At study entry, the history of 72 patients, 51 patients were had neurologic asymptomatic without receiving corticosteroid and 21 patients were had symptomatic with stable doses of corticosteroids.

At the end of assessment, the disease control in the asymptomatic patients showed in 9 patients (18%) and 24% for the brain alone, whereas in the symptomatic patients showed in 1 patients (5%) and 10% for the brain alone.

They also added that the survival rate for long term effect in both groups was about 33% at 1 year (similar with advance melanoma patients without brain metastases), 26% of survival rate in asymptomatic patients at 2 years and 10% of survival rate in symptomatic patients.
For median overall survival in asymptomatic patients was 7 months and 3.7 months in asymptomatic patients.

Furthermore, those who survived and clinically stable at week 24 (11 asymptomatic patients and 2 symptomatic patients), they received maintenance therapy with a 6 to 7 doses of 10 mg/kg ipilimumab every 12 weeks

Since advance melanoma patients with brain metastases were excluded in clinical trials rather than without brain metastases, the lead of study author, Kim Margolin, MD, from the University of Washington in Seattle, and colleagues concluded that their trial showed similar effects of ipilimumab in both with and without brain metastases.

They write on the paper published in the Lance Oncology on March 26, 2012, “Overall, our trial shows that the activity of ipilimumab is similar in patients with advance melanoma with and without brain metastases.”

For adverse effects, the study found similar effects to previous study among advance melanoma patients without brain metastases, such as diarrhea, fatigue, dehydration, hyperglicemia, rash, and raised liver enzymes.
Only 1 patient died from drug-related complications of immune-related colitis, despite treatment with corticosteroids.

The study funded by drug maker, Bristol-Myers Squibb, and some of authors are company employees.

The researchers from Iran said that supplementing diclofenac suppositories with intravenous papaverine showed effectively relieve the pain of renal colic.

This outcomes obtained after they conducted randomized trial of 550 patients suspected with renal colic received diclofenac (100 mg) alone or diclofenac sodium suppository with intravenous of either 1.5 mg/kg papaverine hydrochloride or saline.

According to the findings published in BJU International on February 20, 2012, 91% of diclofenac-papaverine group reduced analgesia (25 mg pethidine IM) use compared with 71% of diclofenac monotherapy group.

However, some adverse events reported dizziness in diclofenac-papaverine group which was managed conservatively.

Overall, the study authors, Dr. Ali Hamidi from Gulian University of Medical Sciences and Razi Hospital and colleagues concluded, “we suggest that IV papaverine hydrochloride may be a useful supplemental therapy for renal colic with no serious side-effects especially combined with NSAIDs,” although further studies needed to confirm their findings since the subjects categorized as renal-colic-suspected.

Recent study conducted by researchers from Iran found that both those medications highly effective in curing scabies patients after several weeks with 1-week interval.

According to their findings published in the Journal of Dermatology on March 5, 2012 (ref), the rate in curing Scabies were 85.9% with single dose of oral Ivermection after 2 weeks of treatment and increased to 100% at 4 weeks post-treatment, while curing scabies with permethrin cream (2 applications with 1-week interval) offering 92.5% in curing rate at 2 weeks post-treatment.

This findings obtained after they studied 272 patients with scabies which is half of them received 5% permethrin cream and others with oral ivermectin during April 2008 to April 2011 at Sina Hospital in Tabriz, Iran.

The study authors, Mohamad Godlbust, MD, from Tabriz University of Medical Sciences, Iran, and colleagues said that both of oral ivermection and topical application of permethrin showed its efficacy in treating scabies patients.

However, based on 4 guidelines developed by other professional organizations such as the American Cancer Society, US Multi-Society Task Force on Colorectal Cancer, American College of Radiology, and Institute for Clinical Systems Improvement, the ACP recommends the following:

- Clinician should perform individual CRC risk evaluation in all adults. Risk factors for CRC incidence and mortality include older age, black race, personal history of polyps, inflammatory bowel disease, CRC, and family history of CRC.

- Clinicians should screen for CRC in adults at average risk beginning at 50 years of age, and in adults at high risk beginning at 40 years of age or at 10 years younger than the age at which the youngest affected relative was diagnosed with CRC.
In these populations, the potential benefits of reduced mortality from earlier detection of CRC outweigh the potential harms of screening.

- Patients at average risk may undergo CRC screening with a stool-based test, flexible sigmoidoscopy, or optical colonoscopy.
Patients at high risk should undergo screening with optical colonoscopy. The benefits, harms, and availability of the specific screening test, as well as patient preferences, should affect choice of screening test.
For adults older than 50 years who are at average risk, the recommended screening interval is 10 years for colonoscopy, 5 years for flexible sigmoidoscopy, virtual colonoscopy, double contrast barium enema, and annually for fecal occult blood test.

- Clinicians should stop CRC screening in adults older than 75 years or who have a life expectancy of less than 10 years because the potential harms of screening outweigh the potential benefits. Risks of colonoscopy include bleeding, intestinal perforation, and adverse reactions related to preparation for the procedure.

In a news release, ACP President, Virginia L. Hood, MBBS, MPH, FACP, said, “we encourage patients to engage in shared decision making with their physician when selecting a screening test so that they understand the benefits and harms.”

She added that successful screening is dependent on the appropriate testing and follow-up patients with abnormal screening results as well as following up with patients for repeat testing at designated intervals.

However, those suggestion may not completely right as current findings found that those link was failed in reducing fractures risk in sport injury due to exceed capacity of stresses on the bone. In fact, Calcium increase that risk.

Surprisingly, the risk of stress fracture was reduced by high intake of vitamin D.

In other words, Vitamin D is beneficial for bone health to those who have active exercise than Calcium.

This findings obtained after the researchers analyzed data of the Growing Up Today Study on 6712 preadolescent and adolescent girls aged 9-15 years at the baseline.

Published in the Archives of Pediatrics & Adolescent Medicine on March 5, 2012, the study authors, Kendrin R. Sonneville, ScD, RD, from LDN Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, and colleagues said that high vitamin D intake lower stress fracture risk in girls and Calcium or calcium-rich dairy products intake have no effect in reducing the risk which actually increase the risk.

Although, the study using self-report in responding to their survey questions that may have bias results, but since it is involved large respondents, this should be confirmed to further studies.

The hazard ratio of Calcium intake in increasing stress fracture risk already adjusted for age, body mass index, age at menarche, and maternal history of low bone density or osteoporosis.
In addition, The mother of this preadolescent and adolescent also involved in the Nurse’s Health Study.

Several studies have investigated the adverse effects of BPA, especially those related to coronary heart disease (CHD). However, the final results of the study still needs further study to confirm the relationship.

Recent study adds more evidences regarding to negative effect of BPA exposure, especially in food packaging to heart disease risk.

According to the findings published in Circulation on February 21, 2012, BPA exposure indicated through high concentration in urination is associated with an increased risk of developing coronary artery disease.

By using 10-year follow-up of the UK EPIC-Norfolk cohort study, people exposed with BPA was not only from food and drink packaging in form of polycarbonate, but also to drinking water, dental sealants, exposure to the skin, and inhalation of household dust.

The study authors, Dr. David Melzer from Peninsula College of Medicine and Dentistry, Exeter, UK, and colleagues said that an increased of 11% of CHD risk were addressed to BPA exposure in UK.

Although this rate is lower than NHANES data that suggested 30%-40% of increase risk of CHD each standard-deviation increase in BPA concentration, in UK however, the BPA concentration much lower than the US study (1.3 ng/mL in UK and 2.7 ng/mL in US).

Despite of difference concentration levels between US and UK studies, while also urine sample in recent study just took only one with a 10-year follow-up, this showed that BPA exposure significantly increase the risk of heart disease in long-term use.

The study authors hypothesized the mechanism behind this scene that BPA binded by estrogen receptor. As the results, while supported by laboratory studies, this can induce damages of liver and oxidative celluler, disrupting in pancreatic cell function, and leading to obesity risk. Thus, all of those effects leads to CAD risk.

Meanwhile, since BPA also found in polycarbonate which purposed to make certain plastics more resilient (such as reusable drink bottles), therefore, warming foods in hard plastic-containers containing polycarbonate should not be practiced.

While previous studies showed complicating results where is European studies mostly indicated positive effect between PPIs and SIBO, but US studies mostly indicated negative effect; which is suggesting dietary factor may influence the outcomes, lack of standard test to diagnose SIBO, and various duration and dose of PPIs use, current studies used patients with chronic acid suppression therapy that would be expected to increase the potential for an abnormal glucose hydrogen breat testing (GBHT), a testing of breath sample for hydrogen (H2) and methane (CH4) to determine the positivity of SIBO.

Reported in the American Journal of Gastroenterology on February 14, 2012, there is no significant differences between once daily vs. twice daily PPI used to positive GHBT based on 4 criteria.
The criteria in this study include:
1. An increase in H2 greater than 20 parts per million (ppm) over baseline.
2. A sustained increase in H2 greater than 10 ppm over baseline.
3. CH4 greater than 15 ppm over baseline.
4. Both increase in H2 and CH4 over baseline (20 ppm and 15 ppm. respectively).

Thus, the suggestion of ‘No Link’ between PPIs and SIBO remain strong after adjusting for other potential confounding factors such as age, body mass index, diabetes, irritable bowel syndrome, and laxative/anti-diarrheal use.

The limitation of current study is the retrospective design, with its inherent issues of confounding and not including duration of PPI use.

However, some side effects of this therapy also needs to watch out for early prevention. While may causes life-threatening in patients with certain medical conditions, recent study also indicated if ICM may also lead to increased production of thyroid hormone due to hyperthyroidism development.

Side effects of ICM to hyperthyroidism risk was discovered after researchers from Harvard Medical School in Boston performed a nested case-control study of adult patients who were euthyroid at baseline and who were exposed to ICM from the Partners HealthCare research Patient Data Registry between January 1990 and June 2010.

According to their findings published in the Archive of Internal Medicine on January 23, 2012, ICM exposure to patients received cardiac catheterization linked to higher risk of hyperthyroidism incidence, overt hyperthyroidism, and overt hypothyroidism.

One of study authors, Connie Rhee, MD, noted that this finding should be an important reference for physicians before administration of ICM due to prolonged effect of hyperthyroidism to cardiovascular patients and survival rate.

Despite these patients may have less intake of iodine in their diet that leading for such risk, early diagnosis whether patients at risk of hyperthyroidism may helpful before performing ICM.

This is because based on the results of community-based study of the Framingham Heart Study (FHS) offspring which is involved 1297 participants were relatively young found that those who have a history of parental stroke associated with higher white matter hyperintensity volume at baseline, baseline performance of visuospatial memory, more likely in the highest quintile of increases in the volume of white matter hyperintesities, and worsening executive function, compared to those without parental history of stroke both in paternal and maternal.

The findings just presented at the International Stroke Conference 2012 of American Stroke Association held on February 1, 2012.

According to the study authors, this finding may have significant improvement in preventing risks of stroke and dementia by performing magnetic resonance imaging (MRI) or other procedures in this population due to parental history of early stroke.

In addition, while suggesting early treatment for those risks, some lifestyle modifications can be helpful recommendation for those who are vulnerable and prone to changes in brain structure and cognitive dysfunction.

There are various foods for probiotics. However, recent study from researchers at the Hospital Santa Catarina, Sao Paulo, Brazil, said that good bacteria of Lactobacillus paracase, L. rhamnosus, L. acidophilus, and Bifidobacterium lactis with their food of Fructo-Oligosaccharides showed significantly improved bowel movement of their patients with chronic constipation compared to placebo groups.

From a study period (4 weeks), every 2 weeks of observation, the probiotics + food groups showed higher in bowel movement improvement compared to placebo groups, which is 0.64 vs. 0.42 in second week and 0.67 vs. 0.42 in fourth week (respectively).

This seems validate claim of folk medicine that probiotics is the best treatment for constipation, even to chronic levels. To find a complete characteristics of best probiotic supplement, you may see in this page.
The results of study also presented at the American Society of Parental and Enteral Nutrition annual meeting held on January 2012.