C-reactive protein test

From: http://www.mayoclinic.com/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

Thalidomide: Research advances in cancer and other conditions

Thalidomide is infamous for the birth defects it caused. So why are doctors still prescribing it?

From: http://www.mayoclinic.com/diseases-conditions/cancer/in-depth/thalidomide/art-20046534

U.S. falling short in 3 "winnable" health battles

Despite progress in certain areas, the CDC says the nation is failing to meet these important health goals

From: http://www.cbsnews.com/news/obesity-smoking-hospital-infections-cdc-falling-short/

Stuttering mysteries unfold in brain imaging study

Findings provide a road map to help develop treatments for stuttering, researcher says

From: http://www.cbsnews.com/news/stuttering-brain-mri-study/

Normal Blood Pressure in Clinic May Mask Hypertension

Young, lean patients can have high blood pressure that's not caught during regular exams, study finds

From: http://www.webmd.com/hypertension-high-blood-pressure/news/20161205/normal-blood-pressure-in-clinic-may-mask-hypertension?src=RSS_PUBLIC

Colon cancer screening: Is there an easier, effective way?

Are you, or is someone you know, postponing their colonoscopy? Maybe it’s the idea of that prep. At best, it requires being home and near a toilet for a day. Worse, it can make people feel awfully ill. Or maybe it’s the invasiveness of the test. At best, it’s unpleasant. At worst, there can be serious complications, including an instrument puncturing the bowel, bleeding, and organ damage. It’s also time-consuming, requiring time off work for you and whoever will be driving you home.

Why is a colonoscopy worth the hassle?

Cancers of the colon and rectum are common, and lives can be saved with early detection. Colorectal cancer is the fourth most common cancer in the United States and the second leading cause of cancer death. There are well over a million people living with the diagnosis, and 134,000 new cases are expected this year. About 4% of all adults will be diagnosed with colorectal cancer in their lifetime; having a first-degree relative with colorectal cancer or precancerous polyps, a personal history of polyps, advancing age, obesity, alcohol use, smoking, and African-American race all increase the risk substantially.^{(1, 2, 3)}

The five-year survival rate for these cancers is about 90% when the cancer is caught before it spreads at all, but only 68% when it has started to spread, and 10% when it is widely spread (metastatic).^{(3, 4)} For this reason, experts agree that it makes sense to screen people at average risk starting at age 50 and up to age 75, with the decision to continue screening after that on a case-by-case basis.^{(3, 4)}

According to the 2016 guidelines from the U.S. Preventive Services Task Force (USPSTF), there are six acceptable ways to screen for colorectal cancers and precancerous polyps: procedures like sigmoidoscopy and colonoscopy; special imaging techniques (CT colonography); basic stool tests for blood (because bleeding in the intestine can be a sign of cancer); the FIT test, which is a fancier, more sensitive stool test for blood; and the combined stool DNA test that looks for molecules, gene mutations, and blood. Which test to use depends on the patient’s situation and preferences, and the USPSTF has called for more research in order to be able to make more precise recommendations.⁽⁵⁾

Cologuard: The new kid on the colon cancer screening block

Recently my patients have been asking about Exact Sciences’ Cologuard combined stool DNA test, which was approved by the FDA in 2014. You may have seen it advertised on TV, featuring a cute little talking box. Medicare and Medicaid will cover the entire cost of this test (about $500) once every three years for average-risk people who have no gastrointestinal symptoms.

The test is easy-peasy. One of us goes to the website and prints out the order form, the patient fills in the insurance information, and I sign the paper, which gets mailed to the company. They in turn mail the patient a little box with the stool collection kit. The patient goes about their usual routine, without any change to diet or prep whatsoever, poops into the cleverly designed toilet cover/collection jar, and mails it back to the company within two days. The company runs the tests, and the numerical results from each test component are run through a special equation, with a cutoff score for a positive or negative result.⁽⁷⁾ They send the results to me, and then I report to the patient. A positive test means that further evaluation is necessary, and that involves a colonoscopy looking for a polyp or cancer.

Just how good is Cologuard?

Based on the one major study cited,⁽⁶⁾ it is pretty darned good: Cologuard detected 92% of colorectal cancers and 42% of advanced polyps. As a comparison, the FIT test detected 74% of cancers and 24% of advanced polyps. So it’s better than the only other real non-invasive option, and without the painful prep, potential discomfort, and potentially serious risks of a colonoscopy or CT colonography. (It is important to know that both of these stool tests are more likely to have a false positive result. That means that the stool test can suggest cancer when there isn’t any, and to know for sure, a patient will need a colonoscopy or CT colonography after all.) Right now, the test is covered by insurance every three years, but more research is needed to know if that is an appropriate interval; eventually, the test may be recommended more or less often than that.

Cologuard sounds so wonderful. And it may actually be, but patients should know that the one major study that provided the data upon which most of the recommendations are based was 100% funded by Exact Sciences, the company that makes the test. Even the one other smaller study showing similar, supporting results was authored by co-inventors of the Cologuard technology and scientific advisors to Exact Sciences.⁽⁸⁾ It’s really important to know that, and to take this amazing little talking box with a big grain of salt. I can understand why the USPSTF is calling for more research, and why doctors aren’t abandoning the good old, dependable, but pain-in-the-rear-end colonoscopy as a basic screening test. Yet.

Am I recommending the Cologuard for my own patients? You bet. I have many patients whom I’ve been encouraging to have their colonoscopies for years, and for one reason or another, they have delayed. Or, there are some patients with medical issues for whom a colonoscopy may be logistically difficult or too risky. In their cases, the stool tests are very viable options, definitely better than no screening, and maybe better than traditional screening. We just don’t know for sure yet.

Notes:

1. NIH National Cancer Institute: Common Types of Cancer.
2. NIH National Cancer Institute SEER (Surveillance, Epidemiology, and End Results) data.
3. Harvard/Massachusetts General Hospital Primary Care Office Insight, chapter on Colorectal Cancer Screening, by Blair Fosburgh, MD; Wynne Armand, MD; Primary Care Operations Improvement Specialist Reviewers: Daniel Chung, MD.
4. Screening for Colorectal Cancer: Strategies for Patients at Average Risk. Up-to-Date (Wolters Kluwer). Chyke Doubeni, MD, FRCS, MPH. Section Editors: J Thomas Lamont, MD; Joann G Elmore, MD, MPH; H Nancy Sokol, MD.
5. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Lin JS, Piper MA, Perdue LA, Rutter CM, Webber EM, O’Connor E, Smith N, Whitlock EP.
6. Multitarget stool DNA testing for colorectal-cancer screening. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, Ahlquist DA, Berger BM. New England Journal of Medicine.
7. Supplement to: Multitarget stool DNA testing for colorectal cancer screening.
8. Stool DNA testing for screening detection of colorectal neoplasia in Alaska Native people. Redwood DG, Asay ED, Blake ID, et al. Mayo Clinic Proceedings.

The post Colon cancer screening: Is there an easier, effective way? appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/colon-cancer-screening-is-there-an-easier-effective-way-2016120510751

C-reactive protein test

From: http://www.mayoclinic.org/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

Thalidomide: Research advances in cancer and other conditions

Thalidomide is infamous for the birth defects it caused. So why are doctors still prescribing it?

From: http://www.mayoclinic.org/diseases-conditions/cancer/in-depth/thalidomide/art-20046534

"Superbug" gene spotted on U.S. pig farm

The gene is resistant to drugs considered a last line of defense against hard-to-treat bacterial infections

From: http://www.cbsnews.com/news/superbug-gene-spotted-on-us-pig-farm/

Even occasional cigarette smoking can be deadly

Smoking just one cigarette a day significantly increases risk of death, a new report finds

From: http://www.cbsnews.com/news/smoking-cigarettes-occasionally-deadly-lung-cancer/

Dr. Vandana Bhide discusses influenza

From: Mayo Clinic http://www.youtube.com/watch?v=JuuNgG-pq88

Regular Drinkers, Irregular Heartbeat?

Even moderate amounts of alcohol may contribute to atrial fibrillation, study suggests

From: http://www.webmd.com/heart-disease/atrial-fibrillation/news/20161205/regular-drinkers-irregular-heartbeat?src=RSS_PUBLIC

'Superbug' Gene Spotted on U.S. Pig Farm

Study suggests potential resistance to a last line of antibiotics for humans

From: http://www.webmd.com/cold-and-flu/news/20161205/superbug-gene-spotted-on-us-pig-farm?src=RSS_PUBLIC

VA Resignations After Maggots Found in Man's Wound

VA Resignations After Maggots Found in Man's Wound

From: http://www.webmd.com/a-to-z-guides/news/20161205/oklahoma-va-resign-maggots?src=RSS_PUBLIC

C-reactive protein test

From: http://www.mayoclinic.com/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

Thalidomide: Research advances in cancer and other conditions

Thalidomide is infamous for the birth defects it caused. So why are doctors still prescribing it?

From: http://www.mayoclinic.com/diseases-conditions/cancer/in-depth/thalidomide/art-20046534

Can't buy love? Sex drugs cost too much for some

Prescription medications like Viagra, Cialis, and Addyi can cost up to hundreds of dollars a month

From: http://www.cbsnews.com/news/sex-erectile-dysfunction-drugs-viagra-cialis-addyi-medicines-cost/

Just 1 Cigarette a Day Can Be Deadly: Study

Light smokers still faced an increased risk of early death

From: http://www.webmd.com/smoking-cessation/news/20161205/just-1-cigarette-a-day-can-be-deadly-study?src=RSS_PUBLIC

Football position linked to blood pressure, heart issues

These "300-pound behemoths" on a college team may face health issues more commonly found in middle-age and older adults

From: http://www.cbsnews.com/news/football-linemen-high-blood-pressure-hypertension-heart-abnormalities/

Flavored E-Cig Liquids May Have Toxic Substances

Study found lower levels in unflavored varieties when heated

From: http://www.webmd.com/smoking-cessation/news/20161202/flavored-e-cig-liquids-may-contain-toxic-substances?src=RSS_PUBLIC

Why cancer rates are rising worldwide

New research looks at the reasons behind a steep increase in cancer cases

From: http://www.cbsnews.com/news/cancer-rates-rise-worldwide-over-past-decade/

Another step closer to artificial blood

Synthetic blood replacement could save lives on the battlefield and in remote areas, but much more research is needed

From: http://www.cbsnews.com/news/another-step-closer-to-artificial-blood/

Nearly 2 Million Pounds of Chicken Recalled

Nearly 2 Million Pounds of Chicken Recalled

From: http://www.webmd.com/food-recipes/food-poisoning/news/20161205/chicken-recall?src=RSS_PUBLIC

Scientists Discover More Clues to Stuttering

MRI shows involvement of brain areas controlling speech, attention and emotion

From: http://www.webmd.com/brain/news/20161205/scientists-discover-more-clues-to-stuttering?src=RSS_PUBLIC

Secretary Vilsack Appoints Members to the Council for Native American Farming and Ranching

WASHINGTON, Dec. 5, 2016 - Agriculture Secretary Tom Vilsack today announced the appointment of six new members and the re-appointment of five members to the Council for Native American Farming and Ranching. As a discretionary advisory committee, the Council provides recommendations to the Secretary of Agriculture on changes to U.S. Department of Agriculture (USDA) regulations and other measures that would eliminate barriers to program participation for Native American farmers and ranchers.

From: http://www.usda.gov/wps/portal/usda/usdahome?contentid=2016/12/0254.xml&contentidonly=true

C-reactive protein test

From: http://www.mayoclinic.org/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

Thalidomide: Research advances in cancer and other conditions

Thalidomide is infamous for the birth defects it caused. So why are doctors still prescribing it?

From: http://www.mayoclinic.org/diseases-conditions/cancer/in-depth/thalidomide/art-20046534

Mayo Clinic Minute: Burn calories without burning out on exercise

From: Mayo Clinic http://www.youtube.com/watch?v=1ePXIsa6WLg

Colon cancer screening: Is there an easier, effective way?

Are you, or is someone you know, postponing their colonoscopy? Maybe it’s the idea of that prep. At best, it requires being home and near a toilet for a day. Worse, it can make people feel awfully ill. Or maybe it’s the invasiveness of the test. At best, it’s unpleasant. At worst, there can be serious complications, including an instrument puncturing the bowel, bleeding, and organ damage. It’s also time-consuming, requiring time off work for you and whoever will be driving you home.

Why is a colonoscopy worth the hassle?

Cancers of the colon and rectum are common, and lives can be saved with early detection. Colorectal cancer is the fourth most common cancer in the United States and the second leading cause of cancer death. There are well over a million people living with the diagnosis, and 134,000 new cases are expected this year. About 4% of all adults will be diagnosed with colorectal cancer in their lifetime; having a first-degree relative with colorectal cancer or precancerous polyps, a personal history of polyps, advancing age, obesity, alcohol use, smoking, and African-American race all increase the risk substantially.^{(1, 2, 3)}

The five-year survival rate for these cancers is about 90% when the cancer is caught before it spreads at all, but only 68% when it has started to spread, and 10% when it is widely spread (metastatic).^{(3, 4)} For this reason, experts agree that it makes sense to screen people at average risk starting at age 50 and up to age 75, with the decision to continue screening after that on a case-by-case basis.^{(3, 4)}

According to the 2016 guidelines from the U.S. Preventive Services Task Force (USPSTF), there are six acceptable ways to screen for colorectal cancers and precancerous polyps: procedures like sigmoidoscopy and colonoscopy; special imaging techniques (CT colonography); basic stool tests for blood (because bleeding in the intestine can be a sign of cancer); the FIT test, which is a fancier, more sensitive stool test for blood; and the combined stool DNA test that looks for molecules, gene mutations, and blood. Which test to use depends on the patient’s situation and preferences, and the USPSTF has called for more research in order to be able to make more precise recommendations.⁽⁵⁾

Cologuard: The new kid on the colon cancer screening block

Recently my patients have been asking about Exact Sciences’ Cologuard combined stool DNA test, which was approved by the FDA in 2014. You may have seen it advertised on TV, featuring a cute little talking box. Medicare and Medicaid will cover the entire cost of this test (about $500) once every three years for average-risk people who have no gastrointestinal symptoms.

The test is easy-peasy. One of us goes to the website and prints out the order form, the patient fills in the insurance information, and I sign the paper, which gets mailed to the company. They in turn mail the patient a little box with the stool collection kit. The patient goes about their usual routine, without any change to diet or prep whatsoever, poops into the cleverly designed toilet cover/collection jar, and mails it back to the company within two days. The company runs the tests, and the numerical results from each test component are run through a special equation, with a cutoff score for a positive or negative result.⁽⁷⁾ They send the results to me, and then I report to the patient. A positive test means that further evaluation is necessary, and that involves a colonoscopy looking for a polyp or cancer.

Just how good is Cologuard?

Based on the one major study cited,⁽⁶⁾ it is pretty darned good: Cologuard detected 92% of colorectal cancers and 42% of advanced polyps. As a comparison, the FIT test detected 74% of cancers and 24% of advanced polyps. So it’s better than the only other real non-invasive option, and without the painful prep, potential discomfort, and potentially serious risks of a colonoscopy or CT colonography. (It is important to know that both of these stool tests are more likely to have a false positive result. That means that the stool test can suggest cancer when there isn’t any, and to know for sure, a patient will need a colonoscopy or CT colonography after all.) Right now, the test is covered by insurance every three years, but more research is needed to know if that is an appropriate interval; eventually, the test may be recommended more or less often than that.

Cologuard sounds so wonderful. And it may actually be, but patients should know that the one major study that provided the data upon which most of the recommendations are based was 100% funded by Exact Sciences, the company that makes the test. Even the one other smaller study showing similar, supporting results was authored by co-inventors of the Cologuard technology and scientific advisors to Exact Sciences.⁽⁸⁾ It’s really important to know that, and to take this amazing little talking box with a big grain of salt. I can understand why the USPSTF is calling for more research, and why doctors aren’t abandoning the good old, dependable, but pain-in-the-rear-end colonoscopy as a basic screening test. Yet.

Am I recommending the Cologuard for my own patients? You bet. I have many patients whom I’ve been encouraging to have their colonoscopies for years, and for one reason or another, they have delayed. Or, there are some patients with medical issues for whom a colonoscopy may be logistically difficult or too risky. In their cases, the stool tests are very viable options, definitely better than no screening, and maybe better than traditional screening. We just don’t know for sure yet.

Notes:

1. NIH National Cancer Institute: Common Types of Cancer.
2. NIH National Cancer Institute SEER (Surveillance, Epidemiology, and End Results) data.
3. Harvard/Massachusetts General Hospital Primary Care Office Insight, chapter on Colorectal Cancer Screening, by Blair Fosburgh, MD; Wynne Armand, MD; Primary Care Operations Improvement Specialist Reviewers: Daniel Chung, MD.
4. Screening for Colorectal Cancer: Strategies for Patients at Average Risk. Up-to-Date (Wolters Kluwer). Chyke Doubeni, MD, FRCS, MPH. Section Editors: J Thomas Lamont, MD; Joann G Elmore, MD, MPH; H Nancy Sokol, MD.
5. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Lin JS, Piper MA, Perdue LA, Rutter CM, Webber EM, O’Connor E, Smith N, Whitlock EP.
6. Multitarget stool DNA testing for colorectal-cancer screening. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, Ahlquist DA, Berger BM. New England Journal of Medicine.
7. Supplement to: Multitarget stool DNA testing for colorectal cancer screening.
8. Stool DNA testing for screening detection of colorectal neoplasia in Alaska Native people. Redwood DG, Asay ED, Blake ID, et al. Mayo Clinic Proceedings.

The post Colon cancer screening: Is there an easier, effective way? appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/colon-cancer-screening-is-there-an-easier-effective-way-2016120510751

11% of Stroke Survivors Struggle With Epilepsy

Study found those who suffered more brain damage were more likely to have seizures afterwards

From: http://www.webmd.com/stroke/news/20161203/11-percent-of-stroke-survivors-struggle-with-epilepsy?src=RSS_PUBLIC

Cancer Rates Up More Than a Third in Past Decade

Researchers cite population aging and growth

From: http://www.webmd.com/cancer/news/20161203/worldwide-cancer-rates-up-more-than-one-third-in-past-decade-report?src=RSS_PUBLIC

C-reactive protein test

From: http://www.mayoclinic.com/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

Thalidomide: Research advances in cancer and other conditions

Thalidomide is infamous for the birth defects it caused. So why are doctors still prescribing it?

From: http://www.mayoclinic.com/diseases-conditions/cancer/in-depth/thalidomide/art-20046534

Why you should keep tabs on your drinking

It’s that time of year again, when people gather with friends and family to celebrate the holiday season. The festivities often feature wine, champagne, and other alcoholic beverages. But before you raise your glass, make sure you’re aware of just how much alcohol you’re actually consuming — and how it may affect your heart.

For the most part, moderate drinking — defined as one drink per day for women and two drinks per day for men — is considered safe. But there are some caveats.

Defining “one” drink

“We ask people about numbers of drinks, but you have to be careful about what they really mean by that,” says cardiologist Dr. Stephen Wiviott, associate professor of medicine at Harvard Medical School. For some people, “one drink” may be 6 ounces of whiskey, which is actually four drinks, he notes. One standard drink contains roughly 14 grams of pure alcohol, which is found in:

• 12 ounces of regular beer (about 5% alcohol)
• 5 ounces of wine (about 12% alcohol)
• 1.5 ounces of distilled spirits, such as whiskey, rum, and vodka (about 40% alcohol)

Despite popular belief, the evidence that alcohol is good for your heart is fairly weak and based solely on what researchers call observational data. “We observe that people who drink moderately have lower rates of heart disease and death from heart disease, but that doesn’t prove cause and effect,” says Dr. Wiviott. For example, light-to-moderate drinkers tend to be educated and relatively wealthy, and they’re likely to have heart-healthy habits that may explain their lower risk.

Holiday heart

There’s a well-established connection between binge drinking and atrial fibrillation or afib, an irregular heart rhythm that can increase the risk of a stroke. It’s known as holiday heart syndrome because it typically happens around the holidays and on weekends, when some people drink to excess. It’s not exactly clear why binge drinking (defined as consuming about four to five drinks over a two-hour period) triggers afib. But it can happen in people with and without a history of the heart rhythm problem.

A recent study found that even as little as one drink a day may enlarge the heart’s upper left chamber (atrium) and increase the risk of developing afib. Researchers found that every 10 grams of alcohol consumed was linked to a 5% higher risk of developing afib. About 24% (and in some cases, up to 75%) of the higher risk could be traced back to an enlargement of the left atrium. Stretching of the atria — which can also result from longstanding high blood pressure or a genetic problem — seems to make the heart more electrically unstable, Dr. Wiviott explains.

So what should you do?

These new findings don’t change the observation linking moderate drinking to a lower risk of heart attack noted in some studies. But no one should ever start drinking in hopes of avoiding a heart attack, he says. For his patients who do drink alcohol, he suggests no more than one drink a day, even for men. If you have afib and drink alcohol, you should probably have a discussion with your doctor, Dr. Wiviott advises.

The National Institute on Alcohol Abuse and Alcoholism already advises people ages 65 and older to limit themselves to one daily drink. Age-related changes, including a diminished ability to metabolize alcohol, make higher amounts risky regardless of gender.

If you’re trying to cut back on your drinking, try these tips:

• Keep a drinking diary. Write down what and how much you drink for several weeks to get a sense of how much you usually imbibe.
• Keep alcohol out of your house. This can help you to limit your drinking to restaurants and social occasions.
• Dilute and drink slowly. Dilute your wine or cocktail with sparkling water and ice. Sip it slowly. Never drink on an empty stomach.
• Establish alcohol-free days. Choose a few days per week to abstain completely from alcohol.

The post Why you should keep tabs on your drinking appeared first on Harvard Health Blog.

From: Julie Corliss http://www.health.harvard.edu/blog/why-you-should-keep-tabs-on-your-drinking-2016120210686