February 2012

Sylvester News
        Daniel Sussman, M.D., an assistant professor of gastroenterology at the University of Miami School of
Medicine, commented that lifestyle, diet and obesity are causing an increase in reflux symptoms. "My suspicion is that
obesity is the biggest contributor to that," he said.  He noted there is evidence that losing weight will help improve
reflux symptoms and
lower the risk for esophageal cancer.

        The first randomized trial to investigate the use of trastuzumab emtansine (T-DM1) -
an antibody-guided drug -
for the initial treatment of HER2
- (human epidermal growth factor receptor-2) positive metastatic breast cancer has
shown that it makes a significant difference in the amount of time women live without their disease progressing.


       
 Lorraine Portelance, M.D., associate professor of radiation oncology at Sylvester, presented results of a
study indicating that
for women with cervical cancer, intensity-modulated radiation therapy to the pelvis after surgery
provides disease control similar to that seen with standard external beam radiation therapy, but with lower acute bowel
toxicity.


        
Alan Pollack, M.D., Ph.D., professor and chairman of Radiation Oncology at Sylvester, was the lead
investigator on a phase 3 clinical trial that found delivering
higher doses of external-beam radiation over a shorter
period (hypofractionated radiation) was as effective
as conventional radiation in preventing treatment failure in men
with intermediate- to high-risk prostate cancer.


        
Ronald Goldberg, M.D., professor of medicine, biochemistry and molecular biology, was quoted in an article
about a study that found
long term use of cholesterol-lowering drugs (statins) does not increase the risk of cancer and
may even decrease users' risks for lymphoma, melanoma and endometrial tumors.


UHealth/Miller School News
        Tracie L. Miller, M.D., professor of pediatrics and director of the Division of Pediatric Clinical Research,
published two major multicenter studies under the auspices of the NIH-funded Pediatric HIV/AIDS Cohort Study
(PHACS) network, which was established to evaluate the long-term consequences of antiretroviral therapies
administered early in life.  Both suggest that clinicians should carefully monitor HIV-infected children for abnormal
vascular markers of premature atherosclerosis, abnormal lipid measurements, and abnormal body composition to
identify those at highest risk for cardiovascular and cardiometabolic disease so appropriate interventions are initiated.  
     

“It appears that remarkable improvements in survival brought on by antiretroviral therapies may come at the expense
of premature cardiovascular disease,
’’ said Miller. “Cardiovascular disease is now a leading cause of mortality in adults
with HIV, and it appears that children with HIV are destined for the same fate unless clinicians intervene early.’’

        
Barth Green, M.D., professor and chair of neurological surgery, and Enrique Ginzburg, M.D., professor of
surgery in the Division of Trauma and Surgical Critical Care, were interviewed about the Miller School's efforts in Haiti
two years after that country's devastating earthquake. Their work through UM's Project Medishare includes
establishing Haiti's first critical care hospital, fitting amputees with prosthetic limbs and training Haitians to provide a
high level of health care on their own.


       
 Luca Inverardi, M.D., research professor of Medicine, Microbiology and Immunology and Co-Director of the
Cell Transplant Center at the Diabetes Research Institute, was interviewed about a new type of
stem cell treatment for
people with type 1 diabetes t
hat appears to help re-educate rogue immune system cells, which allows cells in the
pancreas to start producing insulin again.

        
Steven Shapiro, M.D., voluntary associate professor of dermatology and cutaneous surgery, was a principal
investigator on a clinical trial of a
non-invasive treatment for facial wrinkles, which recently received FDA clearance.

        
Philip Rosenfeld, M.D., Ph.D., professor of ophthalmology at Bascom Palmer Eye Institute, was interviewed
about new software diagnostic tools for dry age-related macular degeneration (AMD) and glaucoma. The new software
(Cirrus HD-OCT version 6.0) has received clearance from the FDA. Rosenfeld also commented on a newly approved
drug,
Eylea (aflibercept), as a third treatment option for wet macular degeneration. This new drug may mean fewer
shots in the eye, and savings for patients with the incurable eye disease.

        
The Miller School is listed as one of 25 neuroscience centers that will be part of the NeuroNEXT consortium, a
group of centers that will conduct clinical research studies on a variety of brain-related diseases.

        
Alan Delamater, Ph.D., professor of pediatrics and psychology, conducted a study designed to investigate
whether use of
an online asthma game could help families improve illness management, quality of life, asthma self-
efficacy, and asthma knowledge. The 6-month assessment showed sustained improvements in self-efficacy,
adherence, knowledge, child responsibilities, and symptoms.

        
Michael Benatar, M.D., Ph.D., associate professor of neurology and chief of the Neuromuscular Division, has
helped develop a new
web-based registry for people with the familial (inherited) form of amyotrophic lateral
sclerosis (ALS).
The project aims to connect families affected by familial ALS with scientists who study the disease, in
an effort to accelerate the development of treatments and cures.


Cancer News
        Patients with chronic lymphocytic leukemia (CLL) -- a cancer of the white blood cells (lymphocytes) that mainly
affects adults -- who had insufficient vitamin D levels when their cancer was diagnosed saw their disease progress
much faster and were two times more likely to die than those with adequate vitamin D levels.  Similar findings were
seen in a different group of CLL patients who were followed for 10 years, according to the researchers.

        The evidence for
exercise during and after cancer treatment is so high an American College of Sports Medicine
panel has concluded that patients and survivors should strive to get the same amount of exercise recommended for
everyone else, about 150 minutes a week of moderate-intensity aerobic exercise. Resistance training and stretching
also are recommended.

        Scientists have uncovered evidence that
prostate cancer is not one disease. Researchers identified
secondary mutations that cause some types of prostate cancer cells to be lethal.

       
 Abirateone acetate, an investigational drug aimed at treating patients with advanced prostate cancer, was
found to be so successful
l at extending survival times during a Phase III trial that those on a placebo were offered the
option of receiving it.


        Patients who receive
radiation before surgery for rectal cancer are about 50 percent less likely to experience a
return of their cancer.

        Genetic counselors warn that
women should pay attention to their father’s family history of breast or ovarian
cancer
, as they may inherit a mutated gene from their fathers.

        Women in their 40s, who are thoroughly confused by recent moves to push the recommended age for having
mammograms up to 50, may find clarity in a new study that found having the
breast screening scans in the 40s can
save lives.
 The question is not so much whether earlier mammograms save lives, but by how much.

        
Prolonged use of hormone replacement therapy (estrogen-plus-progestin) raises the risk of breast cancer, new
research finds.  It also ups the risk for more severe forms of the disease and increases a woman's chances of dying.  
The researchers added that this is the first time an increase in mortality has been shown.

        Scientists have discovered
a tiny RNA molecule, called miR-520 that at once blocks two important pathways in
the development of cancer in cells.
In estrogen receptor-negative breast cancer, the production of this microRNA is
often reduced and this is correlated with malignant behavior of tumor cells. Tumors with low levels of miR-520 have a
particularly strong tendency to metastasize.

        
Only about 15 percent of lung cancer cases are diagnosed at an early stage, when it's most treatable. But two
preliminary studies suggest that scientists are moving closer to developing new screening tests that could potentially
detect lung cancer in its earliest stages.

       
 Researchers have created a drug delivery system that is able to effectively deliver a tremendous amount of
chemotherapeutic drugs directly to prostate cancer cells.


        
The first major gene mutation associated with an increased risk for hereditary prostate cancer has been
identified
by scientists. Men who inherit the mutation in the HOXB13 gene have a 10 to 20 times increased risk of
developing prostate cancer, according to the study.

        
Adding oxaliplatin to a standard chemotherapy regimen boosts survival rates for patients with advanced colon
cancer,
according to a new study that bolsters previous research on the drug by looking at a broader group of patients.

        New research suggests that
Avodart, a drug used to treat an enlarged prostate gland, may help slow the
progression of early stage prostate cancer
, reducing the need for aggressive treatment in some men.

        Genetic mutations known as
BRCA1 and BRCA2 raise the risk of getting ovarian cancer, but new research
shows that those same mutations may boost a woman's odds of surviving the deadly disease.
Women with invasive
epithelial ovarian cancer who carry the mutations have a better prognosis than women without the genetic variations.

        The
addition of the cancer-fighting medication Avastin to chemotherapy prior to breast cancer surgery
increases the chance that all of the cancer will be removed, according to new research.

        The FDA has approved a drug to treat the most common form of skin cancer, basal cell carcinoma.
Erivedge
(vismodegib) is the first drug sanctioned in the United States to treat basal cell skin cancer that has metastasized
, or
spread. The once-daily pill is also designed for cases deemed unsuitable for surgery or radiation.

       
 Scientists have developed a new vaccine to treat cancer at the pre-clinical level. The research team discovered
a new approach for treating the disease based on manipulating the immune response to malignant tumors. The
discovery has been patented and there are plans to develop the vaccine for clinical use for cancer patients.

        Researchers have discovered new links between
leukemia cells and cells involved in bone formation, offering a
fresh perspective on how the blood cancer progresses and raising the possibility that therapies for bone disorders
could help in the treatment of leukemia.

        
Physicians can boost their chances of finding signs of colorectal cancer in patients with a second flexible
sigmoidoscopy test, which is a less invasive procedure than a colonoscopy, a new study shows.

        
People who consume a few alcoholic drinks a day and have a family history of colorectal cancer are at
increased risk for developing colon cancer
, new research suggests. Those at greatest risk also ate the most red meat,
smoked more and consumed the least folate, which suggests they ate fewer green vegetables and cereal.


Other
        Analysis of the cerebrospinal fluid can detect whether a person has Alzheimer's disease before symptoms
appear.
Researchers at the Sahlgrenska Academy in Gothenburg, Sweden, have studied biomarkers that offer more
reliable diagnosis and, in the longer term, the possibility of effective new treatments.  To promote wider use of these
new biomarkers, the researchers have established an international quality control program for these measurements.
Besides facilitating diagnosis, the biomarkers could also be used when new drugs for Alzheimer's are tested.

       
 A rise in resting heart rate during middle age signals an increased risk of dying from heart disease, new
research indicates.  People whose heart rates increased from under 70 beats per minute to more than 85 beats per
minute over 10 years had a 90 percent increased risk of dying from heart disease compared to people whose heart
rates stayed around 70 beats per minute, according to the large study.

        Obese people who undergo
weight loss surgery appear to reduce their risk of heart attack, stroke and death,
researchers report. And these heart-health benefits seem to be connected with metabolic changes that occur after the
surgery, such as altered insulin production, rather than the weight loss, the researchers say.

        
Too many calories, not too much protein, have been found to lead to unhealthy weight gain associated with
overeating, new research suggests.

        A new study shows that
deep brain stimulation (DBS) is a safe and effective intervention for treatment-resistant
depression in patients with either unipolar major depressive disorder (MDD) or bipolar ll disorder (BP).

        Researchers have concluded that
consuming adequate quantities of dietary fiber can lead to improvements in
gastrointestinal
health, and reduction in susceptibility to diseases such as diverticular disease, heart disease, colon
cancer, and diabetes. Increased consumption has also been associated with increased satiety and weight loss.

        
An experimental anti-blood-clotting drug can serve as a replacement for other drugs such as Plavix in the days
before heart surgery
, a new study has found. The intravenous drug cangrelor appears to have the potential to serve
as a "bridge" medication for heart patients to take in the several days before procedures such as coronary artery
bypass grafting, because it minimizes excessive bleeding caused by the anti-blood-clotting drug Plavix.

        
Researchers who identified a protein that worsens symptoms of Parkinson's disease say their finding could
eventually lead to new treatments for the neurodegenerative disease. The protein, RGS4, normally helps regulate the
activity in neurons in the striatum, the part of the brain that controls movement.

        Researchers have found
cooking in olive or sunflower oil is not linked to heart disease or premature death.
Heart disease risk factors -- such as high blood pressure, high cholesterol and obesity -- have been linked to eating
fried foods.

       
 People who donate a piece of their liver to someone in need of a transplant can still live a long and healthy life,
according to a new study. This is possible because only a small portion is removed from a donor, and the liver is an
organ that can regrow quickly, researchers explain.

        
Each year, approximately 45,000 Americans die from diseases that could have been prevented by vaccines,
health officials indicate. Despite this, the number of American adults who get needed vaccines remains low, according
to the U.S. Centers for Disease Control and Prevention.

        A new medication,
rivaroxaban (Xarelto), which helps prevent strokes in people with atrial fibrillation, poses less
risk of bleeding in the brain
than a commonly used drug, warfarin (Coumadin), according to research comparing the
two.

        Norwegian investigators have identified
a link between sleep problems and an increased risk in women
developing fibromyalgia
(long-term body-wide pain and tenderness in the muscles, joints, tendons, and other soft
tissues). The risk of developing the syndrome increased with severity of sleep problems.

        A new study finds that
protein, not sugar, stimulates certain brain cells into keeping people awake.  Also, by
telling the body to burn calories, it helps keep people thin.

HEALTH NEWS
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All Information published in The Pap Corps FYI issues is excerpted from communications
furnished by
Lisa Worley, Director of Media Relations
Office of Communications, University of Miami Miller School of Medicine
* * *
Ann Brown Stern, VP Education
education@papcorps.org