Using a concentrated, highly targeted dose of radiation to the breast has equally good results as irradiating the whole area, with no adverse effects on survival and a much better cosmetic outcome, Hungarian researchers have found. Reporting the ten-year results of a randomised trial, Professor Csaba Polg

Researchers from the Georgia Institute of Technology and the Centers for Disease Control and Prevention (CDC) have developed a new laboratory test that can rapidly identify the bacterium responsible for staph infections. This new test takes advantage of unique isotopic labelling combined with specific bacteriophage amplification to rapidly identify Staphylococcus aureus.
Quickly and accurately detecting infections caused by S. aureus is critical because the pathogenic bacterium causes a broad spectrum of infections, ranging from acute to chronic disease, which need to be treated in a prompt manner with the correct antibiotic.
The test uses mass spectrometry to quantify the number of S. aureus organisms in a large number of samples in just a few hours, compared to a day or two for culturing techniques typically used to detect this bacterium.
‘Our method for detecting staph infections using mass spectrometry will be valuable in a variety of situations, but will be crucial when a large number of people need to be tested very quickly, which will ultimately improve treatment,’ said Facundo Fern

To improve the quality of life in gay men and minorities treated for prostate cancer, a greater awareness of ethnic and sexual preference-related factors is needed to help men choose a more-suitable treatment plan, researchers from Thomas Jefferson University Hospital conclude in a literature review.
Some of the factors to consider, for example, include increased risk of urinary and bowel function decline in African Americans regardless of treatment received and differing sexual expectations and social support in gay men.
‘Different communities of men view the effects of prostate cancer treatments very differently,’ said co-author Edouard J. Trabulsi, M.D., of the Department of Urology and Kimmel Cancer Center at Thomas Jefferson University Hospital, noting the poorer quality of life among certain sub-populations.
‘It’s in the patient’s best interest for caregivers to acknowledge perceptions and expectations during the treatment decision process,’ he said. ‘They should take specific demographics, socio-economic status, and sexual preference into consideration, and tailor an approach based on a patient’s specific concerns about the implications of various treatments.’
Today, many of these confounding factors are poorly documented and poorly addressed by medical practitioners when discussing treatment, be it radical prostatectomy, radiation or androgen deprivation therapy. There is also scant research about prostate-cancer-related quality of life effects in men who have sex with men (MSM).
In this literature review, the authors use several studies to illustrate differences in treatment outcomes, sexual function and coping mechanisms among subpopulations, including African Americans, Latin Americans, Asians and MSM.
According to the analysis, African Americans, who have higher prostate cancer incidence and mortality rates than whites, are less likely to initiate and complete treatment and less likely to trust a physician. They are also at an increased risk of urinary, bowel and general physical function decline, regardless of treatment.
Treatment preferences and sexual outcomes also differ. According to the review, in a study of 665 military men who had the same access to care, white men were three times more likely to choose a radical prostatectomy as their treatment options for low and intermediate risk prostate cancer, whereas African Americans tended to prefer non-surgical treatments, such as external beam radiation therapy.
A multi-centre longitudinal cohort study set up to monitor urinary and sexual function in over 1,200 men who underwent radical prostatectomy for clinically localised prostate cancer showed that African Americans were more likely to retain sexual function.
As with African Americans, Latin American men who underwent radiation therapy or a radical prostatectomy demonstrated greater levels of severe sleep dysfunction than whites. They were also are less likely to enter hospice.
MSM with prostate cancer have additional social and sexual challenges often overlooked. MSM are typically diagnosed later in life and may be reluctant to divulge their sexual preference to their caregiver. This may preclude them from discussing their quality of life expectations and sexual practices.
One reason for poorer quality of life may also be attributed to a lack of social support group, the researchers discovered in their analysis. As MSM men are less likely to have long-term partners, they might not have the same level of support at home and might look for support in other places.
However, the number of support groups specifically tailored for MSM with prostate cancer is limited.
‘In the United States, MSM-specific support groups are available in just six cities. MSM living outside these cities might rely more on Internet-based support groups and are at increased risk of becoming socially isolated,’ the authors write.
MSM are also less likely to invite their partners into the examiner room when discussing treatment options and related adverse effects. Study findings also suggest that treatment with androgen deprivation therapy for prostate cancer could have a greater negative impact on quality of life for gay men compared to heterosexual men.
‘There are potential barriers for accurately assessing and measuring quality of life in MSM. Here, we focus attention on these poorly studied aspects to help overcome such concerns,’ said Dr. Trabulsi, who is also the Director of the Multidisciplinary Genitourinary Cancer Center at Jefferson’s Kimmel Cancer Center. ‘It’s everything from discussion about sexual preference to toxicity-related effects to their ability to maintain a relationship with a partner.’ EurekAlert

Normal everyday life for parents requires organisation. Parents of children who require ventilators, oxygen, IVs and other tools to live, those day-to-day tasks can be time-consuming, difficult and stressful on the family. But researchers from Case Western Reserve University found that mothers who successfully integrate the care of the technology-dependent child into family life have families that function better.
‘It

Attitude may play an important role in how exercise affects menopausal women, according to Penn State researchers, who identified two types of women — one experiences more hot flashes after physical activity, while the other experiences fewer.
‘The most consistent factor that seemed to differentiate the two groups was perceived control over hot flashes,’ said Steriani Elavsky, assistant professor of kinesiology. ‘These women have ways of dealing with (hot flashes) and they believe they can control or cope with them in an effective way on a daily basis.’
Women who experienced fewer hot flashes the day after participating in vigorous to moderate physical activity were more likely to be part of the group that felt they had control over their hot flashes. Women who had more hot flashes following exercise were likely to be those who felt they had very few ways of coping with their hot flashes, Elavsky and her colleagues report in a recent issue of Maturitas.
Elavsky suggested that cognitive behavioural therapy may help some women feel they have more control over their bodies and reactions to hot flashes.
The participants with fewer hot flashes the day after vigorous exercising were also less likely to experience anxiety and depression. However, women who had fewer hot flashes the day after only light or moderate physical activity had higher levels of pessimism and depression than others.
‘The bottom line for research is that people need to look at individual differences,’ said Elavsky. ‘It’s not enough anymore to do a study and look at overall impact of an exercise program on symptoms. It’s very clear that we need to look at the different responses that women might have, and try to understand these individual differences more.’
Elavsky and her colleagues followed 24 menopausal women for the length of one menstrual cycle, or for 30 days if they were no longer menstruating. Each woman used a personal digital assistant to record hot flashes and wore an accelerometer at the hip to track physical activity. The women in the study regularly had hot flashes before the start of the study, experiencing from five to 20 a day.
‘The real-time reporting of symptoms and the objective measurement is a strength of the study,’ said Elavsky. ‘There aren’t any studies out there that use both of these approaches.