(HealthDay News) -- New imaging techniques that provide a closer look inside lungs may improve early detection of diseases, such as emphysema, researchers say.
"Up until now, imaging the way lungs function in real time has been limited by conventional methods which result in rather low resolution images," Dr. Warren Gefter, chief of thoracic imaging in the radiology department of the University of Pennsylvania School of Medicine, said in a prepared statement.
"We are developing a way to get a better look inside the lungs by polarizing atoms -- making them all spin in the same direction -- with magnetic resonance (MR), which allows the atoms to have a strong signal for sharper images," he said.
Patients inhale helium that's been exposed to laser light to make all of the atoms spin in the same direction. MR is used to track the polarized helium as it moves through the lungs.
"We have moved from imaging the structure to imaging the function of the lung to a scale well below a millimeter in size. It's truly groundbreaking," Gefter said.
Another MR technique developed by Penn researchers uses polarized carbon-13-labeled molecules to provide lung function images at the cellular and intracellular level in order to look for disease.
More information
MedlinePlus has more about lung disease.
Saturday, March 31, 2007
Some People Find Angry Expressions Rewarding
(HealthDay News) -- While most people are upset or concerned when someone gives them an angry look, there are others -- with high levels of testosterone -- who actually enjoy angry expressions and seek ways to provoke them, new research suggests.
"It's kind of striking that an angry facial expression is consciously valued as a very negative signal by almost everyone, yet at a non-conscious level can be like a tasty morsel that some people will vigorously work for," study co-author Oliver Schultheiss, an associate professor of psychology at the University of Michigan, said in a prepared statement.
He said the findings may help explain why some people are so fond of teasing.
"Perhaps teasers are reinforced by that fleeting 'annoyed look' on someone else's face and therefore will continue to heckle that person to get that look again and again. As long as it does not stay there for long, it's not perceived as a threat but as a reward," Schultheiss said.
He and lead author Michelle Wirth measured testosterone levels in volunteers and then had them do a computer task in which certain complex keyboard sequences triggered different images on the computer screen -- an angry face, a neutral face, or no face.
Males and females with higher testosterone levels than other members of the same sex learned the angry face sequence better than the other sequences. This did not happen among volunteers with lower testosterone levels.
The association between higher testosterone levels and better learning of the angry face keyboard sequence was strongest when angry faces flashed on the computer screen subliminally -- too fast for conscious identification.
"Better learning of a task associated with anger faces indicates that the anger faces were rewarding, as in a rat that learns to press a lever in order to receive a tasty treat. In that sense, anger faces seemed to be rewarding for high-testosterone people but aversive for low-testosterone people," Wirth said in a prepared statement.
The study was published in the journal Physiology and Behavior.
More information
The Center for Effective Parenting offers advice on helping children handle teasing.
"It's kind of striking that an angry facial expression is consciously valued as a very negative signal by almost everyone, yet at a non-conscious level can be like a tasty morsel that some people will vigorously work for," study co-author Oliver Schultheiss, an associate professor of psychology at the University of Michigan, said in a prepared statement.
He said the findings may help explain why some people are so fond of teasing.
"Perhaps teasers are reinforced by that fleeting 'annoyed look' on someone else's face and therefore will continue to heckle that person to get that look again and again. As long as it does not stay there for long, it's not perceived as a threat but as a reward," Schultheiss said.
He and lead author Michelle Wirth measured testosterone levels in volunteers and then had them do a computer task in which certain complex keyboard sequences triggered different images on the computer screen -- an angry face, a neutral face, or no face.
Males and females with higher testosterone levels than other members of the same sex learned the angry face sequence better than the other sequences. This did not happen among volunteers with lower testosterone levels.
The association between higher testosterone levels and better learning of the angry face keyboard sequence was strongest when angry faces flashed on the computer screen subliminally -- too fast for conscious identification.
"Better learning of a task associated with anger faces indicates that the anger faces were rewarding, as in a rat that learns to press a lever in order to receive a tasty treat. In that sense, anger faces seemed to be rewarding for high-testosterone people but aversive for low-testosterone people," Wirth said in a prepared statement.
The study was published in the journal Physiology and Behavior.
More information
The Center for Effective Parenting offers advice on helping children handle teasing.
Heart Patients Seek Guidance on Stents, Statins
(HealthDay News) -- A number of controversial findings presented during the American College of Cardiology meeting this week has probably left many heart patients scratching their heads over which treatment is best for their particular cardiovascular condition.
Experts note the answer has never been easy, and what works for one heart patient might not work for another.
"I think that we sometimes try and make things too simple, in the media and in the scientific community," said Dr. Stephen Siegel, a cardiologist at the New York University Medical Center in New York City. "The goal is to translate that information from evidence-based medicine, to take care of each patient."
One study overturned the long-held notion that surgical techniques such as angioplasty and stenting were better than drug therapy at treating stable heart disease. Other studies questioned the usefulness and safety of expensive, drug-coated stents. And other trials trumpeted the expanding benefits of statins, raising the question of who shouldn't be taking these drugs.
Take the angioplasty-vs.-drug therapy debate. The study of almost 2,300 patients found no differences in death, nonfatal heart attacks, strokes or hospitalization between patients with "stable" heart disease treated with medication alone vs. those who got drugs plus angioplasty and stenting.
While many cardiologists welcomed the findings, stent manufacturers and some interventional cardiologists (doctors specializing in procedures such as angioplasty) said the study was biased in favor of drug therapy. The trial was overseen by U.S. and Canadian health agencies but did receive funding from the pharmaceutical industry.
However, Dr. Raymond Gibbons, president of the American Heart Association, said the study simply "challenges an assumption that has often been present in both patients and doctors, which was that doing an angioplasty and stenting a blockage would reduce the chance of death and heart attack," he said. "The trial clearly shows that that is not the case."
Gibbons, who is also professor of medicine at the Mayo Clinic in Rochester, Minn., stressed that the trial had to pass muster not only with the ACC but with the tough peer-review board at the New England Journal of Medicine, which published the results this week.
"Mayo, where I work, was a center in this trial," he added. "If we had had any concerns about the study's design, we would not have participated."
Gibbons stressed that the findings only apply to patients with chronic but stable heart disease. These patients may experience intermittent chest pain (angina) but have no history of heart attack.
"We need to recognize that the study does not apply to acute heart attack [patients]," he said. The study also does not apply to patients with stable heart disease whose chest pain has not responded to medicines, Gibbons added. Both of those groups are very appropriate candidates for invasive procedures such as angioplasty, he said.
According to Siegel, in too many cases, patients with stable heart disease are routinely sent off for an angiogram. And once doctors notice an obstruction -- any obstruction -- their temptation is to surgically remove it.
"There's clearly a gut reaction when you see a closed artery -- that it's better to have it opened," said Siegel, who is also clinical assistant professor at New York University School of Medicine. "But the trouble with the whole concept of 'opening everything' is that it does nothing for the underlying disease."
Angioplasty and stents both come with risk, he said, and the new study shows that, in many cases, it may be best to resist that urge to perform surgery and see if medicines can do the trick on their own.
Another expert agreed. "If you are having really horrible chest pain with exertion, it may be appropriate to have a stent, but too often, they are being done with just the promise of preventing a heart attack, and they don't do that," said Dr. Arthur Agatston, an associate professor of medicine at the University of Miami School of Medicine. He said he rarely treats chronic heart disease patients with stents, preferring medication and lifestyle change instead.
Drugs such as aspirin, statins, beta blockers and ACE inhibitors ease the inflammation and cholesterol build-up that causes cardiovascular disease to begin with, the experts said.
"The key to remember here is that every patient needs medical therapy," Gibbons said, "because angioplasty only treats the area of the artery with the severe blockage. If people find a physician who does not seem to believe in optimal medical therapy, then they should find another physician."
Other studies at the meeting highlighted the potential pitfalls of drug-coated stents, which can cost upwards of $2,000 each. Medications embedded in the devices keep artery re-closure at bay, but the use of these devices has also been linked to the occasional development of large clots. For that reason, patients are advised to take blood-thinners such as aspirin and clopidogrel (Plavix) for at least one year after stent placement.
However, two studies found that some stented patients don't respond to Plavix (raising their clot risk), and about 30 percent of patients fail to take the medications as prescribed.
So, are drug-coated stents appropriate for everyone in serious danger of heart attack or stroke? Certainly not, the experts said.
Because patients must take blood-thinning aspirin and Plavix, "if the patient has increased bleeding risks, then drug-eluting stents are not for them," Gibbons said. "For patients needing non-cardiac surgery within the next 12 months, drug-eluting stents are not a good option. And if patient's resources are such that they are unlikely to be able to afford clopidogrel for the next year, drug-eluting stents are not for them."
Otherwise, the advantage of a drug-coated stent is assessed by doctors on a case-by-case basis, Gibbons said. "The advantage often depends on the size of the blood vessel and individual patient characteristics," he explained.
Finally, there was more good news at the ACC meeting on the role of LDL ("bad") cholesterol-lowering statins. Use of one such drug, Crestor, helped keep plaque from settling in arteries, a study found. Another trial found that the prompt use of Lipitor in the emergency room boosted the long-term survival of patients after heart attack.
Statins typically come with very few side effects, raising the question of whether everyone over a certain age might someday take them.
Like many heart doctors, Siegel is a big supporter of statins, which he called one of the "foundations" of current therapy aimed at lowering heart risks. But he said he doesn't recommend them across the board to patients.
"Let's say you have an LDL cholesterol of 108 -- a little bit over the 100 'desirable' range but less than [the more dangerous] 130," he said. "Now, if you have a family history where your grandparents are alive at 98, and nobody's ever had heart disease, I wouldn't even think about prescribing it," Siegel said. "On the other hand, if your father dropped dead at 42 of a heart attack, I don't care what your cholesterol is, I would put you on a statin."
The bottom line, according to Siegel, is that big clinical trials are great, but every patient is unique.
"There's not a 'large group of patients' sitting across from my desk, or on my exam table," he said. "It's an individual."
More information
For more on spotting and treating heart disease, head to the American Heart Association.
Experts note the answer has never been easy, and what works for one heart patient might not work for another.
"I think that we sometimes try and make things too simple, in the media and in the scientific community," said Dr. Stephen Siegel, a cardiologist at the New York University Medical Center in New York City. "The goal is to translate that information from evidence-based medicine, to take care of each patient."
One study overturned the long-held notion that surgical techniques such as angioplasty and stenting were better than drug therapy at treating stable heart disease. Other studies questioned the usefulness and safety of expensive, drug-coated stents. And other trials trumpeted the expanding benefits of statins, raising the question of who shouldn't be taking these drugs.
Take the angioplasty-vs.-drug therapy debate. The study of almost 2,300 patients found no differences in death, nonfatal heart attacks, strokes or hospitalization between patients with "stable" heart disease treated with medication alone vs. those who got drugs plus angioplasty and stenting.
While many cardiologists welcomed the findings, stent manufacturers and some interventional cardiologists (doctors specializing in procedures such as angioplasty) said the study was biased in favor of drug therapy. The trial was overseen by U.S. and Canadian health agencies but did receive funding from the pharmaceutical industry.
However, Dr. Raymond Gibbons, president of the American Heart Association, said the study simply "challenges an assumption that has often been present in both patients and doctors, which was that doing an angioplasty and stenting a blockage would reduce the chance of death and heart attack," he said. "The trial clearly shows that that is not the case."
Gibbons, who is also professor of medicine at the Mayo Clinic in Rochester, Minn., stressed that the trial had to pass muster not only with the ACC but with the tough peer-review board at the New England Journal of Medicine, which published the results this week.
"Mayo, where I work, was a center in this trial," he added. "If we had had any concerns about the study's design, we would not have participated."
Gibbons stressed that the findings only apply to patients with chronic but stable heart disease. These patients may experience intermittent chest pain (angina) but have no history of heart attack.
"We need to recognize that the study does not apply to acute heart attack [patients]," he said. The study also does not apply to patients with stable heart disease whose chest pain has not responded to medicines, Gibbons added. Both of those groups are very appropriate candidates for invasive procedures such as angioplasty, he said.
According to Siegel, in too many cases, patients with stable heart disease are routinely sent off for an angiogram. And once doctors notice an obstruction -- any obstruction -- their temptation is to surgically remove it.
"There's clearly a gut reaction when you see a closed artery -- that it's better to have it opened," said Siegel, who is also clinical assistant professor at New York University School of Medicine. "But the trouble with the whole concept of 'opening everything' is that it does nothing for the underlying disease."
Angioplasty and stents both come with risk, he said, and the new study shows that, in many cases, it may be best to resist that urge to perform surgery and see if medicines can do the trick on their own.
Another expert agreed. "If you are having really horrible chest pain with exertion, it may be appropriate to have a stent, but too often, they are being done with just the promise of preventing a heart attack, and they don't do that," said Dr. Arthur Agatston, an associate professor of medicine at the University of Miami School of Medicine. He said he rarely treats chronic heart disease patients with stents, preferring medication and lifestyle change instead.
Drugs such as aspirin, statins, beta blockers and ACE inhibitors ease the inflammation and cholesterol build-up that causes cardiovascular disease to begin with, the experts said.
"The key to remember here is that every patient needs medical therapy," Gibbons said, "because angioplasty only treats the area of the artery with the severe blockage. If people find a physician who does not seem to believe in optimal medical therapy, then they should find another physician."
Other studies at the meeting highlighted the potential pitfalls of drug-coated stents, which can cost upwards of $2,000 each. Medications embedded in the devices keep artery re-closure at bay, but the use of these devices has also been linked to the occasional development of large clots. For that reason, patients are advised to take blood-thinners such as aspirin and clopidogrel (Plavix) for at least one year after stent placement.
However, two studies found that some stented patients don't respond to Plavix (raising their clot risk), and about 30 percent of patients fail to take the medications as prescribed.
So, are drug-coated stents appropriate for everyone in serious danger of heart attack or stroke? Certainly not, the experts said.
Because patients must take blood-thinning aspirin and Plavix, "if the patient has increased bleeding risks, then drug-eluting stents are not for them," Gibbons said. "For patients needing non-cardiac surgery within the next 12 months, drug-eluting stents are not a good option. And if patient's resources are such that they are unlikely to be able to afford clopidogrel for the next year, drug-eluting stents are not for them."
Otherwise, the advantage of a drug-coated stent is assessed by doctors on a case-by-case basis, Gibbons said. "The advantage often depends on the size of the blood vessel and individual patient characteristics," he explained.
Finally, there was more good news at the ACC meeting on the role of LDL ("bad") cholesterol-lowering statins. Use of one such drug, Crestor, helped keep plaque from settling in arteries, a study found. Another trial found that the prompt use of Lipitor in the emergency room boosted the long-term survival of patients after heart attack.
Statins typically come with very few side effects, raising the question of whether everyone over a certain age might someday take them.
Like many heart doctors, Siegel is a big supporter of statins, which he called one of the "foundations" of current therapy aimed at lowering heart risks. But he said he doesn't recommend them across the board to patients.
"Let's say you have an LDL cholesterol of 108 -- a little bit over the 100 'desirable' range but less than [the more dangerous] 130," he said. "Now, if you have a family history where your grandparents are alive at 98, and nobody's ever had heart disease, I wouldn't even think about prescribing it," Siegel said. "On the other hand, if your father dropped dead at 42 of a heart attack, I don't care what your cholesterol is, I would put you on a statin."
The bottom line, according to Siegel, is that big clinical trials are great, but every patient is unique.
"There's not a 'large group of patients' sitting across from my desk, or on my exam table," he said. "It's an individual."
More information
For more on spotting and treating heart disease, head to the American Heart Association.
Emotions Play Major Role in Teen Condom Use
(HealthDay News) -- Emotions play a large role in teen condom use, and helping teens manage their emotions may be as important as practical information in promoting safe sex, a U.S. study suggests.
The study of 222 youths, aged 13 to 18, found that lack of self-efficacy (the belief that one could effectively engage in a particular behavior) when confronted with the stress of using condoms is a major barrier to their use.
Compared to teens with lower self-efficacy, teens with higher self-efficacy about condom use (they felt they could effectively use condoms) were more likely to use them consistently even when they were feeling upset, angry, depressed or bad about themselves.
"We found that adolescents need help feeling more comfortable and less distressed about discussing and using condoms," study author Celia Lescano, of the Bradley Hasbro Children's Research Center and the Warren Alpert Medical School of Brown University in Providence, R.I., said in a prepared statement.
The study is published in the current issue of the Journal of Prevention and Intervention in the Community.
Managing the stresses associated with condom use is important for promoting safe sex among teens.
"Adolescents can learn to decrease their anxiety about discussing and using condoms in order to use them safely and effectively," Lescano said.
More information
The Nemours Foundation offers advice to teens about discussing condoms with their partners.
The study of 222 youths, aged 13 to 18, found that lack of self-efficacy (the belief that one could effectively engage in a particular behavior) when confronted with the stress of using condoms is a major barrier to their use.
Compared to teens with lower self-efficacy, teens with higher self-efficacy about condom use (they felt they could effectively use condoms) were more likely to use them consistently even when they were feeling upset, angry, depressed or bad about themselves.
"We found that adolescents need help feeling more comfortable and less distressed about discussing and using condoms," study author Celia Lescano, of the Bradley Hasbro Children's Research Center and the Warren Alpert Medical School of Brown University in Providence, R.I., said in a prepared statement.
The study is published in the current issue of the Journal of Prevention and Intervention in the Community.
Managing the stresses associated with condom use is important for promoting safe sex among teens.
"Adolescents can learn to decrease their anxiety about discussing and using condoms in order to use them safely and effectively," Lescano said.
More information
The Nemours Foundation offers advice to teens about discussing condoms with their partners.
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