Children's Personalities Linked To Their Chemical Response To Stress

Is your kid a "dove" cautious and submissive when confronting new environments, or perhaps you have a "hawk" bold and assertive in unfamiliar settings?

These basic temperamental patterns are linked to opposite hormonal responses to stress differences that may provide children with advantages for navigating threatening environments, researchers report in a study published online July 8 in Development and Psychopathology.

"Divergent reactions both behaviorally and chemically may be an evolutionary response to stress," says Patrick Davies, professor of psychology at the University of Rochester and the lead author of the study.

"These biological reactions may have provided our human ancestors with adaptive survival advantages. For example, dovish compliance may work better under some challenging family conditions, while hawkish aggression could be an asset in others."

This evolutionary perspective, says Davies, provides an important counterpoint to the prevailing idea in psychology that "there is one healthy way of being and that all behaviors are either adaptive or maladaptive."

Coauthor Melissa Sturge-Apple agrees: "When it comes to healthy psychological behavior, one size does not fit all." The assistant professor of psychology at the University of Rochester adds that the findings "give us insight into how basic behavioral patterns are also chemical patterns."

To understand the role of stress in children's reactions, Davies, Sturge-Apple, and Dante Cicchetti, a professor of child development and psychiatry at the University of Minnesota, focused on parental conflict in young families. "Research has shown that exposure to repeated aggression between parents is a significant stressor for children," explains Davies.

The study looked at 201 two-year-old toddlers, all from impoverished families with similar socio-economic profiles. Based on interviews and questionnaires with the mothers, the authors assessed children's exposure to levels of aggression between parents.

The researchers also documented the dove or hawk tendencies of the toddlers in a variety of unfamiliar situations. Children who showed dovish tendencies were vigilant and submissive in the face of novelty. The toddlers clung to their mothers, cried, or froze when encountering new surroundings. Hawks used bold, aggressive, and dominating strategies for coping with challenge. They fearlessly explored unknown objects and new environments.

When the researchers exposed the children to a mildly stressful simulated telephone argument between their parents, distinct patterns of hormonal reactions emerged. Children exposed to high levels of interparental aggression at home showed different reactions to the telephone quarrel. Doves with parents who fought violently produced elevated levels of cortisol, a hormone that is thought to increase a person's sensitivity to stress.

Hawks from such stressful home environments put the breaks on cortisol production, which is regarded as a marker for diminishing experiences of danger and alarm.

This high-and-low-cortisol reactivity provides different developmental advantages and disadvantages, the authors write. Heightened cortisol levels characteristic of the doves were related to lower attention problems but also put them at risk for developing anxiety and depression over time. By contrast, the lower cortisol levels for hawks in aggressive families were associated with lower anxiety problems; however, at the same time, these children were more prone to risky behavior, including attention and hyperactivity problems.

Source: University of Rochester

Most Obese States, Least Active Named In New Fitness Reports

In two new reports, the most obese and the least active states have been named. Sixteen out of the 50 U.S. states have gotten fatter according to a new report released this week. Thus, obesity rates in a dozen states have risen about 30% with Mississippi being the largest state in the commonwealth overall. Jackson, MI comes in as the nation's fourth least active city in parallel.

Mississippi has an adult obesity rate of 34.4% and Colorado is winning with a rate of 19.8% obesity level overall, being the only state with an adult obesity rate below 20%. Four years ago, only one U.S. state had an adult obesity rate above 30%, according to the report.

The study also explained that over the past 15 years, seven states have doubled their rate of obesity and 10 states have doubled their rate of diabetes, and since 1995, obesity rates have risen fastest in Oklahoma, Alabama and Tennessee, while Colorado, Connecticut and Washington, D.C., had the slowest increases.

This somewhat coincides with a similar study presented by Men's Health Magazine last month that listed Jackson, Mississippi as the third least active city in The Union.

Lexington, Kentucky, with its really blue bluegrass, world class horse farms and home of the University of Kentucky Wildcats, ranks as the absolutely laziest city in the United States. Indianapolis in Indiana and Jackson, Mississippi also ranked among the least active, while Seattle, San Francisco and Oakland, California were the most physically active.

Editors looked at how often residents exercise, the number of households that watched 15 hours of cable television a week and bought more than 11 video games a year, and the rate of DVT, a blood clot in a vein, usually in the leg, which is associated with inactivity. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Here just below are the full lists released by Men's Health Magazine. These are the last ten and top ten out 100 ranked.

Least Active:Lexington, KY Indianapolis, IN Jackson, MS Charleston, WV Oklahoma City, OK Tulsa, OK Little Rock, AR Nashville, TN Laredo, TX Birmingham, AL Most Active:Seattle, WASan Francisco, CAOakland, CAWashington, DCSalt Lake City, UTReno, NVPortland, MEAtlanta, GADenver, COMinneapolis, MN Matt Marion, deputy editor of Men's Health explains:

'What hurt Lexington most was the actual amount of activity, or exercise, people reported engaging in, or any physical activity at all, which was relatively low. They did have higher rates of deaths from deep vein thrombosis (DVT) as well. When we crunched the numbers Lexington finished at the bottom."

Southern cities dominated the least active metropolises. Tulsa and Oklahoma City, also scored a low grade, as did Birmingham, Alabama, Laredo in Texas, Nashville, Little Rock and Charleston, West Virginia.

Public health experts around the world have raised the alarm about exploding rates of obesity and many are promoting efforts that increase physical activity and encourage access to affordable, healthy food.

In the United States, where two-thirds of adults and nearly one third of children are obese or overweight the obesity epidemic is sending healthcare costs higher and threatening everything from worker productivity to military recruitment.

Risa Lavizzo-Mourey, chief executive of the Robert Wood Johnson Foundation states the following:

"Changing policies is an important way to provide children and families with vital resources and opportunities to make healthier choices easier in their day-to-day lives."

Sources: The Robert Wood Johnson Foundation, Men's Health and The American Heart Association

Europe's Suicide Rates Up Following Financial Crisis

Suicide rates among the under-65s in the European Union (EU) rose markedly between 2007 and 2009, with Greece, Ireland and Latvia rising the most, say researchers who have been taking a first look at how the financial crisis affected deaths in the EU. The period also saw an increase in road deaths, especially in new member countries, probably due to a greater number of unemployed people making fewer car journeys.

Writing in The Lancet this week, Dr David Stuckler from the University of Cambridge, Professor Martin McKee of the London School of Hygiene and Tropical Medicine, both in the UK, and Dr Sanjay Basu, from the University of California San Francisco, in the US, and colleagues, say that up to 2007 there had been a steady decline in suicide rates among people aged 65 and under in the EU, but it reversed after that.

Rates of unemployment fell by 2.6% between 2007 and 2009, a 35% relative increase, across the whole of the EU. The reversal in suicide trends coincides with this, say the authors.

They looked at the EU as two groups: the "old" member states, and the "new" ones who joined in 2004, and found that the 2008 increase in suicide from 2007 was less than 1% in the new member states, but nearly 7% in the old ones. And in both groups the rates went up further in 2009.

"Among the countries studied, only Austria had fewer suicides (down 5%) in 2009 than in 2007 [despite a simultaneous increase in unemployment of 0.6%]. In each of the other countries the increase was at least 5%," they write.

They refer to an earlier paper where they propose that strong social support networks and social protection measures, including active labour market policies, can help prevent suicides, and perhaps this explains the figures for Austria.

In the past, Finland, a country that also has a strong social protection system, has also shown resilience against suicide during times of economic downturn, but in this latest financial crisis, they saw an unexpected increase in suicides of over 5%.

One of the problems the authors faced in their analysis is because data is more detailed from some countries than others, this affects the overall pattern. For instance, among the "old" members, the UK has the biggest influence, and Romania's data has the biggest effect on the "new" member patterns.

They say they will update their figures as more data becomes available from other countries, but they maintain the current figures are good enough to see that:

"... countries facing the most severe financial reversals of fortune, such as Greece and Ireland, had greater rises in suicides (17% and 13%, respectively) than did the other countries, and in Latvia suicides increased by more than 17% between 2007 and 2008."

The authors note that road traffic deaths in the EU also fell substantially, particularly in the new member countries, where they were very high at first. Thus deaths on the roads of Lithuania, a new member to the EU, fell rapidly, by almost 50%, whereas in the Netherlands, an "old" member country, where road deaths were already low, they fell hardly at all.

The analysis appears to echo what is happening outside the EU. For instance in the US, road deaths fell by 10% between 2007 and 2009. This is thought to be due to less use of the car at times of higher unemployment.

The fall in road deaths has reduced the availability of organs for transplant. This problem has particularly affected Spain and Ireland, where road deaths have fallen by more than 25% between 2007 and 2009.

Apart from the increase in suicide rates and reduction in road deaths, the authors say they can see no other major deviations from past trends in deaths from all causes.

They conclude that their findings "reveal the rapidity of the health consequences of financial crises".

The authors are now working on a more detailed analysis of the health effects of the crises, using a number of information sources, including individual level data from European household surveys together with results on the effects various policies.

They want to find out why some individuals, communities and societies seem to be more vulnerable while others appear more resilient to economic shocks. And also how different measures taken by governments influence health.

"There is clearly much more to be written on the health consequences of the events of 2008," they write.

"Effects of the 2008 recession on health: a first look at European data."
David Stuckler and others.
The Lancet Vol 378, published online 9 July 2011.

Source : The Lancet Press Office.

Man Receives New Windpipe Made From His Own Stem Cells And Artificial Material

Last month in Sweden, a man suffering from late-stage tracheal cancer received a new windpipe made in the lab from a synthetic scaffold with flesh grown from his own stem cells. This is the first successful transplant in the world of a tissue-engineered trachea that does not use a scaffold made from a donor organ.

The 36-year-old man is due to be discharged today: he is not taking immunosuppressant drugs because the transplanted tissue was made with his own cells, said the hospital.

The operation took place on 9 June 2011 at the Karolinska University Hospital in Huddinge, Stockholm. Professor Paolo Macchiarini, who works at the Hospital and the Karolinska Institutet, led the international transplant team.

Macchiarini, a world expert in regenerative medicine, has successfully transplanted tissue-engineered tracheas before, for instance at the Hospital Clinic of Barcelona. But those tissue-engineered windpipes used "scaffolds" from trachea taken from organ donors. In those procedures the donated windpipe has the donor cells stripped away, leaving just the extracellular matrix, and then the recipient's stem cells are used to seed new tissue onto the scaffold.

This new operation is a world first because it used an artificial scaffold made from a nanocomposite polymer material (a sort of spongy and flexible plastic made of extremely small building blocks).

Also on the team were Professor Alexander Seifalian of University College London in the UK, who designed and built the Y-shaped scaffold, and members from Harvard Bioscience in Boston in the US, who custom-produced the bioreactor that, in only two days, grew the flesh onto the scaffold from the patient's own stem cells.

The man's cancer had progressed to the point where he needed a transplant but no suitable donor organ was available. The tumor in his trachea was about 6 cm long and beginning to spread to a main bronchus, a tube that leads to a lung. He had received maximum treatment with radiotherapy, but to no avail.

The tissue-engineered option was the only one left to save his life. He was receiving cancer treatment at Landspitali University Hospital in Iceland, under the supervision of Professor Tomas Gudbjartsson who referred him to the Swedish hospital. Gudbjartsson was also on the transplant team.

The successful transplant brings hope to thousands of other patients who have late-stage tracheal cancer or other conditions that block the passage of air into the lungs. Children in particular would benefit from having this option, since child donor tracheas are much harder to obtain.

In a CNN-reported comment to the media about the significance of the operation, Macchiarini described it as a "beautiful international collaboration":

"If scientists and clinicians work together, we can help humanity," he said.

Source : Karolinska University Hospital, CNN.

Genetic Marker Linked To Rectal Cancer Treatment

A team of researchers led by Keck School of Medicine of the University of Southern California (USC) oncologist Heinz-Josef Lenz, M.D., has identified a genetic marker that may predict which patients with rectal cancer can be cured by certain chemotherapies when combined with surgery. The discovery, scheduled for publication in the August 1 edition of Clinical Cancer Research, brings doctors closer to customizing cancer treatment to individual patients.

Lenz, professor of medicine and preventive medicine in the division of medical oncology at the Keck School and the study's principal investigator, analyzed the DNA of European patients with locally advanced rectal cancer who were treated with cetuximab (marketed as Erbitux) prior to surgery.

"Cetuximab is usually used for metastatic colon cancer, for which it is effective. We're asking if it could be effective for locally advanced rectal cancer," said Lenz, associate director of the Gastrointestinal Oncology Program at the USC Norris Comprehensive Cancer Center and Hospital.

Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death among men and women in the United States, according to the American Cancer Society. The disease develops in the colon or rectum and, if detected in its early stages, usually can be completely removed by surgery. When it is locally advanced, however, the tumor cannot be easily removed and doctors prescribe chemotherapy and radiation to make it more manageable before attempting surgical removal.

The retrospective analysis, first published online on June 14, found that 45 percent of patients with a particular genetic combination (EGF 61 G/G) emerged disease-free when treated with cetuximab before surgery, compared to 21 percent and 2 percent of patient groups who did not have the same genotype. This is the first study to suggest that the genetic variation - detectable by blood test - can be used to predict whether a patient with locally advanced rectal cancer will respond to cetuximab before surgery.

Cetuximab is a drug that is typically used to treat head and neck cancer and colorectal cancer that has spread to other parts of the body. It blocks epidermal growth factor receptors (EGFR) from binding with epidermal growth factor (EGF) proteins found in the body, which have been linked to increased risk for cancer. For tumors that are difficult to cut out but have not yet spread to other parts of the body, the standard treatment is a combination of capecitabine (Xeloda), fluorouracil (5-FU) and radiation. The patients in the study received intravenous doses of cetuximab in addition to standard care.

Notes:

Additional data is required to validate the results, Lenz said. His lab is participating in another trial looking at a larger sample size in the United States.

The study was performed in the Sharon A. Carpenter Laboratory at the USC Norris Comprehensive Cancer Center and Hospital and funded by the National Institutes of Health, Dhont Family Foundation, Deutsche Forschungsgemeinschfat (DFG), Cologne Fortune and San Pedro Peninsula Cancer Guild. It is the second study published in Clinical Cancer Research that uses the same data set; the first measured gene expression levels of proteins involved in tumor growth. Co-authors include Siwen Hu-Lieskovan, Wu Zhang, Dongyun Yang, Alexander Pohl and Melissa Labonte, among others.

Source:
Alison Trinidad
University of Southern California

Breastfeeding Does Not Protect Against MS Relapse, Study

Despite previous research suggesting otherwise, breastfeeding does not appear to protect against multiple sclorosis (MS) relapses, according to a new study published in Neurology this week. Researchers in Italy found that the likelihood of relapse after pregnancy was tied to relapses before and during pregnancy but not to whether the mothers in their study breastfed or not. They concluded breastfeeding may not be a feasible option for mothers at high risk of relapse after pregnancy, because they may need to resume drug treatments straight away.

First author Dr Emilio Portaccio of the University of Florence, told the media that:

"Breastfeeding should not be encouraged by doctors to protect against MS relapses, especially among women with MS who have high disease activity and high risk of postpartum relapses."

"Since it is not considered safe for women to take MS drugs while breastfeeding, breastfeeding may not be feasible for these women who may need to resume treatment to avoid relapses soon after giving birth," he added.

Portaccio and colleagues conducted a prospective study of 298 women recruited from 21 Italian MS centers and followed up their pregnancies from 2002 to 2008. Over this time, 302 out of 423 pregnancies resulted in full-term delivery, and follow ups continued for at least one year after delivery.

34.4% of the mothers breastfed for at least two months after delivery, while the remaining 65.6% breastfed for less than this or not at all and were considered as not breastfeeding.

During the 12 months following delivery, 37% of the mothers had one relapse and 6.6% had two or more.

Portaccio and colleagues found that:

"The time-dependent profile of the relapse rate before, during, and after pregnancy did not differ between patients who breastfed and patients who did not."

And in a multivariate analysis, a statistical tool where you can look at several measures at once to see which have the strongest influence on the outcome you are interested in (in this case relapse rate after pregnancy), they found that "the only significant predictors of postpartum relapses were relapses in the year before pregnancy ... and during pregnancy".

For relapses in the year before pregnancy they found the Hazard Ratio (HR) was 1.5 (with 95% Confidence Interval, CI, ranging from 1.3 to 1.9, p<0.001), and for relapses during pregnancy HR was 2.2 (95% CI =1.5 to 3.3, p<0.001).

This means women who had relapses in the 12 months leading up to their pregnancy were 50% more likely to have a relapse after delivery than women who did not have a relapse in the year before pregnancy. And women who had relapses during pregnancy were more than twice as likely to have a relapse after delivery as the women who did not experience relapses during pregnancy.

This was after taking into account influencing factors like age at onset of MS, age at pregnancy, duration of the disease, level of disability, and exposure to drugs, including any MS drugs.

There was nothing to suggest breastfeeding worsened the relapse rate.

The researchers concluded that:

"In our sample, postpartum relapses were predicted only by relapses before and during pregnancy."

"Especially, among patients with high risk of postpartum relapses, breastfeeding may not be feasible and early postpartum treatment should be an option," they added.

They also suggested the link between breastfeeding and lower risk of relapses after pregnancy that previous studies have reported may "simply reflect different patient behavior, biased by the disease activity".

As Portaccio explained:

"Women who have fewer relapses before and during pregnancy may be more likely to breastfeed and then continue to have fewer relapses in the postpartum period."

However, he said that a course of steroids taken after pregnancy might protect against later attacks, and pointed out that:

"Approaches of this type were not assessed in this study and might, in consultation with the treating neurologist, enable breastfeeding."

The MS Study Group of the Italian Neurological Society supported the study.

Breastfeeding is not related to postpartum relapses in multiple sclerosis."
E. Portaccio, A. Ghezzi, B. Hakiki, V. Martinelli et al
Neurology published online ahead of print 6 July 2011.
DOI: 10.1212/WNL.0b013e318224afc9

Additional source : American Academy of Neurology.

Researchers Seek To Inspire Interest In The Medical Potential Of Antlers, Horns, Ossicones And Pronghorns

Emerging from the heads of most cud-chewing mammals, headgear inspire an almost mystical and certainly majestic aura. But, scientists say, we know shockingly little about them.

In a paper appearing online ahead of regular publication in the Proceedings of the Royal Society B, a London-based international journal dedicated to biology, a three-member scientific team spells out what is known -- and not known -- about antlers, horns, pronghorns and ossicones.

For antlers, think deer, moose and elk. Horns are worn by cattle, sheep and goats; ossicones by giraffes and okapi. Pronghorns are found on pronghorn antelope, a strictly North American mammal. The represent the cervid, bovid, giraffids and antilocaprid families, respectively.

In addition to their perplexing evolutionary origins, major questions surround how a better biological understanding of these animals' headgear might lead to innovations in medical treatments for such conditions as skin damage from burns, bone cancer and osteoporosis, says lead author Edward Byrd Davis, a paleontologist in the department of geological sciences at the University of Oregon.

"Antlers, for example, are the fastest growing bones of any living vertebrate today," said Davis, who also is fossil collection manager at the UO Museum of Natural and Cultural History and affiliate of the Robert D. Clark Honors College. "They are shed at the end of each season and replaced by new racks every year.

"This is one of those things where you'd think we'd know more, but we don't," said Davis, who became interested in pronghorn antelopes while a doctoral student at the University of California, Berkeley. "Scientists get a lot of press coverage for dark matter or the Higgs boson because they are among deep mysteries that we are still unlocking. A lot of people assume that most of biology is understood, yet something as fundamental as the age-old question 'how did the cow get its horns?' is still not well understood."

Among assumptions only recently overturned was the idea that pronghorn antelope were related to antler-wearing deer or horned cattle, goats and sheep. In fact, a mitochondrial DNA study co-authored by Spain's Manuel Hernandez Fernandez and Yale University's Elisabeth S. Vrba, published in Biological Reviews in 2005, determined that pronghorn antelope are more closely related to giraffes.

It turns out the origin and evolution of headgear was probably messy, with a shared origin among some lineages and independent origins of form and development in others, concluded Davis and co-authors Katherine Brakora, a doctoral student at the University of California, Berkeley, and Andrew Lee, a professor at Midwestern University in Glendale, Ariz.

The hope is, Davis said, that his team's review of the literature will inspire a renewed exploration by biologists of the various headgear found in both living and fossil species.

"We need to be looking more closely at the early development of horns, antlers, ossicones and pronghorns and be making comparisons between fossils and modern animals," he said. "We hope to develop collaborations to better interpret what we find in the fossil record and to better understand the biological development of these headgear. Achieving that, we should be able to uncover a number of applications for human medicine."

Source:
Jim Barlow
University of Oregon

Essential Role Of A Molecule In Skeletal Muscle Development Reveals New UEA Study

According to a report published this week in the journal Proceedings of the National Academy of Sciences (PNAS), an essential role of a molecule in skeletal muscle development has been discovered by researchers at the University of East Anglia (UEA).

The finding of the current study could prove helpful in the future, in curing certain ailments that require muscle regeneration or maintenance of healthy muscle.

Traditionally, microRNAs (short ribonucleic acid molecules) have been among the least understood molecules but recent advances in genome research have allowed scientists to gain more insight into their complexity, importance and function in disease process.

Skeletal muscles which are a form of striated muscle tissue are vital for body movements and healthy aging. The role of microRNA in their development was unknown until now.

The current study was conducted by scientists in the School of Biological Sciences at UEA and the Weizmann Institute of Science, in Rehovot, Israel.

They proved that for normal muscle development to take place in an embryo, a specific microRNA, called miR-206 was crucial. MiR-206 turns off a gene called Pax3 which leads to specialization of embryonic muscle cells into contractile cells required for the muscle to function. The scientists state that adult muscle stem cells which differentiate in response to muscle injury or exercise also follow the same regulation.

"Muscle is vital to our well being, but it can become fragile, for example as we age or through certain muscle-wasting diseases. Therefore understanding how muscle tissue develops and is maintained is important,"

said Andrea Münsterberg, who is the lead author and professor in developmental biology at UEA.

She further stated,

"Discovering how the Pax3 gene is regulated by miR-206 and controls other genes that lead to muscle differentiation is significant. If you control Pax3 you could control when cells become more specialised and take on their unique function. We suggest that what we have learnt about embryo development also applies to adult muscle. In theory, if we could enhance the function of microRNAs in the body we might in the future be able to promote the maintenance of healthy muscle or muscle regeneration in certain diseases."

"MicroRNA regulation of the paired-box transcription factor Pax3 confers robustness to developmental timing of myogenesis"
Proceedings of the National Academy of Sciences

Colorectal Cancer Cases And Deaths Falling, But Screening Not Reaching All Who Need It Say CDC

The rates of colorectal cancer cases and deaths in the US have fallen thanks to more widespread screening, but one in three adults who should be receiving screening is still missing out, according to a new report from the US Centers for Disease Control and Prevention (CDC).

The CDC Vital Signs report for July 2011 shows that between 2003 and 2007:

• New cases of colorectal cancer fell from 52.3 to 45.4 per 100,000.
• Deaths fell from 19.0 to 16.7 per 100,000.
• This translates to 66,000 cases of cancer prevented and 32,000 lives saved compared to 2002.

The report also says half of the prevented cases and deaths were due to screening.

However, it emphasizes that 1 in 3 adults is still not getting screened as recommended.

Of cancers that affect both men and women, colorectal cancer (a disease that occurs in the colon or rectum) is the number 2 cancer killer in the US, the number 1 being lung cancer. In 2007 more than 142,000 Americans found out they had colorectal cancer, and more than 52,000 died of the disease.

However, the CDC say these numbers could be reduced even further if screening reached everyone who should have it. This is because screening helps find precancerous growths or polyps that can be safely removed before they turn into tumors.

The other advantage of screening is that it helps find cancer before it has starting spreading, making it much easier to treat and increasing people's chances of survival and returning to normal life.

If the US government's Healthy People 2020 target of 70.5% for colorectal cancer screening is met, nearly 1,000 more lives will be saved every year, they said.

The latest available figures on screening coverage shows that in 2010, one in three adults aged between 50 and 75 is not up to date with their colorectal cancer screening.

People without health insurance, or who are on low income or who have a low level of education are the ones most likely to not have received any screening or who don't receive it as often as recommended, say the CDC.

A common reason for why men and women fail to get the screening they need is that their healthcare provider doesn't suggest it to them. Other reasons include: some people don't realize the risk goes up as you get older, or they fear the test and/or the result says the report.

American adults should have one of the following screening tests for colorectal cancer:

• Every year: a fecal occult blood test (FOBT): this looks for hidden traces of blood in the stool.


• Every five years: a flexible sigmoidoscopy, where a healthcare provider uses a flexible tube with a camera to look for polyps (and safely removes them if necessary) in the rectum and the lower part of the colon.


• Every 10 years: a colonoscopy, which is like a sigmoidoscopy except that the doctor examines both the upper and lower sections of the colon.

People who should be screened more often include all adults from 50 to 75 years old, and anyone at risk of developing colorectal cancer, such as people with inflammatory bowel disease, Crohn's disease, who have an inherited predisposition, a personal history of polyps or close family members with a history of polyps or colorectal cancer.

The CDC says various provisions in the Affordable Care Act should increase access to colorectal cancer screening, but federal, state and local health departments can also help by establishing their own screening targets and working with state Medicaid programs to identify people who should get screened and make sure they do, plus ensure abnormal results are dealt with quickly.

Source : CDC: Vital Signs Cancer Screening.

Moderate Salt Reduction Reduces Blood Pressure But Not Risk Of Dying

Reducing daily salt intake by a moderate amount reduces blood pressure but not people's chances of dying or getting cardiovascular disease, said UK researchers who systematically reviewed evidence available from published trials. Trials involving much larger groups cutting their salt intake by more than a moderate amount could tell a different story, they noted.

"We believe that we didn't see big benefits in this study because the people in the trials we analyzed only reduced their salt intake by a moderate amount, so the effect on blood pressure and heart disease was not large," lead author Professor Rod Taylor who works at the Peninsula College of Medicine and Dentistry at the University of Exeter, told the press.

Taylor and colleagues wrote about their findings in the latest issue of the The Cochrane Library.

An earlier Cochrane review concluded in 2004 there wasn't sufficient evidence to say what effect reducing salt intake had on mortality or cardiovascular events, so Taylor and colleagues set out to find more recent studies to pool data from. They found seven studies covering a total of 6,489 participants.

When they analyzed the pooled data they found evidence that moderate reductions in salt intake reduces blood pressure:

"Intensive support and encouragement to reduce salt intake did lead to a reduction in salt eaten and a small reduction in blood pressure after more than six months," said Taylor.

But what they wanted to see was evidence that this change in diet also reduced people's risk of dying or having cardiovascualr disease, he explained. But they did not find this.

However, as the old saying goes, "absence of evidence does not equal evidence of absence" and it could simply be that the studies done so far have not been big enough.

Taylor said while 6,500 or so was enough participants to start drawing some conclusions, he believes you need at least 18,000 participants before you start seeing impact on health.

Many countries now have government-supported recommendations calling for reductions in dietary sodium. For example, NICE (short for National Institute of Health and Clinical Guidance, an independent body that gives national guidance on managing health and disease), says the UK should accelerate reduction of dietary salt from a maximum of 6g per day per adult by 2015 to 3g a day by 2025.

Taylor said against a backdrop of governments calling for these accelerated salt intake reductions, and food companies reducing it in their products, "it's really important that we do some large research trials to get a full understanding of the benefits and risks of reducing salt intake".

He also thinks we need to find ways of reducing salt in our diets that are both practicable and inexpensive.

Meanwhile, some of the authors of the studies that Taylor and colleagues included in their review have criticized their methods. They spoke about it to Heartwire.

Dr Lawrence Appel, from Johns Hopkins University Medical School in Baltimore, said the review "adds little to our knowledge about the health effects of sodium reduction".

He said none of the studies were designed to look at the effect of sodium reduction on cardiovascular events and risk of death, and "even in aggregate, the number of events is small and the statistical power is limited".

Dr Nancy R Cook, from the Harvard Medical School in Boston, agrees. She described the analysis as "crude" and "therefore loses information". She said the review misrepresents several of the studies, so the results are not reliable. For example, Taylor and colleagues just counted the number of events and didn't use individual patient data, which is what Cook and colleagues did in their study and that is why they found signficant results, she added.

"They are saying there's no evidence for an effect, but the analyses are different," said Cook, adding that if they had used a different method, Taylor and colleauges would have got different results.

"Reduced dietary salt for the prevention of cardiovascular disease."
Taylor RS, Ashton KE, Moxham T, et al.
Cochrane Database of Systematic Reviews 2011;
DOI: 10.1002/14651858.CD009217
Refer to: http://www2.cochrane.org/reviews/

Sources : Peninsula College of Medicine and Dentistry, Heartwire 5 July 2011.