Role of Antidiabetics in Pancreatic Cancer Risk Unclear

 January 31, 2012 — A case–control study of general practice patients in the United Kingdom suggests that the use of metformin is not associated with a significant wholesale drop in risk for pancreatic cancer as some previous studies have suggested. Rather, researchers saw a reduction in pancreatic cancer risk only in women who filled 30 or more metformin prescriptions during an extended period of time.

In contrast, the authors found that use of antidiabetics such as sulfonylureas and insulin were associated with an increased risk for pancreatic carcinogenesis, report Michael Bodmer, MD, from the Department of Pharmaceutical Sciences, University of Basel, Switzerland, and colleagues in an article published online January 31 in the American Journal of Gastroenterology.
Drawing on data from the United Kingdom–based General Practice Research Database, the investigators identified a cohort of 2763 patients (1276 men and 1487 women) who had a first-time diagnosis of pancreatic cancer between 1995 and 2009, along with 16,578 matched control patients. Of those, 307 (11.1%) of the patients in the case group had diabetes, as did 1347 (8.1%) in the matched control patients.

To assess the effect of antidiabetic drugs on pancreatic cancer risk, the investigators stratified patients according to the duration of use (short-, medium-, or long-term), based on the number of prescriptions filled for metformin, sulfonylureas, and/or insulin during the study period. Confounders such as smoking, body mass index, alcohol consumption, and duration of diabetes mellitus also were factored into risk estimates.

The authors found that the largest reduction in pancreatic cancer risk (adjusted odds ratio [AOR], 0.43; 95% confidence interval [CI], 0.23 – 0.80) occurred in women who had been prescribed metformin 30 or more times. This compares with a higher adjusted risk (AOR, 1.59; 95% CI, 0.95 – 2.66) for men with diabetes who received 30 or more metformin prescriptions.

For the study group as a whole, however, investigators observed a non–statistically significant progression of risk reduction as use of the agent continued for longer periods. They reported AORs of 1.01 for from 1 to 9 metformin prescriptions (95% CI, 0.67 – 1.54), 0.92 for 10 to 29 prescriptions (95% CI, 0.62 – 1.35), and 0.87 for 30 or more prescriptions (95% CI, 0.59 – 1.29).

These newly published results vary from those of Li et al, who reported reduced risks (OR, 0.38; 95% CI, 0.22 – 0.69; P = .001) for male and female metformin users alike in a 2009 study of 973 patients with pancreatic adenocarcinoma.

Dr. Bodmer and colleagues report in the current paper that long-term use of other antidiabetics may be associated with increased risk of pancreatic cancer. “[L]ong term use of sulfonylureas (adj. OR: 1.90, 95% CI: 1.32-2.74) and insulin (adj. OR 2.29, 95% CI: 1.34-3.92) were associated with a materially increased risk of pancreatic cancer,” the authors write.

The investigators note cautiously that the women in the study group appeared to have a greater risk than the men, with regard to sulfonylureas-related cancer risk, whereas it was the men who demonstrated an elevated risk with long-term insulin treatment.

“As with metformin, these results are based on a limited number of exposed cases and controls and require careful interpretation, since no previously reported data are available suggesting different effects of sulfonylureas or insulin across genders,” the authors caution.

Various confounders, drug combinations, and observational controls have been modeled into previous studies that sought to quantify the theorized effects of metformin, insulin, and other antidiabetic agents on pancreatic and nonpancreatic tumor development. One analysis found that patients with diabetes who relied on insulin alone faced as much as 4.5 times the estimated risk for pancreatic cancer, as measured in cancer events per 1000 patient years

Although scientists have targeted different primary outcome measures with each research effort, Dr. Bodmer and colleagues note that their most recent inquiry does not alter a central observation: Diabetes mellitus appears to be both a cause of and a risk factor for pancreatic cancer.

The work was partially supported by the Swiss Cancer League and the Research Fund of the University of Basel. The authors have disclosed no relevant financial relationships.

Am J Gastroenterol. Published online January 31, 2012.

From: http://www.medscape.com/viewarticle/757743?sssdmh=dm1.754711&src=nldne

Procycling Racing February 2012 Dates

February 2012

01-05 Feb	Etoile de Bessèges Etoile de Bessèges (Directvelo.com)	Fra	2.1	2012 2012
04 Feb	G.P. Costa degli Etruschi (Castagneto-carducci.li.it)	Ita	1.1	2012
05-10 Feb	Tour of Qatar Tour of Qatar (Matsport)	Qat	2.HC	2012 2012
05-10 Feb	Tour d’Egypte	Egy	2.2	X
05 Feb	Trofeo Palma de Mallorca	Esp	1.1	2012
06 Feb	Trofeo Migjorn (was Trofeo Cala Millor-Cala Millor)	Esp	1.1	2012
07 Feb	Trofeo Deià (was Trofeo Inca)	Esp	1.1	2012
08 Feb	Trofeo Serra de Tramuntana / Trofeo final (was Trophée Deià)	Esp	1.1	2012
09-12 Feb	Giro della Provincia di Reggio Calabria-Challenge Calabria Giro della Provincia di Reggio Calabria-Challenge Calabria (Facebook) Giro della Provincia di Reggio Calabria-Challenge Calabria (Ficr.it)	Ita	2.1	2011 2011 2011
09 Feb	Trofeo Magaluf-Palmanova	Esp	1.1	-
12 Feb	Grand Prix of Sharm el-Sheikh	Egy	1.2	X
14-19 Feb	Tour of Oman (.om) Tour of Oman (Letour.fr) Tour of Oman (Matsport)	Oma	2.1	2012 2012 2012
14-18 Feb	Asian Cycling Championships Kuala Lumpur	Mas	CH	2012
15-19 Feb	Volta ao Algarve Volta ao Algarve (Edosof.com)	Por	2.1	2012 2011
16 Feb	Les challenges de la Marche verte – GP Sakia El Hamra	Mar	1.2	X
17 Feb	Les challenges de la Marche verte – GP Oued Eddahab	Mar	1.2	X
18 Feb	Les challenges de la Marche verte – GP Al Massira	Mar	1.2	X
18-19 Feb	Tour du Haut Var	Fra	2.1	2012
18 Feb	Trofeo Laigueglia	Ita	1.1	2012
19-23 Feb	Vuelta a Andalucia Ruta Ciclista Del Sol	Esp	2.1	2012
20-27 Feb	Vuelta Independencia Nacional (Ciclismo.com.do) Vuelta Independencia Nacional (Zciclismo.blogspot.com)	Dom	2.2	2011 2011
21-25 Feb	Giro di Sardegna Giro di Sardegna (Gsemilia.it) Giro di Sardegna (Ficr.it)	Ita	2.1	2011 2011 2011
21-26 Feb	Rutas de America (Edosof.com) Rutas de America (Federacionciclistauruguaya.com.uy)	Uru	2.2	2011 2011
24 Feb-04 Mar	Le Tour de Langkawi	Mas	2.HC	2012
25 Feb	Gran Premio Regio Insubrica (3vallivaresine.com)	Ita	1.1	2011
25 Feb	Omloop Het Nieuwsblad Elite Omloop Het Nieuwsblad Elite (Kbwb-rlvb.com)	Bel	1.HC	2012 2011
25 Feb	Ster van Zwolle	Ned	1.2	2011
25 Feb	VZW. Beverbeek Classic	Bel	1.2	2012
26 Feb	Clasica de Almeria	Esp	1.HC	down
26 Feb	Classica Sarda Sassari – Cagliari Classica Sarda Sassari – Cagliari (Ficr.it)	Ita	1.1	2011 2011
26 Feb	GP di Lugano / Gran Premio di Lugano	Sui	1.1	2012
26 Feb	Kuurne-Brussel-Kuurne / Kuurne-Bruxelles-Kuurne	Bel	1.1	2012
26 Feb	Les Boucles du Sud Ardèche – Souvenir Francis Delpech	Fra	1.1	2012
29 Feb	Le Samyn Le Samyn (Alarrivee.be)	Bel	1.1	2012 2011

Waltham Health Care Facility Closing

Kindred Healthcare has announced it is closing its Waltham health care facility.

In a statement e-mailed to Waltham Patch, the company confirmed it would close the location, which provdies short-term rehabiliation services among other types of care, within 90 days.

“We made this decision because we serve the community through several hospitals in the area and determined it was not feasible to continue operating in Waltham,” the statement reads.

The facility has ceased accepting new patients and has informed the state of its decision, according to the statement.

The company plans to continue providing services as the closing approaches and plans to help patients transfer to other health care facilities, according to the statement.

From: http://ping.fm/xWK9S

L’Oréal USA announces plans to close Solon plant

L’Oréal USA’s manufacturing plant in Solon announced a plan to transfer production which will result in the closing of the facility on or about the end of 2013.

The decision to relocate the majority of production and equipment to the company’s Florence, Kentucky and Franklin, New Jersey plants was taken to ensure that the company could meet the business growth for professional products anticipated in the future.

All shampoo and conditioner production will be centralized at one location in North America.

Tuesday’s announcement will affect approximately 260 employees. The company will offer affected employees in good standing continued employment at other L’Oréal USA locations where possible.

From: http://ping.fm/ThF8n

S&P Warns Cuts Loom for G20 Nations on Health Costs – Business News – CNBC

Ratings agency Standard & Poor’s warned it may downgrade “a number of highly rated” Group of 20 industrialized countries from 2015 if their governments fail to enact reforms to curb rising health-care spending and other costs related to aging populations.

Developed nations in Europe, as well as Japan and the United States, are likely to suffer the largest deterioration in their public finances in the next four decades as more elderly strain social safety nets, S&P said in a report.

“Steadily rising health-care spending will pull heavily on public purse strings in the coming decades,” S&P analyst Marko Mrsnik wrote in the report. “If governments do not change their social protection systems, they will likely become unsustainable.”

If no reforms are adopted, health-care-related credit downgrades would likely start within three years, eventually leading to an increase in the number of junk-rated countries as of 2020, the study showed.

Byun Yanggyu, director of macroeconomics at the Korea Economic Research Institute warned developed nation will eventually become the victims of their social safety nets.

“The more developed countries get, the more complicated their welfare structures become. In order to cover all necessary means in terms of welfare, spending elsewhere will have to shift there,” Byun told Reuters.

“I believe our country is headed more so in that direction… and it will dull our production in the end,” he said. “There is a bigger chance that developed countries will be subject to a downgrade from this point of view.”

Health care will likely be the fastest-growing expenditure for developed countries, which already have high social protections and rapidly worsening demographic profiles.

From: http://ping.fm/FNvpc

Grower to lay off more than 2,100 seasonal workers

In a move experts said is part of an ongoing trend, local fruit and vegetable grower Sun Pacific Farming Cooperative, Inc. will permanently lay off more than 2,100 employees based at its Bakersfield facility in favor of a seasonal workforce provided entirely by farm labor contractors. The layoffs will take place on or about March 12.

The company, which operates facilities in Kern and Tulare counties, alerted the county to the layoffs in a Jan. 12 Worker Adjustment and Retraining Notification Act notice, as is legally required for employers laying off large numbers of workers.
“We don’t have a need to employ 2,100 people year-round,” said Sun Pacific Chief Financial Officer Toby Maitland-Lewis in an interview earlier this month. “What we’ve done is make a decision to lay off all of our seasonal employees, primarily because we don’t have the amount of acreage we’ve had historically.”

Maitland-Lewis said the uncertainty about crops from year to year, coupled with a decline in acreage — by 30 percent over the last three years — led to the decision to eliminate the permanent positions, which include harvesters, pruners, crew bosses and other workers associated with Sun Pacific’s table grape and kiwi farming.

“We feel that moving to farm labor contractors for seasonal (work gives us) more flexibility over the course of the year,” he said, adding that he sees the changes less as “layoffs” and more as workers “changing employers and it just doesn’t happen to be us.”

Already, Maitland-Lewis said, about 70 percent of its seasonal laborers at peak harvest times are employees of independent farm labor contractors, as opposed to permanent employees of Sun Pacific. The layoffs, he said, mean that number will be increased to 100 percent.

The shift toward hiring most seasonal workers through farm labor contractors, rather than keeping workers on a company’s payroll is hardly a novel phenomenon, said University of California Cooperative Extension Specialist Emeritus Howard Rosenberg, who has studied agricultural labor management for decades.

He said that when he looked at Salinas’ vegetable industry in the early 1980s, “most employment there was directly on (farmers’) payrolls.”

Since then, he said, he’s seen the proportion of the agricultural workforce hired by way of farm labor contractors increase.

“It has grown from the low 20 percents, to now over 40 percent,” he said, “and some people would say that it’s now over 80 percent.”

Rosenberg said going with farm labor contractors can help growers avoid “transaction costs for hiring and firing.”

He added that large farming operations require a lot of management and knowledge of different fields, so dealing with middlemen who are theoretically experts at “dealing with the complex regulatory environment,” is a way of outsourcing some of that burden.

Guadalupe Sandoval, managing director for the California Farm Labor Contractor Association, said the trend toward contracting out labor is, in part, a product of the current economic climate.

From: http://ping.fm/Zp3O5

Gov. Bill Haslam’s $31 billion budget abolishes government jobs

NASHVILLE — Under the theme “believe in better,” Gov. Bill Haslam proposed Monday a $31 billion state budget for the coming year that provides a 2.5 percent pay raise for state employees while abolishing 1,166 government jobs.

The budget also allocates $263 million toward the $2.1 billion in construction on college and university campuses that the higher education system had proposed and seeks $70 million in additional state funds to give businesses expanding or relocating in Tennessee.
“We can believe in better for how state government serves Tennesseans,” the governor said in a “State of the State” speech to the General Assembly. “We can believe in better when it comes to the education of our children, and we can believe in better when we talk about a stronger, healthier economy for our state.”

Overall, the proposed budget would spend $31.08 billion. When the current year’s budget was adopted, it was pegged as costing $30.2 billion. But money has been added to current year spending since then — mostly in federal funds, but some in college tuition increases and otherwise — to build the current year total to $31.93 billion, officials said.

Thus, the budget for next year is presented as actually spending less than in the current year, though officials acknowledged that the $31.08 billion will likely increase by next year, just as the current year’s budget has increased.

The pay raise for state employees, teachers and higher education staff will be provided in a sum sufficient to cover an across-the-board increase following a 1.6 percent general boost in salaries this year. Pending legislation would grant local school systems and state department heads more authority to base pay raises on merit, meaning some teachers or employees would get more than others.

Of the eliminated state jobs, 617 are currently filled and 459 vacant, officials said. The reductions lower the total state employee positions in state government from 45,072 in the current fiscal year, which ends June 30, to 43,906 in the next, a 2.6 percent reduction. State employment was at a peak in 2008 with 49,835 employees.

Haslam is also asking for a “salary study” by an outside contractor. The proposed budget allocates $30 million for implementing changes recommended by the study to adjust upward salaries in designated job positions.

The governor makes official his acceptance of cabinet recommendations to close Lakeshore Mental Health Institute in Knoxville and the Taft Youth Center for juvenile offenders in Pikeville. Budget documents say the Lakeshore closing will eliminate 308 job positions.

Higher education officials had sought $2.1 billion for capitol outlay through a bond issue. Haslam’s budget recommended $263 million for construction projects and another $72 million for capital maintenance, both far less than sought but more than in recent years. Biggest projects on the list for actual construction work in the coming fiscal year are a $94 million Strong Hall Science Laboratory at the University of Tennessee Knoxville and a $126 million science building at Middle Tennessee State University.

The $263 million includes $14 million in “pre-planning” money for other higher education construction projects, which may be seen as a commitment to build them in future years. One of those, designated for $3 million in pre-planning, is a UT Knoxville Academic and Instructional Center.

In grants to business, Haslam proposes to add $50 million to the current year’s budget as a “supplement” to provide that money in cash grants to an unnamed business or businesses before July 1. He proposes another $20 million for cash to businesses in the next fiscal year.

Other budget provisions as outlined by the governor include:

n Restoring about $100 million of $160 million scheduled for elimination in the upcoming budget year after “core services reserve” fund were used to keep the programs alive during the current year. The surviving programs provide school nurses, alcohol and drug abuse treatment, diabetes prevention, juvenile justice grants and extended work years for some teachers.

From: http://ping.fm/EWcRx

Euro Zone Jobless Hits Highest Level Since Birth of Euro

Euro zone unemployment has risen to its highest level since the euro single currency was introduced, data showed on Tuesday, a day after EU leaders promised to focus on creating millions of new jobs to try to kickstart Europe’s floundering economy.

Seasonally adjusted unemployment among the 17 countries sharing the euro rose to 10.4 percent in December, on a par with an upwardly revised November figure, the European Union’s statistics office Eurostat said.

It was the highest rate since June 1998, before the introduction of the euro in 1999.

“We’re looking at a further increase over the coming months, so that is worrying,” said Martin van Vliet, an economist at ING.

“Look at Greece, where unemployment is some 20 percent, and it is 23 percent in Spain this could lead to political unrest.” After two years of a deep debt crisis and budget austerity, the number of Europeans out of work has risen to 16.5 million people, with another 20,000 people without a job in December from the month before.

The rate steadily crept up through 2011 as growth stalled and recession loomed.

At a summit on Monday, Europe’s leaders tried to shift the debate from fighting the debt crisis to reviving growth in a bloc that produces 16 percent of global economic output.

They are looking to deploy 82 billion euros of unspent funds from the EU’s 2007-2013 budget in an attempt to boost employment.

But most economists expect scant progress while the euro zone’s high debtors are compelled to persist with harsh austerity programmes.

A growing gap between the wealthy nations of northern Europe and those of the poorer, less productive south overshadows any EU-wide growth and jobs policies implemented from Brussels.

Germany’s unemployment rate fell to 6.7 percent in January, separate figures showed, a new record low since figures for unified Germany were first published.

Austria boasted the euro zone’s lowest jobless rate at 4.1 percent in December, followed by the Netherlands at 4.9 percent.

But unemployment in Spain reached a new high of 22.9 percent in November and December.

In Greece, joblessness was 19.2 percent for October, the latest data available. Unemployment reached 13.6 percent in Portugal in the final month of 2011.

From: http://ping.fm/b1zBA

Greece failing to afford athletes for Olympics

What happens if the country that invented the Olympics cannot afford to produce Olympic athletes? As this summer’s London Games approach, that notion is causing great angst in Greece, where elite athletes are feeling the sting of austerity measures in the face of debt crisis.

The government scrapped a plan to spend nearly $10 million a year on Olympic preparation, according to the Hellenic Olympic Committee. Athletes say their financial stipends are frequently months late, and it is common for coaches to go months without paychecks. Training centers have fallen into disrepair or have closed. A sports psychologist who counsels Greek athletes is working pro bono these days.

Greeks will compete in London, but they will perhaps be limping a bit at the opening ceremony July 27. “Young athletes are very skeptical about continuing when they see that the top athletes are not receiving what they deserve, that they are not supported as they should be,” Vassilios Sevastis, the president of the Greek amateur athletics association, known by the acronym SEGAS, said through an interpreter. “This is the major risk.”

Greece has competed in every Summer Olympics since the modern Games began in 1896, when Athens hosted. Even during the Great Depression, Greece managed to send athletes to Los Angeles in 1932 – the year it defaulted on its external debt. For Winter Games, Greece usually sends a handful of skiers.

To build a team for London, the country’s Olympic committee has pursued private-sector sponsors and has increased its dependence on aid from the International Olympic Committee. Now the growing concern is whether Greece, the host of the 2004 Summer Games, which have come to symbolize a decade of overspending, can sustain this course for long.

Like other elite athletes, the pole-vaulter Kostas Filippidis said it had been several months since he received his monthly $1,400 stipend from the athletics federation.

“Of course it’s a thought, but I cannot be worried about this every day,” he said, adding that he lived rent-free in an apartment owned by his father. “Taking part in the Olympics for my country makes me very proud.”

Filippidis trains indoors at the Olympic Stadium complex. He said the heat was on for just one hour a day. On a recent visit, just a few athletes were training there, and a large plastic container was positioned in a long-jump lane – not to be leapt over but to catch water leaking from the skylight above.

Alkisti Avramidou, a water polo player, said that “I think twice” before spending even one euro and that it was becoming difficult to ask her parents for help. Her father, a doctor, has seen his salary cut in half; her mother, a civil servant, has not been paid in several months. With the exception of going to practice, Avramidou avoids driving because she cannot afford gasoline, which costs about $8 a gallon.

Sevastis said the organization received only three-quarters of the $9.6 million budgeted for 2011, and that was after an injection of $1.6 million in December. A month earlier, the association’s board suspended operations to protest. The December infusion allowed coaches and athletes to be paid, Sevastis said, but overall, the association provides money to just 23 elite athletes, compared with 60 two years ago.

From: http://ping.fm/WUtn8

Cheerful counterpoint to depressing news

The writer below has good ideas about this topic, but I would add to it, sports, in my case, bicycling is my cheerful counterpoint activity to this modern day financial depression the world is going through.

Recently a PhD student was talking about her anxiety building. (I’m not attributing the problems quotes because these are pretty common problems.) Part of the problem was this:

I need to stop reading about the lack of jobs in humanities as I am not in humanities. Still makes me panic.
I think my anxiety is related to the pressure to look TT and I never wanted to do that from the beginning.

I suggested stopping reading the news and trying novels, even trashy novels. Someone else chimed in

I started reading novels but kept ending up with dystopias and novels with sad endings. So I went back to news.
trust me, didn’t pick them intentionally. I was looking for goodness& light. Taking recommendations

Being the sort of person I am, I solicited suggestions. I will attribute the suggestions because anyone who is willing to suggest uplifting stuff to read is worth a follow on Twitter

From: http://ping.fm/Ofbhs