CORTE MADERA, Calif., Aug. 28 -- If alcoholics quit drinking early enough and stay sober long enough, the recovery of their mental functions will be nearly complete, a study here suggested.
A group of 48 alcoholics who had remained sober for an average of nearly seven years (and some as long as 13 years), performed essentially the same on an extensive battery of neurocognitive tests as a group of healthy controls, George Fein, Ph.D., and colleagues reported in the September issue of Alcoholism: Clinical & Experimental Research.
SAN ANTONIO, Aug. 25 -- For men with newly diagnosed metastatic prostate cancer treated with androgen deprivation therapy (ADT), PSA levels at seven months seem to predict long-term survival or early failure.
Those whose PSAs fell to below 4 ng/dL while undergoing androgen deprivation therapy had about one-third the mortality risk, of men whose levels were higher, said Maha Hussain, M.D., of the University of Michigan in Ann Arbor, reporting for the Southwestern Oncology Group (SWOG).
"This is the first trial in the setting of new D2 [metastatic] prostate cancer to demonstrate unequivocally the survival advantage associated with absolute PSA value in response to androgen deprivation therapy," Dr. Hussain and colleagues wrote in the Aug. 20 issue of the Journal of Clinical Oncology.
DALLAS, Aug. 22 -- Myocardial infarction survivors who have ventricular dysfunction as measured by an ejection fraction of less than 40% should receive implantable cardioverter defibrillators to prevent sudden cardiac death.
That's the uncomplicated and straightforward consensus of major U.S. and European heart groups that is spelled out in guidelines issued today called Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.
SYLMAR, Calif., Aug. 16 -- Methicillin-resistant bacteria are taking emergency room doctors back to the pre-penicillin days, when skin infections were lanced and drained.
Methicillin-resistant Staphylococcus aureus (MRSA) infection has become the most common cause of skin and soft tissue infections seen in metropolitan emergency departments, and half-century-old therapeutic approaches are being revisited to combat it, according to two studies in the Aug. 17 New England Journal of Medicine.
The Centers for Disease Control and Prevention (CDC) is poised to issue new recommendations for testing for HIV in adults, adolescents, and pregnant women. Frustrated that more than 25 percent of Americans with HIV infection are unaware of their status and that almost 40 percent of those with newly diagnosed AIDS discover that they are infected less than a year before diagnosis, officials have proposed that HIV screening be routinely offered in all health care settings.
The CDC already recommends routine testing among high-risk groups and in high-prevalence settings. The radical departure is the extension of routine testing to the entire population and the reconceptualization of the requirements for consent. Patients would be told that HIV testing was a routine part of care and given the opportunity to opt out. According to the CDC, specific signed consent would no longer be required, because "general consent for medical care is sufficient to encompass consent for HIV testing."
WASHINGTON, Aug. 9 -- The Physicians Committee for Responsible Medicine, a crusading group that has long ranked vegetarianism high on its agenda, has made a compelling case for a low-fat vegan diet to improve glycemic control.
Both a low-fat vegan diet and a diet following American Diabetes Association guidelines improved glycemic control and cardiovascular risk factors in patients with type 2 diabetes, found a 22-week study partially funded by NIH and published in the August issue of Diabetes Care.
Patients with cardiovascular disease are less likely to have a stroke if they are taking statins.
CHICAGO, Aug. 9 -- Loading up on a statin within six months of a stroke or transient ischemic attack reduced the risk of recurrent stroke or TIA, according to results of a major trial published today.
Lipitor (atorvastatin) at 80 mg/day begun during that period was associated with 2.2% five-year absolute reduction in risk of stroke (P=0.03) and a 16% relative reduction in risk of fatal or nonfatal stroke, found the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial.
Secondary endpoints, with the exception of death, also significantly favored the Lipitor group, reported K. Michael Welch, M.B., Ch.B., of Rosalind Franklin University of Medicine and Science, and colleagues, in the Aug. 10 issue of the New England Journal of Medicine.
CHAPEL HILL, N.C., Aug. 9 -- Geneticists are coming to general agreement that they know the future of a breast tumor when they see it.
Four of the five available genetic tests to predict cancer recurrence or death of individual patients are in concordance even though each uses a gene set largely distinct from the others for expression profiles, said geneticist Charles M. Perou, Ph.D., of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues.
When they applied the five tests to tumor samples from 295 patients, the investigators found that four agreed in their predictions of cancer recurrence or death of individual patient, they reported in the Aug. 10 issue of the New England Journal of Medicine.
BOSTON, Aug. 7 -- Women whose mothers took the synthetic estrogen DES (diethylstilbestrol) have a sharply increased risk of breast cancer once they are 40 or older, according to researchers here.
"This is really unwelcome news because so many women worldwide were prenatally exposed to DES, and these women are just now approaching the age at which breast cancer becomes more common," said Julie Palmer, Sc.D., of the Boston University School of Public Health here.
The so-called DES daughters -- perhaps as many as two million in the U.S. -- were already known to be at higher risk of clear cell carcinoma of the vagina and cervix and their mothers have already been shown to be at higher risk of breast cancer.
But the current study, published in the August issue of the journal Cancer Epidemiology, Biomarkers & Prevention, is the first to show clearly that the DES daughters are at higher risk of breast cancer as they age than are women who weren't exposed to the drug, Dr. Palmer and colleagues said.
A single injection of ketamine can eliminate depression symptoms within 110 minutes.
BETHESDA, Md., Aug. 7 -- Symptoms of depression can be made to disappear in less than two hours with a common anesthetic, not the weeks or months required for onset of relief with traditional antidepressants, according to results of a pilot study.
"We have broken the sound barrier in depression treatment," said Carlos A. Zarate, Jr., M.D., chief of the mood disorders section the National Institute of Mental Health, who reported on the effects of ketamine, a common anesthetic, in the August 8 issue of the Archives of General Psychiatry.
SAN FRANCISCO, Aug. 4 -- Even though anticoagulation for atrial fibrillation may boost the chance of an intracranial bleed slightly in elderly patients, the benefits of the therapy outweigh the risk of a hemorrhage, according to researchers here.
In a retrospective study of more than 13,500 adults with non-valvular atrial fibrillation, hemorrhage rates rose with age, and were actually slightly higher among patients who were not taking Coumadin (warfarin), wrote Margaret C. Fang, M.D., M.P.H., of the University of California San Francisco, and colleagues.
The risk for hemorrhage rose "strikingly" after age 80, the authors reported in the Aug. 10 issue of the Journal of the American Geriatrics Society. But they also found the risks for other adverse events outweigh the risks for hemorrhage in patients on Coumadin.
NEW YORK, August 2 -- Stroke risk trumps age, gender or other history of heart disease in determine which atrial fibrillation patients will benefit from anticoagulation, according to revised guidelines issued today by three major heart societies.
Stroke is a natural focus of the new guidelines, said Valentin Fuster, M.D., Ph.D., director of the Mount Sinai Cardiovascular Institute here, because atrial fibrillation is a major risk factor for stroke, and strokes associated with atrial fibrillation "are especially large and disabling."
Dr. Fuster co-chaired the writing committee for the revised guidelines, which were published online by the American College of Cardiology, the American Heart Association, and the European Society of Cardiology. They appeared in Circulation, Journal of the American Heart Association, the Journal of the American College of Cardiology and the European Heart Journal.