Archive for November, 2009

Advice Helps Prevent Pain After Breast Cancer Surgery

Friday, November 27th, 2009

Patients recovering from breast cancer surgery have a greater chance of avoiding a painful and debilitating post-surgery condition if they get a little extra information, a study has found.

Lymphedema is a condition that causes a debilitating swelling of the extremities following breast cancer surgery. Symptoms also include pain, fatigue, numbness and reduced limb mobility. Patients with lymphedema are predisposed to other complications such as fibrosis, cellulitis, infections and septicemia.

About 30 percent of the 2.4 million U.S. breast cancer survivors have developed lymphedema, and all are at risk for the rest of their lives, according to background information in a news release from the New York University Langone Medical Center.

But there are things that patients can do to reduce the risk, including elevating the affected limb to promote fluid drainage, avoiding blood draws and injections in the affected limb and shunning tight clothing, which can aggravate symptoms, experts say.

Those who get additional information about lymphedema reported fewer symptoms and practiced more risk-reducing behaviors, according to a recent study.

“It is important to identify the early warning signs and symptoms of the condition, as well as determine what interventions to take,” said study co-author Dr. Deborah Axelrod, an associate professor in the department of surgery at NYU Langone Medical Center and a member of the NYU Cancer Institute, in the news release. “We also enroll patients into ongoing behavior and risk modification trials and work with physical therapists to ensure symptom reduction.”

Co-author Mei R. Fu said this is the first study to show that education can reduce risk of lymphedema.

“Nurses can play a leadership role in educating patients about lymphedema and can play a role in improving the quality of life in cancer survivors,” Fu, assistant professor in the College of Nursing at New York University, stated in the news release.

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Health Tip: Stifle Back-to-School Allergy and Asthma Problems

Sunday, November 22nd, 2009

Going back to school with asthma and allergies means dealing with pollens, molds and other allergens that contaminate the air during autumn.

The American College of Allergy, Asthma and Immunology offers these suggestions to help prevent allergy and asthma flares in your child:
-Have your child visit the doctor before school starts to make sure symptoms are well-controlled.
-Give a copy of your child’s treatment plan to the school staff, which should be familiar with your child’s triggers and medications.
-With the pediatrician’s approval, make sure your child is vaccinated for seasonal flu and swine flu.
-Make sure your child carries an inhaler at all times, and an epinephrine kit if the child has life-threatening allergies.
-Talk to your child about what triggers symptoms (such as exercise or chalkboard dust), and make sure he or she knows to avoid them.
-Check out the school and look for any potential problems, such as cafeteria foods that could be dangerous to your child.

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Milk Allergy Symptoms May Ease With Exposure

Tuesday, November 17th, 2009

Children who are allergic to milk may be able to overcome their allergy by drinking increasingly higher doses of milk, a new study finds.

In 2008, researchers from Johns Hopkins Children’s Center in Baltimore reported that children with a severe milk allergy could “retrain” their immune systems to tolerate milk and other dairy products by gradually consuming increasingly higher doses.

In the current study, researchers followed up with 18 children aged 6 to 16 whose symptoms had eased or gone away during the previous study.

When 13 of the 18 children returned to the clinic up to 17 months later, six continued to have no reaction after drinking 16 ounces of milk, twice the highest amount tested in the earlier study. Seven children had mild reactions, including itchy mouth, hives, sneezing and stomachache after drinking less than 16 ounces. One child needed medications for a cough, the researchers noted in a news release from Johns Hopkins.

The researchers also followed up with three children who could not drink more than 2.5 ounces at the end of the prior study. All three continued to drink milk daily with only mild reactions, and two were able to drink more than 2.5 ounces with few problems, the study authors found.

The study was published in the Aug. 10 online issue of the Journal of Allergy and Clinical Immunology.

One key to keeping the allergy at bay seems to be regular consumption of milk and dairy products, according to the study.

“We now have evidence from other studies that some children once successfully treated remain allergy-free even without daily exposure, while in others the allergies return once they stop regular daily exposure to milk,” said senior author Dr. Robert Wood, director of Allergy & Immunology at Johns Hopkins Children’s Center. “This may mean that some patients are truly cured of their allergy, while in others the immune system adapts to regular daily exposure to milk and may, in fact, need the exposure to continue to tolerate it.”

The researchers also tested for milk allergy using skin-prick testing, a standard food allergy test. Between eight and 15 months post-study, seven children had no reactions. Blood levels of milk IgE antibodies, which indicate allergy, slowly decreased, while IgG4, an antibody that indicates immunity to an allergen, rose.

The study authors also found that the prevalence of reactions continued to decline over time.

As part of the study, children and their parents kept daily logs of milk and dairy consumption and recorded symptoms, such as hives, abdominal pain, sneezing and cough. For the first three months, drinking milk triggered reactions nearly half of the time. During the next three months, milk triggered reactions 23 percent of the time, while some children reported no reactions.

Milk allergy is the most common food allergy. In those who are allergic, milk proteins cause the immune system to overreact, bringing a cascade of symptoms that can range from hives, itching, swelling and vomiting to anaphylaxis in the most severe cases.

Three million U.S. children have at least one food allergy, according to the U.S. Centers for Disease Control and Prevention.

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Home Dialysis a Good Option for Kidney Disease Patients

Thursday, November 12th, 2009

People with kidney disease may do just as well receiving treatment at home as undergoing a kidney transplant from a deceased donor, new research has found.

Researchers in Canada performed a 12-year follow-up study of 1,239 patients who had either received a kidney transplant from a deceased donor or who received night home hemodialysis.

The study found that patients who received the home treatment had survival rates similar to those who had transplants.

In night home hemodialysis, patients’ blood is cleared of toxins that would normally be removed by the kidneys during sleep. Treatments last six-to-eight hours, longer than in a conventional dialysis center, up to seven nights a week.

Survival rates for those who received a transplant from a living kidney donor was better than for both the home dialysis and deceased donor recipients, according to the study published in the September issue of Nephrology Dialysis Transplantation.

Night home hemodialysis may be a “bridge to transplant” or a “suitable alternative” to transplant if a patient is at too high of a risk for a transplant or unable to find a suitable donor due to ongoing organ shortages, the study authors noted in a news release from University Health Network.

“This study allows me to actually answer what my patients have been asking me for over a decade: ‘What does night home hemodialysis mean for my life span?’ I can now tell them that this specific dialysis option is as good as getting a transplant from a deceased donor,” Dr. Christopher Chan, medical director of home hemodialysis at Toronto General Hospital and an associate professor at University of Toronto, stated in the news release.

In the study, the researchers took into account age, race, diabetic status and duration of treatment with conventional in-center dialysis using data from the U.S. Renal Data System.

Over the course of 12 years, 14.7 percent of night home hemodialysis patients died, compared with 14.3 percent for patients with transplants from deceased donors and 8.5 percent for patients who’d received living donor transplants, the study found.

While previous research has shown that patients who received transplants have better survival rates than those on dialysis, these findings show that the long, frequent dialysis provided by nocturnal treatments may have an advantage over conventional dialysis, Chan said.

After trying conventional dialysis, Florence Tewogbade, 27, switched to home hemodialysis in April 2008. “It has changed my life,” Tewogbade said in the news release. “I can now work, go to school, look forward to a future and be self-reliant.”

Canada has among the lowest organ donation rates of any developed nation, according to the study. Of the 4,195 Canadians on a waiting list for a transplant, 71 percent needed a kidney.

About 2 percent of people on the waiting list die while waiting for a donor, according to the study.

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