Brain 'Switch' Helps Doctors Deal With Patients' Pain

(HealthDay News) -- Doctors are able to switch off the part of their brain that helps them appreciate the pain patients experience during treatment, and instead turn on a brain area that controls emotions, according a study by American and Taiwanese researchers.

Because they sometimes have to inflict pain on patients while treating them, doctors have to develop the ability not to be distracted by the suffering of patients, explained co-author Jean Decety, a psychology and psychiatry professor at the University of Chicago.

"They have learned through their training and practice to keep a detached perspective; without such a mechanism, performing their practice could be overwhelming or distressing, and, as a consequence, impair their ability to be of assistance for their patients," Decety said in a prepared statement.

In this study, functional magnetic resonance imaging (fMRI) was used to monitor brain responses in 14 doctors and a control group of 14 other people as they watched videos of people being pricked with acupuncture needles around the mouth and being touched with Q-tips.

The doctors showed no response in the area of the brain that registers another person's pain when they saw someone pricked with an acupuncture needle or touched with a Q-tip. The doctors did show heightened activity in the brain region that controls emotions.

When asked to rate the pain likely felt by the patients as they were pricked by the needles, the doctors said it was likely about 3 on a 10-point scale (10 being the most pain), while those in the control group rated the patients' pain at about 7 points.

The study is currently available online and is expected to be published in the Oct. 9 issue of the journal Current Biology.

More information
There's more on managing pain at the U.S. National Institutes of Health.

more discussion: Forum· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Caffeine Plus Acetaminophen Toxic for Some

(HealthDay News) -- Very high doses of caffeine and acetaminophen (such as Tylenol), taken together, could lead to liver damage, researchers warn.

This combo produces a byproduct enzyme that's toxic to the organ, researchers from the University of Washington report.

This toxic twosome can occur not only by drinking caffeine while taking acetaminophen, the experts added, but also from large doses of painkillers that combine caffeine and acetaminophen.

These painkillers are often used to treat migraines, menstrual discomfort and other conditions.

"Caffeine can interact with an enzyme that can form a toxic metabolite of acetaminophen in such a way that it increases the formation of that toxic metabolite," said lead researcher Sid Nelson, a professor of medicinal chemistry. "This can result in liver damage," he said.

In the study, Nelson's team tested the effects of acetaminophen and caffeine on E. coli bacteria.

These bacteria had been genetically engineered to mimic a human enzyme in the liver that detoxifies many prescription and nonprescription drugs, explained the authors in a report in the Oct. 15 issue of the journal Chemical Research in Toxicology.

Nelson noted that it takes large qualities of caffeine to produce this reaction.

"Normally people wouldn't be ingesting that amount of caffeine," he said. "It would take 10 times the amount of caffeine found in a couple of cups of coffee," Nelson said.

His team found that caffeine triples the amount of a toxin called N-acetyl-p-benzoquinone imine (NAPQI) produced by the enzyme as it breaks down acetaminophen.

This same toxin is also produced during an interaction between alcohol and acetaminophen that's also well known to damage the liver.

In prior studies, Nelson's team had found that high doses of caffeine boosted liver damage in rats that had already suffered acetaminophen-linked liver damage.

The bacteria used in the study were exposed to doses of acetaminophen and caffeine far higher than most people would be exposed to, Nelson noted. It's not clear at what point such a mixture becomes toxic, he said.

Some people may be more vulnerable to this toxic interaction than others, Nelson said. They might include people who take certain antiepileptic medications, such as carbamazepine and phenobarbital, and people who use the alternative remedy St. John's Wort.

These drugs increase levels of the enzyme that produces NAPQI and may produce even more when mixed with acetaminophen and caffeine together, Nelson speculated.

In addition, because alcohol can boost NAPQI production, people who drink a lot may be at increased risk for this toxic interaction, the researcher said. The risk is also increased for people who take drugs that combine acetaminophen and caffeine, used to treat migraines, arthritis and other conditions.

Still, for most people, there's no reason to panic, since the chances of caffeine and acetaminophen becoming a toxic mixture remains small, Nelson said.

"Almost all people don't need to worry about taking caffeine with acetaminophen," Nelson said.

Exceptions might be, " those [people] taking high does of caffeine, high doses of acetaminophen, who are possibly alcoholic and/or are epileptic and take certain anticonvulsive drugs," he said.

More information
For more on acetaminophen, visit the U.S. National Library of Medicine.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Most Women Unaware of Hormone Replacement Study

(HealthDay News) -- Most women are unaware of the results of a large-scale study, released in 2002, that found significant cancer and heart risks associated with long-term hormone replacement therapy (HRT).

That study, called the Women's Health Initiative, generated massive amounts of publicity immediately after it was released. Its data caused many American women to abandon HRT altogether.

But just two years later, in June 2004, fewer than a third of women surveyed by Stanford University researchers said they knew about the findings.

"I was quite surprised by that. Other research had indicated that up to half had heard about it," said senior researcher Dr. Randall Stafford, associate professor of medicine, Stanford Prevention Research Center, Stanford University, Stanford, Calif., and the senior author of the study.

His team's study is published in the September/October issue of the journal Menopause.

When Stafford and his colleagues interviewed 781 women between the ages of 40 and 60, only 29 percent knew about the study. The question was posed this way: "Have you heard or read anything about the results of the Women's Health Initiative (WHI), a major research study in the U.S. suggesting the health risks of taking hormone therapy outweigh the benefits for most women?"

Those polled included 252 women who had not yet entered menopause, 88 classified as perimenopausal (having irregular menstrual cycles, but at least one period in the past 12 months), 227 women who were in or past menopause, and 196 who had surgically induced menopause after having undergone hysterectomy. For 18 women, menopausal status wasn't known due to missing data.

Next, the researchers ask whether HRT increases, decreases or has no impact on the risk of seven health conditions, including memory loss, heart disease, blood clots, stroke, osteoporosis, breast cancer and colorectal cancer.

Only 40 percent of the women answered more of these questions correctly than incorrectly. While 64 percent knew that hormones were thought to increase breast cancer risk, for example, only 9 percent knew the supplemental hormone regimen increased memory loss risk. Just 34 percent understood that HRT might boost their cardiovascular risk.

When asked if they had talked about hormone therapy with their doctors, the researchers found that 36 percent of women aware of the WHI findings had talked about it with their physicians. But only 15 percent of those who didn't know about the study results did.

"We need to do a better job of disseminating information," Stafford said, referring to the health care system.

But another expert familiar with the study viewed the results a bit differently. Some of the women may not have been even thinking yet about menopause, since the survey included women as young as 40, for whom menopause is typically 5 to 10 years away, noted Dr. William Parker, staff gynecologist and past chair of obstetrics and gynecology at Santa Monica-UCLA Medical Center and the Orthopaedic Hospital, Santa Monica, Calif.

"The unanswered question is, 'How many women who need to know the information now do not have it?' " said Parker, who is also clinical professor of ob-gyn, University of California, Los Angeles, School of Medicine.

If a woman is not at the point where she has to make a decision about hormone therapy, he said, it would not jeopardize her care if she was unaware of the study and its findings and didn't have a conversation with her physician.

In his own practice, Parker said, "If a woman is, say, age 48, and comes in, says she is having occasional hot flashes but is still having periods, I tell her, 'Let's have a conversation when you need it, because this information changes so quickly.' " Since the original WHI results were released in 2002, numerous re-analyses have been done of the study to confirm or negate the original findings, he noted.

Unless a woman needs the information immediately, Parker reasoned, the office visit time would probably be better spent on other concerns or preventive health.

The study was funded by the National Heart, Lung, and Blood Institute and GlaxoSmithKline Consumer Healthcare. The pharmaceutical company was interested in the data due to its black cohosh product for menopausal symptom relief, Stafford said.

More information
To learn more about the Women's Health Initiative, visit the National Heart, Lung, and Blood Institute.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Few Americans Know of Leg Artery Danger

(HealthDay News) -- Three-quarters of adult Americans polled recently said they knew little or nothing about peripheral arterial disease (PAD), a very common blockage of blood vessels in the legs that boosts heart risk.

"I don't think that was necessarily a surprise among physicians involved in PAD," said Dr. Timothy Murphy, a professor of diagnostic imaging at Brown University, who co-authored a report on the survey, published in the Sept. 18 issue of Circulation.

"Most of us know that many of the patients at risk don't seek medical attention," Murphy said.

"But it was surprising that the knowledge base was as small as it was, considering that there are 8 million people in the United States with the disease."

Murphy is a member of the Peripheral Arterial Disease Coalition, which conducted the survey.

The coalition is funded by grants from the Bristol-Myers Squibb/Sanofi Aventis Partnership (both members of the Partnership are drug companies) and medical device maker Cordis Endovascular, a division of Cordis Corp.

In PAD, arteries in the legs are narrowed or blocked with fatty deposits. These obstructions can cause leg pain but often produces no symptoms. PAD can damage legs enough to cause amputation, and it can also signal a raised risk of Heart attacks or strokes caused by a narrowing of the arteries elsewhere in the body.

Three-quarters of the 2,051 people aged 50 and over queried via phone in the survey said they were aware of strokes, and two-thirds knew about risks of coronary artery disease and heart failure. But just 25 percent knew about PAD -- far behind awareness levels for much rarer conditions, such as amyotrophic lateral sclerosis or Lou Gehrig's disease (36 percent) and multiple sclerosis (42 percent).

Among the one in four adults who were aware of PAD, only 28 percent associated it with an increased risk of heart attack, and just 14 percent linked it with amputation and death.

That's no big surprise, Murphy said, since "the link between PAD and heart attacks and stroke is just becoming disseminated among primary-care physicians."

Relatively few family doctors routinely perform the basic diagnostic test for PAD, called the ankle-brachial index, he said. Blood pressure is measured in the arm and at the ankle, with the measurements repeated at both sites after five minutes of walking on a treadmill.

Lower pressure at the ankle indicates PAD. The lower the ankle-brachial index, the greater the danger.

"The test is not often done in a primary-care physician's office," Murphy said. "It is not reimbursed under Medicare unless there are symptoms, and it is hard to ask physicians to do a test unless they are reimbursed. We are trying to get support for Medicare to reimburse for it as a diagnostic test."

Diagnosis of PAD indicates the need for attention to the well-known risk factors for arterial blockage elsewhere in the body, such as smoking, high blood pressure, cholesterol levels and lack of exercise, said Dr. Alan T. Hirsch, a professor of epidemiology and community health at the University of Minnesota, and another author of the report.

Lack of awareness means that even adults who have leg pains or other symptoms of PAD are not aware of its dangers, Hirsch said. "At a time when the public is bombarded with health messages, it would seem wise for those with one of the single most common cardiovascular diseases to be aware of the risk," he said.

The survey also shows that physicians are not doing enough about awareness of PAD risk, Hirsch said. While 26 percent of those in the survey who were aware of PAD said they got information from broadcast media such as television, only 19 percent reported first hearing about PAD from a health-care provider.

Physicians should be aware of PAD symptoms as a major warning sign of potential trouble, Hirsch said. "Denigrating leg pain as unimportant is as logical as avoiding chest pain," he said.

More information
Questions about PAD are answered by the PAD Coalition.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Erasing Pathogens: Laser Blasts Viruses in Blood

Johns Hopkins University student Shaw-Wei David Tsen, immunology researcher in the laboratory of T.C. Wu at Hopkins’ Kimmel Cancer Center, sought a new method to rid isolated blood of dangerous pathogens, including the viruses HIV and hepatitis C.

He says current techniques using UV irradiation and radioisotopes can leave a trail of mutated or damaged blood components. Using ultrasonic vibrations to destroy viruses was one possibility, but his father, Kong-Thon Tsen, a laser expert at Arizona State University, had a better idea: Lasers, unlike ultrasound, can penetrate energy-absorbing water surrounding the viruses and directly vibrate the pathogen itself.

The researchers aimed a low-power laser with a pulse lasting 100 femtoseconds into glass tubes containing saline-diluted viruses that infect bacteria, also known as bacteriophages. The amount of infectious virus within each cube plummeted 100- to 1000-fold after the laser treatment. “I had to repeat the experiment several times to convince myself that the laser worked this well,” says the younger Tsen. “Our laser repeatedly sends a rapid pulse of light and then relaxes, allowing the solution surrounding the virus to cool off,” Tsen says. “This significantly reduces heat damage to normal blood components.”

Building on the idea that vibration wrecks a virus’ outer shell, the scientists found that their low-power laser selectively destroys viruses and spares normal human cells around them, while stronger beams kill almost everything.

Father and son speculate that laser vibrations could destroy drug-resistant and -sensitive viruses alike. Wu says that the technique his student developed “could potentially be used to control communicable diseases by giving infusions of laser-treated blood products.”

Source: Johns Hopkins Medical Institutions

Number of Partners Doesn't Explain Gay HIV Rate

(HealthDay News) -- The HIV epidemic among gay men can't be explained by their number of sexual partners, U.S. researchers report.

More than half the new HIV infections diagnosed in the United States in 2005 were among gay men, a team at the University of Washington, Seattle, noted. In addition, as many as one in five gay men living in cities may be HIV-positive.

But the sexual behaviors of gay and heterosexual men in the United States may not be as different as most people think, the researchers said.

In fact, two surveys found that most gay men have a similar rate of sex with unprotected partners compared to straight men or women.

"Just because gay men continue to have much higher levels of HIV, we can't jump to the conclusion that that means that they are promiscuous or that prevention messages aren't working," said lead researcher Steven Goodreau, an assistant professor of anthropology.

In the study, Goodreau and a colleague, Dr. Matthew R. Golden, analyzed data from two large population-based surveys. Using those figures, they estimated how many sex partners gay men and straight men and women have, and what number of gay men have either insertive or receptive anal sex, or both.

The report is published in the Sept. 12 online edition of Sexually Transmitted Infections.
"We found that even if gay men behave the same way heterosexuals do -- in terms of sexual partner numbers -- gay men would still have a huge HIV epidemic," Goodreau said.

Conversely, "even if heterosexual men behaved the way gay men do, they would not have a huge HIV epidemic," he added.

In fact, for straight men and women to experience an epidemic of HIV infection as widespread as that of gay men, they would have to have an average of almost five unprotected sexual partners every year -- almost three times the rate of the average gay male, Goodreau and Golden found.

So, why the higher HIV risk for gay men? "A couple of different things could give gay men an overall higher risk for HIV than heterosexuals," Goodreau said.

One reason HIV remains epidemic among gay men is that anal sex is much more conducive to the transmission of HIV transmission than is vaginal sex, the researcher said.

"That puts gay men at much higher risk overall," he said.

In addition, HIV transmission is more easily transmitted through the penis than via the vagina or the anus, Goodreau said. Heterosexuals tend to maintain the same role (insertive vs. receptive), while gay men can switch roles -- making the transmission of HIV more likely, he noted.

So, for gay men and straight men who have the same number of partners and have unprotected sex, gay men are more likely to transmit and receive HIV, Goodreau said. "That's why you can get huge epidemics among gay men and virtually none among heterosexual men," he said.

To end the HIV epidemic, gay men would need to have significantly lower rates of unprotected sex than those seen among the straight men, Goodreau believes.

One expert believes the study does have its flaws, however.

"The information here is mostly based on people's reports of their own behavior," said Philip Alcabes, an associate professor at the School of Health Sciences of Hunter College/City University of New York. "When trying to make use of information on self-reported sexual behavior, we have to remember that it isn't clear that anybody tells the truth," he said.

More information
For more on HIV, visit the U.S. Department of Health and Human Services.

· Live Blood Analysis Forum
· Ozone-Oxygen-Forum
· Colon courses
· Medical Microscopy-Live Blood Analysis
· Live Blood Analysis (3 days)
· Live Blood Analysis (6 days)
· Live Blood Analysis (80 hours)

Mediterranean Diet May Boost Alzheimer's Survival

(HealthDay News) -- Consuming what's known as a Mediterranean diet -- one loaded with fruits, vegetables, grains and olive oil -- may help Alzheimer's patients live longer, a new study suggests.

The observation comes after researchers tracked the dietary habits of people diagnosed with early-stage Alzheimer's. It follows on earlier work by the same team that suggests these diets may lower the risk of developing Alzheimer's in the first place.

"This time, we found that Alzheimer's patients who were following the Mediterranean diet had longer survival as compared to those who were following the diet less," said study lead author Dr. Nikolaos Scarmeas, an assistant professor in the department of neurology at Columbia University Medical Center in New York City.

The study is published in the Sept. 11 issue of Neurology.

According to the American Heart Association, diets native to the 16 countries bordering the Mediterranean Sea varies somewhat region to region. However, most regimens include a high intake of fruits, vegetables, breads, cereals, potatoes, beans, nuts, seeds, and olive oil.

More than half of all fat-sourced calories in the Mediterranean diet come from monounsaturated fats, such as olive oil. Dairy, fish, poultry, and other sources of saturated fats are eaten at low to moderate levels, the AHA say.

Heart disease rates in Mediterranean nations are lower than in the United States, the AHA adds, although it's not clear that diet alone is responsible for the difference.

To further examine the potential health benefits of the Mediterranean diet, Scarmeas' team compared nutrition and disease progression between 1992 and 2002 among 192 patients with early-stage Alzheimer's, all of whom lived in New York City.

All the patients were 65 and older, most were non-white, and all underwent initial physical and neuro-psychological exams to assess their cognitive capacities. Such evaluations were repeated every 18 months.

In addition, the patients completed questionnaires regarding their food consumption over a one-year period. Daily caloric intake was tallied for seven categories, including dairy, meat, fruits, vegetables, legumes, cereals, and fish.

At no time were patients given any information about nutrition, or instructions about what to eat or how much to eat of any particular food group.

Throughout the full study period, the researchers tracked patients for an average of four-and-a-half years, during which time 85 patients died.

Scarmeas' group found that patients whose consumption habits most closely tracked that of the Mediterranean diet were 76 percent less likely to die in the study period than those whose food intake least mimicked the diet.

Compared with those whose diets most closely resembled a Western diet, Alzheimer's patients who most closely followed the Mediterranean diet lived an average of four years longer.

A more moderate degree of adherence to the Mediterranean diet still translated into extra 1.3 years of survival, the researchers said. That's equal to a 29 percent to 35 percent reduced risk for dying during the study period.

The findings appeared to hold up regardless of patient body mass index, gender, ethnicity, or educational background. Age differences had a nearly imperceptible impact on the findings.

The researchers did not examine how differences in end-of-life care protocols -- such as the possible use of artificial feeding mechanisms and antibiotic therapies -- might have affected survival in some patients.

Scarmeas emphasized that more work needs to be done to tease out the diet's effects.

"For now, we can only speak about the tendency we found in a whole population," he cautioned.

"It is possible that particular people happen to have a constellation of several other factors that contribute to a risk for dying or delay their mortality. So, right now, we can only say that in this observational study we found, in general, that the more you follow this Mediterranean diet, the later you die, even after the onset of Alzheimer's disease."

Greg M. Cole is associate director of the Alzheimer's Disease Research Center at the UCLA David Geffen School of Medicine and a neuroscientist with the Greater Los Angeles VA Healthcare System. He described the findings as provocative but not definitive.

"It could be that the Mediterranean diet is slowing the progression of Alzheimer's," he acknowledged. "But there could also be other explanations. For example, a lot of people who have Alzheimer's also have cardiovascular disease. The risk factors for both illnesses show a lot of overlap. And it is a pretty well established benefit that the Mediterranean diet protects against heart disease."

"So, it could be that the Mediterranean diet is actually slowing down the accompanying spectrum of vascular problems that lead to stroke and heart attack and other problems associated with a cardiovascular disease that lead to mortality," explained Cole. "So, death is not as good a measure here as the progression of cognitive decline. Is the diet actually slowing down the cognitive decline of Alzheimer's itself? That's the next question. And, if so, that would certainly be a very significant result."

More information
For additional information on the Mediterranean diet, visit the American Heart Association.

Researchers Find Better Way to Deliver Blood Thinner

(HealthDay News) -- A new gene-based dosing formula for the anti-clotting drug warfarin should make it easier to prescribe the correct dose of the blood thinner, researchers say.

Up to this point, doctors have had to engage in a trial-and-error process over several weeks that left patients at risk of hemorrhaging from low doses or developing blood clots with too-high doses.

"We already knew these genes affected warfarin dosing, but we didn't know how to use that information clinically," researcher Dr. Brian Gage, medical director of Barnes-Jewish Hospital's Blood Thinner Clinic, said in a prepared statement. "But with this study, we've established a simple way to combine these genetic factors with clinical factors in a dosing algorithm."

Gage and colleagues developed the formula based on study participants who had undergone hip replacement or knee surgery. The study team focused on two genes, VKORC1 and CYP2C9, which are known to affect the way warfarin operates inside the body.

Using the new method, physicians head to a Web-based tool to calculate a patient's initial dosage more accurately.

Writing in the September issue of Blood, Gage and colleagues said the calculated dose will cut down on the number of dose changes patients will need before the amount is correct.

The method follows on the heels of an Aug. 16 requirement by the U.S. Food and Drug Administration that labeling for warfarin include information about the effect of the two genes.

The FDA also called for studies to determine the correct dosage for people with each genetic variation. This is the first study to address that request.

Warfarin, sold under the brand name Coumadin, prevents blood clots and reduces the risk of stroke in patients with atrial fibrillation, artificial heart valves, deep venous thrombosis and pulmonary emboli. It is also used to prevent clots in people who recently had certain orthopedic surgeries.

More information
To learn more about blood clots, visit Deep Vein Thrombosis: What You Should Know.

Test Spots Genetic Damage Done by Smoking

(HealthDay News) -- An experimental lung cancer screening test designed to look for precancerous genetic damage could help better identify patients at risk for the disease, while opening up the possibility for earlier diagnoses and preventive treatments, a new study suggests.

The procedure enabled the researchers to screen people for evidence of chromosomal abnormalities in the lungs that are found among virtually all lung cancer patients. More than 80 percent of patients who did not yet have lung cancer -- but whose smoking placed them at high-risk -- were found to have such disease biomarkers.

"We were able to see precancerous genetic changes in the bronchial cells lining the airways of the lungs in both high-risk smokers and in patients who have lung cancer in another part of the lung," said lead author Dr. Wilbur A. Franklin, a professor of pathology at the University of Colorado Health Sciences Center.

Reporting in the September issue of the American Journal of Respiratory and Critical Care Medicine, the authors cautioned that they are not yet certain that the genetic changes they identified will always lead to lung cancer. However, they said the prospect of such an association was fuel for further research.

Lung cancer is the leading cancer killer in the United States, causing more fatalities than colon, breast, and prostate cancer combined, the researchers noted.

They added that genetic markers for lung cancer risk are good targets for screening interventions, given that once chromosomal abnormalities occur, they are considered irreversible -- even among smokers who kick the habit.

Franklin and his team used two laboratory techniques -- spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH) -- to check the chromosomal status of lung tissue among 71 people. Fourteen of the study participants had already been diagnosed with lung cancer, 43 were considered at high-risk for the disease because they were smokers, and another 14 people were healthy men and women who'd never smoked.

Chromosomal abnormalities were found in 100 percent of the cancer patients and 82 percent of the high-risk smokers.

The researchers also established a so-called chromosomal abnormality index (CAI) to illustrate the extent of genetic damage. They found that while non-smokers had CAI readings of less than 1 percent, high-risk smokers had reading above 10 percent, and cancer patients topped 15 percent.

The researchers said it's not yet known when such potential genetic "markers" for future lung cancer develop or what constitutes the initial "genetic hit" that triggers chromosomal changes.
Still, they were able to identify four chromosomes -- numbers 5, 7, 8, and 18 -- that were most often affected among both cancer patients and the high-risk smokers.

Franklin emphasized that the technology his team used would not be practical for widespread medical use outside of a research setting. But he said he hoped the study is a "small step" forward in the effort to develop widely available screening options that could offer patients at risk of lung cancer a chance at earlier and more effective treatment.

"Ultimately, the point is to identify those patients who are likely to go on to get cancer before they get it," he said. "And, ultimately, we'd like to develop chemo prevention drugs that would target these high-risk individuals."

Franklin said he expects a biomarker screening technique for lung cancer to be available in the "not too distant future."

Dr. Timothy Winton, an associate professor of surgery and division director of thoracic surgery at the University of Alberta and the University of Alberta Hospital in Edmonton, Canada, called the new study a "very interesting" effort to harness modern technology to get a jump on lung cancer diagnoses.

"This is an attempt to look inside the cell at a very early genetic change level to get useful insights into the damage that's been done and the risk that is associated with it," he said. "It's an extension of a series of screening studies ongoing for decades to catch cancer at a very early stage, so it can be cured by surgery or surgery plus chemotherapy.

"It's also further strong evidence that not smoking is one of the major things that people can do to protect themselves from lung cancer," Winton added. "Because the message here is that smoking leads to genetic abnormalities, which go on to lead potentially to cancer. And very few people that do not smoke get lung cancer."

More information
For additional information on lung cancer, visit the American Cancer Society.

Constipation's Many Causes and Cures

(HealthDay News) -- If you've tried loading up on fruits, vegetables and whole grains and still can't get relief from constipation, maybe you need more than a boost of fiber.

"The idea that many patients have, and unfortunately their physicians, if we just keep pushing fiber until the grass grows out of their behind they'll have been treated successfully, that's not really true," said Dr. Arnold Wald, a professor of medicine in the section on gastroenterology and hepatology at the University of Wisconsin.

Doctors recommend consuming fiber, because it's easy to take and cheap, he explained, but it doesn't work for every patient. That's because constipation is a symptom that can have many different causes.

About 80 percent of people suffer from constipation at some point in their lives, according to the American Society of Colon & Rectal Surgeons. Brief bouts of constipation are normal. But when symptoms persist, people may need to consult a physician.

Anyone who experiences at least two symptoms of constipation for at least three months -- not necessarily consecutively -- over a period of six months is considered chronically constipated, said Dr. Satish S.C. Rao, a professor of internal medicine and director of neurogastroenterology and gastrointestinal motility at the University of Iowa in Iowa City.

The symptoms are excessive straining, hard stools, a feeling of incomplete evacuation, a sensation of blockage in the anorectal region, use of digital maneuvers to facilitate a bowel movement, and a stool frequency of less than three bowel movements a week, he said.

People become constipated when the colon absorbs too much water or if muscle contractions in the colon become too slow or sluggish, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Diets that are low in fiber and a lack of exercise are believed to be common causes of constipation.

But constipation can also be a side effect of other health problems, Rao explained. Many medications, including painkillers and antidepressants, can cause constipation, for example. And, the NIDDK noted, certain neurological disorders, such as Parkinson's disease; metabolic and endocrine conditions, including diabetes; and systemic disorders, such as Lupus, also can cause problems by slowing the movement of stool through the colon, rectum or anus.

For some people, constipation is the direct or "primary" result of colonic nerve or muscle dysfunction. This group of people includes patients with "dissynergy defecation," a problem that has only been recognized in the last 15 years, Rao said.

"The problem is that the individual has the inability to coordinate the pelvic floor muscles and anorectal muscles to evacuate stool, so many of them have a sense of stooling, but they can't pass, or they only pass small amounts, or incompletely and so on," he said.

Rao and his colleagues recently examined a technique for teaching these patients to improve bowel function. The study, published in the journal Clinical Gastroenterology and Hepatology, compared the use of biofeedback therapy with either sham biofeedback sessions or standard treatments consisting of diet, exercise and laxatives. The biofeedback group came out "far, far superior" to the other two groups, he reported.

Dr. Henry P. Parkman, a professor of medicine and director of the GI Motility Laboratory at Temple University School of Medicine in Philadelphia, said he uses biofeedback -- a form of complementary medicine in which the patient uses the mind to control the body -- quite a bit in his own practice. "It has a response rate of 50 to 75 percent," he said.

Another type of "primary" constipation, called "slow-transit constipation," takes patients longer to pass stool. There's also irritable bowel syndrome (IBS) with constipation, which causes abdominal pain or discomfort.

Until recently, Zelnorm, a drug made by Novartis Pharmaceuticals, had been approved for treating both groups of patients. But on March 30, the company pulled it from the market after new data indicated an increased risk of heart attack, stroke and death. Gastroenterologists say the move leaves a gap in treatment options, particularly for treating women with IBS with constipation.

Like anything else, constipation can vary in frequency and severity, and only when it becomes "a real problem" will people need to seek referrals for specialty tests and treatment, Wald said.

In fact, he added, most people may find relief on the shelves of their local pharmacy or grocery store. They can try stimulant laxatives or polyethylene glycol, an over-the-counter stool softener. There are also natural stimulants like raisins and prunes.

And there's always fiber.

"Diet doesn't work in every scenario," Rao said, "but for occasional constipation, that is the group that I think diet will be effective for."

More information
For more on constipation, visit the American Gastroenterological Association.