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HONG KONG (Reuters) - Excessive alcohol drinking may increase the risk of depression, a long-term study conducted over 25 years in New Zealand has found.

The study, published in the Archives of General Psychiatry, involved a group of 1,055 children who were monitored and interviewed at various times over 25 years.

“At all ages, there were clear and statistically significant trends for alcohol abuse or dependency to be associated with increased risk of major depression,” wrote the researchers, led by David Fergusson at the University of Otago’s department of psychological medicine.

The study found 19.4 percent of the participants between 17 and 18 were either abusing or dependent on alcohol, and 18.2 percent were diagnosed with depression.

“Individuals who fulfilled the criteria for alcohol abuse or dependency were 1.9 times more likely to also fulfill the criteria for major depression,” the researchers wrote.

The link between the two was significant even after factoring in other possible causes, such as use of cannabis and other illegal drugs, affiliation with “deviant peers,” unemployment and a partner who committed crimes.

“It has been proposed that this link may arise from genetic processes in which the use of alcohol acts to trigger genetic markers that increase the risk of major depression,” the researchers said.

“Further research suggests that alcohol’s depressant characteristics may lead to periods of depressed effect among those with alcohol abuse or dependency.”

via MedlinePlus: Alcohol abuse may lead to depression: study.

The findings, issued by National Council on Radiation Protection and Measurement, add to already mounting evidence that doctors are ordering too many diagnostic tests, driving up the cost of healthcare in the United States and potentially harming patients.

While diagnostic scans give doctors valuable information and many times are necessary, doctors fear too much radiation exposure can cause cancer, especially in younger people.

“Imaging has literally become the guiding hand of medical practice,” said Dr. James Thrall, chair of the American College of Radiology’s Board of Chancellors, who was not part of the study.

“Unfortunately, one of the things we have seen in the imaging world is that many physicians look at imaging as the solution to their financial problems,” Thrall, head of radiology at Massachusetts General Hospital in Boston, said in a telephone interview.

He said imaging technology has created a financial incentive for some doctors to cash in by referring patients to get imaging tests on equipment in their own practices. This is one place the federal government and Congress can look in enacting healthcare reform, Thrall added.

A study by the Government Accountability Office in July found Medicare spending on medical imaging doubled to about $14 billion a year between 2000 and 2006, driven largely by increases in high-tech imaging.

In November, a 10-year study by a team at the University of California, San Francisco, found use of computed tomography or CT scans, an advanced type of X-ray, doubled among patients in a large managed care plan between 1997 and 2006.

Thrall said advanced diagnostic scans have revolutionized the way doctors can treat patients, eliminating the need for unnecessary exploratory surgery and improving patient care.

NON-RADIOLOGISTS

But hundreds if not thousands of non-radiologists have purchased imaging equipment for their offices, and many studies suggest this has helped to drive up medical costs.

The GAO report, for example, found that from 1998 to 2005, the number of self-referred, in-office CT, MRI and nuclear medicine scans done on Medicare patients grew at triple the rate of the same exams performed in all other settings, such as hospitals or stand-alone imaging centers.

“There is a fundamental problem when the person ordering the study has a direct financial interest in maximizing the use of a particular piece of equipment,” Thrall said.

The Medical Imaging and Technology Alliance, an industry group, rejected the notion that financial incentives are driving the increased use of imaging in medicine.

“The GAO report shows that past efforts to cut medical imaging reimbursement, such as the 2005 Deficit Reduction Act, have significantly slowed imaging growth, suggesting further cuts could endanger the availability of these services,” Ilyse Schuman, managing director of the group, said in a statement.

Thrall said the American College of Radiology is working with other radiology groups to craft standards about the appropriate use of imaging, which, when used properly, can improve patient care and help cut medical costs.

Study finds it alters levels of hormones, could raise risk of obesity, diabetes and heart disease

Working the night shift might lead to hormonal and metabolic changes that raise risks for obesity, diabetes and heart disease, researchers say.

“In the long run, the physiological impact of shift work on several markers involved in the regulation of body weight — leptin, insulin, cortisol — seems to contribute to the increased risk for the development of diabetes, cardiovascular disease and obesity,” said study author Frank Scheer, an instructor of medicine in the division of sleep medicine at Brigham and Women’s Hospital and Harvard Medical School, in Boston.

Scheer and his team report the findings in the March 2 online issue of the Proceedings of the National Academy of Sciences.

The authors point out that about 8.6 million Americans perform shift work, which the National Sleep Foundation defines as any type of schedule that falls outside the standard nine-to-five norm for business hours. In the United States, factory workers, hospital staff, policemen, firefighters, pilots, road crews and truck drivers are some of the positions that commonly entail some degree of shift work.

This type of work has been previously associated with gastrointestinal problems, fatigue and poor sleep, the researchers noted. Such complications are thought to arise from a chronic disconnect between the waking and eating habits the work demands and the body’s innate 24-hour sleep/wake clock, commonly known as the circadian rhythm.

To explore how such a misalignment might raise the risk for developing serious health issues, Scheer and his colleagues conducted a laboratory test designed to mimic the acute effects of jet lag and/or the chronic impact of regular shift work.

In the experiment, the bodily responses of five men and five women were tracked as they stuck to an ever-changing sleep/eat schedule for 10 days.

By the study’s conclusion, all the volunteers had eaten and slept across all phases of the circadian cycle, as they followed a daily schedule artificially fashioned along 28-hour blocks.

The results: circadian misalignment provoked a drop in levels of the weight-regulating hormone leptin. Plummeting leptin levels could hasten the onset of obesity and heart disease by prompting increases in appetite and decreases in activity, the researchers said.

Furthermore, changes in blood sugar levels and insulin levels also occurred, resulting in impaired glucose tolerance and decreased insulin sensitivity.

In particular, three participants with no prior history of diabetes developed glucose levels that resembled those of pre-diabetic people after eating on the misaligned schedule. Daytime blood pressure levels were also found to be elevated among these volunteers.

The degree of hormonal change was highest when participant schedules were set 12 hours off the normal sleep/wake cycle — that is, when participants were asked to sleep throughout the day and stay awake through the night.

Yet despite the strength of the findings, Scheer cautioned that more research is needed before drawing too many conclusions.

“First of all, this is an in-laboratory study of short duration,” he observed. “So we don’t yet know if circadian misalignment has a similar impact in the long run in a real-life setting where people are performing night shift work.”

“We also need to look at how different people might respond differently,” Scheer noted. “Because shift work typically affects people’s alertness levels, and GI functioning, and those who don’t cope well with this are likely to drop out. Which means that those who continue with this kind of work might not be so susceptible to such problems, and may be less sensitive to this kind of misalignment. These are all questions for the future.”

For the time being, Dr Joseph Bass, an assistant professor of medicine at Northwestern University’s Feinberg School of Medicine in Chicago, agreed it is too soon to draw direct connections between shift work and specific health risks.

“However, having said that, this isn’t smoke and mirrors,” he said. “Our internal biological clocks represent a whole area of biology that is as critical as blood pressure or breathing. And this work does provide us with a plausible biological mechanism that may underlie and cumulatively contribute to the occurrence of metabolic disorders in certain individuals, because of their work patterns, or because of traveling, or simply because they ignore the normal light cycle.”

via MedlinePlus: Night Shift Work Hard on the Heart.

LONDON (Reuters) - Healthier living could prevent about a third of the most common cancers in rich countries and about a quarter in poorer ones, international researchers said on Thursday.

Better diets, more exercise and controlling weight could also prevent more than 40 percent of colon and breast cancer cases in some countries, according to the study which urged governments and individuals to do more to cut the number of global cancer deaths each year.

“At the time of publication, roughly 11 million people worldwide are diagnosed with cancer and nearly eight million people die from cancer each year,” said Michael Marmot, who led the study from the World Cancer Research Fund and the American Institute for Cancer Research.

“However, cancer is mostly preventable.”

The study involved 23 experts who analyzed both the incidence of 12 common cancers across the world and data on diet, exercise and weight to see how these factors contributed to kidney, mouth, lung, gallbladder and the other cancers.

The researchers found that healthier living would prevent 43 percent of colon cancer cases and 42 percent of breast cancer cases in Britain, and 45 percent of bowel cancer and 38 percent of breast cancer cases in the United States.

The findings follow the same groups’ study in 2007 that showed how quickly people grow and what they eat are both significant causes of cancer.

They recommended — in line with what health experts, including governments and the U.N. World Health Organization, have long been advising — that people follow diets based on fruits, vegetables and whole grains and go easy on red meats, dairy products and fats.

The team also looked at China and Brazil as representatives of low- and middle-income countries, respectively.

Overall improving diet, exercise and weight would in the United States prevent more than a third of the 12 most common cancers — which also included stomach, womb (uterus), prostate, pancreas and esophagus tumors.

This amounted to 39 percent of the cancers in Britain, 30 percent in Brazil and 27 percent in China.

“This report shows that by making relatively straightforward changes, we could significantly reduce the number of cancer cases around the world,” Marmot said in a statement.

“On a global level every year, there are millions of cancer cases that could have been prevented and this is why we need to act now before the situation gets even worse.”

(Reporting by Michael Kahn, Editing by Will Dunham)

via MedlinePlus: Clean living could cut third of many cancers.

It might one day be used as an ingredient in sunscreen, researchers say

Past studies have suggested that caffeine might offer some protection from skin cancer, and new research may explain why.

“We have found what we believe to be the mechanism by which caffeine is associated with decreased skin cancer,” said lead researcher Dr. Paul Nghiem, an associate professor of dermatology at the University of Washington in Seattle.

For the study, Nghiem’s team looked at caffeine’s effect on human skin cells in a laboratory that had been exposed to ultraviolet radiation. They found that in cells damaged by UV rays, caffeine interrupted a protein called ATR-Chk1, causing the damaged cells to self-destruct.

“Caffeine has no effect on undamaged cells,” Nghiem said.

ATR is essential to damaged cells that are growing rapidly, Nghiem said, and caffeine specifically targets damaged cells that can become cancerous. “Caffeine more than doubles the number of damaged cells that will die normally after a given dose of UV,” he said.

“This is a biological mechanism that explains what we have been seeing for many years from the oral intake of caffeine,” he added.

The findings were published online Feb. 26 in the Journal of Investigative Dermatology.

But, Nghiem added, people shouldn’t increase the amount of coffee or tea they drink to prevent skin cancer. “You are talking a lot of cups for a lot of years for a relatively small effect,” he said. “But if you like it, it’s another reason to drink it.”

Nghiem has also been experimenting with applying caffeine directly to the skin. “It suppresses skin cancer development by as much as 72 percent in mice, and human studies are moving ahead slowly,” he said.

It’s possible that topical caffeine preparations might one day be used to help prevent skin cancer, Nghiem said. “Caffeine is both a sunscreen and it deletes damaged cells,” he said. “It may well make sense to put it into a sunscreen preparation.”

Dr. Robin Ashinoff, a dermatologist and clinical associate professor of dermatology at New York University’s Langone Medical Center, thinks these findings need to be verified before they can have any clinical application.

“This study tells me that caffeine may be a useful ingredient topically to remove ultraviolet-genetically damaged cells from reproducing,” Ashinoff said. “This may help prevent the development of skin cancer.”

“It is interesting that caffeine, which is thought to have a negative connotation, has already been shown to be associated with lower incidences of non-melanoma skin cancers in several epidemiological studies,” she added.

Dr. Albert Lefkovits, a spokesman for the Skin Cancer Foundation and an associate clinical professor of dermatology at the Mount Sinai School of Medicine in New York City, doesn’t think it’s been proven that caffeine reduces the risk of skin cancer.

“While this is an interesting concept that has been explored before, it will take years of extensive testing to determine whether this will be a worthwhile prevention method,” Lefkovits said.

“And, the study doesn’t discuss how much caffeine would be needed for any real benefit,” he said. “For instance, many people drink large amounts of caffeine on a daily basis and still get skin cancer. Protecting yourself from the sun is currently the only proven way to prevent skin cancer.”

via MedlinePlus: Caffeine May Offer Some Skin Cancer Protection.

Cervical cancer is highly preventable in most Western countries because screening tests and a vaccine to prevent HPV infections are available. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

Virtually all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital warts.

HPV is so common that most people get it at some time in their lives, but HPV usually causes no symptoms so you can’t tell that you have it. For most women, HPV will go away on its own; however, if it does not, there is a chance that, over time, it may cause cervical cancer.

Screening Tests

Two tests can help prevent cervical cancer:

* The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

* The HPV test looks for the virus that can cause these cell changes.

The Pap test is recommended for all women. Talk with your doctor, nurse, or other health care professional about whether the HPV test is right for you. The most important thing you can do to avoid getting cervical cancer is to have regular screening tests.

If your Pap test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. For more information, visit Making Sense of Your Pap and HPV Test Results.

Also available is Take Time to Save Your Life (Podcast 3:27 mins), a podcast that features Dr. Mona Saraiya discussing how a Pap smear is performed and the age when women should begin having this test.

HPV Vaccine

If you are 11 through 26 years old, you can help prevent cervical cancer by getting the HPV vaccine. It protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers, and is given in a series of three shots. The vaccine is recommended for 11 and 12 year old girls. It also can be given to females 13 through 26 who did not get any or all of the shots when they were younger.

What CDC Is Doing

HPV-Associated Cancers Study

According to a study led by CDC, about 25,000 cases of HPV-associated cancers occur each year. The report, “Assessing the Burden of Human Papillomavirus (HPV)-Associated Cancers (ABHACUS),” appeared in the November 15, 2008 supplement edition of the journal Cancer. To learn more about these kinds of cancer, visit HPV-Associated Cancers.

Free or Low-Cost Pap Tests

If you have a low income or do not have insurance, you may qualify for a free or low-cost Pap test through CDC’s National Breast and Cervical Cancer Early Detection Program. To find out if you qualify, call your local program.

National Gynecologic Cancer Awareness Campaign

CDC developed Inside Knowledge: Get the Facts About Gynecologic Cancer to raise awareness of gynecologic cancers, including cervical cancer.

via CDC Features - Making Progress against Cervical Cancer.

Among women in the United States, ovarian cancer is the eighth most common cancer and the fifth leading cause of cancer death, after lung and bronchus, breast, colorectal, and pancreatic cancers.* Ovarian cancer causes more deaths than any other cancer of the female reproductive system. But when ovarian cancer is found in its early stages, treatment can be most effective.

Signs and Symptoms

Ovarian cancer often causes signs and symptoms. See your doctor, nurse, or other health care professional if you have any of these signs every day for two weeks or longer and they are not normal for you, especially if they get worse:

* Pain in the pelvic or abdominal area (the area below your stomach and between your hip bones).

* Back pain.

* Being tired all the time.

* Bloating, which is when the area below your stomach swells or feels full.

* A change in your bathroom habits, such as having to pass urine very badly or very often.

* An upset stomach or heartburn.

* Discharge from your vagina that is not normal for you.

Also, see your doctor if you have any bleeding from your vagina that is not normal for you, particularly if you are past menopause. These symptoms may be caused by something other than cancer, but the only way to know is to see your doctor. The earlier ovarian cancer is found and treated, the more likely treatment will be effective.

Risk Factors

There is no way to know for sure if you will get ovarian cancer. Most women get it without being at high risk. However, several factors may increase the chance that you will get ovarian cancer, including if you

* Are middle-aged or older.

* Have close family members (such as your mother, sister, aunt, or grandmother) on either your mother’s or your father’s side, who have had ovarian cancer.

* Have had breast, uterine, or colorectal cancer.

* Have an Eastern European (Ashkenazi) Jewish background.

* Have never given birth or have had trouble getting pregnant.

* Have endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body).

If you have one or more of these factors, it does not mean you will get ovarian cancer. But you should speak with your doctor about your risk.

Steps to Help Prevent Ovarian Cancer

There is no known way to prevent ovarian cancer. But these things may lower your chance of getting ovarian cancer:

* Having used birth control pills for more than five years.

* Having had a tubal ligation (getting your tubes tied), both ovaries removed, or a hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).

* Having given birth.

Screening Tests

There is no simple and reliable way to test for ovarian cancer in women who do not have any signs or symptoms. The Pap test does not check for ovarian cancer; however, here are steps you can take:

* Pay attention to your body, and know what is normal for you.

* If you notice any changes in your body that are not normal for you and could be a sign of ovarian cancer, talk to your doctor about them and ask about possible causes, such as ovarian cancer.

* Ask your doctor if you should have a test, such as a rectovaginal pelvic exam, a transvaginal ultrasound, or a CA-125 blood test if—

o You have any unexplained signs or symptoms of ovarian cancer. These tests sometimes help find or rule out ovarian cancer.

o You have had breast, uterine, or colorectal cancer; or if a close relative has had ovarian cancer.

Read the U.S. Preventive Services Task Force recommendation against routine screening for ovarian cancer.

Treatment

If your doctor says that you have ovarian cancer, ask to be referred to a gynecologic oncologist—a doctor who has been trained to treat cancers of a woman’s reproductive system. This doctor will work with you to create a treatment plan.

*Incidence counts cover approximately 96 percent of the U.S. population. Mortality counts cover 100 percent of the U.S. population. Use caution in comparing incidence and mortality counts.

via Cancer - Gynecologic Cancers - Basic Information about Ovarian Cancer.

Finger loss is one result, and experts urge better awareness of how machines work

Snowblowers might make clearing the sidewalk quicker and easier, but those who use them continue to show up in emergency rooms with hand injuries and accidental amputations, say medical experts.

“The injuries need to be prevented, because they’re not the type of injuries that can be reconstructed,” said Dr. Daniel Master, an orthopedic surgery resident at University Hospitals Case Medical Center in Cleveland and the study’s lead author. The nature of the tissue damage caused by snowblowers makes a full recovery extremely difficult and often leads to amputation, he said, and “even if you have the amputated part, it’s essentially useless.”

Master and his colleagues researched snowblower-related hand injuries sustained by 22 patients he treated from 2002 to 2005 at Hartford Hospital in Connecticut. He was expected to present their findings Friday at the American Academy of Orthopaedic Surgeons’ annual meeting, in Las Vegas.

“The weather is a major factor that causes the cluster of these injuries,” Master said. “When the snow is dense, the machines get clogged, and people put their hands down the shoot” to clear it.

Part of the problem, he found, is that people sometimes ignore the safety warnings that come with the snowblowers. “A large majority were aware of the warnings but stuck their hand down the shoot when it was running anyway,” Master said.

In addition, he explained, snowblowers usually have two blades, including one that’s not visible. That’s the one that causes most injuries, he said. Also, “there’s a lag time between when you release the dead-man’s switch and when the blade stops moving,” Master said.

Danger apparently exists even when the machines do not seem to be running, though. Master said that when a clog is removed, the blades can spin again using stored energy.

Dr. James G. Adams, professor and chairman of emergency medicine at the Feinberg School of Medicine at Northwestern University in Chicago, said that he, too, had encountered patients with snowblower-related injuries during his time at Brigham and Women’s Hospital in Boston from 1995 to 2000.

“In the winter, every day, people would come in with their fingers cut off,” Adams said. “I remember taking care of a doctor on the medical staff who was shoveling his driveway and cut his fingers off. When the chute got clogged, there was still tension and torque, so as soon as you got snow out, the snowblower would turn really quickly and cut your fingers off.”

However, he said, manufacturers “changed it so there wasn’t any residual torque, and that seemed to decrease the incidence of snowblower injuries.”

But it didn’t eliminate them.

“It’s a good general public health message,” Adams said. “Any reminder to the public that snowblower injuries are still occurring and have not been completely eliminated is still a good message.”

via MedlinePlus: Snowblower Hand Injuries Often Extensive, Study Finds.

Genetic analysis method can be used on all women with diagnosis, study says

A new genetic test that analyzes a set of 50 genes to identify four types of breast cancer could lead to quicker, more immediate treatment for patients, according to U.S. researchers who developed the test.

“Unlike a widely used genomic test that applies only to lymph-node-negative, estrogen-receptor-positive breast cancer, this new genomic test is broadly applicable for all women diagnosed with breast cancer,” Dr. Matthew Ellis, of the Siteman Cancer Center at Washington University in St. Louis and Barnes-Jewish Hospital and a breast cancer specialist, said in a university news release.

Ellis and his colleagues analyzed the gene activity of more than 1,000 breast tumors and identified 50 genes that could be used to identify each of the four types of breast tumors — luminal A, luminal B, HER2-enriched and basal-like. A genetic test called OncotypeDx, which is currently in wide use, doesn’t identify all four tumor types, according to background information in the news release.

“Our test is the first to incorporate a molecular profile for the basal-like type breast cancers,” Ellis said. “That’s important because these breast cancers are arguably the most aggressive yet the most sensitive to chemotherapy. By identifying them, we can ensure they are treated adequately.”

The new test also identifies what’s often considered a fifth breast cancer type, known as normal-like. But the researchers discovered that, instead of being a fifth type of breast cancer, normal-like is an indicator that a breast tumor sample contains insufficient tumor cells to make a molecular diagnosis and that a new sample needs to be taken.

The researchers also said that the 50-gene test was highly accurate in predicting how 133 breast cancer patients would respond to chemotherapy. Luminal A was not sensitive to chemotherapy, which suggests that women with this good-prognosis type of breast cancer can forgo chemotherapy in favor of hormone-based therapy, they said. Among poor-prognosis types of breast cancer, they found that basal-like was the most sensitive to chemotherapy and luminal B the least sensitive.

via MedlinePlus: New Test May Mean Faster Breast Cancer Treatment.