What You Need To Know News

When they reach menopause, lean women have a fourfold higher risk of asthma than heavier, but not obese, women who are still menstruating.

The surprising finding comes from a multination European study of 1,274 women age 45 to 56. About a third of the women had reached menopause; none was taking hormone therapy for menopausal symptoms.

Earlier studies have found no link between menopause and asthma or respiratory problems. But those studies did not take women’s weight into account, note Francisco Gomez Real, MD, of Norway’s Haukeland University Hospital, and colleagues.

The researchers stratified the women according to their body mass index or BMI — a measure of weight adjusted for height. Those with a BMI of less than 23 had a fourfold higher risk of asthma symptoms.

The normal BMI range is 18.5 to 24.9; the overweight range is 25 to 29.9, and a BMI of 30 or more indicates obesity.

Obese women, too, were at somewhat higher risk of asthma symptoms when they entered menopause.

“Women undergoing the menopausal transition might be at risk of deteriorating lung health,” Gomez Real and colleagues suggest. “This applies to lean women and, to some extent, to obese women.”

Women with a BMI between 23 and 28 appear to have the lowest risk of asthma when they go through menopause.

Why asthma at menopause? That’s not clear. Gomez Real and colleagues suggest that declining estrogen levels increase insulin resistance, which in turn increases risk of lung inflammation.

As fat tissue produces estrogen, the leanest women would be at the highest
risk. Despite the estrogen production from their extra fat, obesity itself increases insulin resistance. So obesity, the researchers suggest, cancels out the extra protection afforded by extra estrogen production by fat cells.

Gomez Real and colleagues report their findings in an in-press issue of the Journal of Allergy and Clinical Immunology, published online Oct. 29, 2007.

Source: http://www.cbsnews.com/

The two factors having the greatest impact on job satisfaction, employee loyalty and retention: job quality and workplace support.

For performance, however, another factor emerges: job demands such as hours worked, overtime with no notice, and job pressures. These job demands have a significant impact on performance, a negative one – comparable to the positive impact of either job quality or workplace support.

This is not good news. This first decade of the new millennium is the era of working smarter and harder – 24/7. These very standards that demand high performance … are having a negative impact on that performance.

Fortunately, the National Study of the Changing Workforce found that “workplace support appears to buffer or protect employees from the negative effects of job demands.”

The secret to mitigating the negative effect of job demands, therefore, is to provide workplace support.
Start by doing whatever
you can to limit job demands.

l Discourage excessively

long hours when possible.

l Accommodate personal

preferences in shift assignments

when possible.

l Limit overtime and plan for it in advance.

l Make sure productivity expectations are reasonable and use motivation (rather than pressure).

And then use these tools.

1. Reciprocate. If the job demands excessive hours, reciprocate for the greater demands you place on employees. Provide opportunities to deal with personal demands and desires. For example: Encourage employees to interact with family and friends during work hours.

Allow employees to access personal e-mail and non-work Web sites (at least during breaks and lunch hours).

Be generous in providing time off to handle personal needs (e.g., doctors’ appointments, day care, etc.).

2. Autonomy. Challenges plus lack of control create frustration, burnout, poor performance and turnover. Challenges coupled with the ability to make meaningful changes create enthusiasm, loyalty and peak performance.

Most employees want to do a good job. But when they’re frustrated by rules, red tape, or micro-managing, their spirits plunge, their performance suffers, and the best among them look for other opportunities. So give employees autonomy to deal with the challenges they face.

For example: The Mirage and Treasure Island hotels operate by “planned insubordination.” Supervisors must explain not only what to do but why. If the explanation is not satisfactory, the employee can refuse to do the task.

This may sound risky, but the hotels have a turnover rate of 12 percent – less than half the industry average.

3. Manage stress. Implement stress management programs. Stress management is a topic unto itself, but there are things you can encourage crew to do, including a time and place for relaxation or meditation, early identification of burnout, the importance of positive attitude, help with anger management, and how to defuse other people’s anger.

Source: http://www.the-triton.com/

A recent study published in the Journal of the American Cancer Society shows that few doctors talk about every option they have to women diagnosed with breast cancers. It seems that only a third of women diagnosed with breast cancer receive information about all removing breast cancer procedures and reconstruction options.

After diagnosed with an early stage of breast cancer women face tough decisions. They have to choose between cutting out the tumor and prolonged therapies with radiation or major surgery and remove the breast.

The study surveyed almost 1,200 early stage breast cancer patients in Detroit and Los Angeles. The two procedures, lumpectomy and mastectomy have the same high five-year survival rates.

Dr. Amy Alderman, lead author of the reconstruction study in cancer, and a plastic surgeon at the University of Michigan Medical Center tried to determine if surgeon preferences, rather than patient preferences, are driving the procedure choosing.

Figures showed that women who were told about the mastectomy and the breast reconstruction were four times more likely to choose mastectomy over lumpectomy.

There is also the possibility of having immediate reconstructive surgery after a mastectomy. It’s one longer operation and it saves a period of four weeks of recovery necessary after every breast surgery. Statistically, this procedure is chosen by 8 percent of diagnosed women in Hawaii, 11 percent in Iowa, and 22 percent in New Mexico.

Source: http://www.efluxmedia.com/

Fat used to be funny.

Some of America’s favorite comics - from W.C. Fields to Jackie Gleason, Roseanne Barr to Rosie O’Donnell - used to get a lot of mileage out of being fat.

Something has shifted in the country’s cultural zeitgeist, however, and now “O” for obesity has become America’s latest scarlet letter.

Just 13 percent of Americans were obese in 1960, and the rate has increased every year since. An ongoing study by researchers at Johns Hopkins University found that by 2015 nearly 75 percent of Americans will be overweight.

Obesity - basically, an unhealthy ratio of weight to height - is becoming the leading preventable cause of death in the United States.

We’re burying our heads at a time when more than 280,000 Americans die each year, according to the National Institutes of Health.

Talk to pediatricians, nutritionists and surgeons on the front lines of obesity’s culture wars, and you hear fear, anger and exasperation in their voices.

“Genetics loads the gun. And the environment pulls the trigger,” said Dr. Sharon Alger, head of Albany Medical Center’s Northeast Center for Eating Disorders.

Dr. Jennifer Lindstrom, a pediatrician and medical director of Albany Med’s bariatric surgery center, is seeing an alarming increase in the number of children becoming sick and even dying of what had previously been considered adult diseases as the result of morbid, or extreme, obesity.

Crisis and epidemic are Lindstrom’s words for what’s happening.

Last year, a 17-year-old Albany girl, who was 5-foot-1, weighed 310 pounds and had a 50-inch waist, died from type 2 diabetes, a form of the chronic disease often triggered by obesity.

But Lindstrom does not recommend bariatric surgery for children, because it carries risks and fundamentally alters an individual’s lifestyle. The term “bariatric surgery” refers to several procedures that drastically reduce the capacity of the stomach, making it physically difficult for the patient to eat to excess.

If current trends continue, America’s children could become the first generation in more than a century to have shorter life spans than their parents.

Nine million children are overweight in the United States, yet pediatricians concede they’re reluctant to warn parents that their child is fat and at risk for health problems, because the mothers and fathers are obese and in denial themselves.

Don’t anticipate a belly laugh anymore after an obese person sits down and causes a chair to collapse. Doctor’s offices and weight-loss centers have furnished their waiting rooms with extra-wide, heavily reinforced chairs known as “bariatric chairs.”

Observing an adult obesity support group isn’t funny, either. Nobody’s giggling as a 400-pound woman in her 50s describes how excess fat in her neck chokes off her windpipe while she sleeps and causes her to stop breathing for a time. If she doesn’t lose weight, her doctor told her, the next step will be a tracheotomy - cutting a hole in her throat and inserting a tube so she can breathe.

Other men and women attending the Thursday night group have similar stories. They’ve become prisoners of their own bodies. Being so overweight has also caused many of them to withdraw socially out of embarrassment and shame.

Obesity seems to have joined smoking, drinking and gambling in our collective community woodpile where the addictions, obsessions and compulsions end up because we have failed to deal with such behavior.

It turns out obesity may be contagious. A Harvard study found that obesity spreads in ways similar to influenza or HIV/AIDS, across groups of close friends and social networks.

Researchers studied the spread of obesity in a network of 12,067 people who underwent repeated measurements over a period of 32 years. They found that if a person becomes obese, a friend’s chances of becoming obese rises 57 percent, a sibling’s chances go up 40 percent and a spouse’s chances increase 37 percent.

Obesity’s annual cost has surpassed $100 billion nationally, and health insurers are scrambling to offer weight loss programs, some with euphemistic names like Weigh 2 Be.

What was the tipping point in this feeding frenzy?

It now costs three times as much for a gallon of gas as it does for an artery-clogging hamburger or crispy chicken sandwich at ubiquitous fast food chains.

We’ve passed laws and called out the trans fat police - “No Trans Fat” has become a sign of the times in windows of strip-mall eateries - and yet the communal waistline continues to expand.

Is there a way forward, an exit strategy, for our nation’s obesity quagmire?
New research isn’t yielding breakthroughs so much as confirming that controlling the nation’s epidemic is at once ridiculously simple and maddeningly complex.

Achieving and maintaining a healthy weight is a sustained daily struggle: year in and year out, without gimmicks or fads. It’s a lifestyle change that focuses on eating healthy foods in appropriate portions, exercising more to burn calories and turning to family and friends for support.

The good news is that the Harvard study found that the obesity contagion phenomenon worked in reverse, as well. People who lose weight increase the chances that their friends and relatives will lose weight, too.

A woman attending the obesity support group at Albany Med said she returned after a lapse of several months in which bad eating habits resurfaced, resulting in a large weight gain.

“Coming here on Thursday nights gives me the strength to drive past Pizza Hut instead of stopping,” she said.

Perhaps the obesity epidemic can borrow a phrase from another addiction recovery movement: One day, one less slice, at a time.

Source: http://www.sfgate.com/

Study: Only a Third of Women Are Told About All Breast Reconstruction Options

Women diagnosed with an early stage of breast cancer face enough tough decisions, like choosing between prolonged therapies or major surgery. Yet, new research indicates doctors aren’t even talking about every option available to women before a decision on how to proceed is made.

A new survey reports only one out of three breast cancer patients said they had talked with their doctors about plastic surgery options to reconstruct a lost breast.

The study, published in the Journal of the American Cancer Society, surveyed nearly 1,200 early stage breast cancer patients in Detroit and Los Angeles. The women who learned about breast reconstruction were four times more likely to choose mastectomy over lumpectomy.

Rebecca Larson, 31, was diagnosed with breast cancer in 2006. “I had no idea what my options for reconstruction were at diagnosis, or even before the first mastectomy,” Larson said.

“No one talked to me, and my plastic surgeon was left out of the loop until well after the initial surgery,” she added.

Cut out the tumor and get radiation, or get a mastectomy and remove the breast. Both treatments have high five-year survival rates. Both come with their own trade-offs of time, self-esteem and peace of mind, experts say.

Doctor’s Discussion

The popularity of breast reconstruction surgery nationwide shows inconsistencies within geographic regions. In Hawaii, 8 percent of women who get a mastectomy have immediate reconstructive surgery. In Iowa, the figure is 11 percent; in New Mexico, it is 22 percent.

“If you think of it, women aren’t that different,” said Dr. Amy Alderman, lead author of the reconstruction study in cancer, and a plastic surgeon at the University of Michigan Medical Center.

Alderman’s research tries to determine if surgeon preferences, rather than patient preferences, are driving reconstruction disparities. She thinks the wide variations in plastic surgery rates may come from regional medical communities’ attitudes toward breast reconstruction.

Source: http://abcnews.go.com/

Avastin plus interferon almost doubled patients’ time without disease progression, study found 

A combination treatment with two drugs, Avastin (bevacizumab) plus interferon, extends the life of patients with kidney cancer, European researchers report.

“Based on the result of earlier trials, there is already considerable enthusiasm to use bevacizumab as a new drug for treating kidney cancer patients,” noted Dr. Mayer Fishman, an assistant professor in the department of interdisciplinary oncology at the Moffitt Cancer Center of the University of South Florida in Tampa. He was not involved in the study.

Publication of large trials such as this can be expected to support the more widespread use of new drugs such as bevacizumab for kidney cancer therapy, Fishman said.

The study was funded by F. Hoffmann-La Roche Ltd., the maker of Avastin. It is published in the Dec. 22/29 issue of The Lancet.

In a phase III trial, Dr. Bernard Escudier from the Institute Gustave Roussy in Villejuif, France, and colleagues randomly assigned 649 patients with kidney cancer to receive Avastin and interferon or interferon plus a placebo.

Among those receiving combined therapy, 114 died compared with 137 of those receiving interferon alone. Moreover, patients taking Avastin plus interferon survived without any signs of disease progression for an average of 10.2 months. That’s almost double the 5.4-month average progression-free survival for those on interferon alone.

“This treatment [bevacizumab plus interferon] is clearly comparable with the most active treatment, and with a very good safety profile, will provide new options for renal cancer patients,” Escudier’s group concluded.

As more and more targeted drugs are developed, and as more combinations are possible, and as immune treatments become more sophisticated, “optimism is building that we will see more and more substantial impacts on kidney cancer treatment,” Fishman said.

“This can result in better survival and better quality of life for survivors. On the other hand, with more and more drugs and combinations, it may become harder to see the impact of an individual drug,” he added.

Another expert lauded the paper.

“This article provides another outstanding example of how a greater understanding of the biology of kidney cancer can lead to successful treatments that delay tumor growth,” said Dr. James Brugarolas, an assistant professor in the division of oncology at the Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center at Dallas.

“An important question that remains to be addressed is whether bevacizumab alone would offer similar benefit with respect to slowing down tumor progression as the bevacizumab/interferon combination, with perhaps less toxicity,” Brugarolas said.

Source: http://health.usnews.com/

A healthy lifestyle can increase a person’s lifespan by as much as 14 years, scientists have claimed.

Researchers have calculated people can extend the length of their lives by up to 17 per cent by not smoking, drinking only moderately, eating healthily and keeping physically active.

Many studies have highlighted the health risks associated with cigarettes, excessive alcohol consumption, poor diet and lack of exercise. However, few have looked at the combined effects of all four on longevity.

Prof Kay-Tee Khaw, a gerontologist at Cambridge University who led the new study, said: “There were substantial differences in mortality associated with the four health behaviours combined.

“The results strongly suggest that these four achievable lifestyle changes could have a marked improvement on the health of middle-aged and older people, which is particularly important given the ageing population in the UK and other European countries.”

Prof Khaw and colleagues, whose study is published in the journal PLoS Medicine, surveyed 20,244 men and women living in Norfolk in the mid-1990s. The participants, none of whom had known cancer or heart disease, were aged between 45 and 79.

They were given a point for each of four healthy behaviours - not smoking, exercising, alcohol intake of less than 15 units per week (less than five large glasses of wine or five pints of medium-strength lager) and having vitamin C levels equivalent to eating five servings of fruit and vegetables a day.

When in 2006 - an average of 11 years later - the researchers re-contacted those who took part, they found 1,987 had died since they were first interviewed.

Those who scored zero points, by having smoked, drank, failed to exercise and failed to eat enough fruit and vegetables, were four times more likely to have died than those who scored four points.

On this basis, the healthiest group in the study were calculated to have a lifespan that was, on average, 14 years longer than those with the least healthy lifestyle.

Those with one point - for displaying only one healthy behaviour - were 2.5 times as likely to have died than the healthiest group.

Smokers were 77 per cent more likely to have died during the study period, and low alcohol intake was associated with a 26 per cent increased chance of survival.

Being physically active and having levels of vitamin C equivalent to eating five servings of fruit and vegetables increased chances of still being alive by the end of study by 24 per cent and 44 per cent, respectively.

SOURCE: www:telegraph.co.uk

NEW YORK (Reuters Health) - Men without children have a lower risk of prostate cancer compared with fathers, but those who father a brood of kids appear to have a relatively low risk also, the results of a large study suggest.

Lead author Kristian T. Jorgensen of the Statens Serum Institut in Copenhagen and colleagues followed all men born in Denmark between 1935 and 1988, researchers found that compared with fathers, childless men were 16 percent less likely to develop prostate cancer.

Among fathers, though, the risk of the disease gradually declined as the number of children in the family increased, the researchers report in the medical journal Cancer.

The reasons for the seemingly contradictory links cannot be determined from the study data, according to the researchers. However, they note, the results build on those from past studies linking childlessness to a lower risk of prostate cancer.

One theory is that men who are childless due to fertility problems may have a lower prostate cancer risk because of lower testosterone levels. This has yet to be proven, however, Jorgensen’s team notes.

Childless men in this study had a variety of possible reasons, according to the researchers — some were infertile; some had an infertile partner; and some had chosen to have no children.

Why men with several children had a lower prostate cancer risk than those with one or two children may potentially be explained by the “healthy father” phenomenon, the researchers speculate. That is, men with a large number of children may retain their fertility to a relatively late age, and may be more resistant to developing prostate cancer.

More studies will be needed to understand the “biologic, environmental, social and/or behavioral factors” that underlie these findings, the researchers conclude.

SOURCE: www.reuters.com

By destroying stem cells that drive tumour’s expansion, melanoma can be controlled

U.S. scientists have pinpointed clusters of dangerous cells that give rise to melanoma skin cancer, and say they have found a way to destroy them, thereby slowing the cancer’s deadly growth in mice.

The study, published yesterday in the journal Nature, bolsters the idea that small populations of rogue cells, called cancer stem cells, drive the formation of most cancers.

Even more importantly, experts say the new destruction strategy developed by the Harvard Medical School researchers could be useful in the fight against other cancers.

“This validates for the first time the potential therapeutic utility of targeting cancer stem cells,” said lead study author, Markus Frank of the Transplantation Research Center of Brigham and Women’s Hospital and Children’s Hospital Boston, and an assistant professor at Harvard Medical School.

The cancer stem cell hypothesis, pioneered in Toronto in the 1990s, is emerging as one of the most promising ideas in its treatment.

Many cancer researchers believe cancer tumours are made up of a hierarchy of cells, with only a small proportion – the stem cells – continually dividing to drive the tumour’s growth. They also believe these cells resist common therapies, including chemotherapy.

John Dick, a senior scientist at University Health Network, first identified cancer stem cells in certain leukemias in 1994. Scientists, including Dick, have since found evidence for them in other cancers, including cancer of the colon, breast, blood, brain and pancreas.

According to Dick, targeting treatment to the cancer stem cells, rather than every cell in a tumour, may be an efficient and effective way to get rid of the disease, much like killing dandelion roots to eliminate the weeds from a stretch of lawn.

Dick cautioned that this study, along with others on cancer stem cells, is in the early stages of a still burgeoning research field.

To investigate the role of cancer stem cells in melanoma, the Harvard group homed in on a protein made by human melanoma cells called ABCB5, which shuttles toxic agents out of the cell and makes them resistant to chemotherapy.

After three years of rigorously studying how these ABCB5-producing cells work, the team decided they were indeed cancer stem cells since they generated melanoma tumours when implanted in mice.

The team then found a way to turn the ABCB5 protein against the melanoma stem cells by injecting the mice with antibodies. This triggered the immune system to attack the stem cells, thereby slowing the growth of the melanoma.

George Murphy, a study co-author and chief of dermatopathology at Brigham and Women’s Hospital, said this proves the principle that specifically targeting and attacking cancer stem cells can work. The next step is to see if the same strategy will work in humans, he said, adding new melanoma treatment will likely be years down the road.

Melanoma is one of the most aggressive forms of cancer, and incidence and death rates are increasing. There were 4,600 new cases in Canada last year and 900 deaths, the Canadian Cancer Society says.

Source: www.thestar.com

A disturbed night’s sleep may increase the risk of developing diabetes, US research has suggested.

The US team discovered that volunteers who were roused whenever they were about to fall into the deepest sleep developed insulin resistance.

This inability of the body to recognise normal insulin signals leads to high blood sugar levels, weight gain and, eventually, even type 2 diabetes.

The study appears in the Proceedings of the National Academy of Sciences.
Previous studies have shown an association with diabetes and a lack of sleep.

It is also already known that the deepest sleep, known as slow-wave sleep, is associated with changes that affect metabolism.

Brain patterns

To test the impact of sleep quality on blood glucose control, nine healthy men and women were first monitored for two consecutive nights to see what their normal sleep patterns were.

Then on the following three nights, the research team woke them with a loud noise when they drifted into deep sleep - characterised by long slow-moving delta waves in the brain.

The amount of overall sleep they had was unchanged.

After injecting the volunteers with glucose and measuring their daytime blood sugar levels and insulin response, the researchers found that eight of them had become less sensitive to insulin.

Lead researcher Dr Ersa Tasali, of the University of Chicago, said there was an alarming rise in the prevalence of type 2 diabetes associated with an ageing population and increased obesity and it was important to understand the factors that promote its development.

“We had shown previously that restricting sleep duration in healthy young adults results in decreased glucose tolerance.

“The current data further indicate that not only reduced sleep duration but also reduced sleep quality may play a role in diabetes risk.

“The current evidence suggests that strategies to improve sleep duration and quality should be considered as a potential intervention to prevent or delay the development of type 2 diabetes in at-risk populations.”

Dr Tasali added that chronic shallow sleep and diabetes are typical factors associated with ageing and more research was needed to find out if age-related changes in sleep quality contribute to such metabolic changes.