Berries, Tea May Cut Men's Odds for Parkinson's: Study

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Depo-Provera Birth Control Might Raise Breast Cancer Risk

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- There appears to be a link between an injectable form of progestin-only birth control, best known as Depo-Provera, and an increased risk of breast cancer in young women, new research suggests.

For the study, researchers compared more than 1,000 Seattle-area women, aged 20 to 44, who were diagnosed with breast cancer, and more than 900 women without breast cancer.

Recent use of the injectable contraceptive (formally called depo-medroxyprogesterone acetate or DMPA) for a year or longer was associated with a 2.2-fold increased risk of invasive breast cancer, the study found.

This increased risk appeared to fade within months after women stopped using the contraceptive, and women who used the contraceptive for less than a year or who had stopped using it more than a year earlier did not have any increased risk of breast cancer, according to the findings published online and in the April 15 print issue of the journal Cancer Research.

"Although breast cancer is rare among young women and the elevated risk of breast cancer associated with DMPA appears to dissipate after discontinuation of use, our findings emphasize the importance of identifying the potential risks associated with specific forms of contraceptives given the number of available alternatives," study leader Dr. Christopher Li, a breast cancer epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, and colleagues wrote.

"In the United States, many women have numerous options for contraception, and so it is important to balance their risks and benefits when making contraceptive choices," Li noted in a news release from the research center.

While the study uncovered an association between Depo-Provera and raised breast cancer risk, it could not prove a cause-and-effect relationship.

Commenting on the study, Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic surgeon at Lenox Hill Hospital in New York City, said, "This study further confirms that some types of progestins are not healthy for the breast. For women who are at elevated risk to develop breast cancer based on family history, or even age, this type of contraception may not be a good choice for them."

But another expert cautioned that the study did have its limits.

Dr. Freya Schnabel, director of breast surgery at NYU Clinical Cancer Center in New York City, noted that the women in the study who seemed at highest risk of developing breast cancer while on Depo-Provera were those with a family history of the disease or women who had never had children (another known risk factor).

Furthermore, she said, "the study did not include information about all breast cancer risk factors in the participants, and this is a real limitation of the analysis which could impact on the results. Also, the mechanism by which the progesterone would increase risk only in current users is not clear."

According to Schnabel, all of this means that "more detailed studies are needed to clarify the relationship between this contraceptive method and risk of breast cancer."

The research was funded by the U.S. National Cancer Institute and the Department of Defense Breast Cancer Research Program.

More information

Planned Parenthood has more about the birth control shot.

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From a Failed Vaccine, New Insights Into Fighting HIV

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- A new study offers insight into why an HIV vaccine failed to protect most people who received it, but it also points to promising new targets for future vaccine efforts.

Scientists believe an HIV vaccine, designed to prevent infection with the virus that causes AIDS, is still several years away. Tests of experimental vaccines have largely been failures so far.

Nevertheless, the prospect of a vaccine remains tantalizing because it could make a major dent in the spread of HIV and AIDS around the world.

The new research "gives us a handle on how the immune system deals with the virus and is affected by a vaccine," said study lead author Dr. Barton Haynes, director at the Duke Human Vaccine Institute at Duke University in Durham, N.C. "It gives us clues and a firm direction to look into."

The study is based on work by more than 100 scientists from 25 institutions, and appears in the April 5 issue of the New England Journal of Medicine.

Haynes and his colleagues examined the results of a 2009 study of an HIV vaccine in Thailand. In a trial involving more than 16,000 people, the vaccine appeared to cut the risk of infection by only 31 percent. That was still considered a major advance over previous vaccines that didn't work at all, Haynes noted.

The vaccine, called RV144, wasn't ready for prime time because it didn't protect enough people, Haynes said. "You want to get it above 50 percent," he said, and some scientists believe the rate should be even higher than that.

Despite the vaccine's failure, the authors of the new study were able to use the data to learn more about how the immune system deals with HIV and how the vaccine changes the "big picture" of the body's response to the virus.

The new research is an "exhaustive molecular analysis," said Dr. Lindsey Baden, an associate professor of medicine in the infectious disease division at Brigham and Women's Hospital in Boston who co-wrote a commentary accompanying the study.

Haynes said one surprising finding is about an antibody -- a soldier of the immune system -- that helps protect against influenza infection. Ironically, the antibody appears to boost the likelihood of HIV infection, he said.

Another finding was that higher levels of antibodies that home in on a particular region of HIV's outer shell, called V1V2, were associated with lower rates of infection with the virus.

This and other information in the study may help researchers come up with theories about where to go next with vaccine development, Baden said. Among other things, it can reveal parts of the immune system that can be most useful in battling the transmission of HIV.

Vaccines are available to fight other kinds of viruses, such as measles and influenza. HIV is unique, however, because it inserts its genetic material into the body's cells.

"When a person gets infected with HIV, that genetic material goes underground," Haynes said. "It's invisible to the body's immune system."

Another challenge is that the virus mutates, becoming a moving target.

"It changes so rapidly in the person who gets infected that even when the immune system does try to control it, in most people the immune system is always playing catch up," Haynes said.

More information

There's more on HIV/AIDS at the U.S. National Library of Medicine.

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Brain Falters Near End of Life, but Games, Puzzles Might Slow Decline

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New Lupus Genes Identified

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- Three new genes linked to the chronic autoimmune disease lupus have been identified by an international team of researchers.

The analysis of more than 17,000 genetic samples from people of several ethnic groups also pinpointed another 11 genetic regions that may be related to lupus and require further study.

The researchers found that the genes IRF8 and TMEM39a are associated with lupus in European-American, African-American, Gullah (a distinctive group of African-Americans in Georgia and South Carolina) and Asian patients. The gene IKZF3 is only significantly associated with lupus in African-Americans and European-Americans.

The researchers said their findings, which appear in the April 6 issue of the American Journal of Human Genetics, show that the genes that cause lupus aren't always universal.

The next step is to study the three genes to find out exactly what role they play in lupus, said lead author Christopher Lessard, a scientist at the Oklahoma Medical Research Foundation in Oklahoma City.

Lupus affects about 1.5 million Americans, and about 90 percent of patients are women. The disease causes the immune system to become overactive and attack the body's own cells. Symptoms include fatigue, fever, rashes and joint pain.

A combination of environmental and genetic factors cause lupus. Learning more about genetic risk factors may lead to improved diagnosis and treatment of the disease.

More information

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

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Researchers Find Gene Mutations That May Be a Key to Autism

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- Genetic mutations that arise spontaneously, as opposed to being passed through generations, could play an important role in the development of autism, new research suggests.

Three research teams sequenced the genes of children with sporadic autism, meaning it did not run in their families, and compared the sequences with those of their parents and siblings. Their results were published in three separate articles on April 4 in the journal Nature.

"We found that 15 to 20 percent of sporadic patients could be explained by 'de novo'

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Cancer Diagnosis May Raise Odds for Suicide, Heart Attack Death

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Doctors Detail High Costs of Fighting Malpractice Claims

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- For doctors defending medical malpractice claims, costs vary widely across specialties and can run into the tens of thousands, even when a patient did not receive a payout, new research shows.

The upshot: Patients end up paying the price in the end, the researchers concluded in their letter published April 5 in the New England Journal of Medicine.

"Higher defense costs and higher malpractice premiums are ultimately passed down to patients through higher physician fees," said co-author Dr. Anupam Jena, a physician at Massachusetts General Hospital, Harvard Medical School, and a senior fellow at the Schaeffer Health Policy Center at the University of Southern California.

According to Jena and his co-authors, cardiologists shell out the most when it comes to malpractice claims -- averaging more than $83,000 for paid claims -- while ophthalmologists spend nearly $24,000 for paid claims.

Expert witnesses, research costs, lawyers' fees and funding overhead costs, such as filing fees, are among the expenses that rack up bills, Jena said.

"The average malpractice claim in our study cost approximately $23,000," he said, adding that the claims that result in payments are more expensive because they take longer to defend, typically up to two years or more.

To come up with defense costs of paid and unpaid malpractice claims by specialty, the authors analyzed costs associated with nearly 27,000 malpractice claims that closed between 1995 and 2005. The claims involved nearly 41,000 physicians who were covered by a national liability insurer.

Jena and his colleagues had examined the same data in a 2011 NEJM study that compared malpractice risk by medical specialty, he said.

"We wanted to follow-up our earlier study by studying the magnitude of defense costs in medical malpractice and to explore how those costs vary by specialty," said Jena.

Why did some specialists rack up defense bills almost four times higher than others? Jena said the chart-toppers, heart and cancer physicians, are more likely to deal with claims linked to a failure to diagnose, and possibly death.

"The damages from malpractice vary, ranging from a missed diagnosis that delays treatment to the unexpected loss of life," he said. "Many cases are complex and those cases can stretch out longer," he said, noting that time is money.

Sonia Suter, an associate professor of law at George Washington University Law School in Washington, D.C., said the letter contains useful information. "It helps inform the ongoing debate about health-care costs and whether or not medical malpractice is contributing to higher costs overall," she said.

"I don't think this letter tells me the whole story, though. It's only one piece of the puzzle," said Suter, adding that she thought obstetrics would have landed higher up on the list. (It's sixth of 25 specialties.)

Dr. Jeffrey Segal is a neurosurgeon and founder and CEO of Medical Justice, a for-profit company that helps physicians deter and manage frivolous medical malpractice lawsuits. He said the letter in NEJM points out not just costs of claims, but the significant number of cases that come through the legal system that aren't won by the patient.

"We see here many claims are coming through that don't have merit. In a perfect legal system, you'd have the dollars going to a patient who is injured by medical negligence," he said. "This reaffirms that it's a system that takes a lot of time and is very expensive."

Segal added, "We've proposed legislation in Florida -- I'm part of a nonprofit that suggests a better way of doing things -- that would help move cases through faster. I'm talking weeks and months instead of years."

Jena said there are some cases where the patient was clearly harmed and, in those cases, it's important that the patient is compensated and compensated early on.

"Waiting two years is not fair," Jena said, and added that a quicker resolution would reduce not just the financial cost to those injured, but the emotional expense as well.

Jena described another solution that might hold promise for reducing malpractice claim costs.

"The University of Michigan hospital system tested a program where they identified errors early on and proactively approached patients and said, 'This is an error that occurred and we apologize, and we'd like to compensate you,'" he said. "Malpractice lawsuits, defense costs, and the time required to resolve claims all went down." He added that this approach of early disclosure needs to be studied further.

Cardiologist Dr. Chip Lavie, medical director of cardiac rehabilitation and prevention at the John Ochsner Heart and Vascular Institute in New Orleans, also weighed in on the new findings.

"I believe if there was substantially less threat of medical malpractice, physicians could practice medicine in a different way, trying to be cost-effective and trying to do the right thing with what is truly best for the patient as opposed to what is the best way to maintain a good defense against any potential subsequent lawsuit," Lavie said.

More information

Visit the Institute of Medicine to see its landmark report on reducing preventable medical errors.

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Mississippi bill may force state's only abortion clinic to close

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Chavez back in Venezuela after more cancer treatment

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Newron agrees Parkinson's drug deal with Zambon

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Sanofi unveils mixed news for Zaltrap cancer drug

Reuters – 20 mins ago PARIS (Reuters) - Sanofi and Regeneron Pharmaceuticals said their Zaltrap drug candidate failed to meet targets in a late-stage study for the treatment of prostate cancer, though U.S. authorities were reviewing it for use in treating colon cancer.

Regeneron had said in December that Sanofi had withdrawn its application for marketing approval for Zaltrap and was planning to resubmit it early this year.

"The study did not meet the pre-specified criterion of improvement in overall survival," Sanofi said, referring to a Phase III study of Zaltrap, also known as aflibercept, in treating prostate cancer.

Sanofi added in a statement on Thursday that the U.S. Food and Drug Administration had granted a priority review to the companies to examine Zaltrap in the treatment of colon cancer. The FDA is due to give a decision by August 4.

Priority review is granted to a drug if preliminary estimates show it has the potential to provide a treatment where no adequate therapy exists or a significant improvement compared with marketed products, Sanofi said.

"Sanofi and Regeneron are committed to the continued development of Zaltrap," Sanofi oncology head Debasish Roychowdhury said in the statement.

(Reporting by Nina Sovich; Editing by James Regan)

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