Thursday, 28 June 2007

Form and Function: Protein synthesis

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I am a Licensed Practical Nurse with five years' experience in this profession. I believe it is essential to go back to the basics in all things in order to really understand them. I am fascinated by how our bodies work and I hope I can get my readers to share my fascination. I hope we all learn new things and marvel again at the things we already know. This feature -- which includes a closing section on how disease affects the topic in question -- will run on The Cancer Blog on Wednesdays, and The Cardio Blog and The Diabetes Blog on Thursdays. [The contents in this post are for informational purposes only and should not be construed as medical advice or substitute for professional medical care.]

We start with the cell, because so much of what happens to us when we get sick, and how we get healthy again, can be explained by what happens on a cellular level. The cell is extremely complex and I will only touch on the basics in these posts, but at least we can have a rudimentary understanding.

We have discussed cell membranes (May 24), as well as cell organelles (May 31). On , June 7,we discussed the cellular transport mechanisms and on June 14, we discussed the cell nucleus. On June 21 we discussed cell division and today we will end the series on the cell with a short look at protein synthesis.

Although cells synthesize many chemicals to maintain homeostasis, they are mainly devoted to synthesizing large numbers of proteins. Proteins are used as enzymes and as structural materials in the cells. Many proteins are retained in the cell for intracellular use. Some proteins are used to assemble cellular structures such as the plasma membrane, the cytoskeleton and other organelles. There are many specialized human proteins that are exported and function in cellular activities. For example, protein makes up the hormone insulin, the ligaments and tendons of joints, the hair, skin, and nails of the body.

The instructions for making proteins are found mainly in the DNA in the nucleus. For protein synthesis to occur, there are several essential materials that must be present: a supply of the 20 different amino acids, a series of enzymes, DNA, and ribonucleic acid (RNA). The information encoded in a region of DNA is first copied to produce a specific molecule of RNA. Then the information contained in the RNA is translated into a corresponding sequence of amino acids that forms the protein molecule. The code for a single amino acid consists of three bases in the DNA molecule: this triplet of bases may be called a codon. The genetic code is the set of rules that regulate the base triplet sequence of DNA to the corresponding codons of RNA and the amino acids they specify. If there is a mistake in the DNA, that is, incorrect bases or triplets of bases, this mistake will be copied. The result is the formation of a malfunctioning or non-functioning protein. This is called a genetic or hereditary disease.

How does this affect you?
Studies such as one that looked at the correlation between the rate of protein synthesis and hypertrophy in kidney cells help us have a better understanding of diabetes and its effects.

Diabetes in youth on the rise: Race, ethnicity and type 1/type 2 analyzed

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Just released in the Journal of the American Medical Association (JAMA), the SEARCH for Diabetes in Youth Study involved 2,435 young people under 20 newly diagnosed with diabetes in 2002 and 2003. This effort claims to be unique as it is the first study designed to estimate our nation's incidence of diabetes across race, ethnicity and diabetes type in this younger population.

Estimated rates of type 1 diabetes over previous estimates are up 40-60 percent for white children and 20-40 percent for black and Hispanic children. But the study also cautions direct comparisons can't be made as earlier studies incorporated varying methodologies.

The study states overall diabetes incidence in children and adolescents is 24.3 cases per 100,000 annually. Type 1 and Type 2 diabetes are most common in whites (26.1 per 100k), blacks (25.4) and American Indian (25.0) youth, and lowest in Hispanic (20.2) and Asian/Pacific Islander (16.7) youth.

Type 2 rates were pretty low, only 19 cases in 5-9 year-olds, 215 in 10-14 year-olds and 296 in 15-19 year-olds. No kids under 5 had type 2, thank goodness. In the teens aged 15-19, type 1 was most common in whites. Conversely, it was least common in American Indians, however for type 2, reverse those statistics. Dana Debelea of the University of Colorado Health Sciences Center stated for older kids the diabetes picture is complex. African Americans, Asian/Pacific Islanders and Hispanics have almost half and half of type 1 and type 2.

Catherine DeAngelis, editor of JAMA, stated a newly diagnosed adult has 20 to 30 years of suffering ahead, while a child with diabetes faces 50 to 60 years of the same. I hadn't seen this sobering statistic before -- each year 15,000 children and teens are diagnosed with type 1, and 3,700 diagnosed with type 2.

Form and Function: Protein Synthesis

Filed under: ,

I am a Licensed Practical Nurse with five years' experience in this profession. I believe it is essential to go back to the basics in all things in order to really understand them. I am fascinated by how our bodies work and I hope I can get my readers to share my fascination. I hope we all learn new things and marvel again at the things we already know. This feature -- which includes a closing section on how disease affects the topic in question -- will run on The Cancer Blog on Wednesdays, and The Cardio Blog and The Diabetes Blog on Thursdays. [The contents in this post are for informational purposes only and should not be construed as medical advice or substitute for professional medical care.]

We start with the cell, because so much of what happens to us when we get sick, and how we get healthy again, can be explained by what happens on a cellular level. The cell is extremely complex and I will only touch on the basics in these posts, but at least we can have a rudimentary understanding.

We have discussed cell membranes (May 24), as well as cell organelles (May 31). On June 7, we discussed the cellular transport mechanisms and on June 14 the cell nucleus. On June 21 we discussed cell division and in this last post on the cell, we are taking a short look at protein synthesis.

Although cells synthesize many chemicals to maintain homeostasis, they are mainly devoted to synthesizing large numbers of proteins. Proteins are used as enzymes and as structural materials in the cells. Many proteins are retained in the cell for intracellular use. Some proteins are used to assemble cellular structures such as the plasma membrane, the cytoskeleton and other organelles. There are many specialized human proteins that are exported and function in cellular activities. For example, protein makes up the hormone insulin, the ligaments and tendons of joints, the hair, skin, and nails of the body.

The instructions for making proteins are found mainly in the DNA in the nucleus. For protein synthesis to occur, there are several essential materials that must be present: a supply of the 20 different amino acids, a series of enzymes, DNA, and ribonucleic acid (RNA). The information encoded in a region of DNA is first copied to produce a specific molecule of RNA. Then the information contained in the RNA is translated into a corresponding sequence of amino acids that forms the protein molecule. The code for a single amino acid consists of three bases in the DNA molecule: this triplet of bases may be called a codon. The genetic code is the set of rules that regulate the base triplet sequence of DNA to the corresponding codons of RNA and the amino acids they specify. If there is a mistake in the DNA, that is, incorrect bases or triplets of bases, this mistake will be copied. The result is the formation of a malfunctioning or non-functioning protein. This is called a genetic or hereditary disease.

How does this affect you?
There are various studies that are being done on protein synthesis and heart disease. One of the studies that caught my eye was one in which the effects of insulin on the myocardial protein synthesis was tested. Read more about this study on the American Heart Association's website.

Cancer in the foreshadows

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Not too many years ago, I got breast cancer. I call it chance, coincidence, fate and on some days, even luck. For today's purposes, I'll call it foreshadowing.

I didn't know it then -- way back in 1993 when I did a genogram project in grad school for a counseling class -- but it seems cancer was in my cards. I hinted at the possibility in my research paper and commented on how my family history might put me in the direct line of fire. But my suspicions in no way caused me any worry for the 10 plus years that followed. And still, even after my breast cancer diagnosis and subsequent treatment, I didn't remember I'd predicted this might happen to me. Not until I pulled my yellowed, faded assignment from an old box in the garage a few days ago did I realize it's not all that odd that cancer headed right for me.

A genogram is a graphic representation of a family tree that displays detailed data on relationships among individuals. It contains names, genders, birth dates, death dates, levels of education, occupations, major life events, and chronic illness. It's not uncommon to find on a genogram patterns of alcoholism, depression, divorce, remarriage, and yes, cancer.

In the paper that accompanied my graphical display, I wrote about my paternal grandmother, my paternal grandfather, my paternal great-grandmother, a paternal cousin, and my maternal great-grandmother. They all died of cancer. I noted in one brief sentence the likelihood of this cancer lineage increasing my risk of developing the disease.

"Yep, you should look at the health issues in your family tree," my professor wrote on my paper in bright blue ink. "Scary, but important nonetheless."

I considered the issues -- for a moment or two -- and then I packed that paper away and completely forgot I'd mentioned this frightening family trend. I kind of like that it happened this way. I didn't ever worry about cancer, didn't fear it coming to get me, and never slowed down as I continued on in school, graduated, got married, traveled, worked, and had kids. Waiting for the disease to sneak up on me would have accomplished nothing. Instead, I lived.

Cancer eventually snuck up on me. I found it. I fought it. Now it's gone. And here sits my genogram in front of me, written in December 1993, foreshadowing the cancer that invaded my left breast in November 2004.

Interesting how life happens, how it unfolds and unravels and then keeps on going. And so in the spirit of life, it's time for me to keep on going. Time to pack that paper back in its box. Time to keep living.

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Using the internet to find information on esophageal cancer

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In The Swallow Tales, the newsletter of the Esophageal Cancer Awareness Association, Roger Tunsley relates an experience he had upon first meeting his surgeon prior to his esophagectomy. The surgeon's first words to Tunsley were, "Do not Google this disease."

Tunsley offers a few tips for reading information on the internet, specifically regarding esophageal cancer. Tunsley writes, "You can't believe everything you read, especially on the web. Read critically. Statistics are heavily influenced by the date that they were published. Everyone's EC experience are very different."

Good advice for anyone doing an internet search on health issues, including cancer.

I would add, know yourself. If you don't think that you are going to be able to handle information after something like a general Google search which is going to pop up anything and everything, find another way to get the information. Of course, your physician should be your primary source of information regarding your specific case.

For more on esophageal cancer on the internet, a good place to start is the Esophageal Cancer Awareness Network's "Finding Help" page.

Wednesday, 27 June 2007

Family-based weight management program promising but costly

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Near the end of the school year, my son's preschool teacher shared a disturbing statistic. My son's generation is expected to have a shorter lifespan than their parents. The main reason? Childhood obesity.

17 percent of children and adolescents in 2004 were overweight, and it's even more dismal for African American and Hispanic youth -- 18-26 percent. The phrase 'childhood obesity epidemic' is not being tossed around lightly, we are in a state of emergency when it comes to the health of our youth.

Results were just released from a one-year randomized trial conducted May 2002-September 2005 on a weight management program called Bright Bodies. Researchers randomly assigned 209 overweight children to the Bright Bodies group or to a control group receiving the usual care offered at a pediatric obesity clinic. Bright Bodies is family-based, involving intensive lifestyle intervention specially designed to speak to the needs of inner-city minority kids. Exercise, nutrition education and behavior modification were all in the mix. The study compared changes in Body Mass Index (BMI), insulin sensitivity, blood pressure and cholesterol.

After 12 months from baseline, body weight was essentially unchanged in the Bright Bodies group (remember, these 8-16 year olds are growing rapidly), and BMI lowered -1.7 units. Compare this to the control group that gained 16.94 pounds and increased BMI 1.6 units. The Bright Bodies group's total body fat was -20.03 lbs compared to an increase in the control group. Total cholesterol improved for Bright Bodies, but not in the control group. Insulin sensitivity also increased for the Bright Bodies kids. These are dramatic results. Researchers surmise changing the lifestyle of overweight children is not a futile effort. The program is very expensive, and the authors plan on including cost-benefit analyses for consideration by existing obesity clinics/health management organizations.

What will motivate parents to change their own habits and model healthier nutrition and exercise for the entire family? Will hardening of the arteries or type 2 diabetes in an obese teenager provide a hard dose of reality? Like Diane Rixon said in this post about junk food manufacturers, it's not solely their fault. We consume the cheese doodles. The gem in this study is lifestyle change must start at the family level. Lowering the rising rate of childhood obesity can happen.

It is never too late to lose weight, but it is much harder to treat obesity than prevent it.

Three-year Byetta study positively a joke

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Here we go again. Big Pharma releases a study and spins a tall tale. Big Media falls for it. This fable stars the lead character Byetta, a.k.a. 'byetta not take it.'

Byetta-makers Amylin and Lilly visited the American Diabetes Association's annual meeting and released clinical results from a three-year trial, the lengthiest one to date. The 217 patients with diabetes enrolled in the study had poor blood glucose control with other diabetes drugs metformin or sulfonylurea. Byetta was added to the mix.

Here's the punchline -- after three years, 46 percent of patients were able to maintain blood-glucose levels of a 7.0 A1C (not impressive for a type 2 diabetic) and 30 percent had a 6.5 A1C -- the target level recommended by the ACE Diabetes Mellitus Consensus Conference in 2001. Notice the media reports do not say anything about the remaining 24 percent who obviously had A1C levels higher than 7.0. Add that 24 percent to the 46 percent at the non-optimal level of 7.0 A1C and you get 70 percent of patients maintaining blood sugars high enough over three years to silently develop retinopathy, kidney problems and nerve damage, to name a few.

Thank you to Jenny at the Diabetes Update blog for her June 26 insights on this study. She also has much to say on Byetta's touted weight loss. While one in four patients did lose an average of 29 pounds (impressive), three out of four only lost an average of eleven pounds -- not much weight loss.

It's Men's Health Month -- How healthy are you?

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One in three men can expect to have cardiovascular disease in some form by the time they're 60 years old, which makes it the #1 killer of men in the United States. Working to reduce the risk for both the general population and for individuals is all about controlling the risk factors, because CVD is largely preventable just by living a healthy lifestyle. Eating right and getting regular exercise, avoiding excessive alcohol and smoking, and keeping an eye on cholesterol and blood pressure can all make a huge difference over the course of a person's lifetime.

And of course no matter how wonderfully you live sometimes you might need a little extra help, so stay in touch with your doctor and use his help to map out the healthiest plan for you. Whether that includes medications or specialized therapies it's worth it -- you only get one heart!

Clearing up common nutritional myths

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Do eggs really raise cholesterol? Are 8 glasses of water a day really necessary? What about carbs -- do they really make you fat? There's a lot of information out there, and when it comes to health, fitness, and weight loss, there's no shortage of mixed messages. One nutritionist is hoping to debunk some of the more common health myths out there and talked about them recently at a health and fitness summit in Dallas. So here's the scoop:
  • Egg yolks are the most cholesterol-dense food there is, but there's little evidence to connect them -- when eaten in moderation (1 or 2 per day) -- to rising cholesterol levels. (As always, however, check with your doctor before changing your diet.)
  • Carbs won't make you fat, when eaten in moderation.
  • People have unique water needs and one size -- or 64 ounces -- does not fit all.
  • If you eat a balanced diet, you likely don't need a vitamin supplement.
What about you -- are there other health myths out there that you'd like to debunk? I'd love to hear them!

Banning trans fats no big deal for the Big Apple

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When New York restaurants were first informed that their culinary delights could no longer be prepared with trans fats, chefs everywhere were not happy. Most eateries have already made the switch from trans fat cooking oils to healthier ones without any issues from chefs or eaters.

Partially hydrogenated vegetable oils, the grease responsible for the delightful texture of McDonald's french fries, are among some of the deadliest offenders when it comes to heart disease. The oils are cheap and have long shelf lives, both qualities that appeal to the restaurant industry.

This ban on trans fats is a bold and positive move. The fact that the change is going so smoothly is heartening for restaurants and diners across the nation. With changes like this one and the bans of smoking in public areas we are slowly moving toward a healthier country.

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Form and Function: Protein synthesis

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I am a Licensed Practical Nurse with five years' experience in this profession. I believe it is essential to go back to the basics in all things in order to really understand them. I am fascinated by how our bodies work and I hope I can get my readers to share my fascination. I hope we all learn new things and marvel again at the things we already know. This feature -- which includes a closing section on how disease affects the topic in question -- will run on The Cancer Blog on Wednesdays, and The Cardio Blog and The Diabetes Blog on Thursdays. [The contents in this post are for informational purposes only and should not be construed as medical advice or substitute for professional medical care.]

We start with the cell, because so much of what happens to us when we get sick, and how we get healthy again, can be explained by what happens on a cellular level. The cell is extremely complex and I will only touch on the basics in these posts, but at least we can have a rudimentary understanding.

We have discussed cell membranes (May 23), as well as cell organelles (May 30). On June 6, we discussed the cellular transport mechanisms and on June 13 the cell nucleus. We discussed cell division on June 20 and today we end the series on the cell with a very short look at protein synthesis.

Although cells synthesize many chemicals to maintain homeostasis, they are mainly devoted to synthesizing large numbers of proteins. Proteins are used as enzymes and as structural materials in the cells. Many proteins are retained in the cell for intracellular use. Some proteins are used to assemble cellular structures such as the plasma membrane, the cytoskeleton and other organelles. There are many specialized human proteins that are exported and function in cellular activities. For example, protein makes up the hormone insulin, the ligaments and tendons of joints, the hair, skin, and nails of the body.The instructions for making proteins are found mainly in the DNA in the nucleus. For protein synthesis to occur, there are several essential materials that must be present: a supply of the 20 different amino acids, a series of enzymes, DNA, and ribonucleic acid (RNA). The information encoded in a region of DNA is first copied to produce a specific molecule of RNA. Then the information contained in the RNA is translated into a corresponding sequence of amino acids that forms the protein molecule. The code for a single amino acid consists of three bases in the DNA molecule: this triplet of bases may be called a codon. The genetic code is the set of rules that regulate the base triplet sequence of DNA to the corresponding codons of RNA and the amino acids they specify. If there is a mistake in the DNA, that is, incorrect bases or triplets of bases, this mistake will be copied. The result is the formation of a malfunctioning or non-functioning protein. This is called a genetic or hereditary disease.

How does this affect you?

In tumor growth, protein synthesis is altered. One study found that the increased protein synthesis that occurs when a tumor is present is similar to that which occurs with inflammation. This knowledge can lead to better cancer therapies as well as to a better understanding of tumors.

Thought for the Day: Are magnets our miracle cure?

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It's believed by some experts that there's a safe, non-addictive, completely harmless way to kill cancer cells as well as many other illnesses. This magical drug? Well, it's not a drug. It's something you probably have in your home right now .... magnets.

Magnets have been shown to kill cancer cells in animals. What's more, a negative magnetic field can function much like an antibiotic when surrounding a tumor, and it can destroy bacterial, fungal and viral infections. The patient in this article reported that using magnetic fields during his battle with colon cancer reduced his discomfort by quite a bit. Ok, maybe this isn't the miracle treatment we've all been waiting for, but maybe it is, and shouldn't there be more hype about this?

Are pharmaceutical companies -- evil, money-hungry, paradoxically both the saviours and enemies of the health industry -- denying us magentic treatment, which could save millions, because they can't make a profit on it? What do you think?

Bulldozing through cancer

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Seventy year old Ronald Baker says that "its hard to think about cancer on a growling bulldozer". He was diagnosed with prostate cancer and receives radiation daily, where he says is the only time during the day he thinks about having cancer.

Baker enjoys driving the two ton bulldozer and feels that staying busy is keeping his mind off of his cancer diagnosis and treatments. When he isn't working Ronald stays at Jack's Place, a temporary home for people needing long-term cancer treatments.

Ronald lives with his wife on a secluded ranch in Colorado where he rides horses and takes people on guided hunting trips in the winter. There wasn't a good treatment center available where he lives so he was referred to Jack's Place, a place he could live and find a job to keep busy during his radiation treatments.

Way to go Ronald!

Few referrals to support groups by physicians

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According to a new study in the June 15th issue of CANCER, use of support groups varies widely by cancer type and there are few referrals to such groups by physicians.

Dr. Jason Owen of Loma Linda University and his team found that about one in four cancer patients did join a support group. Patients with blood malignancies and breast cancer were more likely to join a support group than those with lung and skin cancers. Predictors of use include female gender, Caucasian race, higher education level, and symptoms of depression or anxiety.

Dr. Owen concludes, "This study sheds light on which individuals with cancer use these services. Assistance in identifying and accessing support groups should be a standard of care for all patients receiving curative, follow-up, or palliative care for cancer."

Hopefully, physicians and other healthcare providers working in oncology will continue to improve their efforts to help patients and caregivers find support groups in their communities.

Kidney cancer makes David Foster sick

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David Foster was diagnosed with Advanced Renal Cell Carcinoma in April 2005. Translation: stage four kidney cancer and the sixth deadliest form of cancer. Not a great disease to acquire. Also not the end of the world. Just ask David who is busy working as a National Strategic Advisor in Augusta, Georgia, headlining within the independent magazine community, hanging out with dog Gracie, and documenting his journey in a blog he calls David Foster's Kicking Kidney Cancer's Arse.

He's no wimp, this guy. Just read his June 23 post, titled May kill me, but it ain't gonna beat me. He didn't let that hard-nosed kid Jerry whip him when he was eight -- he smacked him so hard in the lunchroom, Jerry was left stumbling and bleeding -- and he won't let cancer bully him either. Still, David admits: he is sick. He explains it all in a post he calls Mr. Foster, are you really sick?

David got an e-mail one day. It read, Mr. Foster, are you really sick? I read your blog and you don't sound sick.

Regardless of how he sounds or feels, David tells readers that he truly is sick. How does he know? There's the pills -- Sutent, steroids, dilantin, nausea medication -- and the nausea, the dry heaves, the sick feeling that comes just before he goes for a MRI or CT scan, when the uncertainty about his life bubbles to the top. Yes, David Foster is sick. But he's also very much alive. And at this very moment, sickness does not plague him.

This place David inhabits -- one of his cancer friends calls it a place of sickness without illness -- is hard to handle. It's nice, to not always feel sick. Yet it's mentally taxing, to know a life-threatening disease consumes him. With a bit of balance, though, David works it out in his mind by embracing a warrior's attitude and borrowing from the wisdom of other cancer soldiers. Another cancer friend once told him: "A mayfly only lives a day. I bet he makes it a good one."

Call it a hunch, Mr. Foster, but I bet you make every one of your days a good one.

Challenges in cancer prevention

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Dr. John E. Niederhuber, Director of the National Cancer Institute, writes about "Challenges in Cancer Prevention" in the current issue of the NCI Cancer Bulletin.

According to Dr. Niederhuber, research in cancer prevention is focusing more and more on advanced technologies in an effort to further understand the events that take place on the molecular level that are associated with the early signs of cancer development.

Niederhuber cautions that this research is wildly complex; it involves studying germline abnormalities, mutations that occur during our lifetimes as well as understanding the role of environmental exposures and lifestyle factors.

It is easy to say that prevention via lifestyle choices should be a priority for our nation. It certainly should be one of them. However, as Niederhuber reminds us, "For most of the cancers we treat, there exists a heterogeneous mix of genetic changes and numerous potential environmental influences that challenge the development of simple prevention strategies."

Understanding the molecular mechanisms that cause cancer, developing more early detection methods and developing safe, preventative agents along with continuing research on lifestyle and environmental factors are all steps towards the goal of cancer prevention and early detection.

Avastin and tracheo-esophageal fistulas

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Avastin, which is used for advanced colorectal cancer, has been linked to tracheo-esophageal fistulas in a small number of Canadian patients, according to Health Canada officials. Tracheo-esophageal fistulas are abnormal connections between the esophagus and the trachea.

"A direct cause and effect between Avastin and these events has not been established, but cannot be ruled out," Health Canada said in its advisory. "Avastin should no longer be given to patients who develop a TE fistula."

Health Canada officials recommend that patients taking Avastin should contact their physicians if they develop any of the following: chest pain, shortness of breath, wheezing or labored breathing, coughing or choking when eating or drinking, coughing up food or liquids, or wheezing sounds following every breath.

Although a direct cause and effect relationship has not been confirmed between Avastin and TE fistula, it is still something to be aware of if you or a loved one is using this treatment.

Canadian politician Belinda Stronach's battling breast cancer

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Most people in Canada have heard of Belinda Stronach, the young, pretty female politician who rose to fame and famously switched from one opposing political party to the other at the height of her career (getting caught up in a tabloid frenzy over her love life along the way), only to quit politics altogether in April. Where I'm from--a notoriously conservative area--there's a lot of anger towards her, though that has been overshadowed by the revelation this week that she's been privately battling breast cancer for the past few months.

Stronach is battling DCIS -- ductal carcinoma in situ -- which is one of the more treatable forms of breast cancer, and she's had a mastectomy and breast reconstruction since her diagnosis in April.

Love her or hate her, I wish her the best in her fight with the big C. What about you?

Study says cancer drugs are worth the price

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Although cancer drugs are considered to be quite expensive, two new pieces of analysis have concluded that you indeed get what you pay for. Well, at least when it comes to drugs made specifically for breast cancer patients.

Both Aromasin and Herceptin have been proven in clinical trials to improve survival rates in breast cancer sufferers, according to this. In addition, newer breast cancer drugs just about to enter the pipeline (along with other cancer drugs) are raising questions from health officials and insurance companies, who are increasingly wanting to know how economically and clinically viable all these new products actually are.

Because, if newer cancer drugs are more expensive than traditional cancer treatments but are better for the medical and personal economies in the long run, then "you get what you pay for" will have been proven again.

Childhood cancer survivors see health problems later

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A report presented this week to the Journal of the American Medical Association has concluded that some young adults who have survived a childhood cancer malignancy end up having one severe health problem later in life.

The amount of kids that see a health problem in later life represented a minority of childhood cancer survivors, according to the report.

Additionally, the report gave insight into a certain segment of cancer survivors that had not been studied in-depth before, or had been studied without complete follow-up or other problems, lending them somewhat inaccurate. With this specific study, explained in detail here, a more representative picture was given and appropriate follow-up data was collected as well.

Axitinib may improve outcomes for metastatic breast cancer

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Axitinib is an agent that targets angiogenesis -- blood supply to a tumor. It disrupts blood vessels that grow and provide nutrients to cancer cells. Without the nutrients and oxygen supplied by blood vessels, cancer cells cannot grow or replicate.

Researchers conducted a trial to evaluate axitinib in the treatment of metastatic breast cancer. Patients were either given Taxotere or Taxotere plus axitinib. Anticancer responses were achieved in 40 percent of patients treated with the addition of axitinib to Taxotere, compared with only 23 percent of patients treated with Taxotere alone.

The researchers concluded -- that the addition of axitinib to Taxotere improves anticancer responses and delays cancer progression compared to Taxotere alone in the treatment of metastatic breast cancer.

Tuesday, 26 June 2007

Type 2 drug Byetta has one-sixth the hypoglycemia risk

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Is the injectable type 2 diabetes drug Byetta really 'byetter'? Where do they come up with these names? The drug-naming brainstorm team had an off day. But it appears Byetta does have real benefits.

Research indicates diabetics taking Byetta, combined with metformin, had one-sixth the chance of hypoglycemia compared to those taking insulin and metformin. Byetta-makers Amylin and Lilly released study results at the American Diabetes Association's annual conference.

The study tracked 114 diabetics over two 16-week periods. Diabetics taking Byetta/metformin realized a 2.6 percent chance of a hypoglycemia, while those on insulin/metformin had a 17.4 percent chance. Byetta-takers also lost an average of 5.7 pounds, while insulin-takers gained 1.3 pounds. A bonus, especially for type 2s.

Keep cynically in mind, the study was generated by Big Pharma. Amylin and Lilly split $430 million in Byetta sales last year. Jon LeCroy, an analyst for Natexis Bleichroeder, stated Byetta's lower risk of hypoglycemia and weight gain are already well-known by doctors. He does not believe this new study will increase sales.

The generic name for Byetta is exenatide, a synthetic hormone. In short, exenatide is part of a class of drugs called incretin mimetics, which mimic the effects of incretins. Here's a little chemistry for you -- incretins are hormones released into the blood by the intestines in response to food. One such incretin, GLP-1, lowers blood glucose by three mechanisms: increasing pancreatic insulin secretion, slowing absorption of glucose and reducing the action of glucagon. GLP-1 also acts as an appetite suppressant.

Byetta was approved by the Federal Drug Administration in May of 2005.

All about heart disease with AOL body

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Seeing as heart disease is--and has been for many, many years--the number one killer of adults in North America, we should be as educated as possible on the disease, symptoms, risk factors, etc.

Which is why I thought I'd share this link with you: AOL's heart disease page. It's got a plethora of information on everything from the number and facts, to the stories behind the disease. There are some great tool on there too, like the Heart Attack Risk Calculator, and a BMI calculator to determine if you're considered obese or not.

Your heart is so important -- you owe it yourself to take care of it.

Cancer-causing Aspartame under scrutiny once again

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To those knowledgeable about cancer causes, the role of fake (artificial) sweeteners in many beverages these days probably make you not want to drink anything but water. Personally, I banned all soft drinks many years ago regardless of the presence of real or fake sweeteners. It was very hard, yes -- but now after researching the role of Aspartame and other fake sweeteners in the role of cancer, I'll never go back.

Which brings us to the might and oddly bizarre FDA. That federal agency again has swept aside the growing evidence of the artificial sweetener Aspartame contributing to cancer. Another study was released this week that showed this connection, but health officials are making excuses once again.

Yes, there is the commercial interests at play here (like always) with the sweetener companies themselves, but with so much evidence that connects Aspartame with cancer, it's just amazing a ban has not come forward yet.

CA 19-9 can predict how a pancreatic cancer patient will do in the future

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CA 19-9, which has been used as an indicator of how far pancreatic cancer has progressed, can also be used to predict how well a pancreatic cancer patient will do after treatments such as surgery, radiation and chemotherapy, according to researchers from Jefferson University Hospital's Kimmel Center in Philadelphia.

Dr. Adam Berger and his team examined CA 19-9 levels in 385 patients with advanced pancreatic cancer who were treated with surgery and subsequent chemotherapy and radiation. The lower the level of CA 19-9, the longer the survival. After following the patients in the study for three years, the researchers discovered that 30 percent of patients with levels of 180 or under were still alive. According to Dr. Adam Berger, who led the study, "We think that it is a very sensitive predictor of response to chemotherapy and radiation after surgery."

If you or a loved one is facing a diagnosis of pancreatic cancer, you might want to ask your physician about the CA 19-9 level to gain further understanding of the disease's progression and possible response to treatments.

These findings were reported at the semi-annual meeting of the Radiation Therapy Oncology Group (RTOG) in Philadelphia on June 23, 2007.

Genetic placemarker signifies cancer aggressiveness

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The roles of personal lifestyle choices, exposure to the environment and genetics has always fascinated me as the three-legged stool that provides the overall environment for cancer to begin and grow. The specific role of genetics and possible genetic predispositions to certain types of cancer are just now becoming understood, and the prospects for learning more in this area are becoming quite interesting.

In fact, certain molecular "stages" have recently been found as a way to mark the development of cancer in general, which could give medical experts the ammunition to devise detections and treatments before cancer becomes more of a problem inside the human body.

In medical terms, the growing availability of being able to detect the presence (however small) of cancer cells way before they become a problem is one of the more promising areas of cancer research. Agree?

Childhood cancer: Choosing a hospital

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When researching children's hospitals and oncology programs, you should have a list of questions that are relevant to the child's cancer. The same questions should be asked at each hospital so you can compare answers and make an informed decision about where to seek treatment.

Some questions include:

  • What clinical trials are available?
  • What type of research is going on for this type of cancer?
  • What are the success rates?
  • How many of these type of cancer cases do you see each year?
  • Have you treated a child with this type of cancer?
  • What cancers do you specialize in?
  • Do you offer support groups?
  • Do you allow family-centered care which allows families to be part of the treatment plan?

Pediatric cancer care is much different than cancer treatments in adults, many parents decide to go to a children's hospital like St. Jude's for care. Whatever the choice, make sure that you are getting the best possible care for the child as you can. Since you are their voice and their advocate, you have to do what you can to make sure that you are giving them the best opportunity to fight and beat childhood cancer.

Signs of male breast cancer

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Each year more than 211,000 American women learn they have breast cancer. Breast cancer is the most common type of cancer among women in this country other than skin cancer. But breast cancer is not just a cancer that strikes women. Each year 1,700 men in this country will learn that they have breast cancer. About 500 men will die from the disease. So it is just as important for men to know the signs they might experience if developing breast cancer and act on them immediately with a visit to a doctor. It is important to know your body and to recognize changes that might be taking place.

Signs of Male Breast Cancer

1. Abnormal lumps or swelling in either the breast, nipple, or chest muscle
2. Skin dimpling or puckering
3. Nipple retraction (turning inward)
4. Redness or scaling of the nipple or breast skin
5. Nipple discharge

Snack food makers on the offensive

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Say you're in the snack food business. Your products are popular amongst kids and adults alike. You rely on an arsenal of creative marketing to keep the money rolling in. Also, although your snack products are - when you get down to basics - really just reconstituted corn and its byproducts, they involve some pretty high-tech manufacturing techniques. So when the profitability of those products is threatened, you'd fight like the Dickens to protect yourself, wouldn't you?

That's exactly what's going on now, as manufacturers like Coca-Cola, Hershey, Kraft, Kellogg and Frito-Lay tweak their product lineup a little. Juuust enough, mind you, to meet criticism that they are contributing to the so-called obesity epidemic - and it's terrible health complications including heart disease and Type 2 diabetes - through peddling their fat and sugar-saturated products. As this AP article details, the snack food industry changes represent an attempt to, firstly, capitalize on the growing consumer demand for "healthy" food choices and, second, to undermine their critics (including those in government) who accuse them of direct responsibility for the health crisis.

From Kellogg to McDonald's, big business execs are scrambling to protect their companies: their brand image, their profitability, their investments and, yes, their employees. No, this is not really about the health of the nation or anything lofty like that. It's about cynically protecting the bottom line. Yet, strangely, I feel no sense of outrage about this. Can you blame them for giving just a little instead of a lot? What's more, while fatty snacks may be contributing to an overall decline in public health, I'd argue it's a step too far to compare the manufacturers to, say, the tobacco industry. After all, Fritos may be a nutritionist's nightmare but there's no addiction factor here to muddy the ethical waters. Nevertheless, given what happened to Big Tobacco, the snack food industry is taking no chances.

Diabetes control has improved dramatically in U.S.

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My dad keeps track of his daily blood sugars and corresponding insulin usage on a spreadsheet. When he visits his doctor, he brings it along -- a self-generated report card of his blood glucose control. He has always been organized, down to the tools in the garage.

In 2001, only one-third of Americans with diabetes had their disease well-controlled. This was based on lab tests of 4 million type 1 and type 2 diabetics. Poor control silently damages blood vessels, which results in a host of problems such as limb loss, blindness and heart disease.

But diabetes management is improving. Quest Diagnostics Incorporated analyzed 22.7 million hemoglobin A1C lab tests of diabetics between 2001 and 2006. The A1C reveals whether a person's blood sugar has been steady or too high within recent weeks. Here is the good news -- overall diabetes control between 2001 and 2006 improved a whopping 44 percent. As a whole, the nearly 20.8 million Americans with diabetes are doing a better job.

Researchers also found the worst season for diabetes control is winter. Turkey Day and holiday parties don't help. Also, men have poorer control than women. Dr. Francine Kaufman, who analyzed the data, suggested men's poorer control could be due to getting ahead in the workplace and starting a family. I question that presumption as moms are working just as hard juggling full-time or part-time jobs AND often childrearing, too. Maybe women are simply more diligent in controlling their diabetes. I wonder if any research has tested this hypothesis.

HRT: Estrogen may help younger women's hearts

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Many women quit taking hormone replacement therapy (HRT) -- which was formerly the gold standard in treating menopause symptoms and preventing heart damage in women -- when a landmark study found that the medication actually increased the risk of heart attacks, stroke, and breast cancer. Since that time, researchers have spent time picking apart the study's results and have found something interesting: taking estrogen therapy may reduce the amount of hardening of the arteries in younger women.

Most of the women in the original study were in their 60s and 70s, so researchers took a closer look at women who joined the group while in their 50s. What they found was that when estrogen was given to women who had just entered menopause and whose natural estrogen levels hadn't yet dropped, the therapy was beneficial. But once a woman's body has been without estrogen for an extended period of time, adding HRT back in can be detrimental.

Because there are other risks involved when taking estrogen therapy, advice for menopausal women hasn't changed. Use HRT only as needed at the start of menopause to treat symptoms, and for the lowest dose and shortest period of time possible.

Why do the elderly delay seeking heart care?

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It seems the elderly, especially those living in rural areas, may be more likely NOT to seek out the medical care they need for heart problems (as well as other issues) due to their work ethic and unique set of values. Pride in being healthy and able to avoid medical treatment, an unwillingness to further "burden" an already strained health care system, and a general ethic of "stoicism" are all common themes. Sadly, many times by the time the elderly finally seek out the care they need much of the damage has already been done.

Thought for the Day: Sleeping pills

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Reaching for the first sleep aid you find when insomnia hits? Not all sleeping pills are the same. Each class of sleep aid works a bit differently from the other, and side effects vary.

It's important to ask key questions before choosing your sleep medicine.

  • How long does it take for the sleeping pill to take effect?
  • How long do the effects last?
  • What's the risk of becoming dependent on the sleeping pill, physically or psychologically?

All sleep medicines have the potential for causing dependence. In the large majority of cases, however, this is psychological dependence, not physical.

Talk with your doctor, and use this chart to help you decide which sleeping pill is right for you.

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GlaxoSmithKline to launch five new cancer drugs

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Five new cancer treatments are in the works and could be available for use as early as 2010, thanks to GlaxoSmithKline, PLC, the world's second largest drug company.

The drugs will treat a range of different cancers -- one will be cervical cancer -- and are known as cervarix, pazopanib, promacta, rezonic, and ofatumumab.

"Over the next three years, GSK will make a difference to millions of patients facing cancer," said Glaxo's head of research and development, Moncef Slaoui.

Glaxo's most recent cancer drug is Tykerb, an oral breast cancer treatment launched in March.

The dark side of The Secret

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In the top-selling book and DVD, The Secret, by Rhonda Byrne, Byrne proposes that individuals take control of their lives with the 'law of attraction'. According to a recent AP article, Byrne states, "The law of attraction says that like attracts like, and when you think and feel what you want to attract on the inside, the law will use people, circumstances and events to magnetize what you want to you, and magnetize you to it."

However, critics have gathered and some medical professionals say The Secret could lead to a blame-the-victim mentality.

In the AP article, one such critic is Dr. Gail Saltz, a psychiatrist in New York City. Dr. Saltz says she was especially troubled by a piece in the book about breast cancer, where a 'Secret' believer shares that her cancer was cured without any treatment by thinking positively and watching funny movies.

There is another dark side to this 'like attracts like' philosophy. If positive thoughts attract the positive, then negative thoughts attract the negative.In an interview with Newsweek back in March, Byrne was questioned about this flip side to The Secret. She was asked whether or not, according to the 'law of attraction', the victims of the massacre in Rwanda had brought on that tragedy with their own thoughts. Byrne responded, "The law of attraction is that each one of us is determining the frequency that we're on by what we're thinking and feeling ... If we are in fear, if we're feeling in our lives that we're victims and feeling powerless, then we are on a frequency of attracting those things to us ... totally unconsciously, totally innocently, totally all of those words that are so important."

I believe in thinking positively, taking control of your own future, taking action, making plans.

However, there is a physical reality that no amount of positive thinking can overcome. When positive thinking theories like The Secret turn into blaming the victim, whether an individual who is facing cancer or those who suffered in Rwanda, we must reject such theories unequivocally.

Protect yourself against hospital-acquired infection

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Recently, a relative of mine lost his wife to a hospital-acquired infection after a successful cancer surgery. She had been expected to make a full recovery from the cancer.

Such infections are on the rise. A recent media report states that a drug-resistant form of staphylococcus, methicillin-resistant staphylococcus (MRSA), may be infecting as many as 5 percent of hospital and nursing home patients. This rate is about ten times the rate previously estimated.

What can you do to protect yourself or a loved one during a hospital stay? Some tips include asking staff and visitors to wash their hands often and asking the doctor to wash any stethoscopes used. Before a surgery, be sure to ask your surgeon about the hospital's infection rate, about showering or bathing daily with chlorhexidine soap three to five days before the surgery and about the necessity of an antibiotic treatment an hour before the surgery.

My relative who suffered this tragic, unnecessary loss of his wife has started a non-profit organization to educate the public, ODEE PD Health Safety Initiative. From the ODEE educational materials, perhaps the most important piece of advice on how to protect ourselves, changing our attitude:

Protecting ourselves begins with changing our mindset. Maybe we are not accustomed to speaking up! Much as we are impressed by the care our doctors and hospitals can give us, we must not be timid about letting them know our concerns for safety in the hospital.

Today, more than ever, we need to speak up and speak out. We cannot accept the fact that deadly hospital infections exist and threaten our safety. We can be polite, but also must be very firm and persistent. We cannot be shy or feel funny about speaking up.

For more tips on how to protect you or a loved one against hospital-acquired infection, see HospitalInfections.org, Protecting Yourself.

Monday, 25 June 2007

Pregnancy with mildly elevated sugar carries risks

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I remember taking the glucose tolerance test during my pregnancies. With a strong family history of type 1 diabetes, I anxiously awaited my test results. Luckily, everything was fine.

Unfortunately, more pregnant women might receive a diagnosis of gestational diabetes in the future, as blood glucose criteria guidelines may widen. Last Friday, researchers at the American Diabetes Association's annual meeting in Chicago reported even moderately elevated glucose during pregnancy is associated with problems such as cesarean section and heavier babies. The study examined effects of less severe levels of blood sugar during pregnancy, not high enough to warrant a gestational diabetes diagnosis, but higher than ideal levels.

Boyd Metzger, principal investigator, explained the study tried to find where clinically significant effects occur on the spectrum of normal to abnormal glucose during pregnancy. Glucose levels were measured in 25,000 pregnant women from nine countries. Findings revealed women with the highest levels were six times more likely to birth an overweight baby and ten times more likely to have a baby with elevated blood insulin, compared to women in the lowest levels of glucose. Here's the kicker -- women ranging just below the current criteria for gestational diabetes still had a higher risk for problems. They were two to four times more likely to have newborns with high birth weight or elevated insulin levels.

Researchers acknowledge discussion is needed before criteria guidelines are revised, and the study begs more research over how pregnant women with mildly elevated sugar should be treated. Until then, pregnant women should be aware having an elevated sugar level not typically considered gestational diabetes is not a safe place for mom or baby. A more comprehensive article was published in yesterday's Chicago Tribune.

Could adult blood stem cells treat diabetes?

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Research findings emerging from the annual conference of the American Diabetes Association just keep on coming. This study caught my eye, especially in light of President Bush's recent veto (once again!) over lifting restrictions on federal funding for embryonic stem cell research.

Now here's one way to make an end run around the Bush roadblock. An early-stage mice study has shown adult blood may yield insulin-creating stem cells. Not only that, the adult blood could be a better source than the ethically-debated stem cells from fertilized eggs.

Dr. Zhao from University of Illinois extracted insulin-making stem cells from the blood of diabetic mice. The cells were then condensed into a solution. After injecting the solution back into the mice, normal blood-sugar levels were maintained for three months, no treatment required.

Dr. Zhao is planning to seek National Institutes of Health funding for human studies, which could take five years alone for the first phase. He would use adult blood and umbilical cord blood -- absolutely no embryonic stem cells from fertilized eggs -- so no federal funding issues. Interestingly, Dr. Zhao said 70 percent of adult blood stem cells possess insulin-making capacity compared to only 7 percent of embryonic stem cells.

On the treatment level, insulin-making stem cells extracted from the blood of a human diabetic would be injected back into the diabetic patient. Utilizing a patient's own blood reduces chances of rejection. This line of research is a dream right now, but clinical studies could make the dream a reality.

Pastry chef's syringe wins History Channel competition

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Among the best restaurants in Tallahassee, Florida, is Kool Beanz Cafe, where both the eats and the atmosphere are colorful, inventive and fun. That Kool Beanz inventiveness now extends to pastry chef Kim Bertron (pictured), whose design for a syringe won her first prize in the History Channel's "Invent Now Challenge" in March. Today's Tallahassee Democrat profiles Bertron and talks to her about her winning entry, the SimpleShot syringe.

The SimpleShot can be preloaded with both a drug, in powdered form, and a diluting solution. The two substances are stored in separate compartments of the syringe until a dose is required. Then the user needs only to press the plunger, piercing the membrane separating drug from solution and - presto! - it's ready to go. The device brilliantly eliminates the need to measure and load before a shot is given.

The idea came to Bertron after a horrific scare involving her young daughter, who has Type 1 diabetes. When her little one suffered a hypoglycemic episode, Bertron rushed to administer a glucagon injection but her trembling hands fumbled and the needle broke. Bertron ran to her car for her backup kit and her daughter was okay, but mom was severely shaken by the experience.

The invention was actually a team effort involving Bertron as well as two of her friends: mechanical engineer Brian Boothe and patent attorney Wiley Horton. However, it was Bertron who came up with the initial concept, understanding the need for a foolproof syringe; one that could administer drugs fast and with a low risk of dosage errors. Although designed for diabetics, the device could be used by the millions of people taking other reconstituted drugs - injectable powders that must be mixed with a diluting solution immediately before use.

Judges of the Invent Now Challenge included such figures as Apple co-founder Steve Wozniak, Time Magazine editor Jeremy Caplan, and New York Times technology editor David Pogue. Click here to read Pogue's blog, in which he praises the SimpleShot.

Quality of life sinks for diabetic retinopathy patients

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The American Diabetes Association's (ADA) 67th Scientific Sessions conference will draw to a close tomorrow. Among the latest presentations was a report on quality of life for people suffering from diabetic retinopathy. A recent Eli Lilly-funded study involving 684 patients concluded that diabetics with nonproliferative diabetic retinopathy who lose at least ten letters in visual acuity - the measurement used by eye specialists - suffer a notable decline in quality of life. Significance? Vision loss used to be defined as beginning at a loss of at least fifteen letters, but this study says even mild to moderate visual impairment impacts physical functioning. More details of the findings are reported on the website DocGuide.

An example of the insidiousness of diabetes-related health complications, diabetic retinopathy causes damage to blood vessels in the eye's retina. The disease harms vision, and can even lead to blindness. Basically what happens is this: as the disease progresses, blood vessels form on the retina that are particularly susceptible to breaking and bleeding into the eye. This is known as proliferative retinopathy. It obscures the vision and can also lead to the formation of scar tissue that can eventually lead to retinal detachment.

Health Tip: Sadly, you can't cure retinopathy once you have it. However, you can slow its progress by keeping blood sugar and blood pressure levels under control. Diabetics who have not been diagnosed should also know one important fact: diagnosis usually comes after damage has already occurred. It's therefore imperative that you get screened for the disease by an ophthalmologist or optometrist annually. View the ADA's full recommendations by clicking here.

U.S. rates hospitals heart care online

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As consumers, we compare the prices, efficiency, and reliability of many products before buying. Now it's possible to compare the quality of the hospital you use for your heart care needs. The U.S. government recently finished ranking U.S. hospitals based on their treatment of heart failure and heart attacks. The good news is that most of the 4,700 health centers met the national average for patient care, and you can now go online to see how hospitals in your area ranked.

The new website lists mortality rates for each hospital and how they compare to the national average. Besides ranking hospitals, U.S. Centers for Medicare & Medicaid Services -- the organization behind the project -- also offers programs to help hospitals who rank poorly improve the quality of their services.

The new service highlights a change in direction for Medicare. Michael Leavitt, Secretary of U.S. DHHS, says that the service is important "because for most of its history, Medicare has been paying for services, but not paying for results." Experts are hopeful that this will help patients find the hospital that best fits their needs and will give health care centers an extra "push" to improve their care. If you'd like to read more, Brian wrote about the online service over at our health and fitness blog, That's Fit.