News roundup: echinacea, diabetes, cancer

News from the world of medicine:


Researchers have demonstrated that an antibiotic called "monensin" prevents the growth of prostate cancer cells. Evidenceemerged in a project investigating the effects of nearly 5,000 drugs and micromolecules on the growth of prostate cancer cells. Researchers found that small amounts of compounds -- disulfiram (Antabus), thiram, tricostatin A, and monensin -- can prevent the growth of prostate cancer cells without significant effects on the growth of the normal human prostate epithelial cells.

Researchers at Harvard have identified a substance found primarily in dairy fat that appears to lower the risk of type 2 diabetes. Known as trans-palmitoleic acid, it is present in the fat of ruminant animals such as cows, sheep, and goats. In the Harvard study, people with the highest levels of the fatty acid in their blood had a threefold lower risk of developing diabetes over time than people with the lowest levels. They also had healthier HDL, or good, cholesterol levels, lower body fat, and less insulin resistance.

The vitamin D levels of newborn babies appear to predict their risk of respiratory infections during infancy and the occurrence of wheezing during early childhood, but not the risk of developing asthma. The results support the theory that widespread vitamin D deficiency contributes to risk of infections.

Despite its popularity as a natural remedy for treating the common cold, a new study suggests echinacea does not substantially reduce the severity or duration of the common cold.

Women with breast cancer who take multivitamins with minerals appear to face lower odds of having their cancer come back or dying. "Multivitamins appears to especially benefit women undergoin gradiation treatment," says researcher Heather Greenlee, ND, PhD, of Columbia University's Herbert Irving Comprehensive Cancer Center in New York City. The study doesn't prove cause and effect. The association could be explained by other factors.

Lose friends, save your joints

It seems that garlic, and other allium vegetables, such as onions and leeks, have the effect of preventing hip osteoarthritis. Scientists discovered this in a careful study of 1,000 twins in Britain.

They found that in those who consumed a healthy diet with a high intake of fruit and vegetables, particularly alliums such as garlic, there was less evidence of early osteoarthritis in the hip joint. They found that that a compound called diallyl disulphide limits the amount of cartilage-damaging enzymes when introduced to a human cartilage cell-line in the laboratory.

"While we don't yet know if eating garlic will lead to high levels of this component in the joint, these findings may point the way towards future treatments and prevention of hip osteoarthritis," said Dr. Frances Williams, lead author from the Department of Twin Research at King's College London.

Probably a good signal to buy stock in companies selling breath mints.

Can whole milk reduce the risk of diabetes?

New research suggests that whole-fat dairy products -- generally shunned by health experts -- contain a fatty acid that may lower the risk of type 2 diabetes.

The fatty acid is called trans-palmitoleic acid, and people with the highest blood levels of this fatty acid reduce their odds of diabetes by 62 percent compared to those with the lowest blood levels of it.

In addition, "people who had higher levels of this fatty acid had better cholesterol and triglyceride levels, lower insulin resistance and lower levels of inflammatory markers," said study author Dr. Dariush Mozaffarian, co-director of the program in cardiovascular epidemiology at Brigham and Women's Hospital and Harvard School of Public Health.

Whole milk has more trans-palmitoleic acid than 2 percent milk, and 2 percent milk has more of this fatty acid than does skim milk.

Should you start drinking whole milk?

Mozaffarian said it's difficult to know exactly how many servings of dairy it would take to get to the highest levels of trans-palmitoleic acid, but said it was likely three to five servings a day, depending on the type of dairy consumed.

However, he said, it's too soon to make any dietary recommendations based on the results of just this finding.

"This study confirms that something about dairy is linked very strongly to a lower risk of diabetes, but no single study should be enough to change guidelines," he said, adding that he hopes this study will spur more research.

Tell you doctor.

New insights on breast cancer

In recent years, women have heard only bad news about the use of estrogen and progestin to ease symptoms of menopause. Researchers halted a major government study of so-called combination therapy, when women taking these hormones were shown to have a higher risk of breast cancer, heart attack and stroke.

Now, The New York Times reports, there is some second thinking.

A controversial new review of data suggests some good news: certain women who take estrogen alone, without progestin, to treat menopause symptoms may actually be protected from breast cancer.

The review drew immediate criticism from researchers who said it was merely a rehash of old data. But the oncologist behind the report, Dr. Joseph Ragaz, a clinical professor at the University of British Columbia, said the evidence that estrogen can protect against breast cancer had been largely ignored, and that it was time to shine a spotlight on the findings.  

“The data were absolutely missed. They weren’t emphasized, and they weren’t brought to the attention of oncologists,” said Dr. Ragaz, who said he had no ties to any drug firms. “These data are nevertheless very much important because they add to the evidence for estrogen being protective.”

Details at the link. And there's more news on Vitamin D.

More than half of women with breast cancer have low vitamin D levels, British researchers report. 

"Women with breast cancer should be tested for vitamin D levels and offered supplements, if necessary," says researcher Sonia Li, MD, of the Mount Vernon Cancer Centre in Middlesex, England. The findings were presented at the San Antonio Breast Cancer Symposium.

Exercise before you eat in the morning

Exercising in the morning, before eating, seems to significantly lessen the ill effects of a bad diet, a new study shows.

Belgian researchers divided men into three groups and fed them a lot of calories. One group didn't exercise, one exercised after breakfast, and one exercised before breakfast.

The group that exercised before breakfast gained almost no weight and showed no signs of insulin resistance. They also burned the fat they were taking in more efficiently. “Our current data,” the study’s authors wrote, “indicate that exercise training in the fasted state is more effective than exercise in the carbohydrate-fed state to stimulate glucose tolerance despite a hypercaloric high-fat diet.”

Why this happened isn't entirely clear, but there are clues.

As has been known for some time, exercising in a fasted state (usually possible only before breakfast), coaxes the body to burn a greater percentage of fat for fuel during vigorous exercise, instead of relying primarily on carbohydrates. When you burn fat, you obviously don’t store it in your muscles. In “our study, only the fasted group demonstrated beneficial metabolic adaptations, which eventually may enhance oxidative fatty acid turnover,” said Peter Hespel, Ph.D., a professor in the Research Center for Exercise and Health at Catholic University Leuven in Belgium and senior author of the study.

At the same time, the fasting group showed increased levels of a muscle protein that “is responsible for insulin-stimulated glucose transport in muscle and thus plays a pivotal role in regulation of insulin sensitivity,” Dr Hespel said.

In other words, working out before breakfast directly combated the two most detrimental effects of eating a high-fat, high-calorie diet. It also helped the men avoid gaining weight.

These men exercised rather vigorously, so it's not known whether my wimp workout would have any effect. One doctor said, however, that something is better than nothing.

Breakthroughs in our understanding of Alzheimer's

Dark brown amyloid plaques

A surprising new study is part of a wave of unexpected findings that are enriching scientists’ views of the genesis of Alzheimer’s disease.

For years, it seemed, the problem in Alzheimer’s was that brain cells were making too much of a small, sticky protein fragment, beta amyloid. The latest research proves that wrong: It turns out that most people with Alzheimer’s seem to make perfectly normal amounts of amyloid. They just can’t get rid of it.

If researchers could find a way to speed up disposal, perhaps they could slow down or halt the disease. Researchers have also found that amyloid, in its normal small amounts, seems to have a purpose in the brain — it may be acting like a circuit breaker to prevent nerve firing from getting out of control. But too much amyloid can shut down nerves, eventually leading to cell death. That means that if amyloid levels were reduced early in the disease, when excess amyloid is stunning nerve cells but has not yet killed them, the damage might be reversed. 

About all the new research:

The result of all this work is a renewed vigor in the field. After years in which it was not clear how to attack this devastating disease, scientists have almost an embarrassment of riches. The research is in early stages, of course, and there are many questions about which discoveries and insights will lead to prevention or a treatment that works. 

There is a new hopefulness that this terrible disease may eventually be conquered. “We are much closer and quite optimistic that we will be able to do it,” Dr. Richard Mohs, Alzheimer’s group team leader at Eli Lilly, said.

Doctors respond to Obamacare

For all the times that President Obama promised "you'll get to keep your doctor" under his health-care reforms, he apparently failed to ask any practicing doctors.

A recent survey finds that countless MDs will respond to ObamaCare by limiting which patients they'll see.

The Physicians Foundation asked 2,400 doctors and American Medical Association members what they thought of the new law; a full 67 percent were against it.

More important, it asked how they'd cope with the new rules (which don't fully kick in until 2014). Sixty percent said they feel compelled to "close or significantly restrict their practices to certain categories of patients." And 59 percent said the "reform" would oblige them to spend less time with the patients they do have.

Of course, many doctors already limit how many patients they'll take on who depend on government insurance (whose fees rarely cover an MD's costs). But it'll get worse under ObamaCare: In the survey, some 87 percent said they would significantly restrict Medicare patients and 93 percent said they'd significantly restrict Medicaid patients.

Eat right, exercise, live forever

German researchers say you will age slower if you exercise, eat healthy foods, and have a good lifestyle. In fact, they have determined how many years more, on average, you will live if you do those things.

Elderly people who exercise, eat well, and generally have an active lifestyle will live around four (4) years longer than their counterparts that don’t exercise, don’t eat well, and generally have a sedentary lifestyle. People who lived a sedentary and unhealthy lifestyle for most of their lives can begin to live a healthier (and longer) lifestyle if they start to exercise regularly and eat healthy foods later in life.

To reach this conclusion, Dr. Dieter Leyk of German Sport University Cologne looked at a group of physically active people composed of 900,000 marathon and half-marathon runners from the age of 20 to 79 years.

Kinda common sense, no? Here's something to get you started. First, the food pyramid:

And an exercise pyramid:

A better test for prostate cancer

Massimo Mischi, Ph.D. helped develop the new test

Prostate cancer is the most common type of cancer among men, but its diagnosis has up to now been inaccurate and unpleasant. Now researchers have developed an imaging technology that can accurately identify tumors.

The technology is based on ultrasound, and also has the potential to assess how aggressive tumors are. This can lead to better and more appropriate treatment, and to cost savings in health care.

Here's why this is important.

After determining the PSA (prostate-specific antigen) level in the blood, biopsies are performed to see if there are tumors in the prostate. However the PSA level is not a very good indicator: two-thirds of all biopsies turn out to have been unnecessary.

The biopsies also have disadvantages; for example they are not targeted, but instead tissue is sampled randomly using 6 to 12 needles. The chance that the needles will miss a tumor is high, causing a false negative result. In around one-third of cases with negative biopsies, tumors are later found to be present. Furthermore doctors often operate after a positive biopsy, but find a tumor so small that it would have been better not to operate.

Current state of the art is in the Dark Ages. Here's how the new test works.

The new technology uses the injection of microbubbles of a contrast agent with no side-effects. The response of the tiny bubbles to ultrasound is different from that of human tissue or blood. This makes the bubbles traceable from the outside, right into the smallest blood vessels. The pattern of blood vessels in tumors is different from that in healthy tissue. The researchers can recognize this pattern from advanced analysis of the bubble concentrations. And because tumors need blood -- and hence new blood vessels -- to grow, the researchers expect to be able to see how aggressive the cancer is from the pattern of the blood vessels.

Tell your doctor.

What's up for kids, Doc?

News from the world of medicine that matters for the younger ones:

Children who attend large group child care facilities before age 2½ appear to develop more respiratory and ear infections at that age, but fewer such illnesses during elementary school years, according to a report.

Targeting the core social deficits of autism spectrum disorders (ASD) in early intervention programs yielded sustained improvements in social and communication skills even in very young children who have ASD, according to a study funded by the National Institute of Mental Health.

The "A" grades that high schoolers earn aren't just good for making the honor roll -- they also make them healthier as adults, too. "We already know it matters for things like your work and your earnings, but this proves it also matters for your health." "We already know it matters for things like your work and your earnings, but this proves it also matters for your health," says Pamela Herd, an associate professor of public affairs and sociology at the University of Wisconsin-Madison.

Vitamin A supplements are still an effective way to reduce childhood death and disease. A new study by Cochrane researchers strongly endorses the continuation of vitamin A supplementation programs, which reduce the incidence of measles and diarrhea and ultimately save lives.

Attention Deficit Hyperactivity Disorder (ADHD) and developmental reading disability (RD) are complex childhood disorders that frequently occur together; if a child is experiencing trouble with reading, symptoms of ADHD are often also present. However, the reason for this correlation remains unknown. A new study  has suggested that the disorders have common genetic influences, which may also lead to slow processing speed -- the brain taking longer to make sense of the information it receives.

Only about one-fourth of children participating in organized sports -- such as baseball, softball or soccer -- receive the government-recommended amount of physical activity during team practices, according to a report.

More evidence that aspirin prevents cancer

It's been known that taking an aspirin daily can help prevent certain cancers. Aspirin has been found to slow or prevent the growth of tumor cell lines in the laboratory. Observational studies have reported that people who took aspirin were at lower risk for colorectal cancer recurrences, while other studies have pointed to similar reductions in cancers of the lung, stomach and esophagus.

Now researchers have examined the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier.

“There have been hints of this before, but the quality of this study is the gold standard because it is based on randomized clinical trials,” said Dr. Alan A. Arslan, an assistant professor of obstetrics and gynecology and environmental medicine at New York University School of Medicine, who did an observational study several years ago reporting that women who had taken aspirin regularly had a lower risk of ovarian cancer. “Randomized controlled trials carry more weight.” 

But you just can't start popping aspirin without talking to your doctor, because it can cause gastrointestinal bleeding and bleeding in the brain (hemorrhagic strokes). Still, this latest research is significant.

Participants who had been assigned to the aspirin arms of the studies were 20 percent less likely after 20 years to have died of solid tumor cancers than those who had been in the comparison group taking dummy pills during the clinical trials, and their risk of gastrointestinal cancer death was 35 percent lower. The risk of lung cancer death was 30 percent lower, the risk of colorectal cancer death was 40 percent lower and the risk of esophageal cancer death was 60 percent lower, the study reported. 

“This is important as a proof of principle that a single simple compound like aspirin can reduce the risk of cancer substantially,” said the study’s lead author, Dr. Peter M. Rothwell, professor of neurology at the University of Oxford. “There’s been a lot of work over the years showing that certain compounds can increase the risk of cancer, but it’s not been shown before that we can reduce the risk with something as simple as aspirin.” 

So, tell your doctor.

How to save on doctor bills

Even if you're covered by insurance, you might be out of pocket for a lot if your doctor is out of network.

But just as big employers and insurance companiesnegotiate prices down as a matter of course, individuals can bargain with doctors and hospitals, too, says Erin Moaratty, chief of external communications at the nonprofit Advocate Foundation.

Ideally, the time to make your case for a discount is before you go in for a procedure. Call the medical facility and ask for the projected fees; if you have insurance, contact the company next to find out how much it will pay. Then talk over your situation with the billing department, requesting a break. 

You might win as much as 50 percent off full price if you offer to pay quickly by cash or check. Providers accustomed to accepting less than they'd like from insurers often realize that getting payment without hassle or delay is preferable to waiting for the full amount or having to hire a collection agency.

More tips at the link.

How much vitamin D is enough?

The very high levels of vitamin D that are often recommended by doctors and testing laboratories — and can be achieved only by taking supplements — are unnecessary and could be harmful, an expert committee says. It also concludes that calcium supplements are not needed.


The group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine.

It is not clear how or why the claims for high vitamin D levels started, medical experts say. First there were two studies, which turned out to be incorrect, that said people needed 30 nanograms of vitamin D per milliliter of blood, the upper end of what the committee says is a normal range. They were followed by articles and claims and books saying much higher levels — 40 to 50 nanograms or even higher — were needed.

After reviewing the data, the committee concluded that the evidence for the benefits of high levels of vitamin D was “inconsistent and/or conflicting and did not demonstrate causality.”

I take 2,000 units of vitamin D a day, and get more in other supplements. Several doctors have looked at this and approved. I'll continue until I hear otherwise. 

Eating fish is good for the eyes

Researchers at the Wilmer Eye Institute, Johns Hopkins School of Medicine, wanted to know how the risk of age-related macular degeneration (AMD) would be affected in a population of older people who regularly ate fish and seafood, since some varieties are good sources of omega-3 fatty acids. 


A diet rich in omega-3s probably protects against advanced AMD, the leading cause of blindness in whites in the United States. High concentrations of omega-3s have been found in the eye's retina, and evidence is mounting that the nutrient may be essential to eye health.


"Our study corroborates earlier findings that eating omega-3-rich fish and shellfish may protect against advanced AMD." Dr. Sheila K. West, PhD, who led the study, said. "While participants in all groups, including controls, averaged at least one serving of fish or shellfish per week, those who had advanced AMD were significantly less likely to consume high omega-3 fish and seafood," she said.

Worship the sun, live forever

My neighbor: she'll outlive me

Women who sunbathe regularly live longer and enjoy health benefits which outweigh the risk of skin, according to research presented at the Swedish Society of Medicine's annual conference.

Studies of the sun exposure habits of 40,000 women in southern Sweden have found that the health benefits of spending extended periods in the sun outweigh the negatives, such as the increased risk for skin cancer.

Researchers claim that exposure to the sun is attributed to helping against blood clots, which are twice as common in the darker periods of the year than in the summer, the newspaper reported.

Furthermore the incidence of type 2 diabetes also shows seasonal variations, with the winter boom in cases attributed to a lack of vitamin D.

Chief physician Håkan Olsson at the division of oncology at Lund University argued that he was not alone in claiming "that there can be other factors other than the sun which affect the risks for developing malignant melanomas," and that exposure to the sun could help protect against a slew of other conditions.

Stay active, fight diabetes

The Centers for Disease control predicts that as many as one in three American adults may have diabetes by 2050 as the number of diabetes patients doubles or triples over the next 40 years.

There's one simple thing you can do -- exercise.

People with Type 2 diabetes should get 150 minutes of aerobic exercise a week, according to a new recommendation a committee that wrote a position paper for the American College of Sports Medicine and the American Diabetes Association.

"There is probably not a better medicine out there for people with diabetes than exercise," said Sheri Colberg-Ochs, an Old Dominion University exercise science professor and chair of the committee.

They also recommended that diabetics not let more than two days pass between exercise because frequent activity is key to keeping blood glucose levels from rising.

The first line of treatment of diabetes should be lifestyle changes, such as improving diet and exercise habits, Colberg-Ochs said. "The medications are supplemental to that. You should not take the medications until you make the lifestyle changes." Many people can come off medications, especially if they start making the changes early in their diagnosis.

Even a little bit of activity counts. The 150 minutes of recommended exercise could come in 10-minute bursts throughout the week.

"Weeding, washing your dishes counts, and is very important in people with diabetes," she said. "People think of it as they join the gym or they don't do anything. There are a lot of things in between."

On the horizon: painless vaccination, new organs

The advances in medicine come daily.

A cluster of stem cells is encouraged to turn into blood vessels.

Growing living tissue and organs in the lab would be a life-saving trick. But replicating the complexity of an organ, by growing different types of cells in precisely the right arrangement—muscle held together with connective tissue and threaded with blood vessels, for example—is currently impossible. Researchers at MIT have taken a step toward this goal by coming up with a way to make "building blocks" containing different kinds of tissue that can be put together.

A new process for creating a personalized vaccine may become a crucial tool in helping patients with colorectal cancer develop an immune response against their own tumors. This dendritic cell (DC) vaccine, developed at Dartmouth and described in a research paper published this week in the journal Clinical Cancer Research, was used after surgical resection of metastatic tumors to try to prevent the growth of additional metastases. 

A spray solution of a patient's own stem cells is healing their severe burns. So far, early experiments under a University of Utah pilot project are showing some remarkable results.

A new breakthrough in imaging technology using a combination of light and sound will allow health care providers to see microscopic details inside the body. Access to this level of detail potentially eliminates the need for some invasive biopsies, but it also has the potential to help health care providers make diagnoses earlier than ever before -- even before symptoms arise.

Doctors perform the world's first trachea transplant using stem cells to regenerate tissue. They took tissue from her nose and bone marrow stem cells to create a trachea biologically identical to the original organ.

An array of dissolving microneedles is shown on a fingertip.

Researchers are advancing a technology for the painless, self-administration of flu vaccine using patches containing tiny microneedles that dissolve into the skin.