Tuesday, September 27, 2011

FDA 'Remains Concerned' Over Risks of CertainBirth Control Pills

The U.S. Food and Drug Administration said it "remains concerned" a certain type of birth control pill that contains drospirenone could raise the risk of blood clots beyond that of other pills.

In a drug safety communication posted on the agency's website Monday, the FDA said preliminary results of an agency funded study involving 800,000 women suggest about a 1.5-fold increase in the risk of blood clots for women who use drospirenone-containing birth control pills compared to users of other hormonal contraceptives.

Drospirenone is used in pills including Yaz and Yasmin, which are marketed by Bayer.

Drospirenone is a type of female sex hormone called a progestin. Some drospirenone pills are also available in generic versions.

But the FDA said it has not reached a final conclusion that the products raise the risk of blood clots beyond that of other pills and will convene an outside panel of medical experts on Dec. 8 to discuss the matter.

Most birth-control pills contain two types of hormones, estrogen and progestin. All types of pills increase the risk of blood clots and product labels warn of such risk.

The FDA said there's conflicting information about the blood-clot risk possibly associated with drospirenone from six other published studies. Some of the studies have reported that the risk of blood clots for women who use birth-control pills containing drospirenone is higher than that for women who use birth-control pills containing levonorgestrel, while other studies haven't found such a risk. While the risk of blood clots is low among women who take birth-control pills, the FDA said it is higher than the risk among women who aren't taking the pills.

Coffee Can Lower Risk of Depression in Women.

Women who drink four or more cups of coffee a day can lower their risk of depression, a U.S. study out Tuesday showed.

Researchers from the Harvard School of Public Health, Boston, found that women who drink four or more coffees a day had a 20 percent lower risk of developing clinical depression than those who consumed one cup of coffee per week or less.

Women who consumed two to three cups per day had a 15 percent decreased risk of developing depression, according to the study.

The benefits only seem to be associated with drinking caffeinated coffees. There were no similar trends found with decaffeinated coffee, or other caffeinated drinks such as tea or soda.

"Our results support a possible protective effect of caffeine, mainly from coffee consumption, on risk of depression," lead author Michel Lucas said. "Further investigations are needed to confirm this finding and to determine whether usual caffeinated coffee consumption may contribute to prevention or treatment of depression."

The research, published in the Archives of Internal Medicine journal, was based on a 10-year study of 50,739 American women who took part in the Nurses' Health Study, a major health and lifestyle investigation

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Sunday, September 25, 2011

Novartis drug may help older breast cancerpatients.

http://news.yahoo.com/novartis-drug-may-help-older-breast-cancer-patients-1206STOCKHOLM (Reuters) - Novartis's bone drug Zometa extended survival in older breast cancer patients but failed to improve disease-free survival among younger women patients in a large-scale clinical trial, researchers said on Sunday.

Detailed data presented at the European Multidisciplinary Cancer Congress (EMCC) in Stockholm showed that Zometa, a bisphosphonate drug known generically as zoledronic acid, only improved overall survival rates in patients who had undergone the menopause at least five years earlier.

Researchers said the effect was likely to be linked to levels of reproductive hormones, which are lower in women who have been through the menopause.

"This is not a treatment for ever woman with breast cancer," said Robert Coleman of Britain's Sheffield University, who led the study. But for women with low levels of female hormones, either due to aging or specific treatments to induce menopause, Zometa "appears very promising."

An analysis of the subset of older patients showed that at a the five-year follow-up, there was a 26 percent reduction in recurrence of tumors, Coleman said, as well as a 26 percent reduction in the risk of an early death.

These strong results could lead to "a major new treatment approach" for post-menopausal patients, he said.

Zometa, which generated sales of $2.1 billion for Novartis in 2010, is an intravenous drug from a widely used class of osteoporosis medicines called bisphosphonates.

It is increasingly being prescribed to help reduce or delay fractures and other skeletal complications in a variety of cancers that have spread to the bones. From 65 to 75 percent of breast cancer recurrences occur in the bones.

This trial, called AZURE and also published in the New England Journal of Medicine on Sunday, involved 3,360 women with early-stage breast cancer from 174 centers in Britain, Australia, Spain, Ireland, Portugal, Taiwan and Thailand.

Patients randomly allocated receive standard chemotherapy and/or hormone therapy, either with or without the addition of Zometa, a drug that works by inhibiting the cells that break down bone, called osteoclasts.

The results showed that looking across all trial participants, there was no significant difference in disease-free survival or overall survival between patients who received Zometa and those who didn't. But in a subset of older patients, the addition of the Novartis drug did bring clear benefits.

These women, who had at least five years since their last period, had an overall survival rate at five years of 85 percent on Zometa compared with 79 percent for those not on the drug. For all other patients, overall five-year survival was similar, at 86 percent in the Zometa group and 85 percent in the control group.

Investigators said that most surprising among the findings was the drug's effect on the rate at which the cancer recurred outside the bone. The relative risk for developing metastases, or secondary tumors, outside bone during treatment with Zometa was approximately halved in the postmenopausal women compared with the younger patients.

Coleman said the results shed new light on the role bones may play in the progress of the disease.

"The effects on metastasis and recurrence outside bone suggests that the bone marrow is an important sanctuary for tumor cells which can be activated after, sometimes, many years of dormancy," he said. "With help from bone marrow stem cells, they may then spread via the blood stream to set up metastases at other sites."

Friday, September 23, 2011

AP IMPACT: Hospital drug shortages deadly,AP IMPACT: Hospital drug shortages deadly,

TRENTON, N.J. (AP) — A severe shortage of drugs for chemotherapy, infections and other serious ailments is endangering patients and forcing hospitals to buy life-saving medications from secondary suppliers at huge markups because they can't get them any other way.
An Associated Press review of industry reports and interviews with nearly two dozen experts found at least 15 deaths in the past 15 months blamed on the shortages, either because the right drug wasn't available or because of dosing errors or other problems in administering or preparing alternative medications.
The shortages, mainly involving widely-used generic injected drugs that ordinarily are cheap, have been delaying surgeries and cancer treatments, leaving patients in unnecessary pain and forcing hospitals to give less effective treatments. That's resulted in complications and longer hospital stays.
Just over half of the 549 U.S. hospitals responding to a survey this summer by the Institute for Safe Medication Practices, a patient safety group, said they had purchased one or more prescription drugs from so-called "gray market vendors"— companies other than their normal wholesalers. Most also said they've had to do so more often of late, and 7 percent reported side effects or other problems.
Hospital pharmacists "are really looking at this as a crisis. They are scrambling to find drugs," said Joseph Hill of the American Society of Health-System Pharmacists.
A hearing on the issue was set for Friday before the health subcommittee of the House Energy and Commerce Committee. The Food and Drug Administration is holding a meeting Monday with medical and consumer groups, researchers and industry representatives to discuss the shortages and strategies to fight them.
The FDA says the primary cause of the shortages is production shutdowns because of manufacturing problems, such as contamination and metal particles that get into medicine.
Other reasons:
— Companies abandoning the injected generic drug market because the profit margins are slim. Producing these sterile medicines is far more complicated and expensive than stamping out pills, and it can take about three weeks to produce a batch. Making things worse, companies don't have to notify customers or the FDA that they've stopped making a medicine. That means neither FDA nor competitors can fill the gap in time.
— Only a half-dozen companies make the vast majority of injected generics. Even if other companies wanted to begin making a generic drug in short supply, they're discouraged by the lengthy, expensive process of setting up new manufacturing lines and getting FDA approval.
— Theft of prescription drugs from warehouses or during shipment.
— Secondary, "gray market" vendors who buy scarce drugs from small regional wholesalers, pharmacies or other sources and then market them to hospitals, often at many times the normal price. These sellers may not be licensed, authorized distributors.
Hospitals that buy scarce medicines from the "gray market" are taking a gamble.
The drugs may be stolen and hospitals can't always tell whether a medicine was properly refrigerated — as required for many injectable drugs — or whether it's past the expiration date, said Michael R. Cohen, a pharmacist and president of the institute. Either way, the active ingredient might have degraded and the drug might not work well or could harm the patient, he said.
Cohen attributes at least 15 recent deaths to drug shortages based on reports by medical personnel, but says many deaths and injuries go unreported.
In the worst known case, Alabama's public health department this spring reported nine deaths and 10 patients harmed due to bacterial contamination of a hand-mixed batch of liquid nutrition given via feeding tubes because the sterile pre-mixed liquid wasn't available.
So far this year, 210 drugs have been added to the list of drugs in short supply, one less than the total for all of last year, according to the University of Utah Drug Information Service, which tracks the shortages. That's triple the roughly 70 a year from 2003 to 2006, when shortages began to climb steadily.
"The shortages aren't resolving. They're piling up on top of existing ones," said Erin Fox, a pharmacist who manages the service. She said at least 55 drugs from shortages before this year are still unavailable or scarce.
The average price markup on drugs sold by secondary distributors was 650 percent, according to an Aug. 16 report by the Premier Healthcare Alliance, a group that helps U.S. hospitals and other health providers improve their patient care and finances. The report is based on an analysis of 636 unsolicited sales offers that were faxed and emailed to hospitals from secondary distributors in April and May.
Virtually every offer was for at least double the normal price, the survey found. The drugs with the highest markups were for critically ill patients needing anesthesia or other medicines for surgery or for emergency care, cancer, infectious diseases and pain management.
In an extreme case, one vendor was offering a generic drug for dangerously high blood pressure, normally priced at $25.90 per dose, for $1,200.
So far, hospitals have been absorbing the extra costs, but they'll soon have to start passing them on to insurers and patients, according to the American Hospital Association.
Hospitals sometimes have to cave in to save patients, according to Cohen and several hospital pharmacy directors.
The FDA says it must uphold quality standards but also works hard to prevent shortages.
"When FDA detects a contaminant, whether it be shards of glass or metal particles or an infectious agent, we have to take action to protect the public," said Dr. Peter Lurie, a senior adviser in the FDA commissioner's office.
When such problems force a company to shut down production, the FDA urges other manufacturers to boost their output and expedites any approvals needed, said Valerie Jensen, associate director of FDA's drug shortage program. When raw materials used to make drugs are in short supply, the FDA tries to find new sources.
The agency averted 38 shortages last year, Jensen added.
Legislation pending in the House and Senate would increase penalties for drug thefts from warehouses and tractor-trailers. Another proposal, which has bipartisan support, would require drug manufacturers anticipating a shortage to immediately notify the FDA.
Sen. Amy Klobuchar, D.-Minn., the primary sponsor of the Senate version of the notification bill, said other solutions being considered include better tracking of medicine shipments, mandatory accreditation of distributors, stockpiling of key drugs and allowing routine imports of prescription drugs from countries such as Canada.
Distributors that supply about 90 percent of prescription drugs to hospitals buy direct from drug manufacturers and deliver only to customers with appropriate licenses, said John Parker, a spokesman for the Healthcare Distribution Management Association. He said HDMA members don't participate in the "gray market" but would not comment further.
The pitches hospitals get from the secondary distributors generally say they have small batches of specific drugs that are hard or impossible to find. "Are you enjoying this crazy 'roller coaster ride' of pharmaceutical shortages? ... I utilize over 60 vendors to locate and procure needed pharmaceuticals to assist when you have shortage needs," one reads.
Several distributors who sent hospitals solicitations for scarce drugs didn't return calls from the AP. One representative said he wasn't authorized to discuss the issue.
One company, Novis Pharmaceuticals, defended the higher prices, saying secondary distributors have to charge far more because they don't get the big rebates manufacturers give primary distributors. They also have high costs to locate and transport batches of scarce drugs, although the company, which mainly distributes blood plasma, would not disclose its profit margin.
It's illegal for companies to create a monopoly or collude to create a medicine shortage and raise prices, but there's no evidence of that. There's no federal law against price-gouging on prescription drugs, according to the FDA, but it does urge pharmacists to report cases to its Office of Criminal Investigation. An agency spokeswoman said she could not discuss whether any cases are being investigated.
The top three wholesalers say they try to alleviate problems by working with drug manufacturers, updating hospitals on shortages and rationing scarce supplies by giving their regular hospital customers a portion of their normal order. McKesson Corp. and Cardinal Health Inc. say they halt sales to any smaller distributors found to be diverting drugs or otherwise breaking rules. AmerisourceBergen Corp. does background checks on customers.
The hospital association and other groups urge hospitals not to buy from unaccredited vendors, to insist on documentation of the drug's source if they must, and to report price gouging to state authorities. But only three states — Kentucky, Maine and Texas — have price-gouging laws that specifically cover medicines.
"Something has to be done here," said pharmacist Michael O'Neal, head of drug procurement for Vanderbilt University Medical Center in Nashville, which has had to purchase medicines from secondary suppliers about 70 times over the past two years.
"This is unethical," he said. "We're talking about people's lives."

Thursday, September 22, 2011

Lung cancer linked to risk of stroke.

NEW YORK (Reuters Health) - People recently diagnosed with lung cancer are at higher risk of having a stroke than those without lung tumors, suggests a large new study from Taiwan.
Researchers looking at data covering more than 150,000 adults found that among those with lung cancer, 26 in every 1000 experienced a stroke each year, compared with 17 in 1000 who did not have cancer.
"This is one more telling sign of the long term risk of smoking," said Dr. Andrew Russman, a stroke specialist at the Henry Ford Hospital in Detroit, who was not part of the study.
The Taiwanese researchers didn't factor in lifestyle issues -- such as smoking, drinking or diet -- that might influence stroke risk, explained senior author, Dr. Fung-Chang Sung of the China Medical University, to Reuters Health in an email.
Still, they report in the journal Stroke, that stroke risk was highest during the first three months after lung cancer diagnosis for men and during the first four-to-six months for women. Risk decreased in men after one year and after two years in women.
They also found that a less common type of stroke -- hemorrhagic stroke, caused by sudden bleeding into the brain -- occurred more often among the lung cancer patients than ischemic stroke, which is usually caused by a clot blocking blood flow to brain tissue.
Some evidence suggests that excessive bleeding and blood clots, both of which can be caused by tumors, as well as chemotherapy side effects, could partly explain the apparent link between cancer and stroke, researchers note.
"The most common type of lung cancer, adenocarcinoma, increases the body's propensity to form blood clots, even more so than other types of cancers," Russman told Reuters Health.
More than 52,000 people with lung cancer and more than 104,000 people without lung cancer were selected from a nationwide health insurance database.
Most of the study population were blue-collar workers such as farmers, fishermen and vendors, who tended to have high blood pressure, diabetes and heart disease.
"There's a higher rate of high blood pressure and diabetes and pulmonary disease in patients with lung cancer," said Russman. "I think this reflects the heavy burden of smoking and smoking related risk factors in the population," he said.
According to the American Lung Association, smoking is directly responsible for approximately 90 percent of lung cancer deaths.
"In the U.S., smokers have twice the risk of having a stroke, regardless of lung cancer," said Russman.
Stroke accounted for one out of eighteen deaths in the U.S. in 2007, based on a report by the American Heart Association.
SOURCE: http://bit.ly/pKWV0G Stroke, September 13, 2011.

Depressed people have slightly more strokes

The word stroke comes from the Greek language (Greek) meaning a sudden attack thunderstruck. Stroke is a disorder in the brain that is characterized by loss of function of a particular body part (paralysis), which is caused by interruption of blood flow in the brain that manage parts of the body that loses functionality.
Stroke occurs due to a sudden interruption of blood flow in certain parts of the brain. So, a stroke occurs suddenly without any symptoms at first. Impaired blood flow can be blocked (because of blood clots or narrowed arteries) on arterial blood vessels are members of food in the form of oxygen and glucose in certain parts of the brain, so there is disorder of brain function (paralysis). If this blockage lasts only a few minutes only, then the brain is still able to function normally again. But if the blockage had occurred up to several hours, then it will die a part of the brain called the “brain infarction”. Strokes are called ischemic strokes that occurred approximately 85% of all types of stroke.

Stroke causes, stroke type, stroke process, stroke symptoms

NEW YORK (Reuters Health) - A new study shows people who are depressed may be a little more likely than others to suffer a stroke down the road.
Looking back at 28 past studies, researchers estimated there would be 106 extra cases of stroke per 100,000 depressed people each year, 22 of them fatal.
But don't reach for the antidepressants just yet, because the study has major limitations.
The biggest problem is that nobody knows how to account for the link -- people who have the blues might smoke more and exercise less, for instance. Indeed, accounting for that did weaken the apparent tie between depression and stroke, which kills about 137,000 Americans a year.
And there's a more troubling possibility, said An Pan, a researcher at Harvard School of Public Health in Boston who worked on the study.
In an earlier study, he found depressed people who take antidepressants appeared to have an increased risk of stroke compared with depressed people who weren't on the drugs.
"These medications could be one possible reason for the increased risk of stroke in depression and the majority of studies did not control for this," he told Reuters Health.
He stressed, however, that antidepressant use might also just be an indicator of severe depression, which might account for the extra risk.
"The current data on whether medications have an independent role (in stroke) is not clear at this moment," Pan said.
The findings, published in the Journal of the American Medical Association, are based on a total of more than 317,000 people followed for two to 29 years.
For health providers treating depressed people, the results add one more health problem to watch out for on a list that already includes chronic diseases like diabetes and heart disease.
But for a person with the blues, they don't mean a whole lot, said Pan.
SOURCE: http://bit.ly/p1AGJJ Journal of the American Medical Association, September 21, 2011.

Wednesday, September 21, 2011

Conjoined twins successfully separated



In this Jan. 25, 2011 photo provided by Le Bonheur Children's Hospital, conjoined twins Joshua, left, and Jacob Spates are shown in Memphis, Tenn. The boys were joined back-to-back at the pelvis and l



Joshua and Jacob Spates, who spent their first seven months outside the womb as conjoined twins, are recovering in the pediatric intensive care unit of a Memphis hospital after a successful 13-hour surgery to separate them.

In this Jan. 25, 2011 photo provided by Le Bonheur Children's Hospital, conjoined twins Joshua, left, and Jacob Spates are shown in Memphis, Tenn. The boys were joined back-to-back at the pelvis and lower spine, each with separate hearts, heads and limbs. The 7-month-old boys were separated Aug. 29. (AP Photo/Le Bonheur Children's Hospital, Lisa Waddell Buser)http://news.yahoo.com/photos/conjoined-twins-successfully-separated-1316098915-slideshow/jan-25-2011-photo-provided-le-bonheur-childrens-photo-215742751.html

New Natural Sleep Solution Can be Taken in Middle of Night without Causing Morning Grogginess

New Natural Sleep Solution Can be Taken in Middle of Night without Causing Morning Grogginess


New Natural Sleep Solution Can be Taken in Middle of Night without Causing Morning Grogginess

When was the last time you had a deep, restful, and refreshing night’s sleep?  How long has it been since you woke up feeling great, ready to jump out of bed, and tackle your day?  If you are more familiar with what it is like to wake up feeling exhausted or miserable, you may be one of the over 52 percent of adult Americans who suffer from regular difficulty falling asleep and staying asleep.
While exercise and diet get all the media attention, sleep issues are one of the most widespread health problems facing Americans today.  The causes of poor sleep can vary, from stress to natural changes as our bodies age, but the results can be simply devastating.  In addition to fatigue, insufficient sleep can lead to a lack of mental sharpness and concentration, mood swings, difficulty controlling weight, a weaker immune system, and a lifeless complexion.  Too little sleep can affect our relationships and even harm career prospects.
Many people believe their only option when it comes to help falling asleep is to turn to expensive prescription and OTC sleep aids, of which the most popular is Ambien™.  These drugs have potentially serious side effects and can leave you feeling groggy the next morning.  For people that wake up in the middle of the night and can’t fall back asleep, these drugs and their morning grogginess side effect are simply not an option.
There are also a wide variety of “natural” remedies for sleep problems. Many of these substances have been used for thousands of years, and certain compounds have recently been shown to be both safe and effective in clinical research.  But, the problem with natural remedies is that it can be difficult to cut through the hype and know which ones truly work and are safe.
Now however, there is a completely new approach to help improve your sleep—whether your problem is falling asleep at bedtime or falling back aseep in the middle of the night.
It’s called reBloom, and it’s the first safe and effective natural sleep drink; literally, a 2.5 oz. natural beverage you consume before bed to help you fall asleep.  For people that have trouble staying asleep, not falling asleep, simply drink a ½ bottle of reBloom if you wake up in the middle of the night to help you fall back asleep without morning grogginess.
The concept behind reBloom is simple.  Without using any drugs, reBloom naturally relaxes the brain and the body and helps induce deep and peaceful sleep.  Its clinically proven ingredients include Valerian, an ancient root long treasured for its ability to improve sleep; L-Theanine, a key relaxing amino acid found in green tea; and Melatonin, an important natural compound that helps the body regulate its sleep cycles. reBloom is also rich in other anti-oxidants and calming herbs.
Because reBloom helps you relax and fall asleep naturally and then maintain a deep, high-quality sleep throughout the night, you wake feeling refreshed and well rested, not groggy or tired. reBloomhas a pleasant natural taste and is only 5 calories per serving.
But, does it really work?
We analyzed the results of reBloom’s double-blind, placebo controlled clinical study and found the results to be impressive.  Nine out of 10 users of reBloom reported that they fell asleep faster, and three out of four users reported both significantly improved sleep quality and feeling more refreshed upon waking.
Just imagine: A quick and natural beverage that can make sleeping a pleasure again. Sounds almost too good to be true.
Well, now there’s an easy way to find out for yourself.  reBloom is not only offering free shipping for new customers, but they also have a 100% Satisfaction Guarantee that allows you to return your purchase for a full refund—even if up to 7 bottles are empty.
 Click here to learn more about reBloom and their limited time offer for new customers.http://www.howlifeworks.com/a/a/?cid=8088ec_news&AG_ID=1092

Monday, September 19, 2011

Docs Light Up Cancer.

A dye that tracks tumors and glows under fluorescent light helps guide doctors during cancer surgery. Dutch doctors recently used the dye, likened to a homing device, to light up ovarian cancer cells during surgery in a small study of 10 patients.
“Ovarian cancer is notoriously difficult to see, and this technique allowed surgeons to spot a tumor 30 times smaller than the smallest they could detect using standard techniques,” Philip Low, the Purdue University chemistry professor who invented the dye, said in a statement. “By dramatically improving the detection of the cancer — by literally lighting it up — cancer removal is dramatically improved.”

The study results were published Sunday in Nature Medicine.

Surgical cancer removal is usually followed by other treatments, such as chemotherapy, that work better when fewer cancer cells remain.

“With ovarian cancer, it is clear that the more cancer you can remove, the better the prognosis for the patient,” Low said in a statement. “This is why we chose to begin with ovarian cancer. It seemed like the best place to start to make a difference in people’s lives.”

Although researchers tested the dye in patients with ovarian cancer, Low told “Good Morning America” today that he envisioned the same strategy working for 40 percent of cancers.

The dye is linked to folate – a vitamin absorbed by cells to varying degrees. Ovarian cancer has one of the highest rates of folate receptor expression, Low said. But lung, kidney, endometrial, breast and colon cancers can express the receptor, too.

Other dyes have been shown to target and illuminate tumors. But Low said his dye is much more specific, providing better contrast between tumors and the healthy tissue that borders them.

Low said he and his team plan to work with the Mayo clinic on the next stage of clinical trials. In the meantime, they will continue to work to improve the dye.

“We want to be able to see deeper into the tissue, beyond the surface,” Low said in a statement. “Different cancers have tumors with different characteristics, and some branch and wind their way deeper into tissue. We will continue to evolve this technology and make improvements that help cancer patients.”

Sunday, September 18, 2011

UK surgeons separate twin girls joined at head.

Sudanese twins born with the tops of their heads joined together have been separated in a rare and risky series of operations at a London children's hospital, officials said Sunday.
Facing the World, a charity which helps disfigured children, said it had helped fund the four-stage operation on 11-month-olds Rital and Ritag Gaboura. Twins born joined at the head are known as craniopagus twins and they occur in about one in 2.5 million births.
Separating them can be dangerous, especially if — as in this case — there's significant blood flow between their brains.
"Incidences of surviving twins with this condition is extremely rare," lead surgeon David Dunaway said in a statement released by the charity. "The task presented innumerable challenges and we were all very aware of our responsibilities to the family and these two little girls."
The charity released before and after photographs of the girls. The before photo showed the two sprawled out on a bed, with their heads joined just above the hairline to form what appeared to be a single, solid unit. Facing the World said that separation took place in stages at London's Great Ormond Street Hospital, with two operations in May, the insertion of tissue expanders in July and the final separation on Aug. 15.
"Within days the twins were back on the general ward interacting and playing as before," the charity said. Its executive coordinator, Sarah Driver-Jowitt, predicted that the girls' parents — who haven't been named — may soon return home "with two healthy, separate girls."
Although rare, operations to separate twins linked by their heads aren't unheard of. In 2004, a team of doctors at New York's Montefiore Children's Hospital separated Filipino twins in four major surgeries that took place over 10 months. In 2003, surgeons in Dallas successfully separated 2-year-old Egyptian twins joined at the head.
One of the first successful operations to separate craniopagus twins took place in 1956, according to the U.S. National Library of Medicine.

Friday, September 16, 2011

The number of Alzheimer's patients is expected to increase dramatically in coming years, straining the health care system.

John Eckert holds hands with wife Dorothy, who has Alzheimer's disease, at their home in Norristown, Pa. The incidence of Alzheimer's will greatly increase in the coming years, experts say

The number of Alzheimer's patients is expected to increase dramatically in coming years, straining the health care system.
Scientists have not discovered the cause nor devised effective treatments. Even diagnosis is difficult.
In the absence of therapies, attention has turned to teaching the skills necessary to cope with demented patients.
Increasingly caregivers are encouraged to validate the feelings and perceptions of the person with Alzheimer's.
During the YouTube forum with the Democratic presidential candidates in July, the first question about health care came from two middle-age brothers in Iowa, who faced the camera with their elderly mother. Not everybody with Alzheimer’s disease has two loving sons to take care of them, they said, adding that a boom in dementia is expected in the next few decades.
“What are you prepared to do to fight this disease now?” they asked.
The politicians mouthed generalities about health care, larded with poignant anecdotes. None of them answered the question about Alzheimer’s.
Science hasn’t done much better. There is no cure for Alzheimer’s and no way to prevent it. Scientists haven’t even stopped arguing about whether the gunk that builds up in the Alzheimer’s brain is a cause or an effect of the disease. Alzheimer’s is roaring down — a train wreck to come — on societies all over the world.
People in this country spend more than a $1 billion a year on prescription drugs marketed to treat it, but for most patients the pills have only marginal effects, if any, on symptoms and do nothing to stop the underlying disease process that eats away at the brain. Pressed for answers, most researchers say no breakthrough is around the corner, and it could easily be a decade or more before anything comes along that makes a real difference for patients.
Meanwhile, the numbers are staggering: 4.5 million people in the United States have Alzheimer’s, 1 in 10 over 65 and nearly half of those over 85. Taking care of them costs $100 billion a year, and the number of patients is expected to reach 11 million to 16 million by 2050. Experts say the disease will swamp the health system.
It’s already swamping millions of families, who suffer the anguish of seeing a loved one’s mind and personality disintegrate, and who struggle with caregiving and try to postpone the wrenching decision about whether they can keep the patient at home as helplessness increases, incontinence sets in and things are only going to get worse.
Drug companies are placing big bets on Alzheimer’s. Wyeth, for instance, has 23 separate projects aimed at developing new treatments. Hundreds of theories are under study at other companies large and small. Why not? People with Alzheimer’s and their families are so desperate that they will buy any drug that offers even a shred of hope, and many will keep using the drug even if the symptoms don’t get better, because they can easily be convinced that the patient would be even worse off without it.
It is telling, maybe a tacit admission of defeat, that a caregiving industry has sprung up around Alzheimer’s. Books, conferences and Web sites abound — how to deal with the anger, the wandering, the sleeping all day and staying up all night, the person who asks the same question 15 times in 15 minutes, wants to wear the same blouse every day and no longer recognizes her own children or knows what a toilet is for.
The advice is painfully and ironically reminiscent of the 1960s and ’70s, the literal and figurative high point for many of the people who are now coping with demented parents. The theme is, essentially, go with the flow. People with Alzheimer’s aren’t being stubborn or nasty on purpose; they can’t help it. Arguing and correcting will not only not help, but they will ratchet up the hostility level and make things worse. The person with dementia has been transported into a strange, confusing new world and the best other people can do is to try to imagine the view from there and get with the program.
If a patient asks for her mother, for instance, instead of pointing out that her mother has been dead for 40 years, it is better to say something like, “I wish your mother were here, too,” and then maybe redirect the conversation to something else, like what’s for lunch.
If Dad wants to polish off the duck sauce in a Chinese restaurant like it’s a bowl of soup, why not? If Grandma wants to help out by washing the dishes but makes a mess of it, leave her to it and just rewash them later when she’s not looking. Pull out old family pictures to give the patient something to talk about. Learn the art of fragmented, irrational conversation and follow the patient’s lead instead of trying to control the dialogue.
Basically, just tango on. And hope somebody will do the same for you when your time comes. Unless the big breakthrough happens first.


Thursday, September 15, 2011

Student Makes Breast Cancer Breakthrough.

A Welsh student made a scientific breakthrough which could stop people dying from breast cancer by halting the spread of the disease, his university announced Thursday.
Luke Piggott, a Ph. D. student at Cardiff University, Wales, discovered a way to switch off breast cancer stem cells' resistance to a particular drug.
Cancer stem cells make up only a small proportion of the cells in a tumor but many scientists believe they are responsible for cancer growth, spread and relapse. They are also highly 
However Piggott, 25, managed to make breast cancer cells sensitive to the anti-cancer drug TRAIL, which has not previously been used as a breast cancer treatment as it is blocked by a protein in breast cancer cells.
In laboratory experiments, he suppressed the effect of the protein, making the stem cells sensitive to TRAIL.
The method reduced secondary tumors by 98 percent and repeat treatments killed cancer stem cells if they reappeared.
Piggott's supervisor, Richard Clarkson, said, "We believe we have found a crucial 'Achilles heel' in breast cancer stem cells. We can almost completely shut down their ability to spread the disease through the body through secondary tumors. Our success with repeat treatments is also important, offering hope that we can reduce relapse rates of the disease."
Researchers at the university now plan to expand the study and eventually trial the method on breast cancer in the body.


Wednesday, September 14, 2011

Abuse of Xanax leads clinic to halt supply.

Image: Angela Shoemaker
Tina Graham, who suffers from debilitating panic attacks, said her anxiety increased after switching from Xanax for clonazepam

Gayle Mink, a nurse practitioner at a community mental health center here, had tired of the constant stream of patients seeking Xanax, an anti-anxiety drug coveted for its swift calming effect.
“It is such a drain on resources,” said Ms. Mink, whose employer, Seven Counties Services, serves some 30,000 patients in Louisville and the surrounding region. “You’re funneling a great deal of your energy into pacifying, educating, bumping heads with people over Xanax.”
Because of the clamor for the drug, and concern over the striking number of overdoses involving Xanax here and across the country, Seven Counties took an unusual step — its doctors stopped writing new prescriptions for Xanax and its generic version, alprazolam, in April and plan to wean patients off it completely by year’s end.
The experiment will be closely watched in a state that has wrestled with widespread prescription drug abuse for more than a decade and is grasping for solutions as it claims more lives by the week. While Kentucky and other states have focused largely on narcotic painkiller addiction, experts say that benzodiazepines, the class of sedatives that includes Xanax, are also widely misused or abused, often with grim consequences.
While the patients at Seven Counties are mostly poor, experts say the appeal of Xanax cuts across socioeconomic lines. Alprazolam was the eighth most prescribed drug in the nation last year, according to SDI, a data firm that tracks drug sales. Even more than the figures suggest, Xanax has become part of the popular lexicon, as well known as a panic antidote as Prozac is for depression.

The Centers for Disease Control and Prevention last year reported an 89 percent increase in emergency room visits nationwide related to nonmedical benzodiazepine use between 2004 and 2008. And here in Kentucky, the combination of opiate painkillers and benzodiazepines, especially Xanax, is common in fatal overdoses, according to the state medical examiner.
Seven Counties is not the first health care provider to cut off prescriptions for controlled substances — at least several others around the country have stopped giving patients certain opiates and benzodiazepines — but the practice remains contentious. Some doctors say that refusing to prescribe certain drugs under any circumstance is overly rigid, noting that Xanax helps many people who use it responsibly.

“What they’re doing is a noble idea,” said Dr. Laurence H. Miller, who heads a committee on public and community psychiatry for the American Psychiatric Association. But he added: “I could never say never to anything. There are some people who may have done very well on it, are on a small dose and manage their lives on it, and that’s probably O.K.”

This article, “Abuse of Xanax Leads a Clinic to Halt Supply” first appeared in The New York Times.

Experiment to cut off prescriptions for controlled substances called too rigid by some 


Tuesday, September 13, 2011

366 Million People Now Have Diabetes: Report


International Diabetes Federation urges U.N. action, saying disease claims 1 life every

7 seconds


-- The worldwide diabetes epidemic continues to worsen, with an estimated 366 million people struggling with the disease, 4.6 million deaths due to it each year, and annual health-care spending pegged at $465 billion, the International Diabetes Federation announced Tuesday.
The federation released the numbers at a meeting of the European Association for the Study of Diabetes in Lisbon, Portugal, one week before the United Nations Summit on Non-Communicable Diseases. The goal of the summit is to mount a global drive to combat diabetes as well as cancer, heart and chronic respiratory diseases.
It marks just the second time that the United Nations has held a summit on a health-related issue. The first one, in 2001, set goals to treat the HIV/AIDS crisis.
The new diabetes numbers, which are based on international data, illustrates the "relentlessly upwards trajectory" of the disease -- both type 1 and type 2 -- around the world, the federation said.
The statistics are "proof indeed that diabetes is a massive challenge the world can no longer afford to ignore. In 2011, one person is dying from diabetes every seven seconds," IDF President Jean Claude Mbanya said in a federation news release.
"The clock is ticking for the world's leaders -- we expect action from their high-level meeting next week at the United Nations that will halt diabetes' relentlessly upwards trajectory."
The federation statement calls for "strengthening health systems [that] should include developing and evaluating approaches for building local health care capacity, as well as integrating diabetes care and services with primary health care services, management of chronic infectious diseases and maternal and child health."
Type 1 diabetes is an autoimmune disease in which the body doesn't produce the hormone insulin, which transports sugar in the blood to cells throughout the body for energy. Type 2 diabetes, which is much more common than type 1 disease, is often caused by obesity, poor eating habits and lack of exercise.
More information
To learn more about diabetes, visit the American Diabetes Association.


Dr. Cynara Coomer

Dr. Cynara Coomer is the Chief of Breast Surgery & Director of The Comprehensive Breast Center at Staten Island University Hospital.

Dr. Keith Ablow

Dr. Keith Ablow is a psychiatrist and contributor for Fox News Channel and a New York Times bestselling author. 

Dr. Marc Siegel

Dr. Marc Siegel is an Internist and Associate Professor of Medicine at the NYU School of Medicine. 

Dr. Isadore Rosenfeld

Dr. Isadore Rosenfeld, a Professor of Medicine at New York Presbyterian Hospital/Weill Cornell Medical Center, is widely recognized as one of the country's top cardiologists.http://www.foxnews.com/health/index.html

Sunday, September 11, 2011

Colon checks rising — which test is best?

Sam Monismith was prepped and ready to begin his colonoscopy when health workers brought the university professor awkward news: His insurance wasn’t going to cover the colon cancer check. They wanted a signed promise to pay, or the test was off.id/17802801/ns/health-cancer/t/colon-checks-rising-which-test-best/

And is the pricey colonoscopy that studies suggest more people prefer really the better test?
“Here’s where the problem lies: I think people are willing to undergo colonoscopy,” says Dr. Arden Morris, a colon cancer surgeon at the University of Michigan. They’re less willing to do fecal testing — many “think it’s really gross” — or other options that don’t give as full a view of the colon.
“On the other hand, if everybody who’s eligible gets a colonoscopy, we’re going to break the bank,” Morris warns. “Then who gets screening when we don’t have money left? I think this is a really intriguing question.”
Some 153,760 Americans will be diagnosed with colorectal cancer this year, and more than 52,000 will die.
The government says up to 60 percent of those deaths could be prevented if everyone over age 50 underwent routine screening.

Monismith hesitated only briefly — and the test uncovered nine polyps, precancerous growths in his colon. Even better, because doctors removed them on the spot, the bill switched from a cancer screening that insurance wouldn’t pay into a surgical procedure it did.
“The irony of it is if I hadn’t had any polyps, I would have had to pay,” says Monismith, 54, of Harrisburg, Pa., who has had additional polyps removed in the four years since that first check. “I’m just glad I got the test.”
Insurers insist Monismith is a rarity and that most insurance does cover colon cancer screening once people hit age 50, when the risk starts to rise. Still, cancer advocacy groups have begun a push to ensure the last holdouts cover all four government-recommended options — from the $20 annual stool sample to once-a-decade colonoscopies that can exceed $1,000.
Fifteen states are considering legislative mandates, by the American Cancer Society’s count; 19 other states have long had such laws.
The legislative tussle actually highlights tougher issues: Insurance aside, people are reluctant to get checked for the nation’s No. 2 cancer killer. Nearly 42 million Americans over 50 aren’t getting screened. Even though Medicare has long covered the checks for those over 65 — and colonoscopies are rising — only about half of its recipients get properly screened.
“It is a patient education” issue, contends Mohit Ghose, spokesman for America’s Health Insurance Plans, which opposes the mandates.

People prefer colonoscopy 
It’s not just a matter of catching the cancer when it’s still small and more easily treated. The disease usually starts with toadstool-like growths called polyps that can take a decade to turn cancerous. Remove them in time, and the cancer never even forms.
The government backs four screening options. Most used are annual at-home fecal tests to detect hidden blood in the stool and once-a-decade colonoscopies, where doctors use a long, flexible tube to visually inspect the colon. (The others are sigmoidoscopy, an exam of the lower colon only, and a less-used barium enema, repeated every five years.)
The good news: Deaths are declining faster for colorectal cancer than for any other cancer, a 5.7 percent drop between 2003 and 2004 that scientists credit to small upticks in screening.
Where’s the improvement? Mostly, it’s in increasing colonoscopies, says Michigan’s Morris. A study published in December found an almost sevenfold increase in routine colonoscopies once Medicare started covering them in 2001.
Even though for most people the cheaper fecal-blood tests are equally effective, other studies have found problems getting people to repeat them year after year as required, Morris says. “People hate doing” them.
As for the middle ground of a sigmoidoscopy, blacks, women and the elderly are more likely to have cancer in part of the colon that doesn’t reach, she adds.
Where does the legislative fight fit in? The cancer society found that colonoscopies and sigmoidoscopies rose faster between 1999 and 2004 in states that mandated coverage of all the options.
Ghose’s industry group argues that almost every insurer already covers some colon screening. A 2004 congressional probe, the latest available data, surveyed a few dozen insurers in states without mandates. Just 16 percent of small-employer plans and 31 percent of large-employer plans covered fewer than all four options. Least likely to be covered were colonoscopies and barium enemas.
Morris says the key is ensuring enough choices are available — not just for the insured but the uninsured, too — that people simply pick something. “Once we’re used to the notion, it might be easier to talk about the less expensive choices.”