JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. the Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF OTOLARYNGOLOGY—HEAD & NECK SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 21, 2007)
CHRONIC GUM DISEASE ASSOCIATED WITH TONGUE CANCER
STUDY IDENTIFIES PATIENTS’ REASONS FOR QUITTING JOBS AFTER TREATMENT FOR HEAD AND NECK CANCER
ARCHIVES OF DERMATOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 21, 2007)
TOPICAL RETINOL HELPS TO REDUCE WRINKLES ASSOCIATED WITH NATURAL SKIN AGING
ARCHIVES OF SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 21, 2007)
BREAST MRI MAY BE BENEFICIAL FOR DETERMINING SURGICAL MANAGEMENT OF WOMEN WITH NEWLY DIAGNOSED BREAST CANCER
ARCHIVES OF FACIAL PLASTIC SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 21, 2007)
GEL DERIVED FROM A PATIENT’S OWN BLOOD MAY HELP PROMOTE WOUND HEALING
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 21, 2007
Media Advisory: To contact Mine Tezal, D.D.S., Ph.D, call Lois Baker at 716-645-5000, ext. 1417.
CHRONIC GUM DISEASE ASSOCIATED WITH TONGUE CANCER
CHICAGO—Men with chronic gum disease may have an increased risk of tongue cancer, regardless of whether they smoke, according to a report in the May issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.
More than 7,300 Americans died from oral cancer in 2006, according to background information in the article. “Considerable evidence indicates that chronic infections and persistent inflammation are associated with increased cancer risk,” the authors write. “Although viral infections have been associated with carcinogenesis [the development of cancer], the evidence for a connection between bacterial infections and carcinogenesis is also convincing.” The gum disease periodontitis is an oral infection thought to be caused by bacteria, though recent evidence suggests the involvement of viruses as well.
Mine Tezal, D.D.S., Ph.D., and colleagues at the State University of New York at Buffalo and the Roswell Park Cancer Institute, Buffalo, compared 51 white men with tongue cancer to 54 white men without, all of whom were treated at the cancer institute between 1999 and 2005. Periodontitis was assessed in panoramic X-rays of the mouth by calculating the amount of bone loss in the tooth cavities (alveoli), an established measure of the disease’s history and progression.
“The mean [average] alveolar bone loss was significantly higher in cancer cases compared with controls (4.21 vs. 2.74 millimeters),” the authors write. “After adjusting for the effects of age, smoking status and the number of teeth, each millimeter of alveolar bone loss was significantly associated with a 5.23–fold increase in the risk of tongue cancer. Other oral variables (the number of dental decays, fillings, crowns and root canal treatments) were not significantly associated with the risk for tongue cancer.”
Periodontal viruses and bacteria could be toxic to surrounding cells and produce changes that lead directly to oral cancer, or could indirectly contribute to cancer through inflammation, the authors note. “We have presented preliminary data suggesting an independent association between history of periodontitis and the risk of tongue cancer. This association needs to be confirmed by larger studies that include other oral cancer sites, women and subjects of other races with a more comprehensive assessment of confounding,” including factors such as lifelong tobacco use, they write. “If this association is confirmed, it has a potential impact on understanding the etiology of oral cancer as well as on its prevention and control.”
(Arch Otolaryngol Head Neck Surg. 2007;133:450-454. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the National Institute of Dental and Craniofacial Research and a grant from the National Cancer Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 21, 2007
Media Advisory: To contact corresponding author Gerry F. Funk, M.D., call Tom Moore at 319-356-3945.
STUDY IDENTIFIES PATIENTS’ REASONS FOR QUITTING JOBS AFTER TREATMENT FOR HEAD AND NECK CANCER
CHICAGO—After treatment, 38.1 percent of patients with head and neck cancer who were employed at the time of cancer diagnosis reported discontinuing work because of their cancer and treatment, according to a report in the May issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.
“Although most cancer survivors who are of working age who want to return to work are able to do so, cancer survivors experience significantly more work-related problems owing to missed work days than the general population, and the economic consequences for those who are disabled following cancer treatment are a substantial societal burden,” the authors note. Those with head and neck cancer have the third highest rate of discontinuing employment because of their illness when compared to patients with other types of cancer.
Andrea E. Buckwalter, B.S., of the University of Iowa, Iowa City, and colleagues analyzed 666 patients with head and neck cancer who were treated from 1998 to 2004. The patients provided information about their employment status at the time of diagnosis and then at three, six, nine and 12 months after. Those who discontinued employment also rated the importance of five factors (eating, speech, appearance, pain or discomfort and fatigue) in their decision to stop working. The factors were scored on a five-point scale with five being the most important and one being the least important.
Of the 666 patients, 440 were men and 431 were younger than 65 years. Before treatment, 239 (35.9 percent) were employed, 337 (50.6 percent) were not employed and 23 (3.5 percent) were never employed. Of those who were employed at the time of cancer diagnosis, 91 (38.1 percent) [68 men and 23 women] discontinued work because of their cancer and treatment and 37 (40.7 percent) of those who had left their jobs returned to work within the first year. A higher percentage of patients who discontinued employment had advanced-stage disease (78 percent) and were treated with multimodality therapy such as surgery, radiation therapy and chemotherapy, (64 percent), compared with those who continued to work.
“Fatigue had the highest percentage (58.5 percent) of 4 or 5 ratings, followed by speech (51.2 percent), eating (45.1 percent), pain or discomfort (37.8 percent) and appearance (17.1 percent),” the authors write. Among those who returned to work, there were no significant differences in the ranking of factors, but there was a significantly higher number of patients who did not return to work who reported speech and eating as important factors in their decision to discontinue work. Women rated speech, appearance and pain as more important factors in quitting their jobs than men. Appearance was of relatively little importance for both men and women.
“This study demonstrates that fatigue is a parameter that will likely assume a greater importance in head and neck cancer outcome evaluation,” the authors conclude. “Identification of the patient-reported factors associated with the decision to discontinue employment is a first step in providing more useful information about employment to patients and identifying interventions to minimize the disability following treatment for head and neck cancer.”
(Arch Otolaryngol Head Neck Surg. 2007;133:464-470. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant from National Institutes of Health through the Office of Cancer Survivorship. Dr. Smith has an unrestricted educational/research grant from KLS Martin. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 21, 2007
Media Advisory: To contact corresponding author Sewon Kang, M.D., call Katie Gazella at 734-764-2220.
TOPICAL RETINOL HELPS REDUCE WRINKLES ASSOCIATED WITH NATURAL SKIN AGING
CHICAGO—Applying vitamin A to the skin appears to improve the wrinkles associated with natural aging and may help to promote the production of skin-building compounds, according to a report in the May issue of Archives of Dermatology, one of the JAMA/Archives journals.
The wrinkles and brown spots associated with aging appear first and most prominently on skin exposed to the sun, according to background information in the article. “Human skin not exposed to the sun also ages but less dramatically,” the authors write. “In intrinsic, natural or chronological aging, skin loses its youthful appearance by becoming thinner, laxer and more finely wrinkled. These changes are readily appreciated by inspecting the upper inner arm.” Thinner skin results from a reduced production of the protein collagen and may slow wound healing, presenting a public health issue. “Safe and effective therapies to reverse the atrophy of natural skin aging do not exist currently,” the authors note.
Reza Kafi, M.D., then of the University of Michigan Medical School, Ann Arbor, and now of Stanford Medical School, Palo Alto, Calif., and colleagues assessed the effectiveness of vitamin A (retinol) lotion in 36 elderly individuals (average age 87 years). Researchers applied a lotion containing 0.4 percent retinol to participants’ right or left upper inner arms, and lotion with no retinol to the other arm, up to three times a week for 24 weeks. Wrinkles, roughness and overall severity of aging were each graded on a scale from zero (none) to nine (severe) before treatment and two, four, eight, 16 and 24 weeks after beginning treatment. In addition, 4-millimeter biopsy specimens of skin were taken from both arms at the beginning and end of the 24-week treatment period.
A total of 23 individuals completed the full study and 13 withdrew from the study prior to completion. When the researchers included the individuals who had dropped out of the study by assuming their skin did not change after their last measurement, wrinkles, roughness and overall aging severity were all significantly reduced in the retinol-treated arm compared with the control arm. The skin biopsies revealed that the retinol increased the production of glycosaminoglycan and procollagen, structural components of the skin.
“Topical retinol improves fine wrinkles associated with natural aging,” the authors conclude. “Significant induction of glycosaminoglycan, which is known to retain substantial water, and increased collagen production are most likely responsible for wrinkle effacement [reduction]. With greater skin matrix synthesis [production of compounds that form new skin], retinol-treated aged skin is more likely to withstand skin injury and ulcer formation along with improved appearance.”
(Arch Dermatol. 2007;143:606-612. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported in part by grants from the Babcock Endowment for Dermatologic Research, the Merck-American Federation for Aging Research, Alpha Omega Alpha Student Research Fellowship and the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 21, 2007
Media Advisory: To contact corresponding author Kevin P. Bethke, M.D., call Marla Paul at 312-503-8928.
BREAST MRI MAY BE BENEFICIAL FOR DETERMINING SURGICAL MANAGEMENT OF WOMEN WITH NEWLY DIAGNOSED BREAST CANCER
CHICAGO—Among women who are newly diagnosed with breast cancer, magnetic resonance imaging (MRI) of the breast appears helpful in determining surgical treatment, according to a report in the May issue of Archives of Surgery, one of the JAMA/Archives journals.
Women who have been newly diagnosed with breast cancer are at risk of having another, hidden tumor in the same or opposite breast, according to background information in the article. If these additional tumors are detected before surgery to remove the initially diagnosed tumor, the plan for surgical management of the disease can be altered. For instance, if additional cancer is found in the same breast, a surgeon can perform a mastectomy (removal of the whole breast) instead of a lumpectomy (removal of a part of the breast) or remove a larger amount of tissue during a lumpectomy. If cancer is detected in the other breast, surgery can be done on both breasts at once. “However, the impact of routine MRI on the surgical management of new, biopsy-proven breast cancers remains unclear,” the authors write.
Karl Y. Bilimoria, M.D., and colleagues at the Feinberg School of Medicine, Northwestern University, Chicago, assessed 155 women with breast cancer newly diagnosed by mammogram, ultrasound and needle biopsy (testing of a small amount of tissue). The women, who were diagnosed between April 2005 and April 2006, went to a single surgeon who performed an evaluation and developed a plan for the surgical management of the disease. After this consultation, MRI was performed on both breasts. If the MRI detected new tumors that were found to be malignant or suspicious after a biopsy, patients went back to the surgeon for a re-evaluation of the surgical plan.
Breast MRI detected a total of 124 additional suspicious areas in 73 patients. “Breast MRI altered the surgical management of patients with newly diagnosed breast cancer in 36 (23.2 percent) of 155 patients,” the authors write. This included 10 patients who had a mastectomy instead of lumpectomy, 21 women whose lumpectomy removed more tissue than originally planned, and five patients who had surgery on both breasts.
Following surgery, the researchers compared the actual appearance of the cancer to the original mammogram or ultrasound and also to the MRI. The change in surgical management was considered beneficial if pathological findings matched the MRI more closely than they matched mammography or ultrasonography. “Of the 36 women who had a change in surgical management based on MRI findings, 15 were found to have a beneficial change when MRI findings were confirmed on the final pathologic report,” the authors write. The change was determined to be beneficial in eight women whose lumpectomy was converted to a mastectomy, 10 patients who received a larger lumpectomy and two patients who had surgery on both breasts.
“Additional malignancies are uncovered in one patient for every 10 who undergo MRI,” the authors conclude. “These data suggest that breast MRI may have a role in the staging evaluation of newly diagnosed breast cancers.”
(Arch Surg. 2007;142:441-447. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Dr. Bilimoria is supported by a grant from the Goldberg Family Charitable Trust. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 21, 2007
Media Advisory: To contact David B. Hom, M.D., call Jamie Davis at 513-558-4625.
GEL DERIVED FROM A PATIENT’S OWN BLOOD MAY HELP PROMOTE WOUND HEALING
CHICAGO—A preliminary study suggests that topical application of a gel made from platelets in healthy individuals’ own blood may help wounds heal more quickly and completely, according to a report in the May/June issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.
Recent innovations have led to devices that can process blood into a concentrated plasma rich in platelets (particles important for blood clotting), and then to an autologous (from the patient’s own body) platelet gel, according to background information in the article. This gel is currently used in surgery to improve healing, but its clinical application remains controversial.
David B. Hom, M.D., then of the University of Minnesota School of Medicine and Hennepin County Medical Center, Minneapolis, and now at the University of Cincinnati College of Medicine, and colleagues assessed the effectiveness of autologous platelet gel in eight healthy men and women older than 21 years. Five 4-millimeter skin punch wounds were made 3 centimeters apart on both the right and left upper thighs in all eight individuals. The autologous platelet gel was applied to the wounds on one leg, while the wounds on the other leg were treated with only an antibiotic ointment or a dressing. The wounds were monitored by the researchers and were digitally photographed for six months, and additional biopsies (removal of skin) were performed on each leg.
During the six-month follow-up, none of the participants developed infections and no serious adverse events were reported. “Over a 42-day period, the autologous platelet gel–treated sites had statistically increased wound closure compared with controls by visual clinical assessment and by digital planimetry [boundary-tracing] photographic measurements,” the authors write. “On day 17, the percentage of closure was 81.1 percent for the autologous platelet gel–treated sites and 57.2 percent for the control sites.”
Examination of biopsy specimens revealed that the histologic features of the skin (such as cellular characteristics and microscopic signs of healing) at the treated wound sites looked similar to the skin at the control wounds. However, when the count of platelets in the gel was more than six times the count of platelets in the individual’s blood vessels, new tissue appeared three days earlier in the treated wounds than in the control wounds.
“In this pilot study, autologous platelet gel appeared to enhance wound closure in acute full-thickness dermal wounds in healthy subjects,” the authors conclude. “Further investigations are needed to confirm the consistency of these results. If further studies support these findings, autologous platelet gel treatment during surgery could have a useful impact on the enhancement of postoperative dermal wound healing in surgical patients.”
(Arch Facial Plast Surg. 2007;9:174-183. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Dr. Hom has received research support from, and serves as a consultant to, Medtronic Inc.; co-author Dr. Linzie was an employee of, owns stock in and has provided pathology research consultation for Medtronic Inc; and Dr. Huang is an employee of Medtronic Inc. This study was funded by Medtronic Inc. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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