Study Casts Doubt on Angioplasty, Bypass for Many Heart Patients

SUNDAY, Nov. 17, 2019 — Bypass operations, angioplasty and the placement of artery-opening stents: For decades, millions of Americans have undergone these expensive, invasive procedures to help treat clogged vessels.

However, the results of a large and long-awaited clinical trial suggests that, in most cases, these procedures may not have provided any benefit over medications and lifestyle changes.

In fact, people treated with meds and healthy changes in lifestyle wound up about as healthy as those who underwent an invasive procedure to open their hardened arteries, researchers reported Saturday at the American Heart Association (AHA) annual meeting in Philadelphia.

Only a subgroup of patients who suffered from frequent angina appeared to receive any benefit from an invasive procedure, and that benefit was in their quality of life, not in lowering their odds of death or future heart problems.

“Based on the trial results to date, I as a clinician would feel comfortable advising my patient not to undergo the invasive strategy if their angina was absent or controlled or it was tolerated,” said Dr. Alice Jacobs, director of the Cardiac Catheterization Laboratory and Interventional Cardiology at Boston Medical Center. She wasn’t involved in the new research.

Still, doctors are often uncomfortable limiting their treatment of clogged arteries to drugs, diet and exercise alone because they’re worried the patient will wind up suffering a heart attack or other heart-related illness, according to past AHA president Dr. Elliot Antman.

The new findings are expected to give physicians more confidence in saying no to invasive treatments, the experts said.

The study did not focus on people who are admitted to a hospital with a heart attack — these patients often receive bypass, angioplasty or stenting to quickly open a blocked artery.

Instead, the trial focused on patients with stable but severe heart disease.

A typical patient in this group might be a 71-year-old grandmother who has noticed during the past two months some chest heaviness walking from the parking lot to her grandkids’ soccer game, the AHA presenters said. Stress testing and imaging scans could reveal some moderately clogged arteries leading to her heart.

The new trial was very comprehensive, involving nearly 5,200 patients across 37 countries. Half were randomly assigned to undergo an invasive procedure: About three-quarters underwent angioplasty (most receiving a stent as well), while the others had a bypass operation.

The other half of patients were treated with medications and lifestyle changes alone.

Researchers mainly focused on whether the invasive procedure would reduce a patient’s risk of heart-related death, heart attack, hospitalization with unstable angina, heart failure or cardiac arrest.

Overall, an invasive strategy “did not demonstrate a reduced risk over a median 3.3 years” compared with the more conservative, drugs/lifestyle therapy, said trial co-chair Dr. Judith Hochman, a cardiologist and senior associate dean of clinical sciences at NYU Langone Health, in New York City.

However, invasive procedures did have a positive impact on one patient subgroup: People who regularly suffer the chest pain and shortness of breath associated with angina, said co-researcher Dr. John Spertus. He directs health outcomes research at Saint Luke’s Mid-America Heart Institute in Kansas City.

“For a patient who has weekly angina, there would be 15% of them who would be expected to be angina-free with the conservative approach, while 45% would be expected to be angina-free with the invasive approach,” Spertus said. “This is such a large difference that you would only have to treat about three patients with weekly angina for one to be angina-free at three months.”

On the other hand, patients who did not regularly have angina received only minimal quality-of-life or symptom benefits after undergoing an invasive procedure, Spertus added.

A smaller set of trials — this time focused on patients with chronic kidney disease — revealed even less promising results, researchers said. Patients didn’t gain any health benefits and didn’t have any improvement in their quality of life after getting an invasive treatment. Angioplasty might even help put them on dialysis earlier or increase their risk of stroke, the study found.

Dr. Glenn Levine, a professor of cardiology with Baylor College of Medicine in Houston, said that when it comes to kidney patients with clogged arteries, he “will treat them with medical [drug] therapy alone” unless they have marked or uncontrolled angina.

Experts said the main message from these studies is that doctors shouldn’t feel pressured to immediately send patients with clogged arteries into a catheterization lab, especially if they aren’t suffering any symptoms.

That could free up physicians to focus on getting patients to take their medications, Jacobs said. If drug therapy helps relieve their occasional angina or other symptoms, then angioplasty might be avoided in two out of every three patients, she estimated.

The trials were funded by the U.S. National Heart, Lung, and Blood Institute.

For more information:

There’s more on common heart procedures at the American Heart Association.

© 2019 HealthDay. All rights reserved.

Posted: November 2019 – Daily MedNews

Doubt Over Long-Term Use of Hormone Rx for Recurrent Prostate Cancer

TUESDAY, Sept. 17, 2019 — Running contrary to current guidelines, new research suggests that use of hormone-suppressing treatment over the long term may not help some men battling recurrent prostate cancer, and may even cause harm.

In fact, the study found that long-term hormone therapy was tied to a raised risk of death from other causes for some patients who received it.

Blood levels of prostate-specific antigen (PSA) may help predict which men might benefit — and which men might not — from long-term hormone therapy following surgery, said a team led by Dr. Daniel Spratt of the University of Michigan Cancer Center, in Ann Arbor.

“We found that the lower the PSA, the more harm the patient experienced,” explained Spratt, who is research professor of radiation oncology and chair of the Genitourinary Clinical Research Program at the center. “The higher the PSA, the more likely the patient was to benefit from hormone therapy because it decreased their chances of dying from prostate cancer and resulted in improved overall survival rates.”

The study was presented Sunday at the annual meeting of the American Society for Radiation Oncology (ASTRO), in Chicago.

Because prostate tumors grow faster in the presence of hormones such as testosterone, therapies that lower hormone levels are often offered to men as a way to slow the cancer’s spread. However, these treatments can come with side effects, such as urinary incontinence or sexual dysfunction.

Still, clinical trial results first reported in 2017 found that — after surgical removal of the prostate tumor — adding two years of hormone therapy, along with radiation treatment, appeared to boost patients’ long-term survival.

Those findings led to the recommendation that men with recurrent prostate cancer be treated with both radiation and long-term hormone therapy after surgery.

Would those benefits last, however? To find out, Spratt’s team reanalyzed data from the clinical trial of 760 prostate cancer patients that spurred the new guidelines. Men in the trial were treated at centers across North America between 1998 and 2003. All had seen their cancer return after surgery, and they received radiation therapy along with either two years of hormone-suppressing therapy called bicalutamide, or a “dummy” placebo.

Looking at the data more closely, Spratt’s team found that for men with low PSA blood levels after prostate surgery, long-term hormone therapy offered no cancer survival benefit, and was associated with a doubling of the risk that these men would die from causes other than their cancer.

Patients with both low PSA and long-term hormone therapy were also three to four times more likely to experience a combination of severe heart events and neurological problems, the team reported.

“We went into this study expecting that men with low PSAs probably would derive minimal benefit from hormone therapy, but we were surprised at the magnitude of harm that these patients experienced,” Spratt said in an ASTRO news release.

“A lot of these side effects have been reported over the past few decades, but demonstrating this in a clinical trial to this extent has not been done before,” he noted.

“What we showed for the first time is that a patient’s PSA level is a predictive biomarker,” Spratt said. “That is, you can use a patient’s PSA to better select which men should receive hormone therapy, and to predict who will benefit and who will not benefit from this treatment, and who may actually be harmed by it.”

Spratt believes that, based on the new analysis, clinical guidelines for treating men with recurrent prostate cancer should be reconsidered.

“For post-operative patients with low PSAs, they do very well with just radiation therapy after surgery. They actually have very good long-term outcomes,” Spratt said.

Two experts in prostate cancer care said decisions around hormone therapy remain tough for patients and doctors, but the new study offers a bit more clarity.

Dr. Manish Vira is vice chair of urologic research at Northwell Health’s Arthur Smith Institute for Urology, in Lake Success, N.Y. He said the study “wades into the muddy waters” surrounding the risks and benefits of hormone therapy, and questions still remain.

“The results of the current study may not be generalizable to all hormonal therapy, as this study specifically used high-dose bicalutamide,” he said, and other hormone-suppressing medicines might work differently.

“That being said, the study suggests that for patients undergoing radiation therapy with lower PSA values, radiation [alone] may be more prudent,” Vira said.

Urologist Dr. Elizabeth Kavaler agreed.

“This is a very useful study, in that it gives clinicians clear guidelines on how to treat men with high-risk prostate cancer who have elevated PSA after surgery and radiation,” said Kavaler, who practices at Lenox Hill Hospital in New York City.

“Many of these patients do very well post-treatment, and do not need further hormone therapy, which will save many of them from the side effects that hormone-deprivation causes,” she added.

Because the study was presented at a medical meeting, its findings should be considered preliminary until they are published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more on prostate cancer treatment.

© 2019 HealthDay. All rights reserved.

Posted: September 2019 – Daily MedNews

Study Casts Doubt on Safety of Herbal Drug Kratom

By Dennis Thompson        
       HealthDay Reporter

THURSDAY, July 18, 2019 (HealthDay News) — The herbal supplement kratom regularly causes serious side effects and doesn’t appear safe for use, a new study argues.

Kratom, made from the leaves of a Southeast Asian plant, is usually used to treat pain and addiction. But poison control center data shows it has been tied to seizures, withdrawal, hallucinations, agitation and rapid heart rate, researchers report.

Kratom is “probably not something that’s safe enough to be available as an herbal supplement,” concluded lead researcher William Eggleston, a clinical assistant professor with the Binghamton University School of Pharmacy in New York.

Kratom contains compounds that act on the opioid receptors in the brain and the body, according to the U.S. National Institute on Drug Abuse.

And while it’s a legal herbal supplement, the U.S. Food and Drug Administration has already issued a warning against using kratom. The FDA has called the drug “opioid-like” and cited concerns that it might pose an addiction risk.

In the new study, poison control centers received more than 2,300 calls related to kratom between 2011 and 2018.

Those calls increased from 18 in 2011 to 357 in the first seven months of 2018, according to stats drawn from the U.S. National Poison Data System.

The research team zeroed in on 935 cases where kratom was the only substance involved.

About 56% of cases involved kratom taken as a pill, capsule or powder, and in nearly 9 in 10 cases people ate the kratom that had affected them.

The most commonly reported adverse effects were agitation (in almost 20% of cases), rapid heart rate (17%), drowsiness (14%) and vomiting (11%), the data showed.

Severe side effects included seizures (6%), hallucinations (5%), respiratory depression (3%), and coma (2%).  Cardiac or respiratory arrest was reported in 0.6% of cases.

The researchers also identified four cases of neonatal abstinence syndrome, where babies were born addicted to kratom after their mothers took the supplement during pregnancy. They said it caused two deaths.

The National Poison Data System statistics indicated that kratom has a lower risk for fatal overdose than opioids like heroin or fentanyl, Eggleston said.


“The risk for things like serious respiratory depression is probably less with kratom than it is with other opioids,” Eggleston said. “We saw a very low incidence of this in our data.”

However, other studies also have shown that users can experience withdrawal symptoms, Eggleston said.

“That suggests that patients could develop a dependence or a substance use disorder, as you would with other opioids,” Eggleston said. “To me, that exceeds what I would consider a reasonable risk for an herbal supplement you can buy at a local convenience store or head shop.”

Kratom proponents argue that the new study is flawed because it relies on poison control and medical examiner data, which tags kratom as the main suspect and could fail to consider other possible explanations.

“If a person dies and the tox screen identifies kratom in the bloodstream, that is labeled as a kratom-associated death,” said Mac Haddow, a senior fellow on public policy at the American Kratom Association. “It is just as plausible you could identify caffeine in the bloodstream as a result of drinking a cup of coffee that morning.”

Susruta Majumdar, an associate professor with the St. Louis College of Pharmacy in Missouri, said the new study adds a bit more evidence regarding kratom’s safety, but agreed that its reliance on poison control center data makes for a flawed approach.

Based on available data, Majumdar said, kratom probably is safer that prescription and illicit opioids, but “I think we are getting to a point where we can say it’s addictive.”

Majumdar added that he believes kratom-related deaths are not caused by kratom alone, but kratom combined with other substances.

“People are on multiple drugs, and it’s the synergy between those drugs that is causing the toxicity,” Majumdar said.

Eggleston said he does not advocate a ban on kratom, since studies suggest it might have a role in treating chronic pain and addiction.

Instead, clinical trials are needed to assess kratom’s usefulness and establish its safety at certain doses, Eggleston said.

“Our research is not coming from a place where we want to hinder access,” Eggleston said. “We want the public to have all the information they need and be transparent, so they know what works and what’s safe.”

The study findings were published July 9 in the journal Pharmacotherapy.

WebMD News from HealthDay


SOURCES: William Eggleston, Pharm.D., clinical assistant professor, Binghamton University School of Pharmacy, State University of New York; Charles “Mac” Haddow, senior fellow, public policy, American Kratom Association; Susruta Majumdar, Ph.D., associate professor, St. Louis College of Pharmacy, St. Louis, Mo.;Pharmacotherapy, July 9, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

‘); } else { // If we match both our test Topic Ids and Buisness Ref we want to place the ad in the middle of page 1 if($ .inArray(window.s_topic, moveAdTopicIds) > -1 && $ .inArray(window.s_business_reference, moveAdBuisRef) > -1){ // The logic below reads count all nodes in page 1. Exclude the footer,ol,ul and table elements. Use the varible // moveAdAfter to know which node to place the Ad container after. window.placeAd = function(pn) { var nodeTags = [‘p’, ‘h3′,’aside’, ‘ul’], nodes, target; nodes = $ (‘.article-page:nth-child(‘ + pn + ‘)’).find(nodeTags.join()).not(‘p:empty’).not(‘footer *’).not(‘ol *, ul *, table *’); //target = nodes.eq(Math.floor(nodes.length / 2)); target = nodes.eq(moveAdAfter); $ (”).insertAfter(target); } // Currently passing in 1 to move the Ad in to page 1 window.placeAd(1); } else { // This is the default location on the bottom of page 1 $ (‘.article-page:nth-child(1)’).append(”); } } })(); $ (function(){ // Create a new conatiner where we will make our lazy load Ad call if the reach the footer section of the article $ (‘.main-container-3’).prepend(”); });


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Study Casts Doubt on Light Drinking’s Benefits

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Oct. 3, 2018 (HealthDay News) — If you think your nightly glass of vino is doing good things for your health, think again.

A new study suggests that folks who like to tip back a drink or two every day are more likely to die prematurely.

“At any given age, if you drink daily — even just one or two drinks — you have a 20 percent increased risk of death compared to someone who drinks the same amount two to three times a week,” said study author Dr. Sarah Hartz. She’s an assistant professor in the department of psychiatry at Washington University School of Medicine in St. Louis.

“We should no longer say that it’s healthy to drink. It’s a vice that’s not great for us,” she added.

Hartz noted that how significant a 20 percent increased risk of death is depends on your age. She explained that since very few people die in their 20s, a 20 percent increased risk of premature death is less significant at that age than it would be for someone in their 70s.

Although the study did find an association, it did not prove that light drinking caused early death risk to rise.

But how might alcohol boost that risk?

Hartz said most of the increased risk of early death comes from an increased risk of cancer. She said that people often underestimate how much drinking can increase the risk of some cancers, such as breast cancer. And drinking more than four times a week can also increase the risk of heart attack and stroke.

But what of all the studies that have suggested a health benefit from moderate drinking?

Hartz said that there have been several studies this year that have concluded that drinking generally isn’t good for health. And the populations in these studies and the latest one are larger than in previous ones. More importantly, she noted, the newer studies have been able to parse out the lowest levels of drinking.

“We have access to data we haven’t had access to before,” Hartz explained.


The study included information from more than 400,000 people. More than 340,000 (aged 18 to 85) had participated in a national health survey. Another group of nearly 94,000 were between the ages of 40 and 60 and had been treated as outpatients at Veterans Health Administration clinics.

“The lowest risk group was people who drank one or two drinks just two to three times weekly,” she said.

Still, not everyone is convinced that this study is the last word on alcohol and health.

According to Dr. Guy Mintz, director of cardiovascular health and lipidology at North Shore University Hospital in Manhasset, N.Y., “The jury is still out with regard to frequency and quantity of alcohol use.”

Mintz said, “This is an interesting study. One to two drinks four days a week seemed to protect against cardiovascular disease, but drinking every day eliminated those benefits.”

He pointed out that “one of the study’s conclusions was that, as medicine becomes more personalized, some patients with a history of cardiovascular disease may benefit from drinking two or three days a week, but those with a higher risk of cancer may not benefit.”

Mintz tells his patients to drink anything but beer because it has a lot of calories and salt, and can contribute to obesity and high triglycerides (an unhealthy type of blood fat). “I would stress alcohol consumption in moderation, both in frequency and quantity,” he said.

The study was published online Oct. 3 in the journal Alcoholism: Clinical and Experimental Research.

WebMD News from HealthDay


SOURCES: Sarah Hartz, M.D., Ph.D., assistant professor, department of psychiatry, Washington University School of Medicine, St. Louis; Guy Mintz, M.D., director, cardiovascular health and lipidology, North Shore University Hospital, Manhasset, N.Y.; Oct. 3, 2018,Alcoholism: Clinical and Experimental Research, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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Study Casts Doubt on Need for Statins in the ‘Healthy Old’

MONDAY, May 22, 2017 — Senior citizens with no history of heart problems appear to gain no health benefit from cholesterol-lowering statin drugs, a new study suggests.

People 65 and older treated with pravastatin (Pravachol) as part of a major clinical trial had about the same risk of death as people in a placebo group, according to the results. They also appeared to suffer strokes and heart attacks at about the same rate.

“Our study shows there may not be any benefit for taking a statin therapy for primary prevention for people who are over the age of 65,” said Dr. Benjamin Han.

Statins might even pose a risk to people 75 and older, added Han, an assistant professor of medicine and population health at New York University School of Medicine.

“There was some suggestion the statin group had a little bit higher mortality than the placebo group” at that age, Han said. But, this result was not statistically significant, he noted.

Experts from the American Heart Association and Mount Sinai Hospital in New York City urged doctors and patients to take these findings with a grain of salt.

“The only merit to the study is that it raises questions that haven’t been adequately answered,” said Dr. Robert Eckel, an AHA spokesman. “This is not the kind of evidence that should influence guidelines about statin therapy in adults 65 and older,” said Eckel, chair of atherosclerosis at the University of Colorado School of Medicine.

For the study, Han and his colleagues analyzed data from a clinical trial conducted from 1994 to 2002, called the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT).

Most statin studies have focused on middle-aged people, so there’s little known about the effect of these medications on seniors, Han said.

With an aging population, the question keeps coming up, “Should you be on a statin medication even if you don’t have a history of cardiovascular disease?” Han said. “Will this help you in the long run?”

From the antihypertensive trial data, the researchers drew a sample that included almost 3,000 adults 65 and older with high blood pressure, but no plaque buildup in the arteries that would occur due to high cholesterol.

About half of those adults took pravastatin while half received usual care.

The researchers found no health benefit from pravastatin in these older patients. In fact, more deaths occurred in the pravastatin group than in the usual care group — 141 versus 130 among adults 65 to 74, and 92 versus 65 among adults 75 and older.

The side effects of statins, which include muscle pains and fatigue, might weigh more heavily on older people, Han said.

“Anything that can affect their physical function, anything that can affect their ability to do activities on a daily basis, puts them at a higher risk for further decline and a higher risk for mortality,” Han said.

Dr. Robert Rosenson is director of cardiometabolic disorders at the Icahn School of Medicine at Mount Sinai. He said the new study is flawed because its conclusions rely on data from a very small number of patients. For example, the analysis of people 75 and older included only 375 people taking pravastatin and 351 in the control group.

“That’s such a small number to detect difference in events, let alone mortality when you’re dealing with a low-potency statin,” Rosenson said.

Because of this, the effects noted in the study often aren’t backed up by the statistics, he said.

“From a fundamental statistical standpoint, I think they’re far overstating their conclusion,” Rosenson said.

Rosenson also criticized the research team for choosing the ALLHAT-LLT clinical trial as source of their data.

That trial has been controversial because “it was one of the few cholesterol studies that failed to show a reduction” in heart attacks and strokes, Rosenson said.

“If you wanted to make the point that statins don’t help older people and may harm them, then that would be the study you would pick to show that the hypothesis is going to fail,” Rosenson said.

Eckel said he is “somewhat underwhelmed” by the study.

“There are so many limitations to this paper, and the authors, to their credit, list most if not all of them,” Eckel said.

The U.S. National Institutes of Health funded the study. The results were published May 22 in JAMA Internal Medicine.

More information

For more on statins, visit the U.S. Food and Drug Administration.

Posted: May 2017 – Daily MedNews

Study Casts More Doubt on Value of Mammograms

By Dennis Thompson

HealthDay Reporter

MONDAY, Jan. 9, 2017 (HealthDay News) — Mammograms frequently detect small breast tumors that might never become life-threatening, causing women to receive treatment they likely don’t need, a new Danish study finds.

About one in every three women between the ages of 50 and 69 who was diagnosed with breast cancer wound up having a tumor that posed no immediate threat to her health, the researchers reported.

At the same time, mammography did not reduce the number of advanced breast cancers found in women in the study.

“This means that breast screening is unlikely to improve breast cancer survival or reduce the use of invasive surgery,” said study author Dr. Karsten Juhl Jorgensen, deputy director of research for the Nordic Cochrane Center at the Rigshospitalet in Copenhagen. “It also means that breast screening leads to unnecessary detection and treatment of many breast cancers.”

Dr. Otis Brawley, chief medical officer for the American Cancer Society, said the study shows that breast cancer overdiagnosis is real. But, screening for the disease saves lives as well.

Doctors refer to the detection of non-life-threatening cancers as “overdiagnosis.” Women overdiagnosed with breast cancer are frightened needlessly and undergo potentially harmful, but ultimately useless, medical treatments like surgery, chemotherapy and radiation therapy, Jorgensen said.

These results call into question the value of regular mammograms, Jorgensen said. Current U.S. guidelines recommend mammograms every other year for women aged 50 or older, although some medical societies recommend annual screening.

“Breast screening has not lived up to its promises,” Jorgensen said. “All women must seriously consider whether participation in breast screening is right for them, after having sought balanced information about what it can and cannot do.”

The new study was published in the Jan. 9 issue of the Annals of Internal Medicine.

The American Cancer Society’s Brawley agreed that overdiagnosis is a concern. He wrote an editorial that accompanied the study.

But, Brawley said the current regimen still saves lives, and women should continue to get mammograms while doctors hone genetic tests that will provide a more accurate appraisal of each tumor.


“While we try to better define just how good mammography is, that does not mean women should stop getting screened. It does not mean women should stop getting treated right now,” Brawley said. “It does mean that we need to find better screening tests and better treatments.”

For the study, Jorgensen and his colleagues used data from two comprehensive Danish cancer registries to check the effectiveness of breast cancer screening. They reviewed the medical records of all Danish women diagnosed with invasive breast cancer between 1980 and 2010.

Different regions of Denmark adopted regular breast cancer screening at different times, offering the researchers a before-and-after portrait of the effectiveness of mammography, Jorgensen said.

The researchers compared the incidence of advanced tumors in women aged 50 to 84 in areas that had adopted regular breast cancer screening against areas that did not regularly screen.

They also compared the detection of small, non-advanced tumors among women in several age categories: 35 to 49, 50 to 69, and 70 to 84.

The researchers concluded that between almost 15 percent to nearly 39 percent of breast cancers were overdiagnosed.

Guidelines are already shifting to recommend breast cancer screening less frequently, Jorgensen noted.

“The American Cancer Society now recommends less frequent screening of a narrower age group than just two years ago. Our study supports this development, which will continue,” he said. “Independent expert groups in both Switzerland and France recommend that we stop breast screening entirely because the benefit is doubtful whereas the harms are certain and serious.”

While this study shows that overdiagnosis is real, Brawley noted that a number of clinical trials have shown that screening does help detect potentially fatal breast cancers.

“Yes, this study tells us one of the harms is if you’re diagnosed with localized breast cancer, you may receive treatment you may not need,” Brawley said. “But in the same breath, you need to say we have studies that show while we cure some women who don’t need to be cured, we clearly cure some women who need to be cured. Therefore, we net save lives.”


Women will benefit from better breast cancer screening techniques that use genetics to predict the danger each tumor poses, Brawley said.

“In 2017, we’re already scaling up or scaling down our breast cancer treatment according to these genomic definitions,” he said. “I predict that within the next 10 years, there are going to be a group of women who are diagnosed with breast cancer and told genomically we think this is a relatively indolent disease, and therefore we’re going to watch your cancer. We’re not going to treat it initially.”

WebMD News from HealthDay


SOURCES: Karsten Juhl Jorgensen, M.D., deputy director, research, Nordic Cochrane Center, Rigshospitalet, Copenhagen, Denmark; Otis Brawley, M.D., chief medical officer, American Cancer Society; Jan. 9, 2017, Annals of Internal Medicine

Copyright © 2013-2017 HealthDay. All rights reserved.

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NIH Experts Cast Doubt on Rat Study Linking Cellphones, Tumors

FRIDAY May 27, 2016, 2016 — Experts at the U.S. National Institutes of Health are questioning the validity of a widely reported study in rats that linked cellphone radiation to tumors.

The study, released Friday by the federal government’s National Toxicology Program (NTP), found “low incidences” of two types of tumors in male rats exposed to the type of radio frequencies emitted by cellphones, the Wall Street Journal reported.

The two types of tumors were glioma brain cancer and benign schwannomas of the heart, according to the $ 25 million study that is one of the largest and most comprehensive to assess the health impacts of cellphones.

“Given the widespread global usage of mobile communications among users of all ages, even a very small increase in the incidence of disease resulting from exposure to [radio-frequency radiation] could have broad implications for public health,” according to an NTP summary of partial findings from the study released late Thursday, the WSJ reported.

However, NIH experts were quick to highlight flaws in the study, according to the Associated Press.

For example, they pointed out that the study exposed rats to very high levels of cellphone radiation, beginning in the womb and then through the first two years of the rats’ life. Even then, only 2 percent to 3 percent of male rats — and no females — developed a tumor.

The fact that none of the female rats developed a tumor is odd, the NIH experts said, as is the fact that rats who did not get exposed to the radiation died at higher rates than those who did get exposed.

The unexposed rats also failed to develop tumors at a rate that would be expected in a “normal” population, the NIH experts noted.

Based on these findings, “I am unable to accept the authors’ conclusions,” wrote outside reviewer Dr. Michael Lauer, deputy director of NIH’s office of extramural research. “I suspect that this experiment is substantially underpowered and that the few positive results found reflect false positive findings.”

He also said that the fact rats exposed to the radiation actually lived longer “leaves me even more skeptical of the authors’ claims.”

The complete results of the NTP study will be released by the fall of 2017, the NTP said.

The NIH helped oversee the study, and earlier this week said, “It is important to note that previous human, observational data collected in earlier, large-scale population-based studies have found limited evidence of an increased risk for developing cancer from cellphone use.”

Many studies have found no link between cellphones and harmful health effects. For example, a recently released Australian study found no increase in brain cancer rates since mobile phones became available there nearly three decades ago, and similar findings have been made in other countries.

Others believe the new findings may have merit, however. Ron Melnick ran the NTP project until retiring in 2009. He recently reviewed the study and said: “Where people were saying there’s no risk, I think this ends that kind of statement.”

In the meantime, the study’s impact on Federal Communications Commission (FCC) cellphone safety rules is unclear.

“Scientific evidence always informs FCC rules on this matter,” said a spokesman for the agency, which has been briefed on the findings. “We will continue to follow all recommendations from federal health and safety experts including whether the FCC should modify its current policies.”

More information

Visit the U.S. National Cancer Institute for more on cellphones and cancer risk.

Posted: May 2016

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Indian scientists express doubt over meteorite death attribution

Indian scientists have expressed doubt that a man in Tamil Nadu was the first person to have been confirmed killed by a meteorite strike, as the state’s top official has declared.

The experts said the small crater, the absence of a sonic boom before impact, a lack of debris and the green and blue colour of rock recovered from the scene suggest some other cause.

“It is highly improbable, but we will only be absolutely sure after a chemical analysis,” said V. Adimurthy, a senior scientist at India’s space agency.

The mysterious event has triggered an international debate about whether a meteorite, space debris, leftover explosives or even frozen waste from a plane passing overhead may have killed the man.

The meteorite attribution was announced this week by Chief Minister Jayalalithaa Jayaram, a former film star who is known for her authoritarian style.

A bus driver was killed by the meteorite at an engineering college in the state, she said, and awarded a sum of 100,000 rupees ($ 1,470) in compensation to his family.

“A meteorite fell within the college premises,” she said.

Jayalalithaa has a cult-like following in her state, with her pictures on prominent display in the offices of her party’s politicians, as a sign of their unquestioning loyalty. Since her comments, state officials have been reluctant to discuss publicly what happened.

A team of scientists from the Indian Institute of Astrophysics in Bangalore arrived in Tamil Nadu on Tuesday to inspect the 2-metre (6.56-ft) -wide crater and collect the recovered rock sample, which is small enough to fit in a hand. 

G.C. Anupama, an astronomy professor at the institute, said the probe would focus on the chemicals in the debris, as meteorites have high iron levels. She declined to comment whether she believed the debris was a meteorite.

C.B. Devgun, who has been tracking meteorites for the last two decades, said the colour of the rock and absence of other particles ruled out a meteorite.

“It cannot be a meteorite,” he said. “It was a greenish colour and no other pieces of debris were found. Normally it would be a darkish yellow or darkish black in colour, just like burned coal, with a slightly melted surface.”

The last reported death from a meteorite strike was in 1825, according to a list maintained by International Comet Quarterly, a scientific journal.

In 2013, a meteorite that exploded over central Russia rained down fireballs and caused a shock wave that smashed windows, damaged buildings and injured 1,200 people.

(Editing by Douglas Busvine and Clarence Fernandez)

Reuters: Oddly Enough

New Study Casts Doubt on Dangers of Hormone Therapy for Hot Flashes

New Study on Hormone Therapy for Hot Flashes

But other experts warn it’s too soon to say the treatment is safe

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

FRIDAY, March 6, 2015 (HealthDay News) — Hormone replacement therapy for women may not be as potentially risky as previously thought, a new Mayo Clinic review contends.

The new study, which evaluated three decades of prior research, concluded that hormone therapy to treat symptoms of menopause doesn’t increase overall risk of death or the risk of death from heart attack, stroke or cancer.

“This is the latest update of the current evidence,” said lead author Dr. Khalid Benkhadra, a research fellow at the Mayo Clinic in Rochester, Minn. “I can say there’s no risk of dying from any reason because a woman is taking hormone replacement therapy.”

The results, Benkhadra said, should allay concerns of some women with debilitating menopausal symptoms who have feared taking hormones.

But not everyone is sold on the safety of hormone therapy. Heart and cancer doctors who reviewed the new findings said that hormone therapy should still be used sparingly on those most in need, until further research proves otherwise.

“This study may provide some comfort that it shouldn’t shorten your life, but it doesn’t change the concern that the bad effects of hormone therapy are going to be an issue,” said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

Lichtenfeld added that the review’s results are preliminary, and haven’t been subjected to the rigorous peer review necessary for a study to be published in a medical journal.

“No one should change treatment until the data is examined more closely,” he said.

Findings from the new review were scheduled to be presented Friday at the annual meeting of The Endocrine Society, in San Diego.

Concerns about the long-term safety of hormone therapy arose more than a decade ago with results from the Women’s Health Initiative (WHI), a large-scale federal study of the health problems facing postmenopausal women.

The Women’s Health Initiative found that hormone therapy using estrogen and progestin increased a woman’s risk of heart attack, stroke, blood clots and breast cancer, compared with placebo. Estrogen alone increased risk of blood clots and stroke, but made no difference in heart attack risk and had an uncertain effect on breast cancer.

WebMD Health

“There’s No Doubt Moving Battlefield Hardline Back Was the Right Call,” Dev Says

Battlefield Hardline, Electronic Arts’ new cops-and-robbers-themed shooter from Dead Space developer Visceral Games, was originally supposed to release on October 21, 2014. In a recent letter to fans, the game’s Executive Producer and General Manager of Visceral Games Steve Papoutsis said that the decision to delay it to March 17 allowed the studio to make Battlefield Hardlin the complete first person shooter experience it set out to deliver.

“We got some pretty pointed feedback after our early beta that you wanted more,” Papoutsis said. “And we listened. There’s no doubt moving the game back was the right call.”

Papoutsis said Visceral used the extra time to add new multiplayer modes, vehicles, gadgets, and weapons that add “a new dimension of speed to Battlefield. All while still staying true to the thing that most sets Battlefield apart – a focus on teamplay and strategy.”

Papoutsis took questions from fans on Twitter, where he revealed the game will launch with 51 weapons, 28 gadgets, 27 new vehicles, nine maps, and seven modes.

EA also launched a new blog where it will release new Battlefield Hardline details and trailers every Wedensday leading up to release, starting this week with details on the game’s second beta, which should be significantly different than what we’ve played last year.

For more on the game, check out GameSpot’s previous coverage of Battlefield Hardline.


Doubt Cast on Usefulness of ‘Sensory’ Therapies for Autism

MONDAY May 28, 2012 — Sensory therapies using brushes, swings and other play equipment are increasingly used by occupational therapists to treat children with developmental issues such as autism, but a large pediatricians organization says there isn’t much evidence that such therapies actually work.

Still, the group isn’t completely discounting the potential of sensory therapies — it’s a ripe area for research, it noted.

But before parents spend the time and money on taking children to sensory therapy, they should know that, as of now, the techniques are largely unproven.

“It’s OK for parents to try these types of therapies, but there is little research backing up the effectiveness of these therapies and whether or not they improve long-term outcomes for kids with developmental disabilities,” said Dr. Michelle Zimmer, an assistant professor of pediatrics at Cincinnati Children’s Hospital Medical Center.

Zimmer is the co-author of a new American Academy of Pediatrics policy statement on what is often referred to as “sensory integration therapy.” The policy statement appears online May 28 and in the June print issue of Pediatrics.

According to the pediatrician group, “sensory processing disorder” should not be used as a standalone diagnosis.

No one disputes that children with conditions such as autism can have abnormalities in their responses to sensory stimuli, including sight, taste, touch and sound. For example, autistic children may have aversions to loud noises, to certain food textures or to being touched unexpectedly, Zimmer said.

But that doesn’t necessarily mean the problem is with their brain pathways for processing sensory information, as the term “sensory processing disorder” implies.

Instead, some other issue could underlie their reactions to stimuli, such as a behavioral issue, said Dr. Susan Hyman, chair of the American Academy of Pediatrics subcommittee on autism and an associate professor of pediatrics at University of Rochester Medical Center, in Rochester, N.Y.

Instead of chalking up various aversions or compulsions to sensory processing disorder, health care providers need to consider what other developmental issues may be going on with the child, such as autism, attention-deficit hyperactivity disorder (ADHD) and so on, Zimmer said.

“There has never been a study that has shown that a child can have just sensory processing disorder, isolated from another developmental disabilities, such as autism or ADHD,” Zimmer said.

Sensory integration therapy got its start in the 1970s, when an occupational therapist described a theory for how a well-organized sensory system develops. Children, the therapist postulated, gradually learn to make use of information from a variety of sources at the same time in order to understand the world. The theory is that sensory dysfunction occurs when these systems don’t develop correctly.

In sensory integration therapy, occupational therapists put children on a “sensory diet,” exposing them to different sights, smells, sounds and sensations, to improve the brain’s ability to process the information.

For now, however, whether it works remains a theory, Zimmer said.

Zimmer noted that occupational therapists in her hospital’s autism center uses sensory therapies, and anecdotally, she’s seen sensory therapy appear to help some children.

“We are happy to support parents who want to try to these therapies, but we also need to use caution in making sure that the use of these therapies is improving some outcome for their child,” Zimmer said.

In the absence of controlled clinical trials testing whether sensory therapies work, parents have to try to be objective, ask themselves tough questions about whether the treatment is really working, set specific goals and determine if the child is moving toward the target.

“Is it improving the child’s ability to function? That’s where more research needs to happen,” Zimmer said.

Hyman, who studies sensory differences in children with autism, agreed. “The scientific testing of this intervention has not demonstrated that it is effective for all children as a standalone treatment,” she said. “However, for individual children, it may be an important part of a total therapy package.”

Pediatricians should counsel families about the information out there on sensory therapies, she added.

“You don’t want to spend a lot of time money and energy on a treatment if it’s not right for them. They have to be prudent,” Hyman said. “In the absence of data, parents have to utilize the information that’s available to them in making choices.”

More information

The U.S. National Institute on Mental Health has more on autism.

Posted: May 2012

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