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May 20th, 2010
06:50 PM ET

Study: No radiation after surgery ok for certain breast cancer patients

By Miriam Falco
CNN Medical News Managing Editor

Older breast cancer patients who have their small tumors surgically removed get little benefit from radiation treatment, according to a study released Thursday by the American Society of Clinical Oncologists.

Researchers followed 636 women with early stage estrogen-receptor positive breast cancer, which is fairly common in older women. according to ASCO president Dr. Douglas Blaney.

The standard therapy for this type of cancer is to surgically remove the tumor, then give the women a drug called tamoxifen, which blocks the hormone estrogen, which can fuel tumor growth. The tamoxifen is then followed by intense radiation therapy to kill any remaining cancer cells.

All of the women in the study had a lumpectomy and got the hormone-blocking drug. Only half the women also went on to have radiation therapy – the other half did not.

Researchers found the survival was equal after just over 10 years.

"Avoiding radiation is feasible,” study author Dr. Kevin Hughes concludes based on the results.

The impact of these study results could be quite dramatic for breast cancer patients.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, believes the results of this study "will be practice changing,” meaning that it is likely to become the standard treatment for some of these patients.

"Getting the women to the doctor every day for six weeks is very difficult," says Brawley. "One-third of women drop out from radiation after two to three weeks."

Dr. Douglas Blaney, president of ASCO, didn't go so far. He thinks the research is "possibly practice changing" and says when women find out how small the radiation benefit really is and choose to defer getting it, "this gives us some comfort as physicians in supporting our patients."

The study also found only 7 percent of the women in this trial who already passed away actually died from breast cancer, leading Hughes to conclude "death from [this type of] breast cancer is a very rare event for women with very small tumors.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 20th, 2010
09:56 AM ET

Study: Gluten-free diets do not improve autism behavior

By Trisha Henry
CNN Medical Producer

Keeping the proteins found in wheat, barley, rye and dairy out of the diets of children with autism does not lead to behavior improvements, new research has found.

While many doctors do not recommend a special diet as an autism therapy, there are widespread reports from families on the internet lauding the success of keeping foods containing gluten and casein out of an autistic child's diet. Currently, nearly one in three children with autism is given a gluten- and casein-free diet in an effort to reduce symptoms of the neurodevelopmental disease, study authors say.

Actress and activist Jenny McCarthy is one the most vocal parents who claims her son's autism symptoms improved when she switched his diet.

The cause of autism, a neurodevelopmental disorder that hinders communication and social interaction, is not yet known and there is no cure. While there are a few science-based therapies, which applied early in a child's development can improve the behavior in some children, for many families finding way to help children can be challenging and lead them to try many unproven treatments.

Researchers at the University of Rochester Medical Center in upstate New York put the gluten- and casein-free diet to most stringent test today, according to lead author Dr. Susan Hyman.

They looked at 14 children with autism between the ages of 2½ and 5½ years old – but without celiac disease or allergies to milk and wheat.

First they removed gluten and casein from the children’s diet. After four weeks, the children were randomly given either gluten or casein, both, or a placebo, through a carefully measured snack. Parents, teachers and a research assistants were questioned about the child's behavior before and after the snack was eaten.

"Under these controlled circumstances we did not find an effect on behavior in response to challenges with gluten and casein in children with autism but without GI disease," says Hyman.

Parents need to be aware of the potential cost and measure the benefit before they consider trying a new treatment for their child, says IMFAR Program Committee program chair, David Mandell.

Hyman and Mandell both say more studies need to be done looking at the effects of diet and the specific subtypes of autism.

The study is being released this weekend at the International Meeting for Autism Research in Philadelphia.

Autism usually develops by the time a child is 3 years old. An average of 1 in 110 children suffers from some type of an autism spectrum disorder.

Children with autism can have one of several complex neurological disorders, which lead to social impairments, communication difficulties and restrictive and repetitive behaviors. According to the most recent data from the Centers for Disease Control and Prevention, an average of 1 in 110 children suffers from some type of an autism spectrum disorder.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 19th, 2010
05:49 PM ET

Clark: 'I am still scared to jump into the Hudson'

After finishing a training weekend in Austin, Texas, with the rest of the Fit Nation Challenge participants – affectionately known as "the 6-pack," Meredith Clark tells us how her training is going, how she's improving, and what still makes her apprehensive about the Nautica New York City Triathlon on July 18. Meredith and the rest of the 6-pack, along with several CNN employees will jump into the Hudson River to swim a mile, followed by a 25-mile bike ride, and a 6-mile run.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 19th, 2010
02:11 PM ET

Viagra associated with hearing loss

by Madison Park
CNNhealth.com writer/producer

Oh Viagra.

Sure, Pfizer’s wonder pill has side effects such as headaches, facial flushing, upset stomach, erections lasting more than four hours, bluish or sudden loss of vision.  There’s one more risk to the pill that grants erections: Hearing loss.

Research published this week in Archives of Otolaryngology-Head and Neck Surgery showed an association between long-term hearing loss and Viagra.

This side effect is already acknowledged by Viagra - especially after the U.S. Food and Drug Administration forced this labeling changes for oral erectile dysfunction medicines known as PDE5 inhibitors in 2007.

The research conducted at the University of Alabama at Birmingham looked into the data based on 11,525 men.  Men who self-reported hearing problems were twice more likely to indicate that they used erectile dysfunction medication.

While it’s difficult to establish cause and effect in an observational study, these findings  indicate that the FDA labeling was warranted, said study author Gerald McGwin, a professor of epidemiology at the UAB School of Public Health, in a taped news release.

The association was present for long-term hearing loss after using Viagra, and to a lesser extent other ED drugs such as Cialis and Levitra.  The sample sizes for the two latter drugs were smaller.

Since Viagra increases blood flow to the penis, perhaps the drug increases blood flow to the ear causing damage, McGwin hypothesized.

For more facts about Viagra

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 19th, 2010
12:35 PM ET

Is drinking healthy, or do healthy people drink?

By Elizabeth Landau
CNN.com Health Writer/Producer

It seems as if there's always a new study claiming that alcohol is surprisingly good or bad for you. Various studies have suggested that alcohol may help the brain in an injury but, according to other research, shrink the brain.

The latest addition to the growing body of work on this subject suggests that moderate drinking - between one and three glasses of alcohol a day, with 10 grams per glass - is associated with lower anxiety and lower body mass index compared against people with heavier or lighter drinking habits (or who don't drink at all).

A new study published in the European Journal of Clinical Nutrition looked at the drinking habits and health status of nearly 150,000 people in France. Researchers looked at a variety of factors related to cardiovascular health, including obesity and anxiety levels. They determined that moderate alcohol consumption was strongly associated with characteristics "that favor a superior overall health status and a lower risk of CVD [cardiovascular disease]."

But the authors raise the possibility that moderate consumption of alcohol does not cause people to achieve better health; rather, some other factors could be at play - in other words, physical activity and lower stress could be causing the lower risk in cardiovascular disease, and people with those characteristics coincidentally drink moderately.

"Our data suggest that it is clearly premature to promote alcohol consumption as the basis of CV [cardiovascular disease] protection" until it can be proved that alcohol causes those benefits, the authors wrote.

Moderate female drinkers were more likely to report engaging in regular physical activity than their counterparts who drank more or less; among men, those who never drank had the highest physical activity levels, the study found.

The study used self-reported data, meaning results may be skewed by people overstating and understating their actual alcohol consumption. Also, participants elected to join the study, and were not randomly chosen. The authors' analysis finds that these participants are representative of the population of the urban region of Paris-Ile-de-France, but it is unclear how applicable the findings particular to this group would be.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 18th, 2010
05:47 PM ET

How accurate is Google Flu Trends?

By Elizabeth Landau
CNN.com Health Writer/Producer

An Internet tool called Google Flu Trends launched in November 2008 with a lot of enthusiasm (although it was not called "Flugle" as I'd hoped). It promised to predict flu outbreaks based on the abundance of people searching for flu-related items on Google search engine.

But a new study questions its accuracy. Researchers at the University of Washington put Google Flu Trends to the ultimate test: comparing its estimates against the Centers for Disease Control and Prevention's national surveillance programs.

Google Flu Trends results have been shown to be mostly accurate in estimating influenza-like illness, but it had not been evaluated against laboratory tests for confirmed influenza virus, Dr. Justin Ortiz of the University of Washington, who led the study, said in a statement. He presented the findings at the American Thoracic Society meeting in New Orleans, Louisiana.

The Web tool is 25 percent less accurate than the CDC at estimating rates of influenza virus infection confirmed with laboratory testing, the research said. For flu-like illness it is robust, however; previous research showed a 92 percent correlation between Google and CDC for the 2008-2009 season, said Jamie Yood, spokesman for Google Flu Trends.

For Google, these findings are not surprising, Yood said. The system was modeled after flu-like illness data, not laboratory-confirmed cases.

That makes sense because flu-like illness isn't always caused by influenza - in fact, only 20 to 70 percent of flu-like illness cases during the flu season are actually influenza, Ortiz said. But the average Google users aren't likely to have a lab test before punching words like "aches" and "fever" into Google, perhaps to see what the diagnosis would be.

"For them, in a way, it doesn’t matter if it actually technically is influenza or not, it’s more or less the same ailment," Yood said.

Media attention to the flu may skew the results for Google Flu Trends, as evidenced by the deviation in Google vs. CDC data in the 2003-4 season, Ortiz said. That influenza season had early and intense flu activity, and substantial media coverage.

But Google Flu Trends does deliver information about flu activity in a fast and cheap way, and provides a good public health service, Ortiz noted. For individuals, knowing about flu activity may help remind people to get flu shots and take other simple precautions, Yood said.

Google Flu Trends is always trying to improve the model, but not because of this study, Yood said. The search engine gurus are working on expanding geographic areas for flu predictions and on improving granularity.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 18th, 2010
01:51 PM ET

BPA present in most canned food, groups allege

By Caleb Hellerman
Senior Producer, CNN Medical News

The chemical bisphenol-A, more commonly known as BPA, is present in virtually all canned foods, according to a report released today by environmental groups who say the omnipresent chemical poses a health risk, especially to infants and pregnant women. BPA is present in the thin plastic lining that protects the surface of metal food containers. A coalition calling itself “The National Workgroup for Safe Markets” conducted laboratory tests on 50 samples of canned food, purchased in stores or donated from home pantries in 19 U.S. states and Canada. Of the 50, 46 contained at least some BPA. The median level was 35 parts per billion, but some food had much more, as high as 1,140 parts per billion in a can of Del Monte green beans.

Bisphenol-A is what is known as an endocrine disruptor, meaning it has the potential to affect the hormones – chemical signals – that direct a range of processes in the body. In animal studies, researchers have linked BPA to various developmental problems, from behavior issues to an increased risk of cardiovascular disease.

Whether BPA is harmful to humans is unclear. Back in 1963, the FDA declared it safe, but more recently, there’s been a scientific reappraisal. The National Toxicology Program now says there is "some concern" for BPA's effects on the brain, behavior and prostate gland, in developing fetuses, infants and children. In January, the FDA posted guidelines urging parents to minimize infants’ exposure through bottles and feeding cups, but it stopped short of saying there is a definite risk of harm.

Pete Myers, a biologist who has studied the effects of BPA, says the level of in baby bottles that triggered alarm, was less than 30 parts per billion, lower than the numbers reported Tuesday about canned food. Myers is chief scientist at the privately-funded group Environmental Health Sciences, based in Charlottesville, Virginia, and has written several articles critical of BPA, including an editorial in the Journal of the American Medical Association.

The Environmental Protection Agency has also taken steps toward further study and possible restrictions of BPA, although the process is still under review. The National Institute of Environmental Health Sciences is funding $30 million worth of research on BPA, with the first round of findings expected as early as this summer, Myers said.

Myers says that research on animals, and other research involving human cell tissue, show that BPA may suppress the production of a hormone – adiponectin – that protects against heart disease. His biggest worry involves a pregnant woman who ingests BPA and passes it on to her developing fetus. “There are some indications it may concentrate in the fetus. It’s definitely not something the fetus is protected from,” says Myers. “There are several [health concerns about BPA], but for me the most worrisome relate to diabetes and heart disease, triggered in infancy or in the womb.”

The FDA declined to comment on Tuesday’s report.

The Grocery Manufacturer’s Association and several makers of canned goods said Tuesday that BPA is not a safety issue. However, both Del Monte and Conagra, whose Healthy Choice soups were tested by the coalition and found to contain BPA, said they are exploring alternatives to BPA in can liners. Conagra told CNN that “as part of our ongoing commitment to providing quality products that meet or exceed consumer expectations, we are constantly looking for new and better ways to package our products. That includes finding safe and effective replacement can liners that do not use BPA.”

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 17th, 2010
03:28 PM ET

New defibrillator

By Trish Henry
CNN Medical Producer

Researchers say they've developed a new defibrillator that's potentially less risky for patients.

One of the leading causes of death in the U.S. is cardiac arrest due to an irregular heartbeat, or ventrical fibrillation. Implantable cardioverter defibrillators detect heartbeat abnormalities and deliver a shock to as needed to it make the heartbeat regular again. It acts like a personal paramedic and can prevent sudden death.

Conventional defibrillators connect wires to the heart. But the new subcutaneous implantable dardioverter-defibrillator under development doesn't, making it less risky for patients.  Here's how it works: An electrode and shocking coil are positioned to the left of the sternum, with the lead wire connecting it to a pulse generator located over the ribs. The new device doesn't have to go into blood vessels at all. The device "prevents any vascular complications and it allows for leads that may be less subject to wear and tear damage," says Dr. Gordon Tomaselli, spokesman for the American Heart Association.

Leads have to be extremely flexible, especially with the heart beating 70-80 times a minute. They typically have to be replaced every five to seven years because over time the majority of them will break. The new device avoids the usual complications that doctors face of putting foreign materials into an organ. In addition, this new device allows for the leads to be placed in a spot much more easily accessed than with a traditional device.

Study author, Dr. Gust H. Bardy, says the new defibrillator offers the promise of saving lives without the high number of inappropriate shocks that the traditional device is known for. He says the procedure to implant the new defibrillator is easier on the patient and cheaper.

Not placing leads in the heart is especially beneficial, researchers say, for young patients who need defibrillators. "If you can avoid getting into the heart space early in their life and stay under the skin for one or two decades, that's a heck of an advantage…and they won't be subjected to long-term complications," Bardy said.
One disadvantage with the new device, researchers found, is that it won't help patients whose heartbeat abnormalities require both a defibrillator and a pacemaker to correct.

The study of 55 patients was sponsored by Cameron Health Inc., which is developing the new defibrillator. A larger study with 330 patients was recently launched in an effort to gain U.S. approval. The device already is available in Europe.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 17th, 2010
10:05 AM ET

Bracing for blow may ward off brain injury

By Stephanie Smith
CNN Medical Producer

On the ice at a youth hockey game, players hurl and slam into one another - and that's on a good night. That makes it the perfect venue to study how all those collisions - and a player's preparedness for them - can impact the severity of a head injury.

According to a new study in the journal Pediatrics, the better a player anticipated a collision with another player, the less jarring the impact to the head. Makes sense, but perhaps more important is the converse of this finding: The less prepared an athlete was for that jarring collision, the worse the blow to the head.

"If players anticipate collisions they can better absorb the forces related to impact," said Jason Mihalik, lead study author and assistant professor in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill. "[Athletes] who don't expect to get body checked are not able to tense the neck muscles to absorb force, and that can lead to a more severe impact to the head."

Mihalik and colleagues conducted their study by tracking clashes between players at youth hockey games. During a full season, a team of 16 players between 13-14 years old wore special helmets outfitted with devices called accelerometers. The devices measured the acceleration of players' heads as they bumped into one another, while radio frequency devices on the helmets communicated the force of those blows to a computer outside the rink.

When a player's head was struck, the data were recorded on the sideline computer. That data were compared to game videos to determine whether players had anticipated the hits or if they were caught unaware, and the number of head injuries among team members during the season. It may seem like an obvious point, but as Mihalik and colleagues point out in the study, preparedness - and providing technical skills for players to recognize an imminent hit - really matter.

"Players don't anticipate on their own. they need training in it," said Mihalik. "Coaches need to prepare athletes to be aware on the ice and officials are also responsible for helping out."
When players are unprepared, the result, according to Mihalik, can be calamitous.

According to the National Center for Injury Protection and Control, 15- to 19-year-olds are at the highest risk for suffering a TBI. Among children up to 14 years old, 37,000 are hospitalized and 435,000 visit the emergency room as a result of TBI.

Study authors recommend that, "...coaches...promote the skills necessary to keep the safety of participants at the forefront…” - advice that coaches of any youth sport may wish to adopt.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 14th, 2010
03:55 PM ET

Lettuce recall: Dr. Sanjay Gupta digs deeper

The Centers for Disease Control and Prevention has confirmed that at least 23 people in four states have been sickened after eating Romaine lettuce contaminated with E.coli bacteria. The company that distributed the lettuce, Freshway Foods, has voluntarily recalled its products and told CNN it has been cooperating fully with public health officials to track the source of the outbreak. The lettuce was sold to wholesalers, food service outlets, delis and salad bars; no E.coli has been found in the bagged lettuce you can buy in the grocery store.

Dr. Sanjay Gupta sat down with attorney Bill Marler to talk about food safety. Marler, a Seattle, Washington, attorney who specializes in representing victims of foodborne illness, is representing a client in the new lawsuit against Freshway Foods.

Dr. Sanjay Gupta: You and I have talked about these issues over the years. What concerns you the most about this?

Bill Marler: Well, I think one of the big concerns is that we are seeing a new form of pathogenic E. coli hitting the market. This particular outbreak is E.coli 0145 just as deadly as the E.coli we hear about a lot, the 015787. But I think one of the big concerns is that we are seeing a new bug coming after us in the marketplace.

Gupta: A few years ago we went to one of the hardest hit outbreaks in recent years. The thing that you really impressed upon me at that time Mr. Marler, is this idea you have animals sometimes contaminating crops, you have a lot of natural occurrences that naturally can lead to food being contaminated. First of all, have things been improved since then? And can you really prevent that sort of thing from happening?

Marler: Well, I think the industry - many parts of the industry - have done a remarkable job. We certainly are not seeing the large-scale 200-250 sickened in outbreaks. We still see three or four sometimes five spinach or lettuce outbreaks yearly, and they are much smaller. This particular outbreak appears to be emanating from Arizona and this is the first time that there has been a leafy green outbreak in Arizona. So there are a lot of moving parts that I think we will learn a lot of over the next several months.

Gupta: Is it the FDA, the food maker, when you say somebody has to compensate? Who's going to compensate?

Marler: Ultimately it will be the grower, the shipper and the manufacturer of this particular lettuce. They have a responsibility to a consumer to do the absolute best they can to get animal feces out of their food products. And that obviously didn't happen here. Twenty-three states are recalling products. There are at least 23 people sick, probably a lot more because not very many lab tests for E. coli 0145.

See the full interview with Bill Marler on “Sanjay Gupta M.D.,” Saturday and Sunday at 7:30 a.m. ET.


Filed under: Food Safety

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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