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Link Between Vitamin D Insufficiency And Bacterial Vaginosis In Pregnant Women
Bacterial vaginosis (BV) is the most common vaginal infection in US women of childbearing age, and is common in pregnant women. BV occurs when the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria. Because having BV puts a woman at increased risk for a variety of complications, such as preterm delivery, there is great interest in understanding how it can be prevented. Vitamin D may play a role in BV because it exerts influence over a number of aspects of the immune system. This hypothesis is circumstantially supported by the fact that BV is far more common in black than white women, and vitamin D status is substantially lower in black than white women. This relation, however, has not been rigorously studied. To assess whether poor vitamin D status may play a role in predisposing a woman to BV, Bodnar and coworkers at the University of Pittsburgh and the Magee-Womens Research Institute studied 469 pregnant women. The results of their investigation are published in the June 2009 issue of the Journal of Nutrition.
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Melanopsin And Sleep Modulation: A Bright Future For Light Therapy?
Light strongly influences human physiology and notably sleep regulation. An international team of scientists, including Patrice Bourgin from CNRS "Institut des neurosciences cellulaires et intç©gratives" in Strasbourg, has just published a detailed study in PlosBiology on the role of melanopsin, a molecule involved in mediating the effects of light on sleep. These scientists also revealed evidence of new interactions between the different mechanisms acting on the duration and quality of sleep and alertness.
News of the day
NICE Issues Positive Final Appraisal Determination Recommending The Use Of Basilea's Toctino
Basilea Pharmaceutica Ltd. (SWISS: BSLN) announces that the National Institute for Health and Clinical Excellence (NICE) issued the Final Appraisal Determination (FAD) recommending the use of Toctino® (alitretinoin) within its licensed indication, as a treatment option for adults with severe chronic hand eczema that has not responded to potent topical corticosteroids.
Cardiovascular

Addition Of Anaesthetic To Radioisotope Injection Reduces Pain In Patients Undergoing Sentinel Lymph Node Mapping For Breast Cancer

The addition of the anaesthetic lidocaine to radiocolloid injection for sentinel- lymph-node (SLN) mapping in patients with early breast cancer reduces injection pain and improves patient comfort without compromising SLN identification, and should be introduced as standard practice, concludes an Article published Online First and in the September edition of The Lancet Oncology. Sentinel-lymph-node (SLN) mapping and biopsy are used to determine how far cancer has progressed into the lymph nodes in early stage breast cancer. A radioactive colloid and/or blue dye are injected into the area of the tumour and follow the path that tumour cells are most likely to take from the tumour to the lymph nodes. The nodes that initially absorb the dye, the sentinel nodes, are removed and biopsied. Although shown to be effective, a radiocolloid injection is a painful procedure for which there is currently no effective pain management. To investigate methods of pain control, Alexander Stojadinovic from the United States Military Cancer Institute, Washington, USA, and colleagues conducted the first randomised trial to assess whether pH modification of the radioisotope formulation with sodium bicarbonate or addition of the anaesthetic lidocaine could reduce injection pain in patients undergoing SLN mapping. The authors assessed 121 patients with early stage breast cancer who were randomly assigned to receive either the standard topical 4% lidocaine cream and standard radiocolloid injection (28), or topical placebo cream and radiocolloid injection containing either sodium bicarbonate (31), 1% lidocaine (32), or sodium bicarbonate and 1% lidocaine (30). Immediately after the injection patients were asked to report the pain experienced at the time of injection using a pain rating scale and a pain intensity questionnaire. Overall, findings showed a significant reduction in pain reported in the two groups of patients whose injection contained 1% lidocaine, without significantly affecting the success of SLN identification. However, pH modification of the radioisotope solution showed no additional benefit compared with the standard preparation. Mean score on the pain rating scale (0=no pain and 10=most pain) was 6.0 for the standard care group, 4.7 for the sodium bicarbonate group, 1.6 for the 1% lidocaine group, and 1.6 for the sodium bicarbonate plus 1% lidocaine group. Mean pain rating intensity according to the questionnaire (0-78) was 17.5 for the standard care group, 15.4 for the sodium bicarbonate group, 4.6 for the 1% lidocaine group, and 3.4 for the sodium bicarbonate plus 1% lidocaine group. The authors conclude: "For centres that use standard radiocolloid injections for SLN mapping in patients with early breast cancerò€¦adding 1% lidocaine can significantly improve patient comfortò€¦and should be considered a new standard of practice." In an accompanying Reflection and Reaction comment, Hiram Cody from the Memorial Sloan-Kettering Cancer Center, New York, USA, praises the authors for addressing a problem which has been widely ignored by the surgical community and says: "All of us who use [radiocolloid injections]ò€¦are well advised to add lidocaine to our injection protocols; many patients will benefit." Link to article The Lancet Oncology


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