CHRISTUS Santa Rosa Hospital

2827 Babcock Rd.

San Antonio, TX 78229
P 210.705.6300
www.christussantarosa.org

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CHRISTUS Santa Rosa Overview

Conveniently located in the South Texas Medical Center, CHRISTUS Santa Rosa Hospital – Medical Center is the preferred acute care destination for patients and physicians throughout South Texas. The campus features a broad, unique range of inpatient and outpatient clinical services, centered around a modern 178-bed Hospital.

Rounding out the comprehensive medical services offered on the hospital campus are five medical office buildings housing numerous physician offices, highly trained staff and physicians dedicated to the care of elderly patients, specialized diagnostic and treatment services for patients with digestive diseases, outpatient rehabilitation services, wound care and hyperbaric oxygen treatment, and the CHRISTUS Transplant Institute.

CHRISTUS Santa Rosa Hospital – Medical Center brings together state-of-the-art equipment, knowledgeable staff and physicians, and extensive educational support in order to provide holistic treatment in a safe, family-centered environment for all patients.

Neuroscience Articles

  • Parkinson's drugs linked to impulse control disorders

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Drugs for Parkinson's disease can sometimes cause patients to have difficulty controlling their impulses, researchers say.

    The medicines, known as dopamine receptor agonist drugs, were linked with higher risks for pathological gambling, hypersexuality and compulsive shopping in a new study.

    Cases of these severe impulse control disorders linked to the drugs have been reported for more than 10 years, and in many cases the abnormal behavior stops when patients stop taking the medications, lead author Thomas J. Moore of the Institute for Safe Medication Practices in Alexandria, Virginia, and colleagues write in their report of the study.

    The Parkinson's Disease Foundation says on its website that in one earlier study, dopamine agonists were linked with compulsive behaviors in up to 14 percent of patients.

    To further investigate the connection, Moore's team analyzed 2.7 million serious drug side effects reported in the FDA Adverse Event Reporting System between 2003 and 2012 in the U.S. and 21 other countries. They identified 1,580 impulse control disorder events, 710 linked to dopamine agonist drugs and 870 associated with other drugs.

    The dopamine agonists were most often prescribed for Parkinson's disease but were also sometimes prescribed for patients with restless leg syndrome.

    Dopamine agonist drugs were 277 times more likely to result in a report of specific impulse control symptoms than other drugs, Moore told Reuters Health by email.

    "This tells you that reports associating a drug with pathological gambling or hypersexuality are extremely rare, except for this group of drugs," he said.

    That's a large increase in risk, and the actual risk could in fact be higher, since these data rely on official reports of drug side effects, according to Joshua J. Gagne of Brigham and Women's Hospital and Harvard Medical School in Boston.

    Gagne wrote an editorial accompanying the new results.

    There was also a link between impulse control disorders and antidepressants or antipsychotics, but not as powerful as the link with the Parkinson's drugs.

    One characteristic of Parkinson's disease is a reduction in the amount of the neurotransmitter dopamine in the brain. Dopamine agonist drugs, which include pramipexole (Mirapex), ropinirole, cabergoline, bromocriptine (Cycloset), rotigotine and apomorphine (Apokyn) in the U.S., activate dopamine receptors even in the absence of dopamine itself.

    Usually, when a drug can have a serious side effect, the manufacturer is required by the U.S. Food and Drug Administration to put a warning about the problem in the drug's packaging, in a bold black box that makes the warning easy to see.

    None of these six drugs come with so-called Boxed Warnings about the potential behavioral side effects, but all six should come with clear and prominent warnings, the authors write.

    Dopamine plays a complex role in regulating behavior, Gagne said, and drugs that affect the way the brain uses dopamine may reduce the threshold for impulsive behaviors.

    "More and more we are learning what it does," he said. "It makes biological sense that this may be causal."

    These compelling results are some of the best evidence we may be able to get concerning the behavioral consequences of dopamine agonist drugs, Gagne said. It's difficult to study because many patients may not want to disclose their gambling or sexual behavior problems, he said.

    "I think that this is one more piece of the puzzle that there may be something going on here with these drugs," Gagne told Reuters Health by phone.

    Patients need not be concerned, but if they find all of a sudden that they have a gambling problem, they should have a frank discussion about that with their doctor, he said.

    "Doctors should understand and weigh these risks against the benefits," Moore said. "There is a lot of difference between a patient with advanced Parkinson's disease with severely impaired motor control and a patient with a mild case of restless leg syndrome."

    SOURCE: http://bit.ly/IZGqPC JAMA Internal Medicine, October 20, 2014.

  • Soccer-Indian footballer dies after fatal goal celebration

    By Amlan Chakraborty

    NEW DELHI (Reuters) - A 23-year-old Indian footballer has died from severe spinal cord damage after attempting to celebrate a goal with a somersault, an official told Reuters on Monday.

    Bethlehem Vengthlang FC midfielder Peter Biaksangzuala died on Sunday at a hospital in the northeastern Indian state of Mizoram after the incident in Tuesday's match in the third tier Mizoram Premier League (MPL).

    "We are shocked by the case. We at the Mizoram Football Association did all we could but could not save him," MFA secretary Lalnghinglova Hmar told Reuters by telephone.

    After scoring the equalizer against Chanmari West FC, a flipping Biaksangzuala landed awkwardly and was lying unconscious as his team mates surrounded him and gestured for help.

    "We considered the option to fly him to Delhi but his condition was pretty bad. He was mostly unconscious, occasionally spelling out a few words," Hmar said.

    Bethlehem has decided to retire the number 21 jersey as a tribute to Biaksangzuala while Hmar said MFA would organize a match in his memory.

    FIFA said that any additional measures curbing goal celebrations would have to be approved by soccer's rule-making body, the International Football Association Board (IFAB).

    "This is a tragedy and we are very concerned about this incident," said FIFA in a statement to Reuters.

    "It is the responsibility of IFAB to rule on amendments to the Laws of the Game."

    FIFA added that any national association can propose a change to the rules, and the suggestion must be submitted by Dec. 1 to be considered at IFAB's next annual general meeting.

    The laws of the game currently stipulate automatic yellow cards if a player removes his shirt, covers his face with a mask, makes a provocative gesture or climbs a perimeter fence to celebrate a goal.

    The laws also state: "While it is permissible for a player to demonstrate his joy when a goal has been scored, the celebration must not be excessive.

    "Reasonable celebrations are allowed, but the practice of choreographed celebrations is not to be encouraged when it results in excessive time-wasting and referees are instructed to intervene in such cases.

    "Referees are expected to act in a preventative manner and to exercise common sense in dealing with the celebration of a goal."

    Last month, a player in Brazil escaped injury when he leapt into a hole as another goal celebration went wrong.

    Coritiba forward Joel leapt the advertising hoardings behind the goal, unaware that there was a hole with steps leading down from the pitch to the dressing rooms.

    Although he landed in the hole, his fall was softened by a tarpaulin and he was able to continue the match.

  • Third death attributed to ecstasy reported after Dutch dance festival

    By Reuters Staff

    AMSTERDAM (Reuters) - A 41-year-old Dutch woman died after attending a weekend dance festival, police said on Monday, increasing to three the number of deaths at the popular Amsterdam Dance Event suspected of being caused by the drug ecstasy.

    A police department tweet said the woman died after drug use. The police have also issued a warning about tainted drugs.

    The woman and two men, aged 21 and 33, are believed to have gotten sick after taking the party drug, but autopsies have yet to confirm the cause of death.

    A police statement said the woman from the central Dutch city of Utrecht died Sunday morning after going to see DJs perform at the festival, during which hundreds of clubs host electronic music shows.

    Drug deaths are fairly rare in the Netherlands, where use of recreational drugs is tolerated by authorities and party-goers can have drugs tested for free by health authorities.

  • Kids, dogs touch same soft spots in the brain: study

    By Janice Neumann

    NEW YORK (Reuters Health) - Brain scans showing that human responses to our dogs are not unlike those evoked by our children suggest a deep evolutionary bond, according to a recent study.

    The findings are in line with dogs' special place as mankind's best friend, and may support the benefits of dog-assisted therapies, researchers say.

    "The overlap says a lot about how similar the relationships could be, but we're only speculating," said Lori Palley, who led the study with Luke Stoeckel at Massachusetts General Hospital in Boston.

    The experiments involved 14 mothers ages 22 to 45, each with at least one child between two and 10 years old and one dog owned for at least two years.

    Each woman underwent magnetic resonance imaging, or MRI, (which measures brain activity by detecting changes in blood flow) and viewed images of her own child and dog as well as unfamiliar children and canines.

    Afterwards the mothers took an 11-question multiple choice test that asked about the hair color of their child and dog, the number of pictures viewed and had the women rate images based on their emotional value.

    "Basically we compared the human-pet bond with that of the maternal-child relationship and analyzed patterns of brain activity when moms viewed the images with the aim of understanding what areas might be common and what areas distinct," said Palley, who is assistant director of Veterinary Services at the hospital's Center for Comparative Medicine.

    When mothers looked at pictures of their own kids and their own dogs, areas of their brains associated with emotion, reward, visual processing and social cognition showed increased activity on the scans.

    But there was more brain activity in areas involved in bond formation (typically maternal-child and romantic bonds) when mothers viewed their own children versus their own dogs, the study team reports in the journal PLOS ONE.

    "What's really interesting about this is we suspect that perhaps there is some evolutionary significance to that," said Palley. "It would make sense that would be an area where you would want it to be kind of specific for relationships that should be sustained at all cost."

    In all cases, brain responses were strongest when the women viewed their own child versus one they didn't know, and their own dog versus an unknown dog.

    An area of the brain involved in visual and social processing was more active when moms looked at their pets than at their kids.

    "I think perhaps we process the dog's face differently than we process the human face, but we don't know that. We'd actually have to do more work to look at that area more specifically to determine exactly what this finding means," Palley said.

    She added that she was interested in the health benefits of pet ownership and animal-assisted therapy and, in this study, wanted to examine the science involved.

    "How do you better understand the human animal-connection or figure out for whom perhaps pet or animal assisted-therapy would be more beneficial," Palley said. "What is going on in the brain?"

    Palley cautioned that the results would need to be replicated in a larger study involving other people, including women without kids and men.

    The findings help support what many researchers already suspected, according to Alan M. Beck, professor and director of the Center for the Human-Animal Bond at Purdue University School of Veterinary Medicine.

    "We have a long history, a kind of affiliation," said Beck of the relationship people have with dogs. "Dogs learn from us, we learn from dogs, so it's not surprising that even brain activity would show how inborn it is."

    Beck, who has done a number of studies and written extensively on human-animal bonds, also said the study might add some scientific legitimacy to pet ownership.

    "It was kind of cool," Beck said of the study. "It's just one of the tools that allows a better understanding that this is a true biological/species behavior as opposed to something we've learned from our mothers to be nice to animals."

    The study might also help show that people who love pets can also love people.

    "We are wired to some degree to be nurturers of critters that evoke a desire of being nurtured and cared for," Beck said. SOURCE: http://bit.ly/1sfnXDM PLOS ONE, online October 3, 2014.

  • Joan Rivers died of complication during medical procedure

    By Patricia Reaney

    NEW YORK (Reuters) - Comedian Joan Rivers, who passed away last month at the age of 81, died of a complication during a medical procedure, the New York Chief Medical Examiner's Office said on Thursday.

    Rivers was having an examination of the back of the throat and vocal cords at a New York clinic when she stopped breathing and was rushed to Mount Sinai Hospital, where she was put on life support.

    "The manner of death is therapeutic complication," the medical examiner said in a statement, "the death resulted from a predictable complication of medical therapy."

    It listed the cause of death as anoxic encephalopathy, a condition caused when brain tissue is deprived of oxygen and there is brain damage.

    Rivers, the brash, pioneering comedian who paved the way for women in stand-up comedy, died in hospital on Sept. 4, a week after the outpatient procedure.

    "We continue to be saddened by our tragic loss and grateful for the enormous outpouring of love and support from around the world," the comedian's daughter, Melissa Rivers, said in a statement after the release of the autopsy report.

    She had no further comment to make at this time.

    Following her death, the State Health Department launched an investigation into Yorkville Endoscopy where Rivers was treated. It reviewed records and documents and questioned doctors at the clinic which opened in 2013.

    The clinic denied media reports that it had administered a general anesthesia or conducted a vocal cord biopsy on Rivers. Last month the clinic said the doctor who performed the procedure was not currently working there or serving as its medical director.

    The clinic and its spokeswoman did not immediately respond to requests for comment.

    The Brooklyn-born comedian, who once described herself as "the plastic surgery poster girl" and often joked about her numerous cosmetic enhancements, was known for the catchphrase, "Can we talk?"

    Her career as a stand-up comedian, author, talk show host and reality TV star spanned five decades. She starred with her daughter in the reality TV show "Joan & Melissa: Joan Knows Best?", with Rivers living with her grown child.

    Most recently, Rivers was the host of cable television channel E!'s "Fashion Police," commenting on the unfortunate red carpet choices of Hollywood celebrities.

Oncology Articles

  • TV adaptation of Ebola best-seller 'The Hot Zone' in the works

    By Reuters Staff

    LOS ANGELES (Reuters) - Fox's television studio has been developing an adaptation of the best-selling 1994 Ebola chronicle "The Hot Zone" for more than a year, the Twenty-First Century Fox Inc-owned company said on Friday.

    "It's a strange and upsetting coincidence that we all happen to be experiencing this current scare, and we're of course extremely sensitive about it," Executive Producer Lynda Obst, who is developing the project with Fox TV Studios and "Alien" director Ridley Scott's Scott Free Productions, said in a statement.

    "While we are far from a finished product that, regardless, would never air during this current news cycle, I do think Preston's take is illuminating, particularly with some distance," Obst said.

    If the adaptation of Richard Preston's non-fiction thriller about viral hemorrhagic fevers such as Ebola makes it into production, it will likely be as a limited-run series, Fox TV Studios said. The book describes the discovery of a virus related to Ebola in a primate quarantine facility in Reston, Virginia in 1989.

    The current Ebola outbreak has killed more than 4,500 people since March, mostly in the three impoverished West African countries of Guinea, Liberia and Sierra Leone, according to the World Health Organization.

    Fears that the outbreak would spread outside of that region have grown since a nurse in Spain became infected, a Liberian man died Oct. 8 in Dallas, Texas and two of the nurses who treated him were also diagnosed with the illness.

    A series developed by Fox's TV studio also does not guarantee that it would be broadcast on one of its parent company's networks in the United States as it could be sold to another network. Preston's book has become one of the best-selling books on online retailer Amazon two decades after its initial release.

  • Diet may influence ovarian cancer survival

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Women with healthier diets before an ovarian cancer diagnosis are less likely to die in the years following the cancer than women with poorer diets, according to a new study.

    The exceptions were women with diabetes or a high waist circumference, which is often linked to diabetes.

    A healthy diet before diagnosis may indicate a stronger immune system and, indirectly, the capacity to respond favorably to cancer therapy, said lead author Cynthia A. Thomson of Health Promotion Sciences at the Canyon Ranch Center for Prevention and Health Promotion at the University of Arizona in Tucson.

    "It also may reflect our capacity to sustain healthy eating after diagnosis, which in turn could support better health in a broader sense," Thomson told Reuters Health by email.

    Researchers looked back at 636 cases of ovarian cancer occurring between 1993 and 1998, 90 percent of which were invasive cancers.

    The women had filled out dietary and physical activity questionnaires at least one year before their cancer diagnoses as part of the larger Women's Health Initiative study. Researchers measured their heights, weights and waist circumferences.

    The healthy eating index in this study measured 10 dietary components, scoring diets with a higher amount of vegetables and fruit, more variety in vegetables and fruit, more whole grains, lower amounts of fat and alcohol and more fiber as healthier than other diets.

    On average, the women were diagnosed with ovarian cancer around age 63.

    As of September 17, 2012, 354 of the women had died, and 305 of those died specifically from ovarian cancer.

    When the researchers divided the women into three groups based on their diet quality, those in the healthiest-eating group were 27 percent less likely to die of any cause after ovarian cancer diagnosis than those in the poorest diet group, according to the results published in JNCI, the Journal of the National Cancer Institute.

    There was a similar but slightly weaker association between pre-diagnosis diet and death due specifically to ovarian cancer.

    "The index gives more points for eating good foods, such as vegetables and whole grains, and fewer points for eating not-recommended foods, such as added sugars, fatty foods and refined grains," said Dr. Elisa V. Bandera, associate professor of Epidemiology at Rutgers Cancer Institute of New Jersey in New Brunswick.

    "Interestingly, they found that it was not the individual components that affected mortality, but an overall healthy diet," said Bandera, who was not part of the new study.

    A diet rich in fruits, vegetables and whole grains may lower inflammation, which has been linked to ovarian cancer mortality, she told Reuters Heath by email.

    "Such a diet has also been linked to reduced risk of other chronic diseases such as diabetes and cardiovascular disease which may complicate ovarian cancer treatment and increase mortality," she said.

    High scores on the Healthy Eating Index are very similar to guidelines and recommendations for cancer survivors provided by the American Institute for Cancer Research and the American Cancer Society, Dr. Anne McTiernan of the Fred Hutchinson Cancer Research Center in Seattle told Reuters Health by email.

    "However, the data on diet and lifestyle associations with ovarian cancer survival are all observational," said McTiernan, who was not involved in the new study. "Clear recommendations would require a randomized controlled clinical trial - the gold standard of medical evidence - before women with ovarian cancer could be advised to change their lifestyles in order to improve their prognosis."

    Women with a history of diabetes and those with a waist circumference greater than 34 inches did not seem to get the same survival benefit from a healthy diet as other women. In their report, the study authors note that past research has already linked diabetes with higher-than-average mortality in ovarian cancer.

    The amount of regular exercise women got before diagnosis did not seem to affect the link between diet quality and survival.

    Although the researchers accounted for exercise and total calorie intake, they did not account for ovarian cancer treatment. Women who had healthier diets may also have had access to better treatment, Bandera noted.

    In any case, Thomson said, healthy diets do seem to be important to reduce cancer risk and to improve survival after cancer. "One in two U.S. adults will be diagnosed with some form of cancer in their lifetime and eating healthy is important in regards to how we come through this experience."

    Healthy behaviors may also delay the onset of cancer, for example from age 55 to 65, but that is difficult to demonstrate, she said.

    SOURCE: http://bit.ly/VFCL0c JNCI, online October 16, 2014.

  • Freezing women's eggs not risk-free or foolproof-UK fertility expert

    By Kieran Guilbert

    LONDON (Thomson Reuters Foundation) - Freezing a woman's eggs is neither risk-free nor foolproof, a British fertility expert said on Thursday, after Apple and Facebook said they would contribute to the cost of the procedure for female employees.

    Raising the issue of companies' reasons for helping female employees meet the cost of freezing their eggs, Dr Jane Stewart, secretary of the British Fertility Society, said such payments were "not a positive move for women, their rights or their careers."

    Women should be given the opportunity to have a baby at the right time for them, rather than when it is "convenient for the company," she told the Thomson Reuters Foundation.

    "It's an interesting proposal, but I'm not sure what it will achieve as women will still need time off when they are pregnant," Stewart said in a phone interview.

    "Why not just give women maternity leave and pay, and support them to come back on an equal footing after they've had their baby?"

    "Although egg freezing is now considered a clinically effective measure, that doesn't mean it's risk-free or foolproof, and it certainly doesn't guarantee a baby," she said.

    Apple has said that from January 2015 it will pay up to $20,000 for both full- and part-time female employees to freeze and store their eggs.

    NBC News reported on Tuesday that Facebook recently began covering the cost of egg-freezing for non-medical reasons, making it one of the first major employers in the technology sector to do so.

    A Facebook spokeswoman confirmed that the company had rolled out the benefit in January in response to requests from employees, among other reasons.

    In a report published in October 2012, the American Society of Reproductive Medicine (ASRM) said that egg freezing was an exciting and improving technology, and should no longer be considered experimental.

    However, ASRM said it could not endorse the widespread use of the practice, and said it may not be appropriate for older women who desire to postpone reproduction.

    Egg freezing is an expensive but increasingly popular option for women, enabling them to delay child bearing. The procedure is also used by women who have to undergo medical treatments that interfere with fertility, such as cancer treatment.

    The procedure typically costs up to $10,000, with an additional $500 a year for storage.

    The British Fertility Society represents professionals practicing in the field of reproductive medicine.

  • Last-resort leukemia treatment produces dramatic remission rate

    By Gene Emery

    NEW YORK (Reuters Health) - Ninety percent of people facing death because conventional treatments had failed to destroy their leukemia have responded to an experimental therapy that trains their cells to kill out-of-control blood cells, doctors in Philadelphia report.

    Twenty seven of the 25 children and 5 adults initially responded to the new therapy. Nineteen - including a 9-year-old treated two and a half years ago - have remained cancer-free and 15 of those 19 have not receive any subsequent therapy.

    "We're astonished how well it turned out," senior author Dr. Stephan Grupp of Children's Hospital of Philadelphia told Reuters Health. Doctors are often happy if a treatment can improve the remission rate by 3 percent to 5 percent. "In our wildest dreams, we didn't think it would work as well as it did for the patients we've treated so far," Grupp said.

    "It's equally impressive in both the adult and pediatric population," said Dr. Noelle Frey of the University of Pennsylvania, who directed the adult portion of the study.

    "These are patients where the chances of cure are close to zero, if not zero," she said. "This is a therapy that not only gives hope, but is also correlated with tremendous success."

    The treatment results, reported in the New England Journal of Medicine, are part of a broader effort to reprogram the cells of cancer patients so they reproduce rapidly and attack the rogue cells responsible for tumors.

    "If this has curative potential - which we don't know yet, but seems to be the case - it's a game changer," said Dr. Michael Sadelain of Memorial Sloan Kettering Cancer Center, part of a separate team that previously used the technique to produce complete remissions in 14 out of 16 adults who had acute lymphoblastic leukemia (ALL) of a stage "where nobody would go into complete remission."

    "The good news is, this therapy can work just as well in children as it was reported to do in adults," he told Reuters Health.

    In the Philadelphia study, other treatments - as many as four - had failed in the 30 patients. Conventional therapy typically cures 80 percent to 85 percent of children with ALL and those children "don't need this," said Grupp. "The other 15 percent or so are candidates for this."

    Adults with ALL are tougher to treat, "so 50 percent or more might need this," he said.

    In July, the the U.S. Food and Drug Administration gave the treatment, known as CTL019, a Breakthrough Therapy designation designed to expedite its development for ALL.

    The Philadelphia researchers have also been experimenting with CTL019 for chronic lymphocytic leukemia and Hodgkin's lymphoma,. The remission rates in those tests have been high, but not nearly as high as with ALL, Frey told Reuters Health. Those findings have not been published.

    The ALL treatment involves training disease-fighting blood cells known as T-cells. Once removed from a patient's body, they are programmed to hunt cancer cells that have a telltale protein on their surface. The specially-trained cells are then re-injected into the patient. The re-engineering process currently costs about $25,000.

    Of the initial 30 patients, 27 were in complete remission by the one-month mark, but seven relapsed over a period ranging from 6 weeks to 8.5 months after treatment. Twenty three were alive at the six-month mark. Five of the 23 left the study to receive other treatments, including stem cell transplantation.

    The treatment is not without serious risks. The most common is cytokine release syndrome, where the body appears to react to the mass killing of tumor cells.

    Patients "become tired, achy and nauseous," said Frey. "You can also get low blood pressure and breathing difficulties. Unfortunately, it can be life-threatening. But we have, in most cases, been able to reverse it. Yet in most situations it's very manageable."

    "For our patients who have already relapsed after stem cell transplants, or don't have any options for donors," she said, "this option has provided new hope."

    In eight of the 27 cases where there was a response, cytokine release syndrome was judged to be severe and the patients ended up in intensive care.

    At least part of the technique involved in the Philadelphia study has been licensed to Novartis. Sloan Kettering has teamed up with a start-up company, Juno Therapeutics, which will conduct a multicenter study of adults with ALL, Sadelain said.

    "That's a sea change in the field because, until now, this realm of cell therapy was almost exclusively in the hands of academic centers," he said. "Now you see a whole host of companies moving into this space. Investors have been impressed by these results and will take them far beyond what academic centers will do."

    SOURCE: http://bit.ly/1syxUeI New England Journal of Medicine, October 15, 2014.

  • U.S. court rebuffs Marine Corps families in polluted water case

    By Pamela MacLean

    (Reuters) - In a defeat for families claiming they were sickened by groundwater contamination many years ago at a U.S. Marine Corps base in North Carolina, a federal appeals court has rejected an attempt by the state's legislature to extend a time limit for filing pollution-related lawsuits.

    As a result, families involved in 10 lawsuits will be unlikely to collect damages for alleged injuries suffered at Marine Corps Base Camp Lejeune, although a lawyer for the plaintiffs said they were considering further appellate options.

    Families of Marine Corps and Navy personnel stationed at Camp Lejeune over a period of 31 years, ending in 1987, had higher cancer rates than Marines and sailors in other bases without groundwater contamination, according to the plaintiffs.

    Water pollution at the camp was allegedly linked to illnesses more than a decade after the Marine Corps halted its alleged polluting at the sprawling base on the Atlantic Coast.

    Lawsuits were filed and 10 of them were consolidated in 2011 in U.S. District Court in the Northern District of Georgia.

    The federal government tried to have the families' cases dismissed, arguing that North Carolina's 10-year limit on filing lawsuits, known as a statute of repose, barred the actions, which were filed long after the alleged contamination occurred.

    The Georgia judge rejected the federal government's argument, saying that the U.S. Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) preempted the North Carolina time limit. The government appealed.

    In the interim, the U.S. Supreme Court ruled in June, in an unrelated case, that CERCLA did not preempt the North Carolina law. Then, in an attempt to help the families, North Carolina state lawmakers tried to circumvent the Supreme Court ruling by voting in August to allow such lawsuits to be brought retroactively, beyond the 10-year limit, under state law.

    But in a ruling on Tuesday, the 11th U.S. Circuit Court said the state's statutory time limit was not preempted by CERCLA.

    A spokeswoman for the Department of Justice declined to comment on the ruling.

    The federal circuit ruled the state lawmakers' action in August was a new law, not a clarification of existing law, and so could not be applied retroactively to latent diseases that may be undiagnosed for years past the state's 10-year limit.

    "We contend that when the ten-year period began to run is still in dispute and that the cases should not simply be dismissed," said John Korzen, a Wake Forest University law professor representing the families.

    Under the state's statute of repose, a 10-year clock starts when the final instance of pollution occurs or when a property is sold. After that period, no lawsuits may be filed.

    In 2012, President Barack Obama signed a bill offering some of the Camp Lejeune families government-funded medical care.

    The case is Bryant v. United States, 11th U.S. Circuit Court of Appeals, No. 12-15424.

Orthopedic Articles

  • Young baseball pitchers at risk for shoulder damage

    By Shereen Lehman

    NEW YORK (Reuters Health) - Teenaged baseball players who throw more than 100 pitches per week are at heightened risk of an injury that could permanently mar normal shoulder development, says a new study.

    The injury, dubbed "acromial apophysiolysis" by the authors, is characterized by incomplete fusion of the bones that form the top portion of the shoulder joint, the acromion, and local swelling and fluid (edema).

    "Over the years," said lead author Dr. Johannes Roedl, the study team had noticed young baseball players "who came in at the end of the season with shoulder pain, but with MRI imaging on which we really didn't see anything besides the abnormality, that edema at the acromion."

    Roedl, a radiologist in the musculoskeletal division at Thomas Jefferson University Hospital in Philadelphia, said that neither the radiologists nor orthopedic surgeons knew if these abnormalities were clinically relevant, but they knew something was going on, so they decided to take a closer look at all the cases they had seen.

    "We looked at all the clinical data that we had from the orthopedic surgery department," Roedl said. "In terms of how did the patients present, where was the pain, and of course, their history in terms of sports - what kind of sports did those patients play?"

    He said they were surprised at how many patients appeared to have the condition.

    "I mean it's still a relatively rare condition - only about 2.5 percent of patients at the age range between 15 and 25 who come in with shoulder pain have that acromial apophysiolysis," he said.

    Roedl said it is most likely an overuse injury from too much pitching because most of the patients who had it were "really avid pitchers - the majority pitched more than one hundred pitches per week."

    He and his colleagues reviewed medical records for more than 2,000 patients, both male and female, between the ages of 15 and 25 who had MRIs for shoulder pain between 1998 and 2012. Most of the patients were pitchers.

    A total of 61 patients had pain at the top of the shoulder and incomplete fusion of the acromion but no other radiological findings. The study team compared them to a control group of 61 similar patients who had other identifiable causes for their shoulder pain.

    The researchers found that 40 percent of the patients with acromial apophysiolysis threw more than 100 pitches per week compared to 8 percent of the control group, they report in the journal Radiology.

    One patient underwent surgery and all of the patients rested their pitching arms for three months and took nonsteroidal anti-inflammatory (NSAID) medications.

    The research team was also able to review follow-up images, either MRIs or X-rays, for 52 participants after they were 25 years old, the age when bone development would be complete. The average age at follow-up was 27 and a half, and the average interval since the original images was eight years.

    Of the 29 patients with apophysiolysis as teens, 25 showed incomplete bone fusion at the acromion at follow-up, compared to only one out of the 23 controls.

    Torn rotator cuff muscles were also more common - and worse - in the adult patients who had apophysiolysis than in the control group.

    "You can imagine if the bone in the shoulder doesn't fuse it's kind of unstable," Roedl said. "This is not a medical term, but it's essentially 'floating' and doesn't really have a fixed point."

    Roedl said that when a bone floats around it can press on tendons and those tendons can rupture or tear.

    "And that's what we saw in those patients - that they more often had tendon tears of the rotator cuff . . . so it actually had a long-term effect on those patients," he said.

    "Overall, I think it's a great radiology study. The authors describe the presentation of a new condition in a fairly large sample of patients that had previously not been done in that capacity," Kyle Aune told Reuters Health in an email.

    Aune is a clinical researcher with the American Sports Medicine Institute in Birmingham, Alabama. He wasn't involved in the study.

    But, Aune isn't yet convinced the condition is the sole cause of rotator cuff tears.

    "While possible, it is likely that these rotator cuff injuries would be due to a combination of factors including general overuse and impingement from biomechanical flaws within a pitcher's throwing mechanics," he said.

    Aune also wasn't sure that female softball pitchers should have been grouped with male baseball pitchers since the throwing motions are quite different.

    "The majority of the girls in the study played softball - it's a different pitching style, but they still have an over the head movement, and that's probably what causes the problem," Roedl said.

    Roedl added that in the future, they want to look closely at other sports to see if it's really just confined to pitching or if it's found in other athletes who use overhead motions, such as tennis, lacrosse or swimming.

    As for prevention, he said that not overdoing the same pitching motion over and over is the key.

    "It's important to pitch less than 100 pitches per week when you're young," Roedl said. "Take the off-season off, take a break of two or three months," he said.

    SOURCE: http://bit.ly/1uhaPcZ Radiology, online October 14, 2014.

  • Young baseball pitchers at risk for shoulder damage

    By Shereen Lehman

    NEW YORK (Reuters Health) - Teenaged baseball players who throw more than 100 pitches per week are at heightened risk of an injury that could permanently mar normal shoulder development, says a new study.

    The injury, dubbed "acromial apophysiolysis" by the authors, is characterized by incomplete fusion of the bones that form the top portion of the shoulder joint, the acromion, and local swelling and fluid (edema).

    "Over the years," said lead author Dr. Johannes Roedl, the study team had noticed young baseball players "who came in at the end of the season with shoulder pain, but with MRI imaging on which we really didn't see anything besides the abnormality, that edema at the acromion."

    Roedl, a radiologist in the musculoskeletal division at Thomas Jefferson University Hospital in Philadelphia, said that neither the radiologists nor orthopedic surgeons knew if these abnormalities were clinically relevant, but they knew something was going on, so they decided to take a closer look at all the cases they had seen.

    "We looked at all the clinical data that we had from the orthopedic surgery department," Roedl said. "In terms of how did the patients present, where was the pain, and of course, their history in terms of sports - what kind of sports did those patients play?"

    He said they were surprised at how many patients appeared to have the condition.

    "I mean it's still a relatively rare condition - only about 2.5 percent of patients at the age range between 15 and 25 who come in with shoulder pain have that acromial apophysiolysis," he said.

    Roedl said it is most likely an overuse injury from too much pitching because most of the patients who had it were "really avid pitchers - the majority pitched more than one hundred pitches per week."

    He and his colleagues reviewed medical records for more than 2,000 patients, both male and female, between the ages of 15 and 25 who had MRIs for shoulder pain between 1998 and 2012. Most of the patients were pitchers.

    A total of 61 patients had pain at the top of the shoulder and incomplete fusion of the acromion but no other radiological findings. The study team compared them to a control group of 61 similar patients who had other identifiable causes for their shoulder pain.

    The researchers found that 40 percent of the patients with acromial apophysiolysis threw more than 100 pitches per week compared to 8 percent of the control group, they report in the journal Radiology.

    One patient underwent surgery and all of the patients rested their pitching arms for three months and took nonsteroidal anti-inflammatory (NSAID) medications.

    The research team was also able to review follow-up images, either MRIs or X-rays, for 52 participants after they were 25 years old, the age when bone development would be complete. The average age at follow-up was 27 and a half, and the average interval since the original images was eight years.

    Of the 29 patients with apophysiolysis as teens, 25 showed incomplete bone fusion at the acromion at follow-up, compared to only one out of the 23 controls.

    Torn rotator cuff muscles were also more common - and worse - in the adult patients who had apophysiolysis than in the control group.

    "You can imagine if the bone in the shoulder doesn't fuse it's kind of unstable," Roedl said. "This is not a medical term, but it's essentially 'floating' and doesn't really have a fixed point."

    Roedl said that when a bone floats around it can press on tendons and those tendons can rupture or tear.

    "And that's what we saw in those patients - that they more often had tendon tears of the rotator cuff . . . so it actually had a long-term effect on those patients," he said.

    "Overall, I think it's a great radiology study. The authors describe the presentation of a new condition in a fairly large sample of patients that had previously not been done in that capacity," Kyle Aune told Reuters Health in an email.

    Aune is a clinical researcher with the American Sports Medicine Institute in Birmingham, Alabama. He wasn't involved in the study.

    But, Aune isn't yet convinced the condition is the sole cause of rotator cuff tears.

    "While possible, it is likely that these rotator cuff injuries would be due to a combination of factors including general overuse and impingement from biomechanical flaws within a pitcher's throwing mechanics," he said.

    Aune also wasn't sure that female softball pitchers should have been grouped with male baseball pitchers since the throwing motions are quite different.

    "The majority of the girls in the study played softball - it's a different pitching style, but they still have an over the head movement, and that's probably what causes the problem," Roedl said.

    Roedl added that in the future, they want to look closely at other sports to see if it's really just confined to pitching or if it's found in other athletes who use overhead motions, such as tennis, lacrosse or swimming.

    As for prevention, he said that not overdoing the same pitching motion over and over is the key.

    "It's important to pitch less than 100 pitches per week when you're young," Roedl said. "Take the off-season off, take a break of two or three months," he said.

    SOURCE: http://bit.ly/1uhaPcZ Radiology, online October 14, 2014.

  • Young baseball pitchers at risk for shoulder damage

    By Shereen Lehman

    NEW YORK (Reuters Health) - Teenaged baseball players who throw more than 100 pitches per week are at heightened risk of an injury that could permanently mar normal shoulder development, says a new study.

    The injury, dubbed "acromial apophysiolysis" by the authors, is characterized by incomplete fusion of the bones that form the top portion of the shoulder joint, the acromion, and local swelling and fluid (edema).

    "Over the years," said lead author Dr. Johannes Roedl, the study team had noticed young baseball players "who came in at the end of the season with shoulder pain, but with MRI imaging on which we really didn't see anything besides the abnormality, that edema at the acromion."

    Roedl, a radiologist in the musculoskeletal division at Thomas Jefferson University Hospital in Philadelphia, said that neither the radiologists nor orthopedic surgeons knew if these abnormalities were clinically relevant, but they knew something was going on, so they decided to take a closer look at all the cases they had seen.

    "We looked at all the clinical data that we had from the orthopedic surgery department," Roedl said. "In terms of how did the patients present, where was the pain, and of course, their history in terms of sports - what kind of sports did those patients play?"

    He said they were surprised at how many patients appeared to have the condition.

    "I mean it's still a relatively rare condition - only about 2.5 percent of patients at the age range between 15 and 25 who come in with shoulder pain have that acromial apophysiolysis," he said.

    Roedl said it is most likely an overuse injury from too much pitching because most of the patients who had it were "really avid pitchers - the majority pitched more than one hundred pitches per week."

    He and his colleagues reviewed medical records for more than 2,000 patients, both male and female, between the ages of 15 and 25 who had MRIs for shoulder pain between 1998 and 2012. Most of the patients were pitchers.

    A total of 61 patients had pain at the top of the shoulder and incomplete fusion of the acromion but no other radiological findings. The study team compared them to a control group of 61 similar patients who had other identifiable causes for their shoulder pain.

    The researchers found that 40 percent of the patients with acromial apophysiolysis threw more than 100 pitches per week compared to 8 percent of the control group, they report in the journal Radiology.

    One patient underwent surgery and all of the patients rested their pitching arms for three months and took nonsteroidal anti-inflammatory (NSAID) medications.

    The research team was also able to review follow-up images, either MRIs or X-rays, for 52 participants after they were 25 years old, the age when bone development would be complete. The average age at follow-up was 27 and a half, and the average interval since the original images was eight years.

    Of the 29 patients with apophysiolysis as teens, 25 showed incomplete bone fusion at the acromion at follow-up, compared to only one out of the 23 controls.

    Torn rotator cuff muscles were also more common - and worse - in the adult patients who had apophysiolysis than in the control group.

    "You can imagine if the bone in the shoulder doesn't fuse it's kind of unstable," Roedl said. "This is not a medical term, but it's essentially 'floating' and doesn't really have a fixed point."

    Roedl said that when a bone floats around it can press on tendons and those tendons can rupture or tear.

    "And that's what we saw in those patients - that they more often had tendon tears of the rotator cuff . . . so it actually had a long-term effect on those patients," he said.

    "Overall, I think it's a great radiology study. The authors describe the presentation of a new condition in a fairly large sample of patients that had previously not been done in that capacity," Kyle Aune told Reuters Health in an email.

    Aune is a clinical researcher with the American Sports Medicine Institute in Birmingham, Alabama. He wasn't involved in the study.

    But, Aune isn't yet convinced the condition is the sole cause of rotator cuff tears.

    "While possible, it is likely that these rotator cuff injuries would be due to a combination of factors including general overuse and impingement from biomechanical flaws within a pitcher's throwing mechanics," he said.

    Aune also wasn't sure that female softball pitchers should have been grouped with male baseball pitchers since the throwing motions are quite different.

    "The majority of the girls in the study played softball - it's a different pitching style, but they still have an over the head movement, and that's probably what causes the problem," Roedl said.

    Roedl added that in the future, they want to look closely at other sports to see if it's really just confined to pitching or if it's found in other athletes who use overhead motions, such as tennis, lacrosse or swimming.

    As for prevention, he said that not overdoing the same pitching motion over and over is the key.

    "It's important to pitch less than 100 pitches per week when you're young," Roedl said. "Take the off-season off, take a break of two or three months," he said.

    SOURCE: http://bit.ly/1uhaPcZ Radiology, online October 14, 2014.

Transplant Articles

  • Last-resort leukemia treatment produces dramatic remission rate

    By Gene Emery

    NEW YORK (Reuters Health) - Ninety percent of people facing death because conventional treatments had failed to destroy their leukemia have responded to an experimental therapy that trains their cells to kill out-of-control blood cells, doctors in Philadelphia report.

    Twenty seven of the 25 children and 5 adults initially responded to the new therapy. Nineteen - including a 9-year-old treated two and a half years ago - have remained cancer-free and 15 of those 19 have not receive any subsequent therapy.

    "We're astonished how well it turned out," senior author Dr. Stephan Grupp of Children's Hospital of Philadelphia told Reuters Health. Doctors are often happy if a treatment can improve the remission rate by 3 percent to 5 percent. "In our wildest dreams, we didn't think it would work as well as it did for the patients we've treated so far," Grupp said.

    "It's equally impressive in both the adult and pediatric population," said Dr. Noelle Frey of the University of Pennsylvania, who directed the adult portion of the study.

    "These are patients where the chances of cure are close to zero, if not zero," she said. "This is a therapy that not only gives hope, but is also correlated with tremendous success."

    The treatment results, reported in the New England Journal of Medicine, are part of a broader effort to reprogram the cells of cancer patients so they reproduce rapidly and attack the rogue cells responsible for tumors.

    "If this has curative potential - which we don't know yet, but seems to be the case - it's a game changer," said Dr. Michael Sadelain of Memorial Sloan Kettering Cancer Center, part of a separate team that previously used the technique to produce complete remissions in 14 out of 16 adults who had acute lymphoblastic leukemia (ALL) of a stage "where nobody would go into complete remission."

    "The good news is, this therapy can work just as well in children as it was reported to do in adults," he told Reuters Health.

    In the Philadelphia study, other treatments - as many as four - had failed in the 30 patients. Conventional therapy typically cures 80 percent to 85 percent of children with ALL and those children "don't need this," said Grupp. "The other 15 percent or so are candidates for this."

    Adults with ALL are tougher to treat, "so 50 percent or more might need this," he said.

    In July, the the U.S. Food and Drug Administration gave the treatment, known as CTL019, a Breakthrough Therapy designation designed to expedite its development for ALL.

    The Philadelphia researchers have also been experimenting with CTL019 for chronic lymphocytic leukemia and Hodgkin's lymphoma,. The remission rates in those tests have been high, but not nearly as high as with ALL, Frey told Reuters Health. Those findings have not been published.

    The ALL treatment involves training disease-fighting blood cells known as T-cells. Once removed from a patient's body, they are programmed to hunt cancer cells that have a telltale protein on their surface. The specially-trained cells are then re-injected into the patient. The re-engineering process currently costs about $25,000.

    Of the initial 30 patients, 27 were in complete remission by the one-month mark, but seven relapsed over a period ranging from 6 weeks to 8.5 months after treatment. Twenty three were alive at the six-month mark. Five of the 23 left the study to receive other treatments, including stem cell transplantation.

    The treatment is not without serious risks. The most common is cytokine release syndrome, where the body appears to react to the mass killing of tumor cells.

    Patients "become tired, achy and nauseous," said Frey. "You can also get low blood pressure and breathing difficulties. Unfortunately, it can be life-threatening. But we have, in most cases, been able to reverse it. Yet in most situations it's very manageable."

    "For our patients who have already relapsed after stem cell transplants, or don't have any options for donors," she said, "this option has provided new hope."

    In eight of the 27 cases where there was a response, cytokine release syndrome was judged to be severe and the patients ended up in intensive care.

    At least part of the technique involved in the Philadelphia study has been licensed to Novartis. Sloan Kettering has teamed up with a start-up company, Juno Therapeutics, which will conduct a multicenter study of adults with ALL, Sadelain said.

    "That's a sea change in the field because, until now, this realm of cell therapy was almost exclusively in the hands of academic centers," he said. "Now you see a whole host of companies moving into this space. Investors have been impressed by these results and will take them far beyond what academic centers will do."

    SOURCE: http://bit.ly/1syxUeI New England Journal of Medicine, October 15, 2014.

  • Stem cells from human embryos prove safe, improve vision -study

    By Sharon Begley

    NEW YORK (Reuters) - The longest-running trial of stem cells derived from a human embryo found that the cells caused patients none of the problems scientists feared, such as forming tumors, and reversed partial blindness in about half the eyes receiving transplants, researchers reported on Tuesday.

    The results, published in The Lancet, could help re-invigorate the controversial quest to harness stem cells, which have the ability to turn into any of the 200 kinds of human cells, to treat diseases.

    In an accompanying commentary, Dr. Anthony Atala of the Wake Forest Institute for Regenerative Medicine called the work "a major accomplishment."

    After intense excitement among scientists and the public about the promise of stem cells and ethical debates about destroying human embryos to obtain them, the field stumbled when a high-profile trial for spinal cord injury was halted by Geron Corp in 2011 and the interest of other companies waned.

    The small study's main goal was assessing the safety of the transplanted cells. Called retinal pigment epithelial cells, they were created by taking stem cells from a days-old embryo created in a fertility clinic and inducing them to differentiate into the specialized cells.

    The study "provides the first evidence, in humans with any disease, of the long-term safety and possible biologic activity" of cells derived from embryos, said co-author Dr. Robert Lanza, chief scientific officer of Advanced Cell Technology, which produced the cells and funded the study.

    Nine patients with Stargardt's disease (which causes macular degeneration in childhood) and nine with dry age-related macular degeneration (a leading cause of adult blindness) received implants of the retinal cells in one eye. The other eye served as a control.

    Four eyes developed cataracts and two became inflamed, probably due to the patients' age (median: 77) or the use of immune-supressing transplant drugs.

    The retinal cells, which help keep the eye's rods and cones alive and functional, survived in all 18 patients, most of whose vision improved. In those with macular degeneration, treated eyes saw a median of 14 additional letters on a standard eye chart a year after receiving the cells, with one patient gaining 19 letters. The untreated eyes got worse, overall. The Stargardt's patients had similar results.

    In real-life terms, patients who couldn't see objects under 12 feet (4 meters) tall can now see normal-size adults.

    The vision of one 75-year old rancher who was blind in the treated eye (20/400) improved to 20/40, enough to ride horses again, Lanza said. Others became able to use computers, read watches, go to the mall or travel to the airport alone for the first time in years.

    While calling the results "encouraging," stem cell expert Dusko Ilic of Kings College London, who was not involved in the work, warned that even if the larger clinical trial planned for later this year is also successful, "it will take years before the treatment becomes available."

    SOURCE: http://bit.ly/1w1biDB The Lancet, online October 14, 2014.

    (Reporting by Sharon Begley; editing by Andrew Hay)

Women’s Health Articles

  • Third death attributed to ecstasy reported after Dutch dance festival

    By Reuters Staff

    AMSTERDAM (Reuters) - A 41-year-old Dutch woman died after attending a weekend dance festival, police said on Monday, increasing to three the number of deaths at the popular Amsterdam Dance Event suspected of being caused by the drug ecstasy.

    A police department tweet said the woman died after drug use. The police have also issued a warning about tainted drugs.

    The woman and two men, aged 21 and 33, are believed to have gotten sick after taking the party drug, but autopsies have yet to confirm the cause of death.

    A police statement said the woman from the central Dutch city of Utrecht died Sunday morning after going to see DJs perform at the festival, during which hundreds of clubs host electronic music shows.

    Drug deaths are fairly rare in the Netherlands, where use of recreational drugs is tolerated by authorities and party-goers can have drugs tested for free by health authorities.

  • Many US women use custom-compounded hormones for menopause

    By Megan Brooks

    NEW YORK (Reuters Health) - An estimated 1.4 million U.S. women take custom-compounded bioidentical hormone therapy (CBHT) for menopausal symptoms, and most are unaware that these drugs are not FDA-approved, according to late-breaking research presented this week at the North American Menopause Society (NAMS) annual meeting.

    This "important knowledge gap" represents a substantial educational opportunity for clinicians who "play a significant role" in guiding women's choice of menopausal hormone therapy (MHT), the investigators say in a meeting abstract.

    "Even though there are times when a woman might need custom-compounding because she might be sensitive to an approved drug's ingredients, we think that it's important to educate women about the risks and that they are not FDA-approved," JoAnn Pinkerton, of the University of Virginia, Charlottesville, who led the study and presented the data, told Reuters Health by phone.

    To see how many U.S. menopausal women were using CBHT and to explore how much women knew about it versus FDA-approved MHT, two Internet surveys were conducted among women aged 40 and older. One was done by Rose Research in April 2014 and the other was done by Harris Interactive in July 2013.

    In the Rose survey, 5 percent of respondents (883 out of 17,825) were current MHT users. Extrapolating to the general population suggests that at least 3.6 million U.S. women per year use MHT, the researchers say.

    "Multiplying 3.6 million by the average number of drugs current MHT users in Rose were taking per year indicates 57 million prescriptions for MHT may be filled annually," they report.

    Subtracting the roughly 36 million FDA-approved MHT prescriptions filled annually from the estimated 57 million annual MHT prescriptions suggests 21 million CBHT prescriptions may be filled annually, they estimate.

    "Further, dividing the roughly 21 million annual CBHT prescriptions by mean duration of use by number of products being used suggests at least 1.4 million women use CBHT," they say.

    The cost of CBHT prescriptions filled annually in the U.S. "may exceed $1 billion," the researchers say.

    In the Harris survey, 86 percent of the menopausal women appeared to be unaware that these drugs were not FDA-approved, Pinkerton noted.

    "Three-quarters (76 percent) of the Harris completers didn't know whether bioidentical hormone therapies were compounded, if they were FDA-approved or not, and 10 percent believed incorrectly that they were FDA-approved," she told Reuters Health. "That makes us really concerned because it means that we as providers are not doing a good job about talking about the risks."

    She added, "If you think back to the deaths with the fungal meningitis cases, we learned a lot about the unique risks with custom-compounding, that they aren't FDA-approved, monitored or regulated, that there is concern about under dosing or over dosing and there haven't been any large clinical trials to test safety and effectiveness of these products."

    Dr. Pinkerton said that once she looked at this survey data and realized how many women were actually using CBHT, she felt it was important to present it at NAMS and "get the message out" in the hope that more health providers will talk to their patients about the potential risks of using non-FDA-approved compounded products.

  • Kids, dogs touch same soft spots in the brain: study

    By Janice Neumann

    NEW YORK (Reuters Health) - Brain scans showing that human responses to our dogs are not unlike those evoked by our children suggest a deep evolutionary bond, according to a recent study.

    The findings are in line with dogs' special place as mankind's best friend, and may support the benefits of dog-assisted therapies, researchers say.

    "The overlap says a lot about how similar the relationships could be, but we're only speculating," said Lori Palley, who led the study with Luke Stoeckel at Massachusetts General Hospital in Boston.

    The experiments involved 14 mothers ages 22 to 45, each with at least one child between two and 10 years old and one dog owned for at least two years.

    Each woman underwent magnetic resonance imaging, or MRI, (which measures brain activity by detecting changes in blood flow) and viewed images of her own child and dog as well as unfamiliar children and canines.

    Afterwards the mothers took an 11-question multiple choice test that asked about the hair color of their child and dog, the number of pictures viewed and had the women rate images based on their emotional value.

    "Basically we compared the human-pet bond with that of the maternal-child relationship and analyzed patterns of brain activity when moms viewed the images with the aim of understanding what areas might be common and what areas distinct," said Palley, who is assistant director of Veterinary Services at the hospital's Center for Comparative Medicine.

    When mothers looked at pictures of their own kids and their own dogs, areas of their brains associated with emotion, reward, visual processing and social cognition showed increased activity on the scans.

    But there was more brain activity in areas involved in bond formation (typically maternal-child and romantic bonds) when mothers viewed their own children versus their own dogs, the study team reports in the journal PLOS ONE.

    "What's really interesting about this is we suspect that perhaps there is some evolutionary significance to that," said Palley. "It would make sense that would be an area where you would want it to be kind of specific for relationships that should be sustained at all cost."

    In all cases, brain responses were strongest when the women viewed their own child versus one they didn't know, and their own dog versus an unknown dog.

    An area of the brain involved in visual and social processing was more active when moms looked at their pets than at their kids.

    "I think perhaps we process the dog's face differently than we process the human face, but we don't know that. We'd actually have to do more work to look at that area more specifically to determine exactly what this finding means," Palley said.

    She added that she was interested in the health benefits of pet ownership and animal-assisted therapy and, in this study, wanted to examine the science involved.

    "How do you better understand the human animal-connection or figure out for whom perhaps pet or animal assisted-therapy would be more beneficial," Palley said. "What is going on in the brain?"

    Palley cautioned that the results would need to be replicated in a larger study involving other people, including women without kids and men.

    The findings help support what many researchers already suspected, according to Alan M. Beck, professor and director of the Center for the Human-Animal Bond at Purdue University School of Veterinary Medicine.

    "We have a long history, a kind of affiliation," said Beck of the relationship people have with dogs. "Dogs learn from us, we learn from dogs, so it's not surprising that even brain activity would show how inborn it is."

    Beck, who has done a number of studies and written extensively on human-animal bonds, also said the study might add some scientific legitimacy to pet ownership.

    "It was kind of cool," Beck said of the study. "It's just one of the tools that allows a better understanding that this is a true biological/species behavior as opposed to something we've learned from our mothers to be nice to animals."

    The study might also help show that people who love pets can also love people.

    "We are wired to some degree to be nurturers of critters that evoke a desire of being nurtured and cared for," Beck said. SOURCE: http://bit.ly/1sfnXDM PLOS ONE, online October 3, 2014.

  • Stars mourn U.S. actress Elizabeth Pena, dead at 55

    By Reuters Staff

    (Reuters) - Television stars and other celebrities mourned U.S. actress Elizabeth Pena, whose career was marked by roles in the films "La Bamba," "Jacob's Ladder" and "Lone Star," and who died earlier this week at age 55.

    Pena, who more recently appeared on the hit TV show "Modern Family," died on Tuesday at a Los Angeles hospital of natural causes after a short illness, her manager Gina Rugolo said.

    "Rest in Peace Elizabeth Pena," wrote "Desperate Housewives" star Eva Longoria on Twitter late on Wednesday. "You paved the way for so many of us!!"

    Zoe Saldana, the actress and dancer, offered prayers to Pena's family.

    "My heart is broken!!!" she wrote on Twitter.

    Born in Elizabeth, New Jersey and graduating from New York's High School of Performing Arts in 1977, Pena went on to appear in films including "Down and Out in Beverly Hills," "*batteries not included" and "Rush Hour."

    She also acted on television, including her role on "Modern Family." She most recently appeared in several episodes of "Matador," a TV drama.

    Pena also tried her hand at directing, including an episode of Resurrection Boulevard, a TV drama in which she also acted, and became only the fourth Latina to join the Director's Guild of America.

    Pena is survived by her husband, Hans Rolla, and two children, along with her mother and sister, Rugolo said.

  • Diet may influence ovarian cancer survival

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Women with healthier diets before an ovarian cancer diagnosis are less likely to die in the years following the cancer than women with poorer diets, according to a new study.

    The exceptions were women with diabetes or a high waist circumference, which is often linked to diabetes.

    A healthy diet before diagnosis may indicate a stronger immune system and, indirectly, the capacity to respond favorably to cancer therapy, said lead author Cynthia A. Thomson of Health Promotion Sciences at the Canyon Ranch Center for Prevention and Health Promotion at the University of Arizona in Tucson.

    "It also may reflect our capacity to sustain healthy eating after diagnosis, which in turn could support better health in a broader sense," Thomson told Reuters Health by email.

    Researchers looked back at 636 cases of ovarian cancer occurring between 1993 and 1998, 90 percent of which were invasive cancers.

    The women had filled out dietary and physical activity questionnaires at least one year before their cancer diagnoses as part of the larger Women's Health Initiative study. Researchers measured their heights, weights and waist circumferences.

    The healthy eating index in this study measured 10 dietary components, scoring diets with a higher amount of vegetables and fruit, more variety in vegetables and fruit, more whole grains, lower amounts of fat and alcohol and more fiber as healthier than other diets.

    On average, the women were diagnosed with ovarian cancer around age 63.

    As of September 17, 2012, 354 of the women had died, and 305 of those died specifically from ovarian cancer.

    When the researchers divided the women into three groups based on their diet quality, those in the healthiest-eating group were 27 percent less likely to die of any cause after ovarian cancer diagnosis than those in the poorest diet group, according to the results published in JNCI, the Journal of the National Cancer Institute.

    There was a similar but slightly weaker association between pre-diagnosis diet and death due specifically to ovarian cancer.

    "The index gives more points for eating good foods, such as vegetables and whole grains, and fewer points for eating not-recommended foods, such as added sugars, fatty foods and refined grains," said Dr. Elisa V. Bandera, associate professor of Epidemiology at Rutgers Cancer Institute of New Jersey in New Brunswick.

    "Interestingly, they found that it was not the individual components that affected mortality, but an overall healthy diet," said Bandera, who was not part of the new study.

    A diet rich in fruits, vegetables and whole grains may lower inflammation, which has been linked to ovarian cancer mortality, she told Reuters Heath by email.

    "Such a diet has also been linked to reduced risk of other chronic diseases such as diabetes and cardiovascular disease which may complicate ovarian cancer treatment and increase mortality," she said.

    High scores on the Healthy Eating Index are very similar to guidelines and recommendations for cancer survivors provided by the American Institute for Cancer Research and the American Cancer Society, Dr. Anne McTiernan of the Fred Hutchinson Cancer Research Center in Seattle told Reuters Health by email.

    "However, the data on diet and lifestyle associations with ovarian cancer survival are all observational," said McTiernan, who was not involved in the new study. "Clear recommendations would require a randomized controlled clinical trial - the gold standard of medical evidence - before women with ovarian cancer could be advised to change their lifestyles in order to improve their prognosis."

    Women with a history of diabetes and those with a waist circumference greater than 34 inches did not seem to get the same survival benefit from a healthy diet as other women. In their report, the study authors note that past research has already linked diabetes with higher-than-average mortality in ovarian cancer.

    The amount of regular exercise women got before diagnosis did not seem to affect the link between diet quality and survival.

    Although the researchers accounted for exercise and total calorie intake, they did not account for ovarian cancer treatment. Women who had healthier diets may also have had access to better treatment, Bandera noted.

    In any case, Thomson said, healthy diets do seem to be important to reduce cancer risk and to improve survival after cancer. "One in two U.S. adults will be diagnosed with some form of cancer in their lifetime and eating healthy is important in regards to how we come through this experience."

    Healthy behaviors may also delay the onset of cancer, for example from age 55 to 65, but that is difficult to demonstrate, she said.

    SOURCE: http://bit.ly/VFCL0c JNCI, online October 16, 2014.