‘Fantastic 4’ of breast procedures leave women extremely satisfied
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Injecting fat after breast reconstruction to correct implant wrinkling or dimpling may be safe and effective to improve breast shape, according to a study to be presented at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2008 conference, Oct. 31 – Nov. 5, in Chicago. Using fat injections for cosmetic breast enhancement; however, is still controversial and will be the subject of a panel discussion.
“My reconstruction patients could not be happier with the improvement fat transfer gives to the appearance of their breasts,” said Gregory Scott, MD, ASPS Member Surgeon and study co-author. “The initial implant reconstruction sometimes leaves them with contour deformities or wrinkling, but fat injections can correct these problems and give their breasts a smoother, softer, more natural appearance.”
The study looked at 21 patients who had 42 fat transfers for contour deformities or wrinkling. The injections were performed an average of 9.9 months following reconstruction. The fat was taken from the patients’ abdomen or upper thighs. The study found that fat injection to the breast for reconstruction is safe, improves breast shape, and corrects implant wrinkling.
Dementia Won’t Improve With Procaine, and Health Might Suffer
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Procaine, a medication that functions as a topical anesthetic normally, has been touted as an anti-aging drug that might prevent or even reverse dementia. However, a new Cochrane Review suggests that the risks of bad side effects outweigh any benefit.
“There is a lot of information, especially on the Internet, about the effect of procaine, promoting this drug for age-related problems, including dementia,” said lead author Szabolcs Szatmàri at the University of Medicine and Pharmacy in Romania. “At the same time, there were no available updated medical guidelines or evidence-based data for doctors and patients about procaine.”
The review included three studies involving 427 patients. Data from these studies showed high incidence of side effects such as restlessness, dizziness, migraine headaches and systemic lupus erythematosus, a disease in which a person’s immune system attacks itself.
Occasional Memory Loss Tied to Lower Brain Volume
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People who occasionally forget an appointment or a friend’s name may have a loss of brain volume, even though they don’t have memory deficits on regular tests of memory or dementia, according to a study published in the October 7, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.
The study involved 500 people age 50 to 85 with no dementia who lived in the Netherlands. Participants were asked about occasional memory problems such as having trouble thinking of the right word or forgetting things that happened in the last day or two, or thinking problems such as having trouble concentrating or thinking more slowly than they used to.
Participant’s brains were scanned to measure the size of the hippocampus, an area of the brain important for memory and one of the first areas damaged by Alzheimer’s disease.
Withdrawal of Life Support Often an Imperfect Compromise
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Intensive Care Unit (ICU) doctors seeking to balance the complex needs of their patients and the patients’ families may make an imperfect compromise, withdrawing life support systems over a prolonged period of time. This practice is much more common than previously believed, and is also surprisingly associated with higher satisfaction with care-at least among surviving family members.
“We found that sequential withdrawal of life support is not as rare a phenomenon as previously believed,” wrote J. Randall Curtis, M.D., M.P.H., section chief for pulmonary and critical care medicine at the Harborview Medical Center and the University of Washington, in Seattle. “It occurred in nearly half of the patients we studied.”
The findings will be published in the second issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. The study was funded by the National Institute of Nursing Research.
Using a Fan During Sleep May Reduce Infants’ SIDS Risk
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Infants who slept in a bedroom with a fan ventilating the air had a 72 percent lower risk of Sudden Infant Death Syndrome compared to infants who slept in a bedroom without a fan, according to a new study by the Kaiser Permanente Division of Research. The study appears in the October issue of the Archives of Pediatric & Adolescent Medicine.
This is the first study to examine an association between better air ventilation in infants’ bedrooms and reduced SIDS risk.
The finding is consistent with previous research that showed factors influencing a baby’s sleep environment may change SIDS risk. Among those factors are sleeping on the stomach and soft bedding, both of which may limit air ventilation around an infant’s breathing pathway and thus increase the chance of re-breathing exhaled carbon dioxide, said the researchers.
Major study of opiate use in children’s hospitals provides simple steps to alleviate harm
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Hospitalized kids with painful ailments from broken bones to cancer are often dosed with strong, painkilling drugs known as opiates. The medications block pain, but they can have nasty side effects. Constipation, for instance, is one side effect that can cause discomfort and even extend a child’s hospital stay.
“No parent wants their child in the hospital any longer than necessary,” said Paul Sharek, MD, MPH, medical director for quality management and chief clinical patient safety officer at Lucile Packard Children’s Hospital at Stanford. Sharek is the primary author of a new study, detailing the first large multicenter trial in children to show a decrease in harm from pain medications. It shows how simple changes to hospital procedures can sharply reduce the harm children suffer from opiates. The study, a yearlong collaboration between 14 U.S. children’s hospitals, documented a 67 percent drop in harmful events caused by the pain relievers when these procedures were implemented.
“Our collaborative aim was to decrease adverse drug event rates by 50 percent,” Sharek said. “We far exceeded that, which was very exciting.”
Parents foster significant misperceptions of children’s weight
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Results of a survey presented at the American College of Gastroenterology’s 73rd Annual Scientific Meeting in Orlando revealed that many parents do not accurately perceive their children as overweight or at risk for adulthood obesity. Obesity in the United States is often accompanied by an increased risk of gastrointestinal diseases and has emerged as a major health concern, particularly the issue of obesity among children and adolescents.
Researcher Rona L. Levy, Ph.D. and her colleagues at the University of Washington in Seattle and the University of Minnesota measured parental perceptions of their children’s current weight and perceived risk for developing obesity as an adult.
Forty-six parents of children ages 5 to 9 with a body mass index (BMI) in the 70th percentile or higher were recruited for the study. Child height and weight were measured during a routine pediatric clinic visit. Parents were mailed a series of questionnaires, which included questions on their perception of their child’s current weight, and whether they perceived that their child was at risk for developing obesity as an adult.
Neurotransmitter defect may trigger autoimmune disease
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A potentially blinding neurological disorder, often confused with multiple sclerosis (MS), has now become a little less mysterious. A new study by researchers at the Mayo Clinic in Rochester, Minnesota, may have uncovered the cause of Devic’s disease. Their new study, which will appear online on October 6th in the Journal of Experimental Medicine, could result in new treatment options for this devastating disease.
Devic’s disease, also known as neuromyelitis optica (NMO), results in MS-like demyelinating lesions along the optic nerves and spine. Affected individuals often experience rapid visual loss, paralysis, and loss of leg, bladder, and bowel sensation. Some lose their sight permanently. Unlike MS, Devic’s disease can be diagnosed by the presence of a specific self-attacking immune protein—an autoantibody referred to as NMO-IgG—in the blood. Until now, however, clinicians didn’t know how that protein damaged nerves and contributed to disease symptoms.
Air pollution may increase risk of appendicitis
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Could there be a link between high levels of air pollution and the risk of appendicitis? New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando, suggests a novel connection.
“Adult onset appendicitis is a common condition whose cause is unclear and almost universally requires surgery,” explained Dr. Gilaad G. Kaplan of the University of Calgary.
Dr. Kaplan and his colleagues identified more than 5,000 adults who were hospitalized for appendicitis in Calgary between 1999 and 2006. The team used data from Environment Canada’s National Air Pollution Surveillance (NAPS) monitors that collect hourly levels of ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, and particulate matter of varying sizes. Regression analysis was used to evaluate whether short-term daily changes in air pollution levels were related to the development of appendicitis.
Vitamin D deficiency common in patients with IBD, chronic liver disease
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New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Two separate studies highlight the importance of regular Vitamin D checkups in the evaluation of patients with certain digestive diseases.
For IBD Patients, Vitamin D Deficiency Associated with Lower Quality of Life and Higher Disease Activity
Researchers at the Medical College of Wisconsin investigated whether Vitamin D deficiency in patients with IBD is associated with a lower quality of life or higher disease activity independent of other known risk factors and medication use.
Study Finds No Correlation Between Newborn Thryoid Function within Normal Range, Cognitive Developme
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There is no correlation between newborn thyroid function within the normal range and cognitive development, nor is there a correlative between maternal thyroid function and newborn thyroid function in a Boston-area sample, according to data to be presented on Oct. 4, 2008 at the 79th Annual Meeting of the American Thyroid Association (ATA) in Chicago, IL. Normal thyroid function is essential for healthy brain development. Previous studies have suggested that even mild maternal hypothyroidism during pregnancy may adversely affect child cognitive development.
On behalf of Project Viva, a team of researchers led by Dr. Emily Oken of Harvard Medical School and Harvard Pilgrim Health Care and Dr. Elizabeth Pearce of Boston University Medical Center in Boston, Mass., studied 500 children born 1999-2003 to evaluate the relationship between thyroxine levels in newborns, first trimester maternal thyroid function, and childhood cognition. Researchers first tested mothers’ thyroid stimulating hormone, thyroxine, and thyroid peroxidase (TPO) antibody levels at an average of 10.2 weeks gestation and later measured newborns’ thyroxine levels from whole blood samples after birth.
Researchers then performed cognitive testing when the infants were six months old using the visual recognition memory (VRM) test, a measure of infant cognition that can predict later childhood IQ and specific abilities in perceptual speed, language, and memory. When the children were three years old, researchers tested them with the Peabody Picture Vocabulary Test (PPVT), a measure of verbal ability or scholastic aptitude, and the Wide Range Assessment of Visual Motor Ability (WRAVMA), which evaluates visual-spatial analysis, visual-motor ability, and fine motor skills.
What HIV Needs: Identification of Human Factors May Yield Novel Therapeutic Targets for HIV
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The Salk Institute for Biological Studies and Burnham Institute for Medical Research today announced 295 host cell factors that are involved in human immunodeficiency virus (HIV) infection. The study, published in the Oct. 3 issue of Cell, could lead to the development of a new class of HIV therapeutics aimed at disrupting the human-HIV interactions that lead to viral infection.
The research, a collaborative effort between the laboratories of Sumit K. Chanda, Ph.D, previously at the Genomics Institute of the Novartis Research Foundation (GNF) and now at Burnham and John Young, Ph.D. at Salk, combined several layers of genome-wide analysis to identify cellular proteins that aid the virus in establishing an infection.
“HIV has just nine genes, coding for 15 proteins, compared to bacteria, which harbor several thousand genes, or humans, with over 20,000 genes,” said Chanda, associate professor in the Infectious & Inflammatory Disease Center at Burnham and an adjunct faculty member at Salk. “We have known for a long time that HIV hijacks our cellular proteins to complete its life cycle. This study now lays out its flight plan.”
Steroids Not as Effective in Obese Asthma Patients
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Glucocorticoids, the primary controller medication for asthma, are 40 percent less effective in overweight and obese asthma patients than in those of normal weight, according to researchers at National Jewish Health, in Denver. The study also identified a potential mechanism involved in the resistance, which suggests therapeutic targets for future medications.
The study, by Associate Professor of Medicine E. Rand Sutherland, M.D., M.P.H., and his colleagues at National Jewish Health, appears in the first issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
“This study identifies what could be a significant issue for the 20 million Americans with asthma; specifically, the main controller medication might be less effective if you are overweight or obese,” said Dr. Sutherland. “These findings should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics and consider optimizing therapeutic regimens as indicated. We also hope they will spur additional research into the treatment of obese patients with asthma.”
Genes affect weight loss drug effectiveness
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A study conducted by researchers at Mayo Clinic shows that obese patients with specific genetic makeup had enhanced response to the weight loss drug sibutramine, while others who lack these genetic factors lost little or no weight.
The findings are published in the October issue of Gastroenterology (http://www.gastrojournal.org).
In this randomized, double-blind, placebo-controlled study, Mayo researchers measured the impact of two different dosage levels of sibutramine (10 or 15 mg daily) combined with behavioral therapy for 12 weeks in 181 overweight or obese participants. Participants received structured behavioral therapy for weight management at four, eight and 12 weeks.
During exercise, the human brain shifts into high gear on ‘alternative energy’
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Alternative energy is all the rage in major media headlines, but for the human brain, this is old news. According to a study by researchers from Denmark and The Netherlands published in the October 2008 print issue of The FASEB Journal, the brain, just like muscles, works harder during strenuous exercise and is fueled by lactate, rather than glucose. Not only does this finding help explain why the brain is able to work properly when the body’s demands for fuel and oxygen are highest, but it goes a step further to show that the brain actually shifts into a higher gear in terms of activity. This opens doors to entirely new areas of brain research related to understanding lactate’s specific neurological effects.
“Now that we know the brain can run on lactate, so to speak, future studies should show us when to use lactate as part of a treatment,” said Gerald Weissmann, MD, Editor-in-Chief of The FASEB Journal. “From an evolutionary perspective, the result of this study is a no-brainer. Imagine what could have or did happen to all of the organisms that lost their wits along with their glucose when running from predators. They were obviously a light snack for the animals able to use lactate.”
To reach their conclusion, the researchers looked at research that compared the blood running to and from the heads of volunteers undergoing strenuous exercise. They found that the blood on its way to the brain contained considerably more lactate than blood flowing from the brain.
