New Drug Extends Survival for Men With Advanced Prostate Cancer

New Drug Extends Survival for Men With Advanced Prostate Cancer -- For men with advanced hormone-resistant prostate cancer who have also failed chemotherapy, the new drug Zytiga (abiraterone acetate) along with the steroid prednisone appears to boost survival, researchers report.

Based on data from the ongoing clinical trial, Zytiga was approved by the U.S. Food and Drug Administration in April. It works by inhibiting the production of the male hormone testosterone, which promotes the growth of cancer cells. In this regard, the drug mimics hormone therapy.

Zytiga "prolonged overall survival in this patient population that had extremely limited therapeutic options after chemotherapy," lead researcher Dr. Fred Saad, chief of urology at Notre-Dame Hospital in Montreal, said during a Monday morning press conference.

Men taking the drug combination had an average survival of 14.8 months, compared with 10.9 months for men taking a placebo.

"Abiraterone represents a valuable treatment option for patients with metastatic, castration [hormone]-resistant prostate cancer who had been treated previously with chemotherapy, with very manageable treatment-related toxicity," Saad said.

The study was published in the May 26 issue of the New England Journal of Medicine. The findings had also been presented May 16 at the American Urological Association's annual meeting, in Washington D.C.

The study included 1,195 men with prostate cancer who did not respond to hormone therapy and had failed earlier chemotherapy. The researchers, from 147 hospitals across 13 countries, randomly assigned the men to take either Zytiga plus prednisone, or a placebo.

The drug combination was well tolerated and resulted in less fatigue, back pain and spinal compression among the men taking it, compared with the placebo, Saad said.

The most common side effects among those taking Zytiga and prednisone were lower levels of white blood cells, fluid retention, low potassium levels, abnormal liver function tests, high blood pressure and heart problems, the researchers noted.

A one-month supply of 120 pills of Zytiga costs $5,000, said Kelly McLaughlin, a spokeswoman for Centocor Ortho Biotech Inc., the drug's maker and a sponsor of the study.

"This study tells us that there is a form of hormonal therapy, abiraterone, that works in people who had standard hormonal therapy and chemotherapy," said prostate cancer expert Dr. Anthony D'Amico, chief of genitourinary radiation oncology at Brigham and Women's Hospital in Boston.

"It will provide people with late-stage disease with an opportunity for an extended survival that they didn't have before. I can't say it's a home run because it's only a few months improvement," he added.

Very aggressive prostate cancer may be able to make its own testosterone, which the cancer cells need to grow. "Zytiga blocks that," D'Amico explained.

"This drug provides longer life and better quality of life to men with very advanced prostate cancer," D'Amico said. "There are studies now to see if this drug will improve cure rates in men with advanced, but not metastatic [cancer that has spread to other organs], prostate cancer," he added. ( HealthDay News )

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Native American Children Have More Tooth Decay

Native American Children Have More Tooth Decay -- Native American children in the United States and Canada have three times the rate of untreated cavities compared to other kids, according to a new policy statement from a pediatricians group that recommends doctors pay more attention to the oral health of those patients.

A survey of 2,633 children aged 2 to 5 born to indigenous populations in the United States, Alaska and Canada found that 68 percent had untreated cavities. In some Canadian indigenous communities, more than 90 percent of children have tooth decay (dental caries).

"The influence of early childhood caries on overall childhood health and well being goes well beyond the mouth, and many of our indigenous children have not benefited fully from the many advances to improve oral health in North American children," Dr. James Irvine, co-author of the American Academy of Pediatrics' policy statement, said in a news release. "In fact, there are remarkable similarities in health issues and living circumstances of indigenous children in the U.S. and Canada."

The policy statement is published in the June issue of Pediatrics.

Researchers concluded that young indigenous children should have access to oral health care, in conjunction with other preventive measures under the guidance of a pediatrician.

"Many physicians continue to view early childhood caries as a dental problem to be treated by dentists," noted study co-author Dr. Steve Holve. "We want to emphasize that early childhood caries is an infectious disease, knowing that infectious diseases are problems in which pediatricians and primary care providers are experts. The skills of our dental colleagues are highly valued, but we hope to shift the focus of treatment for early childhood caries to primary care providers and preventive measures such as topical fluoride varnishes."

In encouraging pediatricians to assume a larger role in the prevention of tooth decay among indigenous children in the United States and Canada, the American Academy of Pediatrics recommended:

• Parents and caregivers of infants and children should be educated on proper oral hygiene and diet.
• After their first tooth comes in, children should use fluoridated toothpaste under proper supervision.
• Pregnant women should have access to prenatal screening for dental health and referrals for dental care.
• Children should have access to oral health prevention and treatment services, such as fluoride varnish programs. ( HealthDay News )

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Fatal bat disease confirmed in all New England with Maine find

Fatal bat disease confirmed in all New England with Maine find – White nose syndrome, a devastating disease that has killed more than one million bats in the Northeast, has been found in Maine, the last New England state to discover it, wildlife officials said on Tuesday.

Diminishing populations of bats, an important predator of insects, could have harmful consequences for humans, experts say.

Bats at two sites in Maine's Oxford County that displayed signs of a fungal pathogen linked with white nose syndrome tested positive for the disease, said scientists with the Maine Department of Inland Fisheries and Wildlife.

Until this year, Maine appeared insulated from white nose, although nearby states and Canada were not.

Since its discovery in an upstate New York cave in 2006, white nose has been confirmed in 17 states and four eastern Canadian provinces, and it appears to be steadily trekking westward.

North America's loss of bats, a key predator of mosquitoes, beetles and pests that can harm plants, could cost agriculture at least $3.7 billion a year, according to a study published in the journal Science in April.

Scientists predict the disease could wipe out some bat species in New England within 15 years.

In Maine, susceptible species are big brown and little brown bats, northern long-eared and tri-colored bats and eastern small-footed bats.

"It is possible that bats that winter in Maine spent the summer in contact with bats from WNS-infected sites in other states, and then carried the fungus back with them to their winter hibernaculum (caves and mines that are homes to bats) in Maine," said John DePue, a biologist with the Maine agency.

The syndrome gets its name from a white fungus that settles in tufts on infected bats' muzzles and invades their skin. It causes them to use limited body-fat reserves, retreat deeper into chilly caves or exhibit odd behavior, such as flying in daytime and cold weather, when insects they eat are not found.

Oklahoma is the furthest west the fungal pathogen Geomyces destructans linked with white nose has been detected, while full-blown white nose has gone as far west as Kentucky and Tennessee.

Little brown bats are the ones worst hit so far by white nose nationally, and the endangered Indiana and Southeast-based Gray bats potentially could be most acutely affected as well.

White nose is mainly spread bat to bat, but humans can transport fungal spores via clothes and gear from contaminated sites, such as caves and mines. People can help slow the spread by staying out of sites that are homes to bats.

About a dozen species out of a total 45 U.S. bat species are affected by white nose, which is nearly half of the 26 bat species that are cave-hibernating bats.

In some Northeast caves, 90 to 100 percent of populations have died. About 1,100 bat species exist worldwide. ( Reuters )

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Too Many Kids Getting Antibiotics for Asthma

Too Many Kids Getting Antibiotics for Asthma -- Although guidelines don't recommend antibiotics for asthma, almost 1 million children with the respiratory condition are prescribed the medications each year in the United States, a new study finds.

"We are trying to reduce unnecessary antibiotic prescriptions, and this suggests that we as pediatricians are prescribing them way too often," said lead researcher Dr. Ian M. Paul, an associate professor of pediatrics at the College of Medicine of Pennsylvania State University in Hershey.

Why doctors are prescribing antibiotics for asthma is not clear, Paul said. One reason might be that doctors treating severe asthma attacks "feel the need to cover all their bases by also prescribing antibiotics," he suggested.

Sometimes parents may ask doctors to give their child antibiotics, but it doesn't seem to be a big factor, Paul noted. "It probably exists to some degree in clinical practice, but I don't think it happens all that frequently -- certainly not in one in every six visits for asthma," he said.

"The one encouraging finding was, when asthma education was delivered as part of the visit, antibiotics were less likely to be prescribed," he added. When asthma education was not part of the visit, 19 percent of the time antibiotics were prescribed, compared with 11 percent when asthma education was given.

"This suggests that we can educate families and patients and explain the causes of asthma and, hopefully, reduce unnecessary antibiotic prescribing," Paul said.

The dangers of overprescribing antibiotics are that it promotes the development of antibiotic-resistant bacteria and there are side effects for the drugs themselves, Paul pointed out.

The report was published in the May 23 online edition of Pediatrics.

For the study, Paul's team used data from the National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Survey to see the rate of antibiotics prescribed for children between 1998 and 2007.

Over that time, there were some 60.4 million medical care visits for children with asthma for which no prescription for antibiotics was warranted. However, antibiotics were prescribed 16 percent of the time, the researchers found.

Primary care doctors were most likely to prescribe antibiotics, while emergency department doctors were least likely to prescribe them, Paul said.

Other factors that were linked with increased antibiotic prescribing included use of inhaled corticosteroids and being treated in the winter, the researchers noted.

However, when visits to primary care doctors included asthma education, the rate of antibiotic prescribing went down, Paul stated.

In a second study in the same journal, Belgian investigators led by Dr. Kris De Boeck, from the department of pediatric pulmonology and infectious diseases at the University Hospital of Leuven, found similar overprescribing of antibiotics to asthmatic children.

These researchers found children treated with asthma medications were 1.9 times more likely to also get a prescription for antibiotics, compared with children not treated with asthma drugs.

In fact, 35.6 percent of children who were prescribed asthma drugs were also prescribed antibiotics, the researchers found.

"This finding highlights the need for educational opportunities to inform clinicians that such co-prescription should be limited," the authors concluded.

Commenting on both studies, Dr. Paul Krogstad, a professor of pediatric infectious diseases at the University of California, Los Angeles, and co-author of an accompanying journal editorial, said that "these articles indicate that asthma medications and antibiotics were very commonly prescribed in tandem both here and in Belgium, which conflicts with domestic and international recommendations that point out that antibiotics have no routine use in the care of asthmatics."

Antibiotic overuse confuses patients and family, Krogstad said. "They don't understand the true nature of asthma as an inflammatory, not an infectious disorder," he explained.

In addition, overprescribing antibiotics entails personal and societal risks, Krogstad said.

"Personal risks include allergic reactions, side effects, drug interactions and expense. Societal costs include medication-related costs and selection for drug-resistant bacteria. Antibiotic overuse is being reduced, but this remains an area where improvement is sorely needed," he said. ( HealthDay News )

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Three in four mothers-to-be miss out on flu jab

Three in four mothers-to-be miss out on flu jab - Almost three-quarters of pregnant women have not been vaccinated against swine flu, the Health Secretary has admitted.

Andrew Lansley said although the number of expectant mothers who have received the seasonal flu injection had almost doubled compared to last winter, more than 70 per cent remain unprotected.

Critics say the axing of the annual flu jab advertising campaign left mothers-to-be confused about whether they qualified for protection on the NHS.

What now? Critics say the axing of the annual flu jab advertising campaign left mothers-to-be confused about whether they qualified for protection on the NHS

Awareness is increasing, but many surgeries are running out of jabs and pharmacies are refusing to give it to pregnant women.

Official figures show just 27 per cent of pregnant women have been vaccinated, compared to more than 40 per cent of asthmatics and other under-65s at risk of severe illness. More than 70 per cent of pensioners have opted for the jab.

Changes to the immune system make pregnant women more likely to catch swine flu and to suffer pneumonia and other complications. Their unborn baby is also at risk.

The decision to add pregnant women to the ‘at-risk’ groups entitled to an NHS vaccination was made early last year, but was notmade the focus of an advertising campaign.

Labour health spokesman John Healey said in a letter to Mr Lansley that there was public confusion over who the at-risk groups were and who was entitled to a free jab.

He asked why the Health Secretary didn’t ensure more effort was made early to reassure pregnant women the vaccine was safe and important, and why he axed the autumn advertising campaign.

Frances Day-Stirk, of the Royal College of Midwives, said it seemed women were not made aware of the jab’s benefits early enough.

Mr Lansley said the decision on who to vaccinate was made by scientific advisers independently of ministers and that a mass advertising campaign on swine flu vaccination would have been ‘wastefully focused’ on the entire population, when only certain groups were eligible for a free jab.

He added: ‘GPs have been inviting those in at-risk groups to receive the flu vaccine since October and the lack of an advertising campaign this year has had no discernible impact on the uptake of flu vaccine.’

A Department of Health spokesman said: ‘At every stage, we have been guided by the advice of independent experts.’

Flu has claimed 112 lives this winter, with swine flu blamed for most. Senior doctors have warned that the NHS is in ‘gridlock’.

John Heyworth, of the College of Emergency Medicine, said: ‘We have seen A&Es overwhelmed, with people queuing on trolleys and long delays even for those admitted to intensive care.’

The Health Department spokesman said the NHS was better prepared than ever to deal with flu and that the number of intensive care beds taken up by flu patients was falling. ( dailymail.co.uk )

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Are your sleeping habits making you ill?

Are your sleeping habits making you ill?. A good night's sleep is said to be the great restorative ? but sometimes our habits do us more harm than good. Here, we examine the worst culprits.

GRINDING YOUR TEETH

If your partner doesn't tell you, apart from the toll it takes on teeth - which will wear down faster, may chip off or even crack - one of the key signs to watch for is waking up with a crushing headache. Dentists can make you a night guard which will stop you from locking your teeth. They cannot stop then motion but the plastic guard will ensure that teeth are rubbing against a smoother, softer surface.

COLD FEET

A team of Swiss scientists recently confirmed that it is virtually impossible to get to sleep with cold feet and recommended a hot water bottle for curing insomnia. Dr Kurt Krauchi, who led researchers, also favours the hot -water bottle as a means for cooling the body, claiming the arteries in the hands and feet dilate just before sleep, allowing more blood to flow through which cools down the body temperature, which he argues triggers sleep. Some sleep disorders may be caused by a failure of those arteries to dilate and a hot-water bottle can synthetically dilate the veins so that the body temperature falls - inducing sleep.

CURLING UP

Curling up in bed could cause backache or even osteo-arthritis. During the day we adopt postures that are not good for us. 'When we curl up in bed, we are perpetuating an exaggerated form of the bad posture we have assumed all day,' says Robin Shutt, lecturer in physiotherapy at the University of East Anglia. 'This may lead to backache but, more seriously, could cause osteo-arthritis in later years from an overload on the vertebrae.' Rather than automatically curling into the foetal position in bed, try some stretches.

SLEEP-WALKING

Sleep-walking tends to run in families and affects one-in-six children at some stage. During sleep, memories of what occurred during the day are processed, activated and stored. At the stage in sleep where the mind becomes most active, the body becomes most relaxed, except in families genetically predisposed to sleep-walking where the emotional processing of problems may get linked to movement. Sleep-walkers should be gently steered back to bed and possible stress factors should be examined to try to prevent it in the future. Protective measures, such as putting locks on windows, doors and securing gates to the top of stairs, should be taken.

A NIGHTCAP

Alcohol at bedtime is best avoided on a regular basis. It will send you off to sleep faster but as the drink metabolises, the brain becomes more excitable and you are more likely to wake a couple of hours later.

FALLING ASLEEP WITHOUT REMOVING MAKE-UP

Make-up left to clog pores - which will open in the warmth of your bed ? will result in blackheads or eruptions. Eyeliner and mascara left on over night can cause conjunctivitis.

SLEEPING TABLETS

These should only be regarded as a temporary measure. 'Although you wake up feeling as if you have slept very well, what you have got is a suppression of some of your sleep cycles,' says Dr Peter Fenwick, consultant neuro-psychiatrist at the Institute of Psychiatry. 'Most tablets have a knock-on effect,' says Dr Fenwick, 'This means you think less clearly during the day, and will feel sluggish.'

INSOMNIA

How much you suffer may depend not only on the amount of sleep you lose but at what stage in the sleep cycle it occurs. Early insomnia, says Dr Fenwick, is often due to life events. Problems at work, a row with your partner, means you may have difficulty getting off to sleep. Waking in the middle of the night is virtually always due to anxiety. Late insomnia ? where someone sleeps through the night but wakes at 4am, unable to drift off again ? is usually associated with depression. The most effective treatment is through trying to tackle the underlying stress or anxiety responsible. ( dailymail.co.uk )

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Sounding like a chainsaw?

Sounding like a chainsaw?. It’s 2.30am and your partner has thumped you in the ribs for the umpteenth time, growling the old refrain, “Turn over, you’re snoring”. How do you restore harmony and silence to this unhappy scene before your significant other commits a chainsaw massacre?

Many people snore. It’s a hugely irritating habit to their partners, but if you’re responsible for the noise, what’s to be done, other than waiting for them to club you to death with furniture? Firstly, you have to ask yourself whether you suffer any of the following during you waking hours:

• Chronic drowsiness;
• Headaches;
• Decreased libido;
• Irritability;
• Poor concentration;
• Forgetfulness;
• Nodding off at work.

If you have these symptoms you’re probably suffering from sleep apnoea. This happens when you stop breathing while you’re asleep. It usually takes place when you’re sleeping on your back and your throat closes, blocking off your breathing. This causes you to stop breathing – for around 10 seconds in some cases – and then you make a flatulent snorting sound and wake up.

It’s a common ailment. It means that you get by on diminishing amounts of sleep and that you end up feeling like an extra from Night Of The Living Dead. See your doctor.

Other factors that can aggravate snoring include heavy drinking, eating just before going to sleep, or being overweight. So you can cut your chances of sounding like a chainsaw by:

• Not chugging away on draught beer or inhaling six Big Macs less than three hours before supper. And get to the gym. Improve muscle tone and less lard will help you to sleep, as well as being physically tired from working out.
• Learning to sleep on your side. Some people do this by sewing a marble or a tennis ball into the back of their pajama jacket, or whatever passes as a pajama jacket. Others find it’s easier to sleep on a couch for a couple of nights until they get into the habit.
• Elevating the head of your bed, so that if you do sleep on your back there’ll be less likelihood of sleep apnoea developing.
• Ridding your bedroom of potential allergens such as dust, and down-filled pillows or bed linen.
• Wearing a nasal strip. Not everyone likes them, but it’s worth a shot. - ( health24.com )

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Allergies affect sex life

Allergies affect sex life -- Sneezing and wheezing may stamp out those flames of desire. A new study reveals that allergies could be getting in the way of amorous activities.

"If you can't breathe, and your nose is running, and your eyes are itchy, and you're sneezing, and you feel awful and you feel tired, you don't feel very sexy," said Dr. Michael S. Benninger, chairman of the Head and Neck Institute at the Cleveland Clinic in Ohio and a lead author of a recent study.

In a study, allergy sufferers reported more problems with sleep and sexual activity than other groups.

In the study published in the latest edition of Allergy and Asthma Proceedings, 83 percent of people with allergic rhinitis reported that their condition affected sexual activities.

When a person with allergic rhinitis breathes in an allergen such as pollen or dust, he or she can get symptoms such as itching, swelling and sniffling.

"When we look at how people interpret the disability of allergies, they show people who can't go to a park or can't appreciate their kid's ball games," Benninger said. But sexual activities also affect quality of life, he said.

"We're hoping this would stimulate people to start looking beyond the typical symptoms of allergic disease and looking at the impact of how people live," said Benninger. "It's really not your nasal congestion that's the issue. It's really how your nasal congestion impacts how you function. It's looking at the quality of life."

In the study, Benninger and a co-author compared answers from more than 700 people consisting of allergy sufferers, people who have similar symptoms but do not have the condition, and a control group.

Compared to the other two groups, allergy sufferers described more discomfort related to sleep, fatigue and sexual activity. Only 3 percent of people said their allergies never affected sleep.

"Almost all allergy sufferers feel it impacts their sleep," Benninger said. "If you can't breathe, you're not going to sleep well."

Twenty-seven percent reported that allergies almost never affected their sexual activity and 38.8 percent said it sometimes affected it. Another 17 percent answered that it always or almost always had an effect.

The study did not ask patients the reason why their allergies affected their sex life.

"It can be speculated that the chronic obstruction, runny nose, sneezing and decreased smell may all result in impacting the satisfaction of sexual activity," researchers wrote in the study. "Even the simple act of kissing may be altered by these symptoms. Many people may not feel 'sexy' or may actually be embarrassed by their symptoms so that they would avoid intimate contact."

About 17 percent of those with allergies said their condition never affected sexual activity.

"The number of people who said this did not affect them was quite, quite small -- indicating that this is a problem that's out there," said Dr. Clifford Bassett, a medical director at Allergy and Asthma Care of New York, who was not involved in the research. "They're not talking about it with their practitioners. And their practitioners are probably not asking about it."

Bassett said the way allergies affect people's sex lives has not been examined very closely.

"I do hear anecdotally from time to time patients saying, 'I don't feel very sexy or attractive because my nose is running. There's an itch in my nose. My face is itchy. I'm stuffy. I can't breathe. I can't do exercise whether it's lovemaking or anything else that affects me,' " he said.

This could be a hidden and more widespread problem, said Bassett, who plans to ask how allergies affect sexual activities in patient questionnaires.

"The bottom line: It's a high number of people in this study that indicated this was a problem," Bassett said. "I think we need to do a better job discussing this with patients."

Benninger recommended patients find out what they are allergic to, so they can avoid the irritants. For example, a person allergic to pollen should close the window in his or her bedroom to keep the allergen out, he suggested.

"If you're allergic to cats and let's assume that the bedroom is the most frequent place for intimacy and your cat lays on the pillow, and then you go in at night, and you're now sneezing -- that kind of kills it," he said. "There are things people can do to control their environments."

Over-the-counter and prescription medications are available to treat allergies. Allergy sufferers whose sex lives have been affected should avoid sedating antihistamines, which could make a person sleepy, or oral decongestants, which can make a person feel anxious, Benninger said.

"The most important thing is allergies should not be a factor that impacts intimacy and sexual activity," he said. ( cnn.com )

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Tall Tales of the Heart

Tall Tales of the Heart. Over the years, I've heard some pretty wacky theories about what causes heart disease. Here's the truth..

Every day, patients ask my opinion about various treatments and remedies they've found on the Internet. Just as there are stories about mammoth alligators lurking in Manhattan's sewers, urban legends regarding heart disease and what causes it abound. Here are the verdicts on a few I've heard lately:

You can stop a heart attack by coughing. True.

Coughing alternately increases and decreases chest pressure, which can raise a slow heart rate, boost cardiac output, and sometimes even stop an arrhythmia. It's called "cough CPR." If you have coronary disease and feel palpitations and are lightheaded, take deep breaths and cough repeatedly. This may support your circulation a bit longer until help arrives.

Roller coasters are dangerous for your heart. True.

That's why there are all those warning signs at Walt Disney World. If you have a heart condition, any thrill ride can trigger a rush of adrenaline that could cause an irregular heartbeat and even a coronary. People with heart disease should stick to It's a Small World.

The higher your cholesterol, the greater your chance of heart disease. Sort of true.

Total cholesterol tells us which populations have higher risks of heart attack. For example, Americans' average cholesterol levels are much higher than those of the Chinese, and we have a much higher rate of heart attack. However, if you look at the population of this country alone, total cholesterol is a very poor predictor of heart disease risk. Studies show that total cholesterol levels among people who've had heart attacks are almost the same as those of people who haven't. You have to look at the types of cholesterol (HDL, LDL) and their size. These are the most helpful measurements.

You're at risk of a heart attack if there's a crease in your earlobe. Perhaps.

This phenomenon is something I look for and have observed in patients. Some studies show that if you have a pronounced crease running diagonally across one or more lobes, your body's level of elastin is low. Elastin is a protein that affects blood vessel function. It's particularly abundant in your largest artery, the aorta.

The balder the man, the greater his heart attack risk. Probably false.

Balding is triggered in a roundabout way by high levels of testosterone. High testosterone levels are good for a man's sex drive and for lean muscles and good bone mass, but low testosterone levels are associated with prediabetes and type 2 diabetes, both risk factors for heart disease. Although some earlier studies have suggested an association between baldness and heart disease, more recent ones refute the notion.

You're probably a bit surprised that so many of these supposed urban legends have an element of truth to them. But keep in mind that even though there may be some science there, it's soft science. Cardiologists routinely do so many tests to assess heart disease risk that oddball theories like these, even if partially true, become relatively minor. Now, about those alligators ... ( msn.com )

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