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High-dose vitamin d relieves pain for many patients of breast cancer with estrogen-lowering drugs, a new study shows. Credit: Michael c. Purdyhigh-dose vitamin d relieves pain for many breast cancer patients estrogen-lowering drugs, according to a new study from Washington University School of medicine in St. Louis.Drugs, known as aromatase inhibitors, commonly referred to shrink breast tumors that are powered by the hormone estrogen and help prevent recurrence of cancer. It is less toxic than chemotherapy, but for many patients, the drug can cause serious musculoskeletal discomfort, including pain and stiffness in the hands, wrists, knees, hips, lower back, shoulders and legs.
"Approximately half of patients may experience these symptoms," says Antonella Rastelli l., MD, Assistant Professor of medicine and first author of the study, published online in the Journal for research on breast cancer and treatment. "We do not know exactly why pain occurs, but can be very debilitating — the point that patients decide to block the aromatase inhibitors."
This video is not supported by your browser at this time.Washington University physicians found that high doses of vitamin d helps to relieve pain in breast cancer patients estrogen-lowering drugs. Known as aromatase inhibitors, drugs to treat breast tumors being supplied by the hormone estrogen. It is less toxic than chemotherapy, but many patients experience severe musculoskeletal discomfort, including pain and stiffness in the hands, knees, hips, lower back, shoulders and legs. Credit: Clark BowenBecause drugs reduce recurrence of cancer, found a way to help patients remain on is important for long-term survival without relapse, according to Rastelli. Aromatase inhibitors are prescribed to post-menopausal women for at least five years and more frequently after the diagnosis of breast cancer. There is some evidence that patients have the experience of drug side effects are less likely to see the cancer returned, providing even more incentive to help these patients still.Rastelli was by Marie e. Taylor, MD, Assistant Professor of Radiation Oncology, who first noticed that patients with aromatase inhibitors that experienced this pain found some relief from high doses of vitamin d.
Both the Group recruited Rastelli 60 patients reported pain and distress associated with anastrozole, one of the three FDA-approved aromatase inhibitors. Patients examined also had low vitamin d levels. Half of the Group were randomized to receive the recommended daily intake of vitamin d (400 IU) plus a capsule unit-50,000 vitamin d once a week. The other half received the daily intake of 400 units of vitamin d plus weekly placebo. All subjects received 1,000 milligrams of calcium daily throughout the study.
Patients in the study reported no pain suffered through three different questionnaires. They were asked to quantify the intensity of pain, as well as the report how the pain changed the climate, influenced their work and in relationships and everyday activities. The results show that patients with high-dose vitamin d each week reported significantly less musculoskeletal pain and also were less likely to experience the pain that interfered with daily life.
"High-dose vitamin d seems to be really effective at reducing musculoskeletal pain caused by aromatase inhibitors," says Rastelli. "Patients the impression weekly vitamin d better because their pain and sometimes strays completely reduced. This makes the drug much more tolerable. Millions of women worldwide to aromatase inhibitor therapy, and can we have another ' tool ' to remain in this anymore. "
Anastrozole as used in this study, two other aromatase inhibitors approved by FDA, letrozole and exemestane, should also give rise to musculoskeletal pain. Taking into account the similar reactions, Rastelli says patients about these drugs may benefit from high doses of vitamin d.
Vitamin used in this study is of a type derived from a plant called Vitamin D2. Rastelli says that achieves the best results when given weekly, because this body metabolizes within seven to 10 days. Rastelli and her colleagues used high-dose Vitamin D3, which remains in the body longer.
"This was a very carefully conducted study, and the control of the standard makes the findings very impressive," says Matthew j. Ellis, MD, Ph.d., senior author of the study and Director of the breast cancer program at the Center, Alvin j. Siteman cancer at Barnes-Jewish Hospital and Washington University School of medicine in St. Louis. "We have to take up these findings further to determine the most effective and safe approach for additional vitamin d in our patients with breast cancer."
Since vitamin d helps the body absorb calcium, too much of it can cause high levels of calcium in the urine, which may increase the risk of kidney stones. Possible reactions to stress the importance of patient monitoring urine calcium levels taking high doses of vitamin d.
"It is important to monitor patients, but overall it seems to be very safe," says Rastelli. Because Vitamin D2 is removed from the body so quickly, it is very difficult to overdose. "
In addition to the relief of pain, the Group wanted to examine whether it could protect vitamin d in the loss of bone that is often regarded as aromatase inhibitors in patients. The researchers measured each patient bone density at the beginning of the study again after six months.
Perhaps because of its role in calcium absorption, high-dose vitamin d appear to contribute to the maintenance of bone density in the neck of the femur, at the top of the thighbone near hip hinge. Although the result did not reach statistical significance, Rastelli calls the promising and worth further study.
"Great to have something simple as vitamin d to help patients to alleviate some of this pain," says Rastelli. "It is not toxic — does not cause significant side effects. And if that is actually to protect against bone loss, which is even better. "
More info: Rastelli AL, Taylor, Gao F, Armamento Villareal-R, S-Jamalabadi Majidi, Napoli n., Ellis, MJ. Vitamin d and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial separated. Research on breast cancer and treatment. Online June 2011.
Provided by Washington University School of Medicine (news: web)
An international team of scientists led by researchers at the University of California, San Diego School of Medicine (UCSD), and the Scripps Translational Science Institute (STSI) in La Jolla, CA, has identified possible genetic variations that could affect the patient's recovery from an eating disorder such as anorexia or bulimia. Their findings, reported online in the Journal Neuropsychopharmcology, may provide new insights into developing effective interventions for more treatment-resistant patients with these disorders.
"This study highlights important ' or ' genetic variations SNPs within a person's DNA, associated with long-term, chronic eating disorders," said Walter h. Kaye, MD, Professor of Psychiatry and Director of the UCSD eating disorder treatment and research program, who was a senior writer with Ph.d., Nicholas j. Schork, Director of Bioinformatics and Biostatistics to STSI and Professor at the Scripps Research Institute. "These variations indicate genetic Predictor for patients who may be especially susceptible to eating disorders and diseases are more difficult to treat effectively.
Kaye said such genetic traits are also linked to people with higher and higher concerns over mistakes – characteristics associated with anorexia and bulimia.
Researchers from the Institute for collaborative study was responsible for the collection of data of the study, scientists at UCSD and STSI led the design of the study and analysis of results.
According to lead study author, cinnamon Bloss, PhD, Assistant Professor at the STSI, conclusions could ultimately help pave the way towards a more individualised approach in treating patients with eating disorders. "Anorexia and bulimia which possibly originate from many different causes, such as culture, family, life changes and personality traits," Bloss said. "But we know biology and genetics is important in terms of cause and can play a role in how different users respond to treatment. Understanding the genetics behind these treaties are important because ultimately that could help us customize treatment based on the genetic makeup of individuals, with the aim of more personalized and effective treatments. "
Anorexia and bulimia are serious and complex psychiatric disorders. Anorexia nervosa is characterized by an inability to maintain a normal body weight and a relentless pursuit of lachaniase, bulimia is characterized by recurrent episodes of binge eating. Recent studies, researchers, including Kaye speculate that anorexia and bulimia may share some risk factors, and that patients can be genetically predetermined to have personality traits and moods that make them susceptible to eating disorders.
"People with anorexia in particular are often resistant to treatment and lack of awareness of the medical consequences of their behavior, which can lead to chronic, prolonged illness and even death," said Kaye. "Became a problem for us, ' Prognostic factors Exist that could help clinicians to identify good versus poor results for treatments, including medications and psychotherapies? '"
The research team studied a total of 1,878 women in large-scale candidate gene Association study that was designed based on assumptions regarding the genes, pathways, and biological systems involved in sensitive to eating disorders. Most were people with lifetime diagnosis of either anorexia or anorexia and bulimia, hosted and lower body mass index, higher and higher concerns over mistakes from control issues.
Scientists identified then the top 25 most statistically significant SNPs (single nucleotide-other), after assessing a total of 5,151 SNPs in approximately 350 genes. According to Bloss, 10 of the 25 most strongly associated "haplotypes" (combinations of alleles for different genes are closely together on the same chromosome and who tend to be inherited together) involved in GABA genes, SNPs. An intronic SNP on chromosome 4 gene GABRGI showed the strongest correlation in chronic symptoms. "The study suggests that genes can be pre-dispose people in a cycle of chronic eating disorder," Bloss said, adding that additional studies are needed to confirm these compounds.
Provided by the University of California-San Diego (news: web)
US researchers found there was a small but positive impact from a law introduced in 2008 in New York that require chain restaurants with 20 or more branches at the national level, to provide calorie information on menus and menu boards of the city.
Rates of obesity in the United States at a high in both adults and children and is currently one-third of adults and 17% of children of all ages and adolescents are obese. Several studies support an association between fast food consumption and excessive energy intake, but customers often underestimate the number of calories on restaurant meals and before 2007, nutrition information was rarely available at the time of purchase.
Thus, a team of researchers decided to assess the impact of calorie labelling regulation on the energy content of the individual markets in fast food restaurants in New York. High street chains in England are going to launch a similar scheme, though optional, as part of the Deal the Government responsible for public health.
Investigations completed during lunch hours in spring 2007 (one year prior to the regulation) and in the spring of 2009 (nine months after implementation) randomly selected locations in 168 chains of fast food top 11 in the city.
Adult customers supplied in the registry collection and answers to the questions of the survey. Analyzed data from customers in a customers 2007 7,309 and 8,489 2009.
Overall, there has been no reduction in calories purchased across the full sample. However, the three big chains saw significant reductions.
For example, McDonalds, average energy per market decreased by 5.3% to Au Bon Pain, decreased by 14.4% and KFC, decreased by 6.4%. Together, these three chains represented 42% of all customers of the study.
However, the average energy content increased in the chain – Metro – by 17.8%, which was to a large extent, large parts.
The analysis also showed that 15% of clients reported using the calorie information and, on average, these customers purchased 106 fewer as by customers who do not see or use the information in calories.
Researchers say that calorie labelling is only part of a framework for addressing the epidemic of obesity and solicit additional strategies for reducing energy intake by the population. "We must focus particular attention on about training customers on how to interpret and use nutrition information" award.
In an accompanying editorial, Dr Susan Jebb from MRC human nutrition research center at Cambridge believes that labelling is one step forward, but must follow the changes in the food supply. She writes: "Calorie labeling will help consumers to make an informed choice about what they eat, but steady improvement in the diet of the nation will require a transformation of the food supply."
Provided by the British Medical Journal (news: web)