Insurers recoup obesity surgery cost in 2-4 years
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Insurers recoup the costs of weight-loss surgery within two to four years as obese patients become healthier and have fewer medical problems, researchers said on Wednesday.
The findings show that bariatric surgery, an increasingly popular operation, benefits patients’ health and saves money, according to Pierre-Yves Cremieux of the economic consulting firm Analysis Group and the University of Quebec at Montreal, who led the study.
Bariatric surgery alters the digestive system’s anatomy, reducing the volume of food that can be eaten and digested. The most common form is gastric bypass, which makes the stomach smaller and permits food to bypass part of the small intestine.
Early diabetes treatment key for long term health
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People with diabetes given intensive drug treatment soon after diagnosis are healthier when they grow older, even if they become less rigorous about controlling their blood sugar later on, British researchers said on Wednesday.
This means it may be important to prescribe diabetes drugs early, even for people just diagnosed with type 2 diabetes, instead of trying to get them to diet and exercise first, the researchers reported in the New England Journal of Medicine.
“We now know not only that good glucose control from the time type 2 diabetes is diagnosed reduces the rate of diabetic complications but also that this early intervention leads to sustained benefits in the longer term,” Rury Holman of Oxford University, who led the study, said in a statement.
Hepatitis C patients may have abnormal blood sugar
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Nearly two thirds of patients with chronic hepatitis C infection may have abnormal blood sugar levels, according to a report in the American Journal of Gastroenterology.
Blood sugar, or “glucose,” abnormalities “are common and easily underestimated among patients with chronic hepatitis C infection,” Dr. Ming-Lung Yu from Kaohsiung Medical University, Taiwan told Reuters Health. Careful evaluation for undetected glucose abnormalities is “essential” in caring for chronic hepatitis C patients.
Yu and colleagues compared the prevalence and characteristics of glucose abnormalities among 522 chronic hepatitis C patients and a comparison group of 447 without hepatitis C infection (“controls”), based on the results of an oral glucose tolerance test.
Genetic region linked to a 5 times higher lung cancer risk
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A narrow region on chromosome 15 contains genetic variations strongly associated with familial lung cancer, says a study conducted by scientists at Washington University School of Medicine in St. Louis and other institutions in the United States and the United Kingdom.
The researchers found a more than five times higher risk of lung cancer for people who have both a family history of the disease and these genetic variations. The risk was not affected by whether the study participants smoked or didn’t smoke.
Published in the Sept. 13 issue of the Journal of the National Cancer Institute, this study is the fourth since April 2008 to implicate this genetic region in the development of lung cancer, and it strengthens the possibility that testing for variations in this region could become a valuable way to warn individuals of their higher risk.
Treatment for Parkinson’s examined
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The PhD defended by Juan Carlos Gómez-Esteban at the University of the Basque Country analysed the results of the clinical research undertaken at the Movement Disorders Unit at Cruces Hospital since 1998. It involved a study of the most efficacious surgical operations undertaken and pharmaceutical drugs used to treat these disorders as well genetic studies carried out to date.
The field of movement disorders is one of the most complex branches of neurology. The volume of knowledge acquired is so large that it has needed a number of neurologists to sub-specialise in the matter and multidisciplinary units have been created to tackle problems such as the diagnosis of Parkinson’s Disease and of atypical Parkinsonisms, the choice of the most suitable surgical therapies and pharmaceutical drugs or the carrying out of genetic studies. Thus is 1998 the Movement Disorders Unit at Cruces Hospital in Bilbao was created with neurologists, neurosurgeons, neurophysiologists, anaesthetists, neuropsychologists and radiologists. Since its creation, more than 100 surgical operations have been carried out, the majority on patients with Parkinson’s Disease. Currently it is a centre of reference for functional surgery in the Autonomous Community of the Basque Country (CAPV), and even receives patients from other autonomous communities.
Chest Surgeons Propose Measures for Indicating Quality of Lung Surgery
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Even though 30,000 patients in the United States undergo lung surgery each year, no standard criteria exist to measure the quality of their care. In the current issue of The Annals of Thoracic Surgery, Mayo Clinic surgeons have proposed a system of lung surgery quality indicators for surgeons and the public as a method to demonstrate best practices for obtaining positive patient outcomes.
Death rates following surgery are frequently reported. However, because they aren’t adjusted for factors such as patient age and disease severity, they don’t tell the whole story. To overcome this lack of risk adjustment in death rate data, the Mayo Clinic team proposed patient-centered processes that should occur prior to, during and after surgery to assure the likelihood of best surgical outcomes.
“There are certain processes that we can measure and report that clearly indicate whether patients have received high-quality care around the time of their lung operation,” explains Stephen Cassivi, M.D., Mayo Clinic thoracic surgeon and lead study author.
Study examines lung cancer among lifelong nonsmokers
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A new American Cancer Society study sheds light on the ten to fifteen percent of lung cancers that are caused by factors other than tobacco smoking. The study analyzed data on lung cancer occurrence among lifelong nonsmokers in North America, Europe, and Asia and found that lung cancer death rates among never-smokers are highest among men, African Americans, and Asians residing in Asia. The review, the largest to date of lifelong nonsmokers, also suggests that the death rates among never-smokers have remained stable over the past several decades. It appears in the September issue of PLoS Medicine, a peer-reviewed, open-access journal published by the Public Library of Science.
While the great majority of lung cancers are related to smoking, approximately 16,000 to 24,000 lung cancer deaths each year are due to other factors. For comparison, if lung cancers not caused by smoking were considered a separate category, it would rank among the seven to nine most common fatal cancers in the U.S. The researchers say as the number of never-smokers in the U.S. and other developed countries is increasing, this is a subject of particular interest and importance.
To examine the issue, researchers led by Michael J. Thun, M.D. pooled data on lung cancer incidence and death rates among self-reported never-smokers from 13 large cohort studies based in North America, Europe, and Asia that spanned the time period from 1960 to 2004. The pooled data represented hundreds of thousands of individuals (over 630,000 for the incidence data and 1.8 million for the mortality data). The researchers also abstracted data for women from 22 cancer registries in 10 countries in time periods and regions where the smoking prevalence among women was known to be low.
Pain appears common among patients with Parkinson’s disease
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Pain appears to be more common in individuals with Parkinson’s disease than in those without, suggesting that pain is associated with the condition, according to a report in the September issue of Archives of Neurology, one of the JAMA/Archives journals.
“Patients with Parkinson’s disease often complain of painful sensations that may involve body parts affected and unaffected by dystonia,” or involuntary muscle contractions, the authors write as background information in the article. This pain may resemble cramping or arthritis, or have features of pain caused by nerve damage. “The high frequency of these pain disorders in the general population makes it hard to establish whether pain is more frequent among people with Parkinson’s disease than among age-matched controls.”
Giovanni Defazio, M.D., Ph.D., of the University of Bari, Italy, and colleagues compared 402 patients with Parkinson’s disease to 317 healthy individuals who were the same age. Participants provided information about their current age, the age at which they developed Parkinson’s disease, scores on disease rating scales and details regarding any pain that was present at the time of the study and lasted for at least three months.
Active video games burn calories, boost heart rate
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Kids who play the latest physically challenging video games expend energy at levels that might help protect them from becoming overweight and boost their heart health at the same time, according to a new study.
Children burn roughly four times as many calories per minute playing a physically active video game than playing a seated game and their heart rate is also much higher, report Robin R. Mellecker and Alison M. McManus of the Institute for Human Performance at University of Hong Kong in Pokfulam in the latest issue of Archives of Pediatrics and Adolescent Medicine.
These observations are “important because electronic entertainment is not going away,” Dr. Russell R. Pate of the University of South Carolina, Columbia, wrote in a commentary in the journal.
No mental effects seen with Arimidex
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Women taking Arimidex to prevent breast cancer can be fairly reassured that it won’t affect their mental capacities, British researchers report.
Arimidex, a. k. a. anastrazole, belongs to a class of drugs called aromatase inhibitors, which block the production of estrogen. There have been concerns that estrogen depletion might impair cognitive abilities in women, but the results of a new study suggest that anastrazole does not have this effect in women past menopause.
“These findings should be reassuring in the short term for postmenopausal women being treated with anastrozole, their clinicians, and carers,” lead author Dr. Valerie A. Jenkins concludes.
Breast or bottle? New mothers get mixed message
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After giving birth in the United States, a woman is likely to leave the hospital with the message that breast-feeding is best for her baby—and a free sample of baby formula, as well as discount coupons to buy formula for her newborn.
That’s despite the fact that federal health officials at the Centers for Disease Control and Prevention are opposed to giving new mothers free formula samples when they leave the hospital, as are the American Academy of Pediatrics, American College of Obstetricians and Gynecologists and the World Health Organization.
In a report released this week, Anne Merewood of Boston University School of Medicine and colleagues say the prevalence of sample formula pack distribution is “disturbing and incongruous given extensive opposition, but encouraging trends suggest that the practice may be curtailed in the future.”
Increase in Youth Suicide Rate Following Decade-Long Decline May Reflect Emerging Health Crisis
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A sudden and dramatic increase in pediatric suicides may reflect an emerging trend rather than a single-year anomaly. That’s the conclusion of new suicide research, conducted at The Research Institute at Nationwide Children’s Hospital and published in the September 3rd issue of the Journal of the American Medical Association (JAMA), which looked at pediatric suicide trends over a 10-year period.
Following a decade of steady decline, the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent from 2003-2004 – the largest single-year change in the pediatric suicide rate over the past 15 years. Although worrisome, the one-year spike observed in 2003-2004 does not necessarily reflect a changing trend. Therefore, researchers examined national data on youth suicide from 1996-2005 in order to determine whether the increase persisted from 2004-2005, the latest year for which data are available.
Researchers estimated the trend in suicide rates from 1996-2003 using log-linear regression. Using that trend line, they estimated the expected suicide rates in 2004 and 2005 and compared the expected number of deaths to the actual observed number of deaths. Researchers found that although the overall observed rate of suicide among 10 to 19 year olds decreased by about 5 percent between 2004 and 2005 (the year following the spike) both the 2004 and 2005 rates were still significantly greater than the expected rates, based on the 1996-2003 trend.
Monitoring immune responses in disease
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A recent study (doi:10.1016/j.clim.2008.06.009) published in Clinical Immunology, the official journal of the Clinical Immunology Society (CIS), describes a new method enabling the detection of multiple parameters of single human cells. The report demonstrates the characterization of specific blood cells from an individual with type 1 diabetes, providing information about the role these cells might play in the development of the disease and during therapy.
Classification of blood cells, including B and T cells, is important for distinguishing immune responses to pathogens, allergens, or self-antigens in autoimmune diseases. Although various techniques are available to identify cell surface determinants, cytokines and antibodies secreted by blood cells, so far it has not been possible to study multiple secreted proteins while also assigning surface displayed markers to individual living cells.
A collaborative group of investigators from Harvard Medical School and Massachusetts Institute of Technology in the USA, describe how a combination of existing and enhanced immunological methods can identify and characterize rare B cells from blood of a recent onset type 1 diabetic subject.
How gastric bypass rapidly reverses diabetes symptoms
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A report in the September Cell Metabolism, a publication of Cell Press, offers new evidence to explain why those who undergo gastric bypass surgery often show greater control of their diabetes symptoms within days. It also helps to explain why lap-band surgery doesn’t offer the same instant gratification. By studying mice that have undergone both procedures, the researchers show that changes in the intestine are the key.
In addition to removing about two-thirds of the stomach, gastric bypass in effect produces a “double intestine,” said Gilles Mithieux of Institut National de la Sante et de la Recherche Medicale in France. The portion closest to the stomach is taken out of the loop so that it receives no nutrients. The segment normally farther down is then attached directly to the stomach, where it receives all the nutrients coming in.
In both cases, those positional changes ramp up production of blood sugar by the small intestine, Mithieux said. He noted that fasting normally induces blood sugar production by the upper small intestine. By placing the lower small intestine, which doesn’t normally produce much glucose, in close proximity to the stomach, it starts to act more like the upper portion.
Too much calcium in blood may increase risk of fatal prostate cancer
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Men who have too much calcium in their bloodstreams may have an increased risk of fatal prostate cancer, according to a new analysis from Wake Forest University School of Medicine and the University of Wisconsin.
“We show that men in upper range of the normal distribution of serum calcium subsequently have an almost three-fold increased risk for fatal prostate cancer,” said Gary G. Schwartz, Ph.D., associate professor of cancer biology and of epidemiology and prevention at Wake Forest, a part of Wake Forest University Baptist Medical Center. Such excess calcium can be lowered, he said.
The research appears in the September issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
