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Equipment in the NICU
Travel Nurse Informatics Job
If your baby had reflux in the NICU,Reflux in infants
Common conditions treated in the NICU
Procedure:Urine Collection, 24-Hour Specimen
Antioxidants and Cancer Prevention: Fact Sheet

Posted: 06 Jan 2011 05:30 AM PST

equipment and procedures in the neonatal intensive care unit. Seeing your baby hooked up to machines and covered with wires can be scary, but the equipment is all there to help your baby get well.
Monitoring equipment
Infants in special care nurseries are continuously monitored to make sure they are healthy. Monitors commonly used include:

* Cardiac monitors: These use stickers on the chest connected to wires (called leads) that hook up to a monitor to make sure that baby’s heart is beating at the correct speed and with the correct rhythm.

* Respiratory monitors: Often part of the cardiac monitors, these use leads to monitor baby’s breathing rate and pattern.

* Pulse oximeters: These wrap around your baby’s wrist or foot and have a red light that monitors the amount of oxygen in the blood.

IV Equipment
You may be familiar with IVs, or thin tubes that go into the veins to allow staff to infuse fluids or medicines directly into the veins. As part of regular NICU procedures, babies in the NICU may have several types of IV lines.

* Peripheral IVs: These are the “regular” IVs that go into a vein for medications or fluids. Peripheral IVs may be in the feet, hands, arms, or scalps of premature babies. Although scalp IVs look scary to parents, they are very common in the NICU since premature babies don’t always have good veins for IVs in their hands and feet.

* PICC lines: Percutaneously inserted central catheters, or PICC lines for short, look like regular IVs. They have longer catheters, or tubes, than regular IVs, and travel through the vein into the large veins that empty into the heart. Insertion of these lines is one of the procedures NICU babies commonly undergo.

* Umbilical catheters: These are inserted into the umbilical cord stump and travel to the large veins and arteries near the heart. Umbilical lines may be inserted into an artery in the umbilical cord, a vein in the umbilical cord, or both, to allow fluid and medication administration, blood pressure monitoring, painless blood sampling, and other procedures.

Respiratory equipment
Infants in the NICU may need help to breathe or to keep their blood oxygenated. Respiratory equipment in the NICU may include:

* Nasal cannulas: A nasal cannula is a set of small nasal prongs may provide a higher concentration of oxygen than room air. They may also deliver room air at a higher flow, which helps to keep airways open and encourage babies to breathe on their own.

* CPAP: Continuous positive airway pressure, or CPAP, is a mask or a special set of nasal prongs placed firmly on baby’s nose to constantly blow air. The constant pressure encourages open airways and reminds babies to breathe, and higher concentrations of oxygen may be used.

* Ventilators: If a baby is put on a ventilator, then procedure called intubation will be used to place a special tube called an endotracheal tube in the airway through the mouth or nose. The ventilator, or respirator, is the machine that delivers breaths to babies who cannot breathe on their own or who don’t breathe well.

* ECMO: Extracorporeal membrane oxygenation is a highly specialized procedure to oxygenate baby’s blood. ECMO is used only in very sick babies at highly advanced NICUs. With ECMO, the baby’s blood is pumped out of the body so that oxygen can be added and carbon dioxide removed. The blood is then returned to the body.

Other equipment
While in the NICU, your baby may require additional equipment as well.

* Feeding tubes: A feeding tube travels from the mouth (orogastric- called OG) or from the nose (nasogastric- called NG) to the stomach. Infants who are too sick or weak to eat from the breast or from a bottle receive food through these tubes. Inserting the tubes and giving feedings through them are common procedures among premature babies.

* Incubators: Premature infants have trouble keeping themselves warm, so incubators are used to provide a warm place for baby to rest. Skin probes constantly measure the baby’s temperature, so he or she doesn’t get too warm or too cold.

* Phototherapy: Preemies are more likely to have problems from jaundice. Phototherapy lights, also called bili lights, are special lights that help the baby’s body break down bilirubin, the chemical that causes jaundice.

Sources:

American Academy of Pediatrics. "Levels of Neonatal Care"
Pediatrics 2004 114:1341-1347.

Children’s Hospital of Pittsburgh. "Procedures and Equipment
in NICU." Accessed November 22, 2008. http://www.chp.edu/CHP/P02358

Children’s Hospital West. "Our Caring NICU Staff."
2008. Accessed November 22, 2008. http://www.memorialwest.com/neonatal/staff.aspx

March of Dimes. "Glossary: Common NICU Equipment."
October 2008. Accessed November 22, 2008.

Nemours Foundation. "When Your Baby’s In the NICU."
Accessed November 22, 2008. http://kidshealth.org/parent/system/ill/nicu_caring.html

http://preemies.about.com/od/allaboutthenicu/a/NICU2.htm?once=true&

Travel Nurse Informatics Job

Posted: 06 Jan 2011 05:17 AM PST

Position Description for this Travel Nurse Informatics Job :

Nurse Informatics contract assignment. Position is located in the Mid Atlantic region and the project length varies. This is a great opportunity outside of a true clinical setting. Work along with clinicians and analysts to develop and test clinical applications. You’ll serve a project advisor, proposal developer and end user liason. RN Required and Cerner Millennium experience preferred. A great location with lots of history and sites to see when you are not working.
Soliant offers a great benefits including health care plans with Blue Cross Blue Shield, 401k, disability and life insurance. In addition you’ll receive a strong compensation plan. For more information contact:
Kevin Morris at 800.947.8233

Benefits Travel Nurse Informatics Job :

Competitive Salaries. We’re proud to offer some of the most competitive compensation packages in the industry. We’ll even create a custom package to meet your unique needs.
Weekly Pay. If you’re tired of the typical long wait between paychecks, you’ll welcome Soliant’s weekly pay system. You’ll be paid every Friday during your assignment and we’ll be glad to deposit your check directly for you.

Healthcare Benefits for this Travel Nurse Informatics Job
Our health and dental program is not a bare-bones version. You’ll receive the same complete benefits from Blue Cross Blue Shield that all our internal employees enjoy.
Matching 401(K). Our 401(k) retirement plan with matching from Merrill Lynch will make investing for your future easy.
Paid Personal Housing. Privacy is important to everyone. We understand. That’s why we offer the finest in paid personal housing.
Referral Bonus. Earn cash for each new healthcare professional you refer that becomes a part of the Soliant Health family

Facility Description Travel Nurse Informatics Job :

At Soliant Health, we don’t just fill healthcare jobs, we fulfill dreams. Thousands of dreams every year, for professionals just like you.
As a Soliant healthcare professional, you’ll enjoy a personal relationship with a recruiter who is as passionate about your career as you are. Your recruiter works tirelessly to match your personal goals, interests, strengths and professional aspirations with the right job, in the right place. But it doesn’t stop there. Your recruiter is always with you, available for assistance, advice or simply an understanding ear on which you can always count.
It’s this consistent, one-on-one attention that sets Soliant Health apart from other healthcare staffing agencies. Well, this and the fact that we go the distance for our healthcare professionals, taking care of every last detail – travel plans, housing and scheduling – so you can focus on your job, and yourself!

Location Travel Nurse Informatics Job :

Mid Atlantic, Maryland
Note: Click the location link above to see a map of this location. The best available map will be displayed depending on if a real City name and Zip Code are posted.
Job Title: Travel Nurse Informatics Job
Category: Professional: Information Systems/Computers
Position Is For: A Travel Assignment
Position Posted By: A Facility, Registry, or Staffing Company
Posting Expires: February 21, 2011
Contact: Please tell this company you saw their job posting at Absolutely Health Care.

(info@soliant.com)
Phone: 800.849.5502

for further information Travel Nurse Informatics Job <font size=”1″>http://www.healthjobsusa.com/cgi-bin/search.cgi?action=display&ID=82266036&source=web</font>

If your baby had reflux in the NICU,Reflux in infants

Posted: 06 Jan 2011 05:05 AM PST

If your baby had reflux in the NICU

All babies spit up or throw up now and then. But some do so more often than usual. This is called reflux. Reflux is short for gastroesophageal reflux or GER. Reflux is common among premature babies. Most babies outgrow it after a few months. Only 1 percent of babies are still spitting up after their first birthday.

Here’s what happens with reflux:

* Food first passes through the mouth and the esophagus into the stomach. (The esophagus is the tube that connects the mouth and the stomach.)
* Once the food is in the stomach, it comes back up the esophagus and out of the mouth.

Most babies with reflux are less bothered by it than their parents. They grow and develop normally. But for a few babies, reflux is more serious. The baby needs medication to make sure reflux is not dangerous.

Feeding tips
If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spit up. These tips may help:

* Hold your baby upright during feeding.
* Try smaller, more frequent feedings.
* Burp your baby often, especially if you are feeding him with a bottle.
* Try a different nipple on your baby’s bottle so he swallows less air.
* Ask your baby’s health care provider if you can thicken the formula or expressed breastmilk with a small amount of rice cereal.
* Keep your baby still after feeding.
* Raise the head of your baby’s bed 30 degrees or so.
* Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby’s clothes and your furniture.

When to call your baby’s health care provider
These symptoms may mean that your baby has other problems digesting food:

* The spit-up is bright yellow or green.
* There is a large amount of spit-up.
* Your baby arches his back or cries during feeding.
* Your baby vomits with great force (projectile vomiting).
source If your baby had reflux in the NICU,Reflux in infants http://www.marchofdimes.com/advocacy/premature_reflux.html

Common conditions treated in the NICU

Posted: 06 Jan 2011 04:57 AM PST

Conditions treated in the NICU

Premature babies and other very sick newborns face some of the same medical issues. Listed below are some medical conditions that may be seen in the NICU.

The conditions listed may not be relevant to your baby’s situation. We encourage you to read only what you feel would be helpful to you and your child’s particular circumstances.

To find out more information about specific conditions, ask our health experts.

Additional information and support for families with babies in the NICU can be found at Share Your Story, the March of Dimes Web site for NICU families.

Anemia
Premature babies are often anemic. This means that they do not have enough red blood cells. Normally, the fetus stores iron during the latter months of pregnancy and uses it after birth to make red blood cells. Infants born too soon may not have had enough time to store iron. Loss of blood from frequent blood tests also can contribute to anemia. Anemic infants may be treated with dietary iron supplements, drugs that increase red blood cell production or, in some cases, a blood transfusion.

Breathing problems
Premature babies often have breathing problems because their lungs are not fully developed. Full-term babies also can develop breathing problems due to complications of labor and delivery, birth defects and infections. An infant with breathing problems may be given medicines, a mechanical ventilator to help him breathe, or a combination of these two treatments.

Apnea: Premature babies sometimes do not breathe regularly. A baby may take a long breath, then a short one, then pause for 5 to 10 seconds before starting to breathe normally. This is called periodic breathing. It usually is not harmful, and the baby will outgrow it.

Premature and sick babies also may stop breathing for 15 to 20 seconds or more. This interruption in breathing is called apnea. It may be accompanied by a slow heart rate called bradycardia. Babies in the NICU are constantly monitored for apnea and bradycardia (often called "A’s and B’s").

Sensors on the baby’s chest send information about his breathing and heart rate to a machine located near the incubator. If a baby stops breathing, an alarm will begin beeping. A nurse will stimulate the baby to start breathing by patting him or touching the soles of his feet. The neonatologist might consider giving the baby medicine or using equipment, such as C-PAP (continuous positive airway pressure; delivery of air to a baby’s lungs through either small tubes in the baby’s nose or through a tube inserted into the windpipe).

Bronchopulmonary dysplasia (BPD): This chronic lung disease is most common in premature babies who have been treated for respiratory distress syndromre (RDS) (see below). Babies with RDS have immature lungs. They sometimes need a mechanical ventilator to help them breathe. Some babies treated for RDS may develop symptoms of BPD, including fluid in the lungs, scarring and lung damage.

Babies with BPD are treated with medications to help make breathing easier. They are slowly weaned from the mechanical ventilator. Their lungs usually improve over the first two years of life. But some children develop a chronic lung disease resembling asthma. BPD also occasionally occurs in full-term newborns after they have had pneumonia or other infections.

Persistent pulmonary hypertension of the newborn (PPHN): Babies with PPHN cannot breathe properly because they have high blood pressure in their lungs. At birth, in response to the first minutes of breathing air, the blood vessels in the lungs normally relax and allow blood to flow through them. This is how the blood picks up oxygen. In babies with PPHN, this response does not occur. This leads to a lack of oxygen in the blood, and sometimes to other complications including brain damage. Babies with PPHN often have birth defects (such as heart defects) or have suffered from birth complications.

Babies with PPHN often need a mechanical ventilator to help them breathe. They may be given a gas called nitric oxide through a tube in the windpipe. This treatment may help the blood vessels in the lungs to relax and improve breathing.

Pneumonia: This lung infection is common in premature and other sick newborns. A baby’s doctors may suspect pneumonia if the baby has difficulty breathing, if her rate of breathing changes, or if the baby has an increased number of apnea episodes.

The doctor will listen to the baby’s lungs with a stethoscope and then do an X-ray to see if there is excess fluid in the lungs. Sometimes the doctor may insert a tube into the lungs to take a sample of the lung fluid. The fluid is then tested to see what type of bacterium or virus is causing the infection, so that the doctor can choose the most effective drug to treat it. Babies with pneumonia are generally treated with antibiotics. They also may need additional oxygen until the infection clears up.

Respiratory distress syndrome (RDS): Babies born before 34 weeks of pregnancy often develop this serious breathing problem. RDS is sometimes called hyaline membrane disease. Babies with RDS lack a chemical mixture called surfactant, which keeps the small air sacs in the lungs from collapsing. Treatment with surfactant helps affected babies breathe more easily.

Babies with RDS also may receive a treatment called C-PAP (continuous positive airway pressure). The air may be delivered through small tubes in the baby’s nose, or through a tube that has been inserted into his windpipe. As with surfactant treatment, C-PAP helps keep small air sacs from collapsing. C-PAP helps your baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a mechanical ventilator to breathe for them while their lungs recover.

Respiratory syncytial virus (RSV): If your baby was premature, you may be advised to get your baby immunized against respiratory syncytial virus. RSV is a common virus that affects virtually all children before the age of 2. Many babies get only a slight cold from RSV. But RSV can be more serious.

Babies who were born prematurely, or who have heart or lung problems, may benefit from medication that helps prevent a severe RSV infection. This medication is called palivizumab (Synagis). It is given in monthly shots usually from fall through spring. Ask your baby’s health care provider if your baby should receive this medication.

Congenital heart defects
These heart defects are present at birth. They originate in the early part of pregnancy when the heart is forming.

Coarctation of the aorta: The aorta is the large artery that sends blood from the heart to the rest of the body. In this condition, the aorta may be too narrow for the blood to flow evenly. A surgeon can cut away the narrow part and sew the open ends together, replace the constricted section with man-made material, or patch it with part of a blood vessel taken from elsewhere in the body. Sometimes, this narrowed area can be widened by inflating a balloon on the tip of a catheter inserted through an artery.

Heart valve abnormalities: Some babies are born with heart valves that are narrowed, closed or blocked and prevent blood from flowing smoothly. Some babies may require placement of a shunt (artificial graft) to allow blood to bypass the blockage until the baby is big enough to have the valve repaired or replaced.

Patent ductus arteriosus (PDA): PDA is the most common heart problem in premature babies. Before birth, much of a fetus’s blood goes through a passageway (ductus arteriosus) from one blood vessel to another, instead of through the lungs, because the lungs are not yet in use. This passageway should close soon after birth, so the blood can take the normal route from heart to lungs and back. If it doesn’t close, blood doesn’t flow correctly. In some cases, drug treatment can help close the passageway. If that doesn’t work, surgery can also close it.

Septal defects: A septal defect refers to a hole in the wall (septum) that divides the two upper or lower chambers of the heart. Because of this hole, the blood cannot circulate as it should, and the heart has to work extra hard. A surgeon can close the hole by sewing or patching it. Small holes may heal by themselves and not need repair at all.

Tetralogy of Fallot: In this condition, a combination of four heart defects keeps some blood from getting to the lungs. As a result, the baby has episodes of cyanosis (the skin looks blue due to lack of oxygen) and may grow poorly. New surgical techniques allow early repair of this complex heart defect.

Transposition of the great arteries: Here, the positions of the two major arteries leaving the heart are reversed. Each artery arises from the wrong pumping chamber. Surgical advances have enabled correction of this defect in the newborn period.

Feeding
Experts agree that breast milk provides many wonderful and vital health benefits for newborns, especially premature or sick babies. And it is something only a mom can give her baby. A baby needs good nutrition to grow and become stronger. But she may need to be fed a different way for a while, before she is ready for breast or bottle.

Babies who are very small or sick are often fed intravenously (through a vein). A tiny needle is placed in a vein in the baby’s hand, foot, scalp or belly button. She will receive sugar (glucose) and essential nutrients through the vein. As soon as she is strong enough, the baby will be fed breast milk or formula through a tube that is placed through the nose or mouth into the stomach or intestines. This is called gavage feeding.

In gavage feeding, the tube may be left in place or inserted at each feeding. Inserting the tube should not bother the baby too much because babies this small generally do not gag. When the baby can suck and swallow effectively, gavage feedings will be stopped, and the baby will be able to breast or bottle-feed.

Many babies in NICUs start trophic (minimal) feeds shortly after birth. This is done to stimulate the baby’s intestine until the baby is strong enough to tolerate larger feedings.

Hypoglycemia
Hypoglycemia is low blood sugar (glucose). It is usually diagnosed in a baby shortly after birth. Babies born to mothers with diabetes have their glucose levels checked regularly to assess for hypoglycemia. Early feeding and an intravenous glucose solution help to prevent and treat hypoglycemia.

Intrauterine Growth Restriction (IUGR)
A baby with this condition grows more slowly than usual in utero, and is smaller than normal for his gestational age at birth. IUGR is ordinarily diagnosed during pregnancy through an ultrasound. It usually is due to fetal or maternal complications. Upon admission to the NICU, babies are tested to determine possible causes, although this can’t always be determined.

Intraventricular Hemorrhage (IVH)
IVH refers to bleeding in the brain and is most common in the smallest premature babies (those weighing less than 3 1/3 pounds). The bleeds usually occur in the first four days of life. Bleeding generally occurs near the fluid-filled spaces (ventricles) in the center of the brain. An ultrasound examination can show whether a baby has had a brain bleed and how severe it is.

Brain bleeds usually are given a number from 1 to 4, with 4 being the most severe. Most brain bleeds are mild (grades 1 and 2) and resolve themselves with no or few lasting problems. More severe bleeds can cause difficulties for the baby during the hospitalization and possible problems in the future. Some will require careful monitoring of the baby’s development throughout infancy and childhood.

Jaundice
Babies with jaundice have a yellowish color to their skin and eyes. Jaundice occurs when the liver is too immature or sick to remove a waste product called bilirubin from the blood. Bilirubin is formed when old red blood cells break down. Jaundice is especially common in premature babies and in babies who have blood type incompatibilities with their mothers (such as Rh disease, ABO incompatibility or G6PD disease)

Jaundice itself does not usually cause harm to a baby. But if the bilirubin level gets too high, it can cause more serious problems. For this reason, the baby’s bilirubin level is checked frequently. If it gets too high, he is treated with special blue lights (phototherapy) that help the body break down and eliminate bilirubin.

Occasionally, a baby will need a special type of blood transfusion called an exchange transfusion to reduce very high bilirubin levels. In this procedure, some of the baby’s blood is removed and replaced with blood from a donor.

Keeping warm
Babies who are born too small and too soon often have trouble controlling their body temperature. Unlike healthy, full-term babies, they don’t have enough body fat to prevent the loss of heat from their bodies. Babies in the NICU are placed in an incubator or warmer right after birth to help control their temperature. A tiny thermometer taped to the baby’s stomach senses her body temperature and regulates the heat in the incubator. A baby will grow faster if she maintains a normal body temperature (98.6 degrees F.).

Macrosomia
A condition in which a baby is born with excessive birth weight, that is, 4,500 grams (9 pounds, 14 ounces) or more. This is commonly due to maternal diabetes and may require delivery by cesarean section. These babies are also monitored for hypoglycemia.

Necrotizing Enterocolitis (NEC)
This potentially dangerous intestinal problem most commonly affects premature babies. The bowel may become damaged when its blood supply is decreased. Bacteria that are normally present in the bowel invade the damaged area, causing more damage. Babies with NEC develop feeding problems, abdominal swelling and other complications. If tests show that a baby has NEC, he will be fed intravenously while his bowel heals. Sometimes damaged sections of intestine must be surgically removed.

Retinopathy of Prematurity (ROP)
ROP is an abnormal growth of blood vessels in the eye. It occurs only in babies born before 32 weeks of pregnancy. ROP can lead to bleeding and scarring that can damage the eye’s retina (the lining at the rear of the eye that relays messages to the brain). This can result in vision loss. An ophthalmologist (eye doctor) will examine the baby’s eyes for signs of ROP.

Most mild cases heal without treatment, with little or no vision loss. In more severe cases, the ophthalmologist may perform laser therapy or do a procedure called cryotherapy (freezing) to eliminate abnormal blood vessels and scars. Both treatments help protect the retina.

Sepsis
Some babies are admitted to the NICU to determine if they have this potentially dangerous infection of the bloodstream. The infection is caused by a germ which the baby has had difficulty fighting off. Certain lab tests, cultures, and X-rays can help diagnose this condition. These tests may be recommended if your baby has symptoms such as temperature instability, high or low blood sugar levels, breathing problems or low blood pressure. The condition is treated with antibiotics, and the baby is monitored closely for an improvement in symptoms.
source Common conditions treated in the NICU http://www.marchofdimes.com/advocacy/inthenicu_conditions.html

Procedure:Urine Collection, 24-Hour Specimen

Posted: 06 Jan 2011 04:49 AM PST

All 24-hour urine collections shall be collected in the same manner to ensure consistency, safety and non-contamination.

Procedure:

The order for a 24-hour urine collection shall be entered into Sunrise:

The nursing staff shall:

· Obtain the appropriate collection container(s) (with or without preservative)

· Place the patient’s name on the container(s) (use patient addressograph imprinted labels)

· Place the container(s) on ice in a locked area as designated

· Obtain the appropriate urine collection device (collection container will be labeled with the patient’s name)

– Males will use urinals

– Females will use “Fireman’s Caps”

· Instruct the patient in use of the urine collection device

· Assign a specific nursing staff member to assist with the collection of the urine

All collections shall be started at 6:00 a.m., Sunday through Thursday.

The assigned nurse shall assure that:

· The patient shall void into his/her own device.

· The urine shall be emptied into the 24-hour container.

· The containers shall remain iced at all times.

· Assess output and notify Physician as appropriate.

Upon completion of the 24-hour urine collection, the requisitions shall be completed and sent to the laboratory.

source Procedure:Urine Collection, 24-Hour Specimen http://www.uth.tmc.edu/uth_orgs/hcpc/procedures/alpha/nur/uc.htm

Antioxidants and Cancer Prevention: Fact Sheet

Posted: 06 Jan 2011 04:06 AM PST

What are antioxidants?Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.
Can antioxidants prevent cancer?Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions.
What was shown in previously published large-scale clinical trials?Five large-scale clinical trials published in the 1990s reached differing conclusions about the effect of antioxidants on cancer. The studies examined the effect of beta-carotene and other antioxidants on cancer in different patient groups. However, beta-carotene appeared to have different effects depending upon the patient population. The conclusions of each study are summarized below.
- The first large randomized trial on antioxidants and cancer risk was the Chinese Cancer Prevention Study, published in 1993. This trial investigated the effect of a combination of beta-carotene, vitamin E, and selenium on cancer in healthy Chinese men and women at high risk for gastric cancer. The study showed a combination of beta-carotene, vitamin E, and selenium significantly reduced incidence of both gastric cancer and cancer overall (1).
- A 1994 cancer prevention study entitled the Alpha-Tocopherol (vitamin E)/ Beta-Carotene Cancer Prevention Study (ATBC) demonstrated that lung cancer rates of Finnish male smokers increased significantly with beta-carotene and were not affected by vitamin E (2).
- Another 1994 study, the Beta-Carotene and Retinol (vitamin A) Efficacy Trial (CARET), also demonstrated a possible increase in lung cancer associated with antioxidants (3).
- The 1996 Physicians' Health Study I (PHS) found no change in cancer rates associated with beta-carotene and aspirin taken by U.S. male physicians (4).
- The 1999 Women’s Health Study (WHS) tested effects of vitamin E and beta-carotene in the prevention of cancer and cardiovascular disease among women age 45 years or older. Among apparently healthy women, there was no benefit or harm from beta-carotene supplementation. Investigation of the effect of vitamin E is ongoing (5).
Are antioxidants under investigation in current large-scale clinical trials?Three large-scale clinical trials continue to investigate the effect of antioxidants on cancer. The objective of each of these studies is described below. More information about clinical trials can be obtained using http://www.cancer.gov/clinicaltrials, http://www.clinicaltrials.gov, or the RePORT Expenditures and Results (RePORTER) query tool at http://projectreporter.nih.gov/reporter.cfm on the Internet.
- The Women's Health Study (WHS) is currently evaluating the effect of vitamin E in the primary prevention of cancer among U.S. female health professionals age 45 and older. The WHS is expected to conclude in August 2004.
- The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is taking place in the United States, Puerto Rico, and Canada. SELECT is trying to find out if taking selenium and/or vitamin E supplements can prevent prostate cancer in men age 50 or older. The SELECT trial is expected to stop recruiting patients in May 2006.
- The Physicians’ Health Study II (PHS II) is a follow up to the earlier clinical trial by the same name. The study is investigating the effects of vitamin E, C, and multivitamins on prostate cancer and total cancer incidence. The PHS II is expected to conclude in August 2007.
Will the National Cancer Institute (NCI) continue to investigate the effect of beta-carotene on cancer?Given the unexpected results of ATBC and CARET, and the finding of no effect of beta-carotene in the PHS and WHS, NCI will follow the people who participated in these studies and will examine the long-term health effects of beta-carotene supplements. Post-trial follow-up has already been funded by NCI for CARET, ATBC, the Chinese Cancer Prevention Study, and the two smaller trials of skin cancer and colon polyps. Post-trial follow-up results have been published for ATBC, and as of July 2004 are in press for CARET and are in progress for the Chinese Cancer Prevention Study.
How might antioxidants prevent cancer?Antioxidants neutralize free radicals as the natural by-product of normal cell processes. Free radicals are molecules with incomplete electron shells which make them more chemically reactive than those with complete electron shells. Exposure to various environmental factors, including tobacco smoke and radiation, can also lead to free radical formation. In humans, the most common form of free radicals is oxygen. When an oxygen molecule (O2) becomes electrically charged or "radicalized" it tries to steal electrons from other molecules, causing damage to the DNA and other molecules. Over time, such damage may become irreversible and lead to disease including cancer. Antioxidants are often described as "mopping up" free radicals, meaning they neutralize the electrical charge and prevent the free radical from taking electrons from other molecules.
Which foods are rich in antioxidants?Antioxidants are abundant in fruits and vegetables, as well as in other foods including nuts, grains, and some meats, poultry, and fish. The list below describes food sources of common antioxidants.
- Beta-carotene is found in many foods that are orange in color, including sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin, and mangos. Some green, leafy vegetables, including collard greens, spinach, and kale, are also rich in beta-carotene.
- Lutein, best known for its association with healthy eyes, is abundant in green, leafy vegetables such as collard greens, spinach, and kale.
- Lycopene is a potent antioxidant found in tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, blood oranges, and other foods. Estimates suggest 85 percent of American dietary intake of lycopene comes from tomatoes and tomato products.
- Selenium is a mineral, not an antioxidant nutrient. However, it is a component of antioxidant enzymes. Plant foods like rice and wheat are the major dietary sources of selenium in most countries. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants grown in selenium-rich soil have higher levels of selenium in their muscle. In the United States, meats and bread are common sources of dietary selenium. Brazil nuts also contain large quantities of selenium.
- Vitamin A is found in three main forms: retinol (Vitamin A1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3). Foods rich in vitamin A include liver, sweet potatoes, carrots, milk, egg yolks, and mozzarella cheese.
- Vitamin C is also called ascorbic acid, and can be found in high abundance in many fruits and vegetables and is also found in cereals, beef, poultry, and fish.
- Vitamin E, also known as alpha-tocopherol, is found in almonds, in many oils including wheat germ, safflower, corn, and soybean oils, and is also found in mangos, nuts, broccoli, and other foods.

Selected References

Blot WJ, Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483–91.
The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effects of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029–35.
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source Antioxidants and Cancer Prevention: Fact Sheet http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants