Surival Rates Similar for Two Types of Abdominal Aneurysm Repairs






Less-invasive surgery isn’t necessarily better than an open procedure to repair a potentially fatal abdominal aortic aneurysm. That’s the conclusion of researchers at the Johns Hopkins University School of Medicine, who found similar survival rates for both types of procedures.


The medical community was enthusiastic about a new, less-invasive procedure assumed to be safer and better than traditional open surgery, according to Medical News Today. The researchers followed patients for up to nine years. Surprisingly, they found that after four years, survival rates for the two types of surgery were very similar.






An aneurysm is a bulge resembling a balloon in an artery. When the artery’s wall has been weakened by genetic issues, trauma, or certain medical problems, the pressure of blood against it can cause an aneurysm. Aneurysms in the aorta claim the lives of around 13,000 Americans a year, says the National Heart Lung and Blood Institute. Most deaths occur after the rupture of an aneurysm or a split in the aorta’s wall.


An abdominal aortic aneurysm occurs when the aorta — the body’s largest blood vessel — balloons in the abdomen due to pressure on the wall. If it ruptures, massive bleeding can be quickly fatal. This type of aneurysm ranks 14th among leading causes of death for Americans between 60 and 85.


Treatment depends on an aneurysm’s size and location. The traditional surgery for an abdominal aortic aneurysm utilizes a large, open cut. The more recent type of repair is an endovascular embolization, in which the surgeon uses a stent to prop open the blood vessel or reinforce its wall, according to PubMed Health.


While the survival rate was higher after two years in patients in the Hopkins study who had undergone endovascular repair, by the four-year mark, rates were nearly the same. Among elderly patients considered bad risks for an open surgery, individuals didn’t fare better with the newer technique. The team found no increased survival in patients at least 70 years old who had undergone the less-invasive procedure. Any benefits occurred in younger individuals.


Study leader Julie A. Freischlag, M.D., says the results raise an issue over who should undergo aneurysm repair. Even when older patients underwent repairs, their lives weren’t prolonged. She says the issue is whether they should have either procedure, since they’re already dying of diseases associated with old age.


My father lived, largely symptom-free, for years with an abdominal aortic aneurysm . Citing a weak heart, surgeons declined to repair it. When he experienced sudden pain, my mother took him to the emergency room. He survived an open repair procedure but died after 16 days in intensive care of an infection at the surgical site. Although he was 71, we wonder if an endovascular embolization would have provided a different outcome, at least for four years after surgery.


Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.


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Former President George H.W. Bush in intensive care


HOUSTON (AP) — Former President George H.W. Bush has been admitted to the intensive care unit at a Houston hospital "following a series of setbacks including a persistent fever," but he is alert and talking to medical staff, his spokesman said Wednesday.


Jim McGrath, Bush's spokesman in Houston, said in a brief email that Bush was admitted to the ICU at Methodist Hospital on Sunday. He said doctors are cautiously optimistic about his treatment and that the former president "remains in guarded condition."


No other details were released about his medical condition, but McGrath said Bush is surrounded by family.


The 88-year-old has been hospitalized since Nov. 23, when he was admitted for a lingering cough related to bronchitis after having been in and out of the hospital for complications related to the illness.


Earlier Wednesday, McGrath said a fever that kept Bush in the hospital over Christmas had gotten worse and that doctors had put him on a liquids-only diet.


"It's an elevated fever, so it's actually gone up in the last day or two," McGrath told The Associated Press. "It's a stubborn fever that won't go away."


But he said the cough that initially brought Bush to the hospital has improved.


Bush was visited on Christmas by his wife, Barbara, his son, Neil, and Neil's wife, Maria, and a grandson, McGrath said. Bush's daughter, Dorothy, was expected to arrive Wednesday in Houston from Bethesda, Md. The 41st president has also been visited twice by his sons, George W. Bush, the 43rd president, and Jeb Bush, the former governor of Florida.


Bush and his wife live in Houston during the winter and spend their summers at a home in Kennebunkport, Maine.


The former president was a naval aviator in World War II — at one point the youngest in the Navy — and was shot down over the Pacific. He achieved notoriety in retirement for skydiving on at least three of his birthdays since leaving the White House in 1992.


___


Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP


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Police investigate NBC News anchor for showing gun clip






(Reuters) – NBC News anchor David Gregory is being investigated by police after displaying what he said was a high-capacity gun clip on Sunday’s broadcast of “Meet the Press,” Washington‘s Metropolitan Police Department said Wednesday.


Gregory held up what appeared to be a 30-round gun magazine – which would be barred under Washington municipal code – while hosting the nationally broadcast interview with National Rifle Association Chief Executive Officer Wayne LaPierre.






“Here is a magazine for ammunition that carries 30 bullets,” Gregory said as he held aloft the black cartridge, according to video posted on the network’s website.


“Now isn’t it possible that, if we got rid of these, if we replaced them and said ‘Well, you could only have a magazine that carries five bullets or ten bullets,’ isn’t it just possible that we can reduce the carnage in a situation like Newtown?” Gregory asked LaPierre.


“I don’t think it’s what will work,” LaPierre responded.


The network had contacted the police department prior to Sunday’s broadcast “inquiring if they could use a high capacity magazine for the segment,” police spokesman Araz Alali said on Wednesday.


NBC was informed that possession of a high-capacity magazine was not permissible and their request was denied.”


Alali, the police spokesman, declined to elaborate on the investigation into NBC.


Washington’s municipal code prohibits possession, sale or transfer of “any large capacity ammunition feeding device, regardless of whether the device is attached to a firearm.”


The maximum penalty for conviction on such a charge is a $ 1,000 fine and one year in prison.


NBC spokeswoman Erika Masonhall, contacted by email, said the network had no comment on the investigation.


After the broadcast, which originated in Washington, a number of bloggers and websites questioned Gregory’s actions and the legality of the gun clip.


(Reporting by Chris Francescani and Paul Eckert; Editing by Paul Thomasch, Andrew Hay and Gunna Dickson)


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Mayo Scientists Link Enzyme to Aggressive Prostate Cancer






Researchers from the Mayo Clinic have directly linked an enzyme to aggressive prostate cancer. They’ve also developed a compound that restricts the ability of the molecule to fuel metastases of this type of cancer.


The team from Mayo’s Florida campus identified the first direct relationship between the enzyme known as PRSS3 to prostate cancer, according to Medical News Today. They published their results in Molecular Cancer Research.






The National Cancer Institute estimated that close to a quarter of a million men would be diagnosed with prostate cancer in 2012, and around 28,000 of them wouldn’t survive.


For years, medical professionals have relied on two types of screening for this disease: a digital rectal exam and the prostate specific antigen (PSA) test. However, the Mayo Clinic says using the PSA test is sometimes controversial, since it can provide false indicators and since there is no proof that it actually saves lives.


PRSS3, a protease, digests other molecules. The Mayo researchers concluded that activity associated with the enzyme alters the environment surrounding prostate cancer cells. They suspect that PRSS3 frees the cells from surrounding tissue, allowing them to become invasive and to spread cancer.


They haven’t concluded that the enzyme is the only issue linked to aggressive prostate cancer, however. Instead, they suspect that PRSS3 might power a potentially lethal form of this cancer.


The researchers examined databases available to the public that contained information from clinical studies. After finding a link between early breast cancer and protease in earlier work, they sought to discover whether any other type of cancer expressed protease and at which stages of the disease.


They found a dramatic relationship between increases in PRSS3 expression and progression of aggressive prostate cancer. The scientists determined that protease expression played a critical role in prostate cancer metastasis in mice models and found a site for an inhibiting agent to shut down the expression. In mice in which PRSS3 was “shut off,” the malignancy did not spread.


One outcome of the study is the possibility of testing prostate cancer patients for the molecule. Doctors could better determine patients at highest risk for an aggressive form of the disease. While the inhibitor utilized cannot be directly developed into a useful drug, it could provide a template for creating one.


My husband is among those who could eventually profit from this study. After two successive PSA tests with numbers that suddenly skyrocketed, he underwent painful biopsies that showed nothing amiss. Although his PSA numbers bounce, his urologist insists that he keep repeating the test.


With a family history of aggressive prostate cancer, my husband finds it hard to argue. Should he nix more PSA tests and eventually develop the illness, the link between the enzyme and prostate cancer provides some hope of a positive outcome.


Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.


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Toronto reaches skyward, but how dark the clouds?






TORONTO (Reuters) – Barry Fenton walked to the bank of floor-to-ceiling windows in his 30th-floor uptown Toronto penthouse suite and declared, “This is the best view of the city.”


To the south, a mass of steel-and-glass skyscrapers glinted in the bright autumn sun. Several cranes were in motion on unfinished buildings, a common sight in a city in the midst of a residential building boom.






“If you look around the core, every building you look at has a different look to it, a different ambience,” said the energetic co-founder of Lanterra Developments, one of the city’s most active builders. “That’s important.”


Fenton, 56, says he is confident the city’s condominium market will remain strong — despite warnings that it is all moving too far, too fast — and has an ambitious lineup for future development. And he is not alone in his optimism.


Toronto‘s seams are bursting with new condo and hotel towers designed by star architects like Frank Gehry and built by famed developers like Donald Trump.


But Fenton and others who see Toronto emerging from its “pokey” past — as a columnist in the Globe and Mail recently described it — face some formidable obstacles: an infrastructure buckling under soaring density rates, the laws of supply and demand and preservationists who say too many new towers are destroying the city’s character.


Canada’s central bank drew a bead on the city of 2.6 million this month in its weighty “Financial System Review,” warning of “potential future supply imbalances” in the condo market.


The Bank of Canada noted that the number of unsold condominiums in pre-construction has doubled, to 14,000, over the past year.


Greater Toronto home sales have slowed after years of steady increases. Sales fell 16 percent in November from the same month a year ago, according to the Toronto Real East Board. So far, however, prices are flattening, not falling, as some analysts have predicted.


In defiance of warnings by the central bank and economists, two mega-projects were unveiled within days of each other in October — a three-tower condo complex to be designed by Gehry and a multi-tower office project that includes a massive casino.


RACE TO THE TOP


More skyscrapers — 147 of them — are being built in Toronto than anywhere in North America, according to Emporis, the German data provider. That is twice as many as in New York, a city with about three times the population.


Toronto is getting taller fast. Fifteen buildings that will be more than 150 meters (492 feet) high are under construction, more than anywhere in the western hemisphere.


The recently completed Trump International Hotel topped out at 277 meters, just shy of Toronto’s tallest skyscraper, the 72-story First Canadian Place, which is 298 meters. That height could be exceeded by a couple of major projects on the drawing boards, including the Mirvish project.


(The city’s tallest freestanding structure, however, is the CN Tower, which soars over Toronto at 553 meters.)


“Toronto is creating a very sustainable future by building condos downtown,” said Daniel Libeskind, the American architect, who was in Toronto in October for a ceremony for one of his latest projects, the 57-story L Tower, with its sweeping, curvaceous, design that rises above the city’s modernist Sony Center for Performing Arts.


“It fights urban sprawl and brings people into the heart of the city.”


While building in big American cities and in Western Europe cratered following the financial crisis four years ago, Toronto never stopped booming. Demand for residential space has been strong, and while the office market has also been healthy, most of the new developments have been for condo projects.


Lanterra’s Fenton said his company has built some 9,000 condominium units in Toronto over the past 10 years and now has “in the hopper” up to 6 million square feet of property in downtown Toronto that is being rezoned for new projects.


Lanterra gained prominence over the past five years for the development of Maple Leaf Square, which included two condo towers, a hotel and office space, near the city’s hockey shrine, Air Canada Center, on land that had sat vacant for years.


Now it is “one of the hottest places to be,” said Fenton.


“ONE TOWER LEADS TO ANOTHER”


Some worry that Toronto can’t handle much more development.


“We have accumulated a serious infrastructure deficit,” wrote Ken Greenberg, a Toronto architect, in the Globe and Mail in October. “We have failed to make the investments in public transit that are urgently needed. Our narrow sidewalks and poorly designed streets are already jammed.”


He criticized the city officials and developers for a lack of coordinated planning. “One tower leads to another,” he said.


Despite decades of debate about transportation policy, Toronto has just two subway lines, a fleet of charming but lumbering streetcar lines and crumbling roadways.


Commuters in Toronto spend at least 80 minutes in traffic a day, on average — worse than what commuters face in London or Los Angeles — according to the Toronto Board of Trade.


Toronto’s City Planning Department did not respond to numerous requests for comment.


There is also concern about soaring neighborhood density rates. The city’s waterfront area has seen the most growth. Its population has soared 134 percent in a decade and is up 66 percent in the past five years, to 43,295, according to city data.


Toronto’s aging energy grid is strained. In July, downtown Toronto endured an eight-hour blackout after a transformer blew due to high demand. There was a similar outage last January.


THE MEGA-PROJECTS


Now two of the most ambitious projects the city has ever seen are being floated.


First out of the gate was theater impresario David Mirvish, who with his father, the late Ed Mirvish, helped create Toronto’s vibrant arts and theater scene.


In early October, Mirvish unveiled a plan for three condominium towers, with up to 85 floors each, that would be the city’s tallest buildings.


A podium at the buildings’ base would house two museums, including one for the Mirvish family’s contemporary art collection.


The Mirvish buildings would be designed by Gehry, the celebrated Canadian-born architect whose 76-story 8 Spruce Street residential tower was just completed in New York.


“These towers can become a symbol of what Toronto can be,” the 83-year-old Gehry said at project’s unveiling. “I am not building condominiums, I am building three sculptures for people to live in.”


Two weeks later, Oxford Properties Group, a Canadian developer with a $ 20 billion global real estate portfolio, announced a $ 3 billion makeover of the downtown convention center, just south of the Mirvish and Gehry project. It envisions a casino, two hotel towers and two office towers that would be among the tallest in the city.


Adam Vaughan, a city councilor whose district would encompass both projects, said a lot more planning is needed. He had kinder words for the Mirvish proposal — “it’s a transformative and astonishing proposal” — than for Oxford’s project, which he called “all out of proportion.”


“It’s time to have a really smart conversation about how we are building this neighborhood because there is a hell of lot of density arriving not just with this project but with all the projects that have been approved,” he said in an interview.


AT THE KIT KAT


Al Carbone, owner for the past three decades of the Kit Kat restaurant, doesn’t think people like Vaughan are listening to him, as the councilor and other politicians are not heeding the growing concerns about the rapid pace of development.


He said buildings are springing up too close to lot lines, creating jammed sidewalks and alleyways. And the sun does not shine on the streets like it once did.


He supports the Mirvish project, which would preserve his street, known as Restaurant Row. But he is battling a separate 47-story building that would go up steps away from his restaurant.


The plan, which still must be approved, would retain the historic facades of buildings on the street, which Carbone believes will destroy the character of the row.


“It’s a tough battle,” said Carbone, who launched the website SaveRestaurantrow.com to drum up support in opposition to the project. “You can’t have a condo on every corner.”


WHERE IS TORONTO HEADED?


Some believe Toronto is at a crossroads as developers, politicians and citizens debate the rapid changes the city’s urban landscape.


The Globe and Mail’s Marcus Gee dismissed the idea that the development was somehow bad for the city in a column in October, saying the condo boom “has transformed our once-pokey downtown into a vibrant, around-the-clock urban community.”


David Lieberman, an architect who also teaches at the University of Toronto’s architectural school, agrees the new developments have been good for the city, but he is not sure the city’s citizens are ready for it.


“We have such an excellent opportunity to get things right, but there is the Canadian conservatism,” Lieberman said, sipping coffee in his studio in an old downtown Toronto house. “Canadians in their city building are not risk takers.”


(Reporting By Russ Blinch. Editing by Janet Guttsman and Douglas Royalty)


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Newtown celebrates Christmas amid signs of mourning


NEWTOWN, Conn. - Newtown celebrated Christmas amid piles of snow-covered teddy bears and heaps of flowers as volunteers manned a 24-hour candlelight vigil in memory of the 20 children and six adults shot to death in the second-largest school shooting in U.S. history.


Well-wishers from around the country showed up Tuesday morning to hang ornaments on memorial Christmas trees, while police officers from around Connecticut took extra shifts to give local police a day off.


"It's a nice thing that they can use us this way," Ted Latiak, a police detective from Greenwich, Connecticut, said as he and a fellow detective came out of a store with bagels and coffee for other officers.


A steady stream of residents, some in pyjamas, relit candles that had been extinguished in an overnight snowstorm. Others dropped off toys and fought back tears at a huge sidewalk memorial filled with stuffed animals, poems, flowers, posters and cards.


In the morning, resident Joanne Brunetti watched over 26 candles that had been lit at midnight in honour of those slain at Sandy Hook Elementary School. She and her husband, Bill, signed up for a three-hour shift and erected a tent to ensure that the flames never went out throughout the day.


"You have to do something and you don't know what to do, you know? You really feel very helpless in this situation," she said. "My thought is if we were all this nice to each other all the time maybe things like this wouldn't happen."


Julian Revie played "Silent Night" on a piano on the sidewalk at the downtown memorial. Revie, from Ottawa, Canada, was visiting the area at the time of the shootings. He found a piano online and chose to spend Christmas Eve and Christmas Day playing for the people of Newtown.


"It was such a mood of respectful silence," said Revie. "But yesterday being Christmas Eve and today being Christmas Day, I thought now it's time for some Christmas carols for the children."


At a town hall memorial, Faith Leonard waved to people driving by and handed out Christmas cookies and children's gifts. She had driven from Arizona, at almost the other end of the country, to volunteer on Christmas morning alone.


"I guess my thought was if I could be here helping out, maybe one person would be able to spend more time with their family or grieve in the way they needed to," Leonard said.


Many residents attended Christmas Eve services and spent Tuesday morning at home with their families. Others attended church services in search of a new beginning.


At St. Rose of Lima Roman Catholic Church, which eight of the child victims of the massacre attended, the pastor told parishioners that "today is the day we begin everything all over again."


Recalling the events of Dec. 14, the Rev. Robert Weiss said: "The moment the first responder broke through the doors, we knew good always overcomes evil."


"We know Christmas in a way we never ever thought we would know it," Weiss said. "We need a little Christmas and we've been given it."


Police have yet to offer a theory about a possible motive for gunman Adam Lanza's rampage. The 20-year-old resident killed his mother in her bed before carrying out the massacre and killing himself.


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Boston Cop Rescues Drowning Woman






A Boston police officer is being hailed a hero after he jumped into the frigid cold water to rescue a drowning woman.


Cell phone video showed police officer Edward Norton plunging into Fort Point channel Friday afternoon during a torrential downpour to rescue the unidentified woman who’d reportedly fallen in by accident.






Norton, who just happened to be in the right place at the right time, says he didn’t think twice about jumping in.


“It just kind of happened. I saw here there. Someone had to do it,” Norton told ABC News. “As I was in the air, I was thinking I don’t know what’s under the water.”


Once in the water, Norton’s bullet-proof vest weighed him down, making the rescue more complicated than he anticipated. Onlookers did their part by tossing in a life preserver, which helped keep the frantic woman afloat.


“She kept saying stuff like, ‘I can’t hold on.’ So, I told her, ‘Hold on. Help is coming,’” Norton said. The officer remained with the woman in the water until firefighters arrived on the scene and pulled them both out of the water to safety.


Both were taken to local hospitals and checked for hypothermia, but were released with a clean bill of health.


As for the people calling Norton a hero, he says, not really because it’s all in a day’s work.


“I feel like I did what I would expect to do for one of my loved ones. My wife, my daughter, anyone,” Norton said.


While everyone made it out of the water safely with no injuries, there was one casualty so to speak. Norton says his wedding band slipped off when he hit the water and hero or not, his wife is none too pleased.


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Jessica Simpson’s Christmas gift: She’s pregnant






NEW YORK (AP) — Jessica Simpson‘s daughter has the news all spelled out: “Big Sis.”


Simpson on Tuesday tweeted a photo of her baby daughter Maxwell playing in the sand, the words “Big Sis” spelled out.






The 32-year-old old singer and personality has been rumored to be expecting again. The tweet appears to confirm the rumors.


“Merry Christmas from my family to yours” is the picture’s caption. Simpson used a tweet on Halloween in 2011 to announce she was pregnant with Maxwell. She is engaged to Eric Johnson and gave birth to Maxwell in May.


One possible complication regarding her pregnancy: She is a spokeswoman for Weight Watchers.


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Link between pot, psychosis goes both ways in kids






NEW YORK (Reuters Health) – Marijuana (cannabis) use may be linked to the development of psychotic symptoms in teens – but the reverse could also be true: psychosis in adolescents may be linked to later pot use, according to a new Dutch study.


“We have focused mainly on temporal order; is it the chicken or the egg? As the study shows, it is a bidirectional relationship,” wrote the study’s lead author Merel Griffith-Lendering, a doctoral candidate at Leiden University in The Netherlands, in an email to Reuters Health.






Previous research established links between marijuana and psychosis, but scientists questioned whether pot use increased the risk of mental illness, or whether people were using pot to ease their psychotic symptoms, such as hallucinations and delusions.


“What is interesting in this study is that both processes are going on at the same time,” said Dr. Gregory Seeger, medical director for addiction services at Rochester General Hospital in upstate New York.


He told Reuters Health that researchers have been especially concerned about what tetrahydrocannabinol (THC), the active property in pot, could do to a teenager’s growing brain.


“That’s a very vulnerable period of time for brain development,” and individuals with a family history of schizophrenia and psychosis seem to be more sensitive to the toxic effects of THC, he said.


A 2010 study of 3,800 Australian teenagers found that those who used marijuana were twice as likely to develop psychosis compared to teens who never smoked pot (see Reuters Health article of March 1, 2010 here:).


But that study also found that those who suffered from hallucinations and delusions when they were younger were also more likely to use pot early on.


CHICKEN v. EGG


For the new study, published in the journal Addiction, the researchers wanted to see which came first: pot or psychosis.


Griffith-Lendering and her colleagues used information on 2,120 Dutch teenagers, who were surveyed about their pot use when they were about 14, 16 and 19 years old.


The teens also took psychosis vulnerability tests that asked – among other things – about their ability to concentrate, their feelings of loneliness and whether they see things other people don’t.


Overall, the researchers found 940 teens, or about 44 percent, reported smoking pot, and there was a bidirectional link between pot use and psychosis.


For example, using pot at 16 years old was linked to psychotic symptoms three years later, and psychotic symptoms at age 16 were linked to pot use at age 19.


This was true even when the researchers accounted for mental illness in the kids’ families, alcohol use and tobacco use.


Griffith-Lendering said she could not say how much more likely young pot users were to exhibit psychotic symptoms later on.


Also, the new study cannot prove one causes the other. Genetics may also explain the link between pot use and psychosis, said Griffith-Lendering.


“We can say for some people that cannabis comes first and psychosis comes second, but for some people they have some (undiagnosed) psychosis (and) perhaps cannabis makes them feel better,” said Dr. Marta Di Forti, of King’s College, London, who was not involved with the new research.


Di Forti, who has studied the link between pot and psychosis, told Reuters Health she considers pot a risk factor for psychosis – not a cause.


Seeger, who was also not involved with the new study, said that there needs to be more public awareness of the connection.


“I think the marijuana is not a harmless substance. Especially for teenagers, there should be more of a public health message out there that marijuana has a public health risk,” he said.


Griffith-Lendering agrees.


“Given the severity and impact of psychotic disorders, prevention programs should take this information into consideration,” she said.


SOURCE: http://bit.ly/Rr63N8 Addiction, online December 7, 2012.


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Bolivia’s Morales visits Cuba after Chavez surgery






HAVANA (AP) — Bolivian President Evo Morales has made a lightning trip to Havana where key ally Hugo Chavez is convalescing after cancer surgery.


Morales did not speak to foreign journalists during his weekend visit. Cuban state-run media didn’t confirm that he visited Chavez, but said he came “to express his support” for the Venezuelan president. The Cuban government had invited media to cover Morales’ arrival Saturday and departure Sunday but withdrew the invitation with no explanation.






Photos released by Cuban media showed President Raul Castro greeting Morales at the airport in Havana.


Morales aides said Monday he planned to make a statement later about Chavez.


Chavez underwent on Dec. 11 his fourth cancer-related operation since last year, two months after winning reelection to a six-year term. Venezuelan officials say his condition is stable.


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