Association Between Colorectal Cancer Risk and Levels of Fat Cell Hormone

High plasma levels of adiponectin, an insulin-sensitizing hormone secreted by fat cells, are associated with a decreased risk of colorectal cancer, a new study has found.


Adiponectin concentrations are inversely associated with body fat (that is, people with higher amounts of body fat tend to have lower circulating levels of adiponectin), and low levels of adiponectin are associated with insulin resistance and hyperinsulinemia. To determine whether plasma levels of adiponectin are associated with the risk of colorectal cancer, Esther K. Wei, Sc.D., of the Channing Laboratory at Brigham and Women's Hospital in Boston, and colleagues compared the baseline plasma adiponectin levels of 179 men in the Health Professionals Follow-up Study who developed colorectal cancer with those of 356 men who did not develop cancer.


They found that men with the highest plasma adiponectin levels had a lower risk of developing colorectal cancer than men with the lowest plasma adiponectin levels. The inverse association remained even after adjusting for various measures of body fatness and other colorectal cancer risk factors. The authors conclude that more studies--particularly in women, who tend to have higher circulating levels of adiponectin than men--are needed to fully understand the relationship between adiponectin and carcinogenesis.


The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jncicancerspectrum.oxfordjournals.


Kate Travis

kate.travisoxfordjournals

Journal of the National Cancer Institute

jncicancerspectrum.oupjournals

HealthGrades Study: Bariatric Patients Have 65% Lower Chance Of Complications At Top Hospitals

Bariatric surgery patients treated at highly rated hospitals have, on average, a 65 percent lower chance of experiencing serious complications compared to patients who undergo surgery at poorly rated hospitals according to a study released by HealthGrades, the nations leading independent healthcare ratings organization. As part of the study, the quality ratings of hospitals performing bariatric surgery in 17 states have become available at healthgrades/.



HealthGrades' third annual Bariatric Surgery Trends in American Hospitals study, which evaluated bariatric surgical outcomes at every hospital that performed them in 17 states, also found that the complication rate for these surgeries continues to rise, increasing six percent from 2004 to 2006. One possible reason: lower volume facilities have higher complication rates.



Bariatric surgery is a general term describing several types of weight loss procedures. HealthGrades study analyzed the outcomes of the most common, including traditional open surgical gastric bypass procedures as well as newer, less invasive procedures such as "lap-banding" and laparoscopic gastric bypass.



Complications associated with gastric bypass surgery accounted for the highest rise in complications, increasing 17 percent. Comparatively, complications from less invasive laparoscopic surgery increased by just more than one percent. Complications associated with bariatric surgery include heart attack, kidney failure, stroke and post-surgical infections.



The HealthGrades study found a significant shift toward laparoscopic bariatric procedures. From 2004 through 2006, open gastric bypass procedures declined by 81.82 percent while during the same time period laparoscopic procedures increased 418.86 percent.



Meanwhile, the total volume of bariatric surgical procedures in the U.S. continues to grow rapidly. The American Society for Bariatric Surgery estimates that such surgeries have increased 1,431 percent in the last decade to more than 250,000 annually.



"The tremendous variation we are seeing in quality among bariatric surgery providers underscores the importance of readily available quality data to help consumers make a truly informed decision about where to seek care," said Rick May, MD, a senior physician advisor with HealthGrades and an author of the study.



Additionally, the third annual HealthGrades Bariatric Surgery Trends in American Hospitals study found that:
A typical patient having a bariatric surgical procedure at a five-star rated hospital in one of the 17 states studied has on average, a 65 percent lower chance of experiencing one or more inhospital complications than at a one-star rated hospital and a 41 percent lower chance than at a three-star rated hospital during 2004- 2006.















Five-star (top rated) hospitals performed almost twice the volume of procedures compared to 1-star and 3-star facilities - an average of 526 procedures from 2004 through 2006 compared with 266 and 283 respectively.


Higher volume was associated with fewer risk-adjusted complications. Facilities with an annual case volume of 125 procedures had the lowest risk-adjusted complications. Facilities performing less than 25 cases per year had the highest rate of risk-adjusted complications.


If all patients had received their bariatric surgery procedure at 5-star hospitals (from 2004 through 2006), 5,125 inhospital complications could have been potentially avoided in the 17 states studied.

HealthGrades Bariatric Surgery Ratings



HealthGrades' quality ratings for bariatric surgery at individual hospitals in 17 states were posted today to healthgrades/ as a free resource for consumers. Each hospital receives a star rating based on their patient outcomes for bariatric surgery. Hospitals with above-average outcomes receive a five-star rating. Hospitals with average outcomes receive a three-star rating, and hospitals with outcomes that are below average receive a one-star rating.



The study included a total of 154,451 bariatric inpatient surgery procedures performed in 680 hospitals in 17 states from 2004 through 2006. The majority of procedures were performed in four states: New York, Texas, Pennsylvania, and California.
93 hospitals stand out as "best" performers (5-star rated)


263 hospitals were rated as "as expected" performers (3-star rated)


99 hospitals were rated as "poor" performers (1-star rated)

Individuals contemplating bariatric surgery will find both quality and cost information at healthgrades/. In addition to the free hospital-quality ratings, Web site visitors can also research surgeons who perform bariatric surgery as well as medical-cost reports that detail all of the costs, including out-of-pocket expenses, for the procedure.



Methodology



For this study, HealthGrades analyzed 154,451 bariatric procedures performed in the years 2004, 2005 and 2006. The states included in the study are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Pennsylvania, Texas, Utah, Virginia, Washington, Wisconsin



To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression to account for age, gender and underlying medical conditions that could increase the patient's risk of mortality or complication. The full study and individual hospital ratings for bariatric surgery and other procedures can be found at healthgrades/.







About HealthGrades



Health Grades, Inc. (Nasdaq: HGRD) is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians. Millions of consumers and many of the nation's largest employers, health plans and hospitals rely on HealthGrades' independent ratings, advisory services and decision-support resources to make healthcare decisions based on the quality and cost of care. More information on the company can be found at healthgrades/.



HealthGrades Baratric Surgery Trends Study 2008



Source: Scott Shapiro


HealthGrades

Crohn's Disease - NPS To Advance Clinical Development Of Teduglutide As Treatment

NPS Pharmaceuticals,
Inc. (Nasdaq: NPSP) announced today that the company plans to advance the
clinical development of its experimental drug teduglutide based upon results
achieved in a Phase 2a proof-of-concept study of 100 patients with moderate to
severe Crohn's disease.


The four-arm, eight-week clinical trial compared three doses of
teduglutide delivered by daily subcutaneous injection to a placebo. The study
was designed to evaluate the drug's safety and potential efficacy in the
treatment of Crohn's disease. Overall, the study results showed a positive
and consistent trend toward efficacy and a dose response favoring the highest
dose group: 36.8% of patients receiving the highest dose of teduglutide
reached clinical remission (Crohn's disease activity index (CDAI) score of
less than 150 points) at week two versus 16.7% of the placebo group, while
55.6% of patients in the highest dose group reached clinical remission by week
eight compared to 33.3% of the placebo group. Teduglutide was well tolerated
with no serious adverse events related to the drug. The most common
treatment-related adverse event in the trial was redness at the injection
site. Study investigators plan to submit the trial results for presentation
at a future medical meeting.


Alan Buchman, M.D., a clinical investigator for the study and associate
professor and director of the IBD Center at Northwestern University's Feinberg
School of Medicine, said, "The results from this preliminary study are
encouraging and warrant further study of this novel agent alone or in
combination with other drugs as a potential new class of therapy for the
treatment of Crohn's disease. Remission rates of this magnitude at two weeks
and eight weeks are unusual in clinical trials and suggest that teduglutide
may play an important role in the management of this difficult-to-treat
disease."


Although the study was not powered to demonstrate statistical significance
and the primary end point (the percentage of patients who achieved remission
or at least a 100-point reduction from their baseline CDAI score at week 8)
was not met due to the relatively small number of study subjects and a high
placebo response, the company believes the high clinical remission rates seen
in patients receiving the highest dose of teduglutide support further
dose-ranging efficacy studies of teduglutide in patients with Crohn's disease.


Hunter Jackson, Ph.D., NPS chairman and CEO, commented, "We are pleased
with the results from this trial and the suggestion that some patients
demonstrated remission as early as two weeks into the study. The high placebo
response seen in this trial is not unusual in Crohn's disease. We plan to
conduct additional studies to confirm the efficacy response observed in this
trial and look forward to advancing this novel compound into later-stage
development this year as a promising treatment alternative in Crohn's
disease."















Teduglutide is a proprietary analog of glucagon-like peptide 2 (GLP-2), a
naturally occurring hormone that regulates the growth, proliferation and
maintenance of cells lining the gastrointestinal tract. A previous Phase 2
clinical study in patients with Short Bowel Syndrome showed that daily
subcutaneous injections of teduglutide resulted in significant growth of the
intestinal lining and improved dietary absorption of nutrients and fluids.
NPS is currently testing teduglutide in a pivotal Phase 3 study as a treatment
for Short Bowel Syndrome.


About Crohn's Disease


Crohn's disease is a chronic inflammatory bowel disease characterized by
inflammation of any part of the gastrointestinal tract and associated with
chronic morbidity. Crohn's disease affects nearly one million patients in the
United States and Europe.


Conference Call and Webcast Information


NPS will conduct a conference call today at 5:00 p.m. EST with Daniel
Present, M.D., clinical professor of medicine at Mt. Sinai School of Medicine,
to discuss the teduglutide study. To participate in the call, dial
800-299-7098 and use passcode 59474346. International callers may dial
617-801-9715 and use the same passcode. In addition, live audio of the call
will be webcast and may be accessed on the Investor Relations page, Calendar
of Events section of the company's website (npsp). The conference
call replay may be accessed by dialing 888-286-8010 (with passcode 42742393).
A replay for international callers can be accessed with the same passcode at
617-801-6888. Both the webcast and conference call will be archived until
March 6, 2006.


About NPS Pharmaceuticals


NPS discovers, develops and commercializes small molecules and recombinant
proteins as drugs, primarily for the treatment of metabolic, bone and mineral,
and central nervous system disorders. The company has one FDA-approved
product, one product candidate undergoing regulatory review for approval to
market in the U.S. and Europe, as well as other drug candidates in various
stages of clinical development backed by a strong discovery research effort.
Additional information is available on the company's website, npsp.


Safe Harbor Statement


Note: Statements made in this press release, which are not historical in
nature, constitute forward-looking statements for purposes of the safe harbor
provided by the Private Securities Litigation Reform Act of 1995. Such
statements include those regarding our expectation that teduglutide may be a
promising treatment alternative in Crohn's disease, our intention to advance
the clinical development of teduglutide into later-stage development this
year, and our intent to commercialize small molecules and recombinant proteins
as drugs. These statements are based on management's current expectations and
beliefs and are subject to a number of factors and uncertainties that could
cause actual results to differ materially from those described in the
forward-looking statements. Such risks and uncertainties include: future
clinicals may demonstrate that teduglutide is not safe and/or efficacious; we
may not be able to enroll patients in our clinical trials in a timely manner;
we may not be able to prepare and finalize clinical protocols in a timely
manner to commence additional clinical trials with teduglutide for Crohn's in
a timely manner; we may not be able to collect, analyze and report data from
our clinical trials in a timely manner; we may never develop additional
products that generate revenues; our product candidates may not prove to be
safe or efficacious; the FDA may delay approval or may not approve any of our
product candidates; current collaborators or partners may not devote adequate
resources to the development and commercialization of our licensed drug
candidates which would prevent or delay introduction of drug candidates to the
market. All information is as of February 27, 2006, and we undertake no duty
to update this information. A more complete description of these risks can be
found in our filings with the Securities and Exchange Commission, including
our Annual Report on Form 10-K/A for the year ended December 31, 2004 and our
Quarterly Report on Form 10-Q for the quarter ended September 31, 2005.


NPS Pharmaceuticals, Inc.
npsp

Consensus Document Outlines Practical Steps For Reducing Gastrointestinal Risks Of Antiplatelet And NSAID Use

The American College of
Cardiology in collaboration with the American College of Gastroenterology
and the American Heart Association released consensus guidelines
outlining a stepwise approach for reducing the risk of ulcers and
gastrointestinal (GI) bleeding among patients using nonsteroidal
anti-inflammatory drugs (NSAIDs) along with antiplatelet agents.



Gastrointestinal bleeding is a major and potentially life-threatening
complication for patients taking antiplatelet and NSAID therapy, according
to Deepak L. Bhatt, M.D., document co-chair and chief of cardiology, VA
Boston Healthcare System. Patients taking low-dose aspirin plus NSAIDs have
a two- to four-fold increased risk of gastrointestinal bleeding compared
with those not taking these medications.



NSAIDs - the most widely used class of medications in the United States
- can reduce fever, pain, and inflammation (swelling and redness). Some are
available over the counter (OTC), while others require a prescription. The
best-known NSAID is aspirin (which also acts as an antiplatelet agent).
Other common NSAIDs are ibuprofen, ketoprofen and naproxen.



Antiplatelet drug treatment, which reduces the blood's ability to clot,
is considered a cornerstone in cardiovascular prevention - preventing an
event (or subsequent event) in people with atherosclerotic disease. This is
usually accomplished by prescribing daily low-dose aspirin. Antiplatelet
agents (usually aspirin plus clopidogrel) are also recommended for patients
after receiving coronary artery stents to prevent dangerous clotting that
could cause a heart attack.



As more Americans survive and live with heart disease in addition to
conditions that require them to take NSAIDs (e.g., arthritis, inflammation
and related musculoskeletal pain), managing GI risk will become an
increasingly important part of cardiovascular care.



"Doctors are uncertain about how best to prevent bleeding complications
in patients receiving antiplatelet therapy and NSAIDs, which are both
commonly used, and can cause erosions in the stomach lining," said Dr.
Bhatt. "These recommendations represent the collective expertise of leading
cardiologists and gastroenterologists, as well as an extensive review of
the literature, and provide specialists with practical measures to manage
competing risks and help improve patient safety."
















"We must be more proactive in assessing individual patient risk to be
able to prevent gastrointestinal problems as antiplatelet therapy is
actually initiated," said David A. Johnson, M.D., immediate past president
of the American College of Gastroenterology and professor of medicine and
chief of gastroenterology at Eastern Virginia Medical School.
"Communication among cardiologists, gastroenterologists and primary care
physicians is critical. At the same time, patients must tell their doctors
about any and all medications they are taking-prescription and
over-the-counter medicines-so appropriate measures can be taken to reduce
risk."



In fact, according to a recent survey, 18 percent of patients failed to
report recent use of non-prescription NSAIDs, which greatly complicates
attempts to manage risk. Since GI problems may arise with few, if any,
symptoms (e.g., blood in stool, fatigue, abdominal pain), ongoing
monitoring is also important.



"The recommendations will help physicians evaluate the risk profile for
each patient and either change medications or provide appropriate therapies
to help reduce GI complications," said Elliot Anttman, M.D., a member of
the writing group and a professor of medicine at Harvard Medical School.



To reduce problems, providers must assess individual patient risk
factors for possible GI complications, including age, previous history of
ulcers or bleeding, presence of H. pylori (a common bacteria that
contributes to the development of stomach ulcers), dyspepsia or GERD
(gastroesophageal reflux disease or "acid reflux") symptoms, as well as the
simultaneous use of NSAIDs, anticoagulants and/or corticosteroids. The
presence of several risk factors further increases the possibility of
bleeding.



"We have an opportunity to work collaboratively to reduce the risk of
gastrointestinal problems to improve public health," says James Scheiman,
M.D., document co-chair and professor of medicine, Gastroenterology
Division, University of Michigan, Ann Arbor, Michigan. "There are
strategies to minimize or reverse GI injury, especially as many of the
medications become less costly as generics become available."



These recommendations are part of an ongoing dialogue between the three
collaborating organizations and, according to the authors, will be updated
as more definitive data are accrued. This document was developed by the
American College of Cardiology Foundation Task Force on Expert Consensus
Documents, which helps guide clinical practice in areas where rigorous
evidence may not be available or the evidence to date is not widely
accepted.



About the American College of Cardiology



The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The ACC is a 36,000-member
nonprofit medical society and bestows the credential Fellow of the American
College of Cardiology upon physicians who meet its stringent
qualifications. The College is a leader in the formulation of health
policy, standards and guidelines, and is a staunch supporter of
cardiovascular research. The ACC provides professional education and
operates national registries for the measurement and improvement of quality
care. For more information, visit acc.



About the American College of Gastroenterology



Founded in 1932, the American College of Gastroenterology (ACG) is an
organization with an international membership of more than 10,000
individuals from 80 countries. The College is committed to serving the
clinically oriented digestive disease specialist through its emphasis on
scholarly practice, teaching and research. The mission of the College is to
serve the evolving needs of physicians in the delivery of high quality,
scientifically sound, humanistic, ethical, and cost-effective health care
to gastroenterology patients. To learn more, visit acg.gi.



About the American Heart Association



Founded in 1924, the American Heart Association today is the nation's
oldest and largest voluntary health organization dedicated to building
healthier lives, free of heart disease and stroke. These diseases,
America's No. 1 and No. 3 killers, and all other cardiovascular diseases
claim nearly 870,000 lives a year. In fiscal year 2006-07 the association
invested more than $554 million in research, professional and public
education, advocacy and community service programs to help all Americans
live longer, healthier lives.


American College of Gastroenterology

acg.gi



View drug information on Ketoprofen.

Gastrointestinal Practice Issues National Challenge After Half Of Needy Patients Screened Show Polyps

As Washington policymakers debated health care reform on weekend talk shows, 48 people who are out of work or without health insurance received free colonoscopy screenings at Gastrointestinal Associates (GIA) here.


More than half of the group at the first "GIA Screening Colonoscopy Day" had polyps removed. One was Gloria Hutchison, 60, a Knoxville woman with no health insurance.


"I saw the sign at The Free Medical Clinic and knew I should do it," Hutchison said. "I have a family history of polyps. I am so glad I was able to do this; it's so important. They did find a polyp and removed it."


Polyps are typically benign, but a small percentage may contain a small area of cancer or develop into cancer. Colon cancer is the second most deadly type.


"More than half of the people screened today had polyps, and this is a higher percentage than in the population as a whole," said Dr. Bergein F. (Gene) Overholt of GIA. "This is a big step in the battle against colon cancer. It was a real privilege to serve this group of people."


GIA screened recipients referred by the InterFaith Health Clinic and The Free Medical Clinic of America, two Knoxville-based organizations that provide health care to those in need.


Overholt called on other U.S. gastrointestinal practices to replicate "GIA Screening Colonoscopy Day" to help those less fortunate and to make everyone aware of the need for colon screenings.


"The national health care debate has focused attention on the role of physicians and other health care professionals," he said. "I think this can be a great demonstration of the concern medical professionals have for the well-being of their patients."


Periodic colon exams are essential to preventing colon cancer, especially for persons age 50 or over. People with a family history of colon cancer may need to have the exam even earlier.


Of the 48 persons screened Saturday, a total of 25 had polyps removed and sent for testing, 16 women and nine men. Twenty-three had no polyps, 15 women and eight men.


Other screening sponsors include Anesthesia Associates of Knoxville, Mercy Health Partners, Premier Surgical Associates, The Endoscopy Center, GI Pathology of Memphis, Boston Scientific, Interactive Optics, the American Cancer Society and Braintree Laboratories Inc.


GIA is a leading gastrointestinal practice in the Southeast.

SOurce
Gastrointestinal Associates

Konsyl (REG) Original Provides More Fiber Per Dose Than Traditional Bulk Forming Laxatives

Konsyl Pharmaceuticals, Inc., a leading producer of high quality, all natural fiber supplements for improving digestive health, offers Konsyl® Original as a powder-form, natural fiber supplement and bowel normalizer. Providing more fiber per dose than traditional bulk forming laxatives, Konsyl Original includes 6.0 grams of primarily soluble 100% psyllium fiber per dose. Additionally, Konsyl Original is sugar and sugar substitute-free, and contains no other additives or chemical stimulants.


Gentle and non-addictive, Konsyl Original effectively regulates the bowel without damaging the colon. Konsyl Original contains only 3 calories* per dose and requires fewer daily doses than other products. Safe for pregnant women and patients on gluten-free diets, Konsyl Original also benefits diabetes management, and contains the soluble fiber that has been proven to lower cholesterol levels.


Konsyl Original is available in fine pharmacies and chain stores throughout the United States. Konsyl products can also be purchased online at konsyl.


*Available calories


About Konsyl Pharmaceuticals, Inc.


Konsyl Pharmaceuticals, Inc. produces high quality, all natural fiber supplements for improved digestive health. Konsyl products treat a variety of digestive issues, such as constipation, hemorrhoids, diarrhea, IBS and diverticular disease. For over 45 years, doctors have recommended 100% natural Konsyl products as a soluble fiber supplement for patients of all ages. The high fiber content of Konsyl products helps consumers to achieve dependable digestive health. Konsyl products are available in fine pharmacies and chain stores throughout the United States.


For more information on Konsyl Pharmaceuticals, Inc. or its complete line of products, contact a company representative at 800-356-6795, or visit the company's website at konsyl.

If You Feel Unwell Stay At Home - Infection Control Advice From Addenbrooke's Hostpial, Cambridge, England

Norovirus, also known as winter vomiting, is a typical seasonal bug which appears when the colder weather sets in. Symptoms usually last 48 hours and include diarrhoea and vomiting. To protect vulnerable patients, the hospital is asking visitors feeling unwell to stay at home.


Cheryl Trundle, senior nurse for infection control, said: "Addenbrooke's, along with other hospitals in the region, is seeing an increase in patients presenting with suspected viral diarrhoea and vomiting. This is an acute illness which may come on suddenly but is usually over within 48 hours.


"We would advise that if you are affected you stay at home, drink plenty of fluids and follow good hygiene practices including hand washing. If you have been unwell or are feeling unwell you should not visit until you have been free from symptoms for at least 48 hours. This is to protect vulnerable patients in the hospital."


Source

David Williams

Press & Media Manager

addenbrookes.nhs