By jeremyc | March 1, 2015
A recent study has found a new technique known as ultrasound-guided paravertebral blocks (PVB) to treat the chronic pain associated post breast cancer surgery. PVB, when added to standard anesthesia care, was found to have helped prevent post-operative chronic pain.
PVB involves a local anesthetic similar to what is used in dentistry for ‘freezing’ nerves in the area surrounding the breast. General anesthetics are generally administered when a women undergoes breast cancer surgery. Post-surgery, the pain is generally managed using narcotic pain medicines.
The study was led by Faraj W. Abdallah, an anesthesiologist at St. Michael’s Hospital in Toronto, who said, “Sadly, the pain these women experience can be so severely debilitating that it may require treatment by a pain specialist and pain killers.”
The researchers associated with this study wanted to see if PVB added to the general care process would help in prevent chronic pain later on.
Women typically rate their pain on a 1-10 scale, but this scale may not have the specificity to determine the presence of neuropathic pain, which may happen if the nervous system is damaged in a way during surgery. The symptoms can vary widely. Abdallah said, “One patient will lose sensation and not be able to feel a pin prick, another will experience severe pain if the skin is even lightly touched and the next patient may feel constant tingling or pins and needles. Grading pain on a scale of one to 10 fails to capture neuropathic pain symptoms and frequently leads to under-diagnosis.”
For this study, 66 women due to undergo breast surgery were split into two groups. One group took general anesthesia and routine care, and the other received PVB. On analysis, they found that PVB had decreased the post-surgical chronic pain risk by 50 percent.
By jeremyc | February 28, 2015
According to a new study, statins may be lower the risk of liver cancer, even in patients who have diabetes or hepatitis B risk factors. Statins are generally prescribed for reducing cholesterol levels.
The study was led by Katherine A. McGlynn, PhD, of the National Cancer Institute in Bethesda, Maryland. She said, “We found that statin use was associated with a reduced risk of liver cancer, overall. This finding may have particular significance for individuals at increased risk of liver cancer due to the presence of chronic liver disease or diabetes, as our study found that statins were associated with reduced risk in the presence of these factors.”
Previous studies have also suggested that statins could lower liver cancer risk, but they were limited to groups of people whose hepatitis B infection was the greater risk factor for the cancer. For this study, the researchers looked at patients whose risk factors were diabetes as well as the liver disease.
The researchers looked at around 1,200 liver cancer patients and over 4,600 without the cancer. They wrote, “The results of the current study suggest that use of statins among persons at high risk of developing liver cancer, even in low-risk settings, may have a net cancer protective effect.”
By jeremyc | February 27, 2015
The US Food and Drug Administration (FDA) has approved a new once-daily insulin injection, intended for diabetes patients, called Toujeo by Sanofi.
Toujeo has a lower risk of hypoglycemia than its predecessor, Lantus. However, this lower risk is not indicated on its product label, with a warning of the risk still indicated on the label.
The medication consists of insulin, which is a hormone used for regulating blood sugar. Diabetes patients either do not produce enough insulin, which happens in type 1 diabetes, or cannot properly process insulin, which happens in type 2 diabetes.
John Anderson, MD, an internal medicine and diabetes specialist at Frist Clinic in Nashville, Tennessee, said, “Nearly 50 percent of people living with diabetes remain uncontrolled. Despite the proven efficacy of insulin, ensuring effective [dosing] and maintenance can be a challenge for both patients and healthcare professionals due to hypoglycemia concerns. Toujeo provides a new option that may help patients manage their diabetes.”
Insulin injections can help diabetes patients control their blood sugar level and keep it within normal levels. If their blood sugar level is not regulated, they have a greater risk of suffering from health problems like kidney damage and heart disease.
Toujeo is recommended to be administered once a day for diabetes patients to maintain their blood sugar levels. It contains around three times more insulin than Lantus. Its efficacy and safety has been tested by several tests that have involved over 3,500 patients. Apart from hypoglycemia, it also has a risk of upper respiratory tract infection and cold symptoms.
By jeremyc | February 26, 2015
According to a new study, the rate of suicides among middle-aged adults has increased significant in the recent years, and this may have been due to legal or economic issues triggered by the recession.
Angelos Halaris, MD, PhD, a Loyola University Medical Center psychiatrist, said that this study could increase suicide awareness. He said, “The best resource is seeking out a mental health professional in the community where they live or wherever they can get an appointment as promptly as possible. Suicidal thoughts can escalate fairly rapidly to a suicide plan and associated action especially if the person has a tendency to be impulsive. Sharing such thoughts with another person they feel close to, such as spouse, sibling, parent or close friend … can be of significant benefit and protection.”
The study was led by Katherine A. Hempstead, PhD, of the Robert Wood Johnson Foundation in Princeton, New Jersey. The researchers said, “The sharpest increase in external circumstances appears to be temporally related to the worst years of the Great Recession, consistent with other work showing a link between deteriorating economic conditions and suicide.”
For this study, the researchers used data on people aged 40-64 years from 2005-2010 from the National Violent Death Reporting System. They found that 35 percent of suicide cases among middle-aged adults was due to external circumstances, which could include legal, financial or job problems. This reason was more common among men than women (39 percent versus 23 percent). In 40 percent of these external circumstances-caused suicides, a recent life crisis was reported. In 2005-2010, the number of external circumstances-caused suicides rose from 33 percent to close to 38 percent.
The researchers suggested that this increase may have been because of the problems in the job market, and rising healthcare costs, declining health and other financial woes may have also been driving factors.
By jeremyc | February 25, 2015
A study found that bariatric surgery was tied to certain benefits for women who got pregnant later on, such a lower risk of gestational diabetes and overweight babies. However, it was also linked to certain negative effects. For instance, bariatric surgery was linked to a greater risk of underweight babies.
The study was led by Kari Johansson, PhD, who said, “Since bariatric surgery followed by pregnancy has both positive and negative effects, these women, when expecting, should be regarded as risk pregnancies. They ought to be given special care from the maternal health services, such as extra ultrasound scans to monitor fetal growth, detailed dietary advice that includes checking the intake of the necessary post-surgery supplements.”
For the study, the researchers collected data on close to 600 pregnancies that occurred after the women underwent weight loss surgery in 2006-2011. Among these women, 98 percent underwent gastric bypass surgery. The data from this group was compared with that of close to 2,400 pregnancies in women that did not undergo the surgery. The surgery group and control group had the same BMIs.
On analysis, just 2 percent of the surgery group had gestational diabetes, which occurs during pregnancy, while 7 percent in the control group had the condition. Also, 9 percent of the surgery group had larger-than-average babies, as compared to 22 percent of the control group. However, the surgery group was two times more likely to have smaller-than-average babies and shorter pregnancies.
By jeremyc | February 24, 2015
According to a new study, exercise and diet may be able to reduce or prevent knee pain in older adults who are diabetic or overweight.
The authors of this study said, “We found an intensive intervention program of weight loss and exercise reduced the short-term risk for developing knee pain among overweight adults with type 2 diabetes. These findings suggest that diet and exercise may be effective for preventing the development of knee pain. Health care providers should consider recommending diet and exercise to their patients who are overweight or obese as a potentially effective means to prevent the development of knee pain.”
The study was led by Daniel K. White, PT, ScD, of the Department of Physical Therapy at the University of Delaware in Newark. White used data on obese and type 2 diabetes patients from the Action for Health in Diabetes (Look AHEAD) study. From these patients, the researchers looked at close to 3,000 patients who did not report any knee pain.
The patients were 45-76 years old and had a high risk of osteoporosis in their knees because they were obese. They were split into two groups. The intensive lifestyle intervention (ILI) group was given the goal of losing at least 7 percent of body weight and spend at least 175 minutes per week in intensive exercise. The ILI group patients also received extensive support and counselling, a supervised exercise session and dietary education every week.
The second group was the diabetes support and education (DSE) group, and the patients in this group went through three group sessions a year about general eating and exercise guidelines.
After the first year, the ILI patients were found to be 15 percent less likely to have knee pain than DSE group patients. The knee pain risk dropped to 4 percent in the ILI group after four years. However, the researchers found that the benefits of the ILI program did disappear over time, and by the fourth year, the ILI group patients were not likely to be able their exercise and diet recommendations.
By jeremyc | February 23, 2015
According to a new study, active surveillance may be a better option for intermediate-risk prostate cancer patients with a life expectancy of at least 10 years, rather than aggressive treatment.
Doctors grade prostate cancer according to risk, based on a number of factors such as the size and type of cancer and where in the body it has spread to. Low-risk prostate cancer, for instance, is slow-growing and so small in size that it cannot be felt in a physical exam. Active surveillance is a well-accepted treatment of low-risk prostate cancer, and this study indicates that it could be extended to cover more intermediate-risk cases too.
The researchers said, “Our results provide evidence to support active surveillance as an initial approach for men with favorable intermediate-risk prostate cancer.” The study was led by Ann C. Raldow, MD, of Brigham and Women’s Hospital in Boston.
For this study, the researchers looked at data on over 5,500 prostate cancer patients who were treated during 1997-2013. They compared low-risk and intermediate-risk prostate cancer patients who underwent brachytherapy, in which small radiation pellets are used for cancer treatment. On assessing the causes of death for the over 600 patients in the study, just 34 were found to have died of prostate cancer. Moreover, the risk of death was no different for low-risk and intermediate-risk cancer patients.
Aggressive cancer treatment comes with various risks, such as side effects to radiation and medication. Active surveillance is a less aggressive treatment option in which the cancer is observed but not treated unless it is seen to be growing or progressing.
By jeremyc | February 22, 2015
Women suffering from multiple sclerosis (MS) may have fewer antioxidants and anti-inflammatory nutrients in their body than women without MS, according to a new study.
The study was led by Sandra D. Cassard, ScD, of the Johns Hopkins University School of Medicine in Baltimore, who said, “Since MS is a chronic inflammatory disorder, having enough nutrients with anti-inflammatory properties may help prevent the disease or reduce the risk of attacks for those who already have MS.”
Cassard added, “Antioxidants are also critical to good health and help reduce the effects of other types of damage that can occur on a cellular level and contribute to neurologic diseases like MS. Whether the nutritional differences that we identified in the study are a cause of MS or a result of having it is not yet clear.”
With these results, the researchers asked for MS patients to consume more anti-inflammatory nutrients and antioxidants, apart from following their medication and treatment regimes. Antioxidants are naturally made in the body, but some come from diets such as dark chocolates, grains, vegetables and fruits. Anti-inflammatory nutrients are usually found in fish, whole grains and lean meat.
The researchers for this study found that women diagnosed with MS had lower levels of vitamin E, magnesium, folate, quercetin and lutein-zeaxanthin, among others.
By jeremyc | February 21, 2015
A new study has found that radiation therapy was more common for treating prostate cancer than active surveillance or surgery, indicating that these two other treatment options may be underused.
Radiation therapy is known to come with certain side effects, and some cases of prostate cancer can be treated with less aggressive treatments too.
The study was led by Jim C. Hu, MD, of the David Geffen School of Medicine at the University of California, Los Angeles. The authors wrote, “These men may experience considerable detriments of quality of life owing to sexual, urinary, and/or rectal toxic effects associated with these treatments.”
Active surveillance involves close monitoring of the cancer to see if it is advancing, since prostate cancer can sometimes grow so slowly that it never even requires treatment. However, the researchers pointed out that past studies have found that doctors and patients are going for more aggressive treatments.
For this study, the researchers looked at data on over 37,000 prostate cancer patients, all of whom were 65 years or older, from the National Cancer Institute and Medicare. The men were all diagnosed with the cancer in 2004-2007 and they were followed up to 2009.
On analysis, 57.9 percent of the patients underwent radiation therapy, making it the most common treatment. Radical prostatectomy was opted for 19.1 percent of patients, making it the second-most common treatment. Just 9.6 percent opted for active surveillance.
By jeremyc | February 20, 2015
According to a new study, women undergoing compounded hormone therapy (CPT) for menopause were often not made aware of the potential risks of these medications and that the fact they have not yet been proven effective and safe.
The study was conducted by JoAnn V. Pinkerton, MD, of the University of Virginia in Charlottesville, and Nanette F. Santoro, MD, of the University of Colorado School of Medicine in Aurora.
The authors used two surveys to find that women undergoing CHT did not know that the treatment has not yet been approved by the US Food and Drug Administration. They said, “Providers have an educational opportunity to ensure that women considering hormone therapy understand the risks and benefits of inadequately regulated CHT.”
Tiffany Jackson, MD, a gynecologist at Baylor Medical Center at Garland in Texas, said, “A woman may choose to take compounded bioidentical hormone therapy because she has been informed or believes that these hormones are lower risk because they are ‘more natural.’ Furthermore the idea of having a formulation that is custom made for you according to your biochemical profile is very appealing to many women.”
The authors of this study noted that 1-2.5 million women in the country undergo CHT after or during menopause at present. CHT is different from hormone therapies that use FDA-approved formulations, in that they use bio-identical formulations custom-compounded by pharmacists. The resulting formulations vary widely and the therapies are not regulated closely.
This particular study involved two surveys for women of or over the age of 40 years. The first survey involved a little over 2,000 women who underwent FDA-approved hormone therapy or CHT. Just 14 percent of the respondents knew that CHT was not FDA-approved, and 76 percent were not sure.
The second survey of over 800 women found that most of the women had discussed treatments and symptoms of menopause with their doctors.