Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

GlaxoSmithKline wins U.S. approval for new flu vaccine






(Reuters) – U.S. health regulators have approved a new four-strain seasonal influenza vaccine made by GlaxoSmithKline Plc, the company said on Monday.


The U.S. Food and Drug Administration has approved Fluarix Quadrivalent to immunize children age 3 and older and adults against flu virus subtypes A and B contained in the vaccine.






It is the first intramuscular vaccine to protect against four influenza strains. Three-strain flu vaccines currently administered help protect against the two most common A virus strains and the B strain expected to be predominant in a given year, the company said.


Since 2000, however, two B virus strains have circulated to varying degrees each season, meaning patients infected with the B virus not contained in the vaccine were not immunized.


Fluarix Quadrivalent helps protect against the two A strains and adds coverage against a second B strain, the company said.


Three-strain vaccines “have helped protect millions of people against flu, but in six of the last 11 flu seasons, the predominant circulating influenza B strain was not the strain that public health authorities selected,” said Dr. Leonard Friedland, head of clinical development and medical affairs for Glaxo’s North American vaccines program.


“Fluarix Quadrivalent will help protect individuals against both B strains and from a public-health standpoint, can help decrease the burden of disease.”


Glaxo said it will make the vaccine available in time for the 2013-14 flu season and plans to fulfill orders for its trivalent, or three-strain, vaccines. Healthcare providers traditionally order flu vaccines about a year in advance of each flu season.


Fluarix Quadrivalent is not currently approved or licensed in any country outside of the United States.


(Reporting By Toni Clarke; Editing by Maureen Bavdek)


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Boehner opens door to tax hikes, shifts U.S. fiscal cliff talks






WASHINGTON (Reuters) – U.S. House of Representatives Speaker John Boehner‘s offer to accept a tax rate increase for the wealthiest Americans knocks down a key Republican road block to a deal resolving the year-end “fiscal cliff.”


The question now boils down to what President Barack Obama offers in return. Such major questions, still unanswered so close to the end of the year suggest, however, that no spending and tax agreement is imminent.






A source familiar with the Obama-Boehner talks confirmed that Boehner proposed extending low tax rates for everyone who has less than $ 1 million in net annual income, meaning tax rates would rise on all above that line.


Under current law, the 35 percent top tax rate is scheduled to expire on January 1, and would automatically go to 39.6 percent. Boehner’s proposal would allow that rate to rise as scheduled at a threshold of $ 1 million – putting it back to where it was during the Clinton administration.


The White House has not accepted the proposal and the source could not confirm any additional talks were held on Sunday between Obama and Boehner.


With just over two weeks before the fiscal cliff’s $ 600 billion in automatic tax hikes and spending cuts are triggered, threatening a new recession, there is little time to craft a comprehensive deal that will satisfy both Democrats and Republicans.


Until the latest Republican offer, made on Friday, Boehner had insisted on extending all of the Bush era’s lower tax rates, resisting Obama’s demand to let the marginal rates rise on income above $ 250,000. A rising chorus of business executives also had urged Republicans to agree to this.


Some lawmakers and congressional aides had predicted that Republicans, once serious negotiations began, might try to raise the $ 250,000 threshold, say to $ 500,000 or $ 1 million. They also speculated that Republicans, if forced into a tax rate hike on the upper-income groups, might seek a smaller increase, say to around 37 percent.


Although the White House has not accepted Boehner’s gambit, it could push negotiations away from entrenched, ideological positions.


“Boehner has now accepted the premise of higher rates. So now we’re just arguing over details. I think it’s a significant step,” said Greg Valliere, chief political strategist at Potomac Research Group.


A framework deal spelling out tax revenue and spending cut targets to be finalized in the new year could be possible, Valliere said.


“Boehner’s offer to allow tax rates to go up for taxpayers earning over $ 1 million fundamentally transforms fiscal cliff negotiations,” added Sean West, U.S. policy analyst at Eurasia Group, a political risk consultancy.


In a note to clients, West wrote that it signals, significantly, that Boehner ultimately believes a deal to avoid the cliff is still possible.


“The political burden is now shifted back to the president, who must be willing to take on his party in order to get a deal Boehner can ultimately pass. We do not think the president will overreach: Obama will work with Boehner to get to a deal.”


There are still several critical elements to a deal besides a tax rate increase on the wealthy, including Republican demands to cut spending on social programs.


Changes to the expensive Medicare and Medicaid health care programs for the elderly and the poor could be central to any deal, which must also include an increase in the federal debt limit needed by the end of February.


DEMANDS SOCIAL PROGRAM CUTS


Boehner conditioned his tax rate increase offer on Obama’s agreement to cuts in social program spending, often called entitlements.


Many Republican lawmakers want to raise the eligibility age for Medicare to 67 from 65. They also want to link Medicare to the income of recipients, making wealthier retirees pay more for their care.


Currently, Medicare does have some means testing, charging higher premiums for coverage of doctors visits and prescription drugs to individuals earning more than $ 85,000 and married couples earning more than $ 170,000. Only about 5 percent of recipients pay these higher premiums.


Thus far, Obama has offered only about $ 400 billion in 10-year entitlement savings, mostly through small adjustments in reining in health care costs – not fundamental changes such as raising the eligibility age.


And just as Boehner faces opposition in his own party to raising any tax rates, Obama faces opposition to cuts to Medicare, Medicaid and Social Security from Democrats, who pledged in election campaigns they would protect these programs.


A major bloc of congressional Democrats has already signaled they will not accept major cutbacks in Medicare as part of any fiscal cliff deal.


House Minority Leader Nancy Pelosi of California and Maryland Representative Chris Van Hollen of Maryland are among the high ranking Democrats in the House who have come out forcefully in recent days against raising the age for eligibility for Medicare to 67 years of age.


“Given the level of savings that is being talked about from Medicare, you can’t get it all from providers and drug makers,” said Paul Heldman, an analyst at Potomac Research, which tracks Washington policy for investors.


“So opponents of raising the eligibility age have reason to believe beneficiaries will take some sort of hit if a mega-deal is cut,” he said.


If Republicans are not successful in securing entitlement program cuts in exchange for a tax-rate increase on the wealthy, they are adamant about using a debt-limit increase as leverage to overhaul Social Security and Medicare.


The U.S. Treasury expects to reach its $ 16.4 trillion statutory debt cap by year-end, and will exhaust its remaining borrowing capacity around mid-February, risking a potential default.


Louisiana Republican Representative John Fleming, a member of the conservative Tea Party caucus who has never voted to increase the debt ceiling, said he would support a debt limit hike if it were part of a deal to make Medicare and Social Security sustainable.


The pace of activity could pick up the coming week.


House Republicans were told to prepare for a possible weekend session next week, potentially interrupting travel plans for the long Christmas holiday weekend.


House Majority Leader Eric Cantor scheduled “possible legislation related to expiring provisions of law,” a reference to the expiring tax cuts, for the end of the week, portending a weekend session. Cantor has said the House would meet through the Christmas holidays and beyond.


(This story was fixed to correct current top tax rate to 35 percent from 36 percent)


(Additional reporting by Thomas Ferraro, Richard Cowan and Kim Dixon; Editing by Fred Barbash, Todd Eastham and Jackie Frank)


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Clinton sustains concussion; Benghazi testimony postponed






WASHINGTON (Reuters) – Secretary of State Hillary Clinton, who canceled an overseas trip last weekend because of illness, suffered a concussion after fainting due to dehydration, prompting the postponement of her scheduled congressional testimony on the attack on a U.S. mission in Libya, officials said on Saturday.


“While suffering from a stomach virus, Secretary Clinton became dehydrated and fainted, sustaining a concussion,” State Department spokesman Philippe Reines said in a statement.






“She has been recovering at home and will continue to be monitored regularly by her doctors,” Reines said, adding that she would work from home and stay in regular contact with other top officials.


Clinton, 65, fell ill with a stomach virus last weekend and was forced to cancel a planned trip to the Middle East and North Africa. The virus also hit other members of her staff, who were returning with her from a European trip, and was described as uncomfortable, but not medically serious.


Clinton’s doctors, Lisa Bardack of the Mt. Kisco Medical Group and Gigi El-Bayoumi of George Washington University, issued a statement saying that Clinton fainted as a result of “extreme dehydration” due to the virus.


“Over the course of this week we evaluated her and ultimately determined she had also sustained a concussion,” the doctors said in their statement, which was distributed by the State Department.


“We recommended that the secretary continue to rest and avoid any strenuous activity, and strongly advised her to cancel all work events for the coming week. We will continue to monitor her progress as she makes a full recovery.”


Clinton has often been cited as a potential Democratic candidate for the U.S. presidency in 2016 and frequently refers to her general good health. She said in an interview with ABC broadcast on Wednesday that she has “incredible stamina and energy.”


She has maintained a punishing schedule in her final weeks as the top U.S. diplomat, a position she intends to leave toward the end of January when U.S. President Barack Obama is sworn in for a second term.


Obama telephoned Clinton to wish her well, White House spokesman Tommy Vietor said.


BENGHAZI TESTIMONY NEXT WEEK


Clinton had been expected to testify on December 20 before the House of Representatives and Senate foreign affairs committees on a report on the deadly attack on the U.S. diplomatic post in Benghazi, Libya, in September that killed the U.S. ambassador and three other Americans and raised questions about security at far-flung posts.


Jodi Seth, a spokeswoman for Senate Foreign Relations Committee head John Kerry, said that given her condition, Clinton’s testimony would be postponed, but did not say until when. Seth said the planned hearings would be held with other senior officials appearing in Clinton’s place.


The Republican chair of the House of Representatives Foreign Affairs Committee, Ileana Ros-Lehtinen, issued a statement saying she was sorry to hear of Clinton’s ill health, but it was “unfortunate” she would be unable to testify before the committee next week.


“We still don’t have information from the Obama Administration on what went so tragically wrong in Benghazi that resulted in the deaths of four patriotic Americans,” Ros-Lehtinen said.


“We have been combing through classified and unclassified documents and have tough questions about State Department threat assessments and decision-making on Benghazi. This requires a public appearance by the Secretary of State herself.”


Ros-Lehtinen’s statement said William Burns and Thomas Nides, deputy secretaries of state, would provide testimony in Clinton’s place.


REPUBLICAN CRITICISM


Republicans have criticized the Democratic Obama administration for its early public explanations of the attack.


Much of the criticism focused on U.S. Ambassador to the United Nations Susan Rice, who on Thursday said she was withdrawing her name from consideration to replace Clinton as secretary of state to avoid a potentially disruptive confirmation process.


Clinton has appointed a special panel known as an accountability review board to assess both the Benghazi incident and the official response to it.


The board’s report, which will contain both classified and unclassified sections, is expected to be complete next week and Clinton has promised to be as transparent as possible with Congress in sharing its findings.


Clinton, whose husband, Bill Clinton, was president from 1993 to 2001 and who herself came tantalizingly close to winning the Democratic presidential nomination four years ago, has used her star power to promote U.S. interests around the world since Obama named her to lead the State Department in 2009.


She has consistently been rated as the most popular member of Obama’s Cabinet, leading to speculation she might mount another White House bid in 2016, although she herself has played down suggestions that she still hopes to become president.


“I’ve said I really don’t believe that that’s something I will do again. I am so grateful I had the experience of doing it before,” Clinton told ABC’s Barbara Walters in the interview broadcast on Wednesday.


“I just want to see what else is out there. I’ve been doing … this incredibly important and … satisfying work here in Washington, as I say, for 20 years. I want to get out and spend some time looking at what else I can do to contribute.”


(Reporting by Andrew Quinn and Lisa Lambert; Editing by Will Dunham, David Brunnstrom and Mohammad Zargham)


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Colorado Medical Provider Convicted of Medicaid Theft






Colorado Attorney General John Suthers announced today that an occupational therapist from Castle Rock has been convicted of stealing from the state’s Medicaid program. Here are the details.


* The Medicaid Fraud Control Unit of the Office of the Attorney General initiated an investigation of Cheryl Moss, a 47-year-old occupational therapist, following a citizen complaint alleging that she had improperly billed the Medicaid program.






* The investigation revealed 83 forged treatment records that were meant to support fraudulent bills to the Colorado Medicaid Program, the Attorney General’s Office reported.


* Medicaid paid Moss for services she never rendered, based on forged invoices for payment that were submitted between November 2009 and August 2011.


* Moss pleaded guilty to one count of felony theft and one count of felony forgery. She has been ordered to repay the Colorado Medicaid Program $ 54,332 in criminal restitution and will serve 60 days in-home detention and 300 hours of community service. She will pay all fees and court costs resulting from the case, the Attorney General’s Office stated.


* In addition, Moss has agreed to pay the Medicaid program $ 46,000 in order to resolve any potential civil issues and is required to report her conviction to the Colorado Department of Regulatory Agencies, which is the state department responsible for licensing occupational therapists.


* The Colorado Medicaid Fraud Control Unit consists of criminal investigators, an auditor, a nurse investigator and prosecutors experienced in criminal and financial investigations.


* The Colorado Department of Regulatory Agencies reported that, as of fiscal year 2010-11, there were 2,497 registered occupational therapists statewide.


* Occupational therapy, as defined by the Colorado legislature, is the therapeutic use of everyday life activities with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community and other settings, the Department of Regulatory Agencies stated. Occupational therapists work with clients who may be mentally, physically, developmentally or emotionally impaired and occupational therapists help those individuals to develop, recover or maintain daily living and work skills.


* According to a report by Colorado Health Institute, around 65-70 percent of the licensed medical providers in Colorado accept Medicaid. Analysis from the institute found that Medicaid expansion authorized by the Affordable Care Act will create the need for an additional 83 to 141 primary care providers to care for the newly insured.


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Study: People worldwide living longer, but sicker






LONDON (AP) — Nearly everywhere around the world, people are living longer and fewer children are dying. But increasingly, people are grappling with the diseases and disabilities of modern life, according to the most expansive global look so far at life expectancy and the biggest health threats.


The last comprehensive study was in 1990 and the top health problem then was the death of children under 5 — more than 10 million each year. Since then, campaigns to vaccinate kids against diseases like polio and measles have reduced the number of children dying to about 7 million.






Malnutrition was once the main health threat for children. Now, everywhere except Africa, they are much more likely to overeat than to starve.


With more children surviving, chronic illnesses and disabilities that strike later in life are taking a bigger toll, the research said. High blood pressure has become the leading health risk worldwide, followed by smoking and alcohol.


“The biggest contributor to the global health burden isn’t premature (deaths), but chronic diseases, injuries, mental health conditions and all the bone and joint diseases,” said one of the study leaders, Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington.


In developed countries, such conditions now account for more than half of the health problems, fueled by an aging population. While life expectancy is climbing nearly everywhere, so too are the number of years people will live with things like vision or hearing loss and mental health issues like depression.


The research appears in seven papers published online Thursday by the journal Lancet. More than 480 researchers in 50 countries gathered data up to 2010 from surveys, censuses and past studies. They used statistical modeling to fill in the gaps for countries with little information. The series was mainly paid for by the Bill & Melinda Gates Foundation.


As in 1990, Japan topped the life expectancy list in 2010, with 79 for men and 86 for women. In the U.S. that year, life expectancy for men was 76 and for women, 81.


The research found wide variations in what’s killing people around the world. Some of the most striking findings highlighted by the researchers: — Homicide is the No. 3 killer of men in Latin America; it ranks 20th worldwide. In the U.S., it is the 21st cause of death in men, and in Western Europe, 57th.


— While suicide ranks globally as the 21st leading killer, it is as high as the ninth top cause of death in women across Asia’s “suicide belt,” from India to China. Suicide ranks 14th in North America and 15th in Western Europe.


— In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths versus 1 death per 100,000).


— Central and Southeast Asia have the highest rates of fatal stroke in young adults at about 15 cases per 100,000 deaths. In North America, the rate is about 3 per 100,000.


Globally, heart disease and stroke remain the top killers. Reflecting an older population, lung cancer moved to the 5th cause of death globally, while other cancers including those of the liver, stomach and colon are also in the top 20. AIDS jumped from the 35th cause of death in 1990 to the sixth leading cause two decades later.


While chronic diseases are killing more people nearly everywhere, the overall trend is the opposite in Africa, where illnesses like AIDS, malaria and tuberculosis are still major threats. And experts warn again shifting too much of the focus away from those ailments.


“It’s the nature of infectious disease epidemics that if you turn away from them, they will crop right back up,” said Jennifer Cohn, a medical coordinator at Doctors Without Borders.


Still, she acknowledged the need to address the surge of other health problems across Africa. Cohn said the agency was considering ways to treat things like heart disease and diabetes. “The way we treat HIV could be a good model for chronic care,” she said.


Others said more concrete information is needed before making any big changes to public health policies.


“We have to take this data with some grains of salt,” said Sandy Cairncross, an epidemiologist at the London School of Hygiene and Tropical Medicine.


He said the information in some of the Lancet research was too thin and didn’t fully consider all the relevant health risk factors.


“We’re getting a better picture, but it’s still incomplete,” he said.


___


Online:


www.lancet.com


http://healthmetricsandevaluation.org


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Advancing the Promise of Personalized Medicine: Companion Diagnostics






When I was a sophomore in college, my mother unfortunately lost her very short battle with pancreatic cancer, an experience that changed my life forever. During that time I witnessed firsthand the devastating effects caused by the administration of toxic, non-specific treatments which ultimately failed to stop the spread of the cancer, and instead only made my mother extremely sick. Her death, at the young age of 44, profoundly influenced my feelings towards medicine and altered my career path. As a result, I became driven to discover better drugs for treating cancer, with a focus to specifically target diseased cells while leaving healthy tissues unharmed.Thankfully, my passion for developing smarter cancer drugs is shared by many others, and it has been exciting to see the progress made over the years in developing treatments that can be characterized as “personalized medicines”. A commonly cited example that demonstrates the impact of personalized medicine in cancer is the successful development of the breast cancer drug, Herceptin(R), which specifically targets aggressive HER2-positive breast cancer. Importantly, before this medication was developed, women with HER2-expressing breast cancer were less responsive to standard treatments. Now, however, treatment with Herceptin in combination with chemotherapy has amazingly been shown to reduce the recurrence rate of this type of cancer by 52 percent.Building on Biomarkers: Companion DiagnosticsA biomarker is a unique trait of a disease, such as genetic marker or overexpressed protein like HER2. Developing a medicine that targets a specific biomarker can have a positive effect on patient outcome, but this approach is only one part of the therapeutic equation. To truly fulfill the promise of personalized medicine, there must also be a tool available for identifying those patients bearing that biomarker. An agent of this type is called a companion diagnostic. The outcome of this type of test should enable the right drug to be administered, to the right person, at the right time. In this manner, a companion diagnostic helps to identify those patients that may benefit from a given targeted treatment while at the same time identifying patients that will likely not benefit from therapy. Related to the example above, such a test is available to determine if a patient has HER2-positive breast cancer, and it is performed before Herceptin is prescribed.Recently, due to the benefits realized from biomarker testing, interest in developing companion diagnostics has surged. The FDA is very supportive of the development of these patient-selective tests. In fact, one companion diagnostic was approved this year and two within the same month last year to accompany Pfizer’s targeted drug for lung cancer, Xalkori(R), and Roche’s personalized therapeutic for melanoma, Zelboraf(R). Importantly, Roche stated that it aims to have 60 percent of its drugs in development to be accompanied by some form of a companion test, an indication that, like the FDA, the pharmaceutical industry is also embracing the continued development of companion diagnostic agents.There are many reasons for the significant interest in this space that stem from the benefits of identifying patients with companion diagnostics. For example, in the area of cancer, where development of these agents is most advanced, significant delay of tumor growth and increased survival rates have been demonstrated in patients that were preselected using a companion diagnostic. Having the ability to determine whether a patient may or may not respond to a given treatment enables the selection of the best medicine for that individual, without wasting precious time with trial and error approaches.It is precisely this advantage that allows clinical trials to be conducted in a specific patient population, which can decrease the size and related cost of these studies. Lower costs may allow drug developers to use such savings to invest in additional areas of disease research. Furthermore, smaller clinical trial size means that studies can be conducted more quickly, which could accelerate the arrival of these treatments to the market and broaden access to patients. Collectively, these conserved resources translate into savings for the entire healthcare system, which is an important benefit as rising healthcare costs are a significant issue for our nation.It is worth noting that a recent paper published in the New England Journal of Medicine showed that the genetic characteristics of a tumor, such as biomarker expression, can and often do change over time. Thus, in contrast to conventional companion diagnostics that typically utilize tissue samples obtained through biopsy (especially those performed on archived tissue), additional benefits are found with the use of companion diagnostics that are based on whole-body imaging. Results obtained from non-invasive, real-time imaging methodology, therefore, provide the most up-to-date biomarker information possible to inform treatment decision making. But, regardless of the method employed, the impact of patient selection can be substantial.A New ApproachAt Endocyte, we have seen this patient-selective approach translate into positive clinical results. The technology we’re developing consists of targeted therapeutics called small molecule drug conjugates, or SMDCs. Each of these novel compounds consists of a high affinity, cell-specific targeting molecule (the ligand) that is chemically linked to a potent chemotherapy drug. This yields a highly potent, yet selective therapeutic agent; but, this approach also allows us to easily create a companion diagnostic by simply replacing the chemotherapeutic drug in the SMDC construct with an imaging agent.Vintafolide is our most advanced SMDC in development. This therapeutic binds to the folate receptor, which is a confirmed biomarker expressed on many human cancers, including ovarian, lung, breast and colon. Vintafolide’s companion diagnostic imaging agent (etarfolatide) is designed to identify cancer patients that have high levels of the folate receptor expression, which is the exact population of patients expected to respond to this drug.In a previous clinical trial in patients with platinum-resistant ovarian cancer, women identified as “FR-positive” by etarfolatide and then subsequently treated with vintafolide had significantly delayed tumor growth. Based on these unprecedented results, especially in a patient population that fails to adequately respond to any therapy, both etarfolatide and vintafolide are being considered for conditional approval in Europe. This could mean that patients would have access to these agents much sooner than expected. Overall, this exciting opportunity would never have been possible if our companion diagnostic agent was not used to select the right patient population to treat with vintafolide in our clinical trials.A Promising FutureBecause of the numerous benefits companion diagnostics hold for patients, physicians, drug developers and our healthcare system, their continued development and use will only increase in the future. Regulatory agencies worldwide are also embracing this approach, and they continue to encourage drug developers to pursue this path for the treatment of all types of diseases. As the number of companion diagnostics in development continues to grow, we are moving closer each day to truly fulfilling the promise of personalized medicine.


Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
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Chavez cancer surgery successful, Venezuela VP says






CARACAS (Reuters) – Venezuelan President Hugo Chavez‘s cancer operation in Cuba on Tuesday was successful, his vice president said, adding it was a complicated procedure that lasted more than six hours.


The third recurrence of the socialist leader’s illness has thrown his 14-year-old presidency into jeopardy and upended politics in the South American OPEC nation.






“Once again, our comandante has shown his strength,” Vice President Nicolas Maduro said in a broadcast on state TV, as members of the government alongside him applauded.


“We thank the Venezuelan people for all the love they dedicated so this operation ended correctly and successfully.”


He said the post-operative phase would last several days, and they would update the public on the 58-year-old president’s recuperation.


Chavez’s surgery in Cuba, a close ally, was his fourth since mid-2011. Doctors found malignant cells again in his pelvic area soon after he won re-election in October, leading him to name a successor in case he has to step down.


Chavez had twice declared himself cured previously. But he retains hope of recovering in time for the January 10 start of his new six-year term in office.


He named Maduro on Saturday as a potential heir to lead his self-styled revolution in a nation of 29 million people with the world’s largest oil reserves.


The move irked some in Venezuela’s opposition, who say voters – not Chavez – would decide who follows him if he were forced to step down and an election was held within 30 days, as required under the constitution.


(Additional reporting by Caracas bureau; Editing by Peter Cooney)


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Freezing Breast Cancer Tumors Is Better Than Surgery






FIRST PERSON | Surgery for small breast cancer tumors may soon be a thing of the past. A new procedure called cryoablation turns a tumor into a ball of ice. Instead of undergoing surgery to remove the tumor, a doctor can now freeze it. I like that idea.


Freezing tumors






The Telegraph reported on Dec. 10 that doctors are looking into cyroablation as a viable alternative to breast cancer surgery. Cryoablation is available in the United States, but it’s not usually performed on breast cancer tumors. The procedure is simple: A needle is inserted into the tumor and causes it to freeze. There is no need to remove the tumor, as it dies and the body absorbs it.


The needle is hooked up to specialized equipment, which is cooled to a chilly -274 degrees Fahrenheit. A network of tiny tubes deliver liquid nitrogen to the needle, and the physician controls the size of the “ice ball” delivered to the tumor. This allows the doctor to freeze breast cancer tumors as large as a golf ball.


Alternatives to surgery are needed


If cryoablation could be used as an alternative to breast cancer surgery, it would be wonderful. I had two surgeries for breast cancer. The first was a wire-guided surgical biopsy to determine if the tumor was actually cancerous, and then I had a mastectomy of my left breast several months later.


It would have been great to have the choice to opt out of surgery and instead have the tumor frozen. I would still have my left breast, and breast reconstruction would not have been an issue. Instead of undergoing a surgery that took more than 12 hours, I would have had a 15-minute procedure in a doctor’s office. Recovery time from surgery was more than a month. Cryoablation has little to no recovery time.


Hopefully, cryoablation will become a reality for breast cancer patients. Not all women will fall into the guidelines for this procedure, but many will. The medical community should look for any means possible to prevent the disfiguring surgeries current breast cancer treatment requires.


Lynda Altman was diagnosed with breast cancer in November 2011. She writes a series for Yahoo! Shine called “My Battle With Breast Cancer.”


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Britain launches genome database for patients’ DNA






LONDON (Reuters) – Up to 100,000 Britons suffering from cancer and rare diseases are to have their genetic codes fully sequenced and mapped as part of government plans to build a DNA database to boost drug discovery and development.


Prime Minister David Cameron said on Monday he wanted Britain to “push the boundaries” of scientific research by being the first country to introduce genetic sequencing into a mainstream health service.






His government has set aside 100 million pounds for the project in the taxpayer-funded National Health Service (NHS) over the next three to five years.


“Britain has often led the world in scientific breakthroughs and medical innovations, from the first CT scan and test-tube baby through to decoding DNA,” he said in a statement.


“It is crucial that we continue to push the boundaries and this new plan will mean we are the first country in the world to use DNA codes in the mainstream of the health service.”


The government said building a database of DNA profiles will give doctors more advanced understanding of a patient’s genetic make-up, their illness and their treatment needs. This should help those who are sick get access to the right drugs and more personalised care more quickly.


The database should also help scientists develop new drugs and other treatments which experts predict “could significantly reduce the number of premature deaths from cancer within a generation”, Cameron’s office said in a statement,


“By unlocking the power of DNA data, the NHS will lead the global race for better tests, better drugs and above all better care,” Cameron said.


“If we get this right, we could transform how we diagnose and treat our most complex diseases not only here but across the world, while enabling our best scientists to discover the next wonder drug or breakthrough technology.”


Some critics of the project, known as the “UK genome plan”, have voiced concerns about how the data will be used and shared with third parties, including with commercial organisations such as drug companies.


Genewatch, a campaign group fighting for genetic science and technologies to be used in the public interest, has said anyone with access to the database could use the genetic codes to identify and track every individual on it and their relatives.


Cameron’s office stressed, however, that the genome sequencing would be entirely voluntary and patients will be able to opt out without affecting their NHS care. It added the data would be “completely anonymised before it is stored”.


The government’s chief medical officer Sally Davies said the new project and the 100 million pounds of funding for it “opens up the possibility of being able to look at the three billion DNA pieces in each of us so we can get a greater understanding of the complex relationship between our genes and lifestyle.”


(Reporting by Kate Kelland; Editing by Stephen Powell)


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Booze, smokes on agenda for quirky gov’t group












BELTSVILLE, Md. (AP) — Deep in a secure laboratory just outside Washington sits the federal government‘s heaviest smoker.


It is a half-ton hulk of a machine, all brushed aluminum and gasping smoke holes, like a retrofit of equipment used on an Industrial Revolution production line. It can smoke 20 cigarettes at once and conclude which are unsafe because they are counterfeit and which are unsafe merely because they are cigarettes.












Down the hall, a chemist tests shiny flecks from a bottle of Goldschlager, the spicy cinnamon schnapps, to make sure they’re real gold. A government agent was sent out to stores to buy it and hundreds of other alcoholic drinks randomly chosen for analysis.


Back at headquarters in downtown Washington, a staffer prepares for a meeting of the Tequila Working Group — a committee created to mollify Mexico and keep bulk tequila flowing north across the border.


These are the proud scientists, rule-makers and trade ambassadors of the Alcohol and Tobacco Tax and Trade Bureau, one of the federal government’s least-known and most peculiar corners.


The bureau, known as TTB, collects taxes on booze and smokes and tells the companies that produce them how to do business — from approving beer can labels to deciding how much air a gin bottle can contain between lid and liquor.


It decides which valleys in Oregon and California can slap their names on wine labels, what grapes can go into wine and which new alcoholic drinks are safe to import.


The bureau is one example of the specialized government offices threatened by Washington’s current zeal for cost-cutting. Obama administration officials weighed eliminating it during the fiscal stalemate of 2011, according to news reports at the time. Its officials were called to the White House budget office to justify their existence — or risk having their duties split between the Internal Revenue Service and the Food and Drug Administration.


The White House ultimately left the bureau’s $ 100 million budget in place for this year — perhaps because it spends far less money to collect each tax dollar than its counterpart, the IRS. But officials there remain hyper-aware of their vulnerability as Republicans and Democrats look to squeeze savings from unlikely places.


If they look closely, the belt-tighteners will discover an agency whose responsibilities often appear to conflict — a regulator that protects its industry from rules it deems unfair, a tax collector that sometimes cuts its companies a break.


Some of its decisions are open to negotiation. A tequila-like liquor with a scorpion floating in it made scientists balk until the producer convinced them that the scorpions are farm-raised and non-toxic.


In other words, this may be the only federal agency that responds favorably to receiving scorpion candy in the mail — an edible tool for persuading scientists that the arthropods were fit for human consumption.


If labs, rules and taxes weren’t enough for the bureau’s 500-odd employees, they also have law enforcement authority. TTB investigators can send people to jail for things like removing alcohol from the production line and reselling it before it has been taxed by authorities.


With all these responsibilities, it’s no surprise the agency’s priorities sometimes clash. The bureau gives companies a wide berth on some rules and taxes, officials and experts say, mainly because of its small size and history of collaborating with business. It has granted millions in tax givebacks because of concerns that companies will sue and tie up government resources.


“Because we’re regulated by such a friendly agency, and because enforcement isn’t huge, there’s a level of non-compliance that’s sort of acceptable,” says Rachel Dumas Rey, president of Compli, a California company that helps wineries comply with Treasury policy.


Agency officials say they use scant resources where they can make the most difference, generally on the biggest producers or companies where there is an indication of wrongdoing.


Yet last July, the bureau slashed a tax bill for the multinational agribusiness conglomerate Cargill from $ 839,370 to $ 63,000. Cargill failed to report or pay taxes on about 23,000 gallons of nearly pure industrial alcohol that leaked from a rail car, violating several U.S. laws, according to documents on the bureau’s website.


Since 2010, under similar deals with alcohol and tobacco companies, the agency has forgiven more than $ 25.4 million; the total amount is unclear because some public documents do not list the size of the tax bill or penalty that is being reduced. Nine companies persuaded the agency to slash their bills by more than 95 percent, including Procter & Gamble’s Olay subsidiary, which uses alcohol in its skin care products.


Tom Hogue, a spokesman for the bureau and former explosives inspector, says it only agrees to reduce companies’ tax bills “if we are satisfied that the (remaining) penalty is commensurate with the violation and is sufficient to deter future illegal conduct.” In cases where settlements are granted, Hogue says, “they allow us to use our resources to counter non-compliance, instead of tying them up in court.”


When the alcohol and tobacco bureau was split from the Bureau of Alcohol, Tobacco and Firearms, it held on to the former agency’s tax collection duties, including for firearms and ammunition. It’s still the government’s third-biggest revenue collector, after the IRS and Customs and Border Protection. It took in $ 23.5 billion in federal taxes on alcohol, tobacco, weapons and ammo in the fiscal year ended Sept. 30, 2011, the most recent data available. That amounts to $ 468 for every dollar the agency spent collecting taxes — more than twice the IRS’ ratio, officials note.


The bureau also works with government trade officials to protect and expand international markets for American alcohol and tobacco. Its expertise is crucial in negotiating with Europeans about wine labeling, or standing up to countries that refuse to recognize American “straight bourbon” for what the government says it is: corn whiskey stored in charred new oak containers for at least two years.


In this role, the agency has come to the rescue over the years of whiskey lovers in China, Colombia and Brazil. Those countries’ governments tried to ban booze containing too much fusel alcohol, the pungent byproduct of fermentation that gives some whiskey its spicy, solvent-like aroma. Working through international trade groups, armed with data from TTB scientists, U.S. officials spent years convincing them to reverse their policies and allow the importation of whiskey that meets American standards. That was a win for American alcohol producers.


Sometimes, to protect U.S. producers, the bureau erects trade barriers of its own. Under a proposal by the bureau last spring, anything labeled Pisco must have originated in Chile and Peru. (Pisco is a South American grape brandy whose signature cocktail, the Pisco Sour, is so celebrated that it has its own official Peruvian holiday.)


Aspiring Pisco producers in Bolivia, in the U.S. government’s eyes, can take a hike.


This is no accident: It’s the result of a trade agreement that compels Chile and Peru, in exchange for the Pisco rule, to make sure any bourbon sold there is from the U.S. and meets this country’s standards.



The U.S. is the only nation with an alcohol regulator based in its Treasury Department. Treasury was the federal government’s monitor of products seen as sinful or illicit even before Prohibition began in 1919.


When the government first tried to crack down on cocaine and heroin in 1914, it did so by enacting steep taxes. For a time, marijuana also was controlled by imposing taxes so high, it was hoped, that people might lose interest.


After Prohibition was repealed in 1933, the government tried to keep a handle on the alcohol industry by writing production standards for alcohol directly into the tax code. That’s where wine’s alcohol content is limited to 24 percent.


The government uses taxes to control social phenomena, explains Bill Foster, who ran the bureau’s headquarters before retiring this summer.


“Tobacco and alcohol are two of those commodities,” Foster says.


The taxes are collected directly from producers and manufacturers, which pass those costs along to consumers. Liquor producers generally pay a flat rate of $ 13.50 per proof gallon — a gallon of liquid that is one-half alcohol by volume. Small cigars and cigarettes are taxed at a rate of $ 50.33 per 1,000 sticks.



The current Alcohol Tobacco Tax and Trade Bureau was split from the Bureau of Alcohol, Tobacco and Firearms in 2003. ATF was moved to the Justice Department, where it focuses on firearms, explosives and violent crime.


Officials who regulate and tax alcohol and tobacco remained at Treasury, where they continue to ensure that wine doesn’t contain pesticides and absinthe is free of thujone, the psychoactive ingredient — now banned — that gave it its hallucinogenic reputation.


That’s how Dr. Abdul Mabud found himself overseeing 26 chemists at a lab in Beltsville, Md., that tests hundreds of bottles, cigarettes and perfumes every year.


One afternoon, Mabud holds aloft a jar of pure, clear alcohol containing a coiled king cobra, its hood flared and forked tongue extended. Surrounding it are smaller green snakes that appear to be biting each other’s tails.


The snake liquor was submitted for consideration as an import from east Asia, where snakes are believed to increase virility.


“With that much snake in there, it’s probably not a beverage,” Mabud says, explaining why the shelves of America’s liquor stores and supermarkets are free of giant, gin-soaked snakes.


Mabud traces his lab’s history to 1886, when Congress passed steep taxes on margarine — at the time, an upstart competitor to the nation’s dairy products. The 1886 law aimed to prevent crooked margarine-pushers from selling their product as butter. Treasury’s first food-quality lab was set up to preserve butter’s integrity.


Today, the bureau owns some of the most sophisticated equipment available, including the smoking machine, which can be set to inhale in at least three ways, depending on how long and hard the smoker being simulated prefers to puff: light, medium and Canadian. The last one is when the perforations around the cigarette’s filter are blocked and the machine takes bigger, more frequent puffs. It was invented by the Canadian government, and does not necessarily reflect the actual smoking habits of Canadians, says Dawit Bezabeh, chief of the bureau’s tobacco lab.


“That’s the worst-case scenario,” he says.



Officials are less chatty about a third agency priority: The diplomatically sensitive work of promoting the international alcohol and tobacco trade.


The bureau helps strike deals with other countries that have liquor industries, like the one with Peru and Chile over Pisco. The idea is to protect U.S. alcohol and tobacco producers from unfair competition. Jim Beam’s prices might be easily undercut, for example, if an overseas firm was allowed to label something as bourbon even though it was aged in a cask that is neither charred nor oak nor new.


That’s how the Tequila Working Group was born. Citing safety concerns, Mexico had threatened to stop exporting bulk tequila — a commodity that supports 500 U.S. bottling jobs. After the bureau agreed in 2006 to regular meetings with Mexico’s tequila industry, Mexico backed down. The jobs were saved.


Until the early 2000s, the U.S. negotiated wine-making standards as part of a European wine trade group. As the American wine industry blossomed, officials began to believe that the group was favoring European wineries, for example, by refusing to endorse American agricultural methods. Every member of the group had veto power, and France was willing to use it.


The U.S. escaped Europe’s dominance by joining with other oenological up-and-comers like Australia, Argentina, Canada, Chile, New Zealand and South Africa to form the World Wine Trade Group. The group encourages countries to accept each other’s wine-making methods.



Its complicated history helps explain why the bureau looks and acts different from most government offices. As a tax-collecting agency, it wants to see its industries thrive. As a consumer-protection outfit tasked with keeping antifreeze-spiked wine off the market, the bureau must rein in dangerous, sloppy practices by industry members.


If other government agencies ran that way, the Consumer Product Safety Commission would be promoting U.S. baby crib makers at the same time it evaluated their products as potential death traps.


“There’s some peril with that kind of approach,” says Jeff Bumgarner, a professor of criminal justice at the University of Minnesota who studies the history of federal law enforcement. “The trade part of your mission is one of support and standing up the industries, and the tax collection part and the regulatory part and the compliance part is one of holding those industries in check.”


That basic conflict leaves the U.S. government with an alcohol regulator that recently hosted industry executives at conferences to educate them about the bureau’s rules and encourage “voluntary compliance,” then months later raided a Native American reservation that was suspected of harboring cigarette tax evaders.


Critics say the bureau’s close relationship with industry makes it less likely to take a hard line against violators.


Foster sees it another way. He says agents and officials like him are more effective overseers of the industry because they started out working on the distillery floor, measuring batches of liquor and handing producers their tax bills.


“It gave us all a significant understanding of how the industry operates and what their challenges were,” he says.


Agency officials say they are making the most of limited resources, and doing better than most federal departments. And their workload is increasing steadily. The alcohol and tobacco bureau is responsible, for example, for approving every label to be used on an alcohol product in the U.S. As the number of microbrewers and microdistilleries explodes, the work of reviewing those labels is becoming a heavier lift.


The bureau now regulates more than 56,000 companies, an increase of 27 percent since 2007. In that time, its core budget rose only 8 percent.



Like any government office, the agency has had its share of hiccups. Agawam grapes were known on U.S. wine labels as Agwam grapes until the bureau corrected its spelling error in rules published last year.


Vintners with leftover Agwam labels were given until October to stop using them.


___


Daniel Wagner can be reached at www.twitter.com/wagnerreports.


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Judge rejects bid to block Washington state “stoned driving” rules












OLYMPIA, Washington (Reuters) – A judge on Friday rejected a request by a medical marijuana user to block Washington state from enforcing tougher “stoned driving” rules after it became one of the first U.S. states to legalize the recreational use of marijuana.


Washington state voters last month approved marijuana legalization by a margin of 56 percent to 44 percent, making the state, along with Colorado, the first in the country to legalize recreational pot use.












The new rules, which for most marijuana smokers would put them over the legal driving limit for a couple hours after taking two or three hits from a joint, took effect on Thursday.


The legal challenge came from Arthur West, an Olympia-based lawyer and medical marijuana patient who said the ballot initiative‘s title wrongly left out any mention of the DUI provisions.


He also argued that those provisions will enable police to target medical marijuana users, who typically have higher residual blood levels of THC–the active ingredient in marijuana–for car stops.


“I don’t think it’s fair that the tens of thousands of patients in the state of Washington have to choose between whether they take their medicine or be subject to arrest for driving under the influence every time they get in their cars,” he said.


In rejecting West’s request for a preliminary injunction, Judge Lisa Sutton noted that police have long been empowered to pull over drivers they suspect of impaired driving.


“That is the same case today, after the passage of this initiative, as it was before,” Sutton said.


Though the hearing Friday dealt primarily with the DUI provisions, West’s lawsuit also asserts that the initiative wrongly earmarks tax money raised by regulating marijuana for unrelated services such as primary health and dental care, and that state legislators improperly advocated its passage.


West said he will push ahead with his case, taking it all the way to the state’s supreme court if necessary.


Assistant Attorney General Bruce Turcott, who defended the new marijuana law in court, said he was satisfied with the ruling.


“I would have been very surprised” if the judge had ruled differently, Turcott added.


Alison Holcomb, an attorney with the Washington state ACLU who led the legalization campaign, declined to comment on the case.


Previously, Holcomb told Reuters that she included the DUI provisions in the initiative after an internal poll in May showed that 62 percent of 602 likely voters said a pot-impaired driving standard would make them more likely to vote for legalization


(Editing by Dan Whitcomb and Andrew Hay)


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Both sides hint at renewed talks on U.S. “fiscal cliff”












WASHINGTON (Reuters) – With little to show after a month of posturing, the White House and Republicans in Congress dropped hints on Thursday that they had resumed low-level private talks on breaking the stalemate over the “fiscal cliff” but refused to divulge details.


A day after a phone conversation between President Barack Obama and John Boehner, the Republican speaker of the House of Representatives, appeared to kick-start communications, both sides used similar language to describe the state of negotiations but imposed a media blackout on developments.












“Lines of communication remain open,” White House spokesman Jay Carney told reporters when pressed on whether staff talks were taking place to avoid the steep tax hikes and budget cuts set for the first of next year unless the parties agree on a way to stop them.


Asked the same question, Boehner spokesman Michael Steel also said “lines of communication are open.”


The acknowledgement, even without signs of anything approaching a breakthrough, passed for encouraging news after a week of public maneuvering on the fiscal cliff by both sides to gain the maximum political and public relations advantage.


Republicans have worried publicly and privately that they are losing the war of appearances in the battle over the cliff.


On Thursday, another poll showed Republicans may have reason to worry about public perception. A Quinnipiac University survey found respondents trust Obama and Democrats more than Republicans on the cliff talks by a wide margin – 53 percent to 36 percent.


In both public statements and private encounters, Obama has tried to encourage Republicans wavering from the position of the party leadership.


Republican Representative Tom Cole, who last week broke ranks with his party and agreed to accept higher tax rates on the richest Americans, said Obama took him aside at a White House Christmas party on Monday and joked about the criticism Cole had received from Republicans.


“The president pulled me over and he said, ‘Cole, come closer, I want to see the bruises,’” Cole told Reuters. “He said, ‘Seriously, I will go further on this thing than you guys think. I know we can get something done.’”


While other Republicans have questioned Obama’s commitment, Cole said, “I take him at his word,” adding: “The best is to get to that discussion as quickly as we can.”


‘SOLVABLE PROBLEM’


Obama, meanwhile, played to his strengths with the latest in a series of the sort of public events he has used against Republicans in the fiscal cliff fight: a visit with a family in the Virginia suburbs of Washington to illustrate how Republican tax proposals would hurt the middle class.


“The message that I think we all want to send to members of Congress is: this is a solvable problem,” Obama said while visiting the home of a couple in Falls Church, Virginia. “We are in the midst of the Christmas season and I think the American people are counting on this getting solved.”


Neither side in the showdown would characterize Wednesday’s conversation between Boehner and Obama or suggest it opened up new area of compromise.


Obama and Democrats in Congress want the tax cuts set to expire at the end of the year to be extended for taxpayers with incomes below $ 250,000 a year but not for the wealthiest 2 percent of Americans.


In exchange, the president has said he is willing to consider significant spending cuts wanted by Republicans to “entitlement” programs such as Medicare, the government health insurance plan for seniors.


Republicans have held out for an extension of all the tax cuts, but they have become increasingly divided about whether they can prevail in the face of Obama’s firm stance and Republican control of only the House but not the U.S. Senate.


TANGLING OVER DEBT LIMIT


The debt ceiling issue – the same one that provoked a showdown in 2011 that led to a downgrading of the U.S. credit rating – has become a centerpiece of the fiscal cliff debate, thanks in part to Obama’s insistence that Congress give him enhanced power to increase the debt limit, which needs to be raised again in the next few months.


“It ought to be done without delay and without drama,” Carney, the White House spokesman, said of raising the debt ceiling.


That issue produced a largely partisan procedural scuffle on Thursday in the Senate when Republicans tried to provoke a vote on giving Obama the power to raise the debt ceiling on his own.


Senate Republican leader Mitch McConnell, who had argued that not even Democrats would support giving Obama greater flexibility, tried to prove it by pushing for a vote.


When Senate Democratic leader Harry Reid went ahead and scheduled it, confident he had enough support to win on a straight majority vote, the Republicans backed down, with McConnell demanding that 60 votes be required for passage, more than the Democrats can muster.


No new vote was scheduled. While the measure could come up again, it was dead for the moment.


“Senator McConnell took obstruction to new heights by filibustering his own bill,” Reid said in a statement.


Democratic Senator Charles Schumer of New York told reporters that Republicans were losing the argument on raising top tax rates and “are trying to pivot away to other parts of the fiscal cliff in a desperate attempt to assert leverage and change the subject.”


The exchange may be a taste of things to come as Congress moves toward the fiscal cliff deadline.


Economists have warned a plunge over the cliff could drive the economy back into a recession. Mark Zandi, chief economist at Moody’s Analytics, told the congressional Joint Economic Committee that failure to strike a deal could have serious economic consequences relatively quickly.


“By mid-February you would be doing a lot of damage,” Zandi said.


(Additional reporting by Margaret Chadbourn, Rachelle Younglai, David Lawder, Jason Lange; Writing by John Whitesides; Editing by Fred Barbash and Eric Beech)


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New Breath Test Developed for Colorectal Cancer Screening












Italian researchers have developed a breath test that shows promise for use in colorectal cancer screening. Although still in the early stages, it’s an easy, non-invasive way to screen for this type of cancer.


Scientists at the University of Bari, Aldo Moro focused on the premise that the metabolism of cancer tissue differs from that of healthy cells. Cancerous tissue manufactures some substances that can be identified in patients’ breath. Experts refer to them as volatile organic compounds (VOCs), substances that could take current cancer screening to a different level, according to ScienceDaily.












Colorectal cancer is a malignancy that develops in a patient’s colon or rectum. Some refer to each type of cancer independently, as colon cancer or rectal cancer, depending on the origin of the illness. The American Cancer Society states that most colorectal cancers develop slowly, typically over several years.


Most cases begin as a non-malignant polyp on the inner lining of the colon or rectum. The chances of a polyp morphing into cancer depend on the type of polyp. For example, while hyperplastic polyps and inflammatory polyps aren’t in general considered pre-cancerous, adenomas are.


According to the Crohn’s & Colitis Foundation of America, doctors diagnose 147,000 new cases of colorectal cancer annually in the United States. More than 57,000 patients with this condition die every year. Because this cancer is highly treatable in its early stages, regular screenings and early detection are particularly important.


Like many patients with Crohn’s disease, I have above-average risk for colorectal cancer. I have this inflammatory disorder in my colon as well as in my small bowel, and I’ve had the disease for more than 10 years. Fortunately, I am not among the group with the highest risk — those whose entire colon is affected by the inflammation.


The Italian researchers collected samples of exhaled breath from 37 colorectal cancer patients and 41 healthy subjects to study the VOC profile. They were able to find VOC patterns that identified the cancer patients separately from the control group.


The scientists used a probabilistic neural network (PNN) to identify the pattern of VOCs that better discriminated between the two sets of subjects. After studying 15 of 58 specific compounds in the samples, the team concluded that the colorectal cancer patients had a different selective VOC pattern from that associated with the healthy subjects.


The PNN had an accuracy rate of greater than 75 percent for identifying the cancer patients. Though the technique used for breath sampling is still in an early stage of development, the researchers consider it both very simple and non-invasive.


Because I have also had several adenomas, my current method of surveillance is something nobody loves: a colonoscopy every two years. A simple breath test for colorectal screening would make life much easier for those of us with elevated risk factors.


Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.


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Disability expected to rise as more premature babies survive












LONDON (Reuters) – Little progress has been made in improving the long-term health of extremely premature babies, and with pre-term births on the rise across Europe, rates of serious disability are likely to increase, doctors said on Wednesday.


A decade of advances in medicine mean more babies born at between 22 and 26 weeks gestation manage to survive, but rates of severe health complications remain as high as they were in 1995, according to research by neonatal specialists in Britain.












The findings of two separate studies published in the British Medical Journal suggest the number of children and adults with disabilities caused by premature birth will rise in coming years.


Babies born before 27 weeks of gestation – 13 weeks before they would be considered full term – face a battle for survival. Many of those who do survive face problems such as lung conditions, learning difficulties and cerebral palsy.


Rates of premature birth are rising in many European countries and are particularly high in Britain and the United States.


“As the number of children that survive pre-term birth continues to rise, so will the number who experience disability throughout their lives,” said Neil Marlow, of University College London’s Institute for Women’s Health, who worked on both studies and presented the results at a briefing in London.


He said this was “likely to have an impact on the demand for health, education and social care services.”


The two studies, led by Marlow and Kate Costeloe of Queen Mary, University of London, compared a group of babies born in the UK between 22 and 26 weeks’ gestation in 2006 with those born between 22 and 25 weeks over a 10-month period in 1995.


The first one looked at the immediate survival rates and the health – until they went home from hospital – of extremely premature babies born in 2006 and compared them with 1995 rates.


Researchers found the number of babies born at 22 to 25 weeks and admitted to intensive care increased by 44 percent during this period. The number of babies who survived long enough to go home from hospital increased by 13 percent.


There was no significant increase in survival of babies born before 24 weeks – the current legal limit for abortion in Britain – and the number of babies who had major health complications was unchanged over the decade.


Costeloe said what while survival rates for babies born at less than 27 weeks gestation were moving in the “right direction”, there was still room for improvement.


“We can’t be complacent, because the fact of the matter is, that in 2006 if at this gestation you were alive at the end of the first week, you had no greater chance of going home (from hospital) than you would have done had you managed to survive the first week of life in 1995.”


The second study looked at the health of the 2006 babies when at three years old and compared this with 1995. It found that while 11 percent more babies survived to three without disabilities the proportion of survivors born between 22 and 25 weeks with severe disability was about the same – at 18 percent in 1995 and 19 percent in 2006.


The researchers also found a link between gestational age and the risk of disability, with babies born earlier more likely to have serious health complications at three years of age.


(Reporting by Kate Kelland, editing by Rosalind Russell)


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Researchers Are Closing In On a Method to Predict Flu Outbreaks












In the near future, you may be able to hear a routine “flu forecast” on the evening news just as weather forecasts are issued each day. A team of scientists working on a flu forecast model recently announced they’re a step closer to producing a model that can reliably warn consumers of flu trends even seven weeks in advance.


Having a method to predict flu outbreaks could help curb the spread of the virus during peak times of the year and could potentially save many lives during a severe pandemic.












“I can envision this being part of the local weather forecast in the same way you have pollen counts and pollution levels,” lead author Jeffrey Shaman, an assistant professor of environmental health sciences at Columbia’s Mailman School of Public Health, told Take Part.


MORE: Flu Vaccines in Grade Schools Significantly Curb Illness


The paper, which appears in the Proceedings of the National Academy of Sciences, is the latest in a series of work by Shaman and colleagues at the National Center for Atmospheric Research. The research is unusual because it applies weather forecasting models to an infectious disease.


Flu is particularly well-suited to this kind of forecasting. There are few other illnesses as seasonal as flu. In the United States, it’s basically a wintertime ailment. However, the authors of the paper note, the flu peak each year can vary dramatically. In some  years, flu cases peak before the holidays and in other years, flu peaks as late as April.


In a 2009 paper, Shaman showed how important environmental factors are on flu transmission and persistence. Flu epidemics tend to follow very dry weather. But in the new study, Shaman and co-author Alicia Karspeck, of NCAR, borrowed a mathematical model used in weather forecasting and combined it with real-time information gathered from Google Flu Trends. Google Flu Trends shows the number of flu-related search queries in a given region and estimates outbreaks based on that demand for flu information.


MORE: The Most Vulnerable Pay a High Price for Flu Infection


In the study, the researchers used the model to look, retrospectively, at flu during the winters of 2003-04 and 2008-09 in New York City. The model accurately predicted the peak timing of the outbreak more than seven weeks in advance. While a weather forecast predicting conditions seven weeks out is not likely to be very accurate, the flu forecast model produced a surprising level of accuracy.


“One of the things about a weather forecast is it degrades the farther out you go,” Shaman says. “Weather forecasts degrade at a certain rate because of the complexity of weather. Flu trends are simpler.”


The researchers’ next step is to create models for various regions of the country because flu cases peak at different times around the country. But Shaman says he thinks a usable flu forecasting system could be available to public health officials in about a year or two.


Eventually, he says, flu forecasts could be made available to the public.


MORE: Flu Shot Myths Debunked: Hey Holdouts, Care to Reconsider?


“We can generate forecasts very similar to what you get in weather,” he says “There is a 40 to 60 percent chance that flu will peak in six weeks — that would be a strong forecast. There is a 10 percent chance that flu will peak in five weeks would be a weak forecast.”


Consumers love to hate weather forecasts, and it might take some time for people to buy into a flu forecast. But Shaman says he thinks consumers will pay attention. Flu infects millions of Americans each year and, on average, causes about 35,000 deaths each year. The illness accounts for many lost school days and time away from work. A flu forecast could prompt people to be more diligent about prevention measures, such as frequent hand-washing, staying home from work when they feel symptoms coming on and even wearing masks to avoid exposure, the authors note.


“If we show the forecasts are reliable and people get a sense that they are, I think they’ll respond to the information sensibly,” he says. “The forecasts even have enough lead time that it can be an effective reminder for people who haven’t been vaccinated to go get the vaccine.”


Public health officials and medical professionals would benefit from a flu forecast by stocking up on anti-viral medication and scheduling extra personnel in hospitals and clinics to care for more patients, he says. In a severe pandemic, city officials could use the information to close schools to thwart transmission.


Question: Do you think it would be helpful to have weekly “flu forecasts” during the winter months? Tell us what you think in the comments.



Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.


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Diabetes may be linked to hearing loss: study












(Reuters) – Diabetes has already been tied to an increased risk of kidney and cardiovascular troubles, nerve damage and vision loss, and now a Japanese study finds diabetics to be more than twice as likely as those without the disease to have hearing impairment.


In a review of past research on the issue, published in the Journal of Clinical Endocrinology and Metabolism, scientists found that younger diabetics were at even higher risk than older adults, though they could not explain why.












“Current meta-analysis suggests that the higher prevalence of hearing impairment in diabetic patients compared with nondiabetic patients was consistent regardless of age,” wrote lead researcher Chika Horikawa, at Niigata University Faculty of Medicine, and colleagues.


It’s not the first time researchers have found a link between diabetes and hearing loss. In 2008, researchers from the U.S. National Institutes of Health (NIH) saw similar patterns in a sample of more than 11,000 people, with people with diabetes twice as likely to have hearing loss as those without.


It’s thought that high blood sugar levels brought on by diabetes may lead to hearing loss by damaging blood vessels in the ears, said Horikawa.


Horikawa and colleagues collected information from 13 previous studies examining the link between diabetes and hearing loss and published between 1977 and 2011. Together, the data covered 7,377 diabetes and 12,817 people without the condition.


Overall, Horikawa‘s team found that diabetics were 2.15 times as likely as people without the disease to have hearing loss. But when the results were broken down by age, people under 60 had 2.61 times the risk while people over 60 hand 1.58 times higher risk.


Some experts caution that this kind of study does not prove that diabetes is directly responsible for the greater hearing loss rates.


“It doesn’t definitively answer the question, but it continues to raise an important point that patients might ask about,” said Steven Smith, a diabetes specialist at the Mayo Clinic in Rochester, Minnesota.


The researchers note that future studies that take more factors into account, such as age and noisy environment, are needed to clarify the link between diabetes and hearing loss.


Still, Horikawa told Reuters Health in an email, people should recognize that diabetics may be at risk for hearing loss based on their results.


“Furthermore, these results propose that diabetic patients are screened for hearing impairment from (an) earlier age compared with non-diabetics,” said Horikawa, adding that hearing loss has also been linked to an increased risk of depression and dementia. SOURCE: http:.//bit.ly/RIVeeW


(Reporting from New York by Andrew Seaman at Reuters Health; editing by Elaine Lies)


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Asperger’s dropped from revised diagnosis manual












CHICAGO (AP) — The now familiar term “Asperger‘s disorder” is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But “dyslexia” and other learning disorders remain.


The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation’s psychiatrists. Changes were approved Saturday.












Full details of all the revisions will come next May when the American Psychiatric Association‘s new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.


This diagnostic guide “defines what constellations of symptoms” doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it “shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care.”


Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association’s board of trustees.


The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.


One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger’s disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.


And some Asperger’s families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.


But the revision will not affect their education services, experts say.


The new manual adds the term “autism spectrum disorder,” which already is used by many experts in the field. Asperger’s disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don’t talk or interact, as well as those with milder forms.


Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger’s.


“To give it separate names never made sense to me,” Gibson said. “To me, my children all had autism.”


Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won’t affect those services, Gibson said. She also has a 3-year-old daughter without autism.


People with dyslexia also were closely watching for the new updated doctors’ guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won’t be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.


The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.


The revised guidebook “represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders,” Dr. David Fassler, the group’s treasurer and a University of Vermont psychiatry professor, said after the vote.


The shorthand name for the new edition, the organization’s fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won’t be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.


Olfson said the manual “seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 … there have been important advances in our understanding of the nature of psychiatric disorders.”


Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group’s autism task force, said anyone who met criteria for Asperger’s in the old manual would be included in the new diagnosis.


One reason for the change is that some states and school systems don’t provide services for children and adults with Asperger’s, or provide fewer services than those given an autism diagnosis, she said.


Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don’t lose services.


Other changes include:


—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids’ who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.


—Eliminating the term “gender identity disorder.” It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn’t a disorder and say calling it one is stigmatizing. The term would be replaced with “gender dysphoria,” which means emotional distress over one’s gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .


Medications/Drugs News Headlines – Yahoo! News


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Little apparent progress in U.S. “fiscal cliff” talks












HATFIELD, Pennsylvania (Reuters) – With barely a month left before the “fiscal cliff,” Republicans and Democrats remained far apart on Friday in talks to avoid the across-the-board tax hikes and spending cuts that threaten to throw the country back into recession.


While President Barack Obama visited a Pennsylvania toy factory to muster public support for tax hikes on the rich, portraying Republicans as scrooges at Christmas time, his primary adversary in negotiations, Republican House Speaker John Boehner, continued to describe the situation as a stalemate.












The argument will resume on Sunday when Boehner, along with Obama’s Treasury secretary, Timothy Geithner, and others, take to weekly political talk shows and pick up further steam next week with a possible confrontation in the House of Representatives between Democrats and Republicans over the timing of a vote on tax hikes.


Lawmakers are nervously eyeing the markets as the deadline approaches, with gyrations likely to intensify pressure to bring the drama to a close.


The markets, in turn watching the politicians, fell as Boehner spoke, but recovered afterward. It was a repeat of the pattern earlier in the week when the speaker offered a similarly gloomy assessment.


The latest round of high-stakes gamesmanship focuses on whether to extend the temporary tax cuts that originated under former President George W. Bush beyond their December 31 expiration date for all taxpayers, as Republicans want, or just for those with incomes under $ 250,000, as Obama and his fellow Democrats want.


After five days of increasingly confrontational exchanges, the work week drew to a close with an announcement by Democrats of a long-shot effort next week to force an early tax-hike vote in the Republican-controlled U.S. House to break the deadlock.


MEDICARE, SOCIAL SECURITY


House Minority Leader Nancy Pelosi said she would undertake the rarely successful effort unless Boehner agreed by Tuesday to bring a bill to the floor allowing taxes on the wealthy to rise, something Boehner is highly unlikely to do until he is ready.


“The clock is ticking,” Pelosi said at a news conference. “The year is ending. It’s really important with tax legislation for it to happen now. We’re calling upon the Republican leadership in the House to bring this legislation to the floor next week.”


While Boehner offered no immediate response to Pelosi’s threat, Cathy McMorris Rodgers of Washington state, recently elected by Republicans to be the fourth-ranking party leader in the House, told Fox News in an interview not to expect any tax vote next week.


Amid the competing statements from the two sides, there were some actual, albeit modest, signs of potential movement.


Senate Minority Leader Mitch McConnell threw Republican proposals into the mix for reform of Medicare, the government health insurance program for seniors, which has exploded in cost in recent years and is a major contributor to the country’s soaring deficit.


McConnell of Kentucky told the Wall Street Journal in an interview that Republicans would agree to more revenue – although not higher tax rates – if Democrats agreed to such changes as raising the eligibility age for Medicare and slowing cost-of-living increases in the Social Security retirement program.


Rodgers, in her Fox News interview, declined to completely rule out a much-discussed potential compromise in which Republicans would accept some increase in tax rates on the rich, but not to the level desired by Obama.


‘A LUMP OF COAL’


More House Republicans – although still just a handful -expressed flexibility beyond that of their party leaders about considering an increase in tax rates for the wealthy, as long as they are accompanied by significant spending cuts.


Most House Republicans refuse to back higher rates, preferring to raise revenue through tax reform.


Obama, speaking in Pennsylvania, said he was encouraged by the shifting views of some Republicans, and urged House approval of a bill that has already cleared the Democratic-controlled Senate that would lock in the middle-class tax cuts and raise the rates for the rich.


“If we can get a few House Republicans on board, we can pass the bill. … I’m ready to sign it,” Obama said.


But neither he nor the other principals in the debate budged from their basic positions.


Instead, Obama turned up the pressure on Friday, hitting the road to drum up support for his drive to raise taxes on the wealthy and warning Americans that Republicans were offering them “a lump of coal” for Christmas.


In a visit to the Pennsylvania toy factory, Obama portrayed congressional Republicans as scrooges who risked sending the country over the fiscal cliff rather than strike a deal to avert the tax increases and spending cuts that begin in January unless Congress intervenes.


“We already all agree, we say, on making sure middle-class taxes don’t go up. So let’s get that done. Let’s go ahead and take the fear out for the vast majority of American families so they don’t have to worry,” Obama said at the Rodon Group factory, which makes K’NEX building toy systems as well as Tinkertoys and consumer products.


In Washington, Boehner said Obama’s plan to raise taxes on the rich was the wrong approach.


“There is a stalemate. Let’s not kid ourselves,” the Ohio Republican said. “Right now we are almost nowhere.”


(Additional reporting by Richard Cowan, Thomas Ferraro, Kim Dixon, Edward Krudy; Writing by John Whitesides; Editing by Fred Barbash and Todd Eastham)


Seniors/Aging News Headlines – Yahoo! News


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