Cancer Research:Working up a sweat may protect men from lethal prostate cancer ♦ Technique to more effectively diagnose, treat cancer developed

Technique to more effectively diagnose, treat cancer developed A method to better trace changes in cancers and treatment of the prostate and lung without the limitations associated with radiation has been developed.

Socioeconomic factors associated with undergoing surgery for early-stage pancreatic cancer While socioeconomic factors such as race, ethnicity, marital status, insurance status, and geographic location are associated with whether patients with localized pancreatic cancer undergo resection (surgical removal of the tumor), only geographic location is associated with survival in these patients,

Working up a sweat may protect men from lethal prostate cancer A study that tracked tens of thousands of midlife and older men for more than 20 years has found that vigorous exercise and other healthy lifestyle habits may cut their chances of developing a lethal type of prostate cancer by up to 68 percent.

Global task force tackles problem of untreatable cancers and disease relapse: Non-toxic chemicals in plants and foods may be key Many cancer therapies are highly toxic, and even when they appear to work, a significant percentage of patients will experience a relapse after only a few months.  Typically these relapses result from small subpopulations of mutated cells which are resistant to therapy, and doctors who try to address this problem with combinations of therapies find that therapeutic toxicity typically limits their ability to stop most cancers

Every Thing You Need to Know About ADHD

Is your child in constant motion? Does he or she talk incessantly? Or have trouble focusing and prefer to daydream?

Then your child may have attention deficit hyperactivity disorder, or ADHD.

This disorder often begins between the ages of 3 and 6 years, according to the National Institute of Mental Health (NIMH). And it’s not just a childhood disease: ADHD may continue through the teenage years and into adulthood (see sidebar). According to the Centers for Disease Control and Prevention (CDC), approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.

Three types of ADHD are recognized:

• inattentive (trouble focusing, following instructions, and finishing tasks)
• hyperactive-impulsive (constantly on the go, talking excessively, and interrupting others)
• combined (symptoms of both inattention and hyperactivity-impulsivity)

Diagnosing the Disorder

Studies show that the number of children being diagnosed with ADHD continues to increase, from 7.8% in 2003 to 11.0% in 2011, according to the CDC. Tiffany R. Farchione, M.D., a child psychiatrist at FDA, reviews drugs to treat ADHD. She explains that the increase may be due to a greater public awareness of the disorder and psychiatric illnesses in general.

Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with the disorder. In addition, boys are more likely to have the hyperactive-impulsive type, which is easier to spot than the quieter child who is inattentive, says Farchione.

If you suspect your child might have ADHD, see your family doctor or pediatrician, suggests Farchione. Your child’s vision, hearing, and anything else that may contribute to inattention should also be checked. The doctor may

Treatments

FDA has approved two types of medications—stimulants and non-stimulants—to help reduce the symptoms of ADHD and improve functioning in children as young as 6 years.

It may seem counterintuitive, Farchione says, but despite their name, stimulants, which contain various forms of methylphenidate and amphetamine, actually have a calming effect on hyperactive children with ADHD. They are believed to increase brain levels of dopamine—a neurotransmitter associated with motivation, attention, and movement.

FDA has also approved three non-stimulants to treat the symptoms of ADHD: Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). These provide a useful alternative for children who do not tolerate stimulants well. Talk with your healthcare professional about what medications may be best for your child.

In addition to medication, some children with ADHD receive behavioral therapy to help manage symptoms and provide added coping skills. Moreover, concerned parents can reach out to their children’s schools and community support groups for information and guidance on how to cope with ADHD behavior. “It’s helpful to engage with the different individuals who are involved in a child’s life when managing the disorder,” Farchione says.

Testing the Effects of Medication in Younger Children

FDA-approved medications currently on the market have been tested for safety and effectiveness in clinical trials of children ages 6 and above. But once a drug has been approved and is on the market, FDA is now asking for clinical trials with participants of children as young as 4 and 5, Farchione says.

“This is a fairly new policy,” she adds. “We know ADHD medications are being prescribed for younger children, and we think it’s essential that the data from clinical studies reflect the safety and effectiveness for this age group.”

Consequences of Not Treating

Left untreated, ADHD can have serious consequences.

A child may fall behind in school, encounter difficulties in friendships, and have conflicts with parents, says the American Academy of Child and Adolescent Psychiatry.

Studies show that children with untreated ADHD have more emergency room visits and are more likely to have self-inflicted injuries than those treated for the disorder. Untreated adolescents with ADHD are more likely to take risks, such as drinking and driving. And they have twice as many motor vehicle accidents as those who are treated.

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ADHD: Not Just for Kids

Studies suggest that approximately 4% of adults may have attention deficit hyperactivity disorder (ADHD). The symptoms of ADHD in adults are the same as those in children, but they manifest somewhat differently. Adults with ADHD may have poor time management skills and trouble with multitasking, become restless with downtime, and avoid activities that require sustained concentration.

A diagnosis of ADHD in an adult is given only when it’s known that some of the symptoms were present early in childhood, usually under the age of seven.

“For some adults, a diagnosis of ADHD can bring a sense of relief,” says psychiatrist Tiffany Farchione. Receiving a diagnosis allows adults to understand the reasons for their problems, and treatment can help them to deal with challenges more effectively

Only 3 in 10 Americans with HIV have virus in check

New study finds that two-thirds of Americans with virus not in check have been diagnosed,

HIV STAGES OF CARE

There is an urgent need to reach more people with testing and make sure those with the virus receive prompt, ongoing care and treatment.

Just 30 percent of Americans with HIV had the virus under control in 2011, and approximately two-thirds of those whose virus was out of control had been diagnosed but were no longer in care, according to a new Vital Signs report published today by the Centers for Disease Control and Prevention.  The new study underscores the importance of making sure people with HIV receive ongoing care, treatment, and other information and tools that help prevent transmission to others, as well as the need to reach more people with HIV testing.  Among those whose infection was not under control, more than three times the proportion (66 percent) were no longer in care as had never been diagnosed (20 percent).

The HIV epidemic continues to threaten the health and well-being of many Americans – with more than one million people living with the disease in the U.S. and 50,000 new infections each year.

When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Treatment has been shown to reduce sexual transmission of HIV by 96 percent, and U.S. clinical guidelines now recommend that everyone diagnosed with HIV receive treatment, regardless of their CD4 cell count or viral load.

"For people living with HIV, it’s not just about knowing you’re infected – it’s also about going to the doctor for medical care,” said CDC Director Tom Frieden, M.D., M.P.H.  “And for health care facilities, it’s not just about the patients in your care – it’s every person diagnosed, and every person whose diagnosis has not yet been made.  Key to controlling the nation’s HIV epidemic is helping people with HIV get connected to – and stay in – care and treatment, to suppress the virus, live longer and help protect others.”

The new study estimates that of the 1.2 million Americans living with HIV in 2011, 70 percent did not have their virus under control. Among the nearly 840,000 people who had not achieved viral suppression:

• 66 percent had been diagnosed but were not engaged in regular HIV care,
• 20 percent did not yet know they were infected,
• 4 percent were engaged in care but not prescribed antiretroviral treatment, and
• 10 percent were prescribed antiretroviral treatment but did not achieve viral suppression.

The percentage of Americans with HIV who achieved viral suppression remained roughly stable (26 percent in 2009 vs. 30 percent in 2011).

CDC focus on stopping HIV transmission through treatment

CDC has increased the focus on diagnosing people with HIV, supporting linkage to ongoing care and treatment, provision of risk reduction information, and increasing medication adherence.  By making the most of these strategies for those who are HIV-positive, as well as other high impact strategies to protect those who remain uninfected but are at highest risk for HIV, CDC believes substantial progress can be made in reducing new infections.

“There is untapped potential to drive down the epidemic through improved testing and treatment, but we’re missing too many opportunities,” said Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. "Treatment is crucial.  It is one of our most important strategies for stopping new HIV infections."

Current initiatives to promote HIV testing and treatment include innovative partnerships to make HIV testing simple, accessible and routine; programs to help health departments identify and reach out to infected individuals who have fallen out of care; and public awareness campaigns to urge testing and encourage people with HIV to seek ongoing care.

These efforts are an essential component of the National HIV/AIDS Strategy, launched in 2010.  Key goals of the strategy include reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.

Younger adults with HIV least likely to have virus under control

Today’s study also found that viral suppression increased with age, with young people significantly less likely than older age groups to have their virus under control – only 13 percent of people aged 18-24 were virally suppressed, compared to 23 percent among those aged 25-34, 27 percent among those aged 35-44, 34 percent among those aged 45-54, 36 percent among those aged 55-64, and 37 percent among those aged 65 and older. The researchers attribute the disparity in large part to the fact that fewer than half (49 percent) of 18- to 24-year olds with HIV have been diagnosed, underscoring the need for more HIV testing in this population.

“It’s alarming that fewer than half of HIV-positive young adults know they are infected,” said Eugene McCray, M.D., director of CDC’s Division of HIV/AIDS Prevention.  “Closing that gap could have a huge impact on controlling HIV – knowing your status is the first critical step toward taking care of your own health and avoiding transmission to others.”

3D Technologies Poised to Change How Doctors Diagnose Cancers

Scientists at the Food and Drug Administration are studying the next generation of screening and diagnostic devices, some of which borrow from the world of entertainment. Soon, three-dimensional (3D) images in actual 3D might help your doctor find hidden tumors and better diagnose cancers, thanks to the regulatory work being done by a team at FDA’s Division of Imaging, Diagnostics, and Software Reliability.

The team is led by Division Director Kyle Myers, a physicist with a Ph.D. in optical sciences. It includes Aldo Badano, Ph.D., a world-renowned expert in display evaluation technology, and Brian Garra, M.D., a diagnostic radiologist doing research in regulatory science at FDA.

They are studying how clinicians receive visual information and analyze it to diagnose a disease. At the center of their research are breast cancer screening devices, which are making the leap from traditional two-dimensional (2D) screening such as mammography to 3D breast tomosynthesis, 3D ultrasound and breast computerized tomography (CT). This technology is very exploratory and years away from becoming standard in your doctor’s office.

New Era in Breast Cancer Detection

There are many new technologies being developed for breast cancer screening, especially 3D alternatives that may eventually replace today’s 2D mammography. FDA has already approved two of these state-of-the-art devices: The Selenia Dimensions 3D System, which provides 3D breast tomosynthesis images of the breast for breast cancer diagnosis; and the GE Healthcare SenoClaire, which uses a combination of 2D mammogram images and 3D breast tomosynthesis images.

The technologies under development include 3D breast tomosynthesis, which artificially creates 3D images of the breast from a limited set of 2D images. Tomosynthesis reveals sections of the breast that can be hidden by overlapping tissue in a standard mammogram.

“The problem of overlapping shadows has confounded breast cancer screening because mammograms don’t show cancers that are hidden by overlapping tissue,” Myers says. And compounding the problem is overlapping tissue that can look like cancer but isn’t. “The new technologies we’re studying overcome these barriers,” she adds.

Another benefit of 3D breast tomosynthesis: It’s more accurate than mammography in pinpointing the size and location of cancer tumors in dense breast tissue, Myers says. With 3D breast tomosynthesis, doctors can detect abnormalities earlier and better see small tumors because the images are clearer and have greater contrast.

“Clinical studies have shown that 3D breast tomosynthesis can increase the cancer detection rate, reduce the number of women sent for biopsy who don’t have cancer, or achieve some balance of these two goals of this new screening technology,” she adds.

There’s also a lot of research and development in 3D ultrasound, which automatically scans the breast and generates 3D data that can be sliced and examined from any direction. Garra, who is a leader in this field, says 3D ultrasound improves breast cancer detection in women with dense breast tissue.

“Both 3D breast tomosynthesis and 3D ultrasound detect breast cancer. But for radiologists and other doctors, there are many more images to examine, and that can reduce the speed at which studies can be interpreted,” he says.

Another promising technology—the dedicated breast CT system—creates a full 3D representation of the breast. The scan is taken while the patient lies face down on a bed with her breast suspended through a cup and the X-ray machine rotates around it. For patients, the procedure is more comfortable than regular mammography because the breast isn’t compressed. Also, there’s less radiation exposure than during a CT exam of the entire chest because only the breast is exposed to X-rays.

Health care practitioners using this technology have to learn how to read and interpret hundreds of high-resolution images produced by the scanner. But what makes the task easier is that the images have less distortion than mammography, and the system is optimized to differentiate between the breast’s soft tissue and cancer tissue.

“These images will be very different from 2D mammograms. They’re truly 3D images of the breast from any orientation. You can scroll through the slices—up and down, left and right—and get a unique view of the breast like never before,” Myers says. “It gives doctors tremendous freedom in how they look at the interior of the breast and evaluate its structures. It’s almost like seeing the anatomy itself.”

New Era in How We See

How can radiologists look at these images and convert them into three dimensions? That’s where Badano’s work comes in. His research lab is exploring various display device technologies to improve how radiologists review 3D images. The studied technologies include devices supported by mobile technologies and special-purpose 3D displays developed specifically for 3D imaging systems.

“These are no longer conventional images, so you need to examine them in the 3D space,” he says. “Using a 2D display might no longer be ideal.” Device manufacturers are building on technologies developed primarily for other markets, including the gaming industry, to show 3D images in actual 3D. But the work is painstaking and far from ready for a medical use.

“As people have experienced in movie theaters and when playing videogames, 3D displays have problems, including the image resolution and added noise. When wearing 3D glasses, our brain needs to separate the images from the left eye and the right eye and reconstruct a 3D object,” Badano says. “In the lab, we’re doing experiments to see how different technologies handle these tradeoffs.”

One of the challenges is that 3D displays for medical imaging require better resolution. For a medical use, the specifications are high—“and so are the stakes,” he adds.

3/26/14 Health News: Three Ways to Take Action on Ocean Health ♦ New Way to Reduce E. Coli in Cows ♦ Smartphones Diagnose Diseases ♦ China 'Has Halved its TB Problem

Three Ways to Take Action on Ocean Health

The earth isn't called the “blue marble” for nothing: All life on Earth is linked to our oceans, including the oxygen we breathe, the plants and fish that we eat, and the moderation of weather patterns all around us.

Despite their key role, oceans are taken for granted. People expect that oceans will keep providing us with life-sustaining services. But the reality is, without swift and wide-scale action, they won’t.They can’t.Continue Reading

University of Florida Finds Way to Reduce E. Coli in Cows, Improving Food Safety

By: Brad Buck, University of Florida A new biological treatment could help dairy cattle stave off uterine diseases and eventually may help improve food safety for humans, a University of Florida study shows. Kwang Cheol Jeong, an assistant professor in … Continue Reading

Smartphones to Diagnose Diseases in Real Time

A team from the US is developing a disease diagnostic system based on nanotechnology that will only require a smartphone and a $20 lens attachment to read results. While there are still some challenges to overcome, they are hopeful the end result will be an affordable diagnostic tool that can be used in the field. Continue Reading

China 'Has Halved its TB Problem,' Survey Data Suggests

China has more than halved its tuberculosis (TB) prevalence, with rates falling from 170 to 59 per 100,000 population, figures suggest. The Lancet report says the success is due to a huge expansion of a community-based disease control programme. The World Health Organization says other countries could use a similar approach. China is a major contributor to the global TB pandemic, accounting for more than one-tenth of cases worldwide.Continue Reading

Attempts Too Diagnose Autism Earlier

Eye Contact Declines in Young Infants with Autism

Beginning as young as 2 months of age, infants later diagnosed with autism show a steady decline in eye contact that might be the earliest marker yet for the disorder. If confirmed, the finding might lead to earlier autism diagnosis and treatment.

Autism is a complex brain disorder that affects about 1 in 88 children. A main symptom is impaired social interaction, including a lack of eye contact. Autism symptoms first appear during early childhood, and a definitive diagnosis can often be made by 2 years of age. Scientists have long been searching for ways to identify the condition at even younger ages, since outcomes tend to be better with earlier intervention.

In hope of finding an autism marker that’s present in the first months of life, Drs. Warren Jones and Ami Klin of Emory University School of Medicine studied eye movements in a group of 110 infants starting at 2 months of age. The infants were separated into 2 groups based on their risk for developing autism spectrum disorder. Those in the high-risk group had an older sibling already diagnosed with autism; those in the low-risk group did not. The research was funded in part by NIH’s National Institute of Mental Health (NIMH). Results were reported online in Nature on November 6, 2013.

Using eye-tracking equipment, the scientists measured the children’s visual scanning as they watched videos of a caregiver. The researchers calculated the percentage of time each child fixated on the caregiver’s eyes, mouth, body, or nonhuman regions of the images. Children were tested at 10 different times between 2 and 24 months of age.

By 3 years of age, 12 of the 59 children in the high-risk group (about 20%) and one child in the low-risk group had been diagnosed with an autism spectrum disorder. The researchers then reviewed the eye-tracking data to see what factors differed between those who had received an autism diagnosis and those who hadn’t.

At 2 months of age, attention to eyes (eye-looking) was similar in children with and without an autism diagnosis. But between 2 and 6 months, eye-looking behavior began to drop in the children later diagnosed with autism. The decline continued throughout the course of the study. By 24 months, the children with autism focused on the caregiver’s eyes only about half as long the children without autism.

The researchers were surprised to find that eye-looking behaviors appeared normal at 2 months of age, since a long-standing theory holds that social behaviors are entirely absent in children with autism. The finding suggests that some social engagement skills initially may be intact in newborns later diagnosed with autism.

“This insight, the preservation of some early eye-looking, is important,” says Jones. “In the future, if we were able to use similar technologies to identify early signs of social disability, we could then consider interventions to build on that early eye-looking and help reduce some of the associated disabilities that often accompany autism.”

The scientists are now enrolling babies and their families into longer term studies in an effort to translate their findings into usable tools for the clinic.

Originally published by the NIH

11/16/13 Health News:, Disease Diagnosing Smartphone, Labeling Meat for Growth Chemicals,

USDA INTRODUCES CERTIFICATION PROGRAM FOR MEAT WITHOUT GROWTH-ENHANCING DRUGS

A new U.S. Department of Agriculture certification program for livestock producers may permit them to market their products with a special “Never Fed Beta Agonists” label. Beta agonists are feed additives used to increase muscle mass and promote weight gain in livestock animals. The drugs are typically added to feed along with vitamins and given...Continue Reading

FDA SHOULD EXPAND FOCUS AND ADOPT FOOD SYSTEMS APPROACH TO SAFETY

Want to hear something delicious? Recently the Food and Drug Administration reported that 12 percent of all U.S. spice imports were contaminated with non-spice-like objects, including whole insects and rodent hairs. As Americans, we are lucky to have FDA, which has been (for years) comprehensively studying the issue of spice safety and is moving toward... Continue Reading

Health IT Could Reduce Demand For Physicians

If health IT were fully implemented in 30% of community-based physicians' offices, the gains in efficiency would reduce demand for physicians by 4% to 9%, according to a new study in Health Affairs. If 70% of office-based physicians adopted comprehensive health IT -- including interoperable EHRs, clinical decision support, provider order entry and patient Web portals with secure messaging -- the impact on physician workforce requirements would be twice as large, the study said.

In addition, the study pointed out, 5% to 10% of real-time "office-based care" could be delivered remotely by providers whose patients are not in the physician's office. Continue reading

Utah Physician Invents Disease-Diagnosing Smartphone App

Intermountain Medical Center physician Joel Ehrenkranz has invented a smartphone app that diagnoses diseases. To show how his i-calQ app works, Ehrenkranz drew a small amount of blood from Brittnie, an expectant mother. She was not in a clinic or a lab, but outside in a small park. Ehrenkranz placed the blood sample in a holder then inserted it into an inexpensive reader attached to a smartphone.  In one minute, the smartphone had the results of her blood hemoglobin. Within 15 minutes, it had evaluated her thyroid test.

…Ehrenkranz got the idea for this new technology in 2007 while working on the border between Uganda and the Congo. During an Ebola outbreak he theorized the beginnings of smartphone technology that could evolve into an immediate diagnosing tool. continue reading

Problems in Diagnosing Epilepsy

Many People with Epilepsy have more than one condition. If more physicians became aware of and understood how often adults with epilepsy reported other medical conditions, these physicians could then screen, diagnose, and treat these conditions to prevent complications in patients with epilepsy.

Epilepsy is a group of disorders all involving recurring seizures but of different types, causes, and severity. Epilepsy affects about 2.3 million U.S. adults. Adults with epilepsy more often report other conditions affecting the heart, lungs, skin, joints, and stomach, as well as pain complications compared to people without epilepsy.

If more physicians became aware of and understood how often adults with epilepsy reported these medical conditions, physicians could then screen, diagnose, and treat these conditions to prevent complications in patients with epilepsy. Physicians can also work with other healthcare providers, public health agencies, the Epilepsy Foundation, and other groups to ensure that adults with epilepsy can manage their epilepsy.

] In many cases a cause of Epilepsy cannot be identified; however, factors that are associated include brain trauma, strokes, brain cancer, and drug and alcohol misuse among others.

Nearly 80% of epilepsy occurs in developing countries. Epilepsy becomes more common as people age. Onset of new cases occurs most frequently in infants and the elderly. Epileptic seizures may occur in recovering patients as a consequence of brain surgery.

Epilepsy is usually controlled, but not cured, with medication. However, more than 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms, all involving episodic abnormal electrical activity in the brain and numerous seizures.

Source CDC