Incision-Free Weight Loss Surgery in Experimental Phase ( Part 2)

After the surgery, the patient is placed on a liquid diet for several weeks and warned that eating too much or too fast could cause vomiting. Nutritionists say the best time to lose weight is in the 6 to 12 months following the surgery, because the body will try to fight the surgery by absorbing more nutrients.

Over the past several years, 98 patients in Mexico and Europe have had the new weight-loss surgery. Those who have passed the one-year mark have lost about 40 percent of their excess weight, on average. But in the U.S., the procedure is strictly experimental and has been used on only a few patients as part of a study paid for by the device maker, Satiety Inc.

Satiety, Inc. was founded in 2001 through a collaboration of medical device incubators Thomas Fogarty Engineering and The Foundry, and is headquartered in Palo Alto, California. Other companies are also developing new devices and minimally invasive operations, but Satiety is among the first to start testing its products in people.

Karleen Perez, a 25-year-old graduate student in social work, was the second patient at New York-Presbyterian Hospital/Columbia to enter the study. Dr. Marc Bessler and Dr. Daniel Davis performed the procedure Ms. Perez, while Satiety employees advised. “It (the procedure) has a lot of promise,” Dr. Bessler said. “I deal with a lot of new technologies. This, I’m really excited about.” Dr. Bessler said that he and Dr. Davis had no financial interest in Satiety other than the company paying for their work on the study.

Dr. Philip Schauer, director of bariatric surgery at the Cleveland Clinic, called the new operation very promising and said that so far it seemed to offer “a drastic reduction in side effects and risk.” Dr. Schauer was not involved in the Toga study.

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Hair Restoration Treatments: Hope or Hype? (Part 1)

Both men and women tend to lose hair thickness and amount as they age. Inherited or "pattern baldness" affects more men than women. Approximately 25 percent of men begin to bald by the time they are 30 years old, and about two-thirds are either bald or have a balding pattern by age 60. Women, on the other hand, generally have diffuse thinning that affects all parts of the scalp. In this situation, much of the hair remains, but the thickness of the hair shaft is smaller than normal.

There are a number of treatment options available designed to re-grow hair and to replace hair that's already been lost. Currently in the United States, there are more than 2,000 topical and oral products, about five surgical procedures and several hair restoration devices, but only a few that actually work. Out of all the topical and oral treatments available, only two are approved by the Food and Drug Administration (FDA). They are Propecia and Rogaine.

Propecia is an oral medication; its chemical name is Finasteride. It was developed nearly 40 years ago as a treatment for prostate hypertrophy (extended prostate). However, users found that the hair in their crown and bridge areas of their scalps was getting thicker, and they weren't losing hair at the same rate they once were. Propecia is known as a DHT-inhibitor, actually slowing or halting the conversion of testosterone into di-hydrotestosterone (DHT), a hormone that shrinks hair follicles as men age. Because DHT is known to be the primary cause of male-pattern baldness, stopping the conversion of DHT allows genetically susceptible hair follicles to remain intact, and in some cases increase in size. The side effects of Propecia are minimal and can include a reduced desire for sex (1% chance) and possible breast enlargement (less than .25% chance).

Rogaine is a topical treatment, the latest version being foam. Its active ingredient is Minoxidil, which was originally developed as a product to control blood pressure. But users found that they were growing hair in areas where hair didn't previously exist. Minoxidil comes in a number of strengths: the maximum non-prescription strength of five percent usually recommended for men, two percent formula recommended for women and prescription strength 12 ½ percent, which is seldom used.

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Hormone Therapy for Prostate Cancer: Helpful or Harmful?(Part 2)

Lu-Yao said, "The reason patients want this is they want something that will improve their quality of life or their survival. But hormone therapy has a detrimental effect on quality of life. And we cannot find any survival benefit for these men in their 70s with very early-stage cancer."

So now we have to ask, why do so many men choose to undergo this unproven treatment that now seems to do more harm than it does good?
Otis Brawley, M.D. and chief medical officer for the American Cancer Society says that it is because it is just an American phenomenon. One of the problems is that when a man finds out that he has early stages of prostate cancer, both he and his physician feel it is necessary to do something. Unfortunately, the result in the end is that the number of men that should get conservative therapy end up getting some kind of intervention.

Brawley and Lu-Yao both suggest that these elderly men would have done just as well if their cancer had never been found. Brawley also notes that many of these men would have likely underwent continued prostate cancer screenings with PSA tests. The other men probably had possible prostate abnormalities that would have been detected by a urologist.
No matter how they got to their conclusions about their cancers, all of these men must have agreed to undergo prostate biopsies. Also, they may have not have been fully informed and could have come to the wrong decision, says the head of urology at New York's Mount Sinai School of Medicine, Simon Hall, MD.

"You have to have a discussion with an older man before he has a prostate biopsy. You have to ask them, 'Do you really want to open Pandora's Box?' Most patients with localized prostate cancer are not going to die from their disease in the first 10 years anyway. It is a legitimate question whether to screen patients this old, and whether urologists should biopsy older patients based on just a knee-jerk reaction."
Hall also noted that he would only treat a very few men with hormone therapy alone. A lot of the elderly men are at a very low risk and really don't need any treatment at all. It seems that the hormone therapy would make no difference so why put these men through the side effects or cost?
All of these experts have noted that the finding of the current study do not apply to the younger men who might receive androgen-deprivation therapy in combination with radiation or surgery. These such men may actually benefit from this type of hormone therapy.

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Blood Test Detects Down Syndrome (and More) with No Risk to Fetus (Part 2)

According to the researchers, the accuracy of the new test was demonstrated in a small study of 18 women and a single male donor where the nine women having a Down syndrome pregnancy were correctly identified. In addition, the test identified two of the women as carrying fetuses with Edward syndrome and one carrying a fetus with Patau syndrome. The test detected every genetic defect and was able to identify every normal pregnancy as well as the male donor.

According to Quake in a telephone interview, “It's the first universal, noninvasive test for Down syndrome. So this should be the first step in putting an end to invasive testing procedures like amniocentesis and chorionic villus sampling.”

Although there are some other noninvasive prenatal tests available, such as the ultrasound, and blood tests like the alpha-fetoprotein test that can find potential signs of a chromosomal disorder such as Down syndrome, they cannot diagnose with certainty. Quake said that these tests are “indirect and weak predictors of what's going on.”

Quake said the next step is to perform a much larger study and that the new test could be widely available in two or three years, possibly becoming a routine prenatal test of a baby's health. Currently, the test would cost about $700. But that cost would drop considerably if it were widely used. The study can be found in the journal Proceedings of the National Academy of Sciences.

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Hormone Therapy for Prostate Cancer: Helpful or Harmful? (Part 1)

If you have prostate cancer and you are an elderly man you may want to consider other options other than hormone therapy. A study has shown the one in four U.S. men with early prostate cancer will undergo hormone therapy, but it more likely to more harmful to them than helpful.

The surgery to remove the prostate, radical prostatectomy, is a little too risky for men that are in their 70s and 80s. When these men are found to have the early stages of prostate cancer, they will have three options to choose from.

The first option is they can wait to see whether this usually slow-moving cancer will become a problem. This type of observation is called conservative therapy or watchful waiting. The second option is to undergo radiation therapy and suffer its side effects. The third option is to undergo androgen-deprivation therapy: hormonal drugs such as Lupron, Eligard, Viduar, and Zoladex, or undergo surgery (orchiectomy) that will cut off the production of the male hormones.

Older men that are in the United States often opt for stand-alone hormone therapy, even thought there is really no proof that it is really helpful. One of the hormone therapy's most obvious side effects is sexual dysfunction. According to recent studies, the greater concern now with hormone therapy is linking the androgen deprivation therapies to heart disease, diabetes, bone fractures, and a reduction in muscle mass.

The most recent study on the hormone therapy strongly suggests that this type of therapy offer elderly men no benefit to justify these serious risks. Grace L. Lu- Yao Ph.D., MPH, which is from the University of Medicine & Dentistry of New Jersey, and her colleagues collected data from more than 19,000 mean that have been diagnosed with the early stages of prostate cancer at the average age of 77. Out of these men, none of them underwent surgery or radiation treatment for the early prostate cancer. Nearly 8,000 of the men, however, did decide to go with androgen deprivation therapy.

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Common Cause of Male Infertility Successfully Treated Without Surgery (Part 2)

Of all the potential pre-treatment predictors of pregnancy such as varicocele severity, hormone levels, ultrasound findings, and other semen parameters, the researchers found that the only significant predictor was sperm movement.

In follow-up data on pregnancy in partners for 173 of the men, 45 couples or 26 percent, reported a pregnancy with five of them assisted by intrauterine insemination.

The study findings indicate that RVE does improve semen quality, resulting in pregnancy about one-third of the time, which prompted the authors to conclude that fertility benefits seen with this procedure are "similar to those reported after surgical repair," and refer to the treatment as a "useful adjunct to in vitro fertilization therapy."

The authors acknowledged several limitations of the study which included the absence of a control group, the lack of further assessment and grading of female infertility in women without proven infertility, and the relatively short observation period for treatment success. The study and its findings appear in the August issue of Radiology.

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Common Cause of Male Infertility Successfully Treated Without Surgery (Part 1)

According to new research, many men who suffer from infertility due to a problem with varicoceles can now be effectively treated with a minimally invasive procedure called retrograde venous embolization.

Varicoceles are abnormally enlarged veins in the scrotum. The condition can cause testicles to shrink and soften. As many as 16 percent of men have this type of varicose vein, which is a common cause of low sperm count. In fact, about 40 percent of men who are infertile have varicoceles, with the traditional treatment being surgery. Why the condition can cause fertility problems in men remains unknown.

Retrograde venous embolization (RVE) is a procedure done with a tiny catheter that works by blocking excessive blood flow into the veins and allowing them to shrink back to their normal size. During the procedure, a radiologist inserts a small catheter through a small incision in the groin and uses an imaging tool to guide it to the affected right or left-sided varicocele. There is a minimal recovery time and according to researchers, most patients can return to work the next day.

Dr. Sebastian Flacke from the University of Bonn Medical School in Germany led the study of infertile men aged 18-50 with at least one varicocele. All of the men had healthy partners who were trying to become pregnant. There was a total of 228 varicoceles in the 223 men who underwent the RVE procedure. Of them, 226 varicoceles were successfully treated while clinical and ultrasound testing revealed that the varicocele was totally resolved in 92.4 percent of patients (206 participants). The procedure significantly improved both sperm count and their ability to move spontaneously and actively (motility), yet the averages were still abnormally low according to the World Health Organization guidelines.

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