WEDNESDAY, May 22 (HealthDay News) -- Physicians weighing the benefits and risks of CT scans for detecting lung cancer now have more information to help with the decision. A new analysis of a 2010 U.S. study finds that low-dose CT scans pick up significantly more lung tumors than chest X-rays do.

People with a long history of smoking are at high risk for lung cancer, the deadliest form of cancer in the United States. But doctors have to consider the potential harm of radiation exposure when ordering screening. The initial 2010 trial suggested that the low-dose CT scans can save lives, but they're not yet routine and insurers typically don't pay for them.

"There's a whole bunch of stuff that has to be worked out," said Dr. Norman Edelman, chief medical officer of the American Lung Association. This includes the prospect of expanding screening to a wider group and relying on radiologists less experienced than those who reviewed the lung scans in the initial study.

Already, some medical centers are offering CT lung scans below cost, at $200 or $300, apparently in the hope that they'll recoup their loss by detecting suspicious nodules in the lungs of patients, he said.

About 158,000 people die from lung cancer in the United States each year, often because it's detected too late for effective treatment. The new analysis of the 2010 study indicated that by identifying malignancies sooner, low-dose CT scans will reduce the death tally.

Who should get screened is a question that must be addressed, said Dr. Otis Brawley, chief medical officer and executive vice president of the American Cancer Society. "Everyone wants to jump toward screening as an answer," Brawley said.

The initial study involved 53,000 current and former heavy smokers, aged 55 to 74, who underwent a CT scan or chest X-ray every year for three years, starting in 2002.

By 2010, the death rate among those who got the CT scans was 20 percent lower than for those who got X-rays.

CT scans revealed potential signs of cancer in 27 percent of those scanned, compared to 9 percent of people who got X-rays, the researchers found. In both groups, about 91 percent had at least one more test.

Most of those suspicious spots and nodules weren't actually cancerous.

After follow-up, lung cancer was diagnosed in 1.1 percent of the patients in the CT group and 0.7 percent of the X-ray group, the researchers reported in the May 23 issue of the New England Journal of Medicine.

The CT scans were much more likely to pick up lung cancer in its early, more treatable stages: stage 1 cancer was found in 158 CT scan patients versus 70 X-ray patients, according to the study.

Brawley said, however, that screening comes with a price, and not just the cost of the scans, which can be expensive. About 1 percent of cancers are thought to be caused by radiation used in medicine, he said. That raises the prospect that some people will develop cancer because they've been scanned for it.

Patients may still decide that cancer screening is appropriate, Brawley said. "We support those who understand the benefits and risks and want to get screened," he said.

"[However], stopping smoking still provides a lot more bang for the buck," he said. "Don't look to lung cancer screening as a great Shangri-La."

Preliminary research presented Tuesday at the American Thoracic Society meeting in Philadelphia found that in a smaller group of smokers and former smokers, 6 percent who underwent low-dose CT scans had lung cancer detected.

More information

For more about lung cancer, see the U.S. National Library of Medicine.

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WEDNESDAY, May 22 (HealthDay News) -- The success of an imaginative and resourceful device used to save an infant born with a serious airway malformation sheds light on new technology created by the marriage of bioengineering and surgery.

A report in the May 23 New England Journal of Medicine describes the situation that sparked the innovation.

At first, the baby born five weeks early seemed perfectly healthy, but he began to have difficulty breathing and eating when he was 6 weeks old. Just two weeks later, his symptoms became so severe he needed a ventilator to breathe.

After a thorough work-up, the news was not good -- the baby had an unusual combination of problems. The arteries going from his lungs to his heart were crisscrossed, and one was unusually big. Part of his aorta, the largest blood vessel in the body, was compressing his left bronchus, one of two of the major branches of the trachea that lead to the lungs.

But the infant's worst problems weren't the blood vessels: The life-threatening issue was having an airway that couldn't stay open on its own.

Called tracheobronchomalacia, the condition occurs when airway walls are so weak they collapse almost like a wet paper towel, during breathing or coughing. In the baby's case, the simple act of breathing was causing his airways to regularly collapse, stopping his heart and breathing, and requiring frequent cardiopulmonary resuscitation (CPR).

"It was scary; I've had children die from similar problems before," said Dr. Glenn Green, a report co-author and an associate professor of pediatric otolaryngology at the University of Michigan Health System.

Tracheobronchomalacia is rare, affecting about 2,000 children in the United States, according to Green.

Green worked with Scott Hollister, also at the University of Michigan, who has a background in bioengineering, to custom-design an airway splint to allow the baby to breathe effectively.

Almost like creating a custom-made suit from a detailed digital photo, the physicians built a corrective implant -- an airway splint -- to precisely fit the baby's particular anatomical circumstances. The splint was designed to be placed in the body but outside the airway, like a lobster's exoskeleton, which provides needed external support.

The researchers designed the splint from a computer image of the baby's airway and fabricated it using laser-based 3-D printing.

"CAT scans and MRIs are of a detail now where we can take the information from those pictures and put it into a computer to make a 3-D model of what [problems] a child has, and create a solution for those problems, combining engineering and surgical knowledge," Green said.

The splint -- which was created in less than 24 hours -- has the consistency of a vacuum hose -- it's tough but flexible, Green said. It is made of polycaprolactone, a biodegradable polyester.

The biodegradable feature is important because, as the baby grows, the tracheobronchomalacia will most likely get better, explained Dr. Kristina Rosbe, a professor of otolaryngology and pediatrics at the University of California, San Francisco, who was not involved with the case. "It means you won't have to go in later and take it out."

The fact that the device is outside the bronchus is also a bonus, because internal splints that are available now can create narrowing of the airway and bleeding, Rosbe added.

The custom splint is expected to gradually disintegrate after about three years, according to the physicians.

After constructing the airway splint, the physicians got emergency permission from the U.S. Food and Drug Administration to use the device. They then performed surgery to repair as much of the deformities as possible, and stitch the splint in place around the left bronchus.

The baby has done well, Green said. "It took about a month for his body to get used to breathing, but he never coded [had his heart or breathing stop] after the splint was placed." The physicians have started a clinical trial testing the airway splint design system that they expect will be completed in about two years, he said.

One expert noted that while tracheobronchomalacia is rare, the solution discussed in this research report will have a huge impact on the infant involved.

"A child like this is probably going to have a completely normal life if it wasn't for this problem, so that's a really big step and very inspirational," said Dr. John Bent, director of pediatric otolaryngology at the Albert Einstein College of Medicine, in New York City.

Is this designer splint an example of personalized medicine?

For her part, Rosbe said, "It's absolutely the wave of the future. It makes me think of all the work they're doing with cancer therapies now, taking individual patient's cells and blood and tailoring treatment to their particular needs. Once you've got the system in place to make [the creation of the airway splint] easier, if you've got the hardware, you'll be ready to go."

More information

Learn more about tracheobronchomalacia from the U.S. Office of Rare Diseases Research.

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WEDNESDAY, May 22 (HealthDay News) -- Children and teens exposed to radiation during CT scans are 24 percent more likely to develop cancer, according to a large, long-term study.

The risks, however, are still low: Among a group of 10,000 young people who each had one CT scan, only about six extra cancers would be expected to occur within 10 years, according to researchers from Australia and Europe.

The researchers said doctors should carefully weight the risks to patients when making decisions about CT (computed tomography) testing. The study was published online May 21 in the journal BMJ.

The researchers used data from Australian Medicare records and national cancer records to compare cancer rates among patients who had a CT scan by age 19 to those who had never undergone the test.

The study involved nearly 11 million young people born between 1985 and 2005. The average length of follow-up for those who underwent a CT scan was 9.5 years, and about 17 years for those who did not have a CT scan.

Of the participants, about 680,000 had a CT scan at least one year before they were diagnosed with cancer. Among those diagnosed with cancer, 18 percent had more than one scan.

By the last follow-up in 2007, the researchers found that 3,150 of those who had a CT scan and about 57,500 of those who didn't had been diagnosed with cancer.

After taking the participants' age, gender and year of birth into account, the rate of cancer was 24 percent higher among those who had a CT scan. That risk increased by 16 percent for each additional scan.

Nearly 60 percent of CT scans involved the brain, according to a BMJ news release. Although the prevalence of brain cancer among those who had a CT scan decreased over time, the study authors found that the incidence was still higher more than 15 years after they had their first scan.

Children exposed before age 5 had the greatest risk. The older a patient is at first exposure to a CT scan, the lower their risk, the researchers said. But even among the oldest participants -- between 15 and 19 -- the study revealed that risk for all cancers combined was still higher.

For cancers involving tumors other than brain cancer, the researchers found the proportional increase in risk was 23 percent among females and 14 percent among males.

The researchers, led by John Mathews, a professor at the University of Melbourne's School of Population and Global Health, said that in some cases brain cancer may have resulted in a CT scan and not the other way around. They added that participants may have developed cancer beyond the final follow-up period in 2007. As a result, they concluded that the "eventual lifetime risk from CT scans cannot yet be determined."

Although the study found an association between having a CT scan in childhood and a higher risk of developing cancer, it did not prove a cause-and-effect relationship.

It's important to realize the incidence of cancer among children is extremely small, said Dr. Aaron Sodickson, who wrote an accompanying journal editorial. Sodickson is the section chief of emergency radiology and medical director of computed tomography at Brigham and Women's Hospital and Harvard Medical School in Boston.

"A 24 percent increase makes this risk just slightly less small," Sodickson wrote. He added that there are many ways to adjust radiation doses and that more accurate assessments of patients' risk can help doctors make more informed decisions about CT scans and other imaging tests.

More information

The U.S. National Institutes of Health has more about CT scans and the risks involved.

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TUESDAY, May 21 (HealthDay News) -- Finding early signs of lung cancer was once next to impossible, but a new study adds to a growing body of evidence suggesting that screening with low-dose CT scans may help spot the beginnings of disease in high-risk patients.

Among patients considered at the greatest risk for lung cancer, 6 percent were found to have lung cancer after getting CT scans and follow-up biopsies to confirm the diagnosis. CT scans detect abnormalities at an earlier stage than standard X-rays, potentially giving patients a head start on lifesaving treatment.

As more advanced technology reduces the radiation risk of computerized tomography (CT) scans, the benefits of such screening could become greater than the downsides, which also include potentially unnecessary biopsies.

"It may someday be like using mammograms," said Dr. Stephen Machnicki, associate chair of radiology at Lenox Hill Hospital, in New York City.

The study affirmed what a lot of radiologists believe: There is a role for low-dose CT in screening for lung cancer, said Machnicki, who was not involved with the research.

The study, scheduled for presentation Tuesday at the American Thoracic Society annual meeting in Philadelphia, was based in part on results from the National Lung Screening Trial. That study, published in the New England Journal of Medicine in 2011, included more than 53,000 heavy smokers and found that those who received low-dose CT scans had a 20 percent lower risk of death from lung cancer than people who had standard chest X-rays.

Lung cancer, the leading cause of cancer deaths in the United States, usually forms in the cells lining air passages of the lungs. According to the U.S. National Cancer Institute, more than 228,000 new cases of lung cancer and almost 160,000 associated deaths are anticipated this year.

The researchers enrolled 84 patients between 61 and 65 years old. Participants had either a smoking history of more than 30 pack-years, or 20 pack-years and one additional risk factor, such as occupational exposure to cancer-causing substances or a personal or family history of cancer or chronic obstructive pulmonary disease (COPD). A pack-year represents the number of cigarettes smoked over time; 30 pack years is the equivalent of a pack a day over 30 years or two packs a day over 15 years.

Each study participant got a low-dose CT scan, which was reviewed for the presence of nodules or other abnormalities that could suggest cancer. Those with nodules of 4 millimeters or larger or opacities (cloudy areas of tissue) were advised to get a biopsy.

Four people had lung cancer confirmed by biopsy, and one had a large mass but refused biopsy, reported study author Sue Yoon, a nurse practitioner in the pulmonary division at the Veterans Administration Boston Healthcare System.

While the new study found that 6 percent of the study participants had lung cancer, the earlier trial found only about 4 percent did, Yoon added.

Yoon noted there were significant differences between the two studies: Hers included many fewer people; scanning technology used in her study was more advanced than that used in the earlier research; and Yoon's patients were predominantly male and most had COPD.

Also, her study focused on finding evidence of cancer, rather than tracking cancer deaths, as the national screening trial did.

One of the issues concerning screening tests, including those for lung cancer, is that sometimes the test is inconclusive, noted Yoon. Many of the nodules detected are harmless, often the result of inflammation or scarring. "Our experience says it's good to have [a CT scan] but we don't know what the impact really is," she explained. After a lung nodule is found, some people don't like the idea of waiting a year and then having another scan.

"Some people worry so much they can't wait, and others, when we tell them they can wait a year to see what happens, they think they can still smoke since they don't have a big mass," she said.

But how often should people be scanned? "The current thought is that if you have a normal first exam, doing an annual exam would be satisfactory," Machnicki noted. "Whether or not longer intervals would be effective has not been tested."

Aggressive cancers may start and grow so quickly that they may be impossible to detect at a curable stage with any current technology, experts say.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

Learn more about screening for lung cancer from the U.S. National Cancer Institute.

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MONDAY, May 20 (HealthDay News) -- The costly form of radiation therapy that has become the norm for prostate cancer in the United States may be no better than the older, cheaper variety -- at least for some men, a new study suggests.

Researchers found that among more than 1,000 U.S. men who had radiation therapy after prostate cancer surgery, the newer form -- known as intensity-modulated radiotherapy (IMRT) -- had no advantage over the conventional version.

Men who received IMRT were no less likely to be treated for a prostate cancer recurrence over the next few years. And their rates of long-term side effects -- such as urinary incontinence and erectile dysfunction -- were no lower.

But the findings, reported online May 20 in JAMA Internal Medicine, will not spell the doom of IMRT. One reason is, the vast majority of U.S. men who receive radiation for prostate cancer are already given IMRT.

"I don't think this is going to change practice," said Dr. Matthew Cooperberg, a urologist at the University of California, San Francisco, who wrote an editorial published with the study.

But he said the findings do beg the question of why IMRT is reimbursed at such a high rate. A 2011 study in the Journal of Clinical Oncology found that Medicare paid out an average of nearly $11,000 more for IMRT, versus the older radiation therapy (called conformal radiotherapy).

"We need a reimbursement system that rewards outcomes instead of technology," Cooperberg said.

Still, Dr. Ronald Chen, one of the researchers on the new study, said the findings apply to a specific group of patients who receive IMRT: men who have it after prostate cancer surgery -- either to help prevent a recurrence or to treat one.

There are other patients who receive radiation as their initial therapy, explained Chen, an assistant professor of radiation oncology at the University of North Carolina at Chapel Hill.

And in a study published last year in the Journal of the American Medical Association, Chen and his colleagues found that for those men, IMRT does carry a lower risk of certain side effects than conformal radiotherapy. It also showed a somewhat lower risk of cancer recurrence.

"I think the question is, when is the new technology helpful, and when is it not?" Chen said. "We need to be smart about how we use technology."

The new findings suggest that when it comes to radiation given after surgery, "newer" does not mean "better."

The IMRT technique was designed to minimize damage to healthy tissue around the tumor. Doctors use 3-D computer images to visualize the area, then target it with thin radiation beams from different angles -- with the individual beams varied in intensity.

IMRT has exploded in the United States in the last decade or so. In 2000, it was barely a blip on the radar, but by 2008 it accounted for 96 percent of all external radiation treatments for prostate cancer, according to the editorial. (Men can also have an internal form of radiation, where radioactive "seeds" are implanted in the prostate gland.)

Why did the technology take off? Cooperberg said IMRT was heavily marketed, and the procedures were also reimbursed at a much higher rate -- a potential incentive to some.

Plus, Cooperberg said, "Hospitals generally want to be seen as cutting-edge, and patients often want the latest and greatest thing."

Chen agreed. "Oftentimes in this country, doctors and patients chase after the newest technology, believing that it must be better -- even before the evidence is in."

But although IMRT is now dominant, Chen said he thinks "there's a chance for a reversal." If the older conformal radiotherapy is just as good for men who've had prostate cancer surgery, then using it would bring down the costs of radiation for those patients.

And that might allow more men to get it, according to Chen. He said that right now, radiation is "underused" in men who might benefit from it after prostate surgery, and costs may be one reason.

The new findings are based on Medicare claims for 457 men who underwent IMRT between 2002 and 2007, and 557 men who had conformal radiation therapy. Chen's team followed their outcomes through 2009.

Overall, there were no major differences in the men's risk of side effects: About 15 percent of those who'd received IMRT were diagnosed with erectile dysfunction, compared with 12 percent of men who'd received the older radiation therapy, for example.

When it came to the cancer itself, just over 8 percent of IMRT patients needed additional therapy during the study, versus 7 percent of conformal radiotherapy patients.

Dr. James Yu, an assistant professor of therapeutic radiology at Yale School of Medicine, said the study was well done.

It "provides an important piece of the puzzle for evaluating this important but costly technology," Yu said.

There are still questions, though, he added. It's possible, for example, that IMRT could have an advantage when it comes to men's ultimate cure rates, or their overall quality of life over time.

Cooperberg said Medicare claims are an imperfect way to gauge quality of life. Yu agreed that claims data may not capture all the ways treatment can affect men's lives, such as their sexual function other than an official diagnosis of erectile dysfunction.

IMRT is not, however, the latest radiation technique out there. That would be proton beam therapy, which is supposed to be even more targeted than IMRT -- and is twice as expensive. But so far, research has suggested the newer technology is no better.

"There's not a shred of evidence that it's better than IMRT," Cooperberg said.

More information

Learn more about prostate cancer from the U.S. National Cancer Institute.

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SATURDAY, May 18 (HealthDay News) -- A new device that gives doctors a better view during colonoscopies may help them miss fewer suspicious growths during those exams, a new study shows.

Colonoscopies are the recommended screening tests for colorectal cancer, which is the second leading cancer killer of men and women in the United States.

To perform a colonoscopy, doctors use a long, flexible tube with a camera mounted on the end called a colonoscope to view the lining of the large intestine.

The basic design of those devices hasn't changed in about 30 years, said study author Dr. Ian Gralnek, a senior physician at the department of gastroenterology at Rambam Health Care Campus and Elisha Hospital in Haifa, Israel.

And the design isn't perfect. A February 2006 study published in the American Journal of Gastroenterology found that traditional colonoscopies missed 22 percent of polyps. Polyps are fleshy growths on the walls of the colon that can turn into cancers if they aren't removed.

Part of the problem, Gralnek explained, is that scopes only have one forward-facing camera, which gives doctors a 170-degree view. That makes it easy to miss polyps, which often grow behind fleshy folds on the colon walls.

To improve detection, an Israeli company has designed a new colonoscope, called the Full Spectrum Endoscopy, or FUSE. The FUSE colonoscope uses three cameras mounted on the front and sides of a flexible arm to give doctors a 330-degree view as they work. EndoChoice of Alpharetta, Ga., the company that's acquired the rights to the device, funded the study.

Gralnek tested the new technology by asking 183 stalwart patients to undergo back-to-back colonoscopies.

About half of the patients were randomly assigned to have a colonoscopy with a traditional colonoscope, followed by the same test using the new FUSE scope. In the other half, the order of the tests was reversed.

During the first test, doctors found and removed as many polyps as they could see. They used the second test to count the number of polyps that were missed on the first go-round.

The FUSE scope missed about 8 percent of adenomas -- small, flat polyps that are especially concerning to doctors because they can turn into full-blow cancers. The standard colonoscopes missed about 43 percent of those growths.

"You really see a lot better [with the FUSE scope]," Gralnek said. "The natural anatomy of the colon has these folds. You can miss polyps on the back sides of these folds and at some of the twists and turns within the colon itself. Because of the extra cameras we're seeing a lot more of the colon itself."

An expert who was not involved in the research says the technology is worth further study.

"These are important data," said Dr. Frank Sinicrope, a professor of medicine and oncology at the Mayo Clinic in Rochester, Minn.

But Sinicrope said it's still not clear whether the new technology will actually prevent more colon cancers than traditional colonoscopies do.

"Detecting more polyps and adenomas does not necessarily indicate that a reduction in cancer risk or mortality will result, since many small adenomas may never develop into cancers," he pointed out.

It's logical that finding more adenomas would make the test more effective, but he points out that hasn't been proven yet.

The study was to be presented Saturday at the Digestive Diseases Week annual meeting in Orlando.

Research findings presented at medical conferences are considered preliminary because they haven't yet had the scrutiny that's required for publication in a peer-reviewed journal.

Until the new technology is ready for widespread use, the most important thing to do is to go for a colonoscopy.

The American Cancer Society recommends that men and women of average risk get colonoscopies every 10 years, starting at age 50.

More information

For more on colonoscopies, head to the U.S. National Institutes of Health.

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FRIDAY, May 17 (HealthDay News) -- There are apps that turn your smartphone into a metal detector, a musical instrument and a GPS system, and now there's an app that may help doctors save your life if you're having a heart attack.

The app, which was designed by engineers and critical care physicians, helps doctors rapidly diagnose certain kinds of severe heart attacks, called STEMIs, before patients get to the hospital.

The app currently is in the experimental stage, but it has undergone field testing.

In a STEMI heart attack, which stands for ST segment elevated myocardial infarction, a clot completely blocks blood flow to the heart. About a quarter of a million people have STEMIs each year in the United States.

These kinds of heart attacks create a unique pattern of pulses when doctors hook up patients to an electrocardiogram, or EKG, machine, which measures the heart's electrical activity.

The problem is that doctors need to see the EKG reading, which is called a tracing, to properly diagnose the attack and quickly assemble the team of specialists that is needed to clear the clot.

There are proprietary systems that use EKG machines hooked up to modems to send images back to hospital computers, but those systems are expensive and not all hospitals and EMS systems can afford them.

As an alternative, paramedics can use their smartphones in the field to snap a picture of the tracing and send it to a doctor at the hospital via email.

But as anyone who has ever tried to email a picture from their phone knows, it's far from foolproof. Large, high-quality images -- the kind doctors need to see -- can take several minutes to send and receive.

To address the issue, Dr. David Burt, an associate professor of emergency medicine at the University of Virginia, challenged a class of systems engineering students to develop an app that could shrink images to make them faster to send, but still maintain the clarity needed for diagnoses.

"It's very easy to use," Burt said. "You hold it over the EKG tracing, you snap a picture." Hitting a button sends the image. When it's finished, the app shakes and makes noise to alert senders to the successful transmission.

"It's very simple but we want it to be very rugged, so that it's kind of like a hammer -- it always works," he said. He also wants to offer the app at no cost to doctors and hospitals.

So far, Burt said, they have tested the app more than 1,500 times using different wireless carriers in a city.

They also have pitted the app against the alternative method of using an iPhone to email a picture. In that study, the app consistently sent images within four to six seconds. Emailed images could take nearly two minutes to go through. The app failed less than 1 percent of the time, while the emailed images flopped between 3 percent and 71 percent of the time, according to the study.

The study is scheduled for presentation Friday at an American Heart Association meeting in Baltimore. Studies presented at medical conferences are considered preliminary because they haven't yet undergone the scrutiny required for publication in a peer-reviewed journal.

Dr. Iltifat Husain, founder of the iMedicalApps website, which keeps up with news about technology in medicine, said he was impressed by the app, but also by how thoroughly the team has been testing it. Husain estimates that less than 1 percent of apps that are developed for doctors are field tested to see if they actually work.

"Something like this would have to be tested before it was put to use because of how critical the information is that you're relaying," said Husain, who was not involved in the research.

Husain, who also is an emergency medicine resident at Wake Forest University in Winston-Salem, N.C., said the time the app shaves off image transmission could be critical.

"The longer you wait, the more heart muscle dies, so every minute counts," he said. "Actually, every second counts."

Surviving a STEMI depends on how quickly doctors can restore blood flow, which often is done by snaking a catheter up to the heart and using a small balloon to clear the clot.

"We'll get an EKG reading and the ER physician will activate the cath lab. Once you activate it, a huge team has to be assembled," Husain said. "If it's overnight, people are sometimes coming in from home. If you can get someone coming in from home five minutes faster, I think it's a big deal."

More information

For more about heart attacks, head to the U.S. National Heart, Lung, and Blood Institute.

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THURSDAY, May 16 (HealthDay News) -- Could you someday zap your way to a smarter brain? Preliminary new research suggests that it's a possibility: Scientists report that they were able to improve the math-calculation skills of college students by buzzing their brains with doses of random high-frequency noise.

But don't go searching for a brain zapper at Walmart just yet. It's not clear why "transcranial random noise stimulation" might boost thinking skills, and the necessary equipment isn't sitting on the shelves at your local hardware store. The treatment is considered to be harmless but has only been studied for a few years, and the study findings aren't definitive.

For now, though, the results of the new study are promising, said author Roi Cohen Kadosh, a cognitive neuroscientist at the University of Oxford, in England. "We can enhance one of the most complicated high-level cognitive [mental] functions and improve brain response after just five days of training, with a long-lasting effect six months later."

Scientists have only been studying transcranial random noise stimulation for about five years, Cohen Kadosh said. Researchers use the technique to stimulate the brain's cortex by putting electrodes on the scalp and delivering random bits of electrical noise. "It is non-invasive, painless -- the level of current is generated by home batteries, and is very low -- and relatively cheap," he said.

Transcranial random noise stimulation is considered to be harmless, and several studies haven't mentioned any adverse effects in those who have been zapped. Researchers are interested in one possible positive effect, though: changes in how the brain processes things.

"The brain is working on electricity, and in some cases poor behavior and cognitive [thinking] abilities appear when there's less activation of regions that are otherwise active," Cohen Kadosh said. "We thought that if we can make it easier for neurons to fire, it will allow an improved performance."

In the study, appearing May 16 in the journal Current Biology, researchers recruited 51 Oxford students and gave them five days of training and testing as they performed arithmetic tasks. The tasks tested their ability to remember math facts (like 4 x 8 = 32) and make calculations (like 32 - 17 + 5 = 20), Cohen Kadosh said.

Some of the participants received transcranial random noise stimulation when they performed the math tasks. Those participants were two to five times better at learning things, he said. And, six months after the stimulation, they were 28 percent better at making calculations than the other participants.

Scientists aren't sure why the stimulation treatment may boost learning and thinking, but Cohen Kadosh said it may have something to do with activating neurons in the brain.

Why might brain-zapping be a good thing? "We all want to improve our learning and to make it faster if possible, and we also want to help those who have problems in learning" due to disease, developmental problems or aging, he said. Also, "around 20 percent of the population finds math challenging."

However, don't try this at home, advised Dr. Colleen Loo, a brain researcher and professor of psychiatry at the University of New South Wales in Australia, who called the research "promising."

"If the electrodes are not correctly applied, it could cause scalp burns," Loo said. "Also, the exact placement of the positive and negative electrodes is essential, otherwise you could create quite different brain effects, including negative effects. There is still a lot more we need to know about this technology."

What's next? "There is a way to go, but this shows that it is feasible to improve human cognition and brain function in a long-lasting fashion," Cohen Kadosh said, "and this will hopefully trigger further research that will have more validity."

More information

For more about the brain, try Harvard Medical School's Whole Brain Atlas.

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TUESDAY, May 14 (HealthDay News) -- Patients prone to dangerously fast heart rhythms may get just as much help and have fewer complications with less-expensive implanted defibrillators that run one wire to the heart instead of two, a new study shows.

Implantable cardioverter defibrillators, or ICDs, are like having an emergency "crash cart" in the chest. The devices can sense runaway heart rhythms and deliver powerful shocks to jolt the heart back to a normal, steady pace.

Studies have shown that the devices cut deaths in patients at risk for sudden cardiac arrest because their heart muscles are too weak to effectively pump blood throughout the body, a condition called cardiomyopathy.

But little evidence exists to help doctors decide when it's better to choose a single-chambered ICD for patients or the more complex dual-chambered model.

The study, published in the May 15 issue of the Journal of the American Medical Association, compared the fates of more than 32,000 Medicare patients who received ICDs, from 2006 through 2009. None of the patients also needed a pacemaker, a device that speeds up a slow heartbeat.

"There is evidence for greater risk of complications. Not clear evidence of benefit. That risk-benefit ratio really doesn't support the routine use of dual-chamber devices for primary prevention," said study co-author Dr. Pamela Peterson, an associate professor of medicine at the University of Colorado at Denver.

About one-third of patients received a single-chamber ICD, in which an electrical lead is attached to the heart's lower right pumping chamber. The other two-thirds got dual-chamber devices, in which wires are attached to the upper and lower chambers of the heart's right side.

After a year, patients who got single-chamber ICDs were no more likely to die or be hospitalized than patients who got the more expensive dual-chamber models. They were, however, slightly less likely to face serious complications, including fluid build-up around the heart or lungs and mechanical problems with the device that required a second surgery to fix.

That was true even after researchers adjusted their results to control for any differences between patients who got single- and dual-chamber devices.

Overall, close to 4 percent of patients with single-chamber ICDs had complications with their devices compared to about 5 percent of patients with dual-chamber models, the investigators found.

The study was observational, which means researchers couldn't prove that the type of ICD was the only reason patients fared the way they did. Though they tried to carefully control their data for important differences between the two groups, other factors they couldn't measure, such as medications people were taking, may have influenced the results.

The study was funded by a grant from the U.S. Agency for Healthcare Research and Quality.

An expert who was not involved in the research praised the study, but said its findings come with an important caveat. The study wasn't able to measure so-called "inappropriate" shocks, instances when the devices misfire after sensing an irregular, but harmless, heartbeat.

Patients describe the powerful jolt as feeling like they're being kicked or hit with a baseball bat. Inappropriate shocks can be a major quality-of-life issue for patients who get them frequently.

Dr. Gregg Fonarow, director of the Cardiomyopathy Center at the University of California, Los Angeles, said the dual-chamber defibrillator may have an advantage in that regard.

"A dual-chamber ICD device, along with its extra atrial lead, is frequently chosen in the belief that it will better discriminate fast heart rates originating in the upper versus lower chambers of the heart and thereby reduce the risk of inappropriate shocks from the device," said Fonarow.

Peterson agreed that not being able to study inappropriate shocks to patients was a limitation of the study. However, she said, "data that has looked at that doesn't demonstrate that there's a benefit of dual-chamber devices in decreasing inappropriate shocks."

Another question they weren't able to address in the study was cost. Single-chamber devices are initially less expensive than dual-chamber models.

A study published in September 2005 in the Journal of the American College of Cardiology said it costs roughly $34,000 for a single-chamber device and about $38,000 for a dual-chamber model.

But that study also found that the cost savings of single-chamber devices can be wiped out if patients need to upgrade to the dual-chamber model because their condition gets worse, a situation that occurs in about 5 to 6 percent of patients in clinical trials.

More information

For more on implantable cardioverter defibrillators, head to the U.S. National Heart, Lung, and Blood Institute.

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THURSDAY, May 9 (HealthDay News) -- Sprawled out on the couch, reading the news on your iPad, you'd never think you could be putting yourself at risk. But you might be, if you happen to have an implanted heart device.

Magnetic interference could alter the settings and even deactivate the technology of implantable cardioverter defibrillators (ICDs), according to a small new study -- conducted by a 14-year-old investigator and her colleagues.

The researchers found that magnets imbedded in the iPad 2 and its Smart Cover may cause electromagnetic interference that can disrupt a cardiac rhythm device.

Specialized magnets are imbedded in the heart devices to allow physicians to routinely adjust their settings. The magnets can suspend the ability of the devices to prevent sudden rapid heart rates, such as tachycardia and fibrillation.

That risk occurs when a person falls asleep with the tablet on the chest. Thirty percent of study participants had interference with their devices when the iPad 2 was placed there, the researchers found. Yet electromagnetic interference was not found when the iPad was at a normal reading distance from the chest.

The magnetic field drops off quickly with distance, explained Gianna Chien, the lead study author. And heavier people who happen to have more fat on their chest -- not just in their abdomen -- also seem to be less sensitive to the interference, she added.

The research is scheduled to be presented Thursday at the Heart Rhythm Society's annual meeting in Denver. Chien, a high school freshman, worked with her father, Dr. Walter Chien, a cardiologist with Central Valley Arrhythmia in Stockton, Calif., to coordinate patient testing.

Other devices with imbedded magnets -- such as cellphones and magnetic resonance imaging (MRI) machines -- may also affect cardiac rhythm devices, but were not tested in this study.

Last year, research published in the Journal of Neurosurgery: Pediatrics suggested that the iPad 2 can interfere with the settings of magnetically programmable shunt devices in the brain when held within two inches of the technology.

That study reported on a 4-month-old girl with hydrocephalus -- abnormal accumulation of cerebrospinal fluid (CSF) in the brain -- who developed a shunt malfunction. This was due to a changed setting of the magnetically programmable valve that regulates the flow of CSF out of the brain cavity, or ventricle. The mother had been using an iPad 2 while holding the infant.

An expert noted how difficult it could be to detect such a malfunction.

"The real problem is that you don't even know; there is no trigger, no light goes off [to alert you]," said Dr. Salvatore Insinga, a neurosurgeon at the Cushing Neuroscience Institute at North Shore-LIJ Health System, in New York. "With all the tech devices people are using now and all the implanted things in patients, this is more of an issue now." Insinga was not associated with either study.

The new heart rhythm device study involved 27 patients at Central Valley Arrhythmia. Just three patients were women. All were at least 50 years old and had implantable cardiac defibrillators, pacemakers or loop recorders (implanted cardiac monitors). The effect of the close presence of an iPad2 on the chest and at reading distance -- at various programming settings on the iPad and on the heart devices -- was noted.

The authors found that almost 19 percent of the patients with defibrillators had interference from the iPad 2. No effects were noted in the people who had implanted pacemakers or the loop recorder.

Gianna Chien said the study had limitations: The sample size was small, and she would like to test a wider variation of heart devices, because most were manufactured by St. Jude Medical.

The bottom line? Insinga at Cushing Neuroscience recommended that physicians discuss with their patients the risks that technological devices may pose to the settings and function of any implanted devices, and check their patients' medical devices frequently. "No more 'set it and forget it,'" he said.

Chien thinks the issue will continue to pose problems unless the design of tablets changes. "With the aging of the population, there's an expected increase in ICD placement and, with more than 100 million iPads sold, it's a concern," she said.

Because the study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

Learn more about heart device safety from the U.S. National Library of Medicine.

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THURSDAY, May 9 (HealthDay News) -- With summer approaching, researchers caution that swimming pools may pose a risk to patients with irregular heartbeats who've received implantable defibrillators.

The issue: a danger that electrical currents linked to standard pool utilities such as lighting may "leak," causing a defibrillator to misread the status of a patient's heart.

Implanted cardioverter defibrillators continuously monitor and control a patient's heart rhythm.

"How common this is, we don't know," said Dr. John Day, second vice president of the Heart Rhythm Society, a group representing arrhythmia specialists. "It's quite possible that there's underreporting going on, because when we see patients and we see noise recorded on their device we can't account for where it's coming from."

The concern stems from a few recent incidents that have been documented. In two cases, people with defibrillators experienced device misreadings while in a private family or hotel pool, and in another two cases, people experienced unwarranted shocks from their defibrillators while in public pools.

The cases all involved younger arrhythmia patients between the ages of 8 and 23. However, the investigators said there's no reason to believe that patients of all ages would not face a similar risk if they had such devices.

"I don't want to be an alarmist, because I do think we would have heard about this sort of thing happening much more often than we have if it were a really widespread problem," said study lead author Dr. Daniel Shmorhun, a pediatric cardiologist-electrophysiologist with Children's Cardiology Associates, an affiliate of the Dell Children's Medical Center of Central Texas in Austin.

"The nice thing about defibrillators is that they put a time-stamp on all activity," he noted. "So we were able to ask questions and delve into this after two patients came in with interference noise on their devices. And we found that both had been in pools at the time their defibrillators read the interference."

Shmorhun and co-author Dr. Arnold Fenrich are slated to present their findings at the Heart Rhythm Society meeting taking place this week in Denver. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Arrhythmia is a chronic condition in which the heart's electrical system has the potential to go awry -- on occasion beating too fast, too slow, or irregularly. While many instances of arrhythmia pose little harm, severe cases can be life-threatening.

For such patients, implanted defibrillators can be life-savers, continuously surveying a patient's heartbeat for signs of trouble and instantaneously correcting for problems as they arise by sending out a corrective electrical pulse.

In the new study, Shmorhun and Fenrich reviewed the cases of two female patients (one aged 8 years and one aged 23 years), in which their defibrillators registered so-called "noise reversions" directly linked to time spent in swimming pools.

In each case their devices picked up the reversion, classified it as an outside interference, reverted to a mode that actively ignored noise, and thereby prevented any accidental shock.

After the lighting system was repaired in the family pool in which the 8-year-old had swam, the girl did not experience any further defibrillator trouble, the researchers said. The older patient, however, simply decided to no longer use public pools, and has experienced no further problems.

Others were not so lucky. For example, in the past year a 21-year-old male -- a competitive college swimmer and lifeguard -- experienced not one but two shocks while swimming in a public pool. "He remembers that he had his back against the pool wall, quite close to lights in water," said Shmorhun. "And as he was moving away from the light he got shocked."

Shmorhun and Fenrich believe that low-level electrical current leaking from swimming pool wiring might be an "underappreciated cause" of unwarranted defibrillator shocks.

"Water is an attractive source for electrical activity," Shmorhun explained. "We don't think there would be an issue at all in, say, the ocean or bay. But in a pool, where you have wires coming into the water from the outside, from the house, from an aging utility system, or an improperly grounded system, there is a potential for this kind of problem. Or if a pool is not properly bonded -- meaning the pool circumference is not intact -- there could be a problem," he noted.

"I'm not sure anybody can really predict up front what pools are an issue, and there's no practical means by which to easily test pools for this," Shmorhun added. "At the same time, we don't know the overall incidence, although three cases in the Austin area in one year seems like a lot to me. But at minimum, [defibrillator] patients need to be counseled about the risk."

For his part, Heart Rhythm Society vice president Day said the finding should not deter patients from swimming.

"We want our cardiac patients to be physically active. We don't want to restrain them and we don't want to create alarm," Day said.

"But in each of these cases we had these underwater pool lights that had an alternating current pool leak that could trigger a shock," noted Day, who is also director of Heart Rhythm Services at Intermountain Medical Center in Murray, Utah. "So, I think we certainly need pool safety. And clinically this is just one more thing that should be considered as a potential source of a problem for any patient with an implantable defibrillator."

More information

Find out more about heart arrhythmias at the U.S. National Heart, Lung, and Blood Institute.

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THURSDAY, May 9 (HealthDay News) -- Scientists report positive results in early testing of a wireless pacemaker that's placed in the heart instead of being connected to it via wires from the upper chest.

There are still many questions regarding the pacemaker, produced by Nanostim Inc. It's only been implanted in a few dozen people who were studied for a matter of months, limiting information about its long-term use and safety. It's also not clear when the pacemaker may be publicly available, and its cost is unknown. And the existing version of the device won't work for most pacemaker patients because it lacks some key features.

Still, a new company-funded study shows that "this is now a possibility" that could reduce infections and the severity of pacemaker surgery, said study author Dr. Vivek Reddy, director of the Cardiac Arrhythmia Service at Mount Sinai Hospital in New York City. "This is going to be the future," he said.

Pacemakers zap the heart with low levels of electricity when the heartbeat becomes too fast, too slow or too irregular. Some are combined with defibrillators, which give the heart a major jolt when needed.

Currently, pacemakers include two components: a battery-powered generator that produces the electrical "prompts" that the wires deliver to the heart when needed, Reddy said. These wires can break or become infected, he explained, making the idea of a wire-free pacemaker appealing.

The new pacemaker is about the size of a AAA battery and provides jolts to one chamber of the heart, Reddy said. Most people with pacemakers require jolts to both chambers, so the pacemaker in its current form wouldn't work for them.

In the new study, researchers implanted the pacemaker in 32 people for the first time through a puncture in the skin; in 10 patients, they had to reposition it. The researchers reported positive results at up to three months. However, one patient died of a stroke while convalescing after suffering a heart injury during implantation and another had the pacemaker replaced with a defibrillator.

Why get a wire-free pacemaker? "For patients with heart problems, this could potentially mean fewer infections related to leads and less discomfort during the implant procedure," Reddy said. And children who get pacemakers wouldn't face chest scarring, he added.

Dr. Saman Nazarian, a cardiologist and assistant professor of medicine at Johns Hopkins Hospital, said the findings are promising and "the new technology has enormous potential." He expects the pacemaker "will likely be utilized for some select patients" after more testing.

Still, he said, the new device will probably be more expensive than other pacemakers, and may pose special risks of its own.

Dr. Harish Doppalapudi, an assistant professor of medicine at the University of Alabama at Birmingham, added that there are unanswered questions regarding replacement of the new pacemakers.

"When the battery of the implanted leadless pacemaker is exhausted, a new implant is necessary, with all the potential risks associated with this," Doppalapudi said. "It is not known if it will be feasible to safely retrieve the old device. If the old device is left in place, it is not known what the long-term effects of this will be."

Study author Reddy has received grant funding from Nanostim, and works for the company as a consultant. He also has received stock options from the company.

The study was to be presented Wednesday at the Heart Rhythm Society annual meeting in Denver. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

For more about pacemakers, visit the U.S. National Library of Medicine.

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TUESDAY, May 7 (HealthDay News) -- By slowing down the programmed response rate on implantable cardioverter defibrillators (ICDs), doctors can reduce the number of shocks these devices deliver without causing a significant increase in the risk of fainting or death, new research suggests.

"The aim of [our] study was to evaluate a different programming strategy to reduce unnecessary therapies delivered by the ICD," explained study author Dr. Maurizio Gasparini, chief of the pacing and electrophysiology unit at the Humanitas Clinical and Research Center in Rozzano, Italy.

"The study found that the strategy utilizing a long detection period to recognize arrhythmias [irregular heartbeats] is associated not only to an overall reduction of therapies, but also to less inappropriate shocks experienced by the patients as well as fewer hospitalizations in the 12 months following ICD implant," Gasparini said.

ICDs are small devices implanted in the upper chest. Electrodes from the device are attached to the heart. If an ICD senses a dangerous heartbeat or no heartbeat, it can help correct that through electrical pacing -- like a pacemaker -- or it can deliver a shock to the heart to restore a normal heartbeat, according to the U.S. National Heart, Lung, and Blood Institute.

Results of the study are published in the May 8 issue of the Journal of the American Medical Association. The study was funded by Medtronic Inc., which makes ICDs.

While ICDs can literally be lifesavers, they can also cause problems for some patients.

"Defibrillator shocks, whether for appropriate or inappropriate indications, are associated with adverse effects. These adverse effects include the acute discomfort of the shock, as well as late and longer-lasting psychological trauma including depression and post-traumatic stress disorder," wrote Dr. Merritt Raitt, author of an accompanying journal editorial. Raitt is with the Oregon Health and Science University and the Portland Veterans Administration Medical Center, in Oregon.

The current study included about 1,900 people who were receiving their first ICD implant. Their average age was 65, and 84 percent of the study volunteers were male.

The volunteers were randomly placed into one of two groups: standard programming or programming with a long detection interval.

"Every time the heart beats, an electrical activity is recorded by the device. An interval is the time between two consecutives beats. Basically it is the time between two heartbeats. So, a long detection interval simply means a longer period of time to permit recognition of arrhythmias," Gasparini explained.

During an average of 12 months of follow-up, 530 episodes of an arrhythmia were recorded. The long detection group had a 37 percent lower rate of delivered therapies (pacing or shocks) than the standard therapy group, according to the study.

There were no significant differences in mortality or in fainting (syncope) episodes between the groups.

"This study shows that we can decrease inappropriate and unnecessary therapies, and clearly you make people feel better because they're not getting inappropriate or unnecessary therapy, said Dr. Ranjit Suri, director of the electrophysiology service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City.

However, Suri said it's not yet clear what the ideal interval time is. The current study doesn't show a benefit in terms of reduced risk of death. Another study, published last December in the New England Journal of Medicine, did find a mortality benefit. But, the interval was longer in that study.

Still, Suri said, doctors could start programming ICDs with longer intervals, and making such a change to the device isn't difficult or time-consuming.

In his editorial, Raitt wrote: "Regardless of whether these programming interventions lead to reduced mortality, the unequivocal reduction in ICD shocks and the reduction in hospitalization without an increase in adverse events such as syncope suggests that this programming approach should be considered for adoption in the care of patients with ICDs and clinical characteristics similar to those enrolled in these studies."

Study author Gasparini noted that the research provides physicians with an easy programming guideline that's "applicable to the great majority of patients who may benefit from the reduction of unnecessary painful shocks and hospitalizations."

More information

Learn more about implantable cardioverter defibrillator from the U.S. National Heart, Lung, and Blood Institute.

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THURSDAY, May 2 (HealthDay News) -- Abnormal brain wiring may explain why some people become so fixated on their appearance that their obsession makes it hard for them to function, a new study suggests.

The study included people with body dysmorphic disorder, a mental illness that causes people to believe they are disfigured and ugly, even though they look normal.

These patients have abnormal network-wiring patterns across the brain, the University of California, Los Angeles (UCLA), researchers discovered. Earlier UCLA research showed that people with body dysmorphic disorder process visual information abnormally. In line with that finding, this study revealed that people with this disorder have abnormal connections between brain regions involved in visual and emotional processing.

The findings, published in the May issue of the journal Neuropsychopharmacology, suggest that abnormal brain wiring in people with body dysmorphic disorder may cause impaired information processing.

"We found a strong correlation between low efficiency of connections across the whole brain and the severity of [body dysmorphic disorder]," study senior author Jamie Feusner, an associate professor of psychiatry, said in a university news release. "The less efficient patients' brain connections, the worse the symptoms, particularly for compulsive behaviors, such as checking mirrors."

For the study, the researchers examined brain scans of 14 adults with body dysmorphic disorder and 16 adults without the disorder.

The findings advance the understanding of body dysmorphic disorder by providing evidence that the "hard wiring" of patients' brain networks is abnormal, Feusner said.

"These abnormal brain networks could relate to how they perceive, feel and behave," he explained. "This is significant because it could possibly lead to us being able to identify early on if someone is predisposed to developing this problem."

Body dysmorphic disorder affects about 2 percent of the population. People with the condition fixate on minor or imagined flaws in their appearance -- such as a blemish on their face -- and some become so distraught that they can't lead normal lives.

More information

The Anxiety and Depression Association of America has more about body dysmorphic disorder.

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THURSDAY, May 2 (HealthDay News) -- Talking tissue boxes and refrigerators may be among the types of "smart" objects that people use in the future, researchers report.

"Smart objects will become more and more a part of our daily lives," S. Shyam Sundar, a professor of communications and co-director of the Media Effects Research Laboratory at Pennsylvania State University, said in a school news release. "We believe the next phase is that objects will start talking and interacting with humans, and our goal is to figure out the best ways for objects to communicate with humans."

As computers and sensors become increasingly smaller and less expensive, smart objects that interact with people will become more common in homes and offices, the researchers said. For instance, smart fridges could talk or send tweets when certain food items are running low or are nearing their expiration dates.

In order to assess how people react to smart objects that talk, the research team observed people when they encountered a tissue box that said, "Bless you," when a person sneezed and followed that up by saying, "Here, take a tissue," and, "Take care."

The tissue box didn't actually speak. The statements were pre-recorded and broadcast to the tissue box by a researcher.

Study participants seemed to have a positive reaction to the talking tissue box, which suggests that people would be accepting of such smart objects, the researchers said.

The findings may also help manufacturers design smart objects. The researchers noted that robots often are made to look human, but many people find such robots creepy.

"This study shows that speech is a social cue," Sundar said. "It may be enough to make the objects more social and not necessarily more human-like in appearance."

The study was presented Wednesday at the annual Conference on Human Factors in Computing Systems in Paris. Data and conclusions presented at meetings should be considered preliminary until published in a peer-reviewed journal.

More information

Visit the U.S. National Science Foundation to learn about robotics and health.

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THURSDAY, May 2 (HealthDay News) -- Women who have a breast biopsy that turns out to be benign are typically told to undergo another imaging test, such as a mammogram, in six to 12 months. Now, a new study suggests that the longer interval might be better.

Researchers who followed women who had benign breast biopsies say having that test less than a year later finds few cancers and is a drain on health care dollars.

''Doing a follow-up imaging study six months after a benign needle breast biopsy has a low likelihood of finding breast cancer at the biopsy site," said study author Dr. Andrea Barrio, an attending breast surgeon at Bryn Mawr Hospital, in Pennsylvania.

Most of these women, she said, can wait longer than six months before repeating the mammogram, ultrasound or MRI.

Dr. Demitra Manjoros, a breast fellow at Bryn Mawr, is due to present the research Thursday at the American Society of Breast Surgeons' annual meeting, in Chicago.

A biopsy is done after an abnormality is found on an imaging test such as a mammogram. The standard of care is to perform an image-guided needle biopsy, Barrio said.

"However, when you do a needle biopsy, you only sample the lesion or abnormality, instead of removing it," she said.

So, the follow-up imaging was suggested. Under current National Comprehensive Cancer Network guidelines, the repeat imaging is recommended six to 12 months after a benign breast biopsy.

"In my practice, I perceived that this short-term imaging did not seem to add anything to the care of the patient," Barrio said.

So, she launched the study, focusing on 337 women who had benign biopsies and met one other criterion: Their pathologic findings explained the finding on the image. Researchers then looked to see if the interval for repeat imaging made a difference in finding cancer.

Of the 337 women, 169 had imaging repeated less than 12 months after their benign biopsy result. Another 101 had no documented imaging test repeated. And another 67 had repeat imaging 12 months or later after the biopsy.

Of the 169, just one breast cancer was identified. Of the 67 who had repeat imaging at 12 months, no malignancies were found.

The cost of detecting a missing cancer with the shorter interval follow-up was nearly $193,000 in this group.

The study findings support a policy of discontinuing repeat testing less than 12 months after such a benign finding, Barrio said.

The findings don't mean no one should have shorter-term imaging follow up, Barrio said. While in general, routine short-term repeat imaging after such a benign biopsy is not needed, she said, "I'm not saying nobody should do it."

"Certain women would require six months follow-up," she said. For instance, a woman whose initial imaging findings were vague or not specific might be advised to get repeat imaging in less than a year, she said.

A breast cancer expert commented on the new research.

The study is sound, said Dr. Laura Kruper, director of the Cooper Finkel Women's Health Center and co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center in Duarte, Calif.

"I think most women would be fine having repeat imaging in 12 months," she said, "but it should be done on a selective basis." A doctor must take the whole patient into account, she said, weighing such factors as family history and a woman's views of the testing intervals.

"There are some patients who are going to be so nervous waiting a year," Kruper said.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about a breast biopsy, visit the American Cancer Society.

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THURSDAY, May 2 (HealthDay News) -- The brains of children with conduct problems don't react in a normal way when they see images of other people in pain, a new study finds.

Conduct problems include antisocial behaviors such as cruelty to others, physical aggression and a lack of empathy (callousness).

In this study, U.K. researchers used functional MRI to scan the brains of children with conduct problems and a control group of normally behaved children as they viewed images of other people in pain.

The children with conduct problems showed reduced responses to others' pain, specifically in regions of the brain that play a role in empathy. Among the children with conduct problems, those who were the most callous had the lowest levels of activation in these brain areas, according to the study. It was published May 2 in the journal Current Biology.

This pattern of reduced brain activity in children with conduct problems may be a risk factor for becoming psychopaths when they're adults, said Essi Viding, of University College London, and colleagues. Psychopathy includes traits such as callousness, manipulation, sensation-seeking and antisocial behaviors.

The researchers noted, however, that not all children with conduct problems are the same, and many do not continue their antisocial behavior as they get older.

"Our findings indicate that children with conduct problems have an atypical brain response to seeing other people in pain," Viding said in a journal news release. "It is important to view these findings as an indicator of early vulnerability, rather than biological destiny. We know that children can be very responsive to interventions, and the challenge is to make those interventions even better, so that we can really help the children, their families and their wider social environment."

More information

The U.S. National Library of Medicine has more about conduct disorder in children.

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WEDNESDAY, May 1 (HealthDay News) -- Using a kid-friendly robot during behavioral therapy sessions may help some children with autism gain better social skills, a preliminary study suggests.

The study, of 19 children with autism spectrum disorders (ASDs), found that kids tended to do better when their visit with a therapist included a robot "co-therapist." On average, they made bigger gains in social skills such as asking "appropriate" questions, answering questions and making conversational comments.

So-called humanoid robots are already being marketed for this purpose, but there has been little research to back it up.

"Going into this study, we were skeptical," said lead researcher Joshua Diehl, an assistant professor of psychology at the University of Notre Dame in Indiana, who said he has no financial interest in the technology.

"We found that, to our surprise, the kids did better when the robot was added," he said.

There are still plenty of caveats, however, said Diehl, who is presenting his team's findings Saturday at the International Meeting for Autism Research (IMFAR) in San Sebastian, Spain.

For one, the study was small. And it's not clear that the results seen in a controlled research setting would be the same in the real world of therapists' offices, according to Diehl.

"I'd say this is not yet ready for prime time," he said.

ASDs are a group of developmental disorders that affect a person's ability to communicate and interact socially. The severity of those effects range widely: Some people have mild problems socializing, but have normal to above-normal intelligence; some people have profound difficulties relating to others, and may have intellectual impairment as well.

Experts have become interested in using technology -- from robots to iPads -- along with standard ASD therapies because it may help bridge some of the communication issues kids have.

Human communication is complex and unpredictable, with body language, facial expressions and other subtle cues coming into the mix, explained Geraldine Dawson, chief science officer for the advocacy group Autism Speaks.

A robot or a computer game, on the other hand, can be programmed to be simple and predictable, and that may help kids with ASDs better process the information they are being given, Dawson said.

"Broadly speaking," she said, "we are very excited about the potential role for technology in diagnosing and treating ASDs." But she also agreed with Diehl that the findings are "very preliminary," and that researchers have a lot more to learn about how technology -- robots or otherwise -- fits into ASD therapies.

For the study, Diehl's team used a humanoid robot manufactured by Aldebaran Robotics, which markets the NAO robot for use in education, including special education for kids with ASDs. The robot, which stands at about 2 feet tall, looks like a toy but it's priced more like a small car, Diehl noted.

The NAO H25 "Academic Edition" rings up at about $16,000. (Diehl said the study was funded by government and private grants, not the manufacturer.)

The researchers had 19 kids aged 6 to 13 complete 12 behavioral therapy sessions, where a therapist worked with the child on social skills. Half of the sessions involved the robot, named Kelly, which was wheeled out so the child could practice conversing with her, while the therapist stood by.

"So the child might say, 'Hi Kelly, how are you?'" Diehl explained. "Then Kelly would say, 'Fine. What did you do today?'" During the non-Kelly sessions, another person entered the room and carried on the same conversation with the child that the robot would have.

On average, Diehl's team found, kids made bigger gains from the sessions that included Kelly -- based on both their interactions with their therapists, and their parents' reports.

"There was one child who, when his dad came home from work, asked him how his day was," Diehl said. "He'd never done that before."

Still, he stressed that while the robot sessions seemed more successful on average, the children varied widely in their responses to Kelly. Going forward, Diehl said, it will be important to figure out whether there are certain kids with ASDs more likely to benefit from a robot co-therapist.

Dawson agreed that there is no one-size-fits-all ASD therapy. "Any therapy for a person with an ASD has to be individualized," she said. The idea with any technology, she added, is to give therapists and doctors extra "tools" to work with.

A separate study presented at the same meeting looked at another type of tool. Researchers had 60 "minimally verbal" children with ASDs attend two "play-based" sessions per week, aimed at boosting their ability to speak and gesture. Half of the kids were also given a "speech-generating device," like an iPad.

Three and six months later, children who worked with the devices were able to say more words and were quicker to take up conversational skills.

Dawson said the robot and iPad studies are just part of the growing body of research into how technology can not only aid in ASD therapies, but also help doctors diagnose the disorders or help parents manage at home.

But both Diehl and Dawson stressed that no robot or iPad is intended to stand in for human connection. The idea, after all, is to enhance kids' ability to communicate and have relationships, Dawson noted. "Technology will never take the place of people," she said.

The data and conclusions of research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

Autism Speaks has information on autism and technology.

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TUESDAY, April 30 (HealthDay News) -- Women with breast implants could run the risk of having breast cancer diagnosed at later stages, when survival might be worse, according to Canadian researchers.

Breast implants can make it more difficult to diagnose breast cancer early because they block some areas of the breast on mammograms, experts say.

"Women who currently have breast implants and those considering breast augmentation should be aware of the possible long-term health effects of cosmetic breast implants," said lead author Eric Lavigne, a Ph.D. graduate in epidemiology with the faculty of medicine at University Laval, in Quebec City.

"They should also be reassured that physicians and other health professionals will continue to offer the best medical practices to these women," he added.

To see whether breast implants had an effect on breast cancer diagnosis and survival, Lavigne's team reviewed studies published after 1993. This process, known as a meta-analysis, attempts to find a consistent pattern from different studies. In many cases, these patterns aren't the focus of or apparent from each individual study, but emerge only after the data are combined.

In this case, by analyzing 12 studies, the researchers found that women with breast implants had a 26 percent increased risk of being diagnosed with late-stage breast cancer compared to women without implants.

When Lavigne's group looked at another five studies, they found that women with breast implants had a 38 percent increased risk of dying from breast cancer than women without implants.

This finding "may be explained by the advanced breast cancer diagnosis received," Lavigne said.

These results, however, need to be interpreted with caution since only a small number of studies were included in this summary, and many factors in each study can affect the overall results, he said.

Although the analysis linked breast implants to later-stage breast cancer diagnoses, it did not establish a cause-and-effect relationship.

The report was published online April 30 in the journal BMJ.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said she will be more cautious with patients.

"Patients ask if it's OK to do implants," Bernik said. "We don't tell them not to, but they have to understand that it comes with a risk of obscuring some of the breast tissue."

If someone has a family history of breast cancer, they should be cautious, Bernik said. "Everybody should be informed that there is this problem," she said. "It will limit the ability for cancer detection with mammography."

Bernik suggested that women with breast implants also have an ultrasound or MRI to get around the problem of the implant hiding breast tissue during a mammogram. She said, however, that for this purpose MRIs aren't covered by insurance.

More information

To learn more about breast cancer, visit the American Cancer Society.

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TUESDAY, April 30 (HealthDay News) -- It sounds like science fiction, but researchers are gaining ground in developing mind-controlled robotic arms that could give people with paralysis or amputated limbs more independence.

The technology, known as brain-computer (or brain-machine) interface, is in its infancy as far as human use -- though scientists have been studying the concept for years. But experts say that people with paralysis or amputations could be using the technology at home within the next decade.

It basically boils down to people using their thoughts to control a robot arm that then performs a desired task, like grasping and moving a cup. That's done via tiny electrode "grids" implanted in the brain that read the movement signals firing from individual nerve cells, then translate them to the robot arm.

"We have the ability to capture information from the brain and use it to control the robotic arm," said Dr. Elizabeth Tyler-Kabara, who presented her team's latest findings on the technology Tuesday, at the annual meeting of the American Association of Neurological Surgeons, in New Orleans.

However, she stressed, "we still have a ton to learn."

Right now, the robot arm is confined to the lab. After getting their electrodes implanted, study patients come to the lab to work with the robotic limb under the researchers' supervision. So far, Tyler-Kabara and her colleagues at the University of Pittsburgh School of Medicine have tested the approach in one patient. Researchers at Brown University in Providence, R.I., have done it in a handful of others.

One of the big questions, Tyler-Kabara said, is "how much control is enough?" That is, how well does the mind-controlled arm need to work to bring real everyday benefits to people?

At the meeting on Tuesday, Tyler-Kabara presented an update on how her team's patient is faring. The 53-year-old woman had long-standing quadriplegia due to a disease called spinocerebellar degeneration -- where, for unknown reasons, the connections between the brain and muscles slowly deteriorate.

Tyler-Kabara performed the surgery, where two tiny electrode grids were placed in the area of the brain that would normally control the movement of the right hand and arm. The electrode points penetrate the brain's surface by about one-sixteenth of an inch.

"The idea is pretty scary," Tyler-Kabara acknowledged. But her team's patient had no complications from the surgery and left the hospital the next day. There've been no longer-term problems either, she said -- though, in theory, there would be concerns about infection or bleeding over the long haul.

The surgery left the patient with two terminals that protrude through her skull. The researchers used those to connect the implanted electrodes to a computer, where they could see brain cells firing when the patient thought about moving her hand.

She was quickly able to master simple movements with the robotic arm, like high-fiving the researchers. And after six months, she was performing "10-degrees-of-freedom" movements, Tyler-Kabara reported at the meeting.

That includes not only moving the arm, but also flexing and rotating the wrist, grasping objects and affecting several different hand "postures." She has accomplished feats like feeding herself chocolate.

The researchers initially used a computer in training sessions with the patient, but after that the robot arm is directly linked to the electrodes -- so there is no need for "computer assistance," according to Tyler-Kabara.

Still, before the technology can ultimately be used at home, she said, researchers have to devise a "fully implanted" wireless system for controlling the robot arm.

Another expert talked about the new technology.

"This is one more encouraging step toward developing something practical that people can use in their daily lives," said Dr. Robert Grossman, a neurosurgeon at Methodist Neurological Institute in Houston, who was not involved in the research.

It's hard to put a time line on it all, Grossman said, since technological advances could changes things. He also noted that several research groups are looking at different approaches to brain-computer interfaces.

One, Grossman said, is to do it noninvasively, through electrodes placed on the scalp.

Study author Tyler-Kabara said that noninvasive approach has met with success in helping people perform simple tasks, like moving a cursor on a computer screen. "But I don't think it will ever be good enough for performing complicated tasks," she said, noting that it can't work as precisely as the implanted electrodes.

A next step, Tyler-Kabara said, is to develop a "two-way" electrode system that stimulates the brain to generate sensation -- with the aim of helping people adjust the robot's grip strength.

She said there is also much to learn about which people will ultimately be good candidates for the technology. There may, for example, be some brain injuries that prevent people from benefiting.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The research is being funded by the U.S. National Institutes of Health, the Department of Veterans Affairs and the University of Pittsburgh.

More information

The University of Pittsburgh has images of the brain-computer interface at work.

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