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How does summer affect the patients with heart disease?

If you have diabetes, dehydration also can occur when blood glucose is not under control. When blood glucose is elevated, this can lead to an increase in the body’s excretion of urine. To prevent dehydration drink plently of caffeine-free fluids such as water, seltzer, sugar-free drinks like iced tea, and lemonade. Limit your intake of alcohol. Store your blood glucose meter, strips and insulin in a cool, dry place. Do not store insulin in extreme temperatures. Never store insulin in the freezer, direct sunlight or in the car or in the glove compartment of the car. Examine your vial of insulin. Clear insulin (Regular, Humalog, Novolog, Apidra, Lantus, Levimir) should remain clear. NPH insulin should not have any clumping or “frosting” on the vials.

A high intake of trans fats could increase colon cancer risk, according to new research published in the American Journal of Epidemiology.

People who ate the most trans fatty acids were more likely to have pre-cancerous growths or polyps in their colons than those who consumed the least, Dr. Lisa C. Vinikoor of the University of North Carolina in Chapel Hill and colleagues found. “These results provide further support for recommendations to limit consumption of trans-fatty acids,” they conclude.

Trans fats are formed by processing vegetable oils to increase their shelf-life, and are found in many baked goods, crackers, snacks and other packaged foods. Eating them increases levels of “bad” LDL-cholesterol, and hence heart disease risk. US food producers are now required to list the amount of trans fat contained in their products, and health authorities recommend people avoid eating trans fats entirely.

While there has been little research on whether trans fats boost colorectal cancer risk, there are many possible ways that they could do so, for example by changing the normal balance of fatty or bile acids in the colon, Vinikoor and her colleagues say.

To investigate a possible link, they looked at 622 people who had colonoscopies at University of North Carolina Hospitals in 2001 and 2002. Study participants were interviewed about their diet, physical activity and other health issues within 12 weeks of having the screening test.

People in the top fourth based on trans-fatty acid consumption, most of whom took in 6.54 grams daily, were 86 percent more likely to have colon polyps than those in the bottom quartile for trans fat intake, for whom median intake was 3.63 g, the researchers found. There appeared to be a threshold effect, with no increased risk seen for people in the bottom three quarters of fatty acid consumption.

Among the 38.5 percent of study participants found to have colon polyps, average trans fatty acid intake was 4.97 g, while most consumed 4.12 g. Average intakes for people who were free of the colon growths was 4.42 g, while the median was 3.61 g.

These results suggest that consumption of high amounts of trans-fatty acid may increase the risk of colorectal polyps, the researchers write, adding that the findings also back current recommendations to limit trans fat intake.

Canadian researchers are challenging the widely held belief that flu shots help protect older people from potentially deadly diseases such as pneumonia.

While the researchers say the vaccine does protect against certain strains of influenza, its overall benefit seems to have been exaggerated by so-called observational studies that found a big reduction in “all-cause mortality” among older patients who’d gotten a flu shot.

The new research was expected to be published in the first September issue of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

For the new study, the researchers included more than 700 “matched” people 65 and older, half of whom had received a flu shot and half who had not. After compensating for a variety of factors that the researchers said weren’t considered or available in the earlier studies, the study authors concluded that any “all-cause mortality” benefit “if present at all, was very small and statistically non-significant and may simply be a healthy-user artifact that they were unable to identify.”

“While such a reduction in all-cause mortality would have been impressive, these mortality benefits are likely implausible. Previous studies were likely measuring a benefit not directly attributable to the vaccine itself, but something specific to the individuals who were vaccinated — a healthy-user benefit or frailty bias,” Dean T. Eurich, a clinical epidemiologist and assistant professor at the University of Alberta School of Public Health, said in a university news release.

Added the study’s principal investigator, Dr. Sumit Majumdar, an associate professor in the faculty of medicine and dentistry at the University of Alberta: “The healthy-user effect is seen in what doctors often refer to as their ‘good’ patients — patients who are well-informed about their health, who exercise regularly, do not smoke or have quit, drink only in moderation, watch what they eat, come in regularly for health maintenance visits and disease screenings, take their medications exactly as prescribed and quite religiously get vaccinated each year so as to stay healthy. Such attributes are almost impossible to capture in large scale studies using administrative databases.”

The Canadian researchers said their study has wide-ranging implications.

For instance, because the earlier studies showing mortality reductions were erroneous, “this may have stifled efforts at developing newer and better vaccines, especially for use in the elderly,” the study authors said.

And for policy makers, efforts directed at “improving quality of care are better directed at where the evidence is, such as hand-washing, vaccinating children and vaccinating health-care workers,” the authors concluded.

Characteristics of normal cells which are present long before any tumor appears may determine how virulent a particular cancer is going to be, new research suggests.

Such cells may travel early on to distant sites in the body, residing innocently there until certain cancer genes are turned on.

“It’s definitely conceptually very profound,” said Dr. Katrina Podsypanina, a senior research scientist at Memorial-Sloan Kettering Cancer Center in New York City. “Our data seems to point toward the inherent decision that is made when the tumor is formed whether it is highly malignant or not. Moreover, since the characteristic might be dependent on the normal cell status, one might imagine that they might be different between individuals.”

The study’s senior author is Harold Varmus, who won the 1989 Nobel Prize for his work in cancer genetics and later went on to become director of the National Institutes of Health.

The finding implies that treatments that only target malignant cells may not be effective.

So far, however, the findings have only been shown in mice, and the research involved certain processes that were imposed which wouldn’t normally occur in the human body.

“This does suggest that cells can sit for a long time, then be activated,” said Dr. Claudine Isaacs, director of the clinical breast cancer program at Georgetown’s Lombardi Comprehensive Cancer Center in Washington, D.C. “But these cells were injected into the circulation. Normal breast cells are not supposed to be in the circulation.”

Also, the normal cells didn’t form tumors until activated.

Conventional medical wisdom holds that the spread of a cancer occurs relatively late in the life of a cancer, happening only after cells from the primary tumor have undergone enough mutations to switch on different cancer genes.

Podsypanina and her colleagues performed a series of experiments in mice.

First, they injected normal mammary cells that contained cancer-inducing oncogenes, which could be switched on and off. These cells migrated through the bloodstream to the lungs, residing there for four months. They did not begin to grow aggressively until the oncogenes had been turned on, but they did so without first going through the stage of being a primary tumor.

Next, they injected normal cells without manipulating any oncogenes.

“Cells that did not have any oncogenes in them and do not transform spontaneously as per all published studies, we could see little colonies of these cells when we inspected the lungs,” Podsypanina said. “At no point, never, did we see a solid vision that would resemble metastatic colonies, [but] it appears that every time we looked at the animal, the colonies appeared to be larger.”

When these normal ectopic cells were injected back into a new generation of mice, they developed into normal mammary glands.

“It’s a beginning,” Podsypanina said. “It’s an important step to show whether or not the first step of the metastatic cascade is something a normal cell can accomplish.”