Indian Medicine

NEW YORK (Reuters Health) - Worried about what to do with fat you've had liposuctioned from pudgy areas? Researchers have turned it into stem cells in the lab, but here's a more immediate use: Fat liposuctioned from other parts of the body can safely be used to increase a woman's breast size, according to study findings presented this week at the Plastic Surgery 2009 meeting in Seattle.

Many surgeons are already "using liposuctioned fat to reconstruct breasts after mastectomy," Dr. Luis Zapiach, a plastic surgeon in Hackensack, New Jersey not affiliated with the study, told Reuters Health.

However, injecting fat into the "breast for cosmetic purposes has been a controversial issue ever since the American Society of Plastic Surgeons banned the procedure in 1987," Dr. Roger K. Khouri, a plastic surgeon in Key Biscayne, Florida, who performed the current study, told Reuters Health.

"The procedure had the reputation of being ineffective, unreliable and potentially dangerous," Khouri said, and at present is not permitted outside of clinical studies.

With reconstructions following breast cancer surgery, Zapiach explained, all of the breast tissue is removed before the fat is injected, so there is no danger that fat - which excretes estrogen, a hormone that stimulates breast cell growth - will bring the cancer back.

With cosmetic augmentations, the tissue still remains, so "there is a theoretical risk that use of fat for augmentations could increase the risk of breast cancer," Zapiach said.

In the current study, however, which was small, there was no evidence to support concerns that the transferred fat may increase the risk of breast cancer.

The current study featured 50 women who had their liposuctioned fat used for breast augmentation. X-rays were used to look for dead tissue and breast cancer 3 to 12 months after the operation.

A key component of the operation, according to Khouri, was the use of a bra-like device he invented called the Brava. The device includes a small battery-operated pump that creates suction on the breast. That, in turn, increases volume and promotes the growth of blood vessels in the area. The device was worn for 4 weeks before the operation and for a few weeks afterward.

Women saw a moderate increase in breast size at 6 to 12 months - on average, about 210 milliliters, which could represent a variety of cup sizes depending on a woman's body type. Over a period of 3 years, breast size fluctuated with weight. All of the subjects were "pleased" with their cosmetic outcomes, the Khouri reported.

Tests indicated that, on average, 18 percent of the transferred fat in each patient died or "did not take." Zapiach said that this rate is "very low" considering that prior studies have shown rates between 30 and 70 percent.

There was an infection following the procedure in one of the 50 women.

According to Zapiach, Brava was initially introduced as a non-surgical means of increasing breast size. He added that while Khouri has had good success with Brava, many surgeons testing fat for augmentations do not use the device.

Zapiach said that the new findings are encouraging, but that the American Society of Plastic Surgeons will wait for results from a number of similar studies currently underway before reconsidering their position on the procedure.

Copyright © 2009 Reuters Limited.

WASHINGTON (Reuters) - When pregnant women get vaccinated against flu, their babies are bigger, healthier and less likely to be premature, researchers reported on Thursday.

The studies show that influenza vaccines protect not only women, who are extremely vulnerable to flu when pregnant, but also their babies before and after birth, the researchers said.

They hope their findings, presented at a meeting in Philadelphia of the Infectious Diseases Society of America, will encourage women to get vaccinated and encourage their doctors to offer the shots.

"We are talking about one vaccine protecting two individuals," Dr. Marietta Vazquez of Yale University in Connecticut told a news conference. "Maybe if they are not getting vaccinated for themselves, they will do it for their babies."

Pregnant women are at special peril from flu in any year. Their immune systems are suppressed to keep the body from rejecting the fetus, and the growing baby presses on their lungs.

The U.S. Centers for Disease Control and Prevention has for years recommended that pregnant women be vaccinated against seasonal flu.

This year, with the H1N1 swine flu pandemic, pregnant women are at the front of the line. The CDC says more than 1,000 Americans have died of swine flu, and figures show that 6 percent of deaths have been among pregnant women.

But only 15 percent to 25 percent are ever vaccinated, and babies under the age of 6 months are too young to get a flu vaccine.

"Obstetricians do not offer influenza vaccine. They should know about this recommendation," Vazquez said.

'85 PERCENT EFFECTIVE'

She and colleagues studied some 350 pregnant women starting in 2000 -- 157 who got flu and 195 who did not.

"Flu vaccine given to women during pregnancy is 85 percent effective in preventing hospitalization in their infants under 6 months of age," the team wrote in a statement.

Dr. Mark Steinhoff of Cincinnati Children's Hospital in Ohio and colleagues studied pregnant women in Bangladesh, who were randomly assigned to get influenza or pneumococcal vaccines.

The newborns of women who got flu vaccine were 63 percent less likely to be infected, Steinhoff told the news conference. And the babies born to vaccinated mothers weighed, on average, half a pound (215 gm) more, he said.

"When you prevent flu in a pregnant woman, you benefit the mother, you benefit the infant, and it is also shown that you benefit the fetus," Steinhoff said.

The team also found 25 percent of the infants were infected with flu during the first six months of life.

Dr. Saad Omer of Emory University in Atlanta and colleagues looked at 6,410 births between June of 2004 and September of 2006, checking to see how many babies were premature or small for gestational age.

When flu was the most widespread, vaccinated moms had an 80 percent lower risk than unvaccinated mothers of having a premature baby, Omer said. The risk of having a baby that was small for gestational age was 70 percent lower for vaccinated mothers.

There was little effect outside flu season, he said.

It is likely that many of the pregnant women had flu infections that they did not report or notice, but this would have affected the baby, Omer said.

"A mild flu infection probably reduces the amount of nutrition that goes through the placenta," Steinhoff said.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Churchgoers have been found to have lower rates of drinking and smoking than those who spend their Sundays elsewhere. Now a new study suggests that for adults, it may not be church attendance itself that explains much of the phenomenon. It might be genes.

The study, which included nearly 1,800 adult male twins, found that in adolescence, the relationship between church attendance and lower rates of drinking and smoking appeared largely a matter of "shared" environment -- those factors influencing both members of a twin pair.

That is, teenagers who attended church regularly were more likely to want to follow their parents' wishes and conform to community expectations.

By adulthood, however, those environmental influences had faded, the researchers found. Instead, genes seemed to account for the relationship between church-going and lesser alcohol and nicotine use.

In this case, genes may enter the picture via their influence over a person's natural temperament, the researchers write in the American Journal of Psychiatry. Many adults who continue to regularly go to church, they speculate, may also be the sorts who would limit their drinking and avoid smoking.

"Church attendance is one of the strongest correlates of substance abuse," lead researcher Dr. Kenneth S. Kendler, of the Virginia Commonwealth University School of Medicine in Richmond, told Reuters Health.

"Understanding the underlying nature of this association is important because of what it tells us about the causes of substance use," he said.

The study included 469 identical twin pairs and 287 pairs of fraternal twins, all of whom were interviewed twice over six years. The men were asked about their current church attendance and smoking and drinking habits, as well as their habits during adolescence.

Twin studies like these allow researchers to disentangle the effects of genes, shared environment (like home life and parenting practices) and non-shared environment (such as friendships and other factors unique to an individual) on a given behavior or disease risk.

Identical twins share all of their genes, while fraternal twins share about half of their genes, on average. So if genes, for example, hold a stronger influence over a particular behavior than shared environment does, identical twins would be more similar in that behavior than fraternal twins would be.

Kendler's team found that when it came to the link between church- going and substance use, the roles of environment changed over time.

By adulthood, shared environment seemed to have almost no role.

Instead, genes largely explained the relationship, with some role of non-shared environmental factors also being apparent. As adults, the researchers point out, twins' personal relationships, with friends and partners, likely take on more importance than the shared family influences that were key in the teen years.

It's not clear how broadly applicable these findings might be, the researchers note. All of the study participants were white men, and most were Protestant, 60 percent of whom were Baptist or fundamentalist.

"Our results," the researchers write, "may not extrapolate to other populations with different patterns of religious affiliations."

SOURCE: American Journal of Psychiatry, October 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Women dread a diagnosis of endometrial cancer, but those who drink at least two cups of caffeinated coffee a day may have a lower risk for this cancer of cells lining the uterus.

Coffee drinking seemed to particularly protect overweight and obese women, study co-author Dr. Emilie Friberg, at the Karolinska Intstituet in Stockholm, Sweden, told Reuters Health by email.

Friberg's team twice surveyed 60,634 Swedish women about their coffee intake - when they enrolled in the Swedish Mammography Cohort study between 1987 and 1990, and again in 1997.

During the 17 years, on average, that the researchers followed patients, 677 women - about 1 percent -- developed endometrial cancer. The average age at diagnosis was 67.

In the overall study group, those who daily drank 2 or more cups were significantly less likely to develop endometrial cancer, compared with those who drank fewer cups of coffee.

Each additional daily cup seemed tied to a 10 percent lower risk for endometrial cancer, after allowing for age and other factors potentially tied to endometrial cancer risk among all the women.

However, they observed the strongest effect among overweight and obese women, who, Friberg's team notes, have "the highest risk for endometrial cancer."

Each additional cup of coffee seemed to decrease endometrial cancer risk by 12 percent among overweight women and by 20 percent among obese women, Friberg and colleagues report in the International Journal of Cancer.

The investigators suggest that coffee may affect blood sugar, fat cells, and estrogen, all of which play a role in endometrial cancer. However, they write that the current findings should be confirmed in other populations.

In particular, "a study also including de-caffeinated coffee would make it possible to separate the effect of coffee and caffeine," Friberg said.

SOURCE: International Journal of Cancer, November 15, 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Anabolic steroids - the kind used by some athletes to build muscle mass - can cause lasting kidney damage, according to research presented today at the American Society of Nephrology's 42nd Annual Meeting in San Diego.

Presenter Dr. Leal Herlitz, from Columbia University Medical Center, New York, told Reuters Health that years ago, her group came across several men who technically met the definition for obesity but who were actually extremely muscular athletes.

Many of the men had been taking steroids for more than a decade - and had more severe kidney disease than those who were obese and not muscular. That led the team to wonder whether steroids could have a toxic effect on the kidneys.

How steroids might damage kidneys is unclear, Herlitz said, but studies in animals suggest that such hormones may worsen such damage.

When they looked at 10 bodybuilders who used steroids, they found significant kidney problems. One progressed rapidly to end-stage kidney disease, which requires dialysis or a kidney transplant.

However, much of the damage was reversible. Eight of the men could be treated successfully with medications. Those who stopped using steroids and reduced the amount of exercise, they lost weight, and their kidney function improved.

"Three patients who essentially returned to normal all presented with relatively early/mild disease, "Dr. Herlitz said. "It appears that when diagnosed and treated in the early stages, the disease is reversible, but in more advanced stages, patients may improve some, but are left with chronic and irreversible kidney damage."

Copyright © 2009 Reuters Limited.