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29 janvier, 2008 12:34

After mastectomy, implants are riskier

Cancer patients who have their breasts reconstructed with implants face a much higher risk of infection than with other methods, according to a new study at Washington University in St. Louis.

In studying 949 patients who underwent breast surgery at Barnes-Jewish Hospital from mid-1999 to mid-2002, researchers found 50 developed an infection within a year. Of those infections, 12 percent occurred in mastectomy patients who immediately had implant surgery. That was twice the rate of those who had reconstructive surgery using their own abdominal tissue. In noncancer patients, no infections occurred after breast augmentation using implants.

"The bottom line is that implants are associated with an increased risk of infection in breast cancer patients," said Margaret Olsen, who headed the study, which was published in the most recent Archives of Surgery. "The question is what factors contribute to this increased risk and what can be done to prevent it?"

Researchers theorize that implants represent a foreign object on which bacteria can grow, presenting a bigger threat to someone whose immune system has been weakened by chemotherapy or radiation. Implant reconstruction also involves at least three separate surgeries, increasing the chance of an infection. Each infection costs about $4,000 to treat.

For younger women

Digital best option for mammograms

Another study has confirmed that digital mammography is superior to old-fashioned film mammograms for certain women.

A new set of results from the Digital Mammographic Imaging Screening Trial (DMIST) found digital mammography better at finding problems for younger women with dense breasts.

"We looked at a cross-section of characteristics," said Dr. Etta D. Pisano of the University of North Carolina, the study's principal investigator. "This paper confirms that if you are under 50 -- pre- or perimenopausal -- and have dense breasts, you should definitely be screened with digital rather than film."

In addition, the study showed digital results somewhat better for women over 65 with fatty breasts, but the difference was not statistically significant. The results were released today and appear in the February issue of Radiology.

Wash. U part of genome project

Washington University in St. Louis will play a leading role in an international collaboration that will sequence the DNA of 1,000 individuals.

The ambitious 1000 Genomes Project will create the most detailed picture to date of human genetic variation and likely will identify many genetic factors underlying common diseases.

Drawing on experts from the United States, China and England, the project will develop a new map of the human genome that will provide a close-up view of medically relevant DNA variations at a resolution previously unmatched.

"A project like this would have been unimaginable only a few years ago," said Elaine Mardis, co-director of the local school's Genome Sequencing Center and one of the project's lead investigators. "We now have the ability to examine in intimate detail variations in the genetic code that differ from person to person."

At the genetic level, any two humans are more than 99 percent alike. However, it is important to understand the small fraction of genetic material that varies among people because it can help explain differences in an individual's risk of disease, response to drugs or reaction to environmental factors.

Study: Virus may facilitate obesity

Telling your wife that you simply "caught" those few extra pounds may not be as far-fetched as it sounds.

Scientists in Louisiana say a common virus may be a contributing factor to the obesity epidemic sweeping the United States and other countries. In experiments, they showed that infection with human adenovirus-36 transforms adult stem cells into fat cells while stem cells not exposed to the virus were unchanged. Adenovirus-36 is a common cause of respiratory and eye infections in humans.

The scientists also said they identified a specific gene in the virus that appears to promote this effect. The findings could lead to a vaccine or antiviral medications to help fight viral obesity in the future, the researchers suggested.

"We're not saying that a virus is the only cause of obesity," said Magdalena Pasarica, who headed the group. "But this study provides stronger evidence that some obesity cases may involve viral infections."

Study: Mixture may slow MS

Combining a medication currently used to treat multiple sclerosis (MS) with an antibiotic may slow the disease's progress, according to a preliminary study that will appear in next month's issue of the Archives of Neurology.

Doctors at the Louisiana State health Sciences Center in Shreveport followed 15 patients with relapsing-remitting MS. They were given a combination of interferon along with a daily 100-milligram dose of the antibiotic doxycycline. They then underwent monthly neurological exams and magnetic resonance image (MRI) scans to detect new damaged brain tissue (lesions).

After four months, 60 percent of the patients had more than a 25 percent reduction in the number of lesions from the beginning of the study. The patients also had reduced average scores on a scale designed to assess disability levels. Only one patient relapsed, and adverse effects were mild.

It is thought that antibiotics in the tetracycline family may help stop enzymes from destroying certain nervous system cells, protect the brain and pump up the immune system.

Article predicts customized diets

Better diets for fighting diabetes, obesity and heart disease one day may be just a finger-prick away, if a forecast in a recent issue of Chemical and Engineering News comes true.

In the article, Carmen Drahl, the magazine's assistant editor, explained that not all people respond to diet in the same way. What makes some people healthy may make others worse. Metabolomics, an emerging study of how foods affect metabolism, may provide new tools and data for customizing today's one-size-fits-all dietary guidelines.

For example, a routine blood test that measures hundreds of compounds could detect shifts in a person's metabolic balance to predict future health problems. Physicians then could develop a customized diet designed to work with that patient's metabolism, while follow-up tests would track improvements in health.

Now all scientists have to do is figure out how all of those compounds affect metabolism in the first place.