed mood and anxiety with about percent showing symptom remission into the normal range. Eightythree percent reported increases in wellbeing or life satisfaction. Some percent of participants reported the experience as one of the top five meaningful experiences in their lives and about percent reported the experience as one of the top five spiritually significant lifetime events. The most interesting and remarkable finding is that a single dose of psilocybin which lasts four to six hours produced enduring decreases in depression and anxiety symptoms and this may represent a fascinating new model for treating some psychiatric conditions says Roland Griffiths Ph.D. http professor of behavioral biology in the Departments of Psychiatry and Behavioral Sciences and of Neuroscience at the Johns Hopkins University School of Medicine. He notes that traditional psychotherapy offered to people with cancer including behavioral therapy and antidepressants can take weeks or even months isnt always effective and in the case of some drugs such as benzodiazepines may have addictive and other troubling side effects. Griffiths says his teams new study grew out of a decade of research at Johns Hopkins on the effects of psilocybin in healthy volunteers which found that psilocybin can consistently produce positive changes in mood behavior and spirituality when administered to carefully screened and prepared participants. The study was designed to see if psilocybin could produce similar results in psychologically distressed cancer patients. A lifethreatening cancer diagnosis can be psychologically challenging with anxiety and depression as very common symptoms says Griffiths. People with this kind of existential anxiety often feel hopeless and are worried about the meaning of life and what happens upon death. For the study the investigators recruited participants diagnosed with lifethreatening cancers most of which were recurrent or metastatic. They were chosen from a total of individuals reached through flyers web advertisements and physician referrals. Most participants had breast upper digestive GI genitourinary or blood cancer and each had been given a formal psychiatric diagnosis including an anxiety or depressive disorder. Half of the participants were female with an average age of . Ninetytwo percent were white percent were AfricanAmerican and percent were Asian. Each participant had two treatment sessions scheduled five weeks apart one with a very low psilocybin dose or milligrams per kilograms taken in a capsule and meant to act as a control placebo because the dose was too low to produce effects. In the other session participants received a capsule with what is considered a moderate or high dose or milligrams per kilograms. To minimize expectancy effects the participants and the staff members supervising the sessions were told that the participants would receive psilocybin on both sessions but they did not know that all participants would receive one high and one low dose. Blood pressure and mood were monitored throughout the sessions. Two monitors aided participants during each session encouraging them to lie down wear an eye mask listen to music through headphones and direct their attention on their inner experience. If anxiety or confusion arose the monitors provided reassurance to the participants. In addition to experiencing changes in visual perception emotions and thinking most participants reported experiences of psychological insight and often profound deeply meaningful experiences of the interconnectedness of all people. The researchers assessed each participants mood attitude about life behaviors and spirituality with questionnaires and structured interviews before the first session seven hours after taking the psilocybin five weeks after each session and six months after the second session. Immediately after the sessions participants completed questionnaires assessing changes in visual auditory and body perceptions feelings of transcendence changes in mood and more. Structured clinical interviews such as the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale and patient questionnaires like the Beck Depression Inventory and the StateTrait Anxiety Inventory assessed depression and anxiety. Other questionnaires assessed quality of life death acceptance meaningful existence optimism and spirituality generally defined as a search for the meaning of life and a connection to something bigger than ones self. To measure the changes in attitudes moods and behavior over time the researchers administered a questionnaire that assessed negative or positive changes in attitudes about life mood and behavior. With regard to adverse effects Griffiths says percent of participants were nauseated or vomited and onethird of participants experienced some psychological discomfort such as anxiety or paranoia after taking the higher dose. Onethird of the participants had transient increases in blood pressure. A few participants reported headaches following the session. Before beginning the study it wasnt clear to me that this treatment would be helpful since cancer patients may experience profound hopelessness in response to their diagnosis which is often followed by multiple surgeries and prolonged chemotherapy says Griffiths. I could imagine that cancer patients would receive psilocybin look into the existential void and come out even more fearful. However the positive changes in attitudes moods and behavior that we documented in healthy volunteers were replicated in cancer patients. Up to percent of people with cancer suffer from a mood disorder according to the National Comprehensive Cancer Network. Anticipating wide interest in the psilocybin research from scientists clinicians and the public the journal solicited commentaries to be copublished with the study results written by luminaries in psychiatry palliative care and drug regulation including two past presidents of the American Psychiatric Association a past president of the European College of Neuropsychopharmacology the former deputy director of the U.S. Office of National Drug Control Policy and the former head of the U.K. Medicines and Healthcare Products Regulatory Authority. In general the commentaries were supportive of the research and of using these drugs in a clinical setting as tools for psychiatry. Additional authors included Matthew Johnson Michael Carducci Annie Umbricht William Richards Brian Richards Mary Cosimano and Margaret Klinedinst all of The Johns Hopkins University. The study was funded by grants from the Heffter Research Institute the RiverStyx Foundation William Linton the Betsy Gordon Foundation the McCormick family the Fetzer Institute George Goldsmith Ekaterina Malievskaia and the National Institute on Drug Abuse RDA."

"An experimental drug preserved and even improved the walking ability of boys with Duchenne muscular dystrophy httphealth.nytimes.comhealthguidesdiseaseduchennemusculardystrophyoverview.htmlinlinenytclassifier in a clinical trial raising hopes that the first effective treatment for the disease may be on the horizon. Boys with the disease who received the highest dose of the drug had a slightly improved ability to walk after weeks of treatment the drugs developer Sarepta Therapeutics announced httpinvestorrelations.sareptatherapeutics.comphoenix.zhtmlcpirolnewsArticleIDhighlight Wednesday. By contrast the boys who received a placebo suffered a sharp decline in how well they could walk. The drug called eteplirsen also appeared to restore levels of the crucial protein that muscular dystrophy httphealth.nytimes.comhealthguidesdiseasemusculardystrophyoverview.htmlinlinenytclassifier patients lack to about half of normal levels Sarepta said. I think this changes the entire playing field for muscular dystrophy said Dr. Jerry R. Mendell director of the gene therapy and muscular dystrophy programs at Nationwide Childrens Hospital in Columbus Ohio and the lead investigator in the trial. There are many caveats. The trial had only patients with only four receiving the high dose and four the placebo and the data has not been reviewed by experts. It is also unclear how long the effects of the drug would last or if safety issues would arise with longer treatment. Also eteplirsen would be appropriate for only about percent to percent of Duchenne patients those with the particular genetic mutation the drug is meant to counteract. However a similar approach might work for some other mutations. Duchenne which affects as many as Americans mainly boys and young men is the most severe common form of muscular dystrophy a disease made more prominent by years of Jerry Lewis telethons. Those with the disease make barely any dystrophin a protein necessary for muscles to function. Patients typically lose the ability to walk as teenagers and die by age . While steroids httptopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicssteroidsindex.htmlinlinenytclassifier which reduce inflammation can slow progression of the disease they have undesirable side effects. Eteplirsen which Sarepta says has shown no side effects so far is vying with a similar drug being developed by GlaxoSmithKline to become the first medicine that works by directly countering the cause of the disease. Eteplirsen could also be the first drug to reach the market for Sarepta since it was founded years ago. It changed its name recently from AVI BioPharma httptopics.nytimes.comtopnewsbusinesscompaniesavibiopharmaincindex.htmlinlinenytorg to distance itself from its underachieving past. Shares of Sarepta nearly tripled on Wednesday closing at .. And the stock had already roughly quadrupled since July when Sarepta announced some interim results from the study. The study measured how far the boys could walk in six minutes. Those who received the higher dose walked an average of meters farther after weeks of treatment than at the beginning of the trial a gain of about percent. The boys in the placebo group walked fewer meters at the end than at the beginning a decline of about percent. One possible reason for skepticism is that two of the boys on a lower dose of the drug rapidly lost the ability to walk even though the level of dystrophin in their muscles increased substantially. Our columnist Andrew Ross Sorkin and his Times colleagues help you make sense of major business and policy headlines and the powerbrokers who shape them. Top of Form Bottom of Form Top of Form While the company excluded those boys from its analysis as outliers the Food and Drug Administration might not do so. That could make it harder for the Sarepta to win approval for the drug based only on this small trial something the company hopes to do. If you wait and require this company to do another twoyear study a lot of these boys are going to be in a wheelchair Christopher Garabedian the Sarepta chief executive said in an interview. Patient groups may also put some pressure on the Food and Drug Administration to approve the drug quickly. But some also want Sarepta to make the drug available to more patients on a compassionate basis even before approval. Tenyearold Max Leclaire of Saxtons River Vt. who has been receiving the highest dose in the trial can now walk up stairs without having to pull himself up by the handrail according to his mother Jenn McNary. Hes no longer riding the handicap bus to school she said. But Ms. McNary said Sarepta had refused to provide the drug to Maxs yearold brother Austin who could not be in the trial because he already could not walk. Mr. Garabedian said Sarepta did not have the money or the manufacturing capacity to make the drug available outside of clinical trials. That would be the quickest path to insolvency he said. If eteplirsen gets to market it would come nearly three decades after the discovery of the gene responsible for Duchenne. It would also represent a success after decades of setbacks for the technology eteplirsen uses called antisense which is a way of turning off specific genes. Eteplirsen actually turns off just one part of the dystrophin gene known as exon which contains a mutation that in some patients stops production of dystrophin. By skipping over this exon muscle cells can produce an imperfect form of dystrophin that nonetheless is at least partly functional."

"Amgen Inc said its potent cholesterol fighter Repatha significantly reduced the risk of heart attacks strokes and death in patients with heart disease according to initial results of a large eagerlyanticipated trial released on Thursday. The data should pave the way for greater acceptance by health insurers and pharmacy benefit managers who have been rejecting about percent of prescriptions written for the expensive medicine despite multiple appeals by physicians. An Amgen sign is seen at the companys office in South San Francisco California in this October file photo. REUTERSRobert GalbraithFiles No new safety problems cropped up in the patient study called Fourier Amgen said. It also said Repathas effect on mental function was similar to placebo likely alleviating concerns that it might impair cognition in some patients. The trial was widely expected to be positive especially after a smaller study presented in November showed Repatha therapy led to regression of arteryclogging plaque an underlying cause of heart disease. These results show unequivocally the connection between lowering LDL cholesterol with Repatha and cardiovascular risk reduction even in a population already treated with optimized statin therapy Amgen research chief Sean Harper said in a statement. Details on the magnitude of benefit will be revealed in midMarch at the American College of Cardiology meeting in Washington D.C. Industry analysts have been looking for a percent to percent reduction of major adverse heart events. Repatha with a list price of more than a year was approved based on its ability to dramatically lower bad LDL cholesterol in patients who require more intensive therapy on top of widelyused statins such as Lipitor or who are unable to tolerate statins. But those who control budgets wanted concrete proof that the drug could actually reduce the risk of heart attacks and death before making it easier for patients to get the medicine. Repatha and a rival drug from Regeneron Corp and Sanofi have had endured anemic sales as a result. Amgen reported just million in thirdquarter sales. The company said Repatha would be well on its way to becoming a billion seller if all prescriptions written had been filled. The primary and secondary goals of the study are composites of several adverse outcomes. At the heart meeting in March researchers will also provide details on risk reduction for each of the components such as nonfatal heart attack nonfatal stroke and heartrelated death. The primary goal also included need for a new arteryclearing procedure and hospitalization for angina. Reporting by Bill Berkrot Editing by Alan Crosby Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Two bloodbuilding drugs injected soon after birth may give tiny preemies a lasting longterm edge boosting brain development and IQ by age a firstofitskind study found. The study was small but the implications are big if larger longer studies prove the drugs help even the playing field for these atrisk children the researchers and other experts say. Babies who got the medicine scored much better by age on measures of intelligence language and memory than preemies who didnt get it. The medicine groups scores on an important behavior measure were just as good as a control group of yearolds born on time at a normal weight. The results are super exciting said Dr. Robin Ohls the lead author and a pediatrics professor at the University of New Mexico. She said its the first evidence of longterm benefits of the drugs when compared to no bloodboosting treatment. Even though the treated youngsters didnt do as well as the normalweight group on most measures their scores were impressive and suggest greater brain development than the other preemies Ohls said. They scored about points higher on average on IQ tests than the untreated kids but about points lower than the normalweight group. On tests measuring memory and impulsive behavior the treated kids fared as well as those born at normal weight. Heres how those differences would show up in a preschool setting The untreated group would be the kids who struggle a little in class while those who got the medicines would do OK but not as well as those born at a normal weight said Dr. Michael Schreiber a prematurity expert at the University of Chicagos Comer Childrens Hospital. Survival of extremely tiny preemies has improved dramatically in the past years but treatment for medical problems and developmental delays linked with prematurity has not kept pace Schreiber said. He was not involved in the study. He said larger studies including more diverse patient populations are needed to determine if the drugs can help a broader range of preemies. The study involved children most white or Hispanic born more than a month premature and weighing less than pounds at hospitals in New Mexico Utah and Colorado. Two dozen normalweight children were also included. Results were published Monday in Pediatrics. Shortly after birth the preemies were randomly assigned to receive injections of either erythropoeitin EPO three times weekly darbepoetin once a week for several weeks or no treatment. The drugs build red blood cells and are approved to treat anemia caused by cancer treatment or resulting from other conditions. Preemies lack the ability to make new red blood cells and often need frequent blood transfusions to replace blood taken for lab tests. The drugs are now sometimes used to try to reduce their need for transfusions in doses similar to the ones studied. The drugs can increase endurance by boosting oxygen levels in the blood and have been implicated in some sports doping scandals."

"Blood injections especially of plateletrich blood into the affected area help relieve the pain associated with tennis elbow where other treatment methods have failed according to a Greek study. A player returns the ball during the Monte Carlo Masters tennis tournament in Monaco April . REUTERSEric Gaillard Analogous blood injections in which the patients own blood is taken and then injected into a specific area of the body is used to help harness the healing power of blood to treat the degeneration of tendons. Plateletrich plasma PRP is blood that has been spun in a centrifuge to separate the blood cells. There is now a solution for patients suffering from unrelenting tennis elbow said Christos Thanasas from Henry Dunant Hospital Athens who led the study. Whole blood treatment is a god alternative in remote areas or in health systems that do not support financially the use of PRP he told Reuters Health in an email. Thanasas and his colleagues compared the effectiveness of single local injections of PRP under ultrasound guidance with autologous blood injections in patients with tennis elbow formally known as lateral elbow epicondylitis. Visual analog pain scores at weeks after the injections improved by a mean . points or . percent in patients who had the PRP injections compared to the autologous blood group a mean . points or . percent improvement. Both groups experienced more improvement at and months after the injections with no significant in pain scores between the treatments. The findings were published in The American Journal of Sports Medicine. PRP is probably the best treatment for chronic refractory lateral epicondylitis if it is used after classical types of treatment like rest braces nonsteroidal anti inflammatory drugs cortisone injections or physiotherapy have all failed Thanasas said. The last resort remains surgery. Thanasas added that further studies are needed to see how and when the PRP therapy is most effective adding that he and his colleagues are about to start trials of PRP therapy in which different concentrations of white blood cells are used to see how this affects the regeneration of tendons. Reporting by Will Boggs at Reuters Health editing by Elaine Lies Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Cardiac arrest patients who get cardiopulmonary resuscitation CPR from a bystander at the scene may have better survival odds even when an ambulance takes a long time to arrive a Danish study suggests. Researchers examined data on cardiac arrest patients and found when an ambulance arrived within five minutes of a call patients were . times more likely to survive at least days if they received bystander CPR than if they didnt get this aid at the scene. When ambulances took up to minutes to arrive bystander CPR was associated with tripled survival odds the study also found. After minutes patients who got CPR at the scene continued to have better survival odds but the difference was no longer statistically meaningful. Early CPR saves lives and the lack of CPR efforts from bystanders could result in significantly decreased chances of survival said lead study author Dr. Shahzleen Rajan of Copenhagen University Hospital in Denmark. Cardiac arrest involves the abrupt loss of heart function breathing and consciousness. Unlike a heart attack which happens when blood flow to a portion of the heart is blocked cardiac arrest occurs when the hearts electrical system malfunctions often due to irregular heart rhythms. Cardiac arrest may occur with no warning and is often fatal. Chest compressions or CPR can help restore circulation increasing the odds of survival. Bystander CPR generally wont restore a normal heart rhythm but it can buy time by maintaining blood flow to vital organs. We know from previous research that in people survive after a cardiac arrest if a bystander initiates CPR before the arrival of the emergency medical services Rajan said by email. In contrast if CPR is not initiated before the arrival of the emergency medical services only in people survive a cardiac arrest. For the current study researchers looked at day survival for patients who had cardiac arrests outside of a hospital between and . When the ambulance arrived within five minutes . percent of patients in the bystander CPR group survived at least days compared with . percent in the group that didnt get this help. For ambulance arrival times up to ten minutes . percent in the CPR group and . percent of the other patients survived. If the ambulance took more than minutes the survival rate was . percent in the CPR group and . percent for the others a difference that wasnt statistically meaningful. The study is observational and doesnt prove bystander CPR increases survival odds the authors note in Circulation. Researchers also lacked data on how quickly bystanders intervened after the start of cardiac arrest which could influence outcomes the authors note. Once a victim has sustained a cardiac arrest with little or no blood supply going to the heart or brain the time to reestablishing blood flow with oxygenated blood is critical said Dr. Lenworth Jacobs director of trauma and emergency medicine at Hartford Hospital in Connecticut. It is generally thought that the sooner this is implemented the better Jacobs who wasnt involved in the study added by email. The biggest obstacle to bystander CPR remains that too few people know how to do it said Dr. Peter Pons an emergency physician in Denver and professor emeritus at the University of Colorado School of Medicine. Clearly if someone has been motivated to learn and has been taught CPR they will often assist Pons who wasnt involved in the study said by email. When someone does not have that knowledge they tend to be more reluctant to act and may fear making things worse. SOURCE bit.lyhYhIq httpbit.lyhYhIq Circulation online November . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"

"Its no secret that many people with attention deficit hyperactivity disorder httpshealth.usnews.comconditionsadhd may gravitate towards cigarette smoking httpshealth.usnews.comhealthcarepatientadvicearticlescanadhdincreasetheoddsayoungpersonwillsmoke. Many experts indicate that there is an association between people with the disorder and the desire to light up. See Concerns Parents Have About Their Kids Health httpshealth.usnews.comhealthnewshealthwellnessslideshowsconcernsparentshaveabouttheirkidshealth. Dr. Jeffrey Newcorn professor of psychiatry and director of the Division of ADHD and Learning Disorders at the Icahn School of Medicine at Mount Sinai httpshealth.usnews.combesthospitalsareanymountsinaimedicalcenter says that there is indeed a relationship between ADHD and smoking. People with ADHD are at somewhat of an increased risk to abuse drugs he says adding that the drug theyre more likely to resort to is nicotine because of its role in modulating the neurotransmission of dopamine in the brain. People with ADHD dont produce as much dopamine a neurotransmitter linked to the ability to regulate emotional response as someone without the disorder. Dopamine is also associated with feelings of reward and pleasure. Research has found a connection between ADHD symptoms and lowered dopamine levels or issues with the efficiency of the brains dopamine receptors. Newcorn explains that through the years there have also been some schools of thought that people with ADHD have a harder time quitting the habit. This ultimately drove researchers to think about developing a nonstimulant alternative in the form of a drug that safely mimics the effects of nicotine. However he says that this hasnt yet panned out. Instead what has gained more attention Newcorn says is research about any possible roles ADHD stimulant medications may play in helping someone with the disorder quit or at least reduce nicotine use. There has been and continues to be a lot of interest in this area Newcorn says. More About Smoking Less Not Stopping Completely According to Scott H. Kollins professor and vice chair for research in the department of psychiatry and behavioral sciences at the Duke University School of Medicine there isnt a concrete yes or no to the question of whether ADHD stimulants httpshealth.usnews.comhealthcarepatientadvicearticleswhatnewdrugsareinthepipelinetotreatadhd can help an ADHD person quit. In fact he says that rather than this being an issue of quitting the habit altogether it appears that the focus is more about ADHD stimulants role in possibly lessening the number of cigarettes smoked. In fact Kollins was involved in a study https published in the Journal of Attention Disorders that touched on this very subject. The journal states that our findings suggest that among adult regular smokers with ADHD who are interested in quitting LDX does not increase the probability of smoking cessation more than does placebo but is associated with a significant overall reduction in the amount of cigarettes smoked and is effective for reducing ADHD symptoms. LDX stands for lisdexamfetamine dimesylate an ADHD stimulant more commonly known by the brand name Vyvanse https In this and other related research Kollins has been involved with he says that overall stimulants dont necessarily help people with ADHD quit smoking people dont really improve any greater than with a placebo. However he states that the people taking ADHD stimulants smoked less compared to those taking a placebo. See Hoarding ADHD Narcissism Inside the Minds of Historys Great Personalities httpshealth.usnews.comwellnessslideshowshoardingadhdnarcissisminsidethemindsofhistorysgreatpersonalities. Kollins also points out that this study yielded results comparable other research on the topic. In fact the LDX study notes that findings from this study are consistent with another published trial of osmoticrelease methylphenidate in adult smokers httpshealth.usnews.comhealthcarepatientadvicearticlescantechnologyhelpmequitsmoking with ADHD which reported no effects of the stimulant drug on smoking cessation outcomes but reductions in cigarettes smokedday and significant drugplacebo differences in ADHD symptoms across the study Winhusen et al. . Concerta is an example of an osmoticrelease methylphenidate. httpshealth.usnews.comconditionsadhdA Patients Guide to ADHD httpshealth.usnews.comconditionsadhd Know the basics on symptoms diagnosis and treatment to help as you battle the disease. Anna Medaris MillerJan. All of this begs the question What is it about ADHD stimulant medication that may produce this effect Kollins explains that stimulants do similar things from a pharmacologic perspective as nicotine suggesting that taking such medication may replace the urge to light up as frequently. Treatment with stimulants may put the urge to smoke in check more he speculates. The Road Ahead Such research isnt to say that taking ADHD stimulants will automatically make a person with the disorder ease up on their habit. You certainly couldnt say that stimulants could be used for smoking cessation in people with ADHD Newcorn says. On the other hand stimulants are an appropriate treatment for people with ADHD whether they smoke or not. He explains that currently thinking about stimulants in terms of helping people with ADHD with smoking cessation httpshealth.usnews.comhealthcarepatientadvicearticleshardcoresmokersactuallywanttoquittoo means talking about something offlabel in other words not for intended use despite the fact that certain positive outcomes may arise by taking it. But Newcorn adds that there may be reasonable strategies such as limiting a medication to a specific group of people and within a specific class of medication. For example he explains that Wellbutrin an antidepressant and Zyban a drug to help a person stop smoking are the same drug but they are marketed for different things. Many studies show that Wellbutrin could have a positive effect for people with ADHD he says making the point that sorting through such labeling and marketing intricacies could play a role in further exploration on the topic. See Things You Didnt Know About Counseling httpshealth.usnews.comhealthnewshealthwellnessslideshowsthingsyoudidntknowaboutcounseling. The takehome message is if theres an adult patient with ADHD httpshealth.usnews.comhealthcarepatientadvicearticleshowdoiknowifihaveadhdasanadult who smokes that person should do everything possible to stop smoking Kollins says. To help kick the habit he suggests a person explore the many available options including nicotine replacement therapy or behavioral interventions such as cognitive behavioral therapy httpshealth.usnews.comhealthnewshealthwellnessarticlesdoesonlinecognitivebehaviortherapywork. However Kollins explains that if he or she is being safely treated with stimulants to help manage symptoms and possibly discovers that the medication may help them smoke fewer cigarettes along the way then it should be perceived as an extra benefit."

"Many Americans would rather take a drug than change their habits to control a persistent ailment. Yet every medication has side effects some of which can be worse than the disease they are meant to treat. Drugs considered safe when first marketed can turn out to have hazards both bothersome and severe that become apparent only after millions of people take them for a long enough time. Such is the case with a popular class of drugs called proton pump inhibitors or P.P.I.s now used by more than million Americans and many more people worldwide to counter an increasingly common ailment acid reflux which many people refer to as heartburn or indigestion. These medications are now linked to a growing number of complications http ranging in seriousness from nutrient deficiencies joint pain and infections to bone fractures heart attacks and dementia httpjamanetwork.comjournalsjamaneurologyfullarticle. While definitive evidence for most of the risks identified thus far is lacking consumers plagued by acid reflux would be wise to consider an alternative approach namely diet and lifestyle changes that can minimize symptoms and even heal damage already done. Acid reflux is more than just a nuisance. It involves the backward flow of stomach acid into the tissues above it. It results when the lower esophageal sphincter a ring of muscle between the esophagus and the stomach fails to close tightly enough to prevent the contents of the stomach from moving up instead of down. Sometimes the upper sphincter between the esophagus and the throat malfunctions as well. Acid reflux is a serious disorder that can and must be treated to prevent symptoms and stave off potentially lifethreatening consequences. Known medically and commercially as GERD the acronym for gastroesophageal reflux disease repeated bathing of the soft tissues of the esophagus with corrosive stomach acid can seriously damage them and even cause esophageal cancer which is often fatal. Contrary to what many believe heartburn is but one of the many symptoms of GERD and failure to recognize the others when heartburn is not among them can result in harmful untreated reflux. In addition to indigestion GERD can cause a persistent dry cough sore throat frequent throat clearing hoarseness burping or hiccups bloating difficulty swallowing and a sensation of a lump in the throat. If when faced with such an otherwise unexplainable symptom your doctor fails to think of GERD as a possible reason you might suggest it yourself. An examination of the esophagus may be the only way to find out if someone without obvious heartburn has acid reflux but doesnt know it. Dr. Jonathan Aviv an ear nose and throat specialist affiliated with Mount Sinai Icahn School of Medicine in New York was in his mids when he developed a frightening symptom that turned out to be caused by acid reflux. He was suddenly awakened one night gasping for air and feeling like he was being choked. Because hed never complained of heartburn his own doctor had trouble believing that acid reflux could be the explanation. Yet treating this ailment brought relief and set Dr. Aviv on a yearslong journey to learn how best to manage it. He has now written a book The Acid Watcher Diet that both explains how the varied symptoms of acid reflux arise and details a program for healing and prevention that can help many if not most people avoid the medications commonly prescribed to treat it. One characteristic often associated with acid reflux being overweight especially with abdominal obesity largely explains why the condition has become so common in Western countries. Someone with a body mass index in the overweight range is almost twice as likely to have GERD as a person of normal weight. Losing weight is one of the best ways to find relief without having to rely on medication. Quitting smoking limiting alcohol and avoiding carbonated drinks are also important protective measures. Smoking and alcohol can loosen tension of the upper esophageal sphincter and cause symptoms of reflux like hoarseness postnasal drip and shortness of breath by irritating the mouth larynx and trachea Dr. Aviv reports. Eating big meals lying down before a meal is digested and exercising too soon after eating can also trigger symptoms. Reflux sufferers are often advised to eat five or six small meals a day rather than one or two big ones and to avoid eating within three hours of bedtime. For further protection the head of the bed can be raised by six inches or more. But while certain common foods like raw onions garlic citrus juices coffee and chocolate are likely to cause reflux in most people with the condition Dr. Aviv and other experts emphasize that everyone is different http and trial and error is the most effective way to determine an individuals trigger foods and drinks. Specialists suggest keeping a food and drink diary for a week or two recording everything consumed and the timing of symptoms to help identify a persons trigger foods. A food does not have to be obviously acidic to be troublesome. Highfat foods are problematic for many people because they take a long time to digest. Dr. Aviv points out that many commercially produced foods and drinks are treated with acidcontaining substances to enhance flavor and shelf life. Accordingly the day healing diet he suggests consists almost entirely of natural unprocessed foods especially lean protein foods like lightmeat poultry fish egg whites and lowfat dairy beans combined with whole grains and nonacidic vegetables and fruits. Highfiber foods are very helpful second only to eliminating acidic foods Dr. Aviv said. Fiber enhances digestion reducing pressure on the lower esophageal sphincter and can aid in weight loss and maintenance among other benefits like reducing inflammation. Try to eat a pound of vegetables each day half of which are cooked and the other half eaten raw as well as half a pound of raw fruit. Good sources include broccoli carrots beets green leafy vegetables apples berries bananas avocados and pears. Other helpful fiberrich foods include almonds walnuts lentils chickpeas and lima beans. If adopting the above measures fails to fully control acid reflux taking a proton pump inhibitor may also be needed. But a P.P.I. should be used in the lowest effective dose at the correct time and for the shortest possible period experts say. Studies have revealed that percent of Americans may be taking these powerful meds incorrectly Dr. Aviv wrote. He said they should be taken to minutes before eating breakfast or dinner or both but not used as an antidote to consuming acidic foods."

"Taking folic acid before pregnancy and through the first several weeks of pregnancy may help reduce the risk of autism for those children according to a new study published Tuesday in the Journal of the American Medical Association JAMA httpjama.jamanetwork.comjournal.aspx. Researchers in Norway looked at data from pregnancies and found that women who took the supplement four weeks before pregnancy and through the eighth week of pregnancy were less likely to have children with autism. The Norwegian study is the largest to date on the benefits of folic acid for autism prevention and marks one of the first tangible things a woman can do to reduce her risk of giving birth to a child with the disorder. This is pretty exciting said Alycia Halladay senior director for environmental and clinical sciences for Autism Speaks an autism advocacy group. It actually supports the idea of actionable things women can do before they become pregnant and right as conception happens. Experts have known for some time that taking folic acid can prevent neural tube birth defects like spina bifida in developing fetuses. American Congress of Obstetricians and Gynecologists ACOG guidelines http call for all women of childbearing age not just those who plan to get pregnant to take micrograms of folic acid daily to prevent birth defects. The same dose appears to provide some benefit in preventing autism according to the research. This is another piece of evidence that supports the beneficial uses of folic acid during pregnancy said Halladay who was not connected with the study. The research strongly suggests that taking folic acid prior to pregnancy may reduce the risk of autism in children said Dr. Edward R.B. McCabe medical director for the March of Dimes. The organization also recommends women of childbearing age take micrograms of folic acid daily before conceiving and to micrograms per day while pregnant. But some experts arent quite ready to tout the benefits of folic acid too loudly particularly for autism prevention. It is possible that folic acid ... might provide protection against other neurodevelopmental disorders like autism said Zachary Warren director of the Treatment and Research Institute for Autism Spectrum Disorders at Vanderbilt University who was also not involved in the study. While the current study suggests such protection... the data really do not establish anything close to a causal connection. The Norwegian researchers do admit that more studies should be done to confirm the link. Warren says he wishes the solution were as simple as just taking folic acid. Caring for individuals with autism and their families would be a whole lot easier if we had simple answers about cause and risk he says. The reality is autism is a complex disorder and our best answers about causes and treatment are going to be complex as well. Despite the fact that a link between taking folic acid and reducing autism risk isnt fully proven Halladay says theres no harm in taking the supplement and women should be taking it anyway to prevent birth defects."

"Dieters who go vegetarian not only lose weight more effectively than those on conventional lowcalorie diets but also improve their metabolism by reducing muscle fat a new study published in the Journal of the American College of Nutrition has found. Losing muscle fat improves glucose and lipid metabolism so this finding is particularly important for people with metabolic syndrome and type diabetes says lead author Dr. Hana Kahleov Director of Clinical Research at the Physicians Committee for Responsible Medicine in Washington DC. Seventyfour subjects with type diabetes were randomly assigned to follow either a vegetarian diet or a conventional antidiabetic diet. The vegetarian diet consisted of vegetables grains legumes fruits and nuts with animal products limited to a maximum of one portion of lowfat yoghurt per day the conventional diabetic diet followed the official recommendations of the European Association for the Study of Diabetes EASD. Both diets were restricted by kilocalories per day compared to an isocaloric intake for each individual. The vegetarian diet was found to be almost twice as effective in reducing body weight resulting in an average loss of .kg compared to .kg for the conventional diet. Using magnetic resonance imaging Dr. Kahleov and colleagues then studied adipose fatstorage tissue in the subjects thighs to see how the two different diets had affected subcutaneous subfascial and intramuscular fat that is fat under the skin on the surface of muscles and inside muscles. They found that both diets caused a similar reduction in subcutaneous fat. However subfascial fat was only reduced in response to the vegetarian diet and intramuscular fat was more greatly reduced by the vegetarian diet. This is important as increased subfascial fat in patients with type diabetes has been associated with insulin resistance so reducing it could have a beneficial effect on glucose metabolism. In addition reducing intramuscular fat could help improve muscular strength and mobility particularly in older people with diabetes. Dr. Kahleov said Vegetarian diets proved to be the most effective diets for weight loss. However we also showed that a vegetarian diet is much more effective at reducing muscle fat thus improving metabolism. This finding is important for people who are trying to lose weight including those suffering from metabolic syndrome andor type diabetes. But it is also relevant to anyone who takes their weight management seriously and wants to stay lean and healthy."

"If losing weight was one of your New Years resolutions you might already be growing weary of counting calories and working out. Wouldnt it be great if you could slim down without so much effort Anyone looking for a shortcut to weight loss might be tempted to try one of many supplements that claim to burn fat and boost metabolism. These products often contain a notespeciallyexotic ingredient thats already a staple of the American lifestyle caffeine. The morning coffee drinkers at Dunkin Donuts notwithstanding caffeine has a strong reputation as a weightloss aid. The stimulant is one of the key ingredients of Zantrex the popular weightloss supplement from Zoller Laboratories based in Salt Lake City. The company claims each capsule contains up to milligrams of caffeine and caffeinelike stimulants from green tea and yerba mate among other sources while a government database of supplements says each capsule of Zantrex contains more than mg of caffeine. Thats slightly more than youd get from a typical double shot of espresso. Other ingredients include ginseng and damiana a Latin American herb traditionally used as an aphrodisiac. Users are instructed to take two capsules with a glass of water before a meal or anytime during the day when they need an energy boost. According to the label they shouldnt take more than six capsules in a day. Zantrex is available at many drugstores. You can expect to pay about for a package of capsules. Its What We Have Suspected All Along And Even Worse... LipoFuze a weightloss supplement from E Nutrition Research based in Orem Utah also packs a significant amount of caffeine. The label says that each capsule contains mg of a green tea extract that is caffeine. Other ingredients include vitamin D chromium and coenzyme Q. Users are instructed to take two capsules a day. A package of a onemonths supply costs about . The claims The website for Zantrex says it provides both extreme energy and rapid weight loss more weight loss than the leading ephedrabased diet pill to be exact. The site features a picture of reality TV star and official product endorser Nicole Snooki Polizzi of Jersey Shore pulling a bottle of the pills out of her purse. The website calls her a celebrity and yes the term is in quotation marks. Amy Heaton director of scientific affairs for Zoller says that caffeine and caffeinelike compounds have been proved to improve energy stamina concentration mood and metabolism. But she says they have not been shown to significantly increase weight loss. Heaton adds that its not just about weight loss. Its about fat loss and increased energy. To drive home the message she points to Snookis transformation from a selfprofessed meatball to a sexy and slim fireball. The website for LipoFuze says that the supplement increases the metabolic mechanism in your body. The site also says the green tea and caffeine will rev up your metabolism and increase energy focus and physical performance. The site features testimonials it says are from users who claim they have lost huge amounts of weight with the help of LipoFuze. One man says he dropped more than pounds although its unclear how long that took. A woman says she lost pounds in less than a year including pounds in her first month. Attempts to reach E Nutrition Research for comment were not successful. The bottom line Caffeine shows up in a lot of weightloss products but it doesnt seem to be any sort of silver bullet against flab says C. Michael White a professor of pharmacy at the University of Connecticut in Storrs. White says that to his knowledge there are no welldesigned studies showing that caffeine works better than a placebo when it comes to weight loss. White notes that caffeine is a diuretic which means that people taking large doses might shed some weight through water loss but thats not the kind of slimming most users are looking for. As reported in a issue of the International Journal of Obesity caffeine may in fact be able to increase a persons metabolic rate by or . But according to White theres no clear evidence that this translates into actual weight loss. One possible explanation Any increase in metabolism might go handinhand with a boost in appetite he says. Caffeine does seem to enhance the weightloss powers of some other ingredients White says. For example green tea contains antioxidants that encourage cells to burn extra calories and caffeinated green tea seems to promote more weight loss than decaf versions. But even this combination yields very modest results. In clinical trials the weight loss is . to pounds not pounds White says. Gerald Endress the fitness director of the Duke Diet and Fitness Center at Duke University in Durham N.C. says patients often ask about caffeine as a weightloss aid. I tell them its definitely not going to be as helpful as minutes of exercise. Endress says a little caffeine before a workout might help a person exercise harder and longer which could theoretically help them control their weight. But the real credit would go to the exercise not the caffeine. Endress also warns that too much caffeine such as the high doses found in Zantrex could cause jitteriness anxiety spikes in blood pressure and rapid heartbeats in some people."

"Read this story at http The UAB News Studio http is available for live or taped interviews with UAB experts. Newswise BIRMINGHAM Ala. The Food and Drug Administration recently approved lifitegrast a new eye drop for treating signs and symptoms of dry eye in adult patients. Kelly Nichols https O.D. Ph.D. a dry eye expert and dean of the University of Alabama at Birmingham http School of Optometry https conducted research studies for the parent drug company to explore the efficacy and safety of lifitegrast in treating this eye condition that affects more than million adults in the United States. Inflammation associated with dry eye may eventually lead to damage to the surface of the eye. Dry eye is a common complaint to eye care professionals with millions of U.S. adults experiencing the symptoms of this often chronic disease Nichols said. It is critical for eye care professionals to have a dialogue with patients who report symptoms because dry eye can be a progressive ocular surface disease. The twicedaily eye drop solution of percent lifitegrast ophthalmic solution is the only prescription eye drop indicated for the treatment of both signs and symptoms of dry eye and it is the first new dry eye prescription drop approved in the last years. Nichols and a team of researchers studied patients of whom received lifitegrast in four placebocontrolled week trials. Signs and symptoms were assessed at baseline and at weeks two six and . In all four studies eye dryness was significantly reduced with two of the studies showing improvements at week two. Results from inferior corneal staining tests used by physicians to detect abrasions on the cornea showed improvement in three of the four studies. Nichols continues to push for funding and advancement for dry eye research and treatment. Prior to FDA approval of the lifitegrast eye drop Nichols presented a congressional briefing in Washington D.C. addressing research into dry eye for the National Alliance for Eye and Vision Research. She focused on the cause and potential therapies for dry eye that are being funded through the National Eye Institute and in private industry. Focusing her research on all aspects of the eye Nichols discussed the mechanics of the three layers of the tear film and the importance of each from the cornea outward Mucin layer helps tears adhere to the eye Aqueous layer or water layer nourishes and protects the cornea Lipid or oil layer lubricates and prevents evaporation and provides smooth refractive surface needed for optimal vision We are unsure which of the plus different lipids and plus unique proteins are most important for protecting and lubricating the eye and the absence or insufficiency of which results in dry eye Nichols said. There are more than plus new dry eye basic translational and clinical studies being funded by the NEINational Institutes of Health to further explore these lipids and proteins with more than papers being published monthly. Funding from NIH is helping the optometry world make significant strides in understanding the cause and treatment of dry eye Nichols said. We still have a long way to go but prevention and early detection are major goals. There is hope for dry eye patients worldwide. Diagnosis of dry eye is identified by an eye care professional based on careful evaluation of signs and symptoms including dryness discomfort vision changes and damage to the surface of the eye. Specialty testing for dry eye is performed at the Dry Eye Relief Clinic at UAB Eye Care in the School of Optometry. About UABKnown for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels the University of Alabama at Birmingham is the state of Alabamas largest employer and an internationally renowned research university and academic medical center its professional schools and specialty patientcare programs are consistently ranked among the nations top . UABs Center for Clinical and Translational Science is advancing innovative discoveries for better health as a twotime recipient of the prestigious Center for Translational Science Award http Find more information at http and http EDITORS NOTE The University of Alabama at Birmingham is a separate independent institution from the University of Alabama which is located in Tuscaloosa. Please use University of Alabama at Birmingham on first reference and UAB on all subsequent references. VIDEO http TEXT http TWEETS http"

"Brynne Henn leaned back onto a pristine white couch and settled whiteandred headphones over her ears. She picked up a handset grasping one buzzer in each hand closed her eyes and the session began. The room was quiet. Through the headphones Henn heard an alternating tone first in the right ear then the left back and forth. The handset buzzed in synchrony rightleftrightleft part of a trauma treatment that also involves recalling painful memories. She turned her thoughts to the day her brother Nate died. Nate Henn had been visiting relatives and working with Invisible Children a nonprofit in Kampala Uganda. On July he was at a sports complex with friends enjoying the broadcast of a World Cup soccer match when terrorists struck. Nate was only when shrapnel from a bomb ended his life. The years hadnt diminished Brynne Henns pain. Your brothers dead and you need to come home to take care of your mom she remembered her father saying. With those simple words her brother was gone and she felt compelled to take control in the ensuing chaos. Henn who had been visiting her boyfriend in Chapel Hill immediately returned home to Raleigh N.C. I didnt stop for the first week after Nate died she said. The ordeal didnt end with the news of Nates death. Her other brother Kyle rushed home from Delaware to be with the family. But the private plane carrying him crashed the next day in nearby Chapel Hill. The pilot was killed and the copilot was seriously injured but Kyle survived. And then the media storm went crazy Henn said. The family already had received inquiries from journalists about Nates death Kyles brush with death only intensified the interest of media outlets from Philadelphia to Raleigh. It made it so much worse Henn said. At age she began functioning as the family spokeswoman. I felt like I had to protect my family from all of it she said. She occupied herself with press inquiries and funeral arrangements. But after the whirlwind passed unaddressed grief remained with her. Complicated grief When a person experiences trauma the associated memories can remain as vivid and urgent as on the day the event happened. The brain perceives the trauma as happening in the present and reacts accordingly even in safe situations. When Henns traumatic memories of her brothers violent death were triggered they popped and glowed in her mind as if they were being shown on a projector screen. All these memories around me started playing like a video loop Henn said. Her body remembered the sensations vividly the heat and discomfort of the summer day the pain of her high heels as she delivered the eulogy at the funeral. Henn did cognitive behavioral therapy a form of conventional talk therapy for five years. It helped me realize feelings were normal she explained and that she was not weak for reeling from the tragedy. But I never felt like I was getting over it. Random memories could send her spiraling into panic and fear. Talk therapy helped her manage those attacks but it didnt address the root cause. Henn was initially diagnosed with a condition known as complicated grief she was diagnosed with posttraumatic stress disorder only last year. She was surprised. She had thought of PTSD as an affliction of soldiers and others directly involved in horrendous events not of people like her suffering from the ripple effects of a bombing in Uganda. It was Kyle Henn recovering from his own PTSD after surviving the plane crash who recommended eye movement desensitization and reprocessing therapy or EMDR. Psychologist Francine Shapiro developed EMDR http in . Three years later she founded the EMDR Institute which has trained more than practitioners. Some therapists use sounds from headphones during a session. Others use eye movement moving a finger or object back and forth as the patient follows eyes moving left to right and back again. Others employ a bar on which small bulbs light up from one side to another. Patients follow the light or object with their eyes or listen to the alternating tone while thinking about a specific traumatic memory or series of memories. They describe the memories to the therapist who gives guidance as needed. The idea is that reliving the memories helps remove the sting and that the urgency of the memories can be reduced as the brain begins to move them from shortterm to longterm memory. The sound or the eye movement is supposed to activate both sides of the brain in an imitation of REM sleep when the brain usually converts shortterm memories into longterm recollections. Studies have found benefits httpjournals.cambridge.orgactiondisplayAbstractfromPageonlineaidfileIdS to EMDR. But there is debate about whether the eye movement http makes a difference http Stephen Holland founder of the Capital Institute for Cognitive Therapy and coauthor of the textbook Treatment Plans and Interventions for Depression and Anxiety Disorders. The question is whether stimulation adds to it. He does not use it in his practice because he considers it no more effective than cognitive behavioral therapy. Brynne Henn who lives in the District began seeing a licensed clinical psychologist who practices EMDR last September. In Gail Kalins office nestled in a treeshaded apartment building in Northwest Washington Henn confronted the trauma that still haunted her. The techniques associated with EMDR may merely have a placebo effect some psychologists say. In early sessions Henn focused on the headphones and handset they helped distract her from the terror of reliving the traumatic events surrounding her brothers death she said. This distraction had a positive effect on her she said allowing her to dive deeply into the therapy without freezing in the face of fear. Some insurance plans cover EMDR. Henns does not she pays for the sessions out of pocket. Henn who is a communications associate at a Washington research institution was initially very skeptical of EMDR. It is so weird she said. When I first got there and she hands me these two paddles that vibrate in my hands and then I put on these giant headphones I was like What is this a hearing test What are we doing But Henn was encouraged by the progress she made. I started getting really interested in it she said. Why is my brain coming up with this What in the world are you doing to me that this is what I came up with Henn was surprised by the vivid memories some of which she hadnt known existed that resurfaced after so much time had passed. Reliving the memories It didnt matter to her whether research supported EMDR what mattered was whether it worked for her. Each time a particularly painful memory resurfaced Henn said you have to go through it again until it has no meaning. By confronting the trauma headon she added it became less powerful. Its integrating whats stuck in time explained Kalin the psychologist. Memories formed under the adrenaline of trauma are never put to rest she said. EMDR processing is untangling the knot. Once the memories are processed therapists say they are less vivid less like the film reel Henn would see in her mind. Henn was able to recall processed memories without feeling panic. EMDRs central appeal lies in the possibility of closure an end to PTSD and to therapy for it. Im going to come out equipped with tools to take care of myself Henn said. She already has put these tools to the test Two months after she started EMDR terrorists hit Paris killing at least people. Soon after that attack she heard reports that a video possibly from the Islamic State contained a threat to hit Washington next and she had a fullfledged panic attack she said. I was not sure where I was I was sweating profusely but also really cold she said. She stepped onto the thfloor terrace at work and looked down. The thought came into my head I just need to walk off and that will wake me up Henn remembered. And I had enough awareness that I sat myself down and was trying to think of calming breaths and going back and forth actions reminiscent of EMDR processing. It took a while and it was a little terrifying that I had that thought she said. But the process of being able to calm myself down was much better than anything I had been equipped with before. In a few weeks Henn mentioned to Kalin she would be marrying her college sweetheart. Beneath the excitement she felt a twinge of panic How would she react to her brothers absence from the wedding She asked a close friend to write a speech from Nates point of view as if he were speaking at the celebration. But Henn admitted she was worried that the speech would trigger an extreme emotional reaction a fear shared by many who suffer from PTSD. They never know when the trauma will reignite it can spread from the smallest spark even on the happiest day. Does EMDR deal with the future she asked Kalin. Kalin nodded and they began processing memories again. Among the painful recollections Henn encountered a happy memory friends who arrived at the funeral to support the family and a smile broke through the tears. It felt like a gift from Nate she said. EMDR Henn said allowed her to have a doover to be able to grieve properly and then to move beyond grief. She was finally able to remember the good times with her brother without being overwhelmed by pain. Im still sad but Im not hurt by it anymore she said. Its not opening up any fresh wounds. As Henn walked outside into a brisk April evening after her session there was a new easiness to her as though something had finally been freed."

"Australian researchers have developed an experimental blood test they say is the first blood test capable of detecting melanoma an aggressive form of skin cancer in its early stages with a high degree of accuracy. The test could speed up the diagnosis process saving thousands of lives. Scientists at Edith Cowan University in Western Australia tested blood samples for the antibodies typically created by the immune system in response to melanoma and identified them with significant accuracy. Antibodies are easily accessible in the blood so it provides a fantastic test to identify an earlystage cancer said project lead Professor Mel Ziman leader of the universitys Melanoma Research Group on Monday. In the study httpcdn.cnn.comcnnimagesziman.melanoma.blood.test.pdf published Tuesday in the journal Oncotarget Zimans team screened blood samples from both melanoma patients and healthy volunteers. The researchers were able to identify people with melanoma with accuracy and people without a melanoma with accuracy. In order for it to be valued by clinicians we would need to get to accuracy in detection she said. So we are doing a clinical trial with participants to refine our test to get to this point. If further trials are successful Ziman estimates the test could be distributed internationally in up to five years. Patients who returned a positive result would still need a biopsy to confirm the blood test and determine how far the cancer had developed Ziman said. Multiple groups worldwide are working to develop blood tests that detect a range of cancers. A recent study httpsedition.cnn.comhealthcancerbloodteststudyindex.html showed promise for a test detecting tumors of the ovary liver stomach pancreas esophagus colorectum lung and breast while another study httpsedition.cnn.comhealthbloodtestcancerscreeningintlindex.htmlclaimed to detect cancers including accuracy for ovarian cancer. The Australian team believe theirs would be the first to detect melanoma. In the wrong place with the wrong skin color Melanoma cancers are dangerous abnormal growths on the surface of the skin caused by sun damage which can spread throughout the body if left untreated. They accounted for an estimated . of all cancer diagnoses worldwide https in . The World Health Organization http estimates that melanoma skin cancers occur globally each year. The problem is particularly serious in Australia where melanomas were the fourth most commonly diagnosed cancer in and cause about deaths a year according to the university. This is in large part due to high levels of UV exposure caused by the regions proximity to the ozone https hole over the Antarctic. Were in the wrong place with the wrong skin color. Weve had a lot of migrants from European nations so theyre fairskinned ... and we do have a very intense sun here Ziman said. If detected early skin cancers have a survival rate as high as the research team said but it drops to just if diagnosed late. Surgery to remove the growth is the most common form of treatment. Simpler detection Ziman said current methods of melanoma detection are expensive and invasive involving a trip to a clinician who must biopsy the lesion to discover whether it is cancerous. For potential sufferers in remote areas away from skin specialists diagnosis can be especially tricky he said making a simple blood test an easy alternative to identify those at risk. Over three years the research team identified a combination of types of antibodies that best signal the presence of a melanoma. Antibodies are the products of the bodys immune system created to battle not only bacteria and viruses but abnormal cancer cells Ziman said. Follow CNN Health on Facebook and Twitter See the latest news and share your comments with CNN Health on Facebook https and Twitter httpstwitter.comcnnhealth. Dr. Jodie Moffat head of early diagnosis at Cancer Research UK agreed that a test which finds melanoma earlier could help reduce deaths from the disease adding that melanoma can be more than skin deep and its much harder to treat when diagnosed at a late stage after it has spread. However she stressed the fact this new test has not undergone clinical trials. We need to know how accurate it is if it can save lives and how it could work in practice. So although a blood test to find skin cancer earlier is certainly exciting research in this field still has hurdles to overcome she said. In the meantime people can help spot skin cancer early by knowing whats normal for their skin said Moffat. In turn people should talk to a health professional about any unusual or lasting changes to a mole freckle or normal patch of skin. CNNs Meera Senthilingam contributed to this report"