Indian Medicine

CHICAGO (Reuters Health) - Stereoscopic digital mammography, which gives a 3-dimensional view of the inner structures of the breast, cuts the number of falsely diagnosed tumors in half, compared with conventional mammography, researchers reported here this week.

Preliminary results with stereoscopic digital mammography were described at the meeting of the Radiological Society of North America by one of its developers, Dr. David J. Getty of BBN Technologies of Cambridge, Massachusetts.

The technique involves capturing two images 6 to 10 degrees apart that are cross-polarized and then superimposed, in much the same way as two images are used to create 3-D movies.

"Two-dimensional imaging masks subtle lesions," Getty explained. "With 3-D mammography, this is greatly reduced. Lesions can be seen as lying at different depths."

In the study, 1,093 women referred for evaluation of suspected breast cancer were each examined with conventional mammography and the stereoscopic digital technique.

There were 259 abnormalities detected with one or both approaches, with 109 true positives and 150 false positives. Compared with conventional mammography, stereoscopic digital imaging reduced the false-positive rate by 49 percent.

"A 15 percent drop would have been a significant reduction, so this is a highly statistically significant finding," Getty said. "It cuts the false-positive rate in half, resulting in fewer patient recalls, less anxiety and less cost."

Data on approximately 1500 women are expected to be analyzed by the end of the year, at which point the trial will be complete.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - The substantial benefits of hip replacement for osteoarthritis are sustained in the long-term, British investigators report.

The short-term effectiveness of hip replacement surgery has been well documented, Dr. Cyrus Cooper and his associates note in the medical journal Arthritis Care and Research, but there's not much information about the durability of the benefits.

In 1998, Cooper, at the University of Southampton, and his team reported the results of a study involving 643 osteoarthritis patients who underwent hip replacement in the early 1990s, and 643 matched "controls." Their current report involves follow-up for an average of another 8.3 years for 282 of the original patients and 295 controls.

According to responses to a standard questionnaire, physical function scores improved from 20 initially to 30 at follow-up in the hip replacement group, and declined from 85 to 65 in the controls.

"The long-term improvement in the physical functioning of the cases is striking when set against the decline that occurred in controls," Cooper and his associates observe.

SOURCE: Arthritis Care and Research, December 15, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Both Internet-based therapy and face-to-face counseling can help women with high levels of body dissatisfaction feel better about themselves, a new study shows.

However, the traditional in-person therapy is better than the cyber approach for improving both image concerns and disordered eating, Dr. Susan J. Paxton of La Trobe University in Bundoora, Melbourne, Australia and colleagues found.

Therapy delivered via the Internet is becoming increasingly popular, Paxton and her team point out, and it offers the advantage of privacy and anonymity as well as greater accessibility than in-person care. Nonetheless, computer-based interventions may have disadvantages, such as increasing the likelihood of miscommunication due to the absence of "nonverbal and auditory cues," they add.

The researchers compared the effectiveness of eight weekly small-group therapy sessions led by a therapist when delivered in person or by the internet to 116 women, 18 to 35 years old, all of whom had disordered eating and were highly unsatisfied with their bodies. Forty-two of the women participated in the face-to-face group, 37 received counseling via the Internet, and 37 were assigned to a delayed treatment group that served as a "control" comparison.

Both therapy groups showed large improvements in their scores on tests of body image, shape concerns and eating attitudes and behaviors compared to the control group, although improvements in the face-to-face group were greater.

The women also showed lower levels of psychopathology after participating in the in-person sessions, but computer sessions didn't reduce psychopathology.

Face-to-face therapy participants also attended more sessions than the Internet group, and the more sessions participants completed, the greater their improvement,

By six months after therapy ended, however, there was no difference between the face-to-face and Internet groups.

"The present study provides strong support for the efficacy of face-to-face body image interventions for young adult women when accessible, and on-line synchronous internet interventions when they are not," Paxton and her colleagues conclude.

SOURCE: International Journal of Eating Disorders, December 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Though some have blamed the U.S. obesity problem on the corn syrup ubiquitous in processed foods, a new study casts some doubt on this idea.

Researchers found that high-fructose corn syrup did not differ from regular table sugar in its effects on people's appetite and food intake later in the day. They say the findings counter the argument that high-fructose corn syrup is contributing to the rise of obesity and type 2 diabetes.

Over the past 35 years, food manufacturers have been steadily replacing sucrose (sugar) with high-fructose corn syrup as their sweetener of choice. Some experts have argued that high-fructose corn syrup encourages overeating because of its short-term effects in the body. Glucose triggers an increase in the hormone insulin, which helps the body know that it's full; fructose, however, has a weaker effect on insulin.

Studies also suggest that fructose has a weaker effect on "appetite hormones" that help control food intake.

To further study the question, Tina Akhavan and G. Harvey Anderson from the University of Toronto in Canada conducted two tests with 31 young healthy men.

In each, the men were given various sugar solutions to drink -- containing either table sugar, high-fructose corn syrup or other combinations of glucose and fructose. All of the solutions had the same number of calories.

An hour-and-a-half later, the men were allowed to eat all the pizza they wanted.

In general, the researchers found, there was no difference in the men's reported hunger levels or food intake whether they had high-fructose corn syrup or table sugar earlier in the day.

In addition, although sugar solutions with a higher ratio of glucose to fructose raised insulin levels to a greater degree, all of the solutions suppressed the appetite-stimulating hormone ghrelin to a similar extent.

"These studies," Akhavan and Anderson conclude, "do not support the hypothesis that the replacement of sucrose with high-fructose corn syrup as a caloric sweetener has contributed to overeating and obesity because of differences in their short-term physiologic (effects)."

SOURCE: American Journal of Clinical Nutrition, November 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Mothers adapt to the medical, financial, and caregiver demands of raising a very-low-birth-weight child who has chronic medical problems, study findings suggest. "But that does not mean the stress is not significant," Dr. Lynn Singer told Reuters Health.

Singer, of Case Western Reserve University, in Cleveland, Ohio, and colleagues found that mothers of very-low-birth-weight (VLBW) children with chronic lung disease showed fewer symptoms of depression and anxiety by the time their children were 8 years old than when they were younger than 2 years of age.

However, these mothers also report higher levels of parenting strain and more negative impact on the family and on social and financial aspects of their lives than do mothers of VLBW children without chronic medical problems or mothers of full-term children, Singer's team reports in The Journal of Pediatrics.

They assessed coping skills and stressors over time among 190 mothers of VLBW children with chronic lung problems and without, compared with 112 mothers of full-term children with no abnormalities at birth.

By the time the children reached age 8, the mothers reported similar measures of parental competence, marital satisfaction or divorce, family cohesion, and symptoms of psychological distress. Measures of everyday activities and pain among the children were also similar, the investigators report.

However, mothers of the VLBW kids with medical problems were more likely to describe their child as having greater physical limitations and being more demanding and hyperactive or less adaptable than were mothers of VLBW children without lung problems or full-term kids.

Of note, mothers of VLBW children did not attain educational advancement to the extent of mothers of full-term children, despite the groups' attainment of equal years of education prior to their child's birth, Singer pointed out.

The researchers conclude that long-term care of VLBW children has a significant and lasting impact on the child's families.

SOURCE: The Journal of Pediatrics, November 2007.

Copyright © 2007 Reuters Limited.