‘Hidden’ Prostate Cancer on Biopsy Usually Means Good Outcome: Study | Health News

By Robert Preidt, HealthDay Reporter


MONDAY, Nov. 23, 2020 (HealthDay News) — Negative biopsies among early-stage prostate cancer patients who’ve chosen active surveillance are associated with a low risk of disease progression, but they aren’t a sign that their cancer has completely vanished, a new study indicates.

Active surveillance refers to close monitoring for signs of cancer progression — what’s often called “watchful waiting.” Patients sometimes get regular prostate-specific antigen (PSA) testing, prostate exams, imaging and repeat biopsies.

The objective of active surveillance is to avoid or delay treatment and its side effects without putting patients at risk of cancer progression and death.

Sometimes, active surveillance patients have negative biopsies that show no evidence of prostate cancer. While some of these patients may believe that their cancer has “vanished,” they most likely have low-volume or limited, hidden areas of prostate cancer that weren’t detected in the biopsy sample, according to the authors of the study published recently in The Journal of Urology.

“While a negative biopsy is good news, the long-term implications associated with such ‘hidden’ cancers remain unclear,” said study author Dr. Carissa Chu, from the University of California, San Francisco.

For the study, Chu and colleagues analyzed data from 514 men undergoing active surveillance for early-stage prostate cancer between 2000 and 2019. All of them had at least three surveillance biopsies after their initial prostate cancer diagnosis. Median follow-up time was nearly 10 years.

Of those patients, 37% had at least one negative biopsy, including 15% with consecutive negative biopsies, according to the report.

Men with negative biopsies had more favorable disease characteristics, including low PSA density and fewer samples with cancer at the initial prostate biopsy. Negative biopsies were also associated with good long-term outcomes, the researchers said.

After 10 years, rates of survival with no need for prostate cancer treatment (such as surgery or radiation) were 84% for men with consecutive negative biopsies, 74% for those with one negative biopsy and 66% for those with no negative biopsies.

After adjusting for other factors, the researchers concluded that men with one or more negative biopsies were much less likely to have cancer detected on a later biopsy.

“For men undergoing active surveillance, negative biopsies indicate low-volume disease and lower rates of disease progression,” Chu said in a journal news release. “These ‘hidden’ cancers have excellent long-term outcomes and remain ideal for continued active surveillance.”

SOURCE: The Journal of Urology, news release, Nov. 17, 2020

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3 Inspiring Women Share What Fit Means to Them

We’re drip-fed a stereotype of what fit looks like: lean, slim and magically, maddeningly sweat-free. But real fitness is messy, sweaty and comes in every shape and size.

Featuring our favourite new season sportswear picks from Very, we spoke to three women who are breaking down the stereotypes to find out what fit means to them, and why they love what they do.

Rini Jones (@abrowngirlruns), marathon runner

‘I got into running at 21 after moving to Paris as part of my degree; a friend signed up for the marathon and it sparked the idea in my head. I’d had quite a chequered past with disordered eating and exercise in my teens, and training for a race helped move the focus away from what I looked like and onto what my body could do.

‘My family’s reactions were complex. When I completed my first marathon, they were surprised, proud even. But when that first turned into a fifth, the novelty quickly wore off. Once I started lifting weights, their confusion turned to concern. In South Asian cultures, women are meant to be soft and demure, not strong and muscular. Even now, my family will say to me: “You look great, but don’t get any bigger.” I think to myself, “Don’t they understand that I can run for four hours straight, that I can squat 80kg?”

Ian Harrison

‘I’ve lost count of the number of times I’ve rocked up to the start line and not seen a single other brown woman. Even now, I can’t think of a major campaign in which I’ve seen a South Asian woman running.

‘I’ve run at lots of different sizes. I’ve been thinner, I’ve been bigger than I am now, and I’ve been able to complete a marathon at every size. You don’t have to look a certain way to run, which I find really affirming. I didn’t expect to get messages from so many other women when I started my Instagram page, but it’s hugely motivating. I want to be the representation I wish I’d seen in my teens.’

Clara Holmes (@rollinfunky), boxer

‘I have Ehlers-Danlos syndrome, which is an inherited connective tissue disorder. It means my hips can no longer support me, and I’ve been a wheelchair user since I was 25. For the first five years after I became wheelchair bound, I was definitely grieving.

‘But I didn’t want to take that into my 30s. I could be here for the next 20, 30, 40 years – I don’t want to live like that. I had to accept that this was my situation, and start putting things in motion to improve my life. That’s when I started exercising again.

Ian Harrison

‘I began with stretching, then moved on to using dumbbells and resistance bands at home. Last year, I joined a gym and I’ve just been growing in

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Mouthwash and covid: What the new research really means

Here’s what those studies on mouthwash and coronaviruses actually mean — and why scientists say we should view their results with cautious enthusiasm.

Studying the effects of mouthwash and other oral antiseptic rinses on infectious viruses is not a novel idea. But amid the ongoing pandemic, fueled by a contagious pathogen often found in people’s mouths and noses, there is now “great interest in this area,” said Yvonne Kapila, periodontology chair in the Department of Orofacial Sciences at the University of California at San Francisco.

Over the past several months, researchers in the United States and abroad have examined mouthwashes, oral antiseptics and nasal rinses in controlled laboratory settings to see whether they can effectively inactivate the new coronavirus and other viruses within the same family.

A team in Germany found that when several products, including Listerine, were applied to strains of the novel coronavirus for 30 seconds, they “significantly reduced viral infectivity to undetectable levels,” according to a study published in July in the Journal of Infectious Diseases.

Researchers at Pennsylvania State University College of Medicine recently released similar findings, reporting that Listerine and Listerine-like products could inactivate more than 99.9 percent of a virus similar to the one that causes covid-19 with just 30 seconds of exposure. In a study published this month in the Journal of Medical Virology, the scientists wrote that their results suggest mouthwash could potentially decrease the risk of transmission of the novel coronavirus and “provide an additional level of protection.”

“The data suggests that if you have virus in your mouth, it would kill it” and could reduce your ability to spread it to others, said Craig Meyers, the study’s lead researcher and a professor in the university’s departments of microbiology and immunology and obstetrics and gynecology.

A 1 percent solution of baby shampoo, which is often used by head and neck doctors to rinse sinuses, was also shown to effectively inactivate the virus tested after two minutes of exposure, according to the study.

Meyers noted that the focus of the research was to find a way to lower transmission in situations where masking and being more than six feet apart might not be an option, for instance, during dental procedures.

But the findings do not necessarily mean using mouthwash or nasal rinses will protect you from getting infected, Rowan said.

“I do not think that they’re a good protective measure,” he said. “We’re looking at how it actually works on the virus itself rather than what it does to the body. I think those are two separate questions. . . . The question that we’ve asked so far is does this medication, does this thing that we’re giving, kill the virus? That’s the question that we’re answering right now.”

And based on existing research, experts say, people should not change how they approach pandemic safety, emphasizing that the available studies have notable limitations.

First, the experiments were conducted in labs, and while attempts were made to mimic the environment of a human

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Loss of funding means closure for maternity clinic which delivers half of Medicine Hat’s babies

A maternity clinic that delivers about half the babies in Medicine Hat has announced it will no longer accept new patients by the end of January, and will be closed by the end of July unless new funding can be found.

While family physicians typically pay their own overhead, a gap in Medicine Hat’s obstetric services in the mid-2000s led to the creation of the Family Medicine Maternity Clinic.

Funding was provided by the local Primary Care Network (PCN) and Palliser Health, which later merged with the other regional health authorities to form Alberta Health Services. 

Dr. Gerry Prince, a family doctor who helped establish the clinic in 2006, told the Calgary Eyeopener on Monday that the clinic will be closing because the PCN’s funding is due to end in March, and AHS wants the clinic to cover the overhead that includes rent, utilities and all staffing costs.

Prince said this would be impossible, as the costs to run the maternity clinic are roughly double the amount of what it can bill for patient services — and the doctors are already paying overhead for their family practices. 

“[The clinic] is closing because AHS is backing out of our partnership, and says that they want to rent us the space that we’ve been able to occupy for the last 17 years with their support,” Prince said.

“And the numbers they’ve given us are just impossible. So, they’ve given us an overhead number, which is about double the amount of billing that we would actually do through the clinic in a year.… Our guys, you know, as much as they love it, just — there’s no way you can do that.”

A ‘flawless service’

The Family Medicine Maternity Clinic was established due to a crisis of accessibility, Prince said. At the time, obstetrics was a declining service in the area.

“There [were] fewer and fewer physicians doing it, and got down to the point where there were only two family docs delivering about half of the babies in town — as well as running the regular community clinic,” Prince said.

“It was becoming quickly unmanageable.”

Prince said that some of the local doctors turned to health authorities and asked for help. 

The regional health authority agreed, and later partnered with the Primary Care Network to meet the community need. The clinic was established, attached to the Medicine Hat Regional Hospital.

“We went with this idea of a maternity clinic, a dedicated care centre, and they helped support it. And ultimately, we built a specified, designated, custom-design clinic area in our new ambulatory care building,” Prince said.

Eventually, Prince said, that clinic would deliver 500 to 600 babies a year.

“We’ve had a flawless service that’s been providing great care for 17 years.”

Soon, it’s all coming to an end — and why is complicated.

“The docs want to provide the services, we just need to be able to manage it financially. So the real question is, whose job is it [to save

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Distance learning means kids are missing out on exercise

Katelyn Esmonde is a postdoctoral fellow and Keshia Pollack Porter is a professor of public health at Johns Hopkins University.

This fall hasn’t felt much like “back to school” for many children. Instead, many are staying at home and attending virtual classes indefinitely.

According to the Center on Reinventing Public Education, a nonpartisan research center, about 25% of U.S. school districts have started the year fully remote. This means that children will miss out on vital opportunities for educational, social and emotional development. And, as is familiar during this pandemic, the impact will be unequal: Children in underresourced districts are more likely to be remote learners. These children are hardest hit by school closures as they are more likely to lack access to necessary technologies and are less likely to receive parental help with their learning. They will also lose out on easy access to school meals.

But there’s another harm done by school closures: a child’s ability to be physically active. We are researchers at Johns Hopkins University studying physical activity and its impact on public health. Based on our research, we believe the pandemic is exacerbating health disparities among children and having significant impacts on their physical, social and cognitive development.

No gym classes, no team sports

Children not in school don’t have recess or physical education classes. They aren’t walking to school or to a bus stop. Generally, they can’t participate in school teams or clubs that promote physical activity either (although in some school districts, team sports may go ahead even while in-person education does not).

What’s more, children have traditionally been less physically active in the summer than during the school year, with notable differences by race and ethnicity. And given the punishing trajectory of the pandemic, it is not clear when those prospects for physical activity will be available again.

The U.S. Department of Health and Human Services recommends that children between ages 6 and 17 engage in one hour of moderate to vigorous physical activity per day. That can improve a child’s physical and mental health and prevent the onset of chronic disease, including Type 2 diabetes, heart disease and some cancers.

Physical activity and active play can also be a source of joy for children. As they socialize with peers, they find pleasure in moving their bodies and developing their strength and physical literacy. Many of us look back fondly on childhood memories of soccer games and running around until we tire ourselves out, a delight every child deserves.

Schools, of course, are not perfect when it comes to meeting children’s physical activity needs. Physical education is chronically underfunded, and Black and Latino children typically lose out the most. Even so, schools provide some opportunities for children to be well and healthy.

Low-income communities are hurt the most

A child’s decrease in physical activity is not only a public health issue. It’s also a matter of fairness.

Prior to the pandemic, children from low-income communities and communities of color already

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Experimental coronavirus vaccines: When they will roll out, side effects and what it all means for you

CLEVELAND, Ohio — When University Hospitals needed volunteers willing to test an experimental vaccine for COVID-19, UH’s Dr. Margaret Larkins-Pettigrew signed up, and brought along her physician husband as well.

The couple learned they will undergo two injections of either the vaccine or a placebo; they won’t be told which they were given.

Over the next two years, they will undergo periodic physicals, keep track of their symptoms and turn over their medical records to trial organizers if they are hospitalized for COVID-19.

Larkins-Pettigrew said she felt an obligation, as a physician, to participate in the vaccine trial.

“This is a safe trial to be involved in,” said Larkins-Pettigrew, who is UH Edgar B. Jackson chair of Clinical Excellence & Diversity. “Science will direct us to make sure all of us are protected.”

All over the world, people like Larkins-Pettigrew are signing up to help pharmaceutical companies test prospective COVID-19 vaccines, as part of an effort to get vaccines to the public and stop the pandemic’s devastating effect.

In Ohio, Pfizer and its partner BioNTechSE, and Moderna — forerunners in the race to develop a vaccine — are conducting trials at research centers across the state to determine their safety and efficacy.

Ohio State University Wexner Medical Center is the site of a two-year, Phase 3 trial of the vaccine developed by AstraZeneca, a British-Swedish company, and the University of Oxford.

University Hospitals and the Louis Stokes Cleveland VA Medical Center are among 120 clinical investigational sites around the world that will collectively enroll up to 44,000 participants in a Phase 3 trial to test the vaccine BNT162b2, developed by Pfizer and the German company BioNTechSE.

Rapid Medical Research Inc., in Beachwood is testing the mRNA-1273 vaccine from Moderna in a two-year trial. Two sites in Cincinnati are also testing this vaccine.

How much protection will these vaccines offer? Will we need to get a coronavirus shot every year?

“These are all open questions,” said Dr. Carlos Malvestutto, assistant professor of infectious disease and co-chair of the COVID-19 Task Force, at Ohio State University Wexner Medical Center.

“The only way to answer them is through clinical trials,” Malvestutto said.

The public has questions as well, such as how these vaccines work inside the body, why some trial participants receive a placebo and how to join a trial.

Let’s get some answers.

How do these vaccines work?

All vaccines trigger the body’s immune system to mount a defense against invading illnesses. The approach taken by AstraZeneca is different from how Pfizer and Moderna are approaching the problem.

AstraZeneca’s vaccine uses a modified chimpanzee adenovirus, altered to make it harmless to humans, Malvestutto said. The adenovirus is used as a viral vector to carry a single coronavirus gene into the body. The coronavirus components of the vaccine spark an immune response against the actual coronavirus.

The vaccine does not include the whole virus and cannot cause COVID-19, Malvestutto said.

The Pfizer vaccine candidate is made up of messenger RNA coupled to a

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Landmark – The Inside Story of America's New Health Care Law and What It Means for Us All

Book Review: Landmark – The inside story of America's new health care law and what it means for us all

Landmark is a collection of essays written by various reporters, editors and national staff of 'Washington Post' followed by the actual text of the bill. It provides a comprehensible summary of the legislation and examines its impacts on Americans on various categories and on health care system as a whole. In addition to this, it gives a very rich historical background and perspective. Such as how the legislation came together, the events and negotiations, the political challenges and obstacles, etc etc

The book has a systematic structure and is divided into three sections. The first section provides behind the scene reporting about the way the law came up. The second section highlights the effects and impacts of the new law whereas the third section is a summary of the legislation.

For a lot of people, the presence of the historical background makes it a worthwhile read as it also covers a lot about the national healthcare coverage. People also find it a worthwhile read because it gives a proper and detailed coverage as compared to the fragmented and sensational media coverage.

Although the bill seems to be corrupted in a few places, the authors still manage to convince you that the law will change the way doctors make business and also mark a change in the patients experiences.

This book will increase your knowledge on the issues related to this bill and your ability to discuss and debate on the issue will also be enhanced. This book provides a very balanced perspective and should be read by all.

Landmark is a well written analysis of the new health care reform bill, all of the contributors clarify specific areas of the bill, recommended.

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