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The observation was based on a national study launched at 118 hospitals across the United States. It focused on postmenopausal women who had been diagnosed with estrogen receptor-positive (ER+) breast cancer that was either at stage II or stage III — that is, tumors that were around an inch or greater in size and might have spread to the lymph nodes under the arm.

The most common form of breast cancer, ER+ accounts for about three-quarters of all breast cancer cases in the United States, the authors noted.

The 352 women who participated were monitored for tumor growth before and after being placed on a 16-week regimen of aromatase inhibitors — estrogen-lowering agents — before any surgery. Estrogen stimulates the growth of ER+ tumors.

The women were classified into three groups as the study began: “marginal”, meaning that the women were eligible for a lumpectomy to conserve the breast, but that it would be disfiguring or require several operations; “mastectomy-only”, meaning a lumpectomy was not considered possible; and “inoperable”, meaning that doctors believed that even a mastectomy would not completely remove the cancer.

After the four months of estrogen-lowering therapy, the research team found that 82 percent of those women in the marginal group were, in fact, able to undergo successful breast-conservation surgery.

More than half of those women who had been categorized as mastectomy-only patients were also able to go the lumpectomy route and experience a good outcome. And 75 percent of those thought to be inoperable altogether were able to have breast-conservation surgery.

The investigation was funded by the American College of Surgeons Oncology Group and led by Dr. Julie A. Margenthaler, an assistant professor of surgery and a breast surgeon at the Siteman Cancer Center at Washington University in St. Louis.

“Aromatase inhibitor therapy shrank the tumors in many of these women and improved surgical outcomes,” study chair Dr. Matthey J. Ellis, a breast cancer specialist at Washington University and Barnes-Jewish Hospital, said in a news release. “These results will encourage a change in practice across the country so that more women can benefit from the currently underutilized approach of administering estrogen-lowering agents before surgery.”

The State Indicator Report on Physical Activity 2010 includes data about individual behaviors related to physical activity, as well as the presence or absence of physical features and policies that can make being physically active either easy or hard to do.

The report looks at community access to parks or playgrounds, community centers, and sidewalks or walking paths in neighborhoods. The data showed substantial limits to the number of parks and other areas where physical activity would be convenient.

According to the report, only 20 percent of blocks have parks within a half mile of their boundaries, and only 17 percent of blocks have a fitness or recreation center within that distance.

“Regular physical activity is essential to overall health and can also help people maintain a healthy weight and reduce their risk for heart disease, type 2 diabetes, and other chronic diseases,” said CDC Director Thomas Frieden, M.D., M.P.H. “This state indicator report provides a measure for a state’s ability to support physical activity and shows where a state has been successful and where more work may be needed.”

The report also noted that only 17 percent of the nation’s high school students say they get at least an hour of physical activity each day, the minimum recommended for this age group.

One underlying reason for adolescents’ sedentary lifestyles may be the lack of easy ways for youth to be physically active in their communities and schools. Only 50 percent of young people reported having access to parks, playgrounds, community centers, and sidewalks that make physical activity convenient.

The report also finds that schools and childcare centers cannot be counted on as a place where young people can get the physical activity they need during the week. Only eight states require children to be engaged in moderate or vigorous physical activity in their licensed, regulated child care centers. Only 20 states require or recommend scheduled recess for elementary students, while 37 states require elementary, middle and high schools to teach physical education.

“Today’s report shows that too many kids are spending too much time in front of a computer or a TV or a video game or have limited access to physical activity because they live in neighborhoods that aren’t safe, go to schools where P.E. classes have been cut or live in communities where there are no sports leagues or afterschool activity programs,” said First Lady Michelle Obama. “We need parents and teachers, business and community leaders and the public and private sectors to come together to create more opportunities for our kids to be active so they can lead happy healthy lives.”

“An active lifestyle, combined with healthy eating, is the number one way to prevent obesity and key to preventing a host of serious obesity-related diseases,” said HHS Secretary Kathleen Sebelius. “As we mark National Physical Fitness and Sports Month in May, President Obama is challenging every American to make physical activity, fitness, and sports part of their daily routine. Today’s report shines a spotlight on the additional need for safe and convenient places for Americans to be physically active in their communities.”

“The places where we live, work, learn, and play affect the choices we make, and in turn, our health,” said William Dietz, M.D., Ph.D., director of CDC’s Division of Nutrition, Physical Activity and Obesity. “As chronic diseases place an increasing burden on the nation’s health care system, the need for improving policies and environments for physical activity is more important than ever. This report can help states, communities and others work together to increase the number of Americans who live healthier lives by creating communities that support and encourage physical activity.”

The full report is available at http://www.cdc.gov/physicalactivity/professionals/reports/index.html. For more information about physical activity, visit http://www.cdc.gov/physicalactivity/.

Concern about the possibility is being raised in the form of two new studies, and revolves around the fact that HIV infection risk rises if other infections are already present in the rectal lining of the receptive partner, the study authors noted.

In that light, indications that some lubricants may contribute to a generally increased risk for sexually transmitted infections, and therefore in turn for HIV, are scheduled for presentation this week in Pittsburgh at the International Microbicides Conference.

Conducted between 2006 and 2008, one study — which focused on approximately 900 residents in the Baltimore and Los Angeles region — observed that men and women who use lubricants in general are three times more likely to have some form of a rectal sexually transmitted infection. The finding held regardless of gender, HIV status, condom use, and the number of sex partners the study participants had had in the prior month.

Although no specific lubricants were identified as particularly problematic, most study participants said they used a water-based lubricant (76 percent), while 28 percent used silicon-based products, 17 percent oil-based lubricants, and 6 percent said used a numbing lubricant.

The second study — led by Charlene Dezzutti of the University of Pittsburgh and the Microbicide Trials Network — looked at five of the most popular over-the-counter and/or mail-order lubricants, identified as such through a survey of 9,000 men and women living in 100 different countries.

All the lubricants were water-based, except for one silicon-based product.

The research team — including collaborators from International Rectal Microbicide Advocates (IRMA) — did not examine the effect of lubricant use during actual sex. However, in laboratory testing, some of the lubricants were found to have a toxic effect on cells and rectal tissue, perhaps as the result of the dissolved salts and sugars the products contained.

PRE and Wet Platinum were found to be the safest lubricants in terms of toxicity, whereas Astroglide and KY Jelly appeared to be the most problematic.

“We know we can’t make any conclusions based on this one small study,” cautioned IRMA lubricant safety advocate Marc-Andre LeBlanc, in a news release. “Further research is absolutely necessary to understand the potential role of sexual lubricants in HIV transmission. We should be able to provide consumer guidance regarding lubes that are found to be safer than others.”

“Some lubes are probably better than others, but we don’t know where any of the currently available products fall along the spectrum from good to bad,” added IRMA chair Jim Pickett.

“We must ensure that existing lubes don’t facilitate HIV transmission,” he added. “People have a right to this kind of information, and it’s very past due.”

Conference organizers pointed out that in the United States, 90 percent of men who have sex with men — whether self-identified as gay or not — engage in receptive anal intercourse. Between 10 percent and 35 percent of heterosexual women have done so at least once. And in either instance, condoms are often not used, while lubricants are.

SOURCE: International Microbicides Conference, news release.

Anita De Rossi of the University of Padova, Italy, and colleagues studied 300 children born to HIV-positive mothers. Those who had either of two gene variations were much more likely to acquire the virus than those without the variations.

The children were born between 1984 and 1996 to mothers who didn’t take antiretroviral drugs.

The genetic variations have been previously linked to the level of HIV in the blood in infected people.

Coma patients with irreversible brain damage are often good candidates for organ donation when they die because their other organs are generally healthy. However, the donation must occur within 60 minutes of when the heart stops beating.

“Neurologists must often predict whether the patient will be a candidate for organ donation, but the existing tools are not designed for people with critical brain disease,” study author Alan Yee, of the Mayo Clinic in Rochester, Minn., said in a news release.

Yee explained that current tools, for example, require the patient to be taken temporarily off ventilator support to conduct the test. The new test, designed for people with irreversible brain damage, “is a significant improvement because it can be conducted before the patient is taken off breathing support,” he said.

Yee and colleagues studied 149 coma patients who were taken off life support and identified a number of factors that strongly indicated a person with irreversible brain damage could be a potential organ donor. The four factors are:
No corneal reflex. This is tested by touching the cornea with a small piece of cotton or dripping water solution to see if the patient blinks.
No cough reflex. To check this response, a chemical irritant is placed near the patient in order to see if they cough to expel the irritant.
No motor response to pain or extensor movements that occur on their own or in response to pain. Extensor motor movement is a reflex straightening of the arms and legs.
High scores on the oxygenation index, which is a test of how well the lungs are working.

Coma patients with all of these factors were 93 percent more likely to die within 60 minutes of being taken off life support than patients with none of these factors. Patients with one of the four factors were 65 to 76 percent more likely to die within 60 minutes.

In the study, scientists uncovered early tumors and precancerous lesions in inclusion cysts, which fold into the ovary from its surface.

“This is the first study giving very strong evidence that a substantial number of ovarian cancers arise in inclusion cysts and that there is indeed a precursor lesion that you can see, put your hands on, and give a name to,” lead author Jeff Boyd, chief scientific officer at Fox Chase Cancer Center in Philadelphia, said in a news release. “Ovarian cancer most of the time seems to arise in simple inclusion cysts of the ovary, as opposed to the surface epithelium.”

Boyd and his colleagues analyzed ovaries removed from women with BRCA gene mutations (who have a 40 percent lifetime risk of developing ovarian cancer) and from women with no known genetic risk factors for ovarian cancer.

In both groups of women, gene expression patterns in the cells of inclusion cysts were dramatically different than normal ovarian surface cells. For example, the cells of inclusion cysts had increased expression of genes that control cell division and chromosome movement. The researchers also found that cells from very early tumors and tumor precursor lesions frequently had extra chromosomes.

“Previous studies only looked at this at the morphologic level, looking at a piece of tissue under a microscope,” Boyd said. “We did that but we also dissected away cells from normal ovaries and early-stage cancers, and did genetic analyses. We showed that you could follow progression from normal cells to the precursor lesion, which we call dysplasia, to the actual cancer, and see them adjacent to one another within an inclusion cyst.”

With these findings, researchers can try to develop new screening tests to detect ovarian cancer in the earliest stages, when it is still treatable. Ovarian cancer kills nearly 15,000 women in the United States each year. Fewer than half of ovarian cancer patients live more than five years after diagnosis.

One of the reports, part of a trio of findings published online April 25 in Nature Genetics, found three genetic regions that were associated with the number of cigarettes smoked per day.

“One region was associated with smoking initiation, and one variant was associated with smoking cessation,” said study co-author Helena Furberg, a research assistant professor at the University of North Carolina. “The genetic variants on chromosome 15 that were associated with heavy smoking lie within a region that contains nicotine receptor genes, which other scientists have previously associated with nicotine dependence and lung cancer.”

The findings came from an analysis of phenotypes of 74,053 people.

More research needs to be done before these findings can be translated to the clinic, Furberg said. “At this time, getting tested for these variants will not tell you anything meaningful about your risk of smoking or ability to quit smoking,” she said. But in the future, researchers might be able to use these genetic variants to predict the effects of different smoking cessation treatments, she added.

“Until this goal is realized, all smokers should be encouraged to quit, regardless of genotype,” she said.

In the second report, a research team led by Clyde Francks from Oxford University tested the human genome for genes associated with cigarette smoking.

Based on an analysis of more than 40,000 people, they found that a group of genes on chromosome 15q25 is associated with the number of cigarettes that people smoke per day.

“Understanding the genetics of smoking addiction should have important implications for global health in the long term,” Francks said in a news release from Oxford.

The third study, from researchers in Iceland, also looked through the human genome to find genes associated with the number of cigarettes a person smokes daily. Using data from more than 70,000 smokers, it confirmed that genes on chromosome 15 were linked to tobacco use. The researchers also found two genes, CYP2A6 and CYP2B6, that were involved in nicotine metabolism and two others, CHRNB3 and CHRNA6, that play a role in how the body processes nicotine.

Some of these gene regions are also associated with a predisposition to lung cancer, the researchers noted.

“Key variants in each region associate with nicotine dependence and lung cancer, bringing up the question of whether the risk for lung cancer is through the effect on smoking behavior or whether it involves increased vulnerability to the harmful effects of smoking as well,” the authors wrote.

Dr. Norman H. Edelman, scientific consultant to the American Lung Association, said that the information reported by the study “adds to the current limited data indicating that predilection to smoking has some, perhaps significant, genetic component.”

However, Edelman said he thinks that any direct benefit from the findings is a ways off.

“I don’t think it will directly alter our approach to smoking cessation and prevention in the short term, but down the line it may help change attitudes toward smokers,” he said.

Too many people think of smokers as having self-imposed diseases, Edelman said. “Now we can see some had to fight a genetic predilection while being addicted by an aggressive tobacco industry while they were children, as almost all smokers start as teens or preteens.”

Robert West, a professor of health psychology and director of tobacco studies at the Cancer Research UK Health Behaviour Unit at the University College London, added that “there is clear evidence of a genetic contribution to development of nicotine dependence.”

These studies are helping to create a picture of what mechanisms may underlie this, “but we have a huge task ahead of us to turn this into something that can be used to help treat or prevent nicotine dependence,” West said.

“Whether the fruits of this work would ever have an effect as large as what could be achieved by interventions that we already know are powerful agents for change — such as physician advice, behavioral support programs, tax increases and mass media campaigns — is doubtful,” West added.

SOURCES: Helena Furberg, Ph.D., research assistant professor, University of North Carolina, Chapel Hill; Robert West, Ph.D., professor, health psychology, and director, tobacco studies, Cancer Research UK Health Behaviour Unit, University College London; Norman H. Edelman, M.D., scientific consultant, American Lung Association

Researchers led by scientists from the Pasteur Institute in Lille, France, found that having low levels of a protein called PPAR-gamma, which regulates defenses that kill bacteria in the gut, may make patients less able to fight off gut infections — so boosting PPAR-gamma could help protect against such diseases.

Mathias Chamaillard, who led the study, said in a telephone interview the results showed that drugs already used for other diseases could prove effective in Crohn’s disease.

For example, GlaxoSmithKline’s diabetes drug Avandia, known generically as rosiglitazone, has been shown to restore gut defenses through PPAR-gamma activation, he said, and Takeda Pharmaceutical’s Actos, or pioglitazone, another PPAR drug used in diabetes, acts in the same way.

Inflammatory bowel conditions such as Crohn’s disease and ulcerative colitis affect around 0.5 percent of the population in developed nations and are notoriously difficult to treat.

Treatments include a group of injectable drugs that block an inflammatory protein called tumor necrosis factor (TNF) such as: Johnson & Johnson’s Remicade, Abbott’s Humira and UCB’s

Cimzia, but Chamaillard said not all patients respond to these, and others find they stop being effective after time.

The European team, whose work was published in the Proceedings of the National Academy of Sciences (PNAS) journal, used mice engineered to be low in PPAR-gamma and found they were less able to fight off bacterial infection in the colon compared to normal mice.

Samples taken from the colons of humans diagnosed with Crohn’s disease also show reduced levels of the antimicrobial peptides, or defenses, regulated by the PPAR-gamma protein, they wrote.

Chamaillard said foods or diets containing conjugated linoleic acid (CLA) can also boost PPAR-gamma activity and have been shown to improve colitis and colitis-associated cancer.

CLA is primarily found in milk and meat products.

“In the short-term, managing the disease is what we are looking at, but it may also be that in the future we could develop a way of stopping it,” Chamaillard said.

But he added that curing Crohn’s disease would mean being able to identify those at highest risk before they contracted it and then being able to boost PPAR gamma-related defenses to ward it off — both areas that would need more research.

“It has been assumed that the obesity epidemic in the developed world is driven by an increasingly sedentary lifestyle and the abundance of low-cost, high-calorie foods. However, our results suggest that excess caloric consumption is not only a result of undisciplined eating but that intestinal bacteria contribute to changes in appetite and metabolism,” senior study author Andrew Gewirtz, an associate professor of pathology and laboratory medicine at Emory University School of Medicine, said in a university news release.

He and his colleagues found that increased appetite and insulin resistance can be transferred from one mouse to another via intestinal bacteria. The findings are published online March 4 in the journal Science.

It’s believed that intestinal bacteria populations in people are acquired at birth from family members and are relatively stable. However, they can be affected by diet and antibiotics.

“Previous research has suggested that bacteria can influence how well energy is absorbed from food, but these [new] findings demonstrate that intestinal bacteria can actually influence appetite,” Gewirtz explained.

He said the findings from mice suggest “that it’s possible to ‘inherit’ metabolic syndrome through the environment, rather than genetically. Do obese children get that way because of bad parenting? Maybe bacteria that increase appetite are playing a part.”

A gene called toll-like receptor 5 (TLR5) plays an important role in controlling intestinal bacteria. Gewirtz and colleagues plan to investigate TLR5 variations in humans and how bacteria in TLR5-deficient mice influence appetite and metabolism.

SOURCE: Emory University.