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Women who drink five or more servings of sugar-sweetened cola per week before they conceive increase their risk of developing diabetes during pregnancy, a new study indicates.

“Previous studies have shown an association with other chronic metabolic problems,” said study author Dr. Liwei Chen, an assistant professor of epidemiology at Louisiana State University Health Sciences Center, in New Orleans. “This is the first to show an increased risk among pregnant women.”

Gestational diabetes, known as glucose intolerance during pregnancy, is one of the most common complications of pregnancy. It increases the chances of lifelong diabetes for the woman and also can have permanent effects on the unborn child, Chen said. The report appears in the December issue of Diabetes Care.

“Other studies suggest that babies born to women who are diabetic during pregnancy have higher weight at birth and also higher rates of obesity and diabetes early in life,” she added.

Chen, working with researchers at the Harvard School of Public Health and the U.S. National Institute of Child Health and Human Development, studied 10 years of medical records on a group of 13,475 women from the Nurses’ Health Study II. After adjusting for known risk factors for gestational diabetes, such as age, family history and smoking, the researchers found that women who had more than five servings per week of sugar-sweetened cola beverages had a 22 percent higher risk of gestational diabetes than women who had less than one serving per month.

No such association was found for consumption of other sugar-sweetened beverages or artificially sweetened drinks.

It’s not clear why only cola drinks are associated with the increased risk, Chen said. One explanation could be “the tremendous popularity of cola in the United States,” she said.

The results are not conclusive, and “we need other studies to confirm our findings,” Chen said. “We plan to study other populations, and we hope that other investigators start such studies.”

But meanwhile, “I suggest that women reduce their intake of sugary beverages,” she said. “Women need to be aware of the possible risk not only for their pregnancy but also of the long-term consequences for their babies.”

Maureen Storey, senior vice president of science policy for the American Beverage Association, which represents soft drink companies, said she was skeptical about the findings.

“As with all epidemiological studies, the data do not show a cause-and-effect relationship,” Storey said in a statement.

Sugar-sweetened beverage consumption has not been among the risk factors for gestational diabetes identified by “leading scientific bodies,” Storey added.

“The key to a healthy pregnancy is seeking good medical care and having a healthy lifestyle before and during pregnancy,” the statement said. “This includes eating a variety of foods and beverages in moderation along with getting regular physical activity.”

According to the journal report, there are several potential explanations for the association. For example, sugar-rich foods or beverages can overload the body with glucose, which can impair the function of the beta cells of the pancreas, which make insulin that metabolizes glucose.

Sugar-sweetened beverages are the leading source of added sugar in the American diet, Chen said. The U.S. National Health and Nutrition Examination Survey found that soft drink intake more than doubled between 1977 and 2001 among 19- to 39-year-old Americans, going from 4.1 percent to 9.8 percent, and that those in this age group had the highest rate of soft drink consumption.

Breast ultrasounds found 100 percent of suspicious cancers in women under 40 who found lumps or other suspicious areas of the breast, offering a cheaper, less-invasive alternative to surgery or biopsies, U.S. researchers said on Wednesday.

They said targeted ultrasound — which examines just the area of the breast where a lump is identified — should become the standard of care for women under 40.

The findings may address some of the concerns raised by a federal advisory panel about breast exams done by women or doctors to investigate lumps or hot spots in the breast, which most often turn out to be harmless.

In a controversial set of recommendations issued last month, the U.S. Preventive Services Task Force recommended that women not be taught to perform self breast exams because they often result in worry and expense for tests, biopsies and unnecessary surgery.

“That concerns us because while breast cancer in young women is rare, it absolutely does occur. Often, those cancers are only diagnosed because the woman noticed the lump in her breast or her doctor noticed a lump in her breast,” said Dr. Constance Lehman of the University of Washington and director of imaging at the Seattle Cancer Care Alliance, who presented her findings at the Radiological Society of America meeting in Chicago.

“There are harms that follow after a woman does a self breast exam — unnecessary surgeries, unnecessary biopsies. To that point, what we’re saying is if you use imaging appropriately you can avoid those harms,” Lehman said in a telephone interview.

Lehman did two studies testing the effectiveness of ultrasound to distinguish between potentially cancerous lumps and harmless masses in younger women.

In one, they studied more than 1,100 ultrasound exams of women under age 30. In the second, they studied 1,500 exams in women aged 30 to 39.

In both studies, ultrasound correctly identified the cancers and all of the benign breast changes. The only cancer not found was in a region of the breast that was not identified as an area of concern. Instead, it was identified by a full breast mammogram.

“Less than 3 percent of the patients that presented in this way had cancer. But it’s important for us to find those patients that did have cancer,” Lehman said.

“We had 26 women whose cancers were diagnosed because they brought the lump to the attention of their doctor, or their doctor brought the lump to the attention of the breast imaging specialist,” she said.

Lehman said in the United States there is no standard way of treating women under age 40 who find a lump in their breast.

“Some of them go to the operating room to have the lump removed. Others have it followed. Others have a needle biopsy and we wanted to bring some clarity to this treatment,” she said.

She said ultrasound is a quick and easy test that uses sound waves to create an image of the breast. It typically costs $100 to $200 per exam.

Lehman said using ultrasound could help balance some of the harms of overtreatment with the benefits of self breast exams in women under age 40, who are too young for routine mammogram screening even under the American Cancer Society guidelines.

The task force also recommended against routine mammogram screening for women in their 40s for many of the same reasons, a change the American Cancer Society and many other breast cancer experts reject.

Thirteen stem cell lines have been added to the pool that scientists can use for taxpayer-funded research, and many more such lines will soon be made available, U.S. health officials announced Wednesday.

These are the first additional embryonic stem cell lines approved for research funded by the U.S. National Institutes of Health (NIH) since President Barack Obama last spring lifted restrictions on stem cell research that were imposed eight years ago by then-President George W. Bush.

“With these [lines] now becoming available for federally funded researchers, we believe it will speed up the process of investigating ways in which this remarkable new area of developmental biology can be explored,” NIH director Dr. Francis S. Collins said during an afternoon teleconference Wednesday.

“The field has been waiting with bated breath for this announcement,” one expert, Dr George Daley of Children’s Hospital Boston, told the Associated Press. Eleven of the 13 stem cell lines approved Wednesday were developed at Children’s, Collins noted, while the other two come from Rockefeller University in New York City.

Collins noted that over the past eight years, hundreds of embryonic stem cell lines have been created using private funds. “Many of them with more favorable characteristics for research purposes than the original ones approved by President Bush,” he said.

Citing ethical issues, the Bush administration had limited federally funded research to about 21 stem cell lines already in existence in August 2001. That decision ignited a firestorm of controversy between those who advocated that human embryos should not be tampered with and those who viewed stem cell research as a potential pathway to curing a host of diseases.

Currently, 96 more human embryonic stem cell lines are under review to see if they meet the criteria for NIH-funded research, Collins said. Only one of the Bush-approved stem cell lines is among the 96 under consideration.

Recommendations to approve or reject 20 of these lines is expected on Friday, the NIH director said.

NIH policy still calls for new embryonic stem cell lines to be developed without taxpayer funding. “There is still a ban against the creation of new stem cell lines with federal funds,” Collins stressed.

All the stem cell lines NIH is considering are derived from embryos left over from in vitro fertilization. These embryos would have been discarded, but the donors gave permission for them to be used in research, Collins noted.

At present, 31 NIH research grants, worth $21 million, are on hold, awaiting approval of these stem cell lines. With the approval of the 13 lines, researchers can begin to look at these lines to see if they are appropriate for their projects, Collins said.

Those projects include efforts to grow heart muscle, neurological stem cells and neurons. Other research is focusing on ways to produce more stem cells so they can be available in greater quantities to researchers, he said.

Embryonic stem cells are thought to be especially useful to medical science because they can be manipulated to become any type of body cell. Scientists hope to use these cells to create replacement tissues to treat a variety of diseases, such as diabetes, Parkinson’s, spinal cord injuries and Alzheimer’s disease.

“It is exciting to be able to say that — after what has clearly been a time of some frustration on the part of the scientific community’s inability to gain access with federal funds to cell lines that investigators wish to utilize — that is now changing,” Collins said.

Small or slow-growing nodules discovered on a lung scan are unlikely to develop into tumors over the next two years, researchers reported on Wednesday.

The findings, reported in the New England Journal of Medicine, could help doctors decide when to do more aggressive testing for lung cancer. They could also help patients avoid unnecessarily aggressive and potentially harmful testing when lesions are found.

Lung cancer, the biggest cancer killer in the United States and globally, is often not diagnosed until it has spread. It kills 159,000 people a year in the United States alone.

The work is part of a larger effort to develop guidelines to help doctors decide what to do when such growths, often discovered by accident, appear in a scan.

High-tech X-rays called CT scans can detect tumors — but they see all sorts of other blobs that are not tumors, and often the only way to tell the difference is to take a biopsy, a dangerous procedure.

Tested guidelines for dealing with the nodules do not exist, said Dr. James Mulshine of Rush University Medical Center in Chicago and David Jablons of the University of California San Francisco Cancer Center, in a Journal editorial.

Good guidelines could help make lung cancer screening practical, Dr. Rob van Klaveren of the Erasmus Medical Center in Rotterdam, the Netherlands, who led the new study, said in a telephone interview.

At the moment, routine lung cancer screening is considered impractical because of its high cost and because too many healthy people are called back for further testing.

“All these recall CT scans give rise to a lot of anxiety,” said van Klaveren.

SCREENING

The team looked at 7,557 people at high risk for lung cancer because they were current and former smokers. All received multidetector CT scans that measured the size of any suspicious-looking nodules.

Volunteers who had nodules over 9.7 millimeters in width, or had growths of 4.6 millimeters that grew fast enough to more than double in volume every 400 days, were sent for further testing. Of the 196 people who fell into that category, 70 were found to have lung cancer; 10 additional cases were found years later.

But of the 7,361 who tested negative during screening, only 20 lung cancer cases later developed.

In a second round of screening, done one year after the first, 1.8 percent were sent to the doctor because they had a nodule that was large or fast-growing. More than half turned out to have lung cancer.

The result means that if the screening test says you don’t have lung cancer, you probably don’t, the researchers said. “The chances of finding lung cancer one and two years after a negative first-round test were 1 in 1,000 and 3 in 1,000 respectively,” they concluded.

The study is part of a larger project, known as NELSON, designed to see if a screening program can, over the long term, cut lung cancer death rates by 25 percent. Final results are expected in 2015.

A Family Physician’s View

A woman should remember that the guidelines are based on the entire population and that her own decision must be an individual one, said Dr. David Baron, a family physician and chief of staff at Santa Monica-UCLA Medical Center and Orthopaedic Hospital in Santa Monica, Calif., and an assistant clinical professor of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.

“That’s why communication between a patient and her health-care professional is very important,” Baron said.

The new guidelines, in his view, are encouraging physicians to individualize the screenings.

“Some of this will depend on how risk-adverse a woman is,” Baron said. A 40-year-old woman, for instance, might be afraid of radiation from a mammogram and be at average risk for breast cancer. No matter how much a doctor explains that the radiation amount is minimal, he said, she might not be convinced, and she might be advised to wait.

On the other hand, he said, another 40-year-old woman might be very frightened of breast cancer and want the screening. For her, Baron said, he might advise sticking with annual screening.

To women 50 and up, Baron said he would say: “I think it’s important to have a mammogram. Whether you want to have it every year or every two years is negotiable.”

And for his patients 75 and older? “It’s really a matter of individual choice,” he said.

The task force has drawn criticism for recommending fewer mammograms and starting them later. But Baron offered another perspective. “I respect them a great deal,” he said. “They’ve got no horse in the race. They are independent experts.”

He said the task force did its best to sort through the available evidence and come up with the most scientifically sound guidelines.

Women should also realize that the results of future studies might change the recommendations yet again, Baron said. And no matter what the recommendations are, he said, women must always discuss their own medical history and risks with their doctors when making a decision about screening for breast cancer or any other disease.

The best advice, according to Baron: Know the guidelines. Know your risk. Decide with your health-care professional the best screening schedule for you.

On Wednesday, U.S. Health and Human Services Secretary Kathleen Sebelius issued the following statement on the new screening recommendations:

“There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on. The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government.”

“There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

“What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect and fight breast cancer, the second leading cause of cancer deaths among women.”

“My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions, and make the decision that is right for you,” the statement concluded.

When a U.S. government task force recommended that women wait until they’re 50 to get their first mammogram to check for breast cancer, reaction was swift.

Critics such as the American Cancer Society vowed to stand by its advice that annual screening begin at age 40 for women of average risk. The American College of Radiology agreed.

But what will doctors who see female patients day after day suggest they do?

The guidelines, released Nov. 16 by a federal panel of experts known as the U.S. Preventive Services Task Force, recommend that women aged 40 to 49 and at average risk for breast cancer talk to their doctor about when it would be best for them to begin mammography screening. Those aged 50 to 74 should have every-other-year screenings, rather than an annual mammogram, according to the new guidelines. As for women aged 75 and older, the task force concluded that there is not enough evidence to assess the benefits and harms of the test.

Whether they agree or disagree with the guidelines, experts seem to agree that women should talk to their health-care providers for guidance based on their individual medical history and other factors.

Three such providers — an internist, a family physician and a gynecologist — weigh in on what they will advise their patients to do.

An Internist’s View

“The evidence supports the recommendation,” said Dr. Karla Kerlikowske, director of the Women Veteran’s Comprehensive Health Center at the San Francisco Veterans Affairs Medical Center, who wrote an editorial accompanying publication of the guidelines in the Annals of Internal Medicine.

“I think for women 40 to 49, we should target women who are at high risk,” she said, such as those with a first-degree relative with breast cancer.

Changing the screening interval from annually to every two years for women 50 to 74, she said, “is one of the best things they did.” At her clinic, Kerlikowske said, biennial screening has been a standard for years.

A Gynecologist’s View

Gynecologist Judi Chervenak, an associate clinical professor of obstetrics-gynecology and women’s health at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, said she will tell her patients this: “From age 39 on, a woman should have a yearly visit to her health-care provider, during which she discusses which routine tests are appropriate for her, including mammography.”

But, she also said she favors mammography for many women.

“Unless the patient is at increased risk of radiation exposure or increased mental health stress of dealing with a false-positive test, I still feel that the use of the mammogram is a potentially lifesaving and quality-of-life improving test for many women,” Chervenak said.

“We know that mammography often picks up a cancer before it can be palpated,” she said. “We have to do everything we can to maintain our quality of life.”

If the stresses of college have put you at risk for high blood pressure, try transcendental meditation.

Blood pressure fell among college students who spent about 20 minutes at least once a day to reach the “restful alertness” state of transcendental meditation, Dr. Sanford I. Nidich, at Maharishi University of Management Research Institute in Maharishi Vedic City, Iowa, and colleagues report.

Their study, in the American Journal of Hypertension, found meditating students also had “reduced psychological distress, anxiety, and depression,” Nidich told Reuters Health in an email.

He and colleagues randomly assigned 298 healthy students with and without high blood pressure to transcendental meditation training or to a training wait list. The students, 40 percent men, were just under 26 years old on average and attended universities in and around Washington, D.C.

Among the 207 students still participating in the study 3 months later, those in the meditation group had slight reductions in blood pressure, while the wait-listed students had slight increases in average blood pressure from the start of the study.

The meditating students also showed greater reductions in overall mood disturbances, anxiety, depression, anger, and hostility, and better coping skills compared with baseline measures and wait-listed students.

Nidich’s team further assessed a subgroup of 48 meditating and 64 wait-listed students who initially had high blood pressure (above 130 over 85 millimeters of mercury) or were at risk for high blood pressure.

In this high-blood-pressure-risk group, the meditating students had blood pressures that were lower, on average, than at the start of the study, while the wait-listed students had increases in blood pressure.

Nidich and colleagues also found these “significant reductions” in blood pressure correlated with lower measures of psychological distress and greater coping measures.

The researchers suggest their findings warrant further investigations into the potential health benefits of longer-term transcendental meditation in college students.

Two new studies add to growing evidence that morphine and other opiate-based painkillers may promote the growth and spread of cancer cells.

The papers, scheduled to be presented Wednesday at an international cancer conference in Boston, also demonstrate how preventing opiates from reaching lung cancer cells reduces cancer cell proliferation, invasion and migration.

The findings from tests with cell cultures and mice suggest that the mu opiate receptor — where morphine acts in the body — may offer a potential treatment target.

“If confirmed clinically, this could change how we do surgical anesthesia for our cancer patients. It also suggests potential new applications for this novel class of drugs which should be explored,” Patrick A. Singleton, an assistant professor of medicine at the University of Chicago and principal author of both studies, said in a university news release.

Morphine can increase tumor cell proliferation, inhibit the immune system, promote the growth of new blood vessels (angiogenesis) that feed tumors and decrease barrier function. In cancer patients undergoing surgery, decreased barrier function may make it easier for tumors to invade tissue and spread to other parts of the body, while increased angiogenesis helps tumors thrive in a new location.

Singleton and colleagues found that mice without the mu opiate receptor didn’t develop tumors when injected with lung cancer cells, while normal mice did develop cancer. The researchers also found that methylnaltrexone — developed to treat opiate-induced constipation — reduced the proliferation of cancer cells in normal mice by 90 percent.

New research suggests that having multiple sclerosis puts pregnant women at slightly higher risk for giving birth via cesarean deliveries or having babies that grow at a slower rate in the womb.

But the researchers, whose findings were published online in Neurology, also reported that pregnant women with MS were not more likely than other women to develop such conditions as preeclampsia or premature rupture of membranes.

The findings came from an examination of a national database that included details on about 18.8 million childbirths in 38 states, including deliveries by an estimated 10,000 women with MS.

The two groups of pregnant women differed somewhat. Those with MS were more likely than those without chronic medical conditions to have fetuses that suffered from restricted growth, as defined by weight measured through ultrasound. Among women with MS, 2.7 percent had fetuses in that category, compared with 1.9 percent of other women.

Women with MS were also more likely to have a cesarean delivery: 42 percent had a c-section, compared with 33 percent of other women.

However, the study found that women with MS had lower pregnancy complication rates than did women who had diabetes before becoming pregnant.

“These results are reassuring for women with MS,” study author Dr. Eliza Chakravarty. of Stanford University School of Medicine. said in a news release from the American Academy of Neurology.

“Women and their doctors have been uncertain about the effect of MS on pregnancy, and some women have chosen to delay or even avoid pregnancy due to the uncertainty,” Chakravarty said. “We found that women with MS did not have an increased risk of most pregnancy complications.”

Women undergoing a second round of in-vitro fertilization should get one embryo instead of two, suggests new Swedish research that found the first approach is almost as successful as the second and greatly reduces the risk of multiple births.

A previous study produced the same result, but this latest report examined the women for a longer period of time, through more embryo implantations.

The findings “should provide comfort for those who want to perform single-embryo transfers that the pregnancy rates are equivalent,” said Dr. William E. Gibbons, president of the American Society for Reproductive Medicine and a professor at Baylor College of Medicine in Houston.

Gibbons said debate over the number of embryos to implant began about a decade ago, when in-vitro fertilization (IVF) began to be more successful.

“Since only a fraction of eggs released by a woman are capable of producing a baby, the pregnancy rate is higher when more than one embryo is put back in,” he said. “However, in the late ’90s the standard number of embryos replaced at that time resulted in an increasing rate of triplets and quadruplets.”

Multiple births can lead to a variety of medical complications that can put the lives of some babies at risk.

In the new study, the Swedish researchers examined the records of 661 women who first underwent implantation with a fresh embryo, followed by implantation with one or two frozen embryos if the first attempt was unsuccessful. If those attempts failed, they went through more attempts; the scientists followed them for up to four more tries.

The findings appear in the Oct. 29 issue of the New England Journal of Medicine.

Forty-four percent of those who received one embryo the first time got pregnant and gave birth to live babies; 51 percent of those who got two embryos did.

But only 2.3 percent of those in the first group had multiple births, compared to 27.5 percent in the second group. Those in the first group were also much less likely to have babies born before 37 weeks of gestation, 11.8 percent vs. 25.5 percent for the two-embryo group.

So why not always implant one embryo and then another if necessary? Because it can be more expensive to try multiple times instead of boosting the odds at the start, and “the stress and disappointment of a failed cycle is hard to put a value on,” noted Dr. Laurel Stadtmauer, an associate professor of obstetrics and gynecology at the Jones Institute for Reproductive Medicine in Norfolk, Va.

The economic wrinkle is a real one. In Sweden, Gibbons explained, IVF is covered by national insurance. That’s not the case in the United States.

“For American couples,” he said, “putting two embryos back has a higher pregnancy rate, and twins mean that they can have their family all at once and don’t have to pay for a second child.”