Day: 09/07/2013

Iodixanol produces less patient discomfort than iopamidol.

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A head-to-head comparison of contrast media for coronary CT angiography showed that patients experienced less discomfort after intravenous administration of iodixanol than with iopamidol, according to results presented at the American College of Cardiology (ACC) meeting.

Otherwise, the prospective, multicenter, randomized trial identified no major differences in the agents’ relative performances, according to principal investigator Dr. Reza Arsanjani, a cardiologist at Cedars-Sinai Medical Center. The study results were described during a poster session on March 11 at the ACC meeting in San Francisco.

The study involved 266 patients referred for invasive coronary angiography for suspected occlusive coronary artery disease. They were randomly assigned to groups that received coronary CT angiography (CCTA) enhanced with either iodixanol (Visipaque, GE Healthcare) or iopamidol (Isovue, Bracco Diagnostics). X-ray coronary angiography was used as a gold standard.

Previously published safety trials focused on the relative osmolality of iodinated contrast media, such as iso-osmolar iodixanol (290 mOsm/kg) and low-osmolar iopamidol (796 mOsm/kg) and their potential for contrast-induced nephropathy (CIN) in patients with diabetes and other high-risk conditions.

The Patients With Renal Impairment and Diabetes Undergoing Computed Tomography (PREDICT) study by Kuhn et al (American Journal of Roentgenology, July 2008, Vol. 191:1, pp. 151-157) and the Cardiac Angiography in Renally Impaired Patients (CARE) study by Solomon et al (Circulation, June 26, 2007, Vol. 115:25, pp. 3189-3197) showed that the two agents equally restrained CIN to about 4% of patients in high-risk groups.

Meanwhile, a 2006 meta-analysis, also by Solomon and colleagues, concluded that factors other than osmolality influence the pathogenesis of CIN for contrast media having osmolalities less than 800 mOsm/kg (Investigative Radiology, August 2006, Vol. 41:8; pp. 651-660). Iodixanol and iopamidol are both below those thresholds.

Arsanjani’s study focused on the relatively high iodine content of iopamidol compared to iodixanol. The distinction had no significant effect on the image quality of CCTA enhanced by the two agents. Based on a five-point Likert scanner, cardiologists determined that 92.5% of the iopamidol-enhanced images and 88% of the iodixanol-enhanced images were good or excellent, but the difference was not statistically significant (p = 0.38)

The clinical efficacy of the CCTA studies in the two arms of the trial was also equivalent. Iopamidol had a slight edge over iodixanol for sensitivity, at 87% versus 79%, but all other measures of accuracy and predictive value for the two agents were greater than 90%.

In terms of patient comfort, patients receiving iopamidol experienced a greater frequency of moderate-to-severe flushing symptoms compared to those who received iodixanol (p = 0.003). Iopamidol patients older than age 55 were especially susceptible (p = 0.015).

Iodixanol’s advantage, however, may be negated by a somewhat higher price, Arsanjani said. That difference may be large enough to sway the opinion of cost-conscious physicians.

“But if it were my mom, I would want the less symptomatic agent,”

 Source: AuntMinnie.com.

 

Radiation therapy may create breast cancer stem cells.

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When a breast cancer patient has a radiation therapy treatment, half of any residual tumor cells are killed. However, radiation therapy intended to cure patients may transform the other 50% into treatment-resistant breast cancer stem cells, according to an article published online February 10 in Stem Cells.

Radiation oncologists at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles have determined that radiation may induce a breast cancer stem cell phenotype in differentiated breast cancer cells and can regrow a tumor. The generation of these breast cancer stem cells counteracts the otherwise highly efficient radiation treatment, according to the study’s senior author, Dr. Frank Pajonk, PhD, an associate professor of radiation oncology.

Using nonbreast cancer stem cells sorted from patient samples, the research team discovered that ionizing radiation reprogrammed differentiated breast cancer cells into induced breast cancer stem cells. These showed increased mammosphere formation and increased tumorigenicity, and they expressed the same stemness-related genes as breast cancer stem cells from nonirradiated samples. The irradiated breast cancer cells were then placed in mice.

Pajonk said that the study unites the competing models of clonal evolution and the hierarchical organization of breast cancers, as it suggests that undisturbed, growing tumors maintain a small number of cancer stem cells. However, if “challenged” by ionizing radiation that can reduce the number of cancer stem cells, the breast cancer cells will generate irradiated breast cancer stem cells that, together with the surviving cancer stem cells, may repopulate the tumor.

“These findings have implications for the design of novel treatment protocols that target cancer stem cells,” the authors wrote. “Controlling the radioresistance of breast cancer stem cells, and the generation of new irradiated breast cancer stem cells during radiation treatment, may ultimately improve curability. It may also allow for de-escalation of the total radiation doses currently given to breast cancer patients, thereby reducing acute and long-term adverse effects.”

Finding Joy and Connection In-between Life’s “Big Moments”.

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“Enjoy the little things, for one day you may look back and realize they were the big things.” ~ Robert Brault

After realizing that the past seven months of my life seemed to have flown by, I knew it was time for me to focus on slowing things down.

In real-time, I’m sitting in a coffee shop overlooking the city of Cusco, Peru, wondering if my experiment in slowing down was a little drastic. I decided to take a month long break in Peru to do yoga and deepen my spiritual practice.

life-simpke-things

But something interesting happened. After being so excited for this trip, I landed in South America and immediately wanted to go home. I landed, saw the mountains from the plane and then my mind decided it was time to pack up and head back to my comfortable routines and fleeting moments of actually being present in my life.

“Living in the moment isn’t that important”, I tried to reason with myself.

But those initial feelings really revealed to me the importance of this trip. I’ve been addicted to busy. Addicted to a fast paced life, as if busy somehow meant I was being productive. All busy really meant for me was that I didn’t have to actually show up for my life.

I was certain my complete happiness was beautifully wrapped up in the future moment I finally finish my big writing project. Amongst all this future trippin’, I noticed my meditation practice slip to the back burner and watched as I took less and less time for my spiritual practice.

Deep down, I knew I needed this break in Peru no matter how hard it was going to be for me to slow down. I needed a drastic change. I needed to be away from everything and everyone I knew so I could clear my mind of expectations and really hear my Inner Guidance.

I think a lot of us spend most of our time focusing on the next big thing; going from one accomplishment to the next, without ever slowing down enough to feel the joy and satisfaction in achievement. We’re always hungry for more, and laser-focused on getting it sometime in the future.

What I’ve recently remembered in Peru is that joy and satisfaction is not “out there”. It’s not found in an accomplishment or another person. Joy is something you must choose to feel, and we can only make that choice when we are fully here. Fully in that often elusive and vulnerable present moment.

As I’ve been practicing slowing down and coming back to the present moment, I’ve had a major shift in perception about all the things I thought I wanted in life.

While reflecting on my past travel experiences and some of my most joyful memories, I realized that they were not the “big moments” and those big accomplishments I put most of my energy into.

The moments I felt most alive were all in-between the big ones that I thought would bring me the most satisfaction. It’s in those “small” moments that tend to have the greatest impact on me. So I guess those small moments really aren’t that small after all.

In fact, maybe if we can practice being present for the in-between moments, rather than focusing so much on future achievements, we can feel what we hope to feel in the future, right now.

“The present moment is filled with joy and happiness. If you are attentive, you will see it.” ~ Thích Nhất Hạnh,

Putting this idea to practice revealed to me one of the most beautiful experiences just walking down the cobble streets in Peru the other day.

I rounded the corner armed with my fast paced New York City walk on my way to a coffee shop to do some writing when I saw a little boy standing on the sidewalk crying. I could immediately sense he was really upset about something.

I watched as another little boy ran up to him, and instead of making the situation worse with cry-baby taunts, the boy just gave him a hug. He held the crying boy, letting him bury his face in his arms.

Then another little boy came up and joined the hug in the middle of the sidewalk. The three of them just stood there holding each other for several minutes while the boy cried. At this point, I was almost crying too.

What I witnessed was a beautiful display of vulnerability, compassion and love.

That instant in the street captivated me. I was fully there. And the moment occurred during the in-between. I was on my way from one event of the day to the next. Out of all my days in Peru so far, that moment has been one of my most cherished experiences.

Even though it may be hard to slow down at first, all the joy and connection we deeply crave can only be experienced in the present moment. And this is a practice. Ways I practice slowing down are yoga, becoming aware of my breath, putting down the cell phone at the dinner table, noticing the sensations in my body and the sounds and smells around me.

Are there moments I trail off into the future or the past? Of course. But like I said, this is a practice. Being fully present and engaged with the experiences and people around me is oh-so satisfying, and thankfully, experiencing that has nothing to do with achieving something in the future. Being fully present in your life equals being fully alive.

“Happiness is not something you postpone for the future; it is something you design for the present.” ~ Jim Rohn

What puts a smile on your smile, what makes you happy? Have you learned to appreciate and enjoy life’s simple pleasures? Share your insights by joining the conversation in the comment section bellow.

Source: purpose fairy.

How Negative Energy Affects Your Life and How to Clear It.

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 You know that like attracts like, right? So here’s the deal: Positive people are drawn to positive energy; negative people are drawn to negative energy. We tend to perceive negative energy as something other people have. Sure, sometimes we feel negative – as in, “go away and leave me alone, world!” but did you know that negativity can be so ingrained in you that it goes unnoticed? That’s because negativity sometimes wears a disguise called ‘reality’. It’s easy to rationalize that you’re ‘just being realistic’ in not daring to act on a dream – and believe it! You may assume that positive people are not being realistic – that they’re being naive, that they are in denial with their heads stuck in the sand, that they put on fake smiles in the face of difficulty and so forth. But are they really happy idiots or is there something to their positivity

 Consider this: since when does ‘being realistic’ necessarily mean that things will go wrong and that you have to accept that as the truth?

How Negative Energy Affects Your Life and How to Clear It

 That doesn’t mean that being realistic is automatically negative. When you view the world from a ‘realistic’ standpoint, you can’t help but be negative IF your version of reality is negative. If your version of reality is negative, you are conditioned to believe that whatever can go wrong, will go wrong and whatever can go right, will probably go wrong too. Your unconsciously held beliefs make you into a negative person without your being aware of it! So – if this negativity is so ingrained in you that you don’t notice it, how do you determine whether you’re stuck in a cloud of negative energy that is attracting the wrong people, wrong situations and wrong feelings? And how can you be sure you’re not perpetuating that negativity? Here’s a quick quiz to gauge the level of negative energy within you: – Do you complain? All the time or just sometimes? – Do you often discuss what’s wrong in the world more than what’s right? This includes the ‘terrible’ weather, ‘horrible’ traffic, ‘idiotic’ government, ‘lousy’ economy, ‘stupid’ in-laws, etc. – Do you criticize? All the time or just certain people? – Are you attracted to drama and disaster (can you unglue yourself from the TV when there’s a news story of a disaster and can you avoid getting involved in the lives of dysfunctional celebrities?) – Do you blame? All the time or just certain situations?

 Do you believe that you have no control over most of your results? – Do you feel like a victim? Do you talk about people doing things to you? – Are you grateful for what is or will you be grateful when things finally start going right for you? – Do you feel like things are happening to you? Or do you feel that they are happening through you? These last two points are important: If you’re not grateful except when things go right, you are negative. Gratitude is positive. If you are grateful for what is (including the unpleasant school of life lessons, then you can invite more and more positive energy into your life. Believing that things happen to you puts you in the role of victim; then it’s easy to be negative because it’s convenient to give up that power. So consider this alternative: who or what is to blame when GOOD things happen to you?

 Do you acknowledge that you are responsible for the good things – as in, you worked hard, you earned it, etc… but blame external events or other people for your failures? So how come, when good things happen, they are a result of what you do, but when bad things happen, they are not your fault? Nobody likes to hear that. It takes courage to accept that you create your life experience! If you answered yes to any of the above questions, you are holding on to negative energy to some degree! To clear your negative energy and raise your vibration, you will need to retrain yourself to choose a positive attitude. Here’s another interesting idea to consider: have you noticed that positive people seem to get what they want out of life, and even if things don’t go their way, they still enjoy their lives… while negative people whine and moan about their misfortunes and even the good things in their lives?

To clear negative energy, try this 3 -step process:

 1. Take ownership: “When you think everything is someone else’s fault, you will suffer a lot. When you realize that everything springs only from yourself, you will learn both peace and joy.” – the Dalai Lama

 2. Cancel negative thoughts and replace them with positive thoughts. This takes practice, dedication and making a decision to see the world through the eyes of “what can go right” instead of “what can go wrong.” You’ll have to catch yourself anytime you are acting out or speaking out your negativity, and immediately change your tune.

 3. Use the Love or Above Spiritual Toolkit to clear your energy and bring more light and love into your life; visualize the positive instead of getting sucked into negativity; overcome past conditioning; think intuitively from the soul instead from ‘reality’; create a new, desired reality in your imagination and manifest it in the outer world. Nobody wants negative energy to permeate their lives, yet many of us allow it. But we allow it unconsciously, based on past conditioning that suggests an inevitable outcome to certain situations. When you overcome that conditioning and realize that the future is NOT cast in stone but that you have more control over your circumstances than you believe – then you can begin to consciously design your life.

What’s going to happen then? Your positive energy will magnetically attract what you consider to be good and right for you: people, situations, things… and you’ll notice a huge, huge increase in your happiness and inner peace. Why not choose positive energy? Make some changes within, and you’ll quickly see positive changes in your life. Enjoy the good feelings and abundance!

Source: LoveorAbove