Radiation costs vary widely by delivery, U-M study finds
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When cancer spreads to the bone, radiation treatments can help relieve the pain caused by the tumor. But how best to deliver the radiation may vary widely from one oncologist to the next.
A new analysis from researchers at the University of Michigan Comprehensive Cancer Center shows cost also varies widely from one delivery method to the next. Costs can range from around $1,700 for a single treatment with conventional radiation techniques to more than $16,000 for four treatments using a system of radiation delivery called Cyberknife.
“Some of the technologies that have been shown to be safe and effective, but have not been shown to be superior, can cost up to 10 times what a single dose of conventionally delivered radiation costs,” says David D. Howell, M.D., assistant professor of radiation oncology at the U-M Medical School and medical director of radiation oncology at the Norval K. Morey Cancer Center in Mt. Pleasant, Mich., part of the U-M Radiation Oncology Network.
PMH clinicians map group at high risk for aggressive, ‘hidden’ prostate cancer
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Clinical researchers at Princess Margaret Hospital (PMH) can now answer the question that baffles many clinicians – why do some men with elevated prostate specific antigen (PSA) levels who are carefully monitored and undergo repeated negative biopsies still develop aggressive prostate cancer?
The answer is hidden tumours located on the top of the prostate that evade traditional diagnostic procedures, including ultrasound-guided needle biopsy. The PMH research, published online today in the British Journal of Urology International (BJU 8938), demonstrates that magnetic resonance imaging (MRI) is the best tool to reveal such tumours.
“Our findings identify a specific high-risk group whose tumours are difficult to diagnose because of location. These men benefit from MRI, which guides the biopsy procedure with a high degree of accuracy,” says author Dr. Nathan Lawrentschuk, Urologic Oncology Fellow, PMH Cancer Program, University Health Network. “The research team calls the clinical presentation of elevated PSA and repeated negative biopsy results in ‘prostate evasive anterior tumour syndrome’ (PEATS).”
Too much of a good thing? Scientists explain cellular effects of vitamin A overdose and deficiency
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If a little vitamin A is good, more must be better, right? Wrong! New research published online in the FASEB Journal (http://www.fasebj.org) shows that vitamin A plays a crucial role in energy production within cells, explaining why too much or too little has a complex negative effect on our bodies. This is particularly important as combinations of foods, drinks, creams, and nutritional supplements containing added vitamin A make an overdose more possible than ever before.
“Our work illuminates the value and potential harm of vitamin A use in cosmetic creams and nutritional supplements,” said Ulrich Hammerling, co-author of the study, from the Sloan-Kettering Institute for Cancer Research in New York. “Although vitamin A deficiency is not very common in our society, over-use of this vitamin could cause significant disregulation of energy production impacting cell growth and cell death.”
Although the importance of vitamin A to human nutrition and fetal development is well-known, it has been unclear why vitamin A deficiencies and overdoses cause such widespread and profound harm to our organs, until now. The discovery by Hammerling and colleagues explains why these effects occur, while also providing insight into vitamin A’s anti-cancer effects. The scientists used cultures from both human and mice cells containing specific genetic modifications of the chemical pathways involved in mitochondrial energy production. The cells were then grown with and without vitamin A, and scientists examined the impact on the various steps of energy production. Results showed that retinol, the key component of vitamin A, is essential for the metabolic fitness of mitochondria and acts as a nutritional sensor for the creation of energy in cells. When there is too much or too little vitamin A, mitochondria do not function properly, wreaking havoc on our organs.
Geisinger Physician to Chair Pediatric Obesity Symposium
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William Cochran, M.D., vice chairman of Geisinger Health System’s Janet Weis Children’s Hospital, will chair and speak at a symposium on pediatric obesity and prevention on Oct. 17 in Washington, D.C., during the annual meeting of the American Academy of Pediatrics.
“I am tremendously excited to represent Geisinger at this event,” Dr. Cochran said. “Childhood obesity is becoming an increasingly important topic to discuss, and this symposium will be a great opportunity for professionals to share findings and ideas on the issue.”
Ethnic Background May Be Associated with Diabetes Risk
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Fat and muscle mass, as potentially determined by a person’s ethnic background, may contribute to diabetes risk, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Obesity, a worldwide health concern, is associated with increased insulin resistance, type 2 diabetes and cardiovascular disease. The prevalence of obesity is increasing in all populations across the globe, yet past research has found that body fat distribution varies widely among different ethnic groups. Researchers in this study investigated which ethnic groups were most likely to be at increased risk for diabetes due to higher total body fat and lower muscle mass.
“We know certain ethnic backgrounds show significant differences in amounts of body fat and lean mass,” said Scott Lear, PhD, of Simon Fraser University in Vancouver, Canada and lead author of the study.
Future Diabetes Treatment May Use Resveratrol to Target the Brain
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Resveratrol, a molecule found in red grapes, has been shown to improve diabetes when delivered orally to rodents. Until now, however, little has been known about how these beneficial changes are mediated in the body. A new study accepted for publication in Endocrinology, a journal of The Endocrine Society, shows that the brain plays a key role in mediating resveratrol’s anti-diabetic actions, potentially paving the way for future orally-delivered diabetes medications that target the brain.
Resveratrol activates sirtuins, a class of proteins that are thought to underlie many of the beneficial effects of calorie restriction. Previous studies in mice have provided compelling evidence that when sirtuins are activated by resveratrol, diabetes is improved. Sirtuin activators are now being tested in humans as anti-diabetic compounds.
Sirtuins are expressed virtually everywhere throughout the body and until now, little has been known about what tissues mediate resveratrol’s beneficial effects. Knowing where in the body the beneficial effects of activated sirtuins are mediated could help in the development of more effective targeted diabetes medications.
Air pollution may trigger appendicitis
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A new study http://www.cmaj.ca/press/cmaj082068.pdf in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca suggests that air pollution may trigger appendicitis in adults.
The study, conducted by researchers at the University of Calgary, University of Toronto and Health Canada, looked at 5191 adults admitted to hospital in Calgary, Alberta, Canada. Fifty-two per cent of admissions occurred between April and September, the warmest months of the year in Canada during which people are more likely to be outside.
The dominant theory of the cause of appendicitis has been obstruction of the appendix opening, but this theory does not explain the trends of appendicitis in developed and developing countries. Appendicitis cases increased dramatically in industrialized countries in the 19th and early 20th centuries, then decreased in the middle and late 20th century, coinciding with legislation to improve air quality. The incidence of appendicitis has been growing in developing countries as they become more industrialized.
Heart disease link to prenatal flu exposure
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Children of women infected with influenza during pregnancy have a substantially higher risk of heart disease late in life, according to a study published on Wednesday.
The findings underscore the danger facing pregnant women from the H1N1 swine flu virus, or any other strain of flu, and also demonstrate that what happens in the womb can affect a person decades later.
Caleb Finch of the University of Southern California and colleagues studied records from the 1918 flu pandemic and found that boys whose mothers were infected during the second or third trimester of pregnancy with them had a 23 percent greater chance of having heart disease after age 60 than boys whose mothers were not infected.
Study offers clues on diet benefits without the diet
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Experiments which mimicked a low-calorie diet by tinkering with genes in mice extended their lives and prevented disease, and a drug that has the same effect could give people longer, healthier lives, scientists said on Thursday.
British researchers found that deleting a gene linked to nutrients and growth helped mice to live 20 percent longer on average, and partly explained why eating less appears to improve health and increase longevity.
The findings also offered a possible genetic drug target for protecting against ageing-related diseases, they said.
Childhood Cancer Survivors Exercise Less, Increasing Diabetes Risk
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In a study of adults who survived cancer as children, St. Jude Children’s Research Hospital investigators found that many survivors lead sedentary lifestyles and are more likely to be less physically active than their siblings. Childhood cancer survivors are at greater risk of diabetes, obesity and heart disease than the rest of the population.
Cancer treatments such as cranial radiation can damage the hypothalamus and pituitary; the result is an abnormal metabolism, which increases the risk of obesity and diabetes. Also, chemotherapy with the drug anthracycline increases the risk of heart disease; and radiation to the body can cause blood vessels to become less pliant.
“Physical activity is a key step that survivors can take to reduce the health risk of these effects,” said Kiri Ness, Ph.D., of the Epidemiology and Cancer Control department at St. Jude. “Medical center programs to encourage physical activity in adult survivors could help significantly. However, one problem is that researchers have not firmly established the factors that affect cancer survivors’ participation in physical activity.”
‘Anti-Atkins’ low protein diet extends lifespan in flies
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Flies fed an “anti-Atkins” low protein diet live longer because their mitochondria function better. The research, done at the Buck Institute for Age Research, shows that the molecular mechanisms responsible for the lifespan extension in the flies have important implications for human aging and diseases such as obesity, diabetes and cancer.
The findings, which appear in the October 2 edition of Cell, also provide a new level of understanding of the regulation of mitochondrial genes and open new avenues of inquiry into the interplay between mitochondrial function, diet and energy metabolism.
Mitochondria act as the “powerhouse” of the cells. It is well known that mitochondrial function worsens with age in many species and in humans with Type II diabetes and obesity. “Our study shows that dietary restriction can enhance mitochondrial function hence offsetting the age-related decline in its performance,” said Buck faculty member Pankaj Kapahi, PhD, lead author of the study.
Antidepressant and placebo are equally effective in child pain relief
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When used “off-label,” the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To view this article’s video abstract, go to the AGA’s YouTube Channel at http://www.youtube.com/AmerGastroAssn.
“Many pharmaceutical products are prescribed for off-label use in children due to the lack of clinical trials testing the efficacy of the drugs in children and adolescents. Therefore, the pediatric gastroenterologist frequently has to make treatment decisions without the evidence of how drugs work in children,” said Miguel Saps, MD, of Children’s Memorial Hospital and lead author of the study. “The high placebo effect we identified in this study suggests that further studies of the use of certain antidepressants in children with functional bowel disorders are needed. While several trials have demonstrated a beneficial effect of antidepressants, including amitriptyline, for the treatment of irritable bowel syndrome (IBS) in adults, more research is needed to determine how effective this drug is, if at all, in children.”
Amitriptyline (Elavil®) is used to treat symptoms of depression, however, it is often times prescribed to children for pain relief from pain-predominant functional gastrointestinal disorders (FGIDs). Pain-predominant FGIDs are among the most common causes for medical consultation in children. Such disorders include three common conditions: IBS, functional dyspepsia and functional abdominal pain.
Estrogen link in male aggression sheds new light on sex-specific behaviors
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Territorial behavior in male mice might be linked to more “girl-power” than ever suspected, according to new findings at UCSF. For the first time, researchers have identified networks of nerve cells in the brain that are associated with how male mice defend their territory and have shown that these cells are controlled by the female hormone estrogen.
The research suggests a pivotal role for estrogen – as well as the enzyme aromatase that is responsible for estrogen synthesis – in male territorial behavior, according to findings published in the October 2, 2009 issue of the journal Cell. The paper, based on research at UCSF and Fujita Health University, also appears online at http://www.cell.com.
Estrogen’s role in the mating behaviors of these mice, however, was less clear, which indicates that territorial and sexual behaviors are likely influenced by distinct and separate connections in the brain, according to Nirao Shah, MD, PhD, an assistant professor in the UCSF Department of Anatomy and senior author of the paper.
Treatment of severe burn injuries
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Almost three quarters of patients with extensive burns die of the consequences of a severe infection. In the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106[38]: 607-13), Timo A. Spanholtz of the Cologne-Merheim Burn Center and his coauthors discuss the acute therapy and follow-up care of burn disease.
Optimal treatment of severely burned patients necessitates collaboration between primary care physicians, emergency physicians and specialist departments for plastic surgery. During first aid from the emergency physician, the patient is removed from the danger zone and is administered adequate fluid, and drugs, over several intravenous accesses. Additional first aid measures include cooling and sterile covering of the burned skin.
The Central Office for Burn Injuries in Hamburg then organizes the necessary transfer to a specialist department.
Obesity in middle age bodes ill for old age
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Women who are obese in middle age may live to be at least 70 but they are nowhere near as healthy as women who kept in good shape, U.S. researchers reported on Tuesday.
An ongoing giant study of American nurses showed that only about 10 percent who made it to age 70 could be considered in top shape. Women who steadily gained weight from age 18 on ended up in the worst shape, the researchers said.
Most had some kind of physical or mental limitation, and more than a third had both chronic diseases and also mental or physical limitations.
