Diabetes increases risk of death in breast cancer patients

Breast cancer patients are nearly 50 percent more likely to die of any cause if they also have diabetes, according to a comprehensive review of research conducted by Johns Hopkins physicians.

Peairs says her research suggests that diabetics diagnosed with breast cancer may get less effective treatment because practitioners may be concerned about these patients suffering more side effects from chemotherapy or radiation treatments as a result of the metabolic condition. Patients also may be more likely to be hospitalized, get infections, and/or become anemic ??” complicating their care. Peairs says the higher death rate may also be linked to the fact that they come to breast cancer treatment less healthy than their counterparts without diabetes, which is associated with obesity, high cholesterol and high blood pressure.

Women with diabetes may also be at greater risk of chemotherapy-related toxicity, which may explain ??” and even justify ??” some of the less aggressive treatment, she says.

Peairs says more research should reveal whether increased insulin production in type 2 (adult onset) diabetics contributes to worse outcomes among diabetic breast cancer patients. Small studies suggest that some diabetes drugs may be associated with worse outcomes for cancer patients while other medications may actually improve survival.

She noted that the popular drug metformin, which makes diabetes patients more insulin-sensitive thereby lowering the amount of unused insulin in the body, may be associated with better survival outcomes.

SOURCE Johns Hopkins University School of Medicine

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Modifiable and non-modifiable lifestyle factors influence breast cancer risk

Many risk factors for breast cancer are well studied and documented. Thus, scientists are sure by now that early first menstrual period, late onset of menopause and a family history of breast cancer are associated with an increased breast cancer risk.

Of the modifiable lifestyle factors, it is primarily hormone replacement therapy and a lack of physical activity which increase a woman’s risk of developing breast cancer. Alcohol consumption and overweight were found to have less influence on breast cancer risk. Thus, 19.4 percent of invasive postmenopausal breast cancer are attributed to hormone replacement therapy; 12.8 percent to a lack of physical activity. Both factors together are responsible for 29.8 percent of breast cancer cases. When the investigators took a separate look at the group of patients whose tumors have receptors for sex hormones (hormone receptor-positive breast tumors), they determined an even higher value of 37.9 percent. The study leaders emphasize that these results reflect the situation in Germany with our typical lifestyle and may differ in countries with other lifestyles.

Non-modifiable factors such as family history or age at first and last menstrual period account for 37.2 percent in total of all malignant postmenopausal breast cancers. "That means that two factors which each woman has in her own hands are responsible for a similar number of postmenopausal breast cancer cases as the non-modifiable factors," Karen Steindorf says. "If behavioral changes in these two areas could be brought about, almost 30 percent of breast cancers after menopause could be prevented." Therefore, the DKFZ researchers recommend women to take more exercise and to refrain from hormone replacement therapy, unless it is absolutely necessary.

Source: Helmholtz Association of German Research Centres

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Severe asthma in early childhood may lead to premature loss of lung function during adolescence: Study

Severe asthma in early childhood may lead to premature loss of lung function during adolescence and more serious disease during adulthood, researchers at Emory University School of Medicine report. Early identification and treatment of children with severe asthma is important to help stem asthma progression.

The authors found that children with severe asthma reported a higher frequency of daily symptoms and hospitalization during the previous year despite higher doses of ICS and controller medication, and that they had significantly lower lung function when compared to children with mild-to-moderate asthma. Additionally, they noted that daily asthma symptoms such as coughing and wheezing and sensitization to aeroallergens during the initial evaluation were strong predictors of declines in lung function of more than one percent per year.

The authors conclude that children with severe asthma have a premature loss of lung function during the adolescent years that is associated with an increased frequency of wheezing and asthma symptoms and greater allergic sensitization during childhood. Further studies are needed to determine whether the loss of lung function is due to a slower rate of lung growth or to progressive changes in the lung tissues, and to explore the mechanisms that control the responses of severely asthmatic children to ICS treatment.

Source: Emory University

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Study shows new cardio-pulmonary resuscitation technique increases long-term survival of patients

A study led by Dr. Tom P. Aufderheide, professor of emergency medicine at The Medical College of Wisconsin, shows an alternative method of cardio-pulmonary resuscitation increases long-term survival of patients.

The new technique uses two devices simultaneously to increase circulation. One is a handheld device that attaches with a small suction cup to the patient’s chest. After each compression, the suction cup allows the chest to be lifted up, stimulating blood flow. The second device, called an impedance threshold device, attaches to the patient’s airway using a facial mask or breathing tube. When the chest lifts upward, the impedance threshold device prevents air from rushing into the lungs. That creates a vacuum inside the chest and helps refill the heart after each compression. Researchers found in each compression-decompression cycle, the heart and brain receive nearly three times more blood flow when compared with standard CPR.

A total of 813 standard CPR patients and 840 intervention patients were analyzed in the study. Researchers found 6% of the standards CPR patients survived to hospital discharge with favorable neurologic function. That compares with 9% in the intervention group (improvement of survival chance 53% in intervention group). The same proportions of patients in each group survived to one year.

"Based on our findings, active compression-decompression CPR with augmentation of negative intrathoracic pressure should be considered as an alternative to standard CPR to increase long-term survival after cardiac arrest," said Dr. Aufderheide.

Source: Medical College of Wisconsin

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Time-lapse technique can show cellular-level changes within deep brain regions: Study

Changes within deep regions of the brain can now be visualized at the cellular level, based on research on mice, which was funded by the National Institutes of Health. Published Sunday in Nature Medicine, the study used a groundbreaking technique to explore cellular-level changes over a period of weeks within deep brain regions, providing a level of detail not possible with previously available methods.

Investigators focused on two brain regions within the study, the hippocampus and striatum. The striatum, a brain region important for motor function and habit formation, is also a major target for abused drugs. Some researchers believe that a shift in activity within the striatum is at least partly responsible for the progression from voluntary drug-taking to addiction. This new technique could allow a better understanding of how these processes occur at the cellular level, leading to insights into mechanisms underlying addictive behaviors.

"The results should now allow neuroscientists to track longitudinally in the living brain the effects of drugs of abuse at the levels of neural circuitry, the individual neuron, and neuronal dendrites," said Dr. Mark Schnitzer, corresponding author for the article. "For example, our imaging methods work well in the dorsal striatum, which we have followed with microscopic resolution over weeks in the live brain. This should permit researchers interested in the reward system to address a range of issues that were previously out of reach."

Source: NIH/National Institute on Drug Abuse

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AMBR sensor measures growth and drug susceptibility of bacterial cells without use of microscope

With an invention that can be made from some of the same parts used in CD players, University of Michigan researchers have developed a way to measure the growth and drug susceptibility of individual bacterial cells without the use of a microscope.

"You can basically tell, within minutes, whether or not the antibiotic is working," said Kinnunen.

In the near future, "we expect it will be possible to make the determination even quicker," said graduate student Irene Sinn, the paper’s other lead author. "This is something we are actively working on."

The device also can be used for monitoring the growth and drug susceptibility of other types of cells, said Kinnunen. "The sensor is very sensitive to small changes in growth, so this method can be applied to any applications in the microscale or nanoscale where there are small changes in size. That includes the growth of yeast and cancer cells as well as bacteria."

The technology could have far-reaching implications, said McNaughton.

"At Life Magnetics we are very excited and optimistic about leveraging the single cell sensitivity of the AMBR technology to develop a product that will determine the best antimicrobial in hours instead of days," he said. "This will have a dramatic positive impact for patients and for the health system, cutting costs and saving lives. Inappropriate therapy and the overuse of antimicrobials are large contributors to the problem of increased resistance in bacteria. In fact, with superbugs such as MRSA causing every year in the U.S. more deaths than HIV/AIDS, it is no surprise that the Centers for Disease Control and Prevention considers antimicrobial resistance to be among the most pressing health problems. Our technology is designed to attack that problem."

Source: University of Michigan

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MicroRNA-29 molecule makes brain cells resistant to programmed cell death

Researchers at the University of North Carolina at Chapel Hill have discovered a molecule that can make brain cells resistant to programmed cell death or apoptosis.

They then decided to pinpoint where exactly this molecule played a role in the series of biochemical events leading to cell death. The researchers looked at a number of steps in apoptosis and found that miR-29 acts at a key point in the initiation of apoptosis by interacting with a group of genes called the BH3-only family. Interestingly, the microRNA appears to interact with not just one but as many as five members of that family, circumventing a redundancy that existed to allow cell death to continue even if one of them had been blocked.

"People in the field have been perplexed that when they have knocked-out any one of these members it hasn’t had a remarkable effect on apoptosis because there are others that can step in and do the job," said Deshmukh. "The fact that this microRNA can target multiple members of this family is very interesting because it shows how a single molecule can basically in one stroke keep apoptosis from happening. Interestingly, it only targets the members that are important for neuronal apoptosis, so it may be a way of specifically preserving cells in the brain without allowing them to grow out of control (and cause cancer) elsewhere in the body."

Deshmukh is currently developing mouse models where miR-29 is either "knocked-out" or overactive and plans to cross them with models of Alzheimer’s disease, Parkinson’s disease and ALS to see if it can prevent neurodegeneration. He is also actively screening for small molecule compounds that can elevate this microRNA and promote neuronal survival.

SOURCE University of North Carolina at Chapel Hill

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