Breast cancer
The benefits of exercise during radiation
Exercise is often recommended as a key lifestyle modification for patients with diseases like hypertension, diabetes, and cardiovascular disease. Now, researchers find that regular moderate-intensity aerobic activity can help women undergoing radiation treatment for breast cancer.
According to a study published in the November 15, 2006, issue of CANCER, women who exercised had improved oxygen capacity and stable red blood cell levels during radiation treatment. In contrast, women who didn't exercise experienced significant declines in their oxygen capacity. Although researchers have long known that physical rehabilitation after1 radiation therapy is completed can resolve the fatigue and anemia that are common adverse effects of radiation, this is the first study to investigate the effect of exercise during radiation treatment.
Compared with women who didn't exercise regularly, women in the study who briskly walked 20 to 45 minutes three to five times a week during radiotherapy treatment didn't experience a decline in their hemoglobin, hematocrit, or red blood cell levels. In fact, their hemoglobin and mean red blood cell levels increased slightly. This significantly correlated with increased peak oxygen capacity.
Diabetes
First of a new drug class approved
Your patients with type 2 diabetes will soon have a new option for managing their disease: sitagliptin (Januvia), the first in a new class of drugs known as dipeptidyl peptidase-4 (DPP-4) inhibitors. This type of drug enhances the body's ability to lower an elevated blood glucose level.
The U.S. Food and Drug Administration approved sitagliptin in October 2006 for use in conjunction with diet and exercise to improve the blood glucose level in patients with type 2 diabetes. It can be prescribed as monotherapy or in combination with two other commonly prescribed oral diabetes medications, metformin or a peroxisome proliferator-activated receptor gamma agonist. Sitagliptin can be added to the regimen when either of these drugs alone, along with diet and exercise, doesn't provide adequate blood glucose control.
Sitagliptin prolongs the activity of proteins that increase the release of insulin after the blood glucose level rises, such as after a meal. It does this by blocking the enzyme DPP-4, which breaks down these proteins, leading to better blood glucose control. In clinical studies, the most common adverse effects were upper respiratory tract infection, sore throat, and diarrhea.
Heart disease
"Sudden" cardiac death may not be so sudden
Writing in Circulation: Journal of the American Heart Association, German researchers report that sudden cardiac death isn't as sudden or symptom-free as previously believed.
Their study included 406 sudden cardiac death patients who'd been treated at a physician-manned mobile intensive care unit at the University of Berlin during a 1-year period. After the return of spontaneous circulation or after resuscitation efforts were stopped, the researchers collected detailed, on-the-scene information about symptoms and their duration from bystanders and surviving patients. They made the following observations:
* Of the cardiac arrests-defined as complete cessation of the heart's pumping action-72% occurred at home and 67% were witnessed by others.
* A history of coronary heart disease, documented by angiography, was found in 106 patients; 16 of them had a previous cardiac arrest and resuscitation.
* The most common warning symptom was chest pain, with a duration of 20 minutes to 630 minutes. Chest pain was present in one in four (25%) patients with witnessed arrests and in 33% of patients who had symptoms for less than 1 hour preceding arrest.
* Breathlessness was a symptom in 17% of witnessed arrests and in 30% of patients who had the symptom for less than 1 hour before the arrest. Other common symptoms were nausea, vomiting, dizziness, and fainting.
* Bystanders performed cardiopulmonary resuscitation (CPR) on 57 patients, and 13 of them (23%) survived to hospital discharge. Among the 349 patients who didn't receive bystander CPR, only 13 (4%) survived, which was highly significant.
The researchers said that the study results suggest how important it is to give at-risk patients and their families detailed information about signs of cardiac arrest so they can recognize a developing problem and react accordingly.