June 2009 Mayo Clinic Health Letter Highlights Probiotics, Carotid Artery and Breast Cancer Treatments

ROCHESTER, Minn., July 7 /PRNewswire-USNewswire/ -- Here are highlights from the June issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit www.HealthLetter.MayoClinic.com or call toll-free for subscription information, 1-800-333-9037, extension 9771.

Probiotics: Bacteria That Offer Health Benefits

ROCHESTER, Minn. -- Not all bacteria are bad. Human digestive tracts are loaded with trillions of bacteria that aren’t harmful and can be beneficial or even crucial to health.

The June issue of Mayo Clinic Health Letter delves into probiotics -- foods and supplements that contain so-called friendly bacteria and what’s known about how they might benefit health.

Probiotics seem to change how the immune system reacts to invading microorganisms. They may compete with harmful bacteria or enhance the immune system. Also, they may help calm the immune system’s overreaction in ways not fully understood. And they may help restore or maintain proper bacteria balance in the intestines, which can be upset by antibiotics or invading microorganisms.

Well-done studies suggest that probiotics are effective in treating and possibly preventing diarrhea, caused by antibiotics or certain infections, or that occurs during travel. Strains of lactobacillus and Saccharomyces boulardii seem to be the most effective bacteria to treat diarrhea.

The evidence is less conclusive in other areas, such as whether probiotics might reduce symptoms of irritable bowel syndrome or prevent vaginal or bladder infections. But studies haven’t shown any harm in taking probiotics.

Probiotic supplements come in capsules, tablets and powders. While exact doses haven’t been determined, the general consensus is that a daily dose of about 10 billion colony-forming units is needed to provide benefits. Some foods contain probiotics, such as Dannon’s Activia, Yoplait’s YoPlus, fermented milk products such as Dannon’s DanActive, miso, tempeh, some juices, soy products and those containing kefir. While some foods naturally contain probiotics, the amounts probably don’t reach therapeutic levels.

Consulting a physician before starting probiotics is always a good idea. The care provider can offer recommendations on appropriate probiotic strains for specific health conditions as well as recommendations on reputable suppliers.

Multiple Treatments Available When Carotid Arteries Are Blocked

ROCHESTER, Minn. -- The brain needs blood to function, and any blockage in the carotid arteries -- blood’s primary pathway to the brain -- requires medical treatment.

Carotid artery blockages are serious. More than half of the strokes in the United States are attributed to carotid artery disease. But, according to an overview of carotid artery stenosis in the June issue of Mayo Clinic Health Letter, not all people with carotid artery disease need surgery or stents to open blocked arteries. The best treatment option depends on the extent of the blockage and whether patients have experienced symptoms as a result.

The carotid arteries run up both sides of the neck. With age, they become more prone to damage and less elastic. Damage that occurs on the inner layers of the arteries allows plaque to build up in a process call atherosclerosis. The changes result in narrowing of the arteries, restricting blood to the brain. Symptoms of a blockage -- and warning signs of stroke -- can include:

Any of these conditions indicate a possible stroke and warrant immediate medical attention, even if the symptoms disappear. A doctor can evaluate the health of the carotid arteries with imaging studies and by listening to the blood flow, which has a swooshing sound when there’s a partial blockage. Treatment options include:

Lifestyle changes and medications: This is typically the approach when blockage is less than 60 percent, and no symptoms of stroke are apparent. The goal is to slow the atherosclerosis through exercise, stopping smoking, losing weight if needed, and eating a healthful diet.

In addition, aspirin or blood-thinning medication can reduce the risk of blood clots.

Carotid endarterectomy: This procedure is the most common surgical treatment for severe carotid artery disease. The surgeon makes an incision in the neck, opens the carotid artery and removes the buildup of plaque. When this procedure is performed by an experienced surgeon, the risks are low, even for otherwise healthy patients age 80 or older.

Balloon angioplasty and stent placement: This procedure is an option for patients at high risk for carotid endarterectory. Patients may be precluded from surgery because of the location of the blockage, severe heart or lung disease or kidney disease.

During angioplasty, the surgeon threads a long, hollow tube through the groin artery up to the narrowed carotid artery. A tiny balloon is inflated to open the blockage, and a stent is placed there to keep it open. Large studies are under way to determine if angioplasty might be safe and effective for a larger percentage of people with carotid artery stenosis -- not just those at high risk for carotid endarterectomy.

Researchers Finding New Ways to Prevent, Diagnose and Treat Breast Cancer

ROCHESTER, Minn. -- Breast cancer is the most common cancer specific to women. An eight-page “Special Report” on breast cancer in the June issue of Mayo Clinic Health Letter covers recent advancements in prevention, detection and treatment.

Overall, breast cancer survival rates are among the highest of all cancers, and the number of deaths is declining. Nearly 89 percent of women diagnosed with breast cancer live for at least five years after treatment. Still, 40,000 Americans died from this cancer last year. Here are some advancements making a difference in breast cancer outcomes:

Prevention: Healthy lifestyles reduce the risk of breast cancer. Studies have shown that women who exercise about 30 minutes three or four times a week can decrease their breast cancer risk by about 26 percent. A study published in the Journal of the American Medical Association concluded that women who lost 22 pounds after menopause reduced their risk of developing breast cancer by 45 percent.

Other studies have shown that women who drink one to two alcoholic drinks a day increase their risk of breast cancer by 10 percent. That risk jumps to 30 percent when women consume three or more alcoholic beverages a day.

Screening: Mammography is still the standard of care for screening and remains the only screening test shown to decrease the chance of dying of breast cancer. But recently, several cancer organizations have recommended that women who are at very high risk of developing breast cancer also undergo magnetic resonance imaging (MRI) annually. This technique uses a magnet and radio waves to create detailed two-dimensional images. It’s especially helpful in evaluating abnormalities in women with dense breast tissue and for those who have other risk factors, including:

However, MRIs aren’t for everyone and are not recommended for routine screening. They are expensive, require an intravenous injection of a contrast agent, and have a high rate of anxiety-producing false-positives.

Treatment: Testing the genetic makeup of a tumor can help determine which women are at the highest risk of recurrence and which of those are more likely to benefit from chemotherapy. Conversely, women at lower risk can avoid unneeded treatment.

Researchers are looking at changes in radiation, too. They are finding that shorter-course radiation may be effective for patients with early-stage cancer and no lymph node involvement.

Post-cancer treatment: For some breast tumors, patients typically take the estrogen blocker tamoxifen after treatment. It reduces the risk of recurrence by about 50 percent. But this therapy doesn’t work well for 8 to 10 percent of women -- those who have an inactive variant of the CYP2D6 enzyme. Now, genetic markers from the blood can determine which women most likely would -- or wouldn’t -- benefit from tamoxifen. Other effective treatment options are available for women with the variant CYP2D6 enzyme.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.

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