I think the world has become fascinated by drones. I know I have. I got one for Christmas and it’s really fun to play with. The one I got is really hard to fly, but in many ways that makes it more fun.
What a lot of people don’t realize is how many ways drones are going to be part of our future life. No, I’m not talking about the military drones. In fact, using the term drones is so tied to the military that it’s almost not right to use the term. However, many people have become more familiar with drones thanks to Go pro cameras that are attached and bring us some really amazing footage even from amateurs. Read more →
Breast cancer is not one disease, and eliminating the disparities in outcomes requires improved understanding of biology and implementation of systemwide clinical innovation to deliver high-quality care to all women, one woman at a time. Representing 14.0% of all new cancer diagnoses, an estimated 232 670 new cases of breast cancer will occur in 2014, and an estimated 40 000 women will die of the disease.1,2 Despite significant gains in the treatment of the disease, leading to an overall reduction in breast cancer mortality, black women continue to die disproportionately from aggressive forms of breast cancer. There has been no fundamental shift in the approach to treatment for early-stage breast cancer based on biology.
In this issue of JAMA, Iqbal and colleagues3 found significant differences in the likelihood of diagnosis with stage I breast cancer and risk of death among 8 ethnic/racial groups in the United States using the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Based on their analysis of 373 563 women with invasive breast cancer, including 268 675 non-Hispanic white, 34 928 Hispanic white, 38 751 black, 25 211 Asian, and 5998 other ethnicities, the authors found that black women were less likely to be diagnosed with stage I breast cancer (non-Hispanic white women, 50.8%; black women, 37.0%) and were twice as likely to die of breast cancer with small-sized tumors than non-Hispanic white women (7-year actuarial risk for death from stage I breast cancer of 6.2% vs 3.0% for white women). Asian women had the highest likelihood of being diagnosed with stage I breast cancer and a lower risk of dying compared with white women (0.8% vs 1.5%, respectively; hazard ratio, 0.60 [95% CI, 0.49-0.73]; P < .001). The difference between black women and non-Hispanic white women remained after adjusting for income and estrogen receptor (ER) status and was statistically significant after excluding patients with triple-negative breast cancer (ie, breast cancer cells testing negative for ER, progesterone receptor [PR], and ERBB2).
Triple-negative breast cancer is associated with a poor prognosis, especially among black women.4 These cancers are more likely to be diagnosed at an early age (and therefore not detected by screening if current population guidelines to initiate screening at age 50 years are followed), to have metastasized to lymph nodes even when tumors are less than 2 cm in size, and to rapidly acquire resistance to chemotherapy, leading to shortened overall survival. As Iqbal et al3 rightly concluded, the racial/ethnic disparities in breast cancer outcomes can in part be accounted for by differences in the biological aggressiveness of triple-negative breast cancer in black women compared with other racial/ethnic groups.
With more granular data collection by SEER that includes race/ethnicity as well as ER, PR, and ERBB2 status, ethnic minorities in the United States can no longer be grouped together. The biological differences in breast cancer by race/ethnicity, and failures in the US health care delivery system that lead to suboptimal care for black women and women of other races/ethnicities, can now begin to be addressed. Based on the findings of Iqbal et al,3 biology alone cannot be the contributing factor creating the survival gap in breast cancer. Instead, this report should be viewed in the context of known tumor differences between black and white women, and this knowledge should be integrated into innovative quality improvement efforts in breast cancer management across the continuum of care.
High-risk children who consumed peanut products from infancy until they were 5 years old were significantly less likely to develop a peanut allergy than those who avoided peanuts, according to the LEAP randomized trial (Du Toit G et al. N Engl J Med. 2015;372:803-813).
The 640 infants in the trial were aged 4 to 11 months at enrollment, and all had severe eczema, egg allergy, or both. Results of a skin-prick test to peanut protein separated the participants into 2 cohorts: one with no measurable wheal after testing (nonsensitized) and the other with a wheal 1 to 4 mm in diameter (mildly sensitized). Participants in each cohort were randomly assigned to consume a peanut protein–containing bar or to avoid peanuts. Infants in the group that consumed peanuts ate at least 6 g of peanut protein per week until age 5 years.
Among the 530 infants in the non-sensitized cohort that could be evaluated for the primary outcome, the prevalence of peanut allergy at 60 months was 13.7% in the avoidance group and 1.9% in the consumption group. The absolute difference in risk of 11.8% represents an 86.1% relative reduction in the prevalence of peanut allergy.
In the mildly sensitized cohort (98 infants), the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group.
The LEAP-ON study is currently investigating whether immune tolerance will persist after children stop eating peanuts.
Naltrexone Extended-Release Plus Bupropion Extended-Release for Treatment of Obesity
In September 2014, a proprietary formulation of naltrexone extended-release (ER) plus bupropion-ER (brand name Contrave) was approved by the US Food and Drug Administration (FDA),1 becoming the fourth medication approved for long-term weight management in patients with obesity.2 Liraglutide (brand name Saxenda), a glucagon-like peptide 1 receptor agonist, was also approved for obesity treatment in December 2014. This Viewpoint discusses naltrexone-bupropion ER and its potential use for the adjunctive treatment of patients with obesity.
A flood of recent studies is giving us new insights into how important getting enough good sleep is for staying healthy, feeling great, and thinking straight. So take a short siesta and check out the slumber stats below.
Sleep deprivation makes you eat more.
Skip sleep, and the next day you’ll eat too many calories from fat and too few from carbs, according to a UPenn School of Medicine study. When subjects were kept from sleeping, a brain region called the salience network, which regulates emotions and bodily sensations like a racing heart, lit up and raised their fat cravings. By the way, if you do pig out, just don’t do it late at night: Eating when the body’s usually asleep can hamper learning, damage memory, hurt the immune system, and even lead to type-2 diabetes, UCLA researchers say.
With vivid burgundy seeds and a distinctive sweet flavor, the pomegranate is a nutrient-dense fruit that is fun to eat and steeped in history. Its medieval French name originates from the Latin roots for “apple” and “seedy,” according to the University of California. It was first cultivated in Iran, but spread to the Mediterranean area and later to the Americas. People during the Middle Ages thought pomegranates were good for liver inflammation, a common malady in men, but today, other male health benefits are being discovered.
The US Food and Drug Administration (FDA) has approved a first-of-its-kind weight loss treatment device that electronically suppresses hunger signals traveling between the stomach and the brain. The Maestro Rechargeable System, which is manufactured by EnteroMedics of St Paul, Minnesota, consists of an electrical pulse generator, wire leads, and electrodes that are implanted into the abdomen and intermittently send electrical pulses to the vagus nerve.
A new device targets the brain-stomach nerve connection that controls feelings of hunger and satiety.
Supplements are great when taken in conjunction with a healthy diet and exercise plan, but some supplements can be viewed as more essential than others. A good protein blend, for example, is crucial for building muscle and preserving lean body mass, but beyond the aesthetic reasoning behind most supplements on the shelves today, there is one in particular that belongs at the top of your list: omega-3 fatty acids.
These fatty acids derived from fish oil have been a staple in my supplement regimen for years due to their positive effects on my physical and athletic performance, as well as their brain-boosting, heart-healthy and anti-inflammatory properties. If you’re not taking an omega-3 supplement, now may be the time to start.
TOLEDO — The new machine that could one day replace anesthesiologists sat quietly next to a hospital gurney occupied by Nancy Youssef-Ringle. She was nervous. In a few minutes, a machine — not a doctor — would sedate the 59-year-old for a colon cancer screening called a colonoscopy.
But she had done her research. She had even asked a family friend, an anesthesiologist, what he thought of the device. He was blunt: “That’s going to replace me.” Read more →
Your grandparents never thought twice about eating foods that were loaded with saturated fat. Not long ago, people drank milk with cream on the top, ate whole eggs for breakfast, and enjoyed steak for dinner—and led normal, healthy lives. Yet today, despite all the warnings we’re told to heed about saturated fat and its deleterious effects on the heart, cardiovascular disease is more prevalent than ever. We corralled some of our most trusted nutritionists and asked for their best advice on saturated fats.