The trial, conducted by ACRIN, or the American College of Radiology Imaging Network, headquartered at Brown University, involved statistical analysis of 2,809 women who had participated in 21 clinical trials in the United States, Canada, and Argentina.  All study participants were considered at substantial risk for developing breast cancer and were age 25 or older, had a family history of breast cancer, had dense breasts, and had already undergone a breast biopsy.

Jeffrey Blume, a biostatistician and the trial’s methodologist, led the research team.  Blume serves as deputy director of ACRIN’s Biostatistics and Data Management Center and is an associate professor of Brown’s Department of Community Health.  According to Blume, adding ultrasound screening does reveal more incidences of breast cancer but it also significantly increases the risk of a false positive reading, which leads to biopsies that would otherwise be unwarranted.

Analysis revealed that mammography alone detected breast cancer in 8 of every 1,000 women during the first year of study.  Twenty-five out of 1,000 women received a biopsy because of a false positive outcome.

When ultrasound was added to mammography screening, 12 out of every 1,000 study participants were found to have breast cancer but 93 of every 1,000 underwent biopsies after their screening resulted in a false positive reading.

Essentially, adding the ultrasound screening exposed 4 new cases of breast cancer for every 1,000 women but led to a four-fold increase in false positive readings, or 68 additional false positive results for every 1,000 women thus screened.  Even when both methods of screening are used, 20% (one in five) cases of breast cancer is missed.

The research team concludes that the benefits of additional screening are offset by the high number of false positive outcomes, suggesting the double screening should be reserved for only women who are found to be at high risk of developing the disease.

The May 13 issue of the Journal of the American Medical Association (JAMA) carries full details of the study’s findings.

The particulate matter in the air comes from the burning of fossil fuels and other means of air pollution associated with modern-day living and particles smaller than 10 micrometers are linked to the development of deep vein thrombosis, as well as to the risk of cardiovascular disease and death. The longer the exposure or more intense the pollution, the higher the likelihood of developing the condition.

A Harvard School of Public Health team of researchers in Boston used data from Lombardy, Italy, to assess the link between deep vein thrombosis and common air pollution. The team reviewed records dating from 1995 to 2005 covering 870 patients with deep vein thrombosis and a control group of 1,210 who had been examined for deep vein thrombosis but who didn’t have the condition.

In addition to medical records and personal data, the group incorporated data from 53 different air-quality monitoring sites throughout the Lombardy region to assess exposure levels during the year before diagnosis or exam.

The research team, led by Harvard’s Andrea Baccarelli, MD, PhD, found that every increase of 10 micrograms per square meter of particulate air pollution generated an increase in the risk of developing deep vein thrombosis by 70%.

An additional finding of the study was that exposure to particulate air pollution led to faster clotting time in the study participants’ blood. Clotting time was tested during visits to healthcare facilities. The men in the study seemed to be the most adversely affected by the air pollution, as measured by both the incidence of deep vein thrombosis and accelerated clotting time.

Women in the study enjoyed less risk of developing either condition unless they were undergoing hormone therapy or taking oral contraceptives, both of which are known to affect clotting. When using either hormone treatment, the risk of the women developing deep vein thrombosis and of accelerated clotting closely matched that of the men.

People in general have come to accept air pollution as an annoying but expected by-product of modern life but the true health consequences are still being discovered. Exposure to particulate matter in the air is the number 13 cause of death globally, killing almost 800,000 people each year.

The findings of the Harvard study can be found in the May 12 issue of JAMA and Archives Journals. Funding for the study was provided by the Environmental Protection Agency’s Particulate Matter Center, the National Institute of Environmental Health Sciences, the MIUR Internationalization Program, the CARIPLO Foundation, and the Lombardy region.

When 136 women who have rheumatoid arthritis were compared with 544 women the same age but who do not have RA, it was found that the women who had breast fed a child were less likely to have the disease.  Those who breast fed the longest, 13 months or more, enjoyed a rate of risk for rheumatoid arthritis about half that of women who had not ever breast fed.  Breast feeding for a shorter duration, one month to a year, reduced risk by about 25%.

Breast feeding was compared to taking oral contraceptives, which contain the hormones associated with pregnancy, but there was no similar benefit found in taking the oral contraceptives.

Over the past 30 years, the number of women choosing to breast feed has grown dramatically.  The research team reports that it is difficult to conclusively link breast feeding to a reduced risk for rheumatoid arthritis but the research strengthens the growing body of evidence that breast feeding is beneficial to the baby and, quite possibly, to the mother, too.

Source: BMJ

Central Michigan University graduate student LeAnne Forquer had concerns over her own erratic sleeping habits and turned to her psychology professor, Carl Johnson, to conduct a study of the sleep habits of more than 300 students, from college freshmen to graduate students like herself.  Three sleep-related issues were of particular concern - taking 30 minutes or longer to fall asleep, waking more than once a night for five or more nights per week, and consistent bed- and wake times throughout the week, including weekends.

Forquer, who is now a member of the faculty of the psychology department at Delta State University in Cleveland, Mississippi, published the findings of her study in the Journal of American College Health.  Her findings reveal that about a third of all college students report taking more than 30 minutes to fall asleep and 43% routinely wake up more than once during a night.  Staying awake later and sleeping in longer on weekends is an almost universal practice among college students although it disrupts the body’s circadian rhythm, a 24-hour sleep-wake cycle that governs optimum quality of sleep and daytime performance.

Sleep studies indicate college students are some of the most sleep-deprived Americans even though lack of quality sleep time reduces academic performance and makes it harder to maintain attention.  Driving skills are impaired due to lack of sleep, too, leading to excessive accidents for people of this age group.  Depression and behavioral issues are also associated with sleep deprivation.

Forquer feels so strongly that students could benefit from better sleeping habits during college years that she includes it in the introductory psychology course she teaches at Delta State.

OK, so it may not be any of those things but it does keep my metabolism high through the day. I feel a lot more energetic, and less likely to procrastinate. By now you’re probably tired of hearing me talk about my day, and want to know what I do! Well, it’s pretty simple. When I wake up, I try my best to hop on the treadmill right after I wake up. I roll over, through my cell phone against the wall for waking me up, then smack my alarm clock which goes off about 30 seconds later … and by now, I’m out of bed good and mad.

I grab my water from the fridge, throw back some green tea caps, ALRI Venom, and some cayenne pepper extract and hit the treadmill. I’m a firm believer in low-impact, high-intensity cardio. I crank the incline all the way up (15% grade on mine), and walk at a brisk pace. I worked up .1 mph every day until I was at a comfortable pace (which is 4.5mph for me, any faster and I feel like I’m jogging), and do this for at least 45 minutes.

I’ll be writing more on the topic, but the basic theory behind this is that the body takes about 20 minutes to burn it’s first-supply of glycogen (sugar). This comes from the liver, after that has been used, the body starts converting fat into energy. This is what sheds the pounds, and takes the waistline down. When you do this right after waking up, on an empty stomach, the body will skip right past the liver (as it used that energy to sustain life while sleeping) and start converting fat stores.

If I happened to lose you through that, I’m sorry. Basically … your body starts burning fat FASTER when you do cardio after waking up and on an empty stomach, then it would if you hopped on the treadmill after having even a simple meal! Aim for more than 30 minutes to really make your cardio session effective, and work at a brisk comfortable pace.

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This is a post from FatManUnleashed.com’s Weight Loss Blog:

Wake Up to the Treadmill!

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Finnish men who smoked more than five cigarettes a day were enrolled in the study after providing complete dietary information, and included 26,566 participants, aged 50 to 69 years The average follow up time was 13.6 years. The men who consumed at least 589 mg/day of dietary magnesium daily were found to have a significantly lower risk of ischemic stroke than those who consumed the average amount of 373 mg/day.

To clarify further, strokes are caused either by ischemia (lack of blood flow), or hemorrhage. This study, led by Susanna C. Larsson, PhD, at the Karolinska Institute in Stockholm, Sweden, found that magnesium intake did not influence the incidence of strokes cause by hemorrhage. Dr. Larsson writes: “An inverse association between magnesium intake and cerebral infarction is biologically plausible. In addition to lowering blood pressure, magnesium may influence cholesterol concentration or the body’s use of insulin to turn glucose into energy. Either of these mechanisms would affect the risk for cerebral infarction but not hemorrhage.”

It’s important to recognize the role that nutrient rich foods have on our overall health. Foods that are rich in magnesium include black beans, whole grain cereals, spinach and whole wheat bread.

Food sources of magnesium
• Cashews, dry roasted, 1 oz: 73 mg.
• 1 Cup cooked spinach: 157 mg
• Baked potato with skin, medium sized: 55mg.
• Medium sized banana: 34 mg.
• 100 percent Bran, 1 oz: 134 mg.
• Roasted almonds, 1 oz: 86 mg.
• 1 Cup black beans: 120 mg.
• 1 Cup raw broccoli: 22 mg.

Make an effort to stop smoking, of course, but if you’ve tried and are still struggling, consider the results of this study and increase your dietary intake of magnesium. Better health is a fine goal for today. We’ll deal with tomorrow in about 24 hours, okay?

Ref: Arch Intern Med. 2008;168:459-465.

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Posted by Kathleen, RN

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The contraceptive, synthetic progestin medroxyprogesterone acetate (MPA), is a component of Depo/Provera, an injectable contraceptive favored by millions of young women for its long-lasting effect.  It is estimated that 80% of American women have used oral contraceptives at some point in their lives.

Other women use MPA in the form of Provera, where it is the active ingredient, to relieve menopausal discomfort, regulate menstrual cycles, and treat abnormal uterine bleeding.  MPA is the drug used in the discontinued hormone replacement therapy (HRT) study, the Women’s Health Initiative.  The study was discontinued due to concerns over the cardiovascular consequences of the HRT.

The current study, conducted at the Exercise and Environmental Physiology Laboratories of the University of Oregon, studied the effects on 14 women, aged 19 to 27, using estradiol, a form of estrogen, and an oral contraceptive that also includes MPA.

The estradiol alone was found to improve the function of the endothelial tissue in the brachial artery of the arm.  Endothelial tissue is vital to the flexibility of the arterial walls, allowing them to expand and contract as needed for optimum blood circulation.  Impaired function of the endothelium is an indicator of atherosclerosis, a form of cardiovascular disease.

When the MPV was taken, the positive effects of estradiol were reversed and endothelial function suffered.  Function was assessed by measuring levels of a peptide, endothelin-1, which promotes cellular division and helps to ease inflammation.  The estradiol lowered the peptide levels in study participants but it increased by a substantial measure when MPA was added.

While leading researchers to question a link between oral contraceptive use and the increasing rate of cardiovascular disease in women, they are quick to point out that this study is merely the starting point of extensive research to follow and that no changes to current contraceptive practices should be made at this time, according to Dr. Paul F. Kaplan, co-author of the report describing the study results.

The full details of the report are available online and will be published in the regular edition of the journal, Heart and Circulatory Physiology.

Source: University of Oregon

Anyone who has cared for a family member with dementia is well aware of the challenges. Oftentime, cognitive decline results in the need to place a family member within an institution, as management problems with behaviors escalate. Behavioral problems are very distressing when you’re caring for a loved one.

Using non medical approaches to help someone remain at home has many advantages. There are no side effects, and alternative approaches to care often address a more specific patient need, such as sensory deprivation.

Therapeutic touch and aromatherapy may provide a solution. Hand massage can be very calming. Music and pet therapy may cure boredom that can lead to periods of agitation and aggression.

The presence of a therapy dog for 30 minutes on two occasions during sundown hours reduced the number of agitated behaviors in 28 older adults with dementia in another study.

Multisensory stimulation provokes the senses of sight, hearing, touch, taste, and smell - through the use of effects such as meditative music, lighting, tactile surfaces, and aroma. Examples include moving shapes beamed around the room, bubble tubes, fiber-optic sprays, music, and aromatherapy oil diffusers. Studies have shown that these interventions can provide calm, though the effects were not long lasting, and took four weeks to see the effects.

Hand massage has also been studied, and showed that physical aggression can be calmed with the use of slow stroke hand massage. In the study, verbal aggression was not decreased, but physical signs of agitation responded well to hand massage.

Aromatherapy, using lavender oil, was placed in a resident facility, and diffused for a two hour period. There was a sixty percent “modest” improvement in agitated behavior among the residents when compared to placebo(water).

The use of Melissa oil showed a 60% decrease in agitation when it was applied to the face and arms of a group of severely demented, agitated patients. Melissa oil was compared with sunflower oil, and found to be more effective.

These studies are encouraging, and provide insight on how to help manage a loved one when trying to care for them in the home or in a healthcare setting. No one thing will work for each individual. Perhaps combinations of therapies are worth exploring.

You can search for Melissa oil online. It is expensive, but is said to decrease respirations, and slow heart rate. It has a distinctive lemon scent. Aromatherapy diffusers, calming music, as well as natural lighting may also beneficial. You can purchase pure lavender oil from any natural health store and there are many online merchants from which to choose.

Source: Geriatrics Aging. 2005; 8(4):26-30. ©2005 1453987 Ontario, Ltd.

Posted by Kathleen, RN

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A recent study looked at the Mexican diet, since Hispanic women have a lower incidence of breast cancer than white non-Hispanic women. It was found that those who consumed a native Mexican diet(right), or a Mediterranean diet(below), had a significantly lower risk of developing breast cancer than those who chose to partake of the traditional western diet.

Last year, a study looked at women who consumed a typical “soy-vegetable” Chinese diet, versus the western diet. Those women who switched over to a western diet had a 60% increased risk of developing breast cancer.

Sadly, countries such as China in the above study, that are adopting our “meat-sweet” western diet, are also beginning to experience our high breast cancer incidence as well.

Action point: Lowering the risk of breast cancer can be fun with this knowledge. Go to your library, bookstore, or online, to find ethnic recipes that look enticing.

For further information on cancer prevention, visit http://www.avoidcancernow.com

Posted by Lynne Eldridge, MD

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