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Thursday, February 23, 2012

LOS ANGELES – Millions of people have endured a colonoscopy, believing the dreaded exam may help keep them from dying of colon cancer. For the first time, a major study offers clear evidence that it does.

Removing precancerous growths spotted during the test can cut the risk of dying from colon cancer in half, the study suggests. Doctors have long assumed a benefit, but research hasn’t shown before that removing polyps would improve survival – the key measure of any cancer screening’s worth.

Some people skip the test because of the unpleasant steps need to get ready for it.

“Sure, it’s a pain in the neck. People complain to me all the time, `It’s horrible. It’s terrible,”‘ said Dr. Sidney Winawer, a gastroenterologist at Memorial Sloan-Kettering Cancer Center in New York who helped lead the study. “But look at the alternative.”

A second study in Europe found that colonoscopies did a better job of finding polyps than another common screening tool – tests that look for blood in stool. Both studies were published in Thursday’s New England Journal of Medicine.

Colorectal cancer is the second leading cause of cancer death in the United States and the fourth worldwide. More than 143,000 new cases of cancers of the colon or rectum are expected in the U.S. this year and nearly 52,000 people will die from it, according to the American Cancer Society.

Deaths from colorectal cancer have been declining for more than two decades, mostly because of screening including colonoscopies and other tests, the organization says. People of average risk of colon cancer ages 50 to 75 should get screened, but only about half in the U.S. do.

A government-appointed panel of experts recommends one of three methods: annual stool blood tests; a sigmoidoscopy (scope exam of the lower bowel) every five years, plus stool tests every three years; or a colonoscopy once a decade.

In a colonoscopy, a thin, flexible tube with a tiny camera is guided through the large intestine. Growths can be snipped off and checked for cancer. Patients are sedated, but many dread the test because it requires patients to eat a modified diet and drink solutions the day before to clear out the bowel. It usually costs more than $1,000, compared with a $20 stool test.

Researchers at Sloan-Kettering previously showed that removing polyps during colonoscopy can prevent colon cancer from developing, but it was not clear whether it saved lives.

The new study followed 2,602 patients who had precancerous growths removed during colonoscopies for an average of 15 years. Their risk of dying from colon cancer was 53 percent lower than what would be expected among a similar group in the general population – 12 patients followed in the study died, versus 25 estimated deaths in the general population.

The study was not a randomized trial that’s the gold standard in medical research. But Robert Smith, director of screening at the American Cancer Society, said it’s the first direct evidence that removing polyps can reduce the risk of colon cancer death.

“There’s no question that these are findings that we can take to the bank,” said Smith, who had no role in the research.

The National Cancer Institute and several cancer organizations paid for the study.

Government and private cancer groups also funded the second study in the journal, led by researchers in Spain. About 53,000 participants were given a colonoscopy or a stool blood test. Both tests found similar numbers of colon cancer cases – about 30 in each group.

However, colonoscopies found advanced growths in twice as many people – 514 versus 231 of those given the stool test. Colonoscopy also found 10 times more people with less serious growths than the stool test did.

Neither test proved very appealing – only a quarter of patients offered a colonoscopy had one. Similarly, only a third agreed to the offered stool test.

The Spanish study is continuing and similar research in the U.S. and Norway that began recently is looking at the long-term impacts of colonoscopy.

Stephen Raquet, of Mount Kisco, N.Y., finds the test reassuring even if the preparation is unpleasant. He had his first colonoscopy 13 years ago at age 41, earlier than usual because of a family history of colon cancer.

The sudden death of his 45-year-old sister from the disease prompted Raquet to get checked out. He had a precancerous growth removed at Memorial Sloan-Kettering in 1999, and has had the test every three years since.

During his last appointment four months ago, doctors said he can come back in five years.

“It’s given me peace of mind,” said the 54-year-old business executive.

Online – Guidelines: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm

Source: http://www.gazettenet.com/2012/02/23/study-offers-evidence-that-colonoscopy-cuts-colon-cancer-death-risk

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CHICAGO ? Some gravely ill alcoholics who need a liver transplant shouldn’t have to prove they can stay sober for six months to get one, doctors say in a study that could intensify the debate over whether those who destroy their organs by drinking deserve new ones.

In the small French study, the vast majority of the patients who got a liver without the wait stopped drinking after their surgery and were sober years later. The study involved patients who were suffering from alcohol-related hepatitis so severe that they were unlikely to survive a six-month delay.

The findings, reported in Thursday’s New England Journal of Medicine, could boost demand for livers, already in scarce supply, and reopen a bitter dispute over whether alcoholics should even get transplants.

The controversy peaked in the 1990s when celebrities with drinking problems ? Larry Hagman, David Crosby and Mickey Mantle ? got liver transplants. More recently, British soccer star George Best received a new liver in 2002, started drinking again and died three years later.

Alcohol can cause lethal, liver-destroying diseases such as cirrhosis and hepatitis. Nearly one in five liver transplants in the U.S. go to current or former heavy drinkers. Transplant hospitals commonly require patients waiting for a new liver to give up drinking for six months as a way of assuring doctors they are serious about staying sober after the operation.

Drinkers severely ill with hepatitis account for a very small share of patients needing transplants. The French study suggests that dropping the six-month rule for these patients would increase demand for livers by only about 3 percent.

The study’s lead author, Dr. Philippe Mathurin of Huriez Hospital in Lille, France, said a strict application of the six-month rule may be unfair to such patients. He said they are just as deserving as other liver patients, many of whom have diseases caused by poor lifestyle choices such as drug use or obesity.

Mathurin said he favors keeping the rule for other alcoholics with liver disease, noting that some can recover liver function simply by staying sober.

Dr. Robert S. Brown Jr., transplant director of New York-Presbyterian Hospital/Columbia University Medical Center, agreed it is time to rethink the six-month rule. “The challenge of this paper is to come up with better ways, both to treat alcoholism as a disease and to predict who will succeed with transplantation,” he said.

Mathurin acknowledged that such a change could put more patients on the waiting list for organs, and said: “It means we have to increase the number of donors.”

Nearly 6,300 liver transplants were performed last year in the United States, but more than 1,400 Americans died waiting for a new liver, according to the United Network for Organ Sharing. Adding more people to the list could mean longer waits and more deaths among non-drinkers.

Preschool teacher Jane Sussman, 59, has been waiting for a liver for more than a year. Doctors aren’t sure what caused her liver condition, but it wasn’t alcohol and she has never been a drinker. She doesn’t want the list to get longer by adding more alcoholics.

“Who knows for sure if they’re not going to start drinking right way?” Sussman said from her temporary home in Pittsburgh near her transplant hospital. An organ from a deceased donor is “the most amazing gift you’ll get in your life. If you don’t treat it right, it’s a wasted gift that could have gone to someone else, like myself.”

The French study involved 26 alcoholics with severe hepatitis who were not getting better with drug treatment. They were carefully selected: Among other things, all had support from family or friends. The patients pledged to quit drinking and received transplants. They were compared with a group of similar liver disease patients who weren’t offered transplants.

Not surprisingly, those who got transplants did better: 77 percent were still alive six months later, compared with 23 percent of those who didn’t get new livers.

Also, far fewer fell off the wagon than expected: Only three of the transplant patients started drinking again two to three years later, a rate much lower than the estimated 30 percent relapse rate in general among alcoholic patients who meet the six-month sobriety rule.

Dr. Christopher Hughes, director of liver transplantation at University of Pittsburgh Medical Center, said he is worried the pool of potential organ donors could shrink if the public believes organs are going to active drinkers.

“I think this will be very controversial. I don’t think you’ll find a lot of support for adopting this,” Hughes said.

___

Online:

New England Journal: http://www.nejm.org

___

AP Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson

Source: http://us.rd.yahoo.com/dailynews/rss/health/*http%3A//news.yahoo.com/s/ap/20111109/ap_on_he_me/us_med_transplants_alcoholics

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I’ll admit it: Getting into a bikini and looking good in it would be awesome. But I’m exercising for many others reasons too: to slow the aging process, to keep my joints in shape, to lose a few pounds. I’d also like for my heart to be as healthy as possible for as long as possible.

A new study suggests that the best exercise for heart health might be a combination of cardio/aerobic exercise and weight training.

Oh, yeah, I said “might.”

If you look closely at the study, led by Lori Bateman of the Duke University Medical Center in Durham, N.C., and reported by Reuters Health, you’ll notice that those who combined aerobic exercise with some weight or resistance training lost an average of 4 pounds. Those who did aerobic exercise alone lost 3 pounds. Is that enough to declare that the combination is better than aerobic exercise alone?

For me, I’ll continue to go for it! I’ll stick to my cardio routine to burn calories and improve my cardiovascular health, and I’ll pump some light iron every once in a while to try to create long and lean muscles.

Source: http://www.fitmagascene.com/2011/09/study-claims-to-have-determined-the-best-heart-healthy-exercise.html

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ScienceDaily (Aug. 5, 2011) ? The farther that human populations live from the equator, the bigger their brains, according to a new study by Oxford University. But it turns out that this is not because they are smarter, but because they need bigger vision areas in the brain to cope with the low light levels experienced at high latitudes.

Scientists have found that people living in countries with dull, grey, cloudy skies and long winters have evolved bigger eyes and brains so they can visually process what they see, reports the journal Biology Letters.

The researchers measured the eye socket and brain volumes of 55 skulls, dating from the 1800s, from museum collections. The skulls represented 12 different populations from across the globe. The volume of the eye sockets and brain cavities were then plotted against the latitude of the central point of each individual’s country of origin. The researchers found that the size of both the brain and the eyes could be directly linked to the latitude of the country from which the individual came.

Lead author Eiluned Pearce, from the Institute of Cognitive and Evolutionary Anthropology in the School of Anthropology, said: ‘As you move away from the equator, there’s less and less light available, so humans have had to evolve bigger and bigger eyes. Their brains also need to be bigger to deal with the extra visual input. Having bigger brains doesn’t mean that higher latitude humans are smarter, it just means they need bigger brains to be able to see well where they live.’

Co-author Professor Robin Dunbar, Director of the Institute of Cognitive and Evolutionary, said: ‘Humans have only lived at high latitudes in Europe and Asia for a few tens of thousands of years, yet they seem to have adapted their visual systems surprisingly rapidly to the cloudy skies, dull weather and long winters we experience at these latitudes.’

That the explanation is the need to compensate for low light levels at high latitudes is indicated by the fact that actual visual sharpness measured under natural daylight conditions is constant across latitudes, suggesting that the visual processing system has adapted to ambient light conditions as human populations have moved across the globe.

The study takes into account a number of potentially confounding effects, including the effect of phylogeny (the evolutionary links between different lineages of modern humans), the fact that humans living in the higher latitudes are physically bigger overall, and the possibility that eye socket volume was linked to cold weather (and the need to have more fat around the eyeball by way of insulation).

The skulls used in the study were from the indigenous populations of England, Australia, Canary Islands, China, France, India, Kenya, Micronesia, Scandinavia, Somalia, Uganda and the United States. From measuring the brain cavity, the research suggests that the biggest brains belonged to populations who lived in Scandinavia with the smallest being Micronesians.

This study adds weight to other research that has looked at the links between eye size and light levels. Other studies have already shown that birds with relatively bigger eyes are the first to sing at dawn in low light. The eyeball size across all primates has been found to be associated with when they choose to eat and forage — with species with the largest eyes being those that are active at night.

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Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Oxford.

Journal Reference:

1. E. Pearce, R. Dunbar. Latitudinal variation in light levels drives human visual system size. Biology Letters, 2011; DOI: 10.1098/rsbl.2011.0570

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/kunBjy73rvI/110804214410.htm

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