Early HIV Treatment Might Save Livelihoods as Well as Lives

Scientific American – 7 hrs ago People can work more when their ailments are treated. And HIV is no exception. Adults who tested positive for HIV in Uganda but had a less severe infection were able to work more hours per week, and their kids were more likely to be in school, according to findings presented July 26 at the 2012 International AIDS Conference in Washington, D.C.

If this correlation holds up in further research, more widespread testing and earlier treatment could mean greater earning potential for individuals

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All HIV Patients Should Take Meds Early On, Experts Now Say

HealthDay – 1 hr 41 mins ago MONDAY, July 23 (HealthDay News) -- A new report recommends that physicians begin treating all HIV-positive adults with antiretroviral drugs instead of waiting, at least in countries where the therapy is easily accessible.

All HIV-positive patients should take the drugs, even if blood tests reveal that their immune system is healthy, according to the revised guidelines, which were presented Sunday at the International AIDS Conference in Washington D.C., and published in the July 25 issue of the Journal of the American Medical Association.

Over the last 25 years, antiretroviral drugs have become stronger, easier to tolerate and simpler to take, the authors of the report explained. "New trial data and drug regimens that have become available in the last two years warrant an update to guidelines for antiretroviral therapy in HIV-infected adults in resource-rich settings," Dr. Melanie Thompson and her 2012 International Antiviral Society-USA Panel colleagues said in the report.

While medications don't rid the body of HIV -- the virus that causes AIDS -- they can prevent the virus from replicating and have allowed millions of people to live for years with a greatly reduced threat of developing AIDS, experts have noted.

However, not every person infected with HIV takes the medications. In some cases, doctors prefer to wait until a patient's immune system begins to show signs that the virus is becoming stronger.

The reasons why doctors sometimes wait to prescribe antiretroviral medications may be because the drugs can cause side effects, and there's also the challenge that patients must keep taking them or take the risk that the virus will rebound.

Commenting on the report, Rowena Johnston, director of research with the Foundation for AIDS Research in New York City, explained, "We can't lose sight of the fact that this is a big commitment. Once you start, you can't stop."

The report recommends that initial treatment include two nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine

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All HIV Patients Should Take Meds Early On, Experts Now Say

HealthDay – 1 hr 41 mins ago MONDAY, July 23 (HealthDay News) -- A new report recommends that physicians begin treating all HIV-positive adults with antiretroviral drugs instead of waiting, at least in countries where the therapy is easily accessible.

All HIV-positive patients should take the drugs, even if blood tests reveal that their immune system is healthy, according to the revised guidelines, which were presented Sunday at the International AIDS Conference in Washington D.C., and published in the July 25 issue of the Journal of the American Medical Association.

Over the last 25 years, antiretroviral drugs have become stronger, easier to tolerate and simpler to take, the authors of the report explained. "New trial data and drug regimens that have become available in the last two years warrant an update to guidelines for antiretroviral therapy in HIV-infected adults in resource-rich settings," Dr. Melanie Thompson and her 2012 International Antiviral Society-USA Panel colleagues said in the report.

While medications don't rid the body of HIV -- the virus that causes AIDS -- they can prevent the virus from replicating and have allowed millions of people to live for years with a greatly reduced threat of developing AIDS, experts have noted.

However, not every person infected with HIV takes the medications. In some cases, doctors prefer to wait until a patient's immune system begins to show signs that the virus is becoming stronger.

The reasons why doctors sometimes wait to prescribe antiretroviral medications may be because the drugs can cause side effects, and there's also the challenge that patients must keep taking them or take the risk that the virus will rebound.

Commenting on the report, Rowena Johnston, director of research with the Foundation for AIDS Research in New York City, explained, "We can't lose sight of the fact that this is a big commitment. Once you start, you can't stop."

The report recommends that initial treatment include two nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine

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Whoppers of 2012, Early Edition

unfortunately. The contest so far has been nasty all right, and disregard for the truth has been brutish on both sides, in our judgment. But alas, it won’t be over until Nov. 6.

So many false and misleading claims have already surfaced that, once again, we are moving up the clock on our annual wrap-up of the campaign season’s worst political whoppers, as we did four years ago. We’d like to think there would be no need for a

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Timeline Detected for Rare, Early Alzheimer's

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Nutrient Drink Might Boost Memory in Early Alzheimer's: Study

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Kids Born Even a Little Early Have Lower School Scores: Study

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Early full-term babies may face later school woes

Even for infants born full-term, a little more time in the womb may matter.

The extra time results in more brain development, and a study suggests perhaps better scores on academic tests, too.

Full-term is generally between 37 weeks and 41 weeks; newborns born before 37 weeks are called premature and are known to face increased chances for health and developmental problems.

The children in the study were all full-term, and the vast majority did fine on third-grade math and reading tests. The differences were small, but the study found that more kids born at 37 or 38 weeks did poorly than did kids born even a week or two later.

The researchers and other experts said the results suggest that the definition of prematurity should be reconsidered.

The findings also raise questions about hastening childbirth by scheduling cesarean deliveries for convenience

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Fossilized Teeth Hold Clues to Early Human Species' Diet

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WHO target to cut early chronic illness deaths

"An Indian nurse collects a blood sample from a patient using a glucometer at a diabetic health check up centre in Hyderabad. The World Health Organization has announced it is set to approve a new target to reduce premature deaths from chronic illnesses such as heart disease by a quarter by 2025. (AFP Photo/Noah Seelam)" title

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Research With Dogs Points to Early Test for Arthritis

HealthDay – Fri, May 18, 2012 FRIDAY, May 18 (HealthDay News) -- A new test that can detect and predict osteoarthritis before patients experience symptoms was developed by analyzing the joints of dogs with arthritis.

Osteoarthritis, the most common form of arthritis, affects more than 27 million adults in the United States. Early detection of the disease, which causes pain and swelling in the joints, would allow better treatment options, according to the University of Missouri researchers.

They said their test can be conducted using a single drop of fluid from a patient's joint. The fluid is obtained with a small needle.

"With this biomarker test, we can study the levels of specific proteins that we now know are associated with osteoarthritis," James Cook, a professor of orthopedic surgery and a researcher at the MU College of Veterinary Medicine, said in a university news release.

"Not only does the test have the potential to help predict future arthritis, but it also tells us about the early mechanisms of arthritis, which will lead to better treatments in the future," he explained.

Cook and his colleagues used dogs to develop the test, noting that dog joints operate similarly to the joints of humans and the test is being adapted to human patients. The test has been submitted to the U.S. Food and Drug Administration for approval.

Scientists note, however, that research with animals often fails to provide similar results in humans.

"This test has already shown early usefulness for allowing us to monitor how different treatments affect the arthritic joints in people," Cook said. "With further validation, this test will allow doctors to adjust and fine tune treatments to individual patients. Also, being able to tell patients when they are at a high risk for developing arthritis will give doctors a strong motivational tool to convince patients to take preventive measures including appropriate exercise and diet change."

The research appears in the Journal of Knee Surgery.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about osteoarthritis.

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Early Study Hints at Link Between Certain Sunscreens, Endometriosis

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Back Pain Therapy Often Yields Early Benefits: Study

HealthDay – 1 hr 38 mins ago MONDAY, May 14 (HealthDay News) -- People who receive treatment for chronic and acute low-back pain show significant improvement in the first six weeks, but may still have some pain and disability after one year, according to a new study.

Researchers analyzed data from 33 studies that included more than 11,000 patients to learn more about how treatment affects low-back pain. Their findings appear in the May 14 online edition of CMAJ, the journal of the Canadian Medical Association.

"Our review confirms the broad finding of previous reviews that the typical course of acute low-back pain is initially favorable: there is a marked reduction in mean pain and disability in the first six weeks," Dr. Christopher Maher, director of the musculoskeletal division at the George Institute for Global Health of the University of Sydney in Australia, said in a journal news release.

"Beyond six weeks, improvement slows and thereafter only small reductions in mean pain and disability are apparent up to one year," he added.

One year after beginning treatment, the typical improvement in pain intensity was about 90 percent for patients who had acute low-back pain and about 50 percent for those who had chronic low-back pain, the investigators found.

"There is both good and bad news in our review. It is great that people improve with care, but arguably there is room to do better, particularly for people with persistent low-back pain," Maher said.

"Generally, when people see results like this they want to blame the clinician, but I think that is short-sighted," he added. "One of the principal reasons we have not made more progress in the back pain field is that research agencies do not take back pain research seriously. Around the world, back pain research is hugely underfunded relative to the burden of the disease. It's time for that to change."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about back pain.

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Study finds early signs of malaria drug resistance in Africa

"This file photo shows a mother and her child sitting on a bed covered with a mosquito net, near Bagamoyo, Tanzania, in 2009. Africa's deadliest malaria parasite has shown resistance in lab tests to one of the most powerful drugs on the market -- a warning of possible resistance to follow in patients, according to scientists. (AFP Photo/Tony Karumba)" title

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Warren Buffett Has Early Stage Prostate Cancer

HealthDay – 30 mins ago WEDNESDAY, April 18 (HealthDay News) -- U.S. billionaire investor Warren Buffett says he has prostate cancer and will undergo radiation treatment in the coming months.

The 81-year-old chairman and chief executive of Berkshire Hathaway Inc. said in a letter to investors on Tuesday that he has stage 1 cancer, an early form of the disease that is treatable.

"The good news is that I've been told by my doctors that my condition is not remotely life-threatening or even debilitating in any meaningful way," Buffett said.

After receiving the diagnosis last Wednesday, Buffett said he had other tests that "showed no incidence of cancer elsewhere in my body."

In his letter, Buffett said he expects to begin two months of daily radiation treatment in mid-July. It will restrict his travel, "but will not otherwise change my daily routine."

He added that, "I discovered the cancer because my PSA level

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Pricier therapy no better for early prostate cancer

Reuters – 1 hr 49 mins ago NEW YORK (Reuters Health) - A new study suggests that expensive, high-tech proton beam radiation doesn't do any more for men with prostate cancer than the most commonly-used option.

Proton beam radiation, heavily promoted by facilities that perform the treatment, also came with a higher risk of certain side effects compared to intensity-modulated radiation therapy (IMRT), researchers found.

"This paper is the strongest evidence yet that proton beam (therapy) is not only not better, but probably not as good as IMRT," said Dr. Matthew Cooperberg, a urologist from the University of California, San Francisco, who didn't participate in the new research.

The findings suggest that men have multiple radiation options when it comes to treating early, localized prostate cancer.

Though not covered in the new study, their options also include surgery -- or getting no treatment at all and waiting to see how the disease progresses, researchers said.

Dr. Ronald Chen of the University of North Carolina at Chapel Hill and his colleagues used data from a nationwide cancer registry covering treatment records for men insured by Medicare who were diagnosed with prostate cancer starting in 2000.

At that time, less than one percent of prostate cancers that hadn't spread beyond the gland were treated with IMRT, a minimally-invasive treatment meant to limit damage to the surrounding organs. The rest were treated conformal radiation, the previous standard of care.

By 2008, almost 96 percent of men got the high-dose, targeted radiation.

Intensity-modulated radiation was tied to an approximately 10 to 20 percent lower risk of stomach problems and hip fractures compared to conformal radiation therapy, which exposes more organs around the prostate to radiation. But it also came with a 12 percent higher risk of erectile dysfunction.

Over the course of each year after radiation, 2.5 percent of men who'd received IMRT needed more cancer treatment -- suggesting their disease came back -- compared to 3.1 percent of men in the traditional-radiation group.

That was based on records of close to 13,000 men age 66 and older.

In a smaller analysis, Medicare patients who got proton beam therapy, the most high-tech type of radiation offered, didn't fare much better or worse than those who had IMRT -- except that proton-treated men had more stomach-related side effects.

HUNDREDS OF MILLIONS IN COSTS

The use of both of those technologies has driven up the cost of prostate cancer treatment by hundreds of millions of dollars, the researchers wrote in the Journal of the American Medical Association.

But with conformal radiation fading from popularity, patients' radiation choice now tends to come down to IMRT versus proton therapy -- which is available at far fewer cancer centers because of the technology required.

Researchers said that proton beam facilities can cost $100 million or more to build. A round of proton beam radiation treatment costs insurers up to $100,000 per patient, while IMRT is billed at about $50,000.

"Here we have more expensive therapy that is not proven to give a better outcome," said Dr. Eric Klein, a prostate cancer researcher at the Cleveland Clinic, who didn't take part in the new study.

Researchers agreed that policymakers, including those that decide how much Medicare will pay for various treatments, should reevaluate the evidence for cancer outcomes -- including whether proton beam therapy is worth its hefty price tag.

"There's a trend in this country of adopting newer, costly, promising treatments, without very much evidence to prove they're better," Chen told Reuters Health.

"What our data provides the patients is evidence that IMRT is a good prostate cancer treatment," he said. Until more rigorous studies are available, "That's the type of radiation that they should seek."

WATCHFUL WAITING?

Another perfectly good option for men with early prostate cancer is not to get treatment at all, but to wait and see whether the cancer grows or doesn't cause any harm, researchers said.

"Many men with early disease, especially men who are older, likely don't need treatment," said Dr. W. Robert Lee, a radiation oncologist at the Duke University School of Medicine in Durham who wasn't involved in the new study.

"Active surveillance really plays a very important role," he told Reuters Health.

Cooperberg told Reuters Health that if men find their doctor pushing one treatment option, especially if it's a high-tech radiation option, they should seek outside opinions and think about their priorities -- in terms of what side effects they can put up with and the chance of needing more serious treatment.

"Prostate cancer is very much a disease of options," Lee said.

SOURCE: http://bit.ly/hwxtTL Journal of the American Medical Association, online April 17, 2012.

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Many tests follow surgery for early breast cancer: study

Reuters – 4 hrs ago (Reuters) - Women who have early breast tumors surgically removed may often go through repeat mammograms and invasive procedures for years afterwards, with two-thirds having at least one more invasive procedure over the next decade, according to a U.S. study.

The study, which covered nearly 3,000 women, focused on so-called ductal carcinoma in situ, or DCIS - abnormal cells in the milk ducts that are considered the earliest stage of breast cancer. The most common treatment involves removing only the abnormal tissue and conserves the breast.

But researchers said the findings, which appeared in the Journal of the National Cancer Institute, pointed to a downside of breast-conserving surgery for DCIS.

"Women making treatment decisions about DCIS need to understand that many women will need additional surgery or invasive intervention after breast-conserving surgery," said Joshua Fenton, an assistant professor at the University of California, Davis, who co-wrote an editorial published with the study.

The most common invasive procedure is usually a biopsy to remove abnormal tissue in the same breast.

Of the 2,948 women in the study, all of whom had breast-conserving surgery for DCIS between 1990 and 2001, 41 percent had at least one mammogram to check out symptoms or a suspicious lump. And 66 percent had at least one invasive procedure.

But only eight percent actually had a DCIS recurrence and another eight percent were found to have invasive breast cancer.

Larissa Nekhlyudov at Harvard Medical School and Harvard Vanguard Medical Associates in Boston, who led the study, said women should be aware that breast conserving surgery can come with a long follow-up.

"We're not suggesting that women have a mastectomy instead," she said.

"The good news is that the majority of these women will not have a (cancer) recurrence. But the work-ups for a possible recurrence are likely to continue for years."

The findings fit into the bigger issue of the pros and cons of mammography screening. In the United States, the government-backed U.S. Preventive Services Task Force recommends screening women ages 50 to 74 every other year. Some medical groups, though, call for regular mammograms for all women from age 40.

Since mammograms came into widespread use in the 1980s, the number of DCIS diagnoses has shot up. About one in five newly-diagnosed breast cancers is DCIS.

The problem is that DCIS may or may not progress to tumors that invade the breast tissue, and currently there is no way to predict which cases will progress.

So women with DCIS almost always receive treatment, which for some may be unnecessary.

When it comes to early prostate cancer, which is also usually caught through screening, men have the option to delay treatment and choose "active surveillance" - where the cancer is monitored to see if it's progressing.

That's because prostate cancer is frequently slow-growing and may never threaten a man's life.

But this is not an option for DCIS yet since there's no way of telling which tumors might progress quickly, although it could become one if researchers find certain tumor characteristics that strongly predict it's benign, Fenton said.

This will also probably take a "cultural shift," Nekhlyudov noted, since people typically want aggressive treatment for cancer, even if it's early stage. SOURCE: http://bit.ly/IEYv3o

(Reporting from New York by Amy Norton at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)

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Caloric moderation can reverse link between low birth weight and obesity, early study indicates

ScienceDaily (Apr. 2, 2012) — Babies who are born small have a tendency to put on weight during childhood and adolescence if allowed free access to calories. However, a new animal model study at UCLA found when small babies were placed on a diet of moderately regulated calories during infancy, the propensity of becoming obese decreased.

See Also:Health & MedicineDiet and Weight LossObesityInfant's HealthFitnessPregnancy and ChildbirthDiseases and ConditionsReferenceBirth weightNutrition and pregnancyPremature birthInfant

Because this is an early study, UCLA researchers do not recommend that mothers of low-birth weight infants start restricting their child's nutrition and suggest they consult with their child's pediatrician regarding any feeding questions.

Previous studies have shown that growth restriction before birth may cause lasting changes of genes in certain insulin-sensitive organs like the pancreas, liver and skeletal muscle. Before birth, these changes may help the malnourished fetus use all available nutrients. However, after birth these changes may contribute to health problems such as obesity and diabetes.

"This study shows that if we match the level of caloric consumption after birth to the same level that the growth-restricted baby received in the womb, it results in a lean body type. However, if there is a mismatch where the baby is growth-restricted at birth but exposed to plenty of calories after birth, then that leads to obesity," said the lead author, Dr. Sherin Devaskar, professor of pediatrics and executive chair of the department of pediatrics at Mattel Children's Hospital UCLA. "While many trials that include exercise and various drug therapies have tried to reverse the tendency of low birth weight babies becoming obese, we have shown that a dietary intervention during early life can have long lasting effects into childhood, adolescence and adult life."

The study appears in the June issue of the journal Diabetes and is currently available online.

About 10 percent of babies in the United States are born small, defined as less than the 10th percentile by weight for a given gestation period, said the study's first author, Dr. Meena Garg, professor of pediatrics and a neonatologist and medical director of the neonatal intensive care unit at Mattel Children's Hospital UCLA. She added that some organizations define low birth weight as less than 2,500 grams or 5 pounds, 5 ounces at term.

Low birth weight can be caused by malnutrition due to a mother's homelessness or hunger or her desire not to gain too much weight during pregnancy. Additional causes include illness or infection, a reduction in placental blood, smoking or use of alcohol or drugs during pregnancy.

To conduct the study, researchers used rodent animal models and simulated a reduced calorie scenario during pregnancy. The results showed that low-birth weight offspring exposed to moderately tempered caloric intake during infancy and childhood resulted in lean and physically active adults related to high energy expenditure, as opposed to unrestricted intake of calories, which resulted in inactive and obese adults due to reduced energy expenditure. The authors concluded that early life dietary interventions have far reaching effects on the adult state.

Future studies will follow this study over the stages of aging to see if early regulation of calorie intake reverses diabetes and obesity while aging.

"This is an early pre-clinical trial that first needs to be tested in clinical trials before any form of guidelines can be developed," Devaskar said. "More importantly, we must make sure that control of caloric intake during infancy and childhood does not have any unintended side effects before taking on clinical trials. More research is required to ensure that these metabolic advantages will persist later in life."

The study was funded by the National Institute of Child Health and Human Development.

In addition to Devaskar and Garg, the study was conducted by a team of UCLA researchers including Manikkavasagar Thamotharan, Yun Dai, Shanthie Thamotharan, Bo Chul Shin and David Stout.

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Study finds some early breast cancer overdiagnosed

For years, women have been urged to get screened for breast cancer because the earlier it's found, the better. Now researchers are reporting more evidence suggesting that's not always the case.

A study in Norway estimates that between 15 and 25 percent of breast cancers found by mammograms wouldn't have caused any problems during a woman's lifetime, but these tumors were being treated anyway. Once detected, early tumors are surgically removed and sometimes treated with radiation or chemotherapy because there's no certain way to figure out which ones may be dangerous and which are harmless.

"When you look for cancer early and you look really hard, you find forms that are ultimately never going to bother the patient," said Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, who was not part of the research. "It's a side effect of early diagnosis."

The study is the latest to explore overdiagnosis from routine mammograms

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Early Study Hints That Breast Cancer Vaccine Might Work

HealthDay – 1 hr 44 mins ago MONDAY, April 2 (HealthDay News) -- A vaccine to prevent breast cancer's return in women with a history of the disease has triggered the desired immune response in early research.

The vaccine under development is aimed at preventing recurrence in women who have a form of tumor known as HER2-positive, according to researcher Dr. Diane Hale, a research resident in general surgery at Brooke Army Medical Center at Fort Sam Houston, in San Antonio.

She is set to present results of the study on Monday at the annual meeting of the American Association for Cancer Research in Chicago.

The vaccine, known as the "HER2-based peptide vaccine AE37," is designed to harness the power of the patient's immune system, based on its reaction to a cancer-linked peptide (protein).

"The theory is that once you form that

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