There was anecdotal evidence of just this around the nation for decades, just now a "study" confirms?
Damage to brain region helps smokers quit
Thu Jan 25, 3:13 PM ET
NEW YORK (Reuters Health) - Damage to the brain "insula" -- a silver dollar-sized area located deep in the brain, surrounded by the cerebral cortex, disrupts the addiction to cigarette smoking and makes kicking the habit much easier, according to research reported in the journal Science Friday.
This finding could lead to the development of novel anti-smoking agents.
Previous reports have linked the insula with conscious urges. In addition, senior author Dr. Antoine Bechara, from the University of Southern California in Los Angeles, and colleagues previously encountered a two-pack per day cigarette smoker who was able to stop smoking with little difficulty after experiencing stroke-related damage to the insula.
These findings led the researchers to hypothesize that damage to the insula may help break the addiction to smoking.
To investigate, the authors compared smoking cessation in 19 smokers who sustained damage to the insula and 50 smokers who sustained damage to other brain regions.
http://news.yahoo.com/s/nm/20070125/sc_nm/smoking_dc_2
Spot in brain may control smoking urge
By LAURAN NEERGAARD, AP Medical Writer
Thu Jan 25, 5:44 PM ET
WASHINGTON - Damage to a silver dollar-sized spot deep in the brain seems to wipe out the urge to smoke, a surprising discovery that may shed important new light on addiction. The research was inspired by a stroke survivor who claimed he simply forgot his two-pack-a-day addiction _ no cravings, no nicotine patches, not even a conscious desire to quit.
The quitting is like a light switch that went off," said Dr. Antoine Bechara of the University of Southern California, who scanned the brains of 69 smokers and ex-smokers to pinpoint the region involved. "This is very striking."
Clearly brain damage isn't a treatment option for people struggling to kick the habit.
But the finding, reported in Friday's edition of the journal Science, does point scientists toward new ways to develop anti-smoking aids by targeting this little-known brain region called the insula. And it sparked excitement among addiction specialists who expect the insula to play a key role in other addictions, too.
"It's a fantastic paper, it's a fantastic finding," said Dr. Nora Volkow, director of the National Institute on Drug Abuse and a longtime investigator of the brain's addiction pathways.
"What this study shows unequivocally is the insula is a key structure in the brain for perceiving the urges to take the drug," urges that are "the backbone of the addiction," Volkow added.
Why? The insula appears to be where the brain turns physical reactions into feelings, such as feeling anxious when your heart speeds up. When those reactions are caused by a particular substance, the insula may act like sort of a headquarters for cravings.
Some 44 million Americans smoke, and the government says more than 400,000 a year die of smoking-related illnesses. Declines in smoking have slowed in recent years, making it unlikely that the nation will reach a public health goal of reducing the rate to 12 percent by 2010.
Nicotine is one of the most addictive substances known, and it's common for smokers to suffer repeated relapses when they try to quit.
So imagine Bechara's surprise at hearing a patient he code-named "Nathan" note nonchalantly that "my body forgot the urge to smoke" right after his stroke...
http://news.yahoo.com/s/ap/20070125/ap_on_he_me/smoking_brain_damage_4
Showing posts with label women's health. Show all posts
Showing posts with label women's health. Show all posts
Friday, January 26, 2007
Tuesday, January 02, 2007
Breast Cancer Detection Tests
http://www.more.com/more/story.jsp?storyid=/templatedata/lhj/story/data/GoodNewsAboutBreastCancer_09272002.xml
Researchers Developing Saliva Test to Detect Breast Cancer (dateline April 10, 2002) Format for Printing
http://www.imaginis.com/breasthealth/news/news4.10.02.asp
Saliva Test, Digital Mammography, Computerized Thermal Imaging...
Exciting advances in breast-cancer diagnostics and treatment may one day make standard mammograms, surgery and radiation obsolete.
Saliva Test
In a preliminary study, researchers measured saliva levels of HER2, a protein that is elevated in some breast-cancer cases. They were able to identify 87 percent of those with the disease.
Status: Not yet available. The company that developed the saliva test hopes to apply for FDA approval by the end of 2003.
Digital Mammography
Recent reports show that a mammogram is only as good as the quality of the scan and the skill of the person reading it. Digital mammograms, unlike X-ray film, can be manipulated to improve brightness and contrast. They can also be combined with computer-aided detection systems as a way to help flag suspicious areas in the breast.
Status: The FDA approved digital mammography in 2000, and availability is growing as clinics invest in the equipment. A large trial is under way to compare digital and conventional mammography.
Computerized Thermal Imaging
A heat-sensitive camera captures thermal images of the breast, which can be analyzed to help doctors decide if a suspect area should be biopsied. The technique is based on slight temperature variations between benign and malignant lesions.
Status: It's currently under FDA review and available only to patients in clinical studies
http://www.more.com/more/story.jsp?storyid=/templatedata/lhj/story/data/GoodNewsAboutBreastCancer_09272002.xml
Researchers Developing Saliva Test to Detect Breast Cancer (dateline April 10, 2002) Format for Printing
Researchers are working on a new saliva test to help detect breast cancer, according to data presented at the annual meeting of the International Association for Dental Research. The test measures the amount of HER2 found in a sample of a patient’s saliva. HER2 is a genetic material that, when present in large amounts, has been associated with breast cancer. While the new test is still under development, researchers believe that it may eventually help to detect breast cancer in its early stages and also help physicians monitor treatment in women already diagnosed with the disease....
HER2 (also written HER2/neu)...
According to Dr. Streckfus, the test is not meant to replace breast cancer screening tests, such as mammography or physician-performed clinical breast exams. However, if proven beneficial, the saliva test could be a valuable supplement to these established screening methods, or it could be used as a follow-up test if a screening mammogram detected a breast abnormality. In addition to detecting breast cancer, Dr. Streckfus believes that the saliva test could be used on breast cancer patients to determine whether their treatments are succeeding.
However, the saliva test would not likely detect breast cancer in all women who had the disease because the test identifies elevated HER2 protein levels, which occurs in only around 30% of breast cancer cases. Recently, researchers have developed a drug therapy called Herceptin (generic name, trastuzumab) that seeks out and destroys extra copies of HER2. Herceptin is one of the new "targeted" drug therapies that many experts believe will become more commonly used as advances in cancer treatment continue
http://www.imaginis.com/breasthealth/news/news4.10.02.asp
Saturday, November 18, 2006
Hormone replacement therapy Rubinow/Schmidt opinion on study results
The following is a public service and is not medical advice. Conduct your own search of the internet for further information and viewpoints on both sides of this important issue.
Net the Truth Online
Monday, June 07, 2004
Hormone Replacement Therapy: The Last Waltz or a New Step? By David R. Rubinow, M.D. Peter J. Schmidt, M.D.
Categories: Age-related diseases See user comments and add yours at the bottom of the page
Two years ago, the largest placebo-controlled trial of hormone replacement therapy (HRT) was shut down when women receiving treatment showed an increased risk of heart disease and breast cancer. In this special Crossroads essay, two physicians who study the effect of hormones on the development of mood disorders explain why they think the outright dismissal of HRT was hasty and suggest that researchers not abandon their investigations of HRT.
Two years ago, the publication of the results of the Women's Health Initiative (WHI) turned our attitudes about HRT on end. The longitudinal study was designed to test two widely prescribed forms of HRT: 1) Premarin, a mixture of estrogens extracted from horse urine and 2) Prempro, which contains both Premarin and Provera, a "progestin," or synthetic progesterone-like compound. Because estrogen when administered on its own can trigger a buildup of the uterine lining that acts as a precursor for endometrial cancer, Premarin alone was given only to women who'd had hysterectomies. Most forms of HRT include a progestin such as Provera to avoid the uterine effects caused by estrogen alone. WHI selected Prempro because it is the most commonly prescribed form of HRT.
The studies examined the effects of HRT on breast and colon cancers, bone fractures, and cardiovascular diseases, including coronary heart disease, stroke, and blood clots. Before the WHI, HRT was prescribed to relieve the acute symptoms associated with menopause--such as hot flashes, vaginal dryness, and depression--and to prevent cardiovascular disease and bone fractures. Prescribing HRT to prevent these disorders represented a calculated risk: HRT had previously been associated with a decrease in cardiovascular deaths by up to 50%, but it also increased the risk of breast cancer by 30% after 4 years of treatment. Because cardiovascular disease accounts for 50% of female deaths and breast cancer accounts for only 4%, the benefit provided by HRT seemed worth the risk.
Not so, concluded the WHI study, which was prematurely terminated in July 2002 because women receiving HRT showed an increased--not decreased--incidence of coronary heart disease and an increased incidence of breast cancer compared with those taking a placebo (see "Hot Flash"). With this and subsequent reports, HRT was basically left for dead. "The latest decision by the overseers of the WHI study disproves for good the theory that replacing the sex hormones that fall steeply after a woman reaches the menopause would yield an overall benefit to her health. It marks the final collapse of a medical and commercial edifice that had been constructed over three decades," declared The Washington Post. The journal Science agreed:
"This is the final nail in the coffin for hormone replacement therapy." Clearly, the idea that HRT is good for everyone is incorrect. But is the now-prevailing view that HRT is bad for everyone correct? A closer examination of the data suggests that we might have been too quick to pronounce HRT dangerous and valueless.
As the quote from The Washington Post suggests, the original rationale for HRT was to reverse or prevent the dramatic decrease in sex hormone quantities that occurs in the year after the last menses. This drop was believed to contribute to the rise in heart disease and osteoporosis in women after menopause. The hypothesis that HRT prevents subsequent health problems, then, should be tested in women who are nearing menopause, that is, about 51 years old (the mean age of menopause in the United States). In contrast, the mean age of the women in the WHI study was 63.3, with an age range of 50 to 79 and two-thirds of the subjects over 60. Only 10% of the participants were age 50 to 54.
This paucity of perimenopausal women could be problematic for two reasons. First, animal studies suggest that there is a "window of prevention," after which administration of estrogen will not show a beneficial health effect. Monkeys given estrogen (Premarin) within 2 months of experiencing an artificial menopause induced by removal of their ovaries do not show the degeneration of the coronary arteries that otherwise follows loss of these organs. This protective effect is not seen, however, if estrogen administration is delayed for 2 years following the surgery.
If most of the volunteers in the human studies were more than a year or two into menopause, the window might have closed. Second, older women are less healthy than younger women, and estrogen might have very different effects in the presence of disease. Among the "apparently healthy" postmenopausal women participating in the WHI, 7.7% had a history of prior cardiac disease, 36% had received treatment for high blood pressure, 49% were current or former smokers, and 34% were obese--not a picture of perfect health, but fairly representative of a population of women in their 60s and 70s. In addition to their known health problems, older women are far more likely to have undetected cardiovascular disease. For example, women in their 60s are more likely to have coronary arteries lined with fatty lesions that can obstruct blood flow. Estrogen can increase the risk for heart attack or stroke by turning on an enzyme that can chew away the membrane that contains these lesions, causing them to rupture.
The presence of preexisting disease is one potential explanation for the increased risk of coronary heart disease during the first year of taking HRT, seen in both the WHI and HERS (Heart and Estrogen/progestin Replacement Study) studies. The HERS study tested whether HRT would prevent future coronary events, such as heart attacks, in postmenopausal women who already had documented heart disease. In this study, the risk of coronary events increased during the first year on HRT but then leveled off: No further increase was seen. This result mirrors the pattern seen in the first 5 years of the WHI study, although in that study another significant increase in coronary heart disease was seen in the fifth year of HRT.
The fifth-year spike in the relative rate of heart disease in the WHI study, however, might not reflect a true increase in disease risk. In the first year, the incidence of coronary heart disease is 87% greater in subjects on HRT than in those receiving a placebo (see table). The rates of disease look fairly comparable in the second, third, fourth, and sixth years of the study; a substantial difference is seen in year five. But this apparent HRT-related danger arises from the anomalous decrease of events in the placebo group, not an increase in the incidence of heart disease in the HRT group. Yet this result, along with the increased risk of breast cancer that had been predicted as a possible adverse effect of HRT, led to the termination of the study. ..
(Table)
Earlier observational studies noted that the rate of breast cancer increased by 30% after 4 years of HRT. In the WHI study, one-quarter of the participants had prior exposure to HRT, which means that they had been exposed to larger amounts of hormones than those women who were taking HRT for the first time. When the 25% with prior exposure were removed from the analysis, no increased risk of breast cancer was seen. So it appears that the WHI confirmed the observation that several years' exposure is necessary to increase the risk of breast cancer.
As an aside, the risk of breast cancer is four times higher in women receiving combined HRT than in those taking estrogen alone. In the WHI study, women on Premarin alone showed a decreased risk of breast cancer, suggesting that the progestin, more than the estrogen, increases the risk of developing breast cancer.
WHI demonstrated that initiating HRT in older postmenopausal women can harm them--increasing their risk for breast cancer and stroke. It did not, however, answer the question of whether HRT could benefit women if initiated at the beginning of menopause. This window-of-prevention question will, in all likelihood, not be answered because volunteers and funding for future HRT studies are disappearing, a potentially regrettable consequence of the WHI findings...
http://www.sagecrossroads.net/Default.aspx?tabid=28&newsType=ArticleView&articleId=65
Net the Truth Online
Monday, June 07, 2004
Hormone Replacement Therapy: The Last Waltz or a New Step? By David R. Rubinow, M.D. Peter J. Schmidt, M.D.
Categories: Age-related diseases See user comments and add yours at the bottom of the page
Two years ago, the largest placebo-controlled trial of hormone replacement therapy (HRT) was shut down when women receiving treatment showed an increased risk of heart disease and breast cancer. In this special Crossroads essay, two physicians who study the effect of hormones on the development of mood disorders explain why they think the outright dismissal of HRT was hasty and suggest that researchers not abandon their investigations of HRT.
Two years ago, the publication of the results of the Women's Health Initiative (WHI) turned our attitudes about HRT on end. The longitudinal study was designed to test two widely prescribed forms of HRT: 1) Premarin, a mixture of estrogens extracted from horse urine and 2) Prempro, which contains both Premarin and Provera, a "progestin," or synthetic progesterone-like compound. Because estrogen when administered on its own can trigger a buildup of the uterine lining that acts as a precursor for endometrial cancer, Premarin alone was given only to women who'd had hysterectomies. Most forms of HRT include a progestin such as Provera to avoid the uterine effects caused by estrogen alone. WHI selected Prempro because it is the most commonly prescribed form of HRT.
The studies examined the effects of HRT on breast and colon cancers, bone fractures, and cardiovascular diseases, including coronary heart disease, stroke, and blood clots. Before the WHI, HRT was prescribed to relieve the acute symptoms associated with menopause--such as hot flashes, vaginal dryness, and depression--and to prevent cardiovascular disease and bone fractures. Prescribing HRT to prevent these disorders represented a calculated risk: HRT had previously been associated with a decrease in cardiovascular deaths by up to 50%, but it also increased the risk of breast cancer by 30% after 4 years of treatment. Because cardiovascular disease accounts for 50% of female deaths and breast cancer accounts for only 4%, the benefit provided by HRT seemed worth the risk.
Not so, concluded the WHI study, which was prematurely terminated in July 2002 because women receiving HRT showed an increased--not decreased--incidence of coronary heart disease and an increased incidence of breast cancer compared with those taking a placebo (see "Hot Flash"). With this and subsequent reports, HRT was basically left for dead. "The latest decision by the overseers of the WHI study disproves for good the theory that replacing the sex hormones that fall steeply after a woman reaches the menopause would yield an overall benefit to her health. It marks the final collapse of a medical and commercial edifice that had been constructed over three decades," declared The Washington Post. The journal Science agreed:
"This is the final nail in the coffin for hormone replacement therapy." Clearly, the idea that HRT is good for everyone is incorrect. But is the now-prevailing view that HRT is bad for everyone correct? A closer examination of the data suggests that we might have been too quick to pronounce HRT dangerous and valueless.
As the quote from The Washington Post suggests, the original rationale for HRT was to reverse or prevent the dramatic decrease in sex hormone quantities that occurs in the year after the last menses. This drop was believed to contribute to the rise in heart disease and osteoporosis in women after menopause. The hypothesis that HRT prevents subsequent health problems, then, should be tested in women who are nearing menopause, that is, about 51 years old (the mean age of menopause in the United States). In contrast, the mean age of the women in the WHI study was 63.3, with an age range of 50 to 79 and two-thirds of the subjects over 60. Only 10% of the participants were age 50 to 54.
This paucity of perimenopausal women could be problematic for two reasons. First, animal studies suggest that there is a "window of prevention," after which administration of estrogen will not show a beneficial health effect. Monkeys given estrogen (Premarin) within 2 months of experiencing an artificial menopause induced by removal of their ovaries do not show the degeneration of the coronary arteries that otherwise follows loss of these organs. This protective effect is not seen, however, if estrogen administration is delayed for 2 years following the surgery.
If most of the volunteers in the human studies were more than a year or two into menopause, the window might have closed. Second, older women are less healthy than younger women, and estrogen might have very different effects in the presence of disease. Among the "apparently healthy" postmenopausal women participating in the WHI, 7.7% had a history of prior cardiac disease, 36% had received treatment for high blood pressure, 49% were current or former smokers, and 34% were obese--not a picture of perfect health, but fairly representative of a population of women in their 60s and 70s. In addition to their known health problems, older women are far more likely to have undetected cardiovascular disease. For example, women in their 60s are more likely to have coronary arteries lined with fatty lesions that can obstruct blood flow. Estrogen can increase the risk for heart attack or stroke by turning on an enzyme that can chew away the membrane that contains these lesions, causing them to rupture.
The presence of preexisting disease is one potential explanation for the increased risk of coronary heart disease during the first year of taking HRT, seen in both the WHI and HERS (Heart and Estrogen/progestin Replacement Study) studies. The HERS study tested whether HRT would prevent future coronary events, such as heart attacks, in postmenopausal women who already had documented heart disease. In this study, the risk of coronary events increased during the first year on HRT but then leveled off: No further increase was seen. This result mirrors the pattern seen in the first 5 years of the WHI study, although in that study another significant increase in coronary heart disease was seen in the fifth year of HRT.
The fifth-year spike in the relative rate of heart disease in the WHI study, however, might not reflect a true increase in disease risk. In the first year, the incidence of coronary heart disease is 87% greater in subjects on HRT than in those receiving a placebo (see table). The rates of disease look fairly comparable in the second, third, fourth, and sixth years of the study; a substantial difference is seen in year five. But this apparent HRT-related danger arises from the anomalous decrease of events in the placebo group, not an increase in the incidence of heart disease in the HRT group. Yet this result, along with the increased risk of breast cancer that had been predicted as a possible adverse effect of HRT, led to the termination of the study. ..
(Table)
Earlier observational studies noted that the rate of breast cancer increased by 30% after 4 years of HRT. In the WHI study, one-quarter of the participants had prior exposure to HRT, which means that they had been exposed to larger amounts of hormones than those women who were taking HRT for the first time. When the 25% with prior exposure were removed from the analysis, no increased risk of breast cancer was seen. So it appears that the WHI confirmed the observation that several years' exposure is necessary to increase the risk of breast cancer.
As an aside, the risk of breast cancer is four times higher in women receiving combined HRT than in those taking estrogen alone. In the WHI study, women on Premarin alone showed a decreased risk of breast cancer, suggesting that the progestin, more than the estrogen, increases the risk of developing breast cancer.
WHI demonstrated that initiating HRT in older postmenopausal women can harm them--increasing their risk for breast cancer and stroke. It did not, however, answer the question of whether HRT could benefit women if initiated at the beginning of menopause. This window-of-prevention question will, in all likelihood, not be answered because volunteers and funding for future HRT studies are disappearing, a potentially regrettable consequence of the WHI findings...
http://www.sagecrossroads.net/Default.aspx?tabid=28&newsType=ArticleView&articleId=65
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