Long-term knee function good after ligament repair
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People who have surgery to repair a common knee ligament injury show improvement in knee function as long as 15 years after undergoing the operation, new research shows.
Injuries to the anterior cruciate ligament (ACL), which links the thigh bone to the shin bone, are common among young people, and typically treated by repairing the ligament. But recent studies have suggested that for some people, intensive physical therapy to strengthen and stabilize the joint may be enough.
In the current study, Dr. Britt Elin Olestad of Oslo University Hospital Ulleval, Norway, and her colleagues investigated long-term knee function and osteoarthritis in 221 patients between 15 and 50 years old who were treated with ACL repair between 1990 and 1997—evaluating patients six months, one year, two years, and 10 to 15 years after the surgery.
Robot doesn’t make cancer surgery cheaper: study
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Minimally invasive surgery for endometrial cancer is cheaper on a society-wide and hospital level than surgery done with a robotic system or a more invasive hysterectomy, according to a new study.
But the robot still has other benefits that aren’t reflected in the dollars-and-cents calculation, the authors say, such as greater ease and comfort for the surgeon.
More than 43,000 women in the U.S. will be diagnosed with endometrial cancer - cancer that forms in the lining of the uterus - in 2010, according to the National Cancer Institute. About $1.8 billion is spent on treating endometrial cancer each year in the U.S., but it’s unclear how that number will change if more of the surgeries are done robotically.
Children Who Eat Vended Foods Face Health Problems, Poor Diet
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School children who consume foods purchased in vending machines are more likely to develop poor diet quality – and that may be associated with being overweight, obese or at risk for chronic health problems such as diabetes and coronary artery disease, according to research from the University of Michigan Medical School.
The study also looked at foods sold in school stores, snack bars and other related sales that compete with USDA lunch program offerings and found that these pose the same health and diet risks in school-aged children.
“The foods that children are exposed to early on in life influence the pattern for their eating habits as adults,” says lead study author Madhuri Kakarala, M.D., Ph.D., clinical lecturer of internal medicine at the U-M Medical School.
Personalized medicine: Molecular imaging predicts treatment success in many cancers
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A series of studies published in the September Journal of Nuclear Medicine (JNM) show that molecular imaging plays a critical role in the evaluation and treatment planning for a broad spectrum of cancers, including thyroid cancer and lymphoma.
According to researchers, molecular imaging allows physicians to identify the severity and extent of disease and, in turn, provide patients with personalized care. In addition, molecular imaging allows doctors to see how effective a treatment is early in the process so that changes can be made to ensure the best treatment for each individual patient.
“For patients with thyroid cancer, ‘one size fits all’ no longer applies,” said Ravinder Grewal, M.D., corresponding author of “The Effect of Posttherapy 131I- SPECT/CT on Risk Classification and Management of Patients with Differentiated Thyroid Cancer” and an assistant attending physician in nuclear medicine at Memorial Sloan-Kettering Cancer Center in New York. “Through molecular imaging, the paradigm is changing toward more tailored and customized management of treatment. As a result, we can see how far a disease has spread and spare the patient from additional examination, time and radiation exposure.”
Genetic signature may lead to better TB diagnosis
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Scientists have found a “genetic signature” in the blood of patients with active tuberculosis (TB) and believe their discovery could help develop better diagnostic tests for the disease, as well as better treatments.
More than 2 billion people, or a third of the world’s population, are estimated to be infected with the organism Mycobacterium tuberculosis (MTB), which causes TB, but the vast majority have the infection in latent form and have no symptoms.
The British scientists said they had now found a pattern of genes in the blood that is specific to up to 10 percent of those 2 billion people who develop active TB in their lungs.
Patients with diabetes may need fewer medications after bariatric surgery
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Bariatric surgery appears to be associated with reduced use of medications and lower health care costs among patients with type 2 diabetes, according to a report in the August issue of Archives of Surgery, one of the JAMA/Archives journals.
“The rapidly growing epidemics of obesity and diabetes threaten to overburden the world’s health care systems,” the authors write as background information in the article. “From an epidemiological standpoint, once these diseases develop they are rarely reversed. Dietary, pharmaceutical and behavior treatments for obesity are associated with high failure rates, and medical management of diabetes is also often unsuccessful. Despite many efforts to improve the control of glucose levels in diabetes, including clinical guidelines and patient and provider education, less than half of all patients with type 2 diabetes mellitus achieve the American Diabetes Association recommendation of a hemoglobin A1C level of less than 7 percent.”
The use of bariatric surgery—that results in long-term weight loss, improved lifestyle and decreased risk of death—has tripled in the past five years, the authors note. Martin A. Makary, M.D., M.P.H., and colleagues at the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University School of Medicine, Baltimore, studied 2,235 U.S. adults (average age 48.4) with type 2 diabetes who underwent bariatric surgery during a four-year period, from 2002 to 2005. They used claims data to measure the use of diabetes medications before and after surgery, along with health care costs per year.
High-risk pools an early test for health overhaul
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When James Howard was diagnosed with brain cancer in March he did not know how he would pay for radiation treatments costing $87,000 and $2,300 a week for chemotherapy.
At the time of his diagnosis, Howard was insured by UnitedHealth Group Inc, a policy for which he paid because his employer, Hennessey Performance near Houston, Texas, did not provide healthcare insurance for its employees.
After his diagnosis, UnitedHealth revoked Howard’s policy on the grounds that his was a pre-existing condition. A Texas high-risk insurance pool would have paid for his treatments, but only after a year.
China says no evidence of contamination in milk
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China’s health ministry said on Sunday that it had found no evidence of contamination in milk powder after an investigation into reports that it had caused baby girls to show signs of premature sexual development.
The ministry tested products made by Chinese baby-formula maker Synutra International as well as 20 other brands across the country to compare the level of estrogen in dairy products.
The probe focused on three cases in Wuhan, a populous city in central China’s Hubei province, as well as six cases in five other provinces.
Tackling cancer among poor doesn’t have to cost dear
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The growing burden of cancer in developing countries could be reduced without expensive drugs and equipment, scientists said Monday, but it requires a global effort similar to the fight against HIV/AIDS.
In a study in The Lancet, scientists from the United States, who have formed a Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries (GTF.CCC), said cancer is now a leading cause of death in poor nations but is often neglected in health authorities’ prevention and treatment plans.
While only about 5 percent of global resources for cancer are spent in developing countries, the burden of the disease is far greater there than in rich nations, with up to 80 percent of cancer deaths each year occurring in poorer nations.
Admitting errors doesn’t increase lawsuits: study
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New research hints that when doctors are open about their mistakes, patients don’t file more lawsuits and the healthcare system doesn’t shell out more money in claims.
While many doctors agree that admitting to medical errors and apologizing to patients is the most ethical way to go, some worry that opening up will make an injured patient more likely to sue.
But researchers who examined the University of Michigan Health System (UMHS) showed that this was not the case, and hope their example encourages more hospitals to go the way of full disclosure.
Acetaminophen use in adolescents linked to doubled risk of asthma
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New evidence linking the use of acetaminophen to development of asthma and eczema suggests that even monthly use of the drug in adolescents may more than double risk of asthma in adolescents compared to those who used none at all; yearly use was associated with a 50 percent increase in the risk of asthma.
The research results will be published online on the American Thoracic Society’s Web site ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine.
“This study has identified that the reported use of acetaminophen in 13- and 14 year old adolescent children was associated with an exposure-dependent increased risk of asthma symptoms,” said study first author Richard Beasley, M.D., professor of medicine, at the Medical Research Institute of New Zealand on behalf of the International Study of Asthma and Allergies in Childhood (ISAAC).
Can cancer patients benefit from new drug trials?
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Patients with advanced head and neck cancer survived just as well on experimental drugs as they did on FDA-approved standard therapies in a new study.
These patients were part of phase I trials, an early step in the approval phase for a new drug and often the first time that drug is tested in humans. There has been controversy over whether advanced cancer patients - many of them desperate for any possible chance to get better - are getting taken advantage of in such trials, or whether they can really benefit from experimental drugs.
But the findings suggest that doctors should consider referring their terminally ill patients to such trials, the authors say.
Spinal fluid can help diagnose Alzheimer’s
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Measuring certain proteins in spinal fluid can accurately diagnose Alzheimer’s and predict which patients with memory problems will develop the fatal brain-wasting disease, Belgian researchers said on Monday.
And they may also help identify early signs of the disease in healthy people, the team reported in the Archives of Neurology.
“The unexpected presence of the Alzheimer’s disease signature in more than one-third of cognitively normal subjects suggests that Alzheimer’s disease pathology is active and detectable earlier than has heretofore been envisioned,” Geert De Meyer of Ghent University in Belgium and colleagues wrote.
Eye disorder common among diabetic adults
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Nearly 30 percent of U.S. diabetics over the age of 40 may have a diabetes-related eye disorder, with 4 percent of this population affected severely enough that their vision is threatened, suggests a new study.
The condition, known as diabetic retinopathy, involves damage to the eye’s retina and is the leading cause of new cases of legal blindness among U.S. adults between 20 and 74 years old. It also costs the U.S. approximately $500 million every year.
“The number of people with diabetes is increasing in this country,” lead researcher Dr. Xinzhi Zhang, of the Centers for Disease Control and Prevention in Atlanta, told Reuters Health.
Study Shows Physicians Reluctant to Use Chemoprevention for Prostate Cancer
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Despite the dramatic results of the Prostate Cancer Prevention Trial (PCPT), which showed a significant reduction in prostate cancer among those taking finasteride, physicians have not increased its use, according to a study published in the September issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
The first results of the PCPT were published in 2003 in The New England Journal of Medicine and were widely reported. The randomized controlled trial consisted of 18,000 men and showed a 25 percent reduced risk of prostate cancer.
Unfortunately, it also showed a 27 percent increased risk in high-grade tumors, which was noted in an accompanying editorial. Ian Thompson, M.D., chairman of the department of urology at the University of Texas Health Science Center, who led the study, said the editorial may have colored the perception of finasteride.
