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Tuesday, April 23, 2013
Monday, April 22, 2013
Intensity modulated radiotherapy reduces side effects in patients with early breast cancer
Apr. 21, 2013 ? Intensity modulated radiotherapy (IMRT) gives better results than standard radiotherapy in patients with early breast cancer, according to results from a randomised trial presented today (Sunday) to the 2nd Forum of the European Society for Radiotherapy and Oncology (ESTRO). IMRT is an advanced, high-precision form of radiotherapy that can deliver an even dose of radiation, thus reducing the cosmetic problems that can often occur after breast radiotherapy.
"We believe that this study, the largest prospective trial in the world to test breast IMRT against standard two-dimensional radiotherapy, will be practice-changing at an international level," said Dr Charlottes Coles, from Addenbrooke's Hospital Oncology Centre, Cambridge, UK. "Analysing the results five years after treatment, we saw significant benefits in patients who had received IMRT."
The researchers analysed the radiotherapy treatment plans of 1145 patients with early breast cancer who had previously had breast-conserving surgery. The plans were screened to see if they would produce an uneven radiation dose with standard two-dimensional radiotherapy (2DRT). A total of 71% of the plans fell into this category, and those patients were randomised between standard 2DRT and IMRT. The 29% of patients whose plans would not produce an uneven dose were treated with standard 2D RT, but still followed up within the trial.
One of the aims of external radiotherapy is to treat the target -- in this case the whole breast -- with an even dose distribution, i.e. within a range of 95% to 107% of the prescribed dose. Too low a dose can risk tumour recurrence, and too high a dose can cause undesirable side-effects such as skin changes.
"The problem with 2D breast radiotherapy is that the dose distribution is only recorded across the central part of the breast. Usually it meets the 95-107% constraints, but the shape of the breast changes, so if the same plan is looked at in 3D, then there may well be areas with overly high doses. By modulating the intensity of the radiation beam, IMRT can be used to correct for this and smooth out the dose," said Dr Coles.
The researchers set out to see whether the effect of using IMRT in those patients who would have received a dose greater than 107% to parts of their breast with 2DRT would translate into clinical benefit. IMRT planning uses results from scans to determine the dose intensity that will best treat the tumour, and therefore is more complex and time-consuming than 2DRT planning, so there was an important need to see a clear advantage to patients from the use of the procedure.
The only previous study looking at this was much smaller, and rather than picking out all patients with doses greater than 107% and randomising them, it only included women with larger breasts who are already known to be more likely to have regions of dose above the upper limit. "Our trial was more inclusive as all women were able to take part and we could quantify those who would receive an uneven dose," said Dr Coles.
"We saw that fewer patients in the IMRT group developed skin telangiectasia (dilated blood vessels near the surface of the skin), and the overall cosmetic effect in the breast was better," she said. Although there was no significant difference between the two groups in breast shrinkage, breast oedema, breast induration (hardening), and pigmentation changes, the benefits of using IMRT in these patients were clear.
The researchers intend to follow up their work by analysing the patients' questionnaires to see whether IMRT has an influence on quality of life. The trial has also contributed 1000 blood samples to the UK translational research study RAPPER (Radiogenomics: Assessment of Polymorphisms for Predicting the Effects of Radiotherapy), which aims to ultimately develop individualised radiotherapy plans based on the analysis of individual patients' genetics.
"Although IMRT is employed increasingly in breast cancer, its use is far from universal throughout the world. We hope that the evidence of benefit shown in our trial will encourage its greater use, resulting in improved patient access and, ultimately, improved outcomes for breast cancer patients," said Dr Coles.
President of ESTRO, Professor Vincenzo Valentini, a radiation oncologist at the Policlinico Universitario A. Gemelli, Rome, Italy, said: "This study not only shows a better outcome for the women treated with IMRT, but has an additional value in defining the selection criteria for providing treatment to those patients who will benefit from new frontline technologies. In the study design, the patients who could be treated satisfactorily by standard technology were not referred for IMRT, avoiding the use of a complex technique where it was not necessary. At a time when resources are limited, individualised medicine can help us offer new technology only to those patients who will have a tangible benefit from it."
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Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/~3/EFK4mMIN2Ko/130421074507.htm
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Small fires stop West residents from going home
WEST, Texas (AP) ? Gas tanks damaged by a massive explosion at a Texas fertilizer plant are leaking and have triggered small fires that are keeping displaced residents from returning to see what's left of their homes, officials said Saturday.
The initial blast at the West Fertilizer Co. on Wednesday killed 14 people, injured more than 200 others and damaged or completely destroyed at least 80 homes. The new fires at the site are small, have been contained and have not caused any further injuries, said Bryce Reed, a paramedic and spokesman for the town of West.
The news was another setback for evacuated residents who have waited anxiously to return and assess what remains after the blast. Many are hoping to find key documents such as insurance papers and family records to help with recovery. Others simply hope to reclaim any belongings that might be buried under splintered homes.
Reed said there are dozens of portable, white tanks at the site that are typically filled with anhydrous ammonia from larger storage tanks for when farmers request them. The tanks get weak when they are exposed to fire, he said, and bleed.
"The whole place is still on fire, smoldering, all that kind of stuff. It could spark up," Reed told a hotel lobby crammed with residents waiting to get beyond police blockades to their homes. But, he said, "there isn't really enough structure left to light up and burn."
The tanks are attached to plows pulled by tractors and feed streams of the chemical into the ground as the plow passes to fertilize. Reed said they resemble large, horizontal propane tanks, and told residents to imagine a very big hot water heater.
He told residents, "You're safe where you're at. Otherwise I'd be dragging you out of here myself."
Gene Anderson, 64, said Reed's comments would help avoid panic: "He just nipped it in the bud like it should be."
But closer to the site, things were far more tense. Ron Price, a 53-year-old construction worker, said he approached the police barricade Saturday to check on his son's home, which was damaged in the explosion Wednesday night.
Price said he drove his truck up to the roadblock and was trying to get in when state troopers "came flying down the road" from a half block away and told everyone to get back because there was another chance of explosion. People in their backyards outside the barricade were also told to get back, he said.
"It was pretty scary everybody just jumped and took off running," Price said. "They jumped in their cars and we all started heading back."
Displaced residents have been expressing increasing frustration that the area around the blast site has remained off-limits. Among them was Dorothy Sulak, who lost her home and her job.
Sulak worked as a secretary at the fertilizer plant that exploded in a thunderous fireball. She fled so fast she only had time to leave with the clothes on her back. There's a hole in her roof now, and her medicine, cash, even her glasses are somewhere in the rubble.
"Yes, it's just stuff. But it's my stuff," said Sulak, 71, who used reading glasses to see for three days, but finally got a ride to nearby Waco on Saturday to get fitted for new prescription frames.
The blast, which charred a four-to-five block radius extending from the plant, also smashed an apartment building, schools and a nursing home with its incredible force and fire. Sulak said she had been told that her home on North Reagan Street was so close to the explosion site that she may not be able to return until at least Monday.
The death toll remained steady at 14 and federal and state emergency-response teams that had once been searching for survivors had shifted entirely to recovery efforts.
The cause of the blast is still unknown, although authorities have said it appears to be nothing more than an accident. Franceska Perot, a spokeswoman for the Bureau of Alcohol, Tobacco, Firearms and Explosives, said investigators still were combing through debris.
Ernesto Castro works for a local church and has been allowed past the police barricades to feed investigation teams working inside. He said that if authorities determine homes are structurally sound, they've told him they plan to begin letting residents return in in waves, but only to pick up essentials at first.
"There are people raising all kinds of Cain because they can't get back," Castro said. "But it's not safe yet."
___
Associated Press writer Paul J. Weber in West, Texas, contributed to this report.
Source: http://news.yahoo.com/small-fires-stop-west-residents-going-home-190039811.html
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Study finds scientific basis for 'chemo brain' in breast cancer patients
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Study Finds Scientific Basis for ?Chemo Brain? in Breast Cancer Patients
Reviewed by John M. Grohol, Psy.D. on April 19, 2013
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Study Finds Scientific Basis for ?Chemo Brain? in Breast Cancer Patients
Reviewed by John M. Grohol, Psy.D. on April 19, 2013
Now, a new study has shown a correlation between poorer performance on neuropsychological tests and memory complaints in post-treatment, early-stage breast cancer patients, particularly those who have undergone chemotherapy and radiation.
?The study is one of the first to show that such patient-reported cognitive difficulties ? often referred to as ?chemo brain? in those who have had chemotherapy ? can be associated with neuropsychological test performance,? said Dr. Patricia Ganz, director of cancer prevention and control research at the University of California-Los Angeles?s Jonsson Comprehensive Cancer Center.
Ganz and her colleagues looked at 189 breast cancer patients who enrolled in the study about a month after completing their initial breast cancer treatments and before beginning endocrine hormone-replacement therapy. Two-thirds had breast-conserving surgery, more than half had received chemotherapy, and three-quarters had undergone radiation therapy. Average age of the women was 52.
Because cognitive complaints following cancer treatment have often been associated with anxiety and depressive symptoms, the researchers excluded women with serious depressive symptoms. They also took into account the cancer treatments used and whether menopause and hormonal changes could be influencing the cognitive complaints. A group of healthy women of about the same age was used as a control group.
The researchers gave a self-reporting questionnaire to the women and found that those with breast cancer reported more severe complaints than normal ? 23.3 percent had higher complaints about their memory, and 19 percent reported higher complaints about higher-level cognition, such as problem-solving and reasoning.
The researchers noted that the breast cancer patients who reported more severe memory and higher-level cognition problems were more likely to have undergone both chemotherapy and radiation.
The UCLA researchers found that even when patients reported subtle changes in their memory and thinking, neuropsychological testing showed detectable differences.
For instance, they discovered that poorer performance on the neuropsychological test was associated with higher levels of cognitive complaints and with combined radiation and chemotherapy treatment, as well as with symptoms related to depression.
?In the past, many researchers said that we can?t rely on patients? self-reported complaints or that they are just depressed, because previous studies could not find this association between neuropsychological testing and cognitive complaints,? Ganz said. ?In this study, we were able to look at specific components of the cognitive complaints and found they were associated with relevant neuropsychological function test abnormalities.?
The findings are part of an ongoing study that seeks to examine the extent to which hormone therapy contributes to memory and thinking problems in breast cancer survivors, she said. This latest study provided a pre-hormone therapy assessment, which was able to separate the effects of initial treatments on these cognitive problems, she said. Earlier post-treatment studies of breast cancer patients were difficult to interpret, as they included women already taking hormone therapy, she noted.
?As we provide additional reports on the follow-up testing in these women, we will track their recovery from treatment, as well as determine whether hormone therapy contributes to worsening complaints over time,? Ganz said.
The study was published in the Journal of the National Cancer Institute.
Source: University of California-Los Angeles
Breast cancer patient photo available from Shutterstock
APA Reference
Wood, J. (2013). Study Finds Scientific Basis for ?Chemo Brain? in Breast Cancer Patients. Psych Central. Retrieved on April 22, 2013, from http://psychcentral.com/news/2013/04/20/study-finds-scientific-basis-for-chemo-brain-in-breast-cancer-patients/53922.html
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Sunday, April 21, 2013
Global finance officials endorse World Bank target to end poverty
By Lesley Wroughton
WASHINGTON (Reuters) - Global finance officials on Saturday endorsed a new World Bank goal to end extreme global poverty by 2030 and emphasized that its focus should be on ensuring that the poorest benefit from strong growth and rising prosperity in developing nations.
"For the first time in history we have committed to setting a target to end poverty," World Bank President Jim Yong Kim said on Saturday following a meeting of the World Bank's Development Committee. "We are no longer dreaming of a world free of poverty; we have set an expiration date for extreme poverty," he added.
The goal aimed to reduce extreme poverty to 3 percent globally and targets the bottom 40 percent of people living in each country in the developing world.
Developing economies are growing on average about 6 percent annually, lifting millions of people out of poverty and creating a new global middle class, which has also given rise to growing inequality.
"We recognize that sustained economic growth needs a reduction in inequality. Investments that create opportunities for all citizens and promote gender equality are an important end in their own right, as well we being integral to creating prosperity," the Development Committee said.
The new World Bank target aim to guide the work of the institution, and coincides with efforts by the United Nations to draw up a post-2015 poverty strategy to replace existing goals.
New figures released by the World Bank this week show that extreme poverty globally has plunged to 21 percent in 2010, from 43 percent in 1990, with most of the world's poor now concentrated most heavily in sub-Saharan Africa and South Asia, as China has successfully slashed extreme poverty.
Kim said climate change and the need for more investment in health and education were also discussed by ministers.
"As I talked about in several meetings, we need a plan that is equal to the challenge of a disastrously warming plant," said Kim, who has made tackling climate change one of his main priorities since taking the reins of the institution 10 months ago.
IMF Managing Director Christine Lagarde said there was no better opportunity while developing countries are growing strongly to tackle extreme poverty.
"Timing is everything," Lagarde said, adding that the global economic recovery was proceeding at a three-speed recovery with strong growth in emerging and developing economies. She said the IMF would step up its policy advice to developing countries on managing natural resources, job creation, financial sector development, and subsidies.
FUNDRAISING FOR THE POOREST
The Development Committee called for a "robust" donor fund-raising campaign by the World Bank's fund for its poorest borrowers and urged "strong participation" by all countries.
Donors from rich and developing economies gather every three years to pass the hat around to raise funds for the Bank's International Development Association, or IDA.
Traditionally, the United States, Britain and Nordic nations have been the biggest IDA funders, but over the past several years countries such as Brazil, India and China, Chile, Argentina and Peru have also ponied up money.
With belt-tightening across Europe and in the United States, the World Bank will have to show more strenuous oversight of how the money is used and that it does have an impact on the poor.
Kim has said more emphasis should be on helping fragile and conflict-hit countries.
"Given the fiscal pressures on donors around the world, we believe that the World Bank can and must do more to maximize the development impact of each dollar spent," new Treasury Secretary Jack Lew said in a statement to the Development Committee.
(Editing by Eric Walsh)
Source: http://news.yahoo.com/global-finance-officials-endorse-world-bank-target-end-002832160--sector.html
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Chiropractic Management for Asthma Sufferers: Part 4 ? Healthy ...
By Dr. Donald A. Ozello DC
Las Vegas Informer
Creating new health habits helps asthma sufferers. Big and small changes can add up to a major difference in the reduction of severity and frequency of asthma symptoms. Valuable tools exist in combating asthma including regular chiropractic care, intelligent nutritional strategies and healthy lifestyle modifications.
In my four part series I explain how consistent chiropractic care can help asthma sufferers better manage their condition.
In part one, I provided fundamental information on asthma and chiropractic treatment. In part two, I discussed anatomical and physiological details on how chiropractic care helps those with asthma. In part three, I supplied nutritional tactics to reduce inflammation and better manage asthma symptoms. Part four contains health strategies to help asthma sufferers prevent and lessen the severity of attacks.
Chiropractic care, nutrition and lifestyle modifications are not cures for asthma. Chiropractic treatment may help decrease the severity and lessen the frequency of asthma symptoms by optimizing nerve flow and re-establishing proper skeletal motion. Healthy nutritional strategies may help reduce inflammation and decrease the intensity and occurrence of asthma attacks. The suggested lifestyle modifications are recommendations to help asthma sufferers reduce symptom intensity and incidence.
Exercise: The correct amount of exercise increases health, fitness and immunity. Find an exercise you enjoy and do it correctly and consistently. Find a second exercise that compliments the first exercise and execute it correctly and consistently.
Asthma attacks can be elicited by physical exertion and exercise. Increased oxygen demand during strenuous activity results in accelerated breathing rate and increased mouth inhalation. Air inhaled through the mouth is cooler and dryer than nasal air. The cooler, dryer air may cause asthma attacks. Exercising in colder temperature may increase the possibility of asthma symptoms.
Increasing your breathing capabilities strengthens your lungs. Swimming and underwater breathing exercises increases lung capacity and strengthens the ribcage muscles. Swimming and underwater breathing exercises are strenuous and may prove difficult for asthma sufferers at the onset. The long term benefit far outweighs the demanding beginning.
Be mindful to start and train at a level appropriate for you. Increase duration and intensity in small increments.
Carefully monitor your breathing before, during and after exercise to receive maximum benefit and to prevent exercise-induced asthma attacks. Build a stronger and healthier body with the proper amount of exercise. Help quell you asthma attacks with well-planned and well-executed exercise strategies.
Smoking: Smoke of any type makes breathing difficult. Cigarette, cigar and recreation drug smoke are powerful asthma triggers. Avoid smoking and smoke filled rooms at all costs.
The negative effects of breathing smoke-filled air are well-documented. Reduce your exposure to smoking-induced asthma by encouraging friends and family to quit smoking immediately. Prevent asthma attacks and symptoms by breathing clean, non-toxic air.
Air Quality: The quality of the air we breathe possesses a direct correlation to our health. Toxin filled air induces asthma attacks.
When moving into a new residence have your air ducts professionally cleaned. Build up of trapped particles from the previous owners or construction work may trigger asthma symptoms. Follow-up every few years to keep your home?s air quality healthy.
Change your air filters on a regular basis. This simple task makes a world of difference in keeping your household air clean. Quiet your asthma symptoms by breathing cleaner, fresher air.
Household Chemicals: Limit your exposure to chemicals to improve your health and decrease the severity and frequency of asthma symptoms. Exposure to powerful chemicals often triggers asthma attacks. Long term exposure to strong chemicals can permanently damage the lungs. Do everything possible to lower your contact with disease causing chemicals.
Use cleaning materials that are non-toxic to humans and pets. If a cleaning product provokes asthma or pre-asthma symptoms dispose of it immediately. Purchase organic or natural cleaning products and use them as directed.
Pets: Having dogs and cats as family members is a great experience. Follow several simple tips to make asthma sufferers lives with pets less troublesome.
Pet dander can trigger asthma. Pet dander is old, dead skin which has fallen off the animal. Pet dander can stick to hair, walls, furniture, bedding and clothes.
Here are suggestions to lower your exposure to pet dander. Bathe your animal often. Wash your hands after handling your animal. Wash the animal?s bedding, blankets and toys often. If the animal sleeps on your bed wash the bedding frequently. Have your house and air ducts professionally cleaned.? Sweep up or pick up any animal hair.
Pets are loveable creatures. Enjoy your pet and lessen your asthma symptoms by keeping the animal clean and keeping your home clean.
Immunity: Strengthen your immune system to combat asthma.
Eat a healthy diet filled with nutrients. Consume green leafy vegetables and vitamin C containing fruits.
Get out in the sun. Direct sunlight is the best source of vitamin D. Ten to fifteen minutes of sun during non-peak hours three to four times a week skyrockets your vitamin D levels. Boost your immunity with nature?s best tools: Healthy food and sunlight.
Stress and Anxiety: Calm yourself to better deal with stress and anxiety. Stress and anxiety are asthma initiators.
Improve your reaction to stressful situations to better control your asthma. Decrease anxiety to reduce the severity and occurrence of asthma attacks. Develop calming strategies to better cope with rough situations.
Yoga, meditation, visualization and breathing exercises calm the mind and body. Seek assistance from trained professionals to receive maximum benefit. Utilize relaxation techniques to lessen stress and anxiety. Minimize asthma symptoms by better handling stress and preventing anxiety.
Conclusion: Take control of your asthma. Live an active and healthy life through better asthma management.
Utilize regular chiropractic treatment to re-establish proper skeletal motion and optimize nerve flow. Chiropractic care places the body in a position to function at its highest capacity. Maximize your body?s healing and functional capabilities to move and breathe better.
Choose the healthiest foods for maximum benefit. Determine trigger foods and avoid them. Develop nutritional strategies that work for you and adhere to them. Feed your body the correct amounts of nutrients it needs to flourish and fight disease.
Develop healthy habits to combat asthma. Exercise, sunshine and air quality are vital to propel your health forward. Employ consistent cleaning patterns to cleanse the air you breathe. Exercise to strengthen your immune system and increase your breathing capabilities. Relax and enjoy life.
Asthma may be officially ?incurable? but it can be controlled. Receive regular chiropractic care, consume healthy foods and create healthy habits to live the life you desire and diminish the frequency and severity of asthma symptoms.
Dr. Donald A. Ozello DC is the owner and treating doctor at Championship Chiropractic. 2595 S. Cimarron Rd, Suite #100, Las Vegas, NV 89117. ?His web address is?Championship Chiropractic. He can be contacted at (702) 286-9040 and?DrO@ChampionshipChiropractic.com.
Dr. Donald A. Ozello?s mission is to educate and inspire others to live healthier, fitter, more functional lives.
Dr. Donald A. Ozello DC proudly handles?Standard Process Supplements?and?Foot Levelers Orthotics.
Dr. Donald A. Ozello DC writes a weekly health, fitness, exercise and nutrition column for The Las Vegas Informer. His is published in?OnFitness Magazine,?Livestrong.com,?SpineUniverse.com?and?EHow.com.
Dr. Donald A. Ozello DC is an award-winning public speaker. He has spoken to numerous groups on the importance of health, fitness, exercise, ergonomics, nutrition and injury prevention.
Dr. Donald A. Ozello DC is a fitness enthusiast. Functional kettlebell training, bike riding and running are his favorite forms of exercise.
Before pursuing his career in Chiropractic, Dr. Donald A. Ozello DC served in the United States Navy aboard the USS Bremerton, SSN 698.
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UPDATE: BMO Capital Markets Lowers PT on International ...
In a report published Friday, BMO Capital Markets analyst Keith Bachman reiterated a Market Perform rating on International Business Machines Corp. (NYSE: IBM), but lowered the price target from $233.00 to $220.00.
In the report, Bachman noted, ?In our preview, we indicated that IBM would miss revenues and hit EPS. We were only partially correct. Our 2013 estimate was about $1 billion lower than consensus, and yet IBM missed our March Q revenue estimate by $1.2 billion. IBM indicated that deals slippage was caused by execution issues. We are not so sure. Oracle, Accenture, and now IBM have all posted weak Qs and guidance. We think demand was perhaps weaker than we and the companies thought.?
International Business Machines Corp. closed on Thursday at $207.15.
(c) 2013 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.
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