What Is Anemia? What Causes Anemia?

When the number of red blood cells or concentrations of hemoglobin are low a person is said to have anemia. Hemoglobin is a protein (metalloprotein) inside the red blood cells that contains iron and transports oxygen.

Anemia is the most common disorder of the blood. Approximately 3.5 million Americans are affected by it. It is much more common in developing countries, especially in very poor areas where people suffer from malnutrition. In many parts of Africa severe anemia is also caused by Malaria.

As many people who become infected with Malaria already have pre-existing anemia, most commonly due to malnutrition and helminthiasis (a disease caused by a parasitic worm), the problem is compounded.

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There are hundreds of types of anemia, which is divided into three groups:

Excessive blood loss anemia

Chronic bleeding (long-term bleeding) is often undetected for a long time. The patient gradually loses blood, which means a loss of red blood cells and hemoglobin. Acute bleeding (not long term), can also reduce red blood cell count. Excessive blood loss can be caused by:

• Stomach ulcers.


• Hemorrhoids.


• Inflammation of the stomach (gastritis).


• Cancer - sometimes cancer of the stomach or colon can cause bleeding.


• Some medications - NSAIDS (nonsteroidal anti-inflammatory drugs) if used for prolonged periods, or in high doses, can occasionally cause stomach bleeding.


• Childbirth - childbirth often involves the loss of blood.


• Menstruation - women who have very heavy periods (menorrhagia) have a higher risk of developing anemia.


• Surgery


• Trauma which results in bleeding, such as a car accident.


• Blood donations - some regular blood donors may develop anemia.

Excessive red blood cell destruction (hemolysis) anemia

A red blood cell usually lives for 110-120 days, after which it breaks down and is removed by the spleen. Some illnesses and conditions cause red blood cells to die too early. When this happens the bone marrow has to make more red blood cells than normal. If the bone marrow cannot keep up with the needed red cell production caused by their early deaths, the red blood cell count will start to fall, leading to hemolysis (anemia caused by excessive red blood cell destruction)

The following can cause hemolysis:

• Immune reactions
• Infections
• Some medications
• Toxins (poisons)
• Some medical procedures, such as using a heart-lung bypass machine, or hemodialysis (used by patients with kidney problems)

Decreased or deficient red blood cell production anemia

In this type of anemia the body either does not produce enough red blood cells, or they may not work properly. People with this type of anemia may have:

• Sickle cell anemia - an inherited disorder which causes the red blood cells to have a crescent shape. The red blood cells break down rapidly, before sufficient oxygen and nutrients can reach vital organs.


• Not enough iron (iron deficiency) - lack of iron is generally caused by poor diet, blood loss, or an inability to absorb sufficient iron from food. Anemia due to iron deficiency among pregnant women who do not take an iron supplement is common.


• Not enough vitamins (vitamin deficiency) - such as vitamin B12, often caused because the stomach cannot produce enough of a substance called intrinsic factor. This intrinsic factor is vital for vitamin B12 to be absorbed from food and drink. People with anemia for this reason have pernicious anemia. The deficiency may be caused by poor diet.


• Bone marrow problems - red blood cells are made in the bone marrow. If the bone marrow is faulty it may not be producing enough. This may be caused by a lack of vitamin B12, a serious bone marrow disorder (e.g. leukemia), long term inflammation (e.g. rheumatoid arthritis), or long term infection.


• Some conditions/diseases - people with HIV/AIDS, rheumatoid arthritis, and Crohn's disease may have problems with adequate red blood cell production. Malaria causes anemia in millions of people worldwide. A protein produced by immune cells during malaria infection triggers severe anemia, researchers from Yale University discovered. Patients with chronic kidney disease often have low levels of erythropoietin (a hormone that stimulates the formation of red blood cells) and develop anemia. A study published by the Canadian Medical Association Journal reported that anemia may be beneficial to patients with inflammatory disease, and advocate restraint in treating mild to moderate forms of anemia.


• Some medications - especially some cancer medications which are given in combination. A cancer drug, Avastin, given in combination with Sutent, is linked to microangiopathic hemolytic anemia, which is caused by by a build up of platelets and other organic obstructions on the inner walls of very small blood vessels. These shred healthy red blood cells as they pass through, eventually leading to a whole body shortage of them.

What are the symptoms of anemia?

People whose anemia develops gradually may have no symptoms for a long time. If it develops rapidly symptoms will usually be felt much sooner. Symptoms will vary according to the type of anemia, its underlying cause, and if there are any underlying health problems.

Below are some symptoms linked to anemia - tiredness and lethargy are the most common ones: Lethargy is a mental state while fatigue is a physical state. Lethargy may or may not be associated with physical symptoms. If somebody suffers from fatigue - is physically tired - it is not uncommon for his/her mental state to be affected as well.

• Fatigue (tiredness)
• Lethargy - sluggishness, apathy, a feeling of laziness
• Malaise - a vague feeling that one is not well
• Dyspnea - shortness of breath; difficult or labored breathing
• Poor concentration
• Palpitations - unpleasant irregular and/or forceful beating of the heart
• Sensitivity to cold temperatures

The following symptoms are possible, but less common

• Tinnitus (ringing in the ears)
• Headache
• Sense of taste is affected
• Sore tongue
• Dysphagia - difficulty is swallowing
• Pallor (pale complexion)
• Atrophic glossitis - very smooth tongue
• Dry and flaky nails
• Angular chelosis - ulcers in the corner of the mouth
• Restless leg syndrome - this is more common among patients with iron deficiency anemia

The following symptoms are possible, but extremely rare

• Swelling of the legs and/or arms
• Chronic heartburn
• Vomiting
• Increased sweating
• Blood in stools (feces)

How is anemia diagnosed?

A GP (general practitioner, primary care physician) will probably carry out a physical examination, order a blood test, and ask the patient some questions.

• Blood test
  
  A blood test will measure the patient's red blood count and levels of hemoglobin. If the levels are low the patient has anemia. The blood test will also reveal whether the blood cells have an unusual shape, color or size. Patients with iron deficiency have smaller and paler red blood cells compared to healthy individuals. A patient with a vitamin deficiency will have fewer and larger red blood cells.
  
  Adults should have hematocrit values (red blood cell count) between 32% and 43%, and hemoglobin values from 11 to 15 grams per deciliter.


• Some questions the doctor may ask
  
  The doctor will also try to find out what may be causing or contributing to the anemia by asking:
  
  
  • Diet - what the patient eats, and whether his/her diet includes enough vitamins and minerals, - especially iron and vitamin B12.
  
  
  • Medications - what drugs the patient has been taking, how often, for how long, and what doses.
  
  
  • Menstruation - whether periods are heavy (menorrhagia) and whether heavy periods have been happening for a long time.
  
  
  • Family history - whether any close relatives have/had anemia, blood disorders, or gastrointestinal bleedin/g. A close relative is usually limited to siblings and parents.
  
  
  • Medical history - whether the patient has a chronic disease.
  
  
  • Blood donation - whether the patient is a regular blood donor.
  
  
• Physical examination
  
  
  • Rectal examination - a doctor may carry out a rectal examination to determine whether something in the gastrointestinal tract may be causing bleeding. GPs are used to doing this kind of examination. If an abnormality is detected the GP will refer the patient to a specialist (gastroenterologist).
  
  
  • Pelvic examination - if the GP suspects heavy menstrual bleeding may be causing the anemia he/she may carry out a pelvic examination. If the patient does not respond to iron supplement treatment and has heavy periods the GP may refer her to a gynecologist.

What is the treatment for anemia?

• Iron deficiency - the GP will prescribe an iron supplement to restore body levels of iron. An example is ferrous sulphate, which is taken orally up to three times daily. Side effects, which are rare, may include diarrhea, constipation, stomach upset, and heartburn. Patients who find ferrous sulphate unsuitable may be given ferrous gluconate, which is less likely to have side effects but takes longer to work.


• Diet - patient's whose diets are found to be lacking in iron will be encouraged to consume plenty of iron-rich foods, such as dark-green leafy vegetables, artichokes, apricots, beans, lentils, chick peas, soybeans, meat, nuts, prunes, and raisins.


• Underlying causes - if there is an underlying cause for the anemia this must be treated. If non-steroidal anti-inflammatory drugs (NSAIDs) are found to be a contributory factor the doctor will prescribe an alternative medication.

The doctor will ask the patient to return a few weeks later to check that the treatment is working. If treatment has not worked the doctor will try to find out whether any undesirable side-effects may have made the patient stop taking the iron supplements.

What are the complications of anemia?

• Pregnancy
  
  Pregnant women who are severely anemic have a significant risk of complications, especially when they give birth and afterwards. Giving birth often involves losing blood; being anemic already and then losing blood can result in serious complications. If a mother is severely anemic her baby is much more likely to be born prematurely and underweight. Babies born to mothers with anemia are much more likely to have problems with anemia themselves later on in infancy.


• Fatigue
  
  Fatigue may have a considerable impact on the quality of life of the patient. If the anemia is severe the patient may feel too tired to work, or carry out essential daily tasks. Long-term fatigue may eventually lead to clinical depression.
  
  Researchers from Wake Forest University Baptist Medical Center found that elderly people with anemia have more disabilities and score lower on physical performance and strength tests than those without anemia.


• Susceptibility to illness and infection
  
  People with untreated anemia are more susceptible to illness and infection, compared to healthy people.


• Heart Problems
  
  The heart needs to pump more blood to make up for the lack of oxygen and nutrients if you are anemic. This can eventually lead to congestive heart failure.
  
  Researchers from Charles Sturt University found that the presence of anemia in patients with chronic heart failure is associated with a significantly increased risk of death.


• Nerve damage
  
  Lack of vitamin B-12, one of the causes of anemia, can result in nerve damage. Good nerve function requires an adequate supply of vitamin B-12.

Written by Christian Nordqvist

Going Down?

Going Down?

NEWS PHOTO
EMMA BENNETT
Alyssa King, (left to right) Maralynn Sasse, Nolan Weigel, and Theo Weigel have fun on the Spring Ride at the Medicine Hat Exhibition and Stampede on Friday night.

Injection Reverses Heart-attack Damage

ScienceDaily (July 25, 2009) — Injured heart tissue normally can't regrow, but researchers at Children's Hospital Boston have now laid the groundwork for regenerating heart tissue after a heart attack, in patients with heart failure, or in children with congenital heart defects. In the July 24 issue of Cell, they show that a growth factor called neuregulin1 (NRG1), which is involved in the initial development of the heart and nervous system, can spur heart-muscle growth and recovery of cardiac function when injected systemically into animals after a heart attack.

After birth, heart-muscle cells (cardiomyocytes) normally withdraw from the cell cycle – meaning they stop dividing and proliferating. But the researchers, led by Bernhard Kühn, MD, and Kevin Bersell of the Department of Cardiology at Children's, were able to restart the cell cycle with NRG1, stimulating cardiomyocytes to divide and make copies of themselves -- even though they are not stem cells.

"Although many efforts have focused on stem-cell based strategies, our work suggests that stem cells aren't required and that stimulating differentiated cardiomyocytes to proliferate may be a viable alternative," says Kühn, the study's senior investigator and a practicing pediatric cardiologist at Children's since 2007.

When the team injected NRG1 into the peritoneal cavity of live mice after a heart attack, once daily for 12 weeks, heart regeneration was increased and pumping function (ejection fraction, assessed on echocardiograms) improved as compared with untreated controls. The NRG1-injected mice also lacked the left-ventricular dilation and cardiac hypertrophy that typify heart failure; both were seen in the controls.

When the researchers also stimulated production of a cellular receptor for NRG1, known as ErbB4, cardiomyocyte proliferation was further enhanced, demonstrating that NRG1 works by stimulating this receptor. They also identified the specific kinds of cardiomyocytes (mononucleated) that are most likely to respond to treatment.

In 2007, Kühn and colleagues first demonstrated that the heart has dormant regenerative capacities that can be reawakened. Kühn developed a sponge-like patch, soaked in a compound called periostin that is abundant in the developing fetal heart (and in injured skeletal muscle) but scarce in adult hearts. When the patch was placed over the site of cardiac injury in rats, it induced cardiomyocyte proliferation and improved heart function (Nature Medicine 2007; 13:962-9). Similar results were seen in larger animals, and periostin is now in preclinical development at Children's Hospital Boston for future application in human patients with heart failure.

The new work adds a second compound to the heart-regeneration toolbox, and reveals how both periostin and NRG-1 work at the cellular and molecular level, an essential step in predicting possible side effects. Both compounds ultimately act on the same cellular pathway, Kühn found.

"We applied periostin locally at the site of cardiac injury, but NRG1 works when given by systemic injection – a very promising result that suggests it may be feasible to use this in the clinic to treat heart failure," says Kühn, who won a first prize Young Investigator Award, from the American College of Cardiology in 2007.

The study was funded by the Department of Cardiology at Children's Hospital Boston, the Charles Hood Foundation, and the American Heart Association.

Neglecting Unilateral Neglect

Unilateral neglect (UN) is a debilitating cognitive deficit following traumatic brain injury with long-term implications to both the person affected and the health care system. In the United States, UN affects up to 200,000 stroke survivors, with the incidence and severity of UN increasing with age. However, UN is rarely recognized by the health care team and current post-stroke testing is not specific enough to provide for a definitive diagnosis of UN. As a result, people with UN are under-diagnosed and under-treated; or, when diagnosed and treated, do not receive adequate rehabilitation due to financial constraints imposed by the Medicare system.

UN is most common following damage to the right hemisphere of the brain from stroke; although illness or traumatic brain injury are also linked to the development of UN. When functioning normally, the right hemisphere of the brain is attentive to both sides of the world with a global focus and the ability for prolonged attention while the left hemisphere is attentive only to its opposite side with a centralized focus and shorter attention span.

The wide range and complexity of UN symptoms and the presence of other sensory or motor deficits due to stroke contributes to the high rate of missed diagnoses. A disorder of input and/or output, a person affected with UN will either completely ignore the side opposite to the brain injury or feel that side is totally unimportant; to the extent of not recognizing their own limbs. All deficits are more severe in those affected by UN following stroke and are more likely to be permanent than in people who do not have UN in conjunction with stroke.

People with UN are able to see, hear, and move but do not recognize, listen to, or understand their world. A person with input disorder, also called inattention, will ignore odors, sounds, touch, and sight on the side opposite to their brain lesion; this inattention may also include ignoring one side of hallucinations, dreams or memories. A person with output disorder will not use their limbs opposite to the lesion, despite having the ability to do so; or will only be able to move a limb within the recognized space, but not within the ignored space.

A person with UN will ignore the left side of their visual field, or will be able to see both sides but ignore the left half of each object within the visual field. They will only dress or care and protect one side of their body; will only eat food on one side of their plate; will only look to one side; will completely ignore objects or people on the affected side; or will walk into walls or furniture on the effected side. People are usually unaware of the presence of their deficits due to UN, unlike when other sensory and motor deficits are present following stroke.

Inpatient rehabilitation facilities receive a set amount of money from Medicare, based upon guidelines for each illness or disease. These prospective payment systems limit a patient’s length of stay regardless of their level of functioning upon discharge and have been found to have an impact upon the outcome of people with UN. A person affected with UN does not progress quickly during rehabilitation, requires a long time to recover, and is discharged with a low level of functioning. In addition, people with UN are less likely to return to their homes and live on their own following stroke, and have an increased risk for falls or other injuries.

People are now living longer; the incidence and severity of UN will continue to rise, straining an already overburdened health care system. UN has impacted the elderly today and will have an impact upon aging baby boomers in the very near future. Additional research is needed to ensure early and accurate diagnosis through appropriate testing methods; targeted and effective treatment modalities need to be developed; and the health care team must be educated to increase awareness of this often neglected complication of stroke. Modification of the prospective payment system within the current Medicare system is also needed that recognizes the increased rehabilitation requirements for this group of stoke and brain injury survivors.

References

Gillen R et al. The impact of the inpatient rehabilitation facility prospective payment system on stroke program outcomes. Am J Phys Med Rehabil. 2007 May; 86 (5): 356-63. doi: 10.1097/PHM.0b013e31804a7e2f

Gottesman RF et al. Unilateral neglect is more severe and common in older patients with right hemispheric stroke. Neurology. 2008 Oct 28;71(18):1439-44. doi: 10.1212/01.wnl.0000327888.48230.d2

Jepson R et al. Unilateral Neglect: Assessment in Nursing Practice. J Neurosci Nurs. 2008 Jun; 40 (3): 142-9.

Wee, J., & Hopman, W. (2008). Comparing Consequences of Right and Left Unilateral Neglect in a Stroke Rehabilitation Population American Journal of Physical Medicine & Rehabilitation, 87 (11), 910-920 DOI: 10.1097/PHM.0b013e31818a58bd

Natural Anti-Inflammatory Power Of Tart Cherries May Help Relieve Post-Exercise Muscle Pain

Drinking cherry juice could help ease the pain for people who run, according to new research from Oregon Health & Science University presented at the American College of Sports Medicine Conference in Seattle, Wash. The study showed people who drank tart cherry juice while training for a long distance run reported significantly less pain after exercise than those who didn't. Post-exercise pain can often indicate muscle damage or debilitating injuries.

In the study of sixty healthy adults aged 18-50 years, those who drank 10.5 ounces cherry juice (CHERRish 100% Montmorency cherry juice) twice a day for seven days prior to and on the day of a long-distance relay had significantly less muscle pain following the race than those who drank another fruit juice beverage. On a scale from 0 to 10, the runners who drank cherry juice as their "sports drink" had a 2 point lower self-reported pain level at the completion of the race, a clinically significant difference.

While more research is needed to fully understand the effects of tart cherry juice, researchers say the early finding indicate cherries may work like common medications used by runners to alleviate post-exercise inflammation.

"For most runners, post-race treatment consists of RICE (rest, ice, compression and elevation) and traditional NSAIDS (non-steroidal anti-inflammatory drugs)," said Kerry Kuehl, M.D., a sports medicine physician and principal study investigator. "But NSAIDS can have adverse effects - negative effects you may be able to avoid by using a natural, whole food alternative, like cherry juice, to reduce muscle inflammation before exercise."

The researchers suggest cherries' post-exercise benefits are likely because of the fruit's natural anti-inflammation power - attributed to antioxidant compounds called anthocyanins, which also give cherries their bright red color.

Whether elite athletes or weekend warriors, this natural anti-inflammation power of cherry juice could have far-reaching benefits for the millions of active Americans currently taking over-the-counter pain medications to reduce muscle pain and beyond. A growing body of research suggests cherries could affect inflammation related to heart disease, arthritis and may even help maintain muscle strength for those suffering from fibromyalgia (a common, chronic widespread pain disorder), according to a second study presented by the same researchers at the ACSM conference.

It's Easy to Enjoy "America's Super Fruit"

Cherries are not only good for you, but they're also a homegrown "Super Fruit." According to recent data, more than 9 out of 10 Americans want to know where their food comes from, nearly 80 percent say they're purchasing "locally produced" products, and the majority are defining "local" as made in America.

This homegrown advantage, coupled with potential health benefits for athletes, make cherries "America's Super Fruit." Tart cherries come in dried, frozen and juice forms so they're readily available to enjoy all year long.

Kuehl KS, Chestnutt J, Elliot DL, Lilley C. Efficacy of tart cherry juice in reducing muscle pain after strenuous exercise. American College of Sports Medicine. 851. May, 2009.

Jones KD, Elliot DL, Kuehl KS, Dulacki K. Tart cherry juice for fibromyalgia: new testing paradigm and subgroup benefits. American College of Sports Medicine. 852. May, 2009.

Surveys conducted IRI Data and The Hartman Group, 2008

Source:
Caitlin Solway
Weber Shandwick Worldwide

Psychologists Investigate Cognitive Failings Of Eating Disorder Sufferers

Sufferers of eating disorders have problems with certain mental tasks; this is the finding of a comprehensive overview of studies examining the link between cognitive deficits and eating disorders, published online in the Journal of Neuropsychology today, 22nd July 2009.

Professor Konstantine Zakzanis from the University of Toronto carried out an analysis of 27 studies that investigated the thinking of 608 anorexia nervosa sufferers, and 14 studies of 347 bulimia nervosa patients to look for consistent patterns in cognitive deficits.

Professor Zakzanis said: "Over the last 30 years, many psychological studies have tested people with anorexia or bulimia on tasks such as decision making, verbal memory and reaction times and have found that people with eating disorders perform worse than people who don't have an eating disorder.

"In this overview we found consistent results that people with anorexia and bulimia have significant problems with some cognitive processes, and as sufferers' body mass decreased, the severity of their cognitive impairments increased."

Anorexia sufferers were found to have particular impairments in spatial perception and representation, which could explain the distorted assessment of body image in patients with anorexia nervosa. Bulimia patients had less significant impairments than anorexia sufferers overall, but a particular impairment in impulsivity was observed, with 21 per cent of patients scoring worse on measures of impulsivity when compared to people without an eating disorder.

"These results tell us that people with eating disorders have particular patterns of cognitive deficits. However, at this stage we do not know whether these deficits are a result of abnormal eating patterns, malnutrition for example, or whether these cognitive deficits result in, or affect the progression of eating disorders," Professor Zakzanis continued. "If cognitive deficits are behind eating disorders this could help us to understand why certain people are affected and could help us to develop future psychological treatments."

Source
British Psychological Society

Link Between Healthy Lifestyle And Cardiovascular Health Confirmed

Two large US studies published in a leading journal this month support the already substantial body of evidence that shows choosing to follow a healthy lifestyle helps prevent cardiovascular disease: one found it linked to lower risk of heart failure in men and the other found it linked to lower risk of high blood pressure in women.

Both studies are published in the July 22-29 issue of JAMA, the Journal of the American Medical Association.

For the first study, first author Dr Luc Djoussé, of the Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues used data covering 20,900 men taking part in the Physicians' Health Study in the US and who were followed for an average of 22.4 years.

They found that following any one of six modifiable healthy lifestyle factors was linked to a lower lifetime risk of heart failure compared to not following any.

The six lifestyle factors were: maintaining a normal body weight, never smoking, taking regular exercise, drinking moderate amounts of alcohol, eating plenty of cereals, and eating plenty of fruits and vegetables.

The researchers also found that the more healthy lifestyle choices the men followed, the lower their lifetime risk of heart failure.

For example, the lifetime risk for heart failure was about 1 in 5 (21.2 per cent) for those men who didn't follow any of the healthy lifestyle choices (ie they smoked, they were overweight, they did not have a diet rich in cereals, fruit and vegetables, and they did not take regular exercise). But for those who followed four or more healthy lifestyle choices, the lifetime risk was 1 in 10 (10.1 per cent).

The findings have major implications for public health, especially since heart failure is now known to be a leading cause of acute hospital admission and the most prevalent chronic cardiovascular condition, according a press statement made by the European Society of Cardiology (ESC).

In the second study, first author Dr John P. Forman, also from Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues, used data covering more than 80,000 women taking part in the Nurses' Health Study, described by the ESC as one of the "world's landmark studies in women's health epidemiology".

All of the women's blood pressure was normal (120/80 or less) and they were free of heart disease, diabetes, and cancer at the start of the study which followed them for 14 years.

The researchers found that following any one of six modifiable healthy lifestyle factors was linked to lower blood pressure.

The six modifiable lifestyle factors were: keeping to a normal BMI (under 25), exercising vigorously every day, following a heart-healthy diet, consuming a modest amount of alcohol, using non-narcotic pain relievers no more than once a week, and taking a folic acid supplement.

A heart-healthy diet was described as eating lots of fruits, nuts, legumes and other vegetables, whole grains, low fat dairy products, low sodium intake, and not consuming much red or processed meat or sugary drinks.

In this study too the researchers found a cluster effect: following all six lifestyle choices was linked to an 80 per cent lower risk of developing high blood pressure. Only 0.3 per cent of the women in the study followed all 6 lifestyle choices.

The ESC said this study also had important implications for public health.

ESC spokesman Professor Joep Perk from Oskarshamn District Hospital in Sweden, told the press that there wasn't enough research on preventing poor health in women and called this study "an important piece of evidence".

"The Nurses' Health Study is an observational study, but because of the numbers involved I'm sure the results will be valid in broader female populations," he added.

Talking about the 80 per cent reduction in risk of high blood pressure found in the women who followed all 6 lifestyle choices, Perk said this was like the findings of the Interheart study, the 2004 global study led by McMaster University in Canada.

That study found that 90 per cent of first heart attacks were linked to 9 lifestyle factors.

"So there's a consistent pattern here," said Perk, it suggests, he said, that:

"Four out of five cases of hypertension or heart attack are amenable to lifestyle intervention. So, most of us can do something about prevention."

"It's a public health issue, and we need to put our heads together," he urged.

Perk said the two studies affirmed the ESC message on cardiovascular disease prevention:

• Don't smoke.
• Exercise for at least 30 minutes every day.
• Use calorie control and exercise to keep your BMI in the normal range.

BMI stands for Body Mass Index: it is the ratio of your weight in kilos to the square of your height in metres. A normal BMI is between 20 and 25. Thus a person who weighs 80 kilos (176 pounds) and stands 183 cm tall (6 feet) has a BMI of 23.9 which is in the normal range.

"These two studies yet again confirm the wisdom of this advice, and provide even more evidence to translate our knowledge into action" said Perk.

"Relation between modifiable lifestyle factors and lifetime risk of heart failure."
Luc Djousse; Jane A. Driver; J. Michael Gaziano.
JAMA. 2009;302(4):394-400.

"Diet and Lifestyle Risk Factors Associated With Incident Hypertension in Women."
John P. Forman; Meir J. Stampfer; Gary C. Curhan
JAMA . 2009;302(4):401-411.

Additional source: European Society of Cardiology.

Oldest New Mom Dies, Leaves Twins

MADRID (July 15) -- A Spanish woman who deceived a U.S. fertility clinic about her age and become the oldest woman to give birth has died at 69, leaving behind 2-year-old twins, newspapers reported Wednesday.

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News International / ZUMA Press

Maria del Carmen Bousada, the oldest woman to give birth, died at age 69, leaving behind 2-year-old twins.

Maria del Carmen Bousada gave birth in December 2006 after telling a clinic in Los Angeles that she was 55, the facility's maximum age for single women receiving in-vitro fertilization. Guinness World Records said the 66-year-old was the oldest on record to give birth and the case ignited fierce debate over how much responsibility fertility clinics have over their patients.

Bousada told an interviewer at the time that the Pacific Fertility Center did not ask her for identification, and maintained that because her mother had died at 101, she stood a good chance of living long enough to raise her children.

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Dr. Vicken Sahakian, director and owner of the clinic, said Bousada falsified her birth date on documents from Spain.

When he learned of the deception, "I figured something might happen and wind up being a disaster for these kids, and unfortunately I was right," he said.

It's easy for women to lie to their doctors, he said.

"We don't ask for passports, obviously," Sahakian said. "When is the last time you went to a doctor and he asked you for a birth certificate? We're not detectives here."

Bousada's brother told the local newspaper Diario de Cadiz that she had died but he did not disclose the cause. The newspaper said, without citing a source, that Bousada had been diagnosed with a tumor shortly after giving birth.

Sahakian said he implanted the Spanish woman with a younger woman's eggs and donated sperm, using hormones to "rejuvenate" her uterus with hormone therapy after she had been in menopause for 18 years.

The hormone treatment lasted three weeks. Sahakian said he did not believe that increased the woman's cancer risk.

"Nothing she did (to get pregnant) caused her illness," he said.

The brother, Ricardo Bousada, told the Barcelona-based newspaper El Periodico de Catalunya that he had exclusively sold details of his sister's death to an unidentified television program and that the proceeds would go to looking after his sister's twin boys, Pau and Christian.

Repeated calls by The Associated Press to Ricardo Bousada's residence in the southern province of Cadiz went unanswered. A woman who answered the phone at a number listed for another brother, Jose Luis Bousada, declined to comment. Her death was also reported by the national newspapers El Mundo

There was no word on who would raise the twins. Bousada had once said she would look for a younger man to help her raise them.

¨

Bousada lived with her mother most of her life in Cadiz and worked in a department store before retiring. She decided to have children after her mother died in 2005 and initially kept her plan secret from her family, she told reporters.

She told the British tabloid News of the World that she sold her house to raise $59,000 to pay for the in-vitro fertilization.

"I think everyone should become a mother at the right time for them," Bousada told the paper. "Often circumstances put you between a rock and a hard place, and maybe things shouldn't have been done in the way they were done, but that was the only way to achieve the thing I had always dreamed of, and I did it," she said.

Spanish law on assisted reproduction sets no age limit, but state-funded and private clinics that offer the procedure set the ceiling at age 50 in an informal agreement based on recommendations from the scientific community, according to the Health Ministry.

There is no U.S. law limiting the age at which women can receive in vitro fertilization but Sahakian said he generally limits it to 55 or 56 because "I would like the mother ... to basically survive until the kids reach 18."

When Bousada finally told her relatives she was two months pregnant, they thought she was joking, she said.

"Yes, I am old of course, but if I live as long as my mom did, imagine, I could even have grandchildren," she told the News of the World.

Allan Pacey, secretary of the British Fertility Society, said the organization recommends that assisted conception generally not be provided to women beyond the natural age of menopause at about 50.

"The rationale for all that is that nature didn't design women to have assisted conception beyond the age of the natural menopause...once you get into the mid-50s, I think nature is trying to tell us something," Pacey told The AP.

He added: "I think many people would worry about providing fertility treatment to women in their 60s. I think as a general rule, to embark on pregnancy when you may not see your child go to university is potentially a very difficult situation."

Adriana Iliescu, a Romanian who in 2005 also gave birth at 66, although she was 130 days younger than Bousada, said she was pained to hear of her death and what it meant for her sons.

"It is a great sadness when kids are orphans but civil society will help these children," she told The AP.

She described her little daughter Eliza as "very energetic and spoiled. We dance and sing together."

"I don't feel I am getting old. My pregnancy kept me young," Iliescu said.

AP correspondents Maria Cheng in London, Alison Mutler in Bucharest, and Jorge Sainz and Paul Haven in Madrid contributed to this report.

Cancer Patient Dedicates Life to Research

(July 16) - The diagnosis could not have been more devastating. At 23, medical student PJ Lukac learned he had a rare, often fast-growing brain tumor.
But it's what Lukac did after the diagnosis that has made headlines in the Chicago Tribune.

According to the newspaper, Lukac, a second-year medical student at Columbia University, sought out Dr. Markus Bredel, the director of the Northwestern Brain Tumor Institute's research program, and said he wanted to study his cancer -- and try to save his own life.

Bredel hired the student as an assistant researcher.

This week, the newspaper reported, Bredel's lab announced it had identified genes that are key to forming the type of tumor Lukac has, glioblastoma. The research suggests that certain genes in the tumor could determine how it will grow, which in turn could help doctors better treat the cancer. It is the same type of brain cancer Sen. Edward Kennedy has.

"The last two or three months, being here and doing what I've been able to do, it just feels great," Lukac, now 24, told the Tribune. "It sounds really weird, but it has been two or three of the best months of my life."

Said Bedel: "Having PJ around us as a co-worker and friend is something that motivates our whole team in trying to be as quick and good as possible in finding that needle in a haystack, or needles in the haystack, to make progress in the treatment ... from which, hopefully, PJ will be able to benefit."

Read the full story from the Chicago Tribune.

Prenatal Pollution May Lower IQ Scores

CHICAGO, Ill. (July 20) - Researchers for the first time have linked air pollution exposure before birth with lower IQ scores in childhood, bolstering evidence that smog may harm the developing brain.
The results are in a study of 249 children of New York City women who wore backpack air monitors for 48 hours during the last few months of pregnancy. They lived in mostly low-income neighborhoods in northern Manhattan and the South Bronx. They had varying levels of exposure to typical kinds of urban air pollution, mostly from car, bus and truck exhaust.
At age 5, before starting school, the children were given IQ tests. Those exposed to the most pollution before birth scored on average four to five points lower than children with less exposure.
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Also See: Fetuses Have Memories, Study Says
That's a big enough difference that it could affect children's performance in school, said Frederica Perera, the study's lead author and director of the Columbia Center for Children's Environmental Health.
Dr. Michael Msall, a University of Chicago pediatrician not involved in the research, said the study doesn't mean that children living in congested cities "aren't going to learn to read and write and spell."
But it does suggest that you don't have to live right next door to a belching factory to face pollution health risks, and that there may be more dangers from typical urban air pollution than previously thought, he said.
"We are learning more and more about low-dose exposure and how things we take for granted may not be a free ride," he said.
While future research is needed to confirm the new results, the findings suggest exposure to air pollution before birth could have the same harmful effects on the developing brain as exposure to lead, said Patrick Breysse, an environmental health specialist at Johns Hopkins' school of public health.
And along with other environmental harms and disadvantages low-income children are exposed to, it could help explain why they often do worse academically than children from wealthier families, Breysse said.
"It's a profound observation," he said. "This paper is going to open a lot of eyes."
The study in the August edition of Pediatrics was released Monday.
In earlier research, involving some of the same children and others, Perera linked prenatal exposure to air pollution with genetic abnormalities at birth that could increase risks for cancer; smaller newborn head size and reduced birth weight. Her research team also has linked it with developmental delays at age 3 and with children's asthma.
The researchers studied pollutants that can cross the placenta and are known scientifically as polycyclic aromatic hydrocarbons. Main sources include vehicle exhaust and factory emissions. Tobacco smoke is another source, but mothers in the study were nonsmokers.
A total of 140 study children, 56 percent, were in the high exposure group. That means their mothers likely lived close to heavily congested streets, bus depots and other typical sources of city air pollution; the researchers are still examining data to confirm that, Perera said. The mothers were black or Dominican-American; the results likely apply to other groups, researchers said.
The researchers took into account other factors that could influence IQ, including secondhand smoke exposure, the home learning environment and air pollution exposure after birth, and still found a strong influence from prenatal exposure, Perera said.
Dr. Robert Geller, an Emory University pediatrician and toxicologist, said the study can't completely rule out that pollution exposure during early childhood might have contributed. He also noted fewer mothers in the high exposure group had graduated from high school. While that might also have contributed to the high-dose children's lower IQ scores, the study still provides compelling evidence implicating prenatal pollution exposure that should prompt additional studies, Geller said.
The researchers said they plan to continuing monitoring and testing the children to learn whether school performance is affected and if there are any additional long-term effects.

Interactive Patient Care Technology Improves Outcomes in Heart Failure Care

A hospital bedside technology solution offers significant improvements in heart failure readmission rates, average length of stay, and patient satisfaction.

The Heart Failure Interactive Care Plan is powered by a proprietary workflow engine called Patient Pathways that helps automate patient care processes, and guides patients through critical aspects of their stay, inviting them to learn more about their care, condition, and safety. The system can interface with existing hospital systems, enhancing workflow without requiring the staff to use additional software or take additional steps. Tasks such as education ordering and medication dispensation can be carried out as usual, from within the hospital’s clinical system. The system can then automatically trigger a customized pathway to engage the patient in the care process, sending information back to the hospital’s clinical system for documentation in the patient’s electronic medical record (EMR).

The system comprises a head-end unit with high performance servers designed to support application and database services, private networking, firewall protection, remote access monitoring, and system maintenance services. The system also provides support for redundant power supply and surge protection, and is housed in one full height, high-density rack unit. Each patient-room display device (usually a television monitor) is equipped with a digital set-top box that acts as a controller and conduit between the head-end hardware and the display device. Patients and other end users access the system through a pillow-speaker and accompanying keyboard for text input, or via an optional remote control. Thus, the system transforms the television in the patient room into an interactive resource during the hospital stay. Patients can access an education library, entertainment options, surveys, service request menus, and more, directly at the bedside. The Heart Failure Interactive Care is a product of GetWellNetwork (Bethesda, MD, USA).

“With so much attention in health care today being devoted to improving heart failure outcomes, especially reducing hospital readmission rates, we are excited to be able to report these results,” said David Wright, chief outcomes officer of GetWellNetwork. “This study is a clear example of the impact patient engagement has on advancing quality, cost and even service outcomes in hospitals today. When patients have the resources to be a more active participant in their care, the overall care experience is exceptional.”

Dry Mouth Linked to Prescription and OTC Drugs

A new study reports that a majority of dentists say patients complaining about dry mouth are taking multiple medications.

Researchers affiliated with the U.S. Academy of General Dentistry (AGD; Chicago, IL, USA) reported the findings of a nationwide member survey involving nearly 500 general dentists who responded to a questionnaire. The study reported that 89% of the dentists believe prescription medications are the primary contributor to dry mouth; aging, dehydration, and salivary gland disease were also cited as major contributors. The survey also revealed that approximately two-thirds of the dentists considered dry mouth to be a very serious condition, due to the promotion of tooth decay; 68% said constant thirst is the most common symptom communicated by patients; and 44% said patients have difficulty eating, swallowing, or speaking. According to the survey, more than 92% reported that patients attempt to increase salivary production by drinking water; less than 58% said patients try taking over-the-counter saliva substitutes, chewing sugar free gum, or sucking on hard candy; and more than 60% of those surveyed consider diagnosing a patient with xerostomia after he or she exhibits or reports symptoms of dry mouth.

As indicated by the AGD survey, the most common symptoms reported by patients include constant thirst and difficulty eating, swallowing, or speaking. Foamy or stringy saliva, irritation of the tongue, burning of the tissues inside the mouth, painful ulcerations, and dentin hypersensitivity (extreme sensitivity in one or more teeth) are also dry mouth symptoms. Over time, xerostomia sufferers may experience extensive tooth decay, tooth loss, or gingivitis due to the lack of saliva. The results of the survey were presented at the AGD 57th annual meeting and exhibit, held during July 2009 in Baltimore (MD, USA).

“The number of xerostomia cases has increased greatly over time because people are taking more and more medications,” said Cindy Kleiman, R.D.H, who presented the survey results. “General dentists are seeing this trend in their offices, which is why they are trying to learn all they can about this condition. The more they know, the better they will be at diagnosing and treating patients.”

Xerostomia, sometimes colloquially called pasties or cottonmouth, can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva in remineralizing the enamel is no longer present, and the mucosa and periodontal tissue of the mouth become more vulnerable to infection. Over 500 medications can cause xerostomia, including antidepressants, painkillers, diuretics, antihistamines, and tranquilizers.

What is Cancer? What Causes Cancer?

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumors can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function. Tumors that stay in one spot and demonstrate limited growth are generally considered to be benign.

More dangerous, or malignant, tumors form when two things occur:

1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion


2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.

In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialize in the study, diagnosis, treatment, and prevention of cancer are called oncologists.

What causes cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

What is cancer? - Video

A short, 3D, animated introduction to cancer. This was originally created by BioDigital Systems and used in the Stand Up 2 Cancer telethon.

Genes - the DNA type

Cells can experience uncontrolled growth if there are damages or mutations to DNA, and therefore, damage to the genes involved in cell division. Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.

Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene function, leading to uncontrollable cell growth.

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.

Genes - the family type

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.

Other medical factors

As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) - and anything else that suppresses or weakens the immune system - inhibits the body's ability to fight infections and increases the chance of developing cancer.

What are the symptoms of cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. Some cancers can be felt or seen through the skin - a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.

Other cancers have symptoms that are less physically apparent. Some brain tumors tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumor grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.

As cancer cells use the body's energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.

When cancer spreads, or metastasizes, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

How is cancer classified?

There are five broad groups that are used to classify cancer.

1. Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.


2. Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.


3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.


4. Leukemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.


5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

• Adeno- = gland


• Chondro- = cartilage


• Erythro- = red blood cell


• Hemangio- = blood vessels


• Hepato- = liver


• Lipo- = fat


• Lympho- = white blood cell


• Melano- = pigment cell


• Myelo- = bone marrow


• Myo- = muscle


• Osteo- = bone


• Uro- = bladder


• Retino- = eye


• Neuro- = brain

How is cancer diagnosed and staged?

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body's sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumor, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable.

How is cancer treated?

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

Surgery

Surgery is the oldest known treatment for cancer. If a cancer has not metastasized, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.

Radiation

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilizes high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumor or destroy cancer cells (including those associated with leukemia and lymphoma), and it is also used in combination with other cancer treatments.

Chemotherapy

Chemotherapy utilizes chemicals that interfere with the cell division process - damaging proteins or DNA - so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasized because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

Immunotherapy

Immunotherapy aims to get the body's immune system to fight the tumor. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumor to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumors. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoetic stem cell transplantation) can also be considered immunotherapy because the donor's immune cells will often attack the tumor or cancer cells that are present in the host.

Hormone therapy

Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing estrogen levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukemia and lymphoma cases can be treated with the hormone cortisone.

Gene therapy

The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.

How can cancer be prevented?

Cancers that are closely linked to certain behaviors are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer - most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.

Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus's relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumors as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

How to eat to prevent cancer - Video

A guide to some everyday foods that contain nutrients that may help reduce your risk of getting cancer. Video by Howcast.

Cancer / Oncology news

Medical News Today is a leading resource for the latest headlines on Cancer and Oncology. So, check out our cancer news section. You can also sign up to daily medical news alerts or our weekly digest medical newsletters to ensure that you stay up-to-date with the latest news.

 

What is Asthma - Video

What is Asthma - Video

A video that explains what asthma is and the medications available to help relieve it. (by Altana Pharma)

http://www.youtube.com/watch?v=jmuWKSRqvKI

What is Asthma? What Causes Asthma?

Asthma is a disease affecting the airways that carry air to and from your lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.

The inside walls of an asthmatic's airways are swollen or inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases your susceptibility to an allergic reaction.

As inflammation causes the airways to become narrower, less air can pass through them, both to and from the lungs. Symptoms of the narrowing include wheezing (a hissing sound while breathing), chest tightness, breathing problems, and coughing. Asthmatics usually experience these symptoms most frequently during the night and the early morning.

For information on the different causes of asthma (allergy, colds, stress, exercise, etc) please see page 4 (causes of asthma).

Oldest Mother Dies At 69 Orphaning Twin IVF Babies

Single mother María Carmen del Bousada de Lara, a retired shop worker from Cadiz in Spain, has died at the age of 69, orphaning her two and a half year old twin sons that she gave birth to at the age of 66 after receiving IVF treatment at an American fertility clinic.

Bousada's family told the Spanish newspaper Diario de Cadiz that she died on Saturday but gave no details.

Bousada's death, which according to the Spanish newspaper is thought to be from cancer, has reignited the debate about allowing older women to undergo fertility treatment. The newspaper said she was diagnosed with cancer shortly after giving birth to Christian and Pau at Sant Pau hospital in Barcelona on 29 December 2006.

After the births, Bousada told a Spanish television programme that the drugs she took during the IVF treatment probably helped the cancer to spread. She said however that she had no regrets.

Bousada went to America to have in vitro fertilization treatment in early 2006, after selling her house in Cadiz to help pay for it. She later admitted lying about her age: she told doctors who treated her at the Pacific Fertility Centre in Los Angeles that she was 55.

According to a report in Times Online, one of the doctors, Vicken Sahakian, told the press later that Bousada had presented fake documents showing she was 55 years old. Sahakian said:

"If I had known her real age I would not have treated her."

However, according to the Diario de Cadiz report, Bousada had said that nobody at the Los Angeles clinic had asked to see her passport, nor had they asked for proof of her age.

The first stage of her treatment involved hormone treatment to reverse the menopause: she had not had a period for nearly 20 years. Bousada said later that it felt strange to have a period after so much time.

The Spanish paper reported that during the final stages of her pregnancy doctors were worried and even feared for her life. However, the babies were born with no complications, apart from having to spend one month in incubators.

Bousada's brother, Ricardo said yesterday that his sister's fight against cancer will be covered in a story that has been sold to a Spanish television channel. He did not give details about the exact cause of his sister's disease and said that the money from the deal would help provide for his orphaned nephews.

Bousada's family will most likely care for the two boys; there is speculation that younger cousins thought to be in their thirties or forties will take on the role.

The news has provoked fresh calls for an upper age limit for fertility treatment in Spain, where family values are important, said a Times Online report.

Nuria Terribas of the Borja Bioethics Institute told the press that:

"We think a limit of 45 should be established in law."

"Cases like this not only create physical dangers for the mother but many family complications," added Terribas.

Josep Torrence of the progressive Catholic organization Iglesia Plural said that leaving children unprotected should not be allowed.

"What is needed are stricter controls to stop this happening again," he added.

After her twin boys were born, Bousada reportedly told UK's The News of the World that she expected to live a long life.

"My mother lived to 101 years old and I have every reason to believe longevity runs in my family," she said, even joking that she might live to see her grandchildren.

According to Diario de Cadiz, Bousada had cared for her mother until her death in 2005 and it was only then that she felt she could go ahead and realize her dream to have children. When she told a small circle of friends what she was going to do, nobody believed her, and said it would be impossible, reported the newspaper.

Bousada asked that people not judge her, when she commented about the surprised reactions she evoked when people saw she was pregnant.

According to a BBC report, when Bousada gave birth she was 66 years and 358 days old, which is 130 days older than Adriana Iliescu of Romania who gave birth to a baby girl in 2005.

Many People Can Cope With Knowing They Have Alzheimer's Risk

Many people who discover that they have inherited a higher risk of developing Alzheimer's can cope with the news, especially if they receive the it through genetic counseling: they may experience depression or anxiety at first, but it does not last long, according to a new study from the US.

The study was the work of co-author Scott Roberts, now a researcher at the University of Michigan School of Public Health in Ann Arbor, and colleagues, and is published in the New England Journal of Medicine, NEJM.

Roberts did the research while he was at Boston University. He is also co-principal investigator on the Risk Evaluation and Education for Alzheimer's Disease (REVEAL) study, a series of randomized clinical trials that are looking at the impact of a genetic susceptibility testing program for adult children of people with Alzheimer's.

The NEJM study addresses a debate that has been going on for some time, about whether being told they have an inherited predisposition to Alzheimer's disease causes psychological harm to people, especially if there is a history of it in the family.

People with a family history of Alzheimer's disease are already at higher risk. But the risk is even higher if they also carry a certain variant of the APOE gene (Apolipoprotein E).

Having a parent with Alzheimer's is thought to increase one's risk of developing the disease by age 85 to between 30 and 35 per cent, compared with a general population risk of 10 to 15 per cent, said the authors. If you also carry the APOE variant the risk is 50 per cent.

For the study Roberts and colleagues recruited 162 participants with at least one parent who had been diagnosed with Alzheimer's disease.

The participants first took part in an education session about Alzheimer's and were then offered a genetic test that looked for presence of the APOE variant that conferred higher risk of Alzheimer's.

The participants that agreed to have the test were given their results by trained genetic counselors.

The researchers then followed them for about 12 months and assessed the psychological impact of the revelation. The participants completed tests for depression, anxiety and test-related distress before disclosure, and then 6 weeks, 6 months, and 12 months after.

The results showed that for the participants who were told they had the risk-increasing gene, the test-related distress level was slightly higher at the 6 week point, but not at the 6 month or 12 month point.

Anxiety and depression levels remained stable, said Roberts, who told the press that while some people might say they were thinking a lot about the test result, "it didn't translate into long-term depression or anxiety".

However, the results did show that:

"Persons with high levels of emotional distress before undergoing genetic testing were more likely to have emotional difficulties after disclosure," wrote the authors.

"The findings show if you do (disclose this genetic information) genetic counseling may be an important component to ensure that most people do not respond with significant distress," said Roberts.

Genetic counseling puts the test results in context and helps people understand the meaning and limits of the results, he added, citing the example of a person with a 55 per cent lifetime risk being reminded that this also meant there was a 45 per cent risk that they would not get the disease.

The study's results are timely because as more and more private firms offer genetic testing, it raises the question of whether people should know about genetic risks outside of a clinical context.

Roberts said some might argue that it is "paternalistic" to decide for others what they can and cannot know about their own genes.

He said that after the initial education session, only 20 per cent of the participants refused to go ahead with the test, which meant the majority wanted to know.

"I think most adult children of Alzheimer's patients would favor the right to at least have the choice," said Roberts.

Swearing Appears To Lessen Effects Of Pain

A new UK study found that swearing appeared to lessen the effects of pain, perhaps because it invokes a similar response as that which occurs in fight or flight when it breaks the link between fear of pain and the perception of pain, concluded the researchers.

The study was the work of psychologists Richard Stephens, John Atkins and Andrew Kingston at Keele University in Staffordshire, and was recently published in the journal NeuroReport.

Although swearing is a common response to pain, whether it actually alters our experience of it is somewhat of a mystery.

According to a Reuters news agency report, Stephens said:

"Swearing has been around for centuries and is an almost universal human linguistic phenomenon."

"Our research shows one potential reason why swearing developed and why it persists," he added.

Stephens said it appears to arise in the right brain, whereas most language tends to arise in the left cerebral hemisphere.

For this study, the researchers investigated the extent to which swearing altered the ability of 64 volunteers to withstand immersing their hand in water (cold-pressor pain tolerance). They also measured pain perception and heart rate.

The researchers asked the volunteers to repeat a swear word while they immersed their hand in water. And then they asked them do the experiment again, except this time they repeated a neutral word that described a table.

Stephens and colleagues also examined sex differences, the role of pain catastrophizing, fear of pain and trait anxiety.

They found that compared with not swearing, swearing increased pain tolerance and heart rate, and decreased perception of pain.

However, "swearing did not increase pain tolerance in males with a tendency to catastrophise," they wrote.

They concluded that:

"The observed pain-lessening (hypoalgesic) effect may occur because swearing induces a fight-or-flight response and nullifies the link between fear of pain and pain perception."

Stephens told the press that while they did not establish the link with fight or flight, they think perhaps swearing increases aggression.

"What is clear is that swearing triggers not only an emotional response, but a physical one too", he added, explaining that perhaps this is why the practice of swearing has survived for centuries.