High vitamin C level linked to decreased stroke risk
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A person’s level of vitamin C may predict his or her likelihood of having a stroke, according to a long-term study of some 20,000 middle-aged and older residents of Norfolk, United Kingdom.
During an average follow-up of 9.5 years, 448 strokes occurred in the study population. Researchers found that people with the highest vitamin C concentration at the start of the study had a 42 percent lower risk of stroke over 10 years compared to those with the lowest levels of vitamin C.
The protective effect of vitamin C against stroke remained after accounting for factors that could affect the risk, such as age, sex, smoking, alcohol intake, body mass index, blood pressure, cholesterol, physical activity, diabetes, prior heart attack, supplement use, and social class.
Handwashing can reduce diarrhea episodes by about one third
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Both in institutions and in communities, interventions that promote hand washing lead to significant reductions in the incidence of diarrhoea.
The WHO* estimates that diarrhoea kills around 2.2 million people annually, mostly young children in middle- or low-income countries. Encouraging children and adults to wash their hands after using the lavatory is one intervention that has potential to reduce the risk.
A team of Cochrane Researchers set out to assess the strength of evidence for the benefits of hand washing. They studied data in 14 randomised controlled trials, eight of which had been conducted in day-care centres and schools mainly in high-income countries; five had been community-based trials in low- and middle-income countries, and one looked at a specific high-risk group of HIV-infected adults living in the USA.
A Good Fight May Keep You and Your Marriage Healthy
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A good fight with your spouse may be good for your health, research suggests.
Couples in which both the husband and wife suppress their anger when one attacks the other die earlier than members of couples where one or both partners express their anger and resolve the conflict, according to preliminary results of a University of Michigan study.
Researchers looked at 192 couples over 17 years and placed the couples into one of four categories: both partners communicate their anger; in the second and third groups one spouse expresses while the other suppresses; and both the husband and wife suppress their anger and brood, said Ernest Harburg, professor emeritus with the U-M School of Public Health and the Psychology Department, and lead author. The study is a longitudinal analysis of couples in Tecumseh, Mich.
Anemia Drugs and Stimulants Ease Exhaustion in Some Cancer Patients
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Drugs that promote red blood cell production and stimulants typically used to treat attention deficit disorder relieve excessive tiredness in cancer patients, according to a new systematic review of studies.
Undergoing cancer treatment can affect physical, mental and emotional well-being, and a variety of contributing factors — such as treatment regimens, psychological distress and the effects of the cancer itself — can cause cancer-related fatigue.
“Fatigue is difficult to treat as it usually has a number of contributory causes — many of which are not fully understood,” said lead investigator Dr. Oliver Minton. Patients and professionals alike may consider tiredness as an unavoidable part of cancer treatment, Minton said, rather than a problem to recognize and address.
Talk Therapy Can Help Kids With Chronic Stomach Pain
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“My tummy hurts” is one of the most common complaints of childhood. Yet for up to 25 percent of school-age children, ongoing abdominal pain is serious enough to interfere with school, playtime and family life. In most of these cases, there are no medical problems— and reassurance and support are all the child needs.
For children whose pain persists, however, a new review of the research suggests that cognitive behavioral therapy (CBT) can help.
“The most important finding here is that there seems to be some evidence of benefit of psychosocial interventions in reducing the pain of school-age children with recurrent abdominal pain,” said Angela Heurtas-Ceballos, consultant neonatologist at Elizabeth Garrett Anderson Hospital in London, and lead review author.
Large Mediastinal Teratoma Originating from the Aortic Adventitia
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Many mediastinal tumors do not cause local symptoms, so they are discovered incidentally upon thoracic imaging. We present the case of a patient who had a large, mature, cystic, mediastinal teratoma. The primary tumor arose from the ascending aortic adventitia and was in a highly unusual location—the medial mediastinum. The teratoma, which was diagnosed in our patient on thoracic computed tomography for follow-up evaluation of empyema, was resected completely. To our knowledge, such a teratoma, arising from the adventitia of the ascending aorta in the medial mediastinum, has not previously been reported in the English medical literature.
We review diagnostic methods and therapeutic approaches to such mediastinal tumors. We conclude that surgical resection is the method of choice for treating these tumors, because it enables radical therapy and tissue diagnosis after extirpation.
Key words: Magnetic resonance imaging, mediastinal cyst, mediastinal neoplasms/diagnosis/surgery, radiography, thoracic, surgical resection, teratoma/diagnosis/surgery, tomography, X-ray computed, tumor markers, biological/blood/diagnostic use
Heart and stroke death rates steadily decline; risks still too high
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In an appropriate prelude to American Heart Month, which is just ahead in February, new mortality data from the Centers for Disease Control and Prevention (CDC) shows that, since 1999, coronary heart disease and stroke age-adjusted death rates are down by 25.8 percent and 24.4 percent, respectively. This means that the American Heart Association’s 2010 strategic goal for reducing deaths from coronary heart disease has been achieved, and for stroke nearly achieved – ahead of time. However, potential problems loom for the future, as all of the major risk factors for these leading causes of death are still too high and several are actually on the rise. If this trend continues, death rates could begin to rise again in years ahead.
In 1999, the American Heart Association set a strategic goal of reducing the death rates from coronary heart disease and stroke, and reducing the risk factors for these diseases by 25 percent by 2010. The new CDC data notes early success in meeting the coronary heart disease death rate goal, and shows that success is near for the 25 percent reduction in stroke. However, American Heart Association president Dan Jones, M.D., said the victory could be short-lived if the risk factors that lead to heart disease and stroke are not also reduced.
“This progress in the reduction of death rates is a landmark achievement, and has come about as a result of tremendous efforts from many partners in research, healthcare, government, business and communities,” Jones said.
New therapeutic target for treatment of multiple sclerosis
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An international research team, led by a scientist from the Centre hospitalier de l’Université de Montréal (CHUM), has identified new therapeutic targets for the treatment of multiple sclerosis (MS). In the February issue of Nature Immunology, the team provides fresh answers concerning the role of novel adhesion molecules in the pathogenesis of MS, a chronic autoimmune disease of the nervous system that affects approximately 55,000 young adults in Canada.
Conducted by Dr. Alexandre Prat, a CHUM neurologist and researcher and a professor at the Université de Montréal’s Faculty of Medicine, the study included collaborators from McGill University (Dr. S. David), the Université de Montréal (Dr. N. Arbour), the National Research Council of Canada (Dr. D. Stanimirovic) and University of Zürich (Dr. B. Becher). The team found that the adhesion molecule dubbed ALCAM (Activated Leukocyte Cell Adhesion Molecule), or CD166, plays a major role in the migration of certain types of leukocytes to the brain.
Findings Suggest Link Between Vitamin E and Subsequent Decline in Physical Function for Older Adults
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Low serum concentration of vitamin E, an indication of poor nutrition, is associated with physical decline for older persons, according to a study in the January 23 issue of JAMA.
“The decline in physical function that occurs with aging often represents the early stage of a continuum leading to disability and other important adverse outcomes such as institutionalization,” the authors write. Understanding the mechanisms associated with this process has been identified as a priority. The potential harmful effect of poor nutrition on physical function in older persons is not well understood.
Benedetta Bartali, R.D., Ph.D., of Yale University School of Medicine, New Haven, Conn., and colleagues conducted a study to determine whether a low concentration of specific micronutrients is associated with subsequent decline in physical function.
Combination Therapy Improves Survival For Certain Prostate Cancer Patients
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Men with localized prostate cancer who were treated with male hormone suppression therapy and radiation treatment had longer survival, but those with moderate to high levels of other illnesses did not experience this effect, according to a study in the January 23 issue of JAMA.
Several studies have documented increased survival when androgen (male sex hormone) suppression therapy (AST) is combined with external beam radiation therapy (RT) compared with RT alone in the treatment of unfavorable localized and locally advanced prostate cancer. However, comorbid (co-existing) illnesses may increase the negative effects of specific anti-cancer treatments such as AST, altering the survival benefit observed when AST is added to RT.
Anthony V. D’Amico, M.D., Ph.D., of Brigham and Women’s Hospital and Dana Farber Cancer Institute, Boston, and colleagues performed an analysis of overall survival of 206 men with localized but unfavorable–risk prostate cancer in subgroups defined by their level of comorbidity at the time of their randomization to AST and RT vs. RT alone. During a median follow-up of 7.6 years, 74 deaths occurred.
Skin care: new research into scar-free healing
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New research from the University of Bristol shows that by suppressing one of the genes that normally switches on in wound cells, wounds can heal faster and reduce scarring. This has major implications not just for wound victims but also for people who suffer organ tissue damage through illness or abdominal surgery.
When skin is damaged a blood clot forms and cells underneath the wound start to repair the damage, leading to scarring. Scarring is a natural part of tissue repair and is most obvious where skin has healed after a cut or burn. It ranges from trivial (a grazed knee) to chronic (diabetic leg ulcers) and is not limited to the skin. All tissues scar as they repair; for example, alcohol-induced liver damage leads to fibrosis and liver failure, and after most abdominal surgeries scars can often lead to major complications.
New Implantable Lenses Can Reduce the Need for Glasses After Cataract Surgery
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Cataract surgery involves removing a clouded natural lens from inside the eye and replacing it with a plastic one. While the operation itself hasn’t changed much over recent years, the plastic lenses have. The biggest advantage of the newer lenses is their ability to reduce the need for glasses after surgery, says a newly updated report from Harvard Medical School.
The Aging Eye: Preventing and Treating Eye Disease explains that the older types of plastic lenses help people see well at one distance—be it close up, far away, or at a medium distance. Two newer types of lenses, accommodating and multifocal, let the eye focus at varying distances, so fewer patients need glasses for reading or distance vision.
The accommodating intraocular lens has hinges on its sides that permit it to move as the eye’s ciliary muscle contracts or relaxes. This improves the ability to change focus from near to far. The multifocal intraocular lens uses a new type of refractive technology to provide focus for multiple distances.
Prostatitis May Effect Up To One-half of All Males During Their Lifetimes
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Estimates on the number of males in the United States who will experience prostatitis during their lifetimes range up to 50 percent. Many urologic disease experts feel that from 5 to 10 percent of males are experiencing prostatitis at a particular time, making it one of the most common urologic diseases in the U.S.
Prostatitis is an infection or inflammation of the prostate gland that causes intense pain, urinary complications, sexual dysfunction, infertility, and a significant reduction in the quality of life Prior to the mid-1990s, very little research had occurred that could lead to improved diagnostic techniques and a cure.
Prostatitis is difficult to diagnose and treat, and has a wide range of debilitating and troublesome side affects. Unlike prostate cancer and benign prostatic hyperplasia (BPH), prostatitis often affects the lives of young and middle-aged men.
Pancreatic cancer
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Pancreatic cancer, primarily ductal adenocarcinoma, accounts for about 30,500 cases and 29,700 deaths in the US annually. Symptoms include weight loss, abdominal pain, and jaundice. Diagnosis is by CT. Treatment is surgical resection and adjuvant chemotherapy and radiation therapy. Prognosis is poor because disease is often advanced at the time of diagnosis.
Most pancreatic cancers are exocrine tumors that develop from ductal and acinar cells. Pancreatic endocrine tumors are discussed below.
Adenocarcinomas of the exocrine pancreas arise from duct cells 9 times more often than from acinar cells; 80% occur in the head of the gland. Adenocarcinomas appear at the mean age of 55 yr and occur 1.5 to 2 times more often in men. Prominent risk factors include smoking, a history of chronic pancreatitis, and possibly long-standing diabetes mellitus (primarily in women). Heredity plays some role. Alcohol and caffeine consumption do not appear to be risk factors.
Pancreatic Endocrine Tumors
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Pancreatic endocrine tumors arise from islet and gastrin-producing cells and often produce many hormones. They have two general presentations. Nonfunctioning tumors may cause obstructive symptoms of the biliary tract or duodenum, bleeding into the GI tract, or abdominal masses. Functioning tumors hypersecrete a particular hormone, causing various syndromes. These clinical syndromes can also occur in multiple endocrine neoplasia, in which tumors or hyperplasia affects two or more endocrine glands, usually the parathyroid, pituitary, thyroid, or adrenals.
Treatment for functioning and nonfunctioning tumors is surgical resection. If metastases preclude curative surgery, various antihormone treatments may be tried for functioning tumors. Because of tumor rarity, chemotherapy trials have not identified definitive treatment. However, streptozotocin has selective activity against pancreatic islet cells and is commonly used, either alone or in combination with 5-fluorouracil or doxorubicin. Some centers use chlorozotocin and interferon.
