Gene Assay Informs Chemo Decision in Breast Cancer 10-year recurrence risk of 3.5% in low-risk, node-positive disease

This study identified a substantial population of patients with one to three positive lymph nodes with sufficiently low risk to safely avoid chemotherapy. By tailoring risk categorization to the number of positive nodes, 37% of patients with a single positive lymph node and 15% of patients with two positive nodes were characterized as low risk, by Prosigna, with very favorable outcomes when treated with adjuvant endocrine therapy alone. "Although chemotherapy could still provide some relative additional benefit for patients, when the low-risk group carries a residual rate of recurrence of <5% at 10 years, the absolute benefit that can be achieved by still giving chemotherapy could be, at best, very small (and more than counterbalanced by toxicities)."

Metabolic Surgery May Be Superior To Medical Treatment For Prevention Of Microvascular Complications In T2D

“Metabolic surgery was superior to medical treatment for the prevention of microvascular complications in type 2 diabetes [T2D],” research indicated. The findings of the multi-study meta-analysis were published in the British Journal of Surgery.

YIKES Some Diabetes Patients May Be Injecting Insulin That Has Partially Disintegrated, Research Indicates.

reports that “preliminary research” on just “18 vials of insulin” suggests that “some diabetes patients may be injecting medicine that has partially disintegrated.” The study’s author, a pharmacist, purchased “vials of insulin at a number of pharmacies and found that on average the vials had less than half of what was listed on the label and none met a minimum standard.” The findings were published online in the Journal of Diabetes Science and Technology. https://apnews.com/ccfc2712fa3e469fad2179beede78827/Insulin-quality-questions-have-diabetes-experts-scrambling

Fat Lost On Crash Diets May Have Negative Impact On Heart Health

reports that a study “suggests that fat lost on crash diets may clog the heart and reduce its function.” However, “this effect appears temporary.” Rayner's team theorized that the sudden drop in calories causes fat to be released from different parts of the body into the blood. It's then taken up by the heart muscle. But the negative changes didn't last. By eight weeks, heart function and heart fat were better than normal. Body fat, cholesterol and all of the other metabolic measures also continued to improve. The findings were presented at the European Society of Cardiology meeting. https://consumer.healthday.com/vitamins-and-nutrition-information-27/dieting-to-lose-weight-health-news-195/crash-diets-might-derail-your-heart-health-730863.html

Lung Disease Common in Late-Onset SLE Rates of interstitial lung disease more than doubled

Many potential factors may contribute to the increased pulmonary risks among late-onset lupus patients, including effects on both the innate and adaptive immune systems. For example, neutrophils in older individuals are less capable of killing phagocytosed pathogens but have increased apoptosis, and thymic production of naive T-cells declines, leading to proliferation of memory T cells and a resulting proinflammatory state. An additional contributory factor for interstitial lung disease in older patients may be a possible SLE-Sjogren's syndrome overlap syndrome, which has been reported by several groups. The prevalence of interstitial lung disease in Sjogren's syndrome, at 9% to 75%, is much higher than in SLE, at 1% to 15%, so an overlap syndrome could explain the high incidence in older patients. "In addition to a possible Sjogren's overlap phenotype in late-onset SLE, factors such as duration of disease, environmental exposures, and smoking trends over time might also correlate with SLE interstitial lung disease," the researchers observed. https://www.medpagetoday.com/rheumatology/lupus/70981?xid=nl_mpt_DHE_2018-02-07&eun=g721819d0r&pos=0&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-07&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days

ACIP Issues Updated Adult Vax Schedule Changes to shingles, MMR vaccine recommendations

Changes to the adult immunization schedule include a preferential recommendation for a new recombinant zoster vaccine for older adults, and a third dose of measles mumps rubella (MMR) vaccine to adults who may be at risk of mumps during an outbreak. The CDC Advisory Committee for Immunization Practices (ACIP) recommended changes on use of herpes zoster vaccine and use of an additional MMR dose, with additional changes in the wording of tetanus, diphtheria, and pertussis (Tdap), and other vaccine recommendations, wrote David K. Kim, MD, on behalf of the ACIP, and colleagues, in the Annals of Internal Medicine. The authors noted that the ACIP updated the standards of adult immunization practice "to promote the integration of vaccinations as a part of routine clinical care for adults." This means healthcare providers should assess a patient's vaccination status at every clinical encounter, "strongly recommend" needed vaccines to patients, offer vaccines recommended to patients, and document vaccines administered in the state or local immunization information system. https://www.medpagetoday.com/primarycare/vaccines/70970?xid=nl_mpt_DHE_2018-02-06&eun=g721819d0r&pos=3&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-06&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days

CSF Inflammatory Cytokines Linked to Perinatal Depression Novel research supports neuroinflammatory mechanism

They hypothesized that similar to depression outside of pregnancy, perinatal depression may be associated with CSF cytokines. https://www.medpagetoday.com/meetingcoverage/smfm/70953?xid=nl_mpt_DHE_2018-02-06&eun=g721819d0r&pos=1&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-06&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days