Cellphone and cancer

Dr. Ronald B. Herberman, the director of the University of Pittsburgh Cancer Institute, notes that while the evidence about a cellphone-cancer link remains unclear, people should take precautions, particularly for children.

“Really at the heart of my concern is that we shouldn’t wait for a definitive study to come out, but err on the side of being safe rather than sorry later,” Dr. Herberman told The Associated Press.

Earlier this year, three prominent brain surgeons raised similar concerns while speaking on “The Larry King Show.” Their concerns were largely based on observational studies that showed only an association between cellphone use and cancer, not a causal relationship. The most important of these studies is called Interphone, a vast research effort in 13 countries, including Canada, Israel and several in Europe.

Some of the research suggests a link between cellphone use and three types of tumors: glioma; cancer of the parotid, a salivary gland near the ear; and acoustic neuroma, a tumor that essentially occurs where the ear meets the brain. All these tumors are rare, so even if cellphone use does increase risk, the risk is still very low.

On Wednesday, Dr. Herberman sent a memo to about 3,000 faculty and staff saying that children should use cellphones only for emergencies because their brains are still developing. He advised adults to keep cellphones away from the head and use the speakerphone or a wireless headset, he said.

“Although the evidence is still controversial, I am convinced that there are sufficient data to warrant issuing an advisory to share some precautionary advice on cellphone use,” he wrote in his memo.

Source:

Red Bull gives you wings - and heart trouble?

Source: Times Online

 HIV dates back to around 1900

SOURCE: Nature

 Skin changes in postmenopausal women unaffected by hormone therapy

05 September 2008

SOURCE: J Am Acad Dermatol 2008; 59:397-404

Age-related facial skin changes in postmenopausal women are unaffected by long-term hormone therapy, according to findings published in the Journal of the American Academy of Dermatology.

Declining estrogen levels are associated with a variety of skin changes in postmenopausal women, such as decreased skin thickness, collagen content and elasticity, increased fine wrinkling and dryness, and impaired wound healing. Many of these changes are reportedly reversed or improved by estrogen supplementation.

Phillips and team evaluated the effects of continuous combined norethindrone acetate (NA) and ethinyl estradiol (EE) in the control of mild-to-moderate age-related skin changes in 485 women who were, on average, 5 years postmenopausal. The women were randomly assigned to receive double-blind treatment with placebo, 1 mg NA/5 µg EE, or 1 mg NA/10 µg EE, for 48 weeks.

At week 48, there were no significant differences between placebo and the hormone therapy groups with regard to the primary endpoints: investigator global assessment of coarse and fine facial wrinkling, and patient self-assessment of changes in wrinkling. Instead, slight decreases for both endpoints were observed in all three treatment groups.

There were also no significant differences among the three treatment groups for the secondary endpoints. Secondary endpoints included investigator global assessment and patient self-assessment of skin laxity/sagging and texture/dryness, as well as wrinkle depth and skin elasticity.

"It is possible that longer treatment duration, or different formulations or doses of estrogen, might have more positive effects," comment Phillips and team. "Differing progestogen combinations and examination of nonphotodamaged skin might also demonstrate different outcomes."

Phillips and colleagues note that a marginally significant overall treatment effect was observed in the subgroup of women who were less than 24 months postmenopausal (n=57).

Despite the result being unreliable due to the small sample size, and the fact that the current study was not designed to look at women who were in the early postmenopausal period, the researchers say that "future studies in this group would be of interest, particularly as hormone therapy given close to menopause appears to be safest."

Doctors' dress code

Obesity in adolescent Tehrani students: an epidemic health problem

iranderma news

Overweight has become a public health problem in most developing countries. Evidence suggests that adolescence is a critical period in determining adulthood obesity and its complications.Based on a study done by Dr.Ahranjani and colleagues (Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Shaheed Beheshti University of Medical Sciences and Health Services), published recently in journal of public health (Public Health Nutr. 2004 Aug;7(5):645-648.) overweitght should be considered an epidemic health problem among adolescent students, especially girls, in Tehran. In this study, which was conducted in Tehran, the capital city of Iran, body weight and height were measured and body mass index (BMI) values were calculated in 2321 Tehrani students.The results showed that the overall prevalences of overweight and obesity were 21.1 and 7.8%, respectively. The prevalence of overweight among girl students (i.e. 23.1%; 95% confidence interval (CI) 20.8-25.4) was significantly higher than that among boys (i.e. 18.8%; 95% CI 16.5-21.1, P=0.01) even after adjustment for age .In both sexes, median values of age-specific BMI in this study were statistically higher than corresponding values collected in Tehrani adolescents 10 years ago (P=0.03).

Massage can ease pain after surgery

December 17, 2007

Massage can ease pain after surgery and may complement the use of drugs for patients, U.S. researchers said on Monday.

In a study of 605 men 64 years and older who had major surgery, 200 received nightly 20-minute back massages for four days. On a scale of
1 to 10, those who got massages reported their pain diminished one level faster than those who did not.

All participants got comparable dosages of pain-relieving drugs such as morphine. One-third were not comfortable getting massages, so those who did may have been more appreciative and might have reported more pain relief, the study said.

"The effectiveness of massage in reducing both the intensity and unpleasantness of pain suggests that it may act through more than one mechanism," Allison Mitchinson of the Veterans Affairs Ann Arbor Healthcare System in Michigan wrote in the Archives of Surgery.

"Massage may ameliorate suffering by helping to relieve the anxiety that so effectively synergizes with pain to create distress."

Massage to relieve pain dates to Hippocrates, the Greek physician recognized as a father of medicine.

Massage can dilate blood vessels, raise skin temperature and relax the mind and body. It can also reduce lactic acid levels in aching muscles, stimulate healing of connective tissues and increase lymphatic and blood circulation.

Massage may also create mood-boosting endorphins that offer a competing sensation, or may even block pain, the study said.

One problem is that nurses in modern-day hospitals rarely have time to give massages, it said.

Relieving pain with drugs has been controversial because of wariness among some care-givers and patients about dependency or addiction.
Some studies have pointed to a tendency to not give patients enough pain-relieving drugs....


SOURCE: Reuters

Psoriasis can be a life-threatening disease

Psoriasis is not generally thought of as life- threatening, but it just might be for those with the severest forms of the disease.

People with severe psoriasis had a 50% increased risk of death compared with people without the inflammatory skin disease in a newly reported study.

Men with severe psoriasis died an average of 3.5 years earlier than men without the condition, while women with severe psoriasis died 4.4 years earlier than women without psoriasis.

Having mild psoriasis was not associated with an increased risk of death, and the researchers did not have information on causes of death.

But researcher Joel M. Gelfand, MD, says the findings make it clear that patients with severe psoriasis are at greater risk than has been realized.

"To put this in perspective, this finding suggests that more years of life are lost related to severe psoriasis than to severe hypertension," he tells WebMD.
Psoriasis and Death

As many as 7.5 million Americans have psoriasis, according to the National Institutes of Health.

About 80% to 85% of patients have mild to moderate psoriasis, while 15% to 20% have more extensive skin involvement. These patients generally require treatment with systemic medications like the drugs methotrexate and cyclosporine or newer biologics such as Enbrel, Remicade, and Humira.

Using a national medical records database from the U.K., Gelfand and colleagues from the University of Pennsylvania School of Medicine identified 133,568 patients with mild psoriasis, defined as having a diagnosis of psoriasis but no history of treatment for the condition.

An additional 3,951 patients were identified with severe psoriasis.

For each patient, up to five people without psoriasis who visited doctors for other causes were used for comparison.

During the study period, the death rate among patients with severe psoriasis was almost twice as high as in patients without psoriasis
(21.3 deaths per 1,000 individuals per year vs. 12 deaths per 1,000 individuals per year).

During the study period, patients with severe psoriasis had a 50% increased risk of death compared with those without psoriasis. Those with milder psoriasis didn't have an increased risk of death compared to those without psoriasis.

The study appears in the December issue of the Archives of Dermatology.
Is Inflammation to Blame?

Earlier research by Gelfand and others found that people with severe psoriasis are at increased risk for a wide range of chronic conditions, including heart disease.

Psoriasis is now widely believed to be an autoimmune disease involving inflammation and the accelerated growth of skin cells and blood vessels, which produce the swollen, red lesions characteristic of the condition.

"One theory is that this chronic inflammation impacts other organs and systems within the body," Elizabeth Horn, PhD, of the International Psoriasis Council tells WebMD.

Inflammation within the body is increasingly recognized as a major contributor to a host of life-threatening conditions.

"We know that chronic inflammation is bad for a variety of organs and that it is probably involved in a number of chronic diseases, including cardiovascular disease and diabetes," Gelfand says.

Horn says the latest research should serve as a wake-up call to patients and their doctors that severe psoriasis is a serious disease.

"We are learning that there is something happening in people with severe psoriasis that may not be happening with milder forms of the disease," she says.

Horn and Gelfand agree that patients with severe psoriasis need to be especially vigilant about taking care of their overall health.

"It is very important for these patients to see their internist regularly, to have age-appropriate screenings, and to have their cardiovascular risks assessed and treated, if necessary," Gelfand says.

SOURCES: Gelfand, J.M., Archives of Dermatology, December 2007

FDA Investigates Possible Link Between Singulair and Suicidal Behavior

The FDA has issued an early communication about potential associations between the asthma and allergy drug montelukast (Singulair) and behavior and mood changes, suicidality, and suicide, based on postmarketing reports.

The agency's investigation was triggered by three or four reports of suicide since October, according to the Associated Press.

Until more information becomes available, healthcare providers should monitor patients taking Singulair for mood changes and suicidal thinking and behavior, the FDA says. The agency asks that clinicians and patients report side effects on its MedWatch site.

In addition, the agency is reviewing postmarketing reports of similar behavior in patients taking other leukotriene-modifying medications, including zafirlukast (Accolate) and zileuton (Zyflo and Zyflo CR).

 

Be more careful in holidays! 

 Americans are more likely to die on Christmas Day, the day after Christmas, and on New Year's Day than on any other day of the year.

In a comprehensive study of 53 million U.S. death certificates spanning the years 1973-2001, researchers discovered significant spikes in both cardiac and non-cardiac deaths during the holidays. They also warned this trend is on the rise.

"From the point of view of a public health problem, it's something that's getting worse over time rather than better," said lead researcher David Phillips, a professor of sociology at the University of California at San Diego.

He believes the phenomenon may stem from patients' tendency to postpone medical care during the holidays, as well as holiday-specific staffing patterns at hospitals nationwide.

The findings appear in the Dec. 14 issue of Circulation.

Philip and his colleagues found that three days -- Dec. 25 and 26, and Jan. 1 -- were the worst in terms of deaths from both cardiac and non-cardiac causes.

"In the case of heart deaths, there's an 11.9 percent excess [of deaths] on those days" beyond what would normally be expected during that season, Phillips said.

"In the case of the non-heart deaths for those three days, what you find is an extra 12.2 percent of deaths," he added.

The observed spikes in death rates were especially sharp among individuals who died soon after onset of their symptoms -- patients who were dead on arrival (DOA) by the time they reached emergency care. During the holidays, DOA rates climbed by nearly 5 percent over normal, the researchers found.

Why the sharp rise in deaths around the holidays? According to Phillips, a close examination of data ruled out likely suspects such as cold weather or changes in diet and exercise patterns. For example, he said, the rise in holiday deaths was seen even among nursing home patients, whose diets and activities tend to be strictly controlled.

Kloner suggested that the emotional stress associated with the holiday season might be to blame -- things like "dealing with relatives whether you like them or not, financial stresses, and travel during the holidays."

But Phillips disagreed. He pointed out that the Christmas and New Year's Day peaks in mortality were also seen among individuals affected by advanced Alzheimer's disease. "Many of these people don't even understand anymore that there is a holiday going on," he said. Based on that finding, "we don't think the evidence points neatly toward the idea of emotional stress playing a role," Phillips said.

Instead, two factors -- patient attitudes to symptoms and hospital staffing changes -- appear most likely to blame, he said.

According to Phillips, too many patients adopt an "'I'll take care of that later'" attitude when presented with unsettling symptoms during the holidays.

"They underuse urgent-care facilities. That's been shown in previous studies," he said. There's also the added complication of holiday travel. According to Phillips, individuals far away from their doctors may choose to put off needed care until their return.

Holiday staffing patterns at hospitals may play a key role, as well. "It could be there's reduced levels of health-care staffing, or staff members who are unfamiliar with individual patients," Kloner said.

According to Phillips, more study needs to be done to see if better hospital staffing practices can reduce the holiday rise in mortality.

The findings are much more than a minor statistical bump, he said. According to the study, the "holiday effect" may account for an additional 42,039 U.S. deaths over the study period.

And it's a trend that's been growing in significance year by year, the researchers add. According to the study, the first three years of data (1973-1975) pegged excess holiday mortality at just 0.95 percent above what would be expected during the winter months. By the study's end, 1999-2001, that bump had risen nearly fivefold, to 4.4 percent above seasonal norms.

"This effect is getting bigger over time," Phillips said. "It seems risky to ignore it."

SOURCE: healthday

Patients With Psoriasis are At Increased Risk For Developing Other Serious Medical Conditions

It has long been known that psoriasis, a chronic skin condition characterized by thick, red, scaly plaques that itch and bleed, can have a significant negative impact on a patient's overall quality of life. Now, dermatologists are finding that psoriasis, especially severe psoriasis, is linked with a number of serious medical conditions -- including cardiovascular disease, depression and cancer. 

In the report entitled, "National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening," published online in the Journal of the American Academy of Dermatology, dermatologist Alexa B. Kimball, MD, MPH, FAAD, associate professor of dermatology at Harvard Medical School in Boston, Mass., led a task force of the National Psoriasis Foundation Medical Board that explored psoriasis co-morbidities. The group presented a summary of recently published research on the association between psoriasis and other medical conditions and recommendations on how dermatologists can help at-risk patients find appropriate preventative care or treatment. 

"Our review found that people with more severe cases of psoriasis appear to have an increased incidence of psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer, depression, obesity and even other immune-related conditions such as Crohn's disease," said Dr. Kimball. "I advise patients at minimum to follow the nationally recognized recommendations that are appropriate for their age and gender. These include getting regular, comprehensive exams from their doctors and working to make lifestyle changes such as losing weight, exercising more, quitting smoking, reducing high blood pressure, controlling cholesterol, maintaining emotional health, and managing diabetes as needed." 

Cardiovascular Risk 

Dr. Kimball noted that psoriasis has been associated with increased cardiovascular disease for decades. Initially, this was attributed to the increased prevalence of behavioral risk factors -- such as obesity and smoking, which are thought to be linked to the psychosocial burden of psoriasis. However, two recent studies have enhanced dermatologists' understanding of cardiovascular risk in psoriasis patients. "One large population-based study demonstrated an increased risk of myocardial infarction in patients with psoriasis --particularly those with severe cases of the disease -- even when accounting for major cardiovascular risk factors, such as obesity, smoking, diabetes and hypertension," explained Dr. Kimball. 

"Similarly, a small study of a well-defined population of patients with very severe psoriasis demonstrated that these patients had ahigher frequency of coronary artery disease compared to a control group of patients, even when controlling for known risk factors for atherosclerosis. Taken together, these studies suggest that psoriasis itself may be a risk factor for developing atherosclerosis and myocardial infarction."

 Other factors that may increase the risk of cardiovascular disease include behavioral-driven risk factors such as obesity, smoking and  depression. These risk factors can be modified by changes in lifestyle, including maintaining a healthy weight (often measured by Body Mass Index (BMI) < 25), physical activity for 30 minutes of moderate intensity several times a week and healthy eating habits. Dr.Kimball also recommended that psoriasis patients who smoke stop smoking.

 Depression

 Psoriasis has long been known to cause considerable emotional stress for patients, including a lack of self-esteem and an increased incidence of mood disorders, such as depression. One study estimates that approximately one-fourth (24 percent) of psoriasis patients suffer from depression.

 "Depression in patients with psoriasis is a serious concern that should be addressed, as it may significantly impact a patient's overall emotional and physical well being," said Dr. Kimball. "Another concern is that depression may be a contributing factor to an increased risk of cardiovascular disease, which as we know is already an increased risk in psoriasis patients."

 Cancer

 A number of studies have found an increased risk of certain types of cancer in psoriasis patients, such as a form of skin cancer known as squamous cell carcinoma and lymphoma. In some instances, these cancers have been associated with specific psoriasis treatments which suppress the immune system. "Following the recommended routine health screenings for cancers and avoiding high-risk behaviors that increase the risk of developing some cancers, such as smoking, alcohol abuse, and intentional sun exposure, must be a high priority for psoriasis patients who may be at an increased risk for these potentially life-threatening diseases," said Dr. Kimball.

 Article URL: http://www.medicalnewstoday.com/articles/101524.php

Shisha; more dangerous than cigarette

June 01, 2008

A new study finds that the use of water pipes may be on the rise among college students. Some believe that smoking tobacco this way is less dangerous than smoking cigarettes —which is not the case, the researchers say. 

The study, which appears in the May issue of The Journal of Adolescent Health, looked at water-pipe use among students at Virginia Commonwealth University. It found that of more than 700 students surveyed, more than 40 percent reported having used a water pipe in the previous year. 

The pipes, often called hookahs or shishas, are perhaps best known in the Middle East and are used to smoke flavored and sweetened tobacco. The tobacco is heated over charcoal, and then is cooled as it passes through a bowl of water and is inhaled from a hose. 

Despite the belief of some students, water pipes may expose users to more toxic materials than cigarettes. Each puff has as much as 100 times the smoke as a puff from a cigarette, the study said. And smokers are also inhaling fumes from the charcoal. 
 

Robotic Hair transplant

June 2008

A robot that can pluck and move individual hair follicles on a person's head makes hair transplants look more natural than those performed by humans, a US company claims. 

The robot can also perform the procedure twice as fast as human clinicians, with less pain and scarring for the patient, says Restoration Robotics of Mountain View, California. 

Standard hair transplants typically take 8 to 10 hours. A strip of healthy, hairy scalp 1 centimetre wide and 15 cm long is removed from the back of the head under local anaesthetic. 

After the gap is sewn up, medical staff then manually separate the strip into 2000 individual hair follicle "bulbs". These are painstakingly implanted in 1-millimetre wide incisions across bald parts of the head.

"It's a lot like gardening," says Rogers. "Removing the strip is like pulling turf and implantation is like planting bulbs."

But Frederic Moll of Restoration Robotics says the expensive (from around £3000, or $5800), time consuming and repetitive task needs automating. 

Instead of removing a strip of scalp, which is painful and carries the risk of infection, his robot plucks healthy follicles individually, at a rate up to 1000 an hour...

...The robot has another advantage over manual transplants – the ability to design somebody's hairline on a computer. This can help give the transplanted hair a more natural look... 

Dark Circles

In recent years, the drumbeat against under-eye circles has grown louder.

“Dark circles around the eyes can be unsightly,” declares one advertisement for an eye cream. An advertisement for Hylexin cream features a pale model with black stripes under her eyes, like a football player, for dramatic effect. And just in case you think you are overreacting, the ad reinforces the notion that dark circles are indeed a flagrant shortcoming.

Roughly 53 percent of the 13,000 Clinique users surveyed by the company in 2006 cited under-eye circles and puffiness as their No. 1 beauty concern.

“We were really shocked,” said Dr. Mammone, who has a Ph.D in molecular and cellular biology. “We knew many of our people in distribution and sales suggested that it was a concern, but we didn’t really know until the survey that it is a major issue.”

Sales of anti-aging skin care treatments, which include products designed to get rid of dark circles, increased to $1.08 billion in 2006, up from $588 million annually in 2001, according to Mintel, a market research firm. No one specifically tracks the market for dark-circle remedies.

Taming dark circles is tricky.

There are a lot of factors that contribute to quote-unquote dark circles.

Most people think dark circles are a telltale sign of tiredness, or the unsightly evidence of a binge involving one too many margaritas. That is true to a certain extent, as fatigue makes skin dull, and drinking alcohol dehydrates and thins the skin.

But the most likely culprit causing chronic dark circles, dermatologists say, is excess pigmentation in the skin. Dark circles are prevalent on all skin colors and types, but they especially trouble African-Americans, Southeast Asians and Southern Italians. Beach bunnies should note: sun exposure exacerbates dark circles.

Dilated blood vessels that sit close to the thin under-eye skin are another cause, doctors said.

Aging, which causes skin to thin, can darken the eye area, as can certain medications such as birth control pills, which can dilate blood vessels.

The problem is that few, if any, of the creams on the market are formulated for people with excess pigmentation or dilated veins.

Multiple creams are available, however it is unclear how effective they are!

Source:

Intensive therapy to target normal glycated hemoglobin levels do not reduce major cardiovascular events.