Trazodone hcl Side Effect occurred on 2008-06-23
2008.06.01 — Health Highlights: June 1, 2008
June 01, 2008
Health Highlights: June 1, 2008
Here are some of the latest health and medical news developments, compiled by editors of HealthDay:
Laparoscopic Prostate Cancer Surgery Not Always Best Choice, Report Says
Minimally invasive surgery on prostate cancer patients has mixed results, a new study suggests.
The New York Times reports that a study examining the results of laparoscopic prostate cancer surgery on a sample of 2,702 patients who had undergone the procedure to remove a malignant prostate gland found that there was a 27 percent lower risk of complications immediately after surgery and a shorter hospital stay by an average of almost three days.
But the Times adds, the study also found that laparoscopy patients had a 40 percent greater chance of scarring, which could require additional surgery. And more than 25 percent of the patients also needed hormonal drug treatment within six months, more than double those who had conventional surgery.
The study was published May 10, 2008 in The Journal of Clinical Oncology,
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Baltimore Adopts First-Ever Limit on Single Cigar Sales
Move over, cigarettes. Make room for limitations on cigar sales… at least in Baltimore.
According to the Baltimore Sun, the city council has adopted a proposal that would make Baltimore, Md. the first city in the United States to limit sales of small, individual cigars known as “blunts” or “loosies” in neighborhood stores.
The law is specifically aimed at teenagers influenced by popular hip-hop singers, the Sun reports, and each cigar contains much more nicotine than a cigarette. In addition to packing more of a nicotine wallop, the newspaper says, the cigars are artificially sweetened, adding to their appeal to adolescents.
The sale limitation could be implemented by the city’s health department within days, the Sun reported, and would prohibit selling the cigars individually, at about 50 cents each. Because the cigars would have to be sold in minimum packs of five, city officials theorize the increased cost could reduce the number of teenagers smoking cigars.
Cigars don’t fall under U.S. government regulations against selling cigarettes to minors, the newspaper reports, and this may have led to a 2007 study by Johns Hopkins University researchers that found nearly 24 percent of Baltimore residents between 18 and 25-years-old had smoked a small cigar within the past 30 days.
While scientific studies on the impact of long-term cigar smoking aren’t as comprehensive as those that looked at cigarette smoking, the U.S. government’s National cancer Institute says that research “has shown that cancers of the oral cavity (lip, tongue, mouth, and throat), larynx, lung, and esophagus are associated with cigar smoking.”
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Indian ‘Laugh-In’ Has its Serious, Scientific Side
Once again, an attempt is being made to find out if laughter is indeed the best medicine.
The Washington Post reports that participants in the International Laughter Yoga Conference in India are using as many different types of laughter as their collective imagination can create to replicate findings from 2006 that showed the cardio-pulmonary system was positively affected from a good laugh.
The idea, the Post says, is for the laughers to create enough energy to release endorphins — hormones that elevate the mood and are often released from rigorous exercise.
In the 2006 study, published in the journal Heart, researchers at the University of Maryland Medical Center in Baltimore collected a total of 160 measurements of brachial artery flow from the participants a minute before and after phases of laughter or sadness. The brachial artery, which runs from the shoulder to the elbow, is a good indicator of blood flow throughout the body.
According to the researchers, brachial blood flow was reduced in 14 of the 20 participants after they watched segments from the sad movies. Blood flow was increased in 19 of the 20 participants after they watched clips from comedy movies.
Now, those promoting mirth at the Indian yoga conference are attempting to add to the original research.
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FDA Panel Recommends Drug for Rare Blood Disorder
Despite reservations by U.S. Food and Drug Administration scientists, a panel of experts advising the agency has recommended the full agency’s approval of a drug to treat a rare immune system disorder that causes the body to destroy its own blood platelets.
The advisory panel voted unanimously Friday to recommend Promacta, produced by GlaxoSmithKline and Ligand Pharmaceuticals, the Associated Press reported. Earlier in the week, FDA scientists released data that they suggested found that Promacta was no better than a placebo in treating chronic idiopathic thrombocytopenic purpura. Some 60,000 people in the United States have the disorder, which leads to excessive bleeding and bruising.
While noting that the drug makers haven’t provided long-term data on the drug’s safety and effectiveness, the panel said a pair of six-week studies indicated Promacta was of significant benefit to people with the disorder, the AP reported.
The FDA has until June 19 to decide whether to approve the drug. While it isn’t bound by the recommendations of its expert panels, it typically follows them.
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Facial Features Affect Perception of Mood
A person’s facial expressions and mood can be misperceived due to differences in facial features such as eyebrow shape, eyelid position and wrinkles, according to a U.S. study.
It included 20 health care workers who viewed photos that were digitally altered to change a number of features. The participants were asked to rate, on a scale of 0 to 5, seven expressions or emotions conveyed in the photos: tiredness, happiness, surprise, anger, disgust, fear and sadness, United Press International reported.
Results for the altered photos were compared to the scores from the original photos. Overall, eyebrow shape was deemed to be the greatest indicator of mood, drooping of the eyelids was considered the biggest indicator of tiredness, and raising the lower eyelid and the presence of crow’s feet were associated with happiness.
The study appears in the journal Plastic and Reconstructive Surgery.
“A key complaint of those seeking facial plastic surgery is that people always tell them they look tired, even when they do not feel tired,” study co-author Dr. John Persing said in a prepared statement cited by UPI. “We found that variations in eyebrow contour, drooping of the upper eyelid, and wrinkles may be conveying facial expressions that don’t necessarily match how patients are feeling.”
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Recalled Toy Helicopters Pose Fire, Burn Hazards
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About 152,000 Sky Champion wireless indoor helicopters are being recalled because the rechargeable battery inside the toy can ignite and pose fire or burn hazards to consumers, the U.S. Consumer Product Safety Commission said. There have been two reports of the Chinese-made toy helicopters catching fire but no reports of injuries or property damage, according to importer/distributor Tradewinds International Enterprises Inc. (TWIE), of San Francisco, Calif. |
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The recalled helicopters have the code BH26047 printed on the tail. The code WIC 551777 and the UPC code 630990006005 are printed on the packaging. The toys were sold at Walgreens stores across the United States from June 2007 through November 2007 for about $20.
Consumers should stop using the toys and contact TWIE at 888-583-4908 for a refund. Walgreens will not accept returns or provide refunds, the CPSC said.
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Most Children’s Caregivers Ignorant About Household Poisons
Less than one-third of people who cared for children younger than age six knew the toxicity of common household products, a new U.S. study found.
“Young children are at risk of household chemical ingestion and their caretakers often do not have a good understanding of how toxic those chemical are. Parental education needs to be focused more on younger caretakers with more children,” study leader Dr. Rika N. O’Malley, of the Albert Einstein Medical Center, said in a prepared statement.
The researchers screened primary caregivers who visited emergency departments, asking them to identify toxic items from a list of common household products. People with a higher level of education, responsibility for fewer children, and those more than 23 years old were more likely to have knowledge of household poisons.
The study was presented Friday at a meeting of the Society for Academic Emergency Medicine.
The researchers said doctors needed to boost efforts to educate primary caregivers about the risks of household toxins.
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2008.06.02 — Young Hodgkin Survivors Face Later Risk of Second Cancers
June 02, 2008
Young Hodgkin Survivors Face Later Risk of Second Cancers
SUNDAY, June 1 (HealthDay News) — People who survived Hodgkin disease when they were children or adolescents are much more likely than other people to develop certain cancers, says a new study.
Hodgkin disease (HD), a cancer of the lymph nodes, has a cure rate of more than 90 percent, but survivors may be at future risk of developing second cancers other than HD, according to background information in the study.
Researchers at Roswell Park Cancer Institute in Buffalo, N.Y., examined the frequency and risk factors related to developing second cancers among 182 patients who were up to age 19 years at the time of HD diagnosis between 1960 and 1989. The patients were followed through the end of 2006.
Of the 182 patients, 27 (15 percent) developed at least one second cancer, and 12 (7 percent) were diagnosed with basal cell carcinoma.
Thyroid and breast cancers, and non-Hodgkin lymphoma were the most common types of secondary cancers in both male and females. These cancers occurred six times more often than would be expected in a group of people who hadn’t been treated for HD.
Among HD patients, basal cell carcinoma was 17 times more common in males and 12 times more common in females than in the general population.
There wasn’t an association between the occurrence of second cancers and previous chemotherapy, radiotherapy or surgery, the researchers concluded.
The study was expected to be presented Sunday at the annual meeting of the American Society of Clinical Oncology, in Chicago.
The researchers said the findings help quantify the risk of secondary cancers in HD survivors and highlight the importance of long-term follow-up and counseling about cancer screening/surveillance and healthy behaviors.
More information
The American Cancer Society has more about Hodgkin disease.
– Robert Preidt
SOURCE: Roswell Park Cancer Institute, news release, June 1, 2008
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2008.06.02 — Vaccine May Boost Survival of Brain Cancer Patients
June 02, 2008
Vaccine May Boost Survival of Brain Cancer Patients
MONDAY, June 2 (HealthDay News) — An experimental cancer vaccine is showing promise against the same general type of brain tumor diagnosed in Sen. Edward Kennedy, researchers are reporting.
The vaccine, when given with chemotherapy, more than doubled progression-free survival in patients with glioblastoma multiforme tumors. Kennedy underwent surgery Monday for a malignant glioma, a class of brain tumor that includes glioblastoma.
“It’s a very small study but the results are very encouraging,” said Dr. Deepa Subramaniam, director of the brain tumor center at Georgetown University’s Lombardi Comprehensive Cancer Center in Washington, D.C. “It’s often said that big differences would be obvious even in small studies, [and] in this very small study the average length of time patients were alive and without progression of gliobastoma was 16 months. It’s quite remarkable.”
The study results were to be presented Monday at the annual meeting of the American Society of Clinical Oncology, in Chicago. The study was funded by the U.S. National Institutes of Health and Celldex Therapeutics, which has licensed the rights to the vaccine.
The American Cancer Society estimates that 21,810 malignant tumors of the brain or spinal cord will be diagnosed this year in the United States. Approximately 13,070 people — 7,420 men and 5,650 women — will die from these tumors. The cancers account for about 1.3 percent of all cancers and 2.2 percent of all cancer-related deaths in the United States.
Current therapies for glioblastoma multiforme (GBM) tumors include surgery, chemotherapy and radiation.
The experimental vaccine targets a protein called epithelial growth factor receptor variant III (EGFRvIII), and strengthens the body’s immune response. The protein is produced in about half of all GBM tumors but not in normal tissue.
This phase II trial involved 23 patients with newly diagnosed glioblastoma that was EGFRvIII positive. In addition to the vaccine, all participants also received surgery and radiation as well as chemotherapy with the drug temozolomide (TMZ) either five days a month or continuously.
Median progression-free survival in these patients was 16.6 months, whereas typically, such patients would be expected to live only about 6.4 months, said Dr. John Sampson, lead author of the study and associate professor of neurosurgery at Duke University.
Not only that, when the tumors did recur they did so without producing the EGFRvIII protein. “Tumors which express [produce] the protein have a worse prognosis so the results are even more impressive,” Sampson said.
Also surprising was the degree of immune response. The chemotherapy drug TMZ normally kills white blood cells but, in this case, resulted in a dramatic enhancement of these immune-system cells.
“It’s completely counterintuitive,” Sampson said, adding that he could only speculate at this point why this was so.
THE EGFRvIII vaccine appears even more promising than other cancer vaccines that are in various stages of development.
“Oftentimes these vaccines are not terribly specific to the driving force of the cancer, whereas this particular vaccine… is only being given to those whose tumors expressed this particular protein,” Subramaniam explained.
Phase III trials for the vaccine have already begun and, if successful, may pave the way for marketing of the vaccine in two to four years, Sampson said.
More information
The U.S. National Library of Medicine has more on gliomas.
SOURCES: John Sampson, M.D., Ph.D., associate professor, neurosurgery, Duke University, and associate deputy director, Preston Robert Tisch Brain Tumor Center, Duke University, Durham, N.C.; Deepa Subramaniam, M.D., director, Brain Tumor Center, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C.; June 2, 2008, presentation, American Society of Clinical Oncology annual meeting, Chicago
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2008.06.02 — U.S. Childhood Cancers Vary by Sex, Region
June 02, 2008
U.S. Childhood Cancers Vary by Sex, Region
MONDAY, June 2 (HealthDay News) — A sweeping government study of childhood cancers has found numerous differences in cancer types depending on a child’s age, sex, race and where he or she lives in the United States.
White children had the highest incidence of all cancers, the researchers found, and youngsters in the Northeast were diagnosed with cancer more often than children in other parts of the country.
The study also found that boys were more likely to have a pediatric malignancy than girls, and that adolescents are more likely to have cancer than are younger children.
“We looked at the childhood cancer incidence rate from 2001 through 2003, and further looked at the data by age, sex, ethnicity and U.S. census region,” said the study’s lead author, Dr. Jun Li, an epidemic intelligence office for the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.
“We identified 36,446 cases of childhood cancer during these three years, which is about 166 per every million,” he said.
Li said the information for the study, which represents more than 90 percent of the U.S. population, came from 39 National Program of Cancer Registries and five Surveillance, Epidemiology and End Results (SEER) databases.
Results of the study are published in the June issue of the journal Pediatrics.
Three cancers accounted for about 60 percent of all childhood cancers. Leukemias were the most common childhood malignancy, affecting just over 26 percent of youngsters with cancer. Central nervous system tumors, such as brain tumors, were the next most common type of pediatric cancer, affecting about 17.6 percent of children with the illness. Lymphomas affected about 14.6 percent of kids with cancer, according to the study.
Overall, boys were more likely to develop cancer than girls. The incidence rate for boys was 174 per million, while the incidence rate for girls was 157 per million. The type of cancer each sex commonly developed also varied. Boys were more likely to have lymphoid leukemia, non-Hodgkin lymphoma, Burkitt lymphoma, hepatoblastoma, osteosarcomas, and more. Girls were more likely to develop kidney cancers, thyroid cancers and malignant melanomas.
The cancer incidence rates for those between 15 and 19 were 210 per million, while the incidence rate in children 14 and under was about 151 per million.
White children were the most likely to have cancer, with an incidence rate of 173 per million. The rate for black children was 118 per million, 131 per million for Asian/Pacific Islanders, and 164 per million for Hispanics. American Indians and Alaska Natives had the lowest rates, with 97 per million.
Geography appeared to make a difference as well. Kids in the Northeastern part of the country are most likely to develop cancer, with an incidence rate of 179 per million. In the Midwest, the rate was 166 per million; in the South, it was 159 per million; and in the West, it was 165 per million. Interestingly, the study also reported that the Northeast, despite having the highest cancer rate, also has the lowest death rate from pediatric cancers.
Li said the researchers weren’t able to identify the reasons for the differences in this study, but he believes the data will lay the groundwork for future research. Knowing these differences may help other scientists target their research, he added.
“This is an interesting study, but as a practicing oncologist, I won’t be advising families any differently. And, as a father of three sons, I wouldn’t have any added concern as a parent living in the Northeast,” said Dr. Adam Levy, a pediatric hematologist and oncologist, and director of pediatric neuro-oncology at the Children’s Hospital at Montefiore in New York City.
“My fear is that people may over-interpret this study, and parents really don’t need added anxiety. We’re still talking about very rare pediatric cancers and mild differences. Mostly, this gives epidemiological researchers clues. Parents don’t need to become overly worried by this,” concluded Levy.
More information
Learn more about childhood cancers from the National Cancer Institute.
SOURCES: Jun Li, M.D., Ph.D., M.P.H., epidemic intelligence officer, U.S. Centers for Disease Control and Prevention, Atlanta; Adam Levy, M.D., pediatric hematologist/oncologist, and director, pediatric neuro-oncology, the Children’s Hospital at Montefiore, New York City; June 2008 Pediatrics
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2008.06.02 — Smokers With Colon Cancer Face High Recurrence Risk
June 02, 2008
Smokers With Colon Cancer Face High Recurrence Risk
MONDAY, June 2 (HealthDay News) — Long-term smokers treated for advanced colon cancer are at increased risk for cancer recurrence, a Dana-Farber Cancer Institute study shows.
Researchers analyzed data from 965 people treated for stage III colon cancer, and found that those with a 20 or more pack year history (calculated by number of years smoking times packs per day) were up to 22 percent more likely to have their cancer return or to die than patients who’d never smoked.
The earlier in life a patient started smoking, the greater the risk. Patients who smoked 12 pack years or more before age 30 and developed colon cancer later in life were 37 percent more likely to suffer cancer recurrence or death than nonsmokers.
“After controlling for other factors that may influence the risk of colon cancer recurrence or death, this study highlights further risk of cancer recurrence in individuals who have a higher lifetime total use of cigarettes than never smokers,” lead author Dr. Nadine Jackson said in a prepared statement.
The study was expected to be presented Monday at the American Society of Clinical Oncology annual meeting, in Chicago.
It’s known that tobacco use increases the risk of colon cancer, but little is known about the short- or long-term effects of tobacco use on cancer recurrence. This study is part of the effort to learn more about those effects.
The patients in the study filled out tobacco-use questionnaires during and six months after their treatment for colon cancer. Forty-five percent were past smokers, 9 percent were current smokers, and 46 percent were never smokers.
More information
The National Cancer Institute has more about colorectal cancer prevention.
– Robert Preidt
SOURCE: American Society of Clinical Oncology, news release, May 29, 2008
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2008.06.02 — Sen. Kennedy’s Brain Tumor Surgery Called a ‘Success’
June 02, 2008
Sen. Kennedy’s Brain Tumor Surgery Called a ‘Success’
MONDAY, June 2 (HealthDay News) — Sen. Edward M. Kennedy’s doctors said Monday that they had completed a “successful” three-and-a-half hour surgery to treat his malignant brain tumor.
“I am pleased to report that Senator Kennedy’s surgery was successful and accomplished our goals,” Dr. Allan Friedman said in a statement, the Boston Globe reported.
Friedman, considered one of the nation’s leading neurosurgeons, said Kennedy had been awake during the operation and “should therefore experience no permanent neurological effects from the surgery,” the newspaper said.
Asked by his wife, Vicki, how he felt after the surgery, Kennedy said, “I feel like a million bucks. I think I’ll do that again tomorrow,” the senator’s office said, the Globe reported.
The 76-year-old senator underwent surgery for a malignant glioma, an especially lethal type of brain tumor, at Duke University Medical Center in Durham, N.C. Friedman is neurosurgeon-in-chief at Duke.
After a brief period of recuperation, Kennedy will undergo radiation and chemotherapy treatments at Massachusetts General Hospital in Boston.
The surgery was considered the most aggressive approach that Kennedy could select to treat his tumor. The decision to opt for surgery was considered something of a surprise, the Globe reported, because Kennedy’s doctors did not mention surgery as an option after the tumor diagnosis was announced almost two weeks ago. Instead, Kennedy’s doctors said the focus of treatment would be radiation and chemotherapy.
Specifics about Kennedy’s particular type of tumor haven’t been disclosed. Some cancer specialists said the tumor appears likely to be a glioblastoma multiforme — a serious and tough-to-remove type — because other kinds of brain tumors are more common in younger people, the Associated Press reported.
Still, cancer experts said Kennedy faces a difficult struggle.
“In the more aggressive gliomas, the outlook is not good,” said Dr. Leonard Lichtenfeld, deputy chief medical officer at the American Cancer Society. “This is a serious situation with a difficult outlook.”
Dr. Eugene Flamm, chair of the department of neurosurgery at Montefiore Medical Center in New York City, said a patient with this type of brain tumor typically dies in about a year. “Some patients will die in less than a year, and others may live for two years,” he said.
“No matter where the glioblastoma is located, it’s not curable. When I talk to patients, I don’t talk about cure. I talk about trying to control the tumor,” Flamm said.
Dr. Ania Pollack, a neurosurgeon at the University of Kansas Hospital in Kansas City, agreed. “Life expectancy for a man Senator Kennedy’s age with such a tumor is about 12 to 14 months,” she said.
While there hasn’t been much improvement in survival, there are experimental treatments, Pollack noted. These include immuno treatments and targeted chemotherapy and local radiation therapy, she said.
In fact, a study presented Monday at the American Society of Clinical Oncology annual meeting in Chicago reported that an experimental cancer vaccine is showing promise against the same general type of brain tumor diagnosed in Sen. Kennedy. The vaccine, when given with chemotherapy, more than doubled progression-free survival in patients with glioblastoma multiforme tumors — from 6.4 months to 16.6 months.
Discussing Kennedy’s post-surgery care, Flamm said radiation and chemotherapy are the usual course of treatment. Patients also typically receive anti-seizure medication, he noted.
“Radiation usually takes about four to six weeks,” Flamm said. “While every protocol is different, chemotherapy is usually repeated every eight weeks if you are getting a response.”
Whether Kennedy will be able to return to work in the Senate is not clear. “It’s not just the physical part of it, it’s a psychological burden. If Kennedy feels he wants to do it, he should do it,” Flamm said. “I would think he’d have to wait until the end of radiation therapy. So, it would be several months.”
The American Cancer Society estimates that 21,810 malignant tumors of the brain or spinal cord will be diagnosed this year in the United States. Approximately 13,070 people — 7,420 men and 5,650 women — will die from these malignant tumors. The cancers account for about 1.3 percent of all cancers and 2.2 percent of all cancer-related deaths in the United States.
The first evidence that a person has a malignant tumor is often a seizure like one Kennedy suffered last month, or stroke-like symptoms. Kennedy, the second-longest serving Democratic senator in Congress, suffered a seizure May 17 while at his family’s Hyannisport, Mass., compound and was taken by helicopter to Boston.
In October 2007, a partially blocked carotid artery in Kennedy’s neck was discovered during a routine magnetic resonance imaging (MRI) examination. Doctors cleared the blockage, and Kennedy was released to convalesce in Hyannisport.
Dr. Otis W. Brawley, chief medical officer for the American Cancer Society, last month called Kennedy an “unparalleled leader in the fight against cancer and for access to quality health care for all Americans throughout his distinguished career in the United States Senate. He yields to no one in his accomplishments and in his efforts to bring all the resources of the nation to bear in fighting cancer and other diseases, to reigning in the tobacco industry, and to extending health insurance coverage to all Americans, especially the most vulnerable among us.”
Kennedy is the youngest of nine children, and became a U.S. senator in 1962. His older brother, President John F. Kennedy, was assassinated in 1963. Another brother, Robert Kennedy, who was also a U.S. senator, was assassinated in 1968 during his presidential campaign.
More information
The U.S. National Library of Medicine has more on glioma.
SOURCES: Leonard Lichtenfeld, M.D., Deputy Chief Medical Officer, American Cancer Society, Atlanta; Eugene Flamm, M.D., chair, Department of Neurosurgery, Montefiore Medical Center, New York City; Ania Pollack, M.D., neurosurgeon, University of Kansas Hospital, Kansas City; American Cancer Society; Boston Globe
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2008.06.02 — Public Lacks Confidence to Help in Cardiac Emergencies
June 02, 2008
Public Lacks Confidence to Help in Cardiac Emergencies
MONDAY, June 2 (HealthDay News) — While 89 percent of Americans say they’re willing and able to help if they witness a medical emergency, only 21 percent are confident they could perform cardiopulmonary resuscitation (CPR) and only 15 percent believe they can use an automated external defibrillator.
The American Heart Association online survey of more than 1,100 adults was released as part of the first National CPR/AED Awareness Week, from June 1-7. The week is meant to encourage people to get CPR training and to learn how to use an AED to reduce death and disability from sudden cardiac arrest (SCA).
Only about 6 percent of out-of-hospital SCA victims survive, the AHA said. Without immediate, effective CPR, the odds of surviving out-of-hospital SCA decrease by 7 percent to 10 percent per minute. Even if a victim receives CPR, defibrillation with an AED is needed to restore normal heart rhythm.
“We think it’s critical for people to get CPR training and learn how to use an AED. CPR and AED use are inextricably linked in the SCA survival chain, and it’s crucial that bystanders take rapid action. If more people are trained and respond, we can save thousands more lives,” Dr. Lance Becker, a professor of emergency medicine at the University of Pennsylvania in Philadelphia and AHA spokesman, said in a prepared statement.
AEDs are available in many public places such as schools, workplaces and airports. The devices provide clear, calm voice cues to help guide users through the process of delivering a shock.
“There’s no reason for people to be afraid to act. We want people to feel confident that whatever action they choose — whether using an AED or performing conventional CPR or adult Hands-Only CPR — they are doing something to help, which could be a lifesaving decision,” Becker said.
Among the other findings from the survey:
- More than half of the respondents didn’t recognize an AED in a typical setting.
- Lack of confidence, concern about legal consequences, and fear of hurting a victim are reasons why people wouldn’t take action in a cardiac emergency.
- Sixty-five percent of respondents said they’d received CPR training, but only 18 percent said they’d received AED training.
- Two-thirds of those trained in using CPR and AEDs were required to do so for their jobs, school or the military.
- The majority of respondents (88 percent) said they support requiring schools to have emergency plans, and 65 percent want public places to have AEDS on site.
More information
The U.S. Food and Drug Administration has more about AEDs.
– Robert Preidt
SOURCE: American Heart Association, news release, May 28, 2008
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2008.06.02 — New Hope for Tough-to-Treat Cancers
June 02, 2008
New Hope for Tough-to-Treat Cancers
SATURDAY, May 31 (HealthDay News) — Patients diagnosed with pancreatic cancer — which historically carries a grim prognosis — nearly doubled their overall survival when the cancer drug Gemzar was used after surgery, new research shows.
Unfortunately, only about 15 percent of pancreatic cancer patients are even candidates for surgery.
“Pancreatic cancer is probably the deadliest cancer that we face,” said Dr. Richard Schilsky, president-elect of the American Society of Clinical Oncology (ASCO) and a professor of medicine at the University of Chicago. “It’s frequently not even diagnosed until it’s very far advanced, when treatments are not very effective.”
Schilsky spoke at a teleconference earlier this month; the results of the new trial, a follow-up from data first presented in 2005, were released Saturday at ASCO’s annual meeting in Chicago.
Gemzar (gemcitabine) is the standard treatment for pancreatic cancer that can’t be removed surgically.
At three years, 23.5 percent of participants taking Gemzar had survived without a recurrence, versus 7.5 percent in the placebo group; that number dropped to 16.5 percent at five years, versus 5.5 percent in the control arm.
Overall, 36.5 percent of Gemzar patients were still alive at the five-year mark (vs. 19.5 percent in the placebo group) and 21 percent were still alive after five years (vs. 9 percent in placebo).
“Treatment with gemcitabine as compared to observational in patients with resected [surgically removed] pancreatic cancer resulted in improvements in disease-free survival and overall survival,” said study co-author Dr. Helmut Oettle, of Charite University Medical School in Berlin. “Adjuvant treatment [with Gemzar] doubled long-term survival rate after five years compared with the observation group. Gemcitabine should be the standard of care for adjuvant treatment of pancreatic patients.”
“This represents a very substantial improvement in outcome for these individuals, and I think we can look forward to seeing widespread adoption of gemcitabine for patients with pancreatic cancer that can be surgically removed,” Schilsky said.
Researchers at the ASCO meeting also reported progress with another tough-to-treat cancer, advanced kidney cancer.
While there have been significant advances in recent years with drugs such as Sutent (sunitinib), that success has brought a new challenge: How to treat patients who don’t respond to the latest generation of new therapies.
Enter everolimus, a drug which interferes with blood supply to the tumor and which is one of the first in a relatively new class of compounds. Patients randomized to receive everolimus plus best existing therapy had a 70 percent reduction in the risk of recurrence or death, compared to patients who received best existing therapy alone. For patients on everolimus, it took about four months for the cancer to return, versus about two months in the placebo group.
“While that may not sound like an enormous leap forward, it’s actually a very important observation for several reasons,” Schilsky explained. “This drug is targeting a different molecular pathway compared to anti-angiogenesis drugs [those that block blood supply to the tumor], so it’s working in a completely different way. Secondly, when we make these observations, not only do patients benefit from a delay in progression of their cancer, but this kind of observation always gives us a new lead and an interest in moving these drugs up earlier into cancer treatment.”
“A setting of unmet clinical need that has now been filled,” added study author Dr. Robert Motzer, an attending physician at Memorial Sloan-Kettering Cancer Center in New York City. “Everolimus should be the standard of care in this setting, pending approval by regulatory authorities.”
More information
The National Cancer Institute has more on pancreatic cancer.
SOURCES: May 31, 2008, news conference with Helmut Oettle, M.D., Ph.D., Charite School of Medicine, Berlin, and Robert Motzer, M.D., attending physician, Memorial Sloan-Kettering Cancer Center, New York City; May 15, 2008, teleconference with Richard Schilsky, M.D., president-elect, American Society of Clinical Oncology, and professor, medicine, University of Chicago; May 31, 2008, presentations, American Society of Clinical Oncology annual meeting, Chicago
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2008.06.02 — Marijuana May Shrink Parts of the Brain
June 02, 2008
Marijuana May Shrink Parts of the Brain
MONDAY, June 2 (HealthDay News) — People who use marijuana for a long time can develop abnormalities in their brains, Australian researchers report.
Although growing literature suggests that long-term marijuana use is associated with a wide range of adverse health consequences, many people believe it is relatively harmless and should be legalized, the researchers noted.
“However, this study shows long-term, heavy cannabis use causes significant brain injury, memory loss, difficulties learning new information, and psychotic symptoms, such as delusions of persecution [paranoia], delusions of mind-reading, and bizarre social behaviors in even non-vulnerable users,” said lead researcher Murat Yucel, from the ORYGEN Research Centre and the Neuropsychiatry Centre at the University of Melbourne.
This new evidence plays an important role in further understanding the effects of marijuana and its impact on brain functioning, Yucel said. “The study is the first to show that long-term cannabis use can adversely affect all users, not just those in the high-risk categories such as the young, or those susceptible to mental illness, as previously thought,” he said.
The report was published in the June issue of the Archives of General Psychiatry.
In the study, Yucel’s team did high-resolution MRIs on 15 men who smoked more than five joints a day for more than 10 years. They compared those with scans of 16 men who did not use marijuana.
In addition, all the men took verbal memory tests and were examined for symptoms of psychiatric disorders.
“The more marijuana used, the more these individuals were likely to show reduced brain volumes in the hippocampus and amygdala, as well as being more likely to develop symptoms of psychotic disorders and to have significant memory impairment,” Yucel said.
In fact, the hippocampus of marijuana users was 12 percent smaller, and the amygdala was 7.1 percent smaller than among nonusers. In addition, men who used marijuana also had symptoms of psychiatric disorders, Yucel’s group found.
The hippocampus is associated with the regulation of emotion and memory, while the amygdala controls fear and aggression.
“There is ongoing controversy concerning the long-term effects of cannabis on the brain,” Yucel said. “These findings challenge the widespread perception of cannabis as having limited or no harmful effects on brain and behavior. Although modest use may not lead to significant neurotoxic effects, these results suggest that heavy daily use might indeed be toxic to human brain tissue.”
One expert agrees that heavy marijuana use can have negative effects on the brain.
“These findings are not surprising,” said Dr. Adam Bisaga, an assistant professor of psychiatry at Columbia University and an addiction psychiatrist at New York State Psychiatric Institute. “Chronic use of large amounts of any substance that is affecting neural transmission will most likely invoke adaptive changes and lead to the reorganization of neural networks, and possibly affect brain structures.”
Heavy users of marijuana probably represent only a very small proportion of users, Bisaga said.
“It is not clear if any clinically significant changes can be seen in recreational, infrequent marijuana users, who were not studied here. These findings suggest that public health education, as well as screening, early recognition, and treatment of cannabis dependence, may prevent the progression of the disease and the loss of brain function and related psychiatric complications,” Bisaga said.
More information
For more on drug addiction, visit the National Institute on Drug Abuse.
SOURCES: Murat Yucel, Ph.D., ORYGEN Research Centre, Melbourne Neuropsychiatry Centre, University of Melbourne, Australia; Adam Bisaga, M.D., assistant professor, psychiatry, Columbia University, and addiction psychiatrist, New York State Psychiatric Institute, New York City; June 2008, Archives of General Psychiatry
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