PHILADELPHIA— The number of spinal cord injuries among senior citizens (age 70 and above) has increased five times in the past 30 years, as compared with younger spinal cord injury patients, researchers at Thomas Jefferson University Hospital and Jefferson's Regional Spinal Cord Injury Center of the Delaware Valley recently reported.
As the population within the United States ages, it is estimated that 20 percent of its population will be older than age 65 by the year 2040, and will likely impact spine surgeons and spinal cord rehabilitation centers as these patients become a larger proportion of the spinal cord injury (SCI) population. The findings were just presented by Jefferson neurological surgeons at a meeting in Phoenix, Ariz. of the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons.
"Spinal cord injuries in older patients are becoming more prevalent," said James Harrop, M.D, Assistant Professor of Neurological and Orthopedic Surgery, Jefferson Medical College of Thomas Jefferson University, one of the study's primary investigators. "The mortality of these patients is much greater than younger patients and should be factored in when considering aggressive interventions and counseling families regarding prognosis." However, they also found that these patients have had an increase in survival over this period.
Admissions by geriatric SCI patients have increased five-fold and the percentage of geriatric patients within the SCI population has increased from 4.2 percent to 15.4 percent since 1980. In comparison to younger patients, geriatric patients are less likely to have severe neurological deficits but have higher rates of mortality. Researchers reviewed a database of 3,481 consecutive acute penetrating and blunt spinal cord and spine-injured patients treated at Jefferson Regional Spinal Cord Injury Center over a 28-year period (1978-2006).
http://www.eurekalert.org/pub_releases/2007-03/tju-esc031907.php
Monday, March 19, 2007
SSO: Simultaneous Colon and Liver Resection Safe If Hepatic Lesion Is Small
WASHINGTON, March 19 -- Simultaneous resection of a colorectal lesion and a small hepatic metastasis is safe, but when the liver lesion is more extensive separate procedures may be the better course, a multicenter group found.
"We looked at factors including surgical complications and survival data among the groups and found that in certain patient groups, simultaneous surgery was as safe as separate surgeries, could shorten the length of hospital stay and might lead to fewer surgery-related complications," said Srinevas Reddy, M.D., a surgical resident at Duke.
But for patients needing major hepatic resection, both mortality and severe morbidity were significantly higher after simultaneous versus staged procedures, reported Dr. Reddy and colleagues at the Society of Surgical Oncology meeting here on the basis of a 20-year retrospective study.
Chemotherapy after hepatectomy, but not before, was also associated with longer survival, found the researchers at Duke and colleagues at the Johns Hopkins in Baltimore, and the University of Texas M.D. Anderson Cancer Center in Houston.
http://www.medpagetoday.com/HematologyOncology/ColonCancer/tb1/5274
"We looked at factors including surgical complications and survival data among the groups and found that in certain patient groups, simultaneous surgery was as safe as separate surgeries, could shorten the length of hospital stay and might lead to fewer surgery-related complications," said Srinevas Reddy, M.D., a surgical resident at Duke.
But for patients needing major hepatic resection, both mortality and severe morbidity were significantly higher after simultaneous versus staged procedures, reported Dr. Reddy and colleagues at the Society of Surgical Oncology meeting here on the basis of a 20-year retrospective study.
Chemotherapy after hepatectomy, but not before, was also associated with longer survival, found the researchers at Duke and colleagues at the Johns Hopkins in Baltimore, and the University of Texas M.D. Anderson Cancer Center in Houston.
http://www.medpagetoday.com/HematologyOncology/ColonCancer/tb1/5274
Male Breast Cancer Mortality Higher Among Black Patients
NEW YORK, March 19 -- Men with breast cancer show the same racial disparities in survival as do women with the disease, according to a small population-based study.
Medicare-age black men with breast cancer were three times more likely to die from the disease than white men (hazard ratio 3.29, 95% confidence interval 1.10 to 9.86), said Dawn L. Hershman, M.D., M.S., of Columbia University, and colleagues.
These findings parallel those of previous studies among women, which have shown higher breast cancer mortality rates for black women at all ages, they wrote in a study published online March 16 in the Journal of Clinical Oncology.
"Racial disparities in breast cancer outcomes between black and white women have been attributed to advanced stage at diagnosis, negative HR [hormone receptor] status, higher tumor grade, reduced access to health care, and other socioeconomic factors," they added.
http://www.medpagetoday.com/HematologyOncology/BreastCancer/tb1/5273
Medicare-age black men with breast cancer were three times more likely to die from the disease than white men (hazard ratio 3.29, 95% confidence interval 1.10 to 9.86), said Dawn L. Hershman, M.D., M.S., of Columbia University, and colleagues.
These findings parallel those of previous studies among women, which have shown higher breast cancer mortality rates for black women at all ages, they wrote in a study published online March 16 in the Journal of Clinical Oncology.
"Racial disparities in breast cancer outcomes between black and white women have been attributed to advanced stage at diagnosis, negative HR [hormone receptor] status, higher tumor grade, reduced access to health care, and other socioeconomic factors," they added.
http://www.medpagetoday.com/HematologyOncology/BreastCancer/tb1/5273
World first in medical robotics
Fantastic voyage: From science fiction to reality? École Polytechnique de Montréal researchers successfully navigate a wireless device inside an artery using a clinical MRI system, paving the way for novel, minimally invasive and more accurate surgeries
Some 40 years after the release of the classic science fiction movie Fantastic Voyage, researchers in the NanoRobotics Laboratory of École Polytechnique de Montréal’s Department of Computer Engineering and Institute of Biomedical Engineering have achieved a major technological breakthrough in the field of medical robotics. They have succeeded for the first time in guiding, in vivo and via computer control, a microdevice inside an artery, at a speed of 10 centimetres a second.
Under the direction of Professor Sylvain Martel, holder of the Canada Research Chair in Micro/Nanosystem Development, Construction and Validation, and in collaboration with researchers at the Centre hospitalier de l’Université de Montréal (CHUM), the Polytechnique team has succeeded in injecting, propelling and controlling by means of software programs an initial prototype of an untethered device (a ferromagnetic 1.5- millimetre-diameter sphere) within the carotid artery of a living animal placed inside a clinical magnetic resonance imaging (MRI) system.
http://www.eurekalert.org/pub_releases/2007-03/pdm-wfi031607.php
Some 40 years after the release of the classic science fiction movie Fantastic Voyage, researchers in the NanoRobotics Laboratory of École Polytechnique de Montréal’s Department of Computer Engineering and Institute of Biomedical Engineering have achieved a major technological breakthrough in the field of medical robotics. They have succeeded for the first time in guiding, in vivo and via computer control, a microdevice inside an artery, at a speed of 10 centimetres a second.
Under the direction of Professor Sylvain Martel, holder of the Canada Research Chair in Micro/Nanosystem Development, Construction and Validation, and in collaboration with researchers at the Centre hospitalier de l’Université de Montréal (CHUM), the Polytechnique team has succeeded in injecting, propelling and controlling by means of software programs an initial prototype of an untethered device (a ferromagnetic 1.5- millimetre-diameter sphere) within the carotid artery of a living animal placed inside a clinical magnetic resonance imaging (MRI) system.
http://www.eurekalert.org/pub_releases/2007-03/pdm-wfi031607.php
Spirituality increases as alcoholics recover
Some changes may be linked to chance of sobriety
ANN ARBOR, Mich. — For decades, recovering alcoholics and those who treat them have incorporated spirituality into the recovery process — whether or not it's religious in nature. But few research studies have documented if and how spirituality changes during recovery, nor how those changes might influence a person's chance of succeeding in the quest for sobriety.
Now, a new study from researchers at the University of Michigan Addiction Research Center sheds light on this phenomenon. In the March issue of the Journal of Studies on Alcohol and Drugs, they show that many measures of spirituality tend to increase during alcohol recovery. They also demonstrate that those who experience increases in day-to-day spiritual experiences and their sense of purpose in life are most likely to be free of heavy drinking episodes six months later.
http://www.eurekalert.org/pub_releases/2007-03/uomh-sia031907.php
ANN ARBOR, Mich. — For decades, recovering alcoholics and those who treat them have incorporated spirituality into the recovery process — whether or not it's religious in nature. But few research studies have documented if and how spirituality changes during recovery, nor how those changes might influence a person's chance of succeeding in the quest for sobriety.
Now, a new study from researchers at the University of Michigan Addiction Research Center sheds light on this phenomenon. In the March issue of the Journal of Studies on Alcohol and Drugs, they show that many measures of spirituality tend to increase during alcohol recovery. They also demonstrate that those who experience increases in day-to-day spiritual experiences and their sense of purpose in life are most likely to be free of heavy drinking episodes six months later.
http://www.eurekalert.org/pub_releases/2007-03/uomh-sia031907.php
Health Tip: Take Care of the Caregiver
(HealthDay News) -- Being a caregiver for an elderly family member or friend can be overwhelming and stressful.
The Alzheimer's Association offers these suggestions to help caregivers handle their responsibilities while alleviating stress:Take advantage of services that can help -- adult day care, visiting nurses and other services can offer a caregiver much-needed breaks. Continue educating yourself on the condition that your loved one has. Learn better ways to care for the patient and understand what to expect. Don't be afraid to ask friends and other family members for help. Reduce stress and take care of your body by eating right, getting exercise and making time for activities that you enjoy. Get legal and financial planning under control, and consult an attorney or legal advisor on what needs to be done. Be proud of what you are doing, rather than feeling guilty about what you can't accomplish.
http://www.alz.org/living_with_alzheimers_coping.asp
The Alzheimer's Association offers these suggestions to help caregivers handle their responsibilities while alleviating stress:Take advantage of services that can help -- adult day care, visiting nurses and other services can offer a caregiver much-needed breaks. Continue educating yourself on the condition that your loved one has. Learn better ways to care for the patient and understand what to expect. Don't be afraid to ask friends and other family members for help. Reduce stress and take care of your body by eating right, getting exercise and making time for activities that you enjoy. Get legal and financial planning under control, and consult an attorney or legal advisor on what needs to be done. Be proud of what you are doing, rather than feeling guilty about what you can't accomplish.
http://www.alz.org/living_with_alzheimers_coping.asp
Obesity Doubles Odds of Prostate Cancer Mortality
Obese men diagnosed with prostate cancer in middle age are at a 2.6-fold higher risk of dying from the disease than are patients of normal weight, according to a case-control study.
Surprisingly, the increased prostate-cancer-specific mortality risk was independent of treatment and key prognostic factors at diagnosis, including disease grade and stage, reported Alan R. Kristal, Dr.P.H., of the Fred Hutchinson Cancer Research Center here, and colleagues, in the March 15 issue of Cancer.
Epidemiology data has consistently indicated a modest increase in prostate cancer mortality among men with a body mass index (BMI) of 30 kg/m2 or greater. However, it was unclear whether the effect was due to poor prognostic factors or an effect on progression after treatment.
So, the researchers looked at 752 men ages 40 to 64 with newly diagnosed, histologically confirmed prostate cancer in the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer registry.
The men reported their pre-diagnosis height and weight in a baseline interview and were followed through the registry for an average of 9.5 years.
The mean BMI was 26.7 kg/m2, and 17.0% of the men were obese. About a quarter had regional- or distant-stage prostate cancer at diagnosis (27%), and 14% had Gleason scores of 7 or higher. Most underwent radical prostatectomy as the primary treatment (63%).
http://www.medpagetoday.com/HematologyOncology/ProstateCancer/tb1/5264
Surprisingly, the increased prostate-cancer-specific mortality risk was independent of treatment and key prognostic factors at diagnosis, including disease grade and stage, reported Alan R. Kristal, Dr.P.H., of the Fred Hutchinson Cancer Research Center here, and colleagues, in the March 15 issue of Cancer.
Epidemiology data has consistently indicated a modest increase in prostate cancer mortality among men with a body mass index (BMI) of 30 kg/m2 or greater. However, it was unclear whether the effect was due to poor prognostic factors or an effect on progression after treatment.
So, the researchers looked at 752 men ages 40 to 64 with newly diagnosed, histologically confirmed prostate cancer in the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer registry.
The men reported their pre-diagnosis height and weight in a baseline interview and were followed through the registry for an average of 9.5 years.
The mean BMI was 26.7 kg/m2, and 17.0% of the men were obese. About a quarter had regional- or distant-stage prostate cancer at diagnosis (27%), and 14% had Gleason scores of 7 or higher. Most underwent radical prostatectomy as the primary treatment (63%).
http://www.medpagetoday.com/HematologyOncology/ProstateCancer/tb1/5264
Soy as Prostate Cancer Protection Yields Paradoxical Results
Diets rich in soy protect against prostate cancer. Then again, they don't.
This paradoxical finding came from a study of 43,509 Japanese men. For some soy isoflavones in the diet decreased the risk of localized prostate cancer, but at the same time soy containing miso soup increased the risk of advanced prostate cancer.
So reported Norie Kurahashi, M.D., of the National Cancer Center of Japan, and colleagues, in the March issue of Cancer Epidemiology, Biomarkers & Prevention.
"The present findings provide no clear understanding of when or how localized cancer will develop to aggressive cancer, and of the related effect of isoflavones," said Dr. Kurahashi.
The investigators recommended that Japanese men continue their high consumption of soy from foods, but they discouraged the use of supplements.
The investigators hypothesized that soy in general, and its isoflavones genistein and daizden in particular, may attenuate but not prevent the progression of latent prostate cancer. Soy isoflavones are estrogen mimics and strong antioxidants in vitro, and appear to be protective against cancer in animal models.
http://www.medpagetoday.com/Urology/ProstateCancer/tb1/5272
This paradoxical finding came from a study of 43,509 Japanese men. For some soy isoflavones in the diet decreased the risk of localized prostate cancer, but at the same time soy containing miso soup increased the risk of advanced prostate cancer.
So reported Norie Kurahashi, M.D., of the National Cancer Center of Japan, and colleagues, in the March issue of Cancer Epidemiology, Biomarkers & Prevention.
"The present findings provide no clear understanding of when or how localized cancer will develop to aggressive cancer, and of the related effect of isoflavones," said Dr. Kurahashi.
The investigators recommended that Japanese men continue their high consumption of soy from foods, but they discouraged the use of supplements.
The investigators hypothesized that soy in general, and its isoflavones genistein and daizden in particular, may attenuate but not prevent the progression of latent prostate cancer. Soy isoflavones are estrogen mimics and strong antioxidants in vitro, and appear to be protective against cancer in animal models.
http://www.medpagetoday.com/Urology/ProstateCancer/tb1/5272
Sunday, March 18, 2007
New Pervasive Systems Centre Could Make Independent Living A Reality
Pervasive computing technology which can monitor the welfare of the elderly will be made available within the next 18 months.The technology is to be developed by the University of Southampton's new Pervasive Systems Centre which is being launched this month.The Centre, co-directed by Professor Bashir Al-Hashimi and Professor David De Roure, both from the University's School of Electronics & Computer Science (ECS) brings together multidisciplinary expertise from across the school's research groups, ranging from sensors and wireless communications to computer science theory and practice.This combined expertise will make it possible for them to develop a Wireless Sensor Network (WSN) which can operate in homes to monitor the health of the elderly.According to Stephen Spikings, a PhD student under the supervision of Professors De Roure and Al-Hashimi, statistics show that due to the 1960s baby boom, by 2031 almost a quarter of the population will be over state pension age.In order to make it possible for such individuals to live independently, the researchers are developing low-cost sensor networks to monitor their environment so that changes in health can be detected.For example a weight sensor positioned under the bed could detect the individual's movements throughout the night. A sensor in the bathroom could monitor use of toilet facilities to pick up signs of digestive problems, and body imaging and temperature sensors could highlight areas of the body that are painful.
http://www.medicalnewstoday.com/medicalnews.php?newsid=65468&nfid=crss
http://www.medicalnewstoday.com/medicalnews.php?newsid=65468&nfid=crss
Saturday, March 17, 2007
Without Mouth-to-Mouth, CPR Still Works
Chest compressions — not mouth-to-mouth resuscitation — seem to be the key in helping someone recover from cardiac arrest, according to new research that further bolsters advice from heart experts.
A study in Japan showed that people were more likely to recover without brain damage if rescuers focused on chest compressions rather than on rescue breaths, and some experts advised dropping the mouth-to-mouth part of CPR altogether. The study was published yesterday in The Lancet.
More than a year ago, the American Heart Association revised CPR guidelines to put more emphasis on chest presses, recommending 30 instead of 15 for every two breaths given. Stopping chest compressions to blow air into the lungs of someone who is unresponsive detracts from the more important task of keeping blood moving to provide oxygen and nourishment to the brain and heart.
Another big advantage to dropping the rescue breaths is that it could make bystanders more willing to provide CPR. Many are unwilling to do the mouth-to-mouth part, become flummoxed or are fearful of getting the ratio of breaths to chest compressions right in an emergency
.http://www.nytimes.com/2007/03/17/health/17cpr.html?ex=1331784000&en=93d7b2b0e266a88c&ei=5088&partner=rssnyt&emc=rss
A study in Japan showed that people were more likely to recover without brain damage if rescuers focused on chest compressions rather than on rescue breaths, and some experts advised dropping the mouth-to-mouth part of CPR altogether. The study was published yesterday in The Lancet.
More than a year ago, the American Heart Association revised CPR guidelines to put more emphasis on chest presses, recommending 30 instead of 15 for every two breaths given. Stopping chest compressions to blow air into the lungs of someone who is unresponsive detracts from the more important task of keeping blood moving to provide oxygen and nourishment to the brain and heart.
Another big advantage to dropping the rescue breaths is that it could make bystanders more willing to provide CPR. Many are unwilling to do the mouth-to-mouth part, become flummoxed or are fearful of getting the ratio of breaths to chest compressions right in an emergency
.http://www.nytimes.com/2007/03/17/health/17cpr.html?ex=1331784000&en=93d7b2b0e266a88c&ei=5088&partner=rssnyt&emc=rss
Friday, March 16, 2007
Mid-life cholesterol dip may signal mental decline
NEW YORK (Reuters Health) - While a high total cholesterol level in middle age is a risk factor for developing dementia later in life, a drop in cholesterol after middle age may also be a sign of later cognitive problems, a study shows.
It hints that falling total cholesterol levels after middle age may point to an ongoing disease processes in the brain, and could be a marker for risk of late-life cognitive impairment.
Dr. Miia Kivipelto, from the Aging Research Center at the Karolinska Institute in Stockholm, Sweden, and colleagues investigated changes in total cholesterol levels in relation to cognitive functioning in late-life.
The study involved some 2000 people who had their cholesterol level measured in midlife, and were re-examined an average of 21 years later.
The team focused on 70 people who developed mild cognitive impairment during follow-up, 48 who developed Alzheimer's disease and a "control" group of 1,203 people who remained mentally intact.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-03-16T154712Z_01_COL656553_RTRUKOC_0_US-CHOLESTEROL-DIP.xml&src=rss
It hints that falling total cholesterol levels after middle age may point to an ongoing disease processes in the brain, and could be a marker for risk of late-life cognitive impairment.
Dr. Miia Kivipelto, from the Aging Research Center at the Karolinska Institute in Stockholm, Sweden, and colleagues investigated changes in total cholesterol levels in relation to cognitive functioning in late-life.
The study involved some 2000 people who had their cholesterol level measured in midlife, and were re-examined an average of 21 years later.
The team focused on 70 people who developed mild cognitive impairment during follow-up, 48 who developed Alzheimer's disease and a "control" group of 1,203 people who remained mentally intact.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-03-16T154712Z_01_COL656553_RTRUKOC_0_US-CHOLESTEROL-DIP.xml&src=rss
Memory workouts beat other computer games in study
By Julie Steenhuysen
CHICAGO (Reuters) - Training the brain with a computer workout program may be better than classic computer games at staving off age-related mental decline, scientists reported on Friday.
While the computer and video game store has long been the bastion of teenagers and hard-core gamers, a host of new games for older folk have made their way into the stores.
The games, from companies like Nintendo and Mattel Inc., are based on studies showing that with a little training, older people can improve their brain power.
Researchers in Israel compared how one brain-training program, MindFit, fared versus a workout with a sampling of classic computer games, such as the puzzle game Tetris.
The study, funded by a grant from game maker CogniFit Ltd., involved 121 volunteers over 50 who used the MindFit training program or a sampling of computer games for three months. Volunteers were divided into groups. They were not told whether they were playing the brain workout program or a dummy program.
Both groups benefited, but the group using the MindFit program showed a statistically significant improvement in spatial short-term memory, spatial learning and focused attention.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-03-16T180622Z_01_N16171165_RTRUKOC_0_US-BRAIN-GAMES.xml&src=rss
CHICAGO (Reuters) - Training the brain with a computer workout program may be better than classic computer games at staving off age-related mental decline, scientists reported on Friday.
While the computer and video game store has long been the bastion of teenagers and hard-core gamers, a host of new games for older folk have made their way into the stores.
The games, from companies like Nintendo and Mattel Inc., are based on studies showing that with a little training, older people can improve their brain power.
Researchers in Israel compared how one brain-training program, MindFit, fared versus a workout with a sampling of classic computer games, such as the puzzle game Tetris.
The study, funded by a grant from game maker CogniFit Ltd., involved 121 volunteers over 50 who used the MindFit training program or a sampling of computer games for three months. Volunteers were divided into groups. They were not told whether they were playing the brain workout program or a dummy program.
Both groups benefited, but the group using the MindFit program showed a statistically significant improvement in spatial short-term memory, spatial learning and focused attention.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-03-16T180622Z_01_N16171165_RTRUKOC_0_US-BRAIN-GAMES.xml&src=rss
USPSTF Does Not Recommend Using Aspirin or NSAIDs to Prevent Colorectal Cancer
While many researchers have been expounding the benefits of using aspirin or nonsteroidal anti-inflammatory (NSAID) drugs to prevent polyps and colorectal cancer, the US Preventive Services Task Force (USPSTF) reports that the data do not add up. In a review published in the March 6 issue of the Annals of Internal Medicine, the group shows that the risk for gastrointestinal and cerebrovascular bleeding and the potential for kidney failure outweigh the potential benefits of these drugs.
"For patients at average risk for colorectal cancer, clinicians should not recommend ASA [aminosalicylic acid] or NSAID use for the prevention of polyps or colorectal cancer," Ned Calonge, MD, task force chair and chief medical officer and state epidemiologist for the Colorado Department of Public Health and Information told Medscape. "If they have patients currently on these therapies for colorectal cancer prevention, they should reconsider the risks and benefits."
The USPSTF is an independent panel of experts in prevention and primary care. The task force conducts impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services.
http://www.medscape.com/viewarticle/553408?src=mp
"For patients at average risk for colorectal cancer, clinicians should not recommend ASA [aminosalicylic acid] or NSAID use for the prevention of polyps or colorectal cancer," Ned Calonge, MD, task force chair and chief medical officer and state epidemiologist for the Colorado Department of Public Health and Information told Medscape. "If they have patients currently on these therapies for colorectal cancer prevention, they should reconsider the risks and benefits."
The USPSTF is an independent panel of experts in prevention and primary care. The task force conducts impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services.
http://www.medscape.com/viewarticle/553408?src=mp
Prolonged Strenuous Activity May Cause Increase in Troponin Levels
Troponin levels may increase significantly in marathon runners, even reaching levels diagnostic for acute myocardial infarction, according to results of a study involving participants in the 2002 Boston Marathon.
Dr. Elizabeth B. Fortescue and her colleagues, based at Children's Hospital Boston, recruited 482 runners a day or two before the marathon. As the authors note in the Annals of Emergency Medicine for February, the cohort was heterogeneous in terms of experience, age, and fitness.
The subjects completed questionnaires prior to the race, including demographics and medical history. Immediately after completing the 26.2-mile course, subjects provided a blood sample and answered questions about symptoms during the race.
Overall, 68% of runners had some degree of post-race troponin level increase, ranging from 0.02 to 0.74 ng/mL for troponin T and 0.05 to 4.17 ng/mL for troponin I.
Dr. Fortescue's team defined significantly elevated troponin T as at least 0.075 ng/mL, and elevated troponin I as at least 0.50 ng/mL, based on reference values diagnostic for myocardial infarction. Fifty-five of the runners (11%) had troponin levels in this range.
Eight subjects had never before participated in a marathon, and their risk of elevated serum troponin was 3-fold higher than for experienced runners. Age less than 30 years and female gender were also associated with elevated troponin levels.
http://www.medscape.com/viewarticle/553373?src=mp
Dr. Elizabeth B. Fortescue and her colleagues, based at Children's Hospital Boston, recruited 482 runners a day or two before the marathon. As the authors note in the Annals of Emergency Medicine for February, the cohort was heterogeneous in terms of experience, age, and fitness.
The subjects completed questionnaires prior to the race, including demographics and medical history. Immediately after completing the 26.2-mile course, subjects provided a blood sample and answered questions about symptoms during the race.
Overall, 68% of runners had some degree of post-race troponin level increase, ranging from 0.02 to 0.74 ng/mL for troponin T and 0.05 to 4.17 ng/mL for troponin I.
Dr. Fortescue's team defined significantly elevated troponin T as at least 0.075 ng/mL, and elevated troponin I as at least 0.50 ng/mL, based on reference values diagnostic for myocardial infarction. Fifty-five of the runners (11%) had troponin levels in this range.
Eight subjects had never before participated in a marathon, and their risk of elevated serum troponin was 3-fold higher than for experienced runners. Age less than 30 years and female gender were also associated with elevated troponin levels.
http://www.medscape.com/viewarticle/553373?src=mp
High-Fiber Diets, Fiber Supplements Reduce CRP Levels
Fiber in the diet can reduce C-reactive protein (CRP) levels, a new study suggests. Writing in the March 12 issue of the Archives of Internal Medicine, Dana King, MD, and colleagues from the Medical University of South Carolina in Charleston report that both a high-fiber diet, as well as a fiber-supplemented diet, significantly — if modestly — reduced baseline CRP levels during a 3-week period.
"The study adds prospective trial data to the previous literature on dietary fiber and CRP," Dr. King told heartwire. "The findings support current American Heart Association and other group's guidelines that promote adequate intake of fiber in the diet to promote good health. Clinicians should continue to counsel patients to eat foods high in fiber, or take a supplement to reach their fiber intake goals."
The study is one of the first to specifically examine a cause and effect role for fiber and CRP level in a randomized fashion, the authors add.
http://www.medscape.com/viewarticle/553590?src=mp
"The study adds prospective trial data to the previous literature on dietary fiber and CRP," Dr. King told heartwire. "The findings support current American Heart Association and other group's guidelines that promote adequate intake of fiber in the diet to promote good health. Clinicians should continue to counsel patients to eat foods high in fiber, or take a supplement to reach their fiber intake goals."
The study is one of the first to specifically examine a cause and effect role for fiber and CRP level in a randomized fashion, the authors add.
http://www.medscape.com/viewarticle/553590?src=mp
Zinc Supplementation May Decrease Incidence of Infections in the Elderly
Zinc supplements reduce the incidence of infection in elderly patients, according to the results of a small, randomized, double-blind trial reported in the March issue of the American Journal of Clinical Nutrition.
"Zinc deficiency, cell-mediated immune dysfunction, susceptibility to infections, and increased oxidative stress have been observed in elderly subjects (ie, those > 55 y old)," write Ananda S. Prasad, from the Wayne State University School of Medicine in Detroit, Michigan, and colleagues. "Zinc is an effective anti-inflammatory and antioxidant agent."
At a senior center, a group of 49 healthy adults aged 55 to 87 years and inclusive of all ethnicities were randomized to zinc supplementation (zinc gluconate, 45 mg of elemental zinc per day) or placebo orally for 12 months. Outcome measures included incidence of infections during the study; generation of inflammatory cytokines, T helper 1 and T helper 2 cytokines, and oxidative stress markers; and plasma concentrations of zinc at baseline and after supplementation.
http://www.medscape.com/viewarticle/553524?src=mp
"Zinc deficiency, cell-mediated immune dysfunction, susceptibility to infections, and increased oxidative stress have been observed in elderly subjects (ie, those > 55 y old)," write Ananda S. Prasad, from the Wayne State University School of Medicine in Detroit, Michigan, and colleagues. "Zinc is an effective anti-inflammatory and antioxidant agent."
At a senior center, a group of 49 healthy adults aged 55 to 87 years and inclusive of all ethnicities were randomized to zinc supplementation (zinc gluconate, 45 mg of elemental zinc per day) or placebo orally for 12 months. Outcome measures included incidence of infections during the study; generation of inflammatory cytokines, T helper 1 and T helper 2 cytokines, and oxidative stress markers; and plasma concentrations of zinc at baseline and after supplementation.
http://www.medscape.com/viewarticle/553524?src=mp
New Management Recommendations Issued for Kidney Stones
Researchers offer general practice treatment and evaluation recommendations for kidney stones, based on a literature review reported in the March 3 issue of the BMJ.
"Urolithiasis affects 5-15% of the population worldwide," write Nicole L. Miller and James E. Lingeman, from Indiana University School of Medicine in Indianapolis. "Recurrence rates are close to 50%, and the cost of urolithiasis to individuals and society is high. Acute renal colic is a common presentation in general practice, so a basic understanding of its evaluation and treatment would be useful."
The authors conducted an evidence-based literature review of the management of urolithiasis, including Medline and the Cochrane Library. Although most studies were retrospective, they also cited prospective randomized controlled trials when available.
Based on this review, their summary conclusions were as follows:
For diagnosing urolithiasis, unenhanced helical computed tomography (CT) is the best radiographic technique.
Most ureteral calculi smaller than 5 mm in diameter will pass spontaneously within 4 weeks of symptom onset.
For treating urolithiasis, shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy have replaced open surgery.
Shock wave lithotripsy is effective in approximately 80% to 85% of simple renal calculi.
For complex renal calculi, percutaneous nephrolithotomy is the treatment of choice. Staghorn calculi should be treated, preferably with percutaneous nephrolithotomy in most patients.
For patients who are pregnant, morbidly obese, or have coagulopathy, ureteroscopy is the preferred treatment.
http://www.medscape.com/viewarticle/553460?src=mp
"Urolithiasis affects 5-15% of the population worldwide," write Nicole L. Miller and James E. Lingeman, from Indiana University School of Medicine in Indianapolis. "Recurrence rates are close to 50%, and the cost of urolithiasis to individuals and society is high. Acute renal colic is a common presentation in general practice, so a basic understanding of its evaluation and treatment would be useful."
The authors conducted an evidence-based literature review of the management of urolithiasis, including Medline and the Cochrane Library. Although most studies were retrospective, they also cited prospective randomized controlled trials when available.
Based on this review, their summary conclusions were as follows:
For diagnosing urolithiasis, unenhanced helical computed tomography (CT) is the best radiographic technique.
Most ureteral calculi smaller than 5 mm in diameter will pass spontaneously within 4 weeks of symptom onset.
For treating urolithiasis, shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy have replaced open surgery.
Shock wave lithotripsy is effective in approximately 80% to 85% of simple renal calculi.
For complex renal calculi, percutaneous nephrolithotomy is the treatment of choice. Staghorn calculi should be treated, preferably with percutaneous nephrolithotomy in most patients.
For patients who are pregnant, morbidly obese, or have coagulopathy, ureteroscopy is the preferred treatment.
http://www.medscape.com/viewarticle/553460?src=mp
Research has shed light on the computer frustrations that plague older adults
A number of evolving social changes highlight the importance of making computer technology accessible and usable for older adults. For instance, older adults are using email increasingly to keep up their social contact with others and are using the Internet to look up health information.
An innovative research study was conducted at the University of Alberta which analyzed the performance outcomes of older adults when being tested on the computer and Internet.
What researchers found can be applied as a ‘best practice’ when teaching older adults how to use computer technology. Research found that older adults feel less confident about their computer knowledge than younger adults. Older adults are also concerned about how memory issues may impact their performance.
"This lack of confidence is a major factor in older adults’ ability to become proficient with computer technology, which unfortunately results in less computer use," said Dr. Patricia Boechler from the University of Alberta.
http://www.eurekalert.org/pub_releases/2007-03/uoa-rhs031607.php
An innovative research study was conducted at the University of Alberta which analyzed the performance outcomes of older adults when being tested on the computer and Internet.
What researchers found can be applied as a ‘best practice’ when teaching older adults how to use computer technology. Research found that older adults feel less confident about their computer knowledge than younger adults. Older adults are also concerned about how memory issues may impact their performance.
"This lack of confidence is a major factor in older adults’ ability to become proficient with computer technology, which unfortunately results in less computer use," said Dr. Patricia Boechler from the University of Alberta.
http://www.eurekalert.org/pub_releases/2007-03/uoa-rhs031607.php
Hold the Breath for Bystander CPR
TOKYO, March 16 -- Bystander CPR with no mouth-to-mouth ventilation doubled the chance that those in cardiac arrest would have a good neurologic outcome, researchers here reported.
"Cardiac-only resuscitation by bystanders is the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest, especially those with apnea, shockable rhythm, or short periods of untreated arrest," wrote Ken Nagao, M.D., and colleagues, of Surugadai Nihon University Hospital, in the March 17 issue of The Lancet.
They found in a study of more than 4,000 cardiac arrest cases that while any attempt at out-of-hospital resuscitation was better than doing nothing at preserving neurologic function, cardiac-only resuscitation doubled, or nearly doubled, the chance that patients would have a favorable neurologic outcome.
This was especially so when CPR was started within four minutes of cardiac arrest or in those with apnea or a shockable cardiac rhythm.
http://www.medpagetoday.com/Cardiology/MyocardialInfarction/tb1/5268
"Cardiac-only resuscitation by bystanders is the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest, especially those with apnea, shockable rhythm, or short periods of untreated arrest," wrote Ken Nagao, M.D., and colleagues, of Surugadai Nihon University Hospital, in the March 17 issue of The Lancet.
They found in a study of more than 4,000 cardiac arrest cases that while any attempt at out-of-hospital resuscitation was better than doing nothing at preserving neurologic function, cardiac-only resuscitation doubled, or nearly doubled, the chance that patients would have a favorable neurologic outcome.
This was especially so when CPR was started within four minutes of cardiac arrest or in those with apnea or a shockable cardiac rhythm.
http://www.medpagetoday.com/Cardiology/MyocardialInfarction/tb1/5268
Natriuretic Peptide Assays Potentially Streamline Workup of Stable CAD
Patients with stable coronary disease could potentially avoid echocardiographic or nuclear studies of ventricular function if their serum natriuretic peptide levels are low, suggests a prospective study that further extends the diagnostic and prognostic possibilities for an assay usually used in acute heart failure.
Ventricular dysfunction, either systolic or diastolic as measured by echocardiography, was rare among the study's patients with levels of the natriuretic fragment of brain natriuretic peptide prohormone (N-terminal pro-B-type natriuretic peptide; NT-proBNP) below 100 pg/mL. The chances of any ventricular dysfunction were about 50-50 among those with very high levels, more than 500 pg/mL.
http://www.medscape.com/viewarticle/553648?rss
Ventricular dysfunction, either systolic or diastolic as measured by echocardiography, was rare among the study's patients with levels of the natriuretic fragment of brain natriuretic peptide prohormone (N-terminal pro-B-type natriuretic peptide; NT-proBNP) below 100 pg/mL. The chances of any ventricular dysfunction were about 50-50 among those with very high levels, more than 500 pg/mL.
http://www.medscape.com/viewarticle/553648?rss
High blood sugar tied to increased cancer risk
Results of a study involving nearly 65,000 people point to an association between cancer and abnormally high blood sugar levels.
These results "have obvious implications for lifestyle guidance, as it is well known what factors cause blood glucose increases," Dr. Par Stattin from Umea University Medical Center, Sweden noted in comments to Reuters Health.
By avoiding excessive fat and other dietary risk factors, and by getting regular exercise, "you can decrease your risk of cardiovascular disease, diabetes -- and cancer," he added.
Type 2 diabetes is associated with an increased risk of liver, pancreas, colon cancer, as well as other cancers, Stattin and colleagues note in the journal Diabetes Care. However, less is known about the effect on cancer risk associated with moderately elevated blood sugar levels among non-diabetic subjects.
http://news.yahoo.com/s/nm/20070316/hl_nm/high_blood_sugar_dc
These results "have obvious implications for lifestyle guidance, as it is well known what factors cause blood glucose increases," Dr. Par Stattin from Umea University Medical Center, Sweden noted in comments to Reuters Health.
By avoiding excessive fat and other dietary risk factors, and by getting regular exercise, "you can decrease your risk of cardiovascular disease, diabetes -- and cancer," he added.
Type 2 diabetes is associated with an increased risk of liver, pancreas, colon cancer, as well as other cancers, Stattin and colleagues note in the journal Diabetes Care. However, less is known about the effect on cancer risk associated with moderately elevated blood sugar levels among non-diabetic subjects.
http://news.yahoo.com/s/nm/20070316/hl_nm/high_blood_sugar_dc
Thursday, March 15, 2007
Interferon-Gamma Tests May Be More Effective Than Tuberculin Skin Test
Two interferon-gamma tests are more effective in detecting tuberculosis exposure in contacts than are traditional tuberculin skin tests (TST), according to the results of a randomized trial study reported in the March 15 issue of the American Journal of Respiratory & Critical Care Medicine.
"The tuberculin skin test (TST) has low specificity," write Sandra M. Arend, MD, from the Leiden University Medical Center in the Netherlands, and colleagues. "QuantiFERON-TB Gold (QFT-G) [Cellestis, Carnegy, Australia)] and T-SPOT.TB [Oxford Immunotec, Oxford, UK] are based on interferon (IFN)-γ responses to Mycobacterium tuberculosis–specific antigens. A novel in-tube format of QFT-G (QFT-GIT) offers logistical advantages."
The objective of this study was to compare TST, QFT-GIT, and T-SPOT.TB in bacillus Calmette-Guérin unvaccinated contacts and to correlate the results with other measures of recent exposure.
http://www.medscape.com/viewarticle/553646?rss
"The tuberculin skin test (TST) has low specificity," write Sandra M. Arend, MD, from the Leiden University Medical Center in the Netherlands, and colleagues. "QuantiFERON-TB Gold (QFT-G) [Cellestis, Carnegy, Australia)] and T-SPOT.TB [Oxford Immunotec, Oxford, UK] are based on interferon (IFN)-γ responses to Mycobacterium tuberculosis–specific antigens. A novel in-tube format of QFT-G (QFT-GIT) offers logistical advantages."
The objective of this study was to compare TST, QFT-GIT, and T-SPOT.TB in bacillus Calmette-Guérin unvaccinated contacts and to correlate the results with other measures of recent exposure.
http://www.medscape.com/viewarticle/553646?rss
Bleeding during endoscopy: Do anti-inflammatories play a role?
Does an aspirin-a-day increase the risk of bleeding during invasive diagnostic procedure? This is an important concern for many patients who take these and other antiplatelet agents in an effort to reduce heart attacks or strokes. Researchers at the MUHC have shown that antiplatelet drugs do not contribute to post-endoscopic bleeding. Their findings are published in this month's issue of Alimentary Pharmacology and Therapeutics.
"Clinical guidelines for use of antiplatelets during these procedures have been ambiguous," says Dr. Alan Barkun, MUHC Chief of Gastroenterology. "Some suggest withholding or stopping these medications ten days prior to the endoscopic procedure. Others will not perform the procedure if the patient was taking antiplatelet agents. In some cases this could have serious negative clinical implications. Our findings show that these precautionary measures are not necessary."
http://www.eurekalert.org/pub_releases/2007-03/mu-bde031507.php
"Clinical guidelines for use of antiplatelets during these procedures have been ambiguous," says Dr. Alan Barkun, MUHC Chief of Gastroenterology. "Some suggest withholding or stopping these medications ten days prior to the endoscopic procedure. Others will not perform the procedure if the patient was taking antiplatelet agents. In some cases this could have serious negative clinical implications. Our findings show that these precautionary measures are not necessary."
http://www.eurekalert.org/pub_releases/2007-03/mu-bde031507.php
Soy found protective against localized prostate cancer
The largest study examining the relationship between the traditional soy-rich Japanese diet and development of prostate cancer in Japanese men has come to a seemingly contradictory conclusion: intake of isoflavone chemicals, derived largely from soy foods, decreased the risk of localized prostate cancer but increased the risk of advanced prostate cancer.
The prospective study of 43,509 men, published in the March issue of Cancer Epidemiology, Biomarkers & Prevention, suggests that the effects of isoflavones on prostate cancer development may differ according to disease stage, say researchers at the National Cancer Center in Japan.
One possible explanation is that isoflavones may delay the progression of latent prostate cancer only; once tumors lose estrogen-receptor beta expression and become aggressive, isoflavones may fail to protect against the development of advanced cancer, and might even increase the risk of progression, possibly by reducing serum testosterone, researchers say. It is also possible that advanced and localized prostate cancer may be different tumor subtypes, which may react differently to isoflavones.
http://www.eurekalert.org/pub_releases/2007-03/aafc-sfp031507.php
The prospective study of 43,509 men, published in the March issue of Cancer Epidemiology, Biomarkers & Prevention, suggests that the effects of isoflavones on prostate cancer development may differ according to disease stage, say researchers at the National Cancer Center in Japan.
One possible explanation is that isoflavones may delay the progression of latent prostate cancer only; once tumors lose estrogen-receptor beta expression and become aggressive, isoflavones may fail to protect against the development of advanced cancer, and might even increase the risk of progression, possibly by reducing serum testosterone, researchers say. It is also possible that advanced and localized prostate cancer may be different tumor subtypes, which may react differently to isoflavones.
http://www.eurekalert.org/pub_releases/2007-03/aafc-sfp031507.php
Parkinson's Drug Raises Risk of Cardiac Valve Regurgitation
Findings from a new study add to the growing body of literature suggesting that the long-term use of pergolide for Parkinson's disease increases the risk of cardiac valve regurgitation. By contrast, non-ergot-derived dopamine agonists seem to have little effect on this risk.
Although several studies have linked pergolide with cardiac valve regurgitation, just one has suggested that non-ergot-derived agents also elevate the risk of this problem.
In a case-control study, reported in the March issue of the Archives of Neurology, the occurrence of cardiac valve regurgitation (determined with echocardiography) was compared in 36 pergolide users and 36 matched users of the non-ergot dopamine agonists pramipexole or ropinirole. The severity of regurgitation was graded from 1 (trace) to 4 (severe).
The average regurgitation scores in the pergolide group were 0.83 for the aortic valve, 1.42 for the mitral valve, and 1.43 for the tricuspid valve, lead author Dr. Richard B. Dewey, from the University of Texas Southwestern Medical Center in Dallas, and colleagues report. The corresponding scores in the control group -- 0.19, 0.39, and 0.19 -- were all significantly lower.
http://www.medscape.com/viewarticle/553609?sssdmh=dm1.255183&src=nldne
Although several studies have linked pergolide with cardiac valve regurgitation, just one has suggested that non-ergot-derived agents also elevate the risk of this problem.
In a case-control study, reported in the March issue of the Archives of Neurology, the occurrence of cardiac valve regurgitation (determined with echocardiography) was compared in 36 pergolide users and 36 matched users of the non-ergot dopamine agonists pramipexole or ropinirole. The severity of regurgitation was graded from 1 (trace) to 4 (severe).
The average regurgitation scores in the pergolide group were 0.83 for the aortic valve, 1.42 for the mitral valve, and 1.43 for the tricuspid valve, lead author Dr. Richard B. Dewey, from the University of Texas Southwestern Medical Center in Dallas, and colleagues report. The corresponding scores in the control group -- 0.19, 0.39, and 0.19 -- were all significantly lower.
http://www.medscape.com/viewarticle/553609?sssdmh=dm1.255183&src=nldne
Silent Strokes Linked to Sleep Apnea
Obstructive sleep apnea patients have a high rate of silent brain infarctions that can be seen by magnetic resonance imaging, according to researchers here.
They also have elevated levels of biochemical markers associated with cerebrovascular disease, found Kenji Minoguchi, M.D., Ph.D., of Showa University School of Medicine.
On the other hand, treatment with nasal continuous positive airway pressure (nCPAP) over three months reduced the level of disease markers and may lower the risk of disease, Dr. Minoguchi and colleagues said in the second March issue of the American Journal of Respiratory and Critical Care Medicine.
For reasons that could not be explained, the silent brain infarctions had no obvious clinical consequences.
The researchers enrolled 50 men with newly diagnosed obstructive sleep apnea and 15 obese men who had no sleep disorder to serve as controls. None had other co-morbidities.
http://www.medpagetoday.com/Pulmonary/SleepDisorders/tb1/5260
They also have elevated levels of biochemical markers associated with cerebrovascular disease, found Kenji Minoguchi, M.D., Ph.D., of Showa University School of Medicine.
On the other hand, treatment with nasal continuous positive airway pressure (nCPAP) over three months reduced the level of disease markers and may lower the risk of disease, Dr. Minoguchi and colleagues said in the second March issue of the American Journal of Respiratory and Critical Care Medicine.
For reasons that could not be explained, the silent brain infarctions had no obvious clinical consequences.
The researchers enrolled 50 men with newly diagnosed obstructive sleep apnea and 15 obese men who had no sleep disorder to serve as controls. None had other co-morbidities.
http://www.medpagetoday.com/Pulmonary/SleepDisorders/tb1/5260
Special chiropractic adjustment lowers blood pressure
A Chicago-area study of 50 individuals with a misaligned Atlas vertebra (located high in the neck) and high blood pressure showed that after a one-time specialized chiropractic adjustment, blood pressure decreased significantly. The decrease was equal to taking two blood-pressure drugs at once. The results are published in the online March 2 issue of the Journal of Human Hypertension.
According to lead author George Bakris, MD, director of the hypertension center at the University of Chicago Medical Center, unlike other vertebrae, which interlock one to the next, the Atlas (also known as C-1) relies solely upon soft tissue (muscles and ligaments) to maintain alignment; therefore is uniquely vulnerable to displacement. Displacement of C-1 can occur without pain and thus, often goes undetected and untreated.
A small cadre of chiropractic specialists have foregone typical "full-spine manipulations," limiting their practice to precise, delicate manual alignment of a single vertebra, C-1. These practitioners make up the National Upper Cervical Chiropractic Association (NUCCA).
http://www.eurekalert.org/pub_releases/2007-03/uocm-sca_1031407.php
According to lead author George Bakris, MD, director of the hypertension center at the University of Chicago Medical Center, unlike other vertebrae, which interlock one to the next, the Atlas (also known as C-1) relies solely upon soft tissue (muscles and ligaments) to maintain alignment; therefore is uniquely vulnerable to displacement. Displacement of C-1 can occur without pain and thus, often goes undetected and untreated.
A small cadre of chiropractic specialists have foregone typical "full-spine manipulations," limiting their practice to precise, delicate manual alignment of a single vertebra, C-1. These practitioners make up the National Upper Cervical Chiropractic Association (NUCCA).
http://www.eurekalert.org/pub_releases/2007-03/uocm-sca_1031407.php
Erectile dysfunction in diabetes is due to selective defect in the brain
A new study sheds additional light on how erectile dysfunction (ED) interacts with diabetes. The study is another step in uncovering the link between the two disorders, and may lead to improved efficacy in treatments.
The study, "Lack of Central Nitric Oxide Triggers Erectile Dysfunction in Diabetes," was conducted by Hong Zheng, William G. Mayhan, and Kaushik P. Patel, Departments of Cellular and Integrative Physiology; and Keshore R. Bidasee, Department of Pharmacology, University of Nebraska Medical Center, Omaha, NE. The results appear in the March 2007 edition of the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology, one of 11 peer-reviewed scientific publications issued monthly by The American Physiological Society (APS) (www.The-APS.org).
http://www.eurekalert.org/pub_releases/2007-03/aps-edi031507.php
The study, "Lack of Central Nitric Oxide Triggers Erectile Dysfunction in Diabetes," was conducted by Hong Zheng, William G. Mayhan, and Kaushik P. Patel, Departments of Cellular and Integrative Physiology; and Keshore R. Bidasee, Department of Pharmacology, University of Nebraska Medical Center, Omaha, NE. The results appear in the March 2007 edition of the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology, one of 11 peer-reviewed scientific publications issued monthly by The American Physiological Society (APS) (www.The-APS.org).
http://www.eurekalert.org/pub_releases/2007-03/aps-edi031507.php
Are Common Chemicals Feeding Obesity Epidemic?
Exposure to a class of chemicals commonly found in soap and plastics could be fueling the obesity epidemic by contributing to abdominal obesity and insulin resistance in men, a new study suggests.
The chemicals, known as phthalates, have already been implicated in male reproductive problems including low sperm counts and low testosterone levels. However, it's too soon to know whether they are actually causing these health problems, cautioned the researchers and others.
"It's premature for folks to be alarmed," said study author Dr. Richard Stahlhut, a resident in preventive medicine at the University of Rochester School of Medicine & Dentistry in New York.. "What is more alarming is the reason we are doing studies like this. Another study showed that testosterone levels had dropped about 22 percent in men, and that sperm counts had dropped to levels that are considered subfertile or infertile."
"It's an important observation that chemical exposures could be contributing to obesity and diabetes in the general population," added Dr. Ted Schettler, science director for the Science and Environmental Health Network. "This is one more example of a family of chemicals that may be contributing to this problem, but this study has obvious limits that the authors acknowledge in great detail."
http://news.yahoo.com/s/hsn/20070315/hl_hsn/arecommonchemicalsfeedingobesityepidemic
The chemicals, known as phthalates, have already been implicated in male reproductive problems including low sperm counts and low testosterone levels. However, it's too soon to know whether they are actually causing these health problems, cautioned the researchers and others.
"It's premature for folks to be alarmed," said study author Dr. Richard Stahlhut, a resident in preventive medicine at the University of Rochester School of Medicine & Dentistry in New York.. "What is more alarming is the reason we are doing studies like this. Another study showed that testosterone levels had dropped about 22 percent in men, and that sperm counts had dropped to levels that are considered subfertile or infertile."
"It's an important observation that chemical exposures could be contributing to obesity and diabetes in the general population," added Dr. Ted Schettler, science director for the Science and Environmental Health Network. "This is one more example of a family of chemicals that may be contributing to this problem, but this study has obvious limits that the authors acknowledge in great detail."
http://news.yahoo.com/s/hsn/20070315/hl_hsn/arecommonchemicalsfeedingobesityepidemic
Researchers find heart disease in a marathon runner -- Is too much exercise a bad thing?
Doctors at the University of Maryland Medical Center had a mystery on their hands. A 51-year-old physician colleague who looked the picture of health—no cardiovascular risks, a marathon runner who had exercised vigorously each day for 30 years—had just flunked a calcium screening scan of his heart. The patient had expected a score indicating a healthy cardiovascular system. Instead, the images indicated a high score: a build-up of calcium in his coronary arteries put him at high risk for blocked blood vessels and a possible heart attack.
The mystery was all the more intriguing because his resting blood pressure and fasting cholesterol levels, the usual measures of cardiovascular health, were in the normal range.
In the March 1, 2007, issue of the American Journal of Cardiology, the researchers say this is the first case, to their knowledge, of advanced coronary calcification in an otherwise healthy middle-aged male marathon runner who lacked traditional cardiac risk factors and had no symptoms of heart disease. The researchers conclude that the physician’s intense, long-term exercise regime, coupled with a predisposition toward a type of hypertension, contributed to his cardiovascular disease. "In this particular individual, we think that oxidative stress was an important contributor," says the study’s senior author, Michael Miller, M.D., director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. "But we also found that this individual has exercise-induced hypertension, which I think is vastly under-diagnosed."
http://www.eurekalert.org/pub_releases/2007-03/uomm-rfh031407.php
The mystery was all the more intriguing because his resting blood pressure and fasting cholesterol levels, the usual measures of cardiovascular health, were in the normal range.
In the March 1, 2007, issue of the American Journal of Cardiology, the researchers say this is the first case, to their knowledge, of advanced coronary calcification in an otherwise healthy middle-aged male marathon runner who lacked traditional cardiac risk factors and had no symptoms of heart disease. The researchers conclude that the physician’s intense, long-term exercise regime, coupled with a predisposition toward a type of hypertension, contributed to his cardiovascular disease. "In this particular individual, we think that oxidative stress was an important contributor," says the study’s senior author, Michael Miller, M.D., director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. "But we also found that this individual has exercise-induced hypertension, which I think is vastly under-diagnosed."
http://www.eurekalert.org/pub_releases/2007-03/uomm-rfh031407.php
Genes May Determine Success Of Hip Replacement Surgery
The success of long term hip replacement surgery may lie in the genes, suggests research published ahead of print in the Annals of the Rheumatic Diseases.
The researchers analysed genetic variations in 312 people, just over half of whom (162) had problems after hip replacement in the 10 years following surgery.
Among those with symptoms, 91 had early signs of "aseptic loosening," which describes a condition in which the artificial joint comes loose and the surrounding bone begins to dissolve. The other 71 patients had deep-seated infection, which occurs when the body is unable to control infection caused by bacteria colonising the artificial implants.
DNA samples were taken from all participants to test for genetic variations in genes responsible for generating matrix metalloproteinase 1, or MMP1 for short, interleukin 6, and vitamin D synthesis.
MMP1 is an enzyme that breaks down collagen, the main protein found in bone and cartilage, while interleukin 6 is a chemical involved in bone metabolism and the immune response.
Vitamin D synthesis is important for strong healthy bones.
Variations in the interleukin 6 gene did not seem to have any effect. But those with variations in MMP1 were more than three times as likely to have aseptic loosening as those who did not carry the genetic variation
.http://www.sciencedaily.com/releases/2007/03/070314195704.htm
The researchers analysed genetic variations in 312 people, just over half of whom (162) had problems after hip replacement in the 10 years following surgery.
Among those with symptoms, 91 had early signs of "aseptic loosening," which describes a condition in which the artificial joint comes loose and the surrounding bone begins to dissolve. The other 71 patients had deep-seated infection, which occurs when the body is unable to control infection caused by bacteria colonising the artificial implants.
DNA samples were taken from all participants to test for genetic variations in genes responsible for generating matrix metalloproteinase 1, or MMP1 for short, interleukin 6, and vitamin D synthesis.
MMP1 is an enzyme that breaks down collagen, the main protein found in bone and cartilage, while interleukin 6 is a chemical involved in bone metabolism and the immune response.
Vitamin D synthesis is important for strong healthy bones.
Variations in the interleukin 6 gene did not seem to have any effect. But those with variations in MMP1 were more than three times as likely to have aseptic loosening as those who did not carry the genetic variation
.http://www.sciencedaily.com/releases/2007/03/070314195704.htm
Study Ties Heart Attack Deaths to Weekend Care
study of nearly all heart attack patients in New Jersey finds that those who arrived at a hospital on a weekend were less likely to get aggressive treatment and were slightly more likely to die than those who arrived during the week, researchers are reporting.
The study, based on an analysis of 231,164 heart attack patients admitted to New Jersey hospitals from 1987 to 2002, found a gap of almost a percentage point in heart attack death rates over a three-year span: 12.9 percent for weekend patients versus 12 percent for weekday patients. (The deaths occurred within a month of admission.)
http://www.nytimes.com/2007/03/14/health/14cnd-heart.html?ex=1331524800&en=49ff635470635463&ei=5088&partner=rssnyt&emc=rss
The study, based on an analysis of 231,164 heart attack patients admitted to New Jersey hospitals from 1987 to 2002, found a gap of almost a percentage point in heart attack death rates over a three-year span: 12.9 percent for weekend patients versus 12 percent for weekday patients. (The deaths occurred within a month of admission.)
http://www.nytimes.com/2007/03/14/health/14cnd-heart.html?ex=1331524800&en=49ff635470635463&ei=5088&partner=rssnyt&emc=rss
Undiagnosed Sleep Apnea May Be Common in Patients With Pacemakers
A majority of patients with pacemakers in a recent series were found to have previously undiagnosed, predominantly obstructive, and often severe sleep apnea. The incidence reached 68% among those with atrioventricular block as the indication for pacing.
"Systematic screening of these patients should be performed owing to the potential cardiovascular consequences of sleep apnea syndrome," write the study's authors, Stéphane Garrigue, MD, PhD, from University of Bordeaux and Grenoble in Grenoble, France, and associates, who acknowledge that how best to manage sleep apnea in patients with pacemakers remains unclear.
To be practical, any such screening would likely not involve full sleep studies but, rather, would be limited to simpler assessments such as pulse oximetry and nasal flow measurement, according to coauthor Patrick Lévy, MD, PhD, from the University of Bordeaux and Grenoble. In patients with appropriately equipped pacemakers, he told heartwire, sleep apnea syndrome could be revealed by assessment of nocturnal tidal volumes from measurement of transthoracic impedance, a technique previously demonstrated by his group as well as others.
http://www.medscape.com/viewarticle/553591?rss
"Systematic screening of these patients should be performed owing to the potential cardiovascular consequences of sleep apnea syndrome," write the study's authors, Stéphane Garrigue, MD, PhD, from University of Bordeaux and Grenoble in Grenoble, France, and associates, who acknowledge that how best to manage sleep apnea in patients with pacemakers remains unclear.
To be practical, any such screening would likely not involve full sleep studies but, rather, would be limited to simpler assessments such as pulse oximetry and nasal flow measurement, according to coauthor Patrick Lévy, MD, PhD, from the University of Bordeaux and Grenoble. In patients with appropriately equipped pacemakers, he told heartwire, sleep apnea syndrome could be revealed by assessment of nocturnal tidal volumes from measurement of transthoracic impedance, a technique previously demonstrated by his group as well as others.
http://www.medscape.com/viewarticle/553591?rss
Wednesday, March 14, 2007
Many Blacks, Hispanics Misinformed About Alzheimer's
WEDNESDAY, March 14 (HealthDay News) -- Black and Hispanic communities harbor many misconceptions about Alzheimer's disease, a new survey shows.
Conducted by Harris Interactive for the Alzheimer's Foundation of America, the survey results showed, among other things, that black and Hispanic caregivers were more likely (37 percent and 33 percent) than caregivers of other races (23 percent) to believe that Alzheimer's is a normal part of aging.
"Many of African-Americans and Hispanics thought it was almost normal that people would get Alzheimer's disease as they age," said foundation CEO Eric J. Hall. "This says a lot about the need for education in these communities."
The problem is especially acute in black and Hispanic communities, said Dr. Warachal E. Faison, clinical director of Alzheimer's Research and Clinical Programs at the Medical University of South Carolina. "In minority communities, there is this misconception that Alzheimer's disease is a normal part of aging," she said. "Those subtle symptoms that occur in Alzheimer's disease are often missed in these communities."
http://news.yahoo.com/s/hsn/20070314/hl_hsn/manyblackshispanicsmisinformedaboutalzheimers
Conducted by Harris Interactive for the Alzheimer's Foundation of America, the survey results showed, among other things, that black and Hispanic caregivers were more likely (37 percent and 33 percent) than caregivers of other races (23 percent) to believe that Alzheimer's is a normal part of aging.
"Many of African-Americans and Hispanics thought it was almost normal that people would get Alzheimer's disease as they age," said foundation CEO Eric J. Hall. "This says a lot about the need for education in these communities."
The problem is especially acute in black and Hispanic communities, said Dr. Warachal E. Faison, clinical director of Alzheimer's Research and Clinical Programs at the Medical University of South Carolina. "In minority communities, there is this misconception that Alzheimer's disease is a normal part of aging," she said. "Those subtle symptoms that occur in Alzheimer's disease are often missed in these communities."
http://news.yahoo.com/s/hsn/20070314/hl_hsn/manyblackshispanicsmisinformedaboutalzheimers
FDA says pills can cause 'sleep-driving'
All prescription sleeping pills may sometimes cause sleep-driving, federal health officials warned Wednesday, almost a year after the bizarre side effect first made headlines when Rep. Patrick Kennedy (news, bio, voting record) crashed his car after taking Ambien.
It's a more complicated version of sleepwalking, but behind the wheel: getting up in the middle of the night and going for a drive — with no memory of doing so.
The Food and Drug Administration wouldn't say exactly how many cases of sleep-driving it had linked to insomnia drugs, but neurology chief Dr. Russell Katz said the agency uncovered more than a dozen reports — and is worried that more are going uncounted.
Given the millions of prescriptions for insomnia drugs, Katz called the problem rare, and said he was unaware of any deaths. But because sleep-driving is so dangerous — and there are precautions that patients can take — the FDA ordered a series of strict new steps Wednesday.
First, the makers of 13 sleep drugs must put warnings on their labels about two rare but serious side effects:
_sleep-driving, along with other less dangerous "complex sleep-related behaviors" — like making phone calls, fixing and eating food, and having sex while still asleep.
_and life-threatening allergic reactions, as well as severe facial swelling, both of which can occur either the first time the pills are taken or anytime thereafter.
http://news.yahoo.com/s/ap/20070314/ap_on_he_me/sleep_drug_warning
It's a more complicated version of sleepwalking, but behind the wheel: getting up in the middle of the night and going for a drive — with no memory of doing so.
The Food and Drug Administration wouldn't say exactly how many cases of sleep-driving it had linked to insomnia drugs, but neurology chief Dr. Russell Katz said the agency uncovered more than a dozen reports — and is worried that more are going uncounted.
Given the millions of prescriptions for insomnia drugs, Katz called the problem rare, and said he was unaware of any deaths. But because sleep-driving is so dangerous — and there are precautions that patients can take — the FDA ordered a series of strict new steps Wednesday.
First, the makers of 13 sleep drugs must put warnings on their labels about two rare but serious side effects:
_sleep-driving, along with other less dangerous "complex sleep-related behaviors" — like making phone calls, fixing and eating food, and having sex while still asleep.
_and life-threatening allergic reactions, as well as severe facial swelling, both of which can occur either the first time the pills are taken or anytime thereafter.
http://news.yahoo.com/s/ap/20070314/ap_on_he_me/sleep_drug_warning
Green tea plus painkiller slows prostate cancer
A component of green tea combined with a low dose of a COX-2 inhibitor may act in concert to slow the spread of human prostate cancer.
In the journal Clinical Cancer Research, they report that low doses of the COX-2 inhibitor celecoxib (sold as Celebrex), given along with a green tea polyphenol slowed the growth of prostate cancer in cell cultures and in a mouse model of the disease.
"Celecoxib and green tea have a synergistic effect, each triggering cellular pathways, that, combined, are more powerful than either agent alone," Dr. Hasan Mukhtar from the University of Wisconsin, Madison, said in a statement.
Prior studies have linked the COX-2 enzyme to many cancer types, including prostate cancer. Mukhtar and colleagues previously found that COX-2 inhibitors like Celebrex suppress prostate cancer in animals. COX-2 inhibitors also have been shown to have adverse effects on the heart when taken at high doses for long periods of time.
Mukhtar's team also previously found that the green tea polyphenol called EGCG has cancer-fighting abilities of its own; EGCG, they found, modulates key chemical pathways that fuel the death of human prostate cancer cells.
http://news.yahoo.com/s/nm/20070314/hl_nm/green_tea_dc
In the journal Clinical Cancer Research, they report that low doses of the COX-2 inhibitor celecoxib (sold as Celebrex), given along with a green tea polyphenol slowed the growth of prostate cancer in cell cultures and in a mouse model of the disease.
"Celecoxib and green tea have a synergistic effect, each triggering cellular pathways, that, combined, are more powerful than either agent alone," Dr. Hasan Mukhtar from the University of Wisconsin, Madison, said in a statement.
Prior studies have linked the COX-2 enzyme to many cancer types, including prostate cancer. Mukhtar and colleagues previously found that COX-2 inhibitors like Celebrex suppress prostate cancer in animals. COX-2 inhibitors also have been shown to have adverse effects on the heart when taken at high doses for long periods of time.
Mukhtar's team also previously found that the green tea polyphenol called EGCG has cancer-fighting abilities of its own; EGCG, they found, modulates key chemical pathways that fuel the death of human prostate cancer cells.
http://news.yahoo.com/s/nm/20070314/hl_nm/green_tea_dc
Tuesday, March 13, 2007
Sleeping Pill Wakes Woman After 2 Years in Coma
Ambien 'mini-miracle' may give more insight into how the brain works, experts say
By Jeffrey PerkelHealthDay Reporter
TUESDAY, March 13 (HealthDay News) -- A dose of the prescription sleep aid Ambien had the opposite effect on one French woman, awakening her from a two-year coma.
The 48-year-old woman suffered from akinetic mutism -- a sort of persistent coma in which the patient is alert but can neither speak nor move. She had lain in this state after sustaining damage to the frontal lobe of her brain due to a lack of oxygen caused by an attempted suicide by hanging.
But one day she was given zolpidem (Ambien) to treat ongoing insomnia.
"Twenty minutes later, her family noticed surprising signs of enhanced arousal," the study authors wrote. "She became able to communicate to her family, to eat without (swallowing) troubles, and to move alone in her bed. These effects started 20 minutes after drug administration and lasted for two to three hours."
After treatment, the patient could walk for short periods, and to speak if prompted, though not spontaneously. "This phenomenon was so reproducible that caregivers used to give her up to three tablets each day without sleepiness as 'side effect,' " the researchers wrote.
Using positron emission tomography (PET) scans, the researchers found that the drug treatment caused the woman's frontal lobes to become "way more active," noted Dr. James Grisolia, a neurologist at Scripps Mercy Hospital in San Diego. He was not involved in the research, which was led by Dr. Christine Brefel-Courbon, of the University Hospital in Toulouse, France.
http://www.healthscout.com/news/1/602688/main.html
By Jeffrey PerkelHealthDay Reporter
TUESDAY, March 13 (HealthDay News) -- A dose of the prescription sleep aid Ambien had the opposite effect on one French woman, awakening her from a two-year coma.
The 48-year-old woman suffered from akinetic mutism -- a sort of persistent coma in which the patient is alert but can neither speak nor move. She had lain in this state after sustaining damage to the frontal lobe of her brain due to a lack of oxygen caused by an attempted suicide by hanging.
But one day she was given zolpidem (Ambien) to treat ongoing insomnia.
"Twenty minutes later, her family noticed surprising signs of enhanced arousal," the study authors wrote. "She became able to communicate to her family, to eat without (swallowing) troubles, and to move alone in her bed. These effects started 20 minutes after drug administration and lasted for two to three hours."
After treatment, the patient could walk for short periods, and to speak if prompted, though not spontaneously. "This phenomenon was so reproducible that caregivers used to give her up to three tablets each day without sleepiness as 'side effect,' " the researchers wrote.
Using positron emission tomography (PET) scans, the researchers found that the drug treatment caused the woman's frontal lobes to become "way more active," noted Dr. James Grisolia, a neurologist at Scripps Mercy Hospital in San Diego. He was not involved in the research, which was led by Dr. Christine Brefel-Courbon, of the University Hospital in Toulouse, France.
http://www.healthscout.com/news/1/602688/main.html
FDA approves advanced breast cancer drug
Women with an aggressive form of advanced breast cancer that other treatments have failed to stop gained a new option Tuesday with the approval of a novel drug — but how much benefit it offers is unclear.
The GlaxoSmithKline PLC drug, Tykerb, is to be taken once daily in pill form and is meant for women who have received prior treatment with the intravenous drug Herceptin and older chemotherapy drugs called taxanes and anthracyclines, the company said. The Food and Drug Administration said it approved Tykerb for use in conjunction with the chemotherapy drug Xeloda.
Glaxo said Tykerb would be available in two weeks. It will cost about $2,900 a month, the company said.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/breast_cancer
The GlaxoSmithKline PLC drug, Tykerb, is to be taken once daily in pill form and is meant for women who have received prior treatment with the intravenous drug Herceptin and older chemotherapy drugs called taxanes and anthracyclines, the company said. The Food and Drug Administration said it approved Tykerb for use in conjunction with the chemotherapy drug Xeloda.
Glaxo said Tykerb would be available in two weeks. It will cost about $2,900 a month, the company said.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/breast_cancer
Crave a smoke? Try taking a short walk
As little as five minutes of exercise seems to help smokers curb their craving for a cigarette, a review of a dozen studies found.
The research showed that moderate exercise, such as walking, significantly reduced the intensity of smokers' nicotine withdrawal symptoms.
"If we found the same effects in a drug, it would immediately be sold as an aid to help people quit smoking," said Dr. Adrian Taylor, the study's lead author and professor of exercise and health psychology at the University of Exeter.
Taylor and colleagues reviewed 12 papers looking at the connection between exercise and nicotine deprivation. They focused on exercises that could be done outside a gym, such as walking and isometrics, or the flexing and tensing of muscles. According to their analysis, just five minutes of exercise was often enough to help smokers overcome their immediate need for a nicotine fix.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/fitness_smoking
The research showed that moderate exercise, such as walking, significantly reduced the intensity of smokers' nicotine withdrawal symptoms.
"If we found the same effects in a drug, it would immediately be sold as an aid to help people quit smoking," said Dr. Adrian Taylor, the study's lead author and professor of exercise and health psychology at the University of Exeter.
Taylor and colleagues reviewed 12 papers looking at the connection between exercise and nicotine deprivation. They focused on exercises that could be done outside a gym, such as walking and isometrics, or the flexing and tensing of muscles. According to their analysis, just five minutes of exercise was often enough to help smokers overcome their immediate need for a nicotine fix.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/fitness_smoking
Thrombolysis After Stroke Benefits Men More Than Women
NEW YORK, March 13 -- Men given thrombolysis for acute ischemic stroke were three times more likely than women to have a good functional outcome, despite elevated mortality, researchers here found.
The findings came from a secondary analysis of the multicenter randomized study known as the Glycine Antagonist in Neuroprotection (GAIN) Americas trial, reported Mitchell Elkind, M.D., of Columbia University, and colleagues, in the March 13 issue of Neurology.
In that the GAIN study, published in 2001 in the Journal of the American Medical Association, 1367 ischemic stroke patients were randomized to placebo or gavestinel, an antagonist of the glycine site of the N-methyl-D-aspartate receptor. Gavestinel administered up to six hours after an acute ischemic stroke did not improve functional outcome at three months.
http://www.medpagetoday.com/Neurology/Strokes/tb1/5244
The findings came from a secondary analysis of the multicenter randomized study known as the Glycine Antagonist in Neuroprotection (GAIN) Americas trial, reported Mitchell Elkind, M.D., of Columbia University, and colleagues, in the March 13 issue of Neurology.
In that the GAIN study, published in 2001 in the Journal of the American Medical Association, 1367 ischemic stroke patients were randomized to placebo or gavestinel, an antagonist of the glycine site of the N-methyl-D-aspartate receptor. Gavestinel administered up to six hours after an acute ischemic stroke did not improve functional outcome at three months.
http://www.medpagetoday.com/Neurology/Strokes/tb1/5244
Middle Aged People With Long-lived Parents Tend To Have Lower Risk Of Heart Disease
A new US study suggests that middle aged people born of parents where one or both live to be 85 or more have a lower risk of heart disease.The study is published in the Archives of Internal Medicine.Dr Dellara F. Terry from the University School of Medicine, Boston, Massachusetts and colleagues looked at data on over 1,500 members of the Framingham Heart Study (FHS). The FHS contains risk factor data on cardiovascular and other chronic diseases covering several generations of residents in Framingham, Massachussets from 1948 to the present day. All the participants' parents were members of the FHS and either lived to be 85 or more, or died before 1st of January 2005.In this longitudinal study Dr Terry and colleagues looked at two batches of data, one from the 1970s and the other from the 1980s, and analyzed how the variables had changed over time.
http://www.medicalnewstoday.com/healthnews.php?newsid=65165&nfid=crss
http://www.medicalnewstoday.com/healthnews.php?newsid=65165&nfid=crss
Beta carotene pills may not save vision
Carrots, rich in beta carotene, long have been thought to sharpen eyesight, but a new study suggests that beta carotene pills are powerless against a common type of vision loss among older people. Age-related macular degeneration is the leading cause of blindness in people 65 and older. The condition blurs the center of the field of vision, making it difficult to read, drive, thread a needle and even recognize faces. It affects more than 10 million Americans and there is no cure.
An earlier large study had shown that beta carotene — when taken with certain vitamins and zinc — could slow or prevent vision loss in people with age-related macular degeneration. Commercial formulations of the eye-protecting combination vitamins are sold over the counter.
But the new study found no benefit for beta carotene supplements alone against the disease.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/diet_beta_carotene
An earlier large study had shown that beta carotene — when taken with certain vitamins and zinc — could slow or prevent vision loss in people with age-related macular degeneration. Commercial formulations of the eye-protecting combination vitamins are sold over the counter.
But the new study found no benefit for beta carotene supplements alone against the disease.
http://news.yahoo.com/s/ap/20070313/ap_on_he_me/diet_beta_carotene
Another Supplement, Under the Microscope
Not so long ago, antioxidant vitamins were hailed as nature’s own weapons against chronic illness, powerful antidotes to horrid diets and failed exercise plans.
A parade of observational studies showed that people who consumed large amounts of vitamins C and E and beta carotene were usually healthier than those who ingested comparatively little. Almost overnight, it seemed, millions of consumers morphed into fervid pill poppers, and antioxidants were dolloped into an ever expanding variety of foods.
But recent and more rigorous research suggests that this silver bullet missed its mark. Most long-term prospective trials have shown that using antioxidant vitamin supplements does not prevent heart disease or cancer, with the possible exception of prostate cancer.
In a study published last month in The Journal of the American Medical Association, researchers in Europe analyzed data from 68 large trials in which more than 232,000 adults were given antioxidant supplements.
http://www.nytimes.com/2007/03/13/health/13cons.html?ex=1331438400&en=4e5836186289a10d&ei=5088&partner=rssnyt&emc=rss
A parade of observational studies showed that people who consumed large amounts of vitamins C and E and beta carotene were usually healthier than those who ingested comparatively little. Almost overnight, it seemed, millions of consumers morphed into fervid pill poppers, and antioxidants were dolloped into an ever expanding variety of foods.
But recent and more rigorous research suggests that this silver bullet missed its mark. Most long-term prospective trials have shown that using antioxidant vitamin supplements does not prevent heart disease or cancer, with the possible exception of prostate cancer.
In a study published last month in The Journal of the American Medical Association, researchers in Europe analyzed data from 68 large trials in which more than 232,000 adults were given antioxidant supplements.
http://www.nytimes.com/2007/03/13/health/13cons.html?ex=1331438400&en=4e5836186289a10d&ei=5088&partner=rssnyt&emc=rss
Some Bariatric Surgery Patients Develop Wernicke's Encephalopathy
Weight-loss surgery may also cause memory loss and other serious neurologic problems in a small number of patients.
At least 32 cases of Wernicke's encephalopathy -- a syndrome caused by thiamine deficiency and marked by acute mental confusion, apathy, drowsiness, ataxia, and oculomotor abnormalities -- have been reported in the medical literature in patients who underwent bariatric surgery, found Sonal Singh, M.D., of Wake-Forest University here, and Abhay Kumar, M.D., of the University of Iowa in Iowa City.
A few of the patients suffered persistent memory loss and motor problems, the investigators reported in the March 13 issue of Neurology.
Werrnicke's encephalopathy, first described in 1881 by Polish neurologist Carl Wernicke, M.D., is frequently seen among alcoholics, those with nutritional deficiency states, AIDS patients, and people who are on long-term hemodialysis, but its incidence in bariatric surgery patients had been unknown.
http://www.medpagetoday.com/Neurology/GeneralNeurology/dh/5236
At least 32 cases of Wernicke's encephalopathy -- a syndrome caused by thiamine deficiency and marked by acute mental confusion, apathy, drowsiness, ataxia, and oculomotor abnormalities -- have been reported in the medical literature in patients who underwent bariatric surgery, found Sonal Singh, M.D., of Wake-Forest University here, and Abhay Kumar, M.D., of the University of Iowa in Iowa City.
A few of the patients suffered persistent memory loss and motor problems, the investigators reported in the March 13 issue of Neurology.
Werrnicke's encephalopathy, first described in 1881 by Polish neurologist Carl Wernicke, M.D., is frequently seen among alcoholics, those with nutritional deficiency states, AIDS patients, and people who are on long-term hemodialysis, but its incidence in bariatric surgery patients had been unknown.
http://www.medpagetoday.com/Neurology/GeneralNeurology/dh/5236
Imaging Exposes Alzheimer's-Like Plaque in the Human Brain
Beta-amyloid plaques in the brains of people with Alzheimer's type dementia can be spotted with the aid of the imaging agent Pittsburgh Compound B, researchers here determined.The distribution of amyloid plaques seen on positron emission tomography imaging with the tracer compound closely correlated with that discovered post-mortem in a 76-year-old man with Lewy body dementia, reported Brian J. Bacskai, Ph.D., of Massachusetts General Hospital and the University of Pittsburgh, and colleagues.
The findings provide confirmation that when investigators thought they were seeing amyloid deposition and distribution on PET scan images, they really were, the authors wrote in the March issue of the Archives of Neurology.
"What it says is that if you see positive Pittsburgh Compound B, you're going to find that that person has amyloid pathology in their brain, and that's a valuable first step," said co-author Steven T. DeKosky, M.D., director of the Alzheimer's Disease Research Center at the University of Pittsburgh, in an interview.
http://www.medpagetoday.com/Psychiatry/AlzheimersDisease/dh/5234
The findings provide confirmation that when investigators thought they were seeing amyloid deposition and distribution on PET scan images, they really were, the authors wrote in the March issue of the Archives of Neurology.
"What it says is that if you see positive Pittsburgh Compound B, you're going to find that that person has amyloid pathology in their brain, and that's a valuable first step," said co-author Steven T. DeKosky, M.D., director of the Alzheimer's Disease Research Center at the University of Pittsburgh, in an interview.
http://www.medpagetoday.com/Psychiatry/AlzheimersDisease/dh/5234
Monday, March 12, 2007
Caffeine May Protect Against CVD Death in Older Subjects Without Hypertension
Elderly men and women who regularly drink caffeinated beverages may be protected against death from heart disease, a prospective, epidemiologic study suggests. The study adds to the growing evidence that caffeine, and particularly coffee — long saddled with an unhealthy reputation — may in fact not be harmful to the heart, particularly in people without other risk factors for the disease.
Not all studies have supported a beneficial role for caffeine and coffee, however.
Writing in the March issue of the American Journal of Clinical Nutrition, James A. Greenberg from Brooklyn College of the City University of New York, and colleagues hypothesized that caffeinated beverages — which have a pressor effect, raising blood pressure (BP) levels — might affect postprandial hypotension, a phenomenon that has been linked to risk for coronary events and mortality in older people who already have low BP. Their findings would also explain, in part, why younger subjects, and those with hypertension, may not benefit.
http://www.medscape.com/viewarticle/553458?rss
Not all studies have supported a beneficial role for caffeine and coffee, however.
Writing in the March issue of the American Journal of Clinical Nutrition, James A. Greenberg from Brooklyn College of the City University of New York, and colleagues hypothesized that caffeinated beverages — which have a pressor effect, raising blood pressure (BP) levels — might affect postprandial hypotension, a phenomenon that has been linked to risk for coronary events and mortality in older people who already have low BP. Their findings would also explain, in part, why younger subjects, and those with hypertension, may not benefit.
http://www.medscape.com/viewarticle/553458?rss
Diabetes and Severe Depression Raise Risk of Cardiac Mortality
Among patients with coronary artery disease, comorbid diabetes or depression increases the risk of dying from heart disease.
The risk is even higher when both diabetes and severe depression are present, investigators report today at the annual meeting of the American Psychosomatic Society in Budapest, Hungary.
Senior investigator Dr. Lana L. Watkins said her team's interest was roused by recent findings from the National Health and Nutrition Examination Survey (NHANES), which showed that symptoms of depression increase the risk associated with diabetes.
"We wanted to know if these findings would also hold true for patients with coronary artery disease," Dr. Watkins told Reuters Health.
http://www.medscape.com/viewarticle/553389?sssdmh=dm1.253904&src=nldne
The risk is even higher when both diabetes and severe depression are present, investigators report today at the annual meeting of the American Psychosomatic Society in Budapest, Hungary.
Senior investigator Dr. Lana L. Watkins said her team's interest was roused by recent findings from the National Health and Nutrition Examination Survey (NHANES), which showed that symptoms of depression increase the risk associated with diabetes.
"We wanted to know if these findings would also hold true for patients with coronary artery disease," Dr. Watkins told Reuters Health.
http://www.medscape.com/viewarticle/553389?sssdmh=dm1.253904&src=nldne
Folic Acid Improves Cognitive Performance in Older Adults
A randomized, placebo-controlled trial has shown daily folic acid significantly improves cognitive performance in older adults — specifically as it relates to memory and information processing.
The study, which included 818 subjects aged 50 to 70 years who were folate deficient, showed that those who took 800 µg daily of oral folic acid for 3 years had significantly better memory and information processing speed than subjects in the placebo group.
Furthermore, serum folate concentrations increased by 576% and plasma total homocysteine concentrations decreased by 26% in participants taking folic acid compared with those taking placebo.
"We have shown that 3-year folic acid supplementation improves performance on tests that measure information-processing speed and memory, domains that are known to decline with age, in older adults with raised total homocysteine concentrations," the authors write.
Led by Jane Durga, PhD, of the Wageningen University, the Netherlands, the study is published in the January 20 issue of The Lancet.
http://www.medscape.com/viewarticle/550999_print
The study, which included 818 subjects aged 50 to 70 years who were folate deficient, showed that those who took 800 µg daily of oral folic acid for 3 years had significantly better memory and information processing speed than subjects in the placebo group.
Furthermore, serum folate concentrations increased by 576% and plasma total homocysteine concentrations decreased by 26% in participants taking folic acid compared with those taking placebo.
"We have shown that 3-year folic acid supplementation improves performance on tests that measure information-processing speed and memory, domains that are known to decline with age, in older adults with raised total homocysteine concentrations," the authors write.
Led by Jane Durga, PhD, of the Wageningen University, the Netherlands, the study is published in the January 20 issue of The Lancet.
http://www.medscape.com/viewarticle/550999_print
Carotid Stenting Safe Even in Less Experienced Hands
Carotid stenting with embolic protection was as safe and effective in a real-world registry trial as it was in phase III trials that led to FDA approval, researchers said here.
The one-year stroke rate was 4.8% for the CASES postmarketing study of the Cordis Precise Nitinol Stent and Angioguard XP Emboli Capture Guidewire System, said Barry T. Katzen, M.D., of the Baptist Cardiac and Vascular Institute in Miami, and colleagues.
That rate compares favorably with the 4.9% stroke rate for carotid stenting and the 5.8% endarterectomy-associated stroke rate in the SAPPHIRE trial, Dr. Katzen said at the Society of Interventional Radiology meeting.
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5189
The one-year stroke rate was 4.8% for the CASES postmarketing study of the Cordis Precise Nitinol Stent and Angioguard XP Emboli Capture Guidewire System, said Barry T. Katzen, M.D., of the Baptist Cardiac and Vascular Institute in Miami, and colleagues.
That rate compares favorably with the 4.9% stroke rate for carotid stenting and the 5.8% endarterectomy-associated stroke rate in the SAPPHIRE trial, Dr. Katzen said at the Society of Interventional Radiology meeting.
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5189
Anxiety Disorders Prevalent, Undertreated in Primary Care
Anxiety disorders are prevalent and often go untreated in primary care, according to a study in Annals of Internal Medicine.
Researchers used questionnaires and interviews to assess anxiety in some 970 patients recruited at U.S. primary care clinics. About 20% of the participants had at least one anxiety disorder (PTSD was most prevalent, followed by generalized anxiety disorder, panic disorder, and social anxiety disorder). Of these, 41% reported receiving no current treatment.
The authors write that two short questionnaires used in the industry-sponsored study (the Generalized Anxiety Disorder [GAD]-7 and GAD-2 scales) performed well as screening tools for all four of the most common anxiety disorders. Editorialists note, however, that study participants had high rates of depression, and wonder if "the high predictive validity of the GAD-7 may reflect a high level of nonspecific emotional distress rather than something specifically unique about anxiety."
http://www.annals.org/cgi/content/full/146/5/390
Researchers used questionnaires and interviews to assess anxiety in some 970 patients recruited at U.S. primary care clinics. About 20% of the participants had at least one anxiety disorder (PTSD was most prevalent, followed by generalized anxiety disorder, panic disorder, and social anxiety disorder). Of these, 41% reported receiving no current treatment.
The authors write that two short questionnaires used in the industry-sponsored study (the Generalized Anxiety Disorder [GAD]-7 and GAD-2 scales) performed well as screening tools for all four of the most common anxiety disorders. Editorialists note, however, that study participants had high rates of depression, and wonder if "the high predictive validity of the GAD-7 may reflect a high level of nonspecific emotional distress rather than something specifically unique about anxiety."
http://www.annals.org/cgi/content/full/146/5/390
Cell Phones Do Not Interfere with Hospital Equipment
Cell phones do not interfere with medical equipment when used normally in patient care areas of hospitals, according to a study in the Mayo Clinic Proceedings.
The investigators used phones from two different cellular carriers in patient rooms containing a total of 192 medical devices, such as ECG monitors, ventilators and ultrasound imaging machines. In 300 tests, they found no instances of interference. Two Blackberries tested 40 times near 24 medical devices caused no problems either.
"For institutions that have restricted cellular telephone use, these data support revision or abolition of the existing policy," the study concluded.
An editorialist suggests that "it would be appropriate for the FDA to take a more explicit stand that [interference] is unlikely to occur in a hospital setting and that internal regulations in health care facilities should reflect that fact."
http://www.mayoclinicproceedings.com/Abstract.asp?AID=4308&Abst=Abstract&UID=
The investigators used phones from two different cellular carriers in patient rooms containing a total of 192 medical devices, such as ECG monitors, ventilators and ultrasound imaging machines. In 300 tests, they found no instances of interference. Two Blackberries tested 40 times near 24 medical devices caused no problems either.
"For institutions that have restricted cellular telephone use, these data support revision or abolition of the existing policy," the study concluded.
An editorialist suggests that "it would be appropriate for the FDA to take a more explicit stand that [interference] is unlikely to occur in a hospital setting and that internal regulations in health care facilities should reflect that fact."
http://www.mayoclinicproceedings.com/Abstract.asp?AID=4308&Abst=Abstract&UID=
Sunday, March 11, 2007
The Humanistic Crisis in Medical Education
Beginning in the late 19th century, scientific medicine took unprecedented strides in reducing infectious disease and prolonging life. New public health measures, the rise of bacteriology, the reform of medical education, a virtual explosion of new hospitals, and innovations in diagnostic techniques and therapeutic resources—all pointed toward a seemingly limitless horizon of medical progress. Physicians in the United States had little reason to anticipate the coming assaults on their prestige and moral authority. Sometime in the mid-1960s, however, the bloom began to fall from the rose of modern medicine.
By the early 1990s, vast and unsettling changes had taken place, and a new sense of limits emerged. Almost every aspect of medical practice had been altered. Revelations of abuse in medical experimentation led to new federal regulations for the protection of human and animal subjects. Hospitals were increasingly perceived as strange places dominated by technology, where patients' rights were ignored and bureaucracy prevailed over compassion. Decisions at the bedside were no longer the exclusive concern of an individual physician and patient.
These changes and challenges revealed that scientific medicine—a profession that had explicitly detached itself from broader frameworks of meaning and value—was not equipped to handle the moral and existential questions produced by its own power. In response, entirely new fields of academic inquiry, education, and professional practice arose. These fields became known as bioethics and the medical humanities, and their experts began to grapple with such problematic issues as the protection of research subjects, the goals of medicine, the definitions of death, the rights of patients, the cessation of treatment, the meaning of illness, and the distribution of health care resources.
http://www.acpmedicine.com/wnim/acp_0307.htm#L1
By the early 1990s, vast and unsettling changes had taken place, and a new sense of limits emerged. Almost every aspect of medical practice had been altered. Revelations of abuse in medical experimentation led to new federal regulations for the protection of human and animal subjects. Hospitals were increasingly perceived as strange places dominated by technology, where patients' rights were ignored and bureaucracy prevailed over compassion. Decisions at the bedside were no longer the exclusive concern of an individual physician and patient.
These changes and challenges revealed that scientific medicine—a profession that had explicitly detached itself from broader frameworks of meaning and value—was not equipped to handle the moral and existential questions produced by its own power. In response, entirely new fields of academic inquiry, education, and professional practice arose. These fields became known as bioethics and the medical humanities, and their experts began to grapple with such problematic issues as the protection of research subjects, the goals of medicine, the definitions of death, the rights of patients, the cessation of treatment, the meaning of illness, and the distribution of health care resources.
http://www.acpmedicine.com/wnim/acp_0307.htm#L1
Saturday, March 10, 2007
Google Calendar for Patients: Monitor Your Medical Condition
some patients are using Google Calendar to track the daily or weekly variations of their medical condition, for example, depression or insomnia. The color-coded approach looks complicated to me but some people find it helpful.Google Calendar can potentially be useful for monitoring the progress of patients with other chronic conditions like asthma: daily sx, use of PRN inhalers, sx during the night, etc.It is not difficult to imagine diabetic patients using the calendar to monitor their blood glucose, hypertensive patients recording their blood pressure and so on
.http://casesblog.blogspot.com/2006/04/google-calendar-for-patients-monitor.html
.http://casesblog.blogspot.com/2006/04/google-calendar-for-patients-monitor.html
Treatment of Anemia Questioned
An expert panel of doctors for the National Kidney Foundation plans to assess whether hundreds of thousands of patients with kidney disease are being dangerously overtreated with drugs for anemia.
The decision to convene the panel comes two weeks after studies in The New England Journal of Medicine suggested that kidney patients whose anemia was more aggressively treated were more likely to die or suffer heart problems than those who were allowed to remain more anemic.
As a result, the panel, which will meet early next year, may recommend less aggressive treatment of anemia, potentially hurting sales for Amgen and Johnson & Johnson, which market the drugs, which are among the world’s best-selling prescription medicines.
“There are substantial sums of money involved here,” said Kerry Willis, vice president for medical and scientific activities of the National Kidney Foundation. The foundation, in response to a reporter’s question, confirmed the panel’s plans to meet. The panel’s recommendations would not have the force of law. But they are certain to be closely watched by kidney doctors as well as administrators of the federal Medicare program, which is by far the largest buyer of the drugs worldwide.
http://www.nytimes.com/2006/11/30/health/30drug.html?ex=1322542800&en=8626cc58f7211189&ei=5088&partner=rssnyt&emc=rss
The decision to convene the panel comes two weeks after studies in The New England Journal of Medicine suggested that kidney patients whose anemia was more aggressively treated were more likely to die or suffer heart problems than those who were allowed to remain more anemic.
As a result, the panel, which will meet early next year, may recommend less aggressive treatment of anemia, potentially hurting sales for Amgen and Johnson & Johnson, which market the drugs, which are among the world’s best-selling prescription medicines.
“There are substantial sums of money involved here,” said Kerry Willis, vice president for medical and scientific activities of the National Kidney Foundation. The foundation, in response to a reporter’s question, confirmed the panel’s plans to meet. The panel’s recommendations would not have the force of law. But they are certain to be closely watched by kidney doctors as well as administrators of the federal Medicare program, which is by far the largest buyer of the drugs worldwide.
http://www.nytimes.com/2006/11/30/health/30drug.html?ex=1322542800&en=8626cc58f7211189&ei=5088&partner=rssnyt&emc=rss
Friday, March 09, 2007
Steroid Injections to Cervical Spine Ease Neck Pain
Translaminar steroid injections into the cervical spine may help relieve chronic neck pain, according to a retrospective study.Among 161 patients who underwent the translaminar approach, rather than the more commonly used transforaminal approach, 82% reported pain relief at the first injection, which 35% rated "substantial," said William M. Strub, M.D., of the University of Cincinnati.
Those who had the recommended series of three injections reported even better outcomes, he reported at the Society of Interventional Radiology meeting here.
Furthermore, the lack of major complications were reassuring for this underused procedure, said Brian F. Stainken, M.D., of the Roger Williams Medical Center in Providence, R.I., who moderated a press conference during which the study was discussed.
The procedure, which involves using a fine gauge needle to inject steroids into the spinal column at the C7-T1, is more commonly used to treat lower back pain.
Dr. Strub and colleagues retrospectively analyzed outcomes from all 161 patients (69 male, average age 53) who underwent a total of 280 cervical interlaminar epidural steroid injections from December 2003 through April 2006.
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5185
Those who had the recommended series of three injections reported even better outcomes, he reported at the Society of Interventional Radiology meeting here.
Furthermore, the lack of major complications were reassuring for this underused procedure, said Brian F. Stainken, M.D., of the Roger Williams Medical Center in Providence, R.I., who moderated a press conference during which the study was discussed.
The procedure, which involves using a fine gauge needle to inject steroids into the spinal column at the C7-T1, is more commonly used to treat lower back pain.
Dr. Strub and colleagues retrospectively analyzed outcomes from all 161 patients (69 male, average age 53) who underwent a total of 280 cervical interlaminar epidural steroid injections from December 2003 through April 2006.
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5185
Vitamins and Good Sense
Vitamin studies always seem to stir controversy, but certainly not visions of death. On that score, last week's report on antioxidant vitamins, published in the Journal of the American Medical Association, was a doozy. The researchers concluded that people taking the antioxidants vitamins A, its precursor beta carotene, and vitamin E, for whatever reason, at whatever dose, and for however long, may be putting their lives in jeopardy. But before you toss out your vitamin pills, let's examine this alarmist study a little bit closer.
Researchers from Copenhagen University Hospital set out to determine whether the antioxidant supplements lengthen one's life. That's difficult to answer, since most people taking vitamins are healthy. So the researchers identified antioxidant clinical trials large and small, as long as they reported at least one death. Any death counted, whether from heart disease or cancer, kidney failure or hip fractures, murders or suicides. Out of 747 antioxidant trials reviewed, 68 met the bill. Then, in what is called a meta-analysis, the 68 trials were combined into what is effectively one study.
http://www.usnews.com/usnews/health/articles/070304/12healy.htm
Researchers from Copenhagen University Hospital set out to determine whether the antioxidant supplements lengthen one's life. That's difficult to answer, since most people taking vitamins are healthy. So the researchers identified antioxidant clinical trials large and small, as long as they reported at least one death. Any death counted, whether from heart disease or cancer, kidney failure or hip fractures, murders or suicides. Out of 747 antioxidant trials reviewed, 68 met the bill. Then, in what is called a meta-analysis, the 68 trials were combined into what is effectively one study.
http://www.usnews.com/usnews/health/articles/070304/12healy.htm
Long-Term Pain Relief Found with Vertebroplasty
Percutaneous vertebroplasty reduces pain of collapsed vertebrae without increasing risk of new fractures over the long term, according to Italian researchers.
Among 1,005 consecutive patients who had a cement injected into frail vertebrae, pain dropped a clinically relevant 6.5 points on the 11-point visual analog scale (P<0.0001), said Giovanni C. Anselmetti, M.D., of the Institute for Cancer Research and Treatment, in Candiolo.
Fractures were no more common than those reported historically with medical therapy or no treatment though asymptomatic leakage of the cement into veins or the disc occurred with 31.2% and 1.5% of patients, respectively, he reported at the Society of Interventional Radiology meeting here.
Dr. Anselmetti concluded that vertebroplasty is effective for long-term pain relief regardless of the pathology.
The study included 765 women and 240 men who were treated in 3,752 vertebrae primarily due to osteoporosis (67%) or metastases (20.4%). The mean age was 70.1 (range 26 to 98). The majority of vertebrae treated were in the thoracic and lumbar spine.
The procedure involved injecting 1.5 to 5 mL (mean 2.5) of a cement mixture containing polymethylmethacrylate in each affected vertebra. Most procedures were done under local anesthesia (99.2%) and guided by digital fluoroscopy alone (86.9) or with CT (13.1%).
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5224
Among 1,005 consecutive patients who had a cement injected into frail vertebrae, pain dropped a clinically relevant 6.5 points on the 11-point visual analog scale (P<0.0001), said Giovanni C. Anselmetti, M.D., of the Institute for Cancer Research and Treatment, in Candiolo.
Fractures were no more common than those reported historically with medical therapy or no treatment though asymptomatic leakage of the cement into veins or the disc occurred with 31.2% and 1.5% of patients, respectively, he reported at the Society of Interventional Radiology meeting here.
Dr. Anselmetti concluded that vertebroplasty is effective for long-term pain relief regardless of the pathology.
The study included 765 women and 240 men who were treated in 3,752 vertebrae primarily due to osteoporosis (67%) or metastases (20.4%). The mean age was 70.1 (range 26 to 98). The majority of vertebrae treated were in the thoracic and lumbar spine.
The procedure involved injecting 1.5 to 5 mL (mean 2.5) of a cement mixture containing polymethylmethacrylate in each affected vertebra. Most procedures were done under local anesthesia (99.2%) and guided by digital fluoroscopy alone (86.9) or with CT (13.1%).
http://www.medpagetoday.com/MeetingCoverage/SIRMeeting/tb1/5224
Tai Chi Chuan may benefit type 2 diabetes patients
A new study suggests that participation in the Chinese martial art Tai Chi Chuan may help boost immune function and improve blood sugar control in people with type 2 diabetes.
After completing a 12-week Tai Chi exercise program, men and women with the disease had statistically significant reductions in their levels of A1C, a measurement of long-term blood glucose control. The participants also showed increases in regulatory T cells, which help to keep the immune response in check, while their levels of killer T cells, which destroy abnormal cells in the body, decreased.
People with type 2 diabetes experience chronic inflammation, and while exercise has been shown to be beneficial, strenuous exercise may boost inflammation and cause other problems, Dr. Kuender D. Yang of Chang Gung Memorial Hospital in Taiwan and colleagues note.
Tai Chi, in which a person performs a series of poses in a flowing motion, improves balance and heart and lung function, and recently was shown to benefit immune system function in healthy individuals, they add.
http://news.yahoo.com/s/nm/20070308/hl_nm/diabetes_patients_dc;_ylt=AuQl82bXWDf1M1aujtUOw.MQ.3QA
After completing a 12-week Tai Chi exercise program, men and women with the disease had statistically significant reductions in their levels of A1C, a measurement of long-term blood glucose control. The participants also showed increases in regulatory T cells, which help to keep the immune response in check, while their levels of killer T cells, which destroy abnormal cells in the body, decreased.
People with type 2 diabetes experience chronic inflammation, and while exercise has been shown to be beneficial, strenuous exercise may boost inflammation and cause other problems, Dr. Kuender D. Yang of Chang Gung Memorial Hospital in Taiwan and colleagues note.
Tai Chi, in which a person performs a series of poses in a flowing motion, improves balance and heart and lung function, and recently was shown to benefit immune system function in healthy individuals, they add.
http://news.yahoo.com/s/nm/20070308/hl_nm/diabetes_patients_dc;_ylt=AuQl82bXWDf1M1aujtUOw.MQ.3QA
Want a better memory? Stop and smell the roses
People who want to learn things might do better by simply stopping to smell the roses, researchers reported on Thursday.
German researchers found they could use odors to re-activate new memories in the brains of people while they slept -- and the volunteers remembered better later.
Writing in the journal Science, they said their study showed that memories are indeed consolidated during sleep, and show that smells and perhaps other stimuli can reinforce brain learning pathways.
Jan Born of the University of Lubeck in Germany and colleagues had 74 volunteers learn to play games similar to the game of "Concentration" in which they must find matched pairs of objects or cards by turning only one over at a time.
While doing this task, some of the volunteers inhaled the scent of roses. The volunteers then agreed to sleep inside an MRI tube. Functional magnetic resonance imaging was used to "watch" their brains while they slept.
http://news.yahoo.com/s/nm/20070309/hl_nm/memory_smells_dc
German researchers found they could use odors to re-activate new memories in the brains of people while they slept -- and the volunteers remembered better later.
Writing in the journal Science, they said their study showed that memories are indeed consolidated during sleep, and show that smells and perhaps other stimuli can reinforce brain learning pathways.
Jan Born of the University of Lubeck in Germany and colleagues had 74 volunteers learn to play games similar to the game of "Concentration" in which they must find matched pairs of objects or cards by turning only one over at a time.
While doing this task, some of the volunteers inhaled the scent of roses. The volunteers then agreed to sleep inside an MRI tube. Functional magnetic resonance imaging was used to "watch" their brains while they slept.
http://news.yahoo.com/s/nm/20070309/hl_nm/memory_smells_dc
Thursday, March 08, 2007
Low-Carb Diets Safe and Effective for Weight Loss
March 7, 2007 — Dieters and their clinicians can be reassured that a low-carbohydrate diet is a safe and effective option for losing weight, on the basis of randomized trial results comparing 4 popular diets ranging from low-carbohydrate to low-fat. Results from the Atkins-Traditional-Ornish-Zone (A TO Z) trial found that premenopausal women randomized to the Atkins diet lost statistically more weight than women on the Zone diet, and numerically more than the other 2 diets.
"This isn't the end of the obesity epidemic; this isn't a huge effect," lead author Christopher Gardner, PhD, emphasized to heartwire. "This is a modest weight loss in all four groups and it's a little bigger in the Atkins group, but none of the groups were following their diets well at 12 months.... We had people who lost more than 30 pounds on all four diets, and twice as many did that on Atkins than on the other diets, so it does suggest that you don't necessarily need to follow the low-fat/high-carb diet that we've depended on for 20 years."
http://www.medscape.com/viewarticle/553258?sssdmh=dm1.253182&src=nldne
"This isn't the end of the obesity epidemic; this isn't a huge effect," lead author Christopher Gardner, PhD, emphasized to heartwire. "This is a modest weight loss in all four groups and it's a little bigger in the Atkins group, but none of the groups were following their diets well at 12 months.... We had people who lost more than 30 pounds on all four diets, and twice as many did that on Atkins than on the other diets, so it does suggest that you don't necessarily need to follow the low-fat/high-carb diet that we've depended on for 20 years."
http://www.medscape.com/viewarticle/553258?sssdmh=dm1.253182&src=nldne
Any ECG Abnormality Is Suspicious for Postmenopausal Women
CHICAGO, March 8 -- Any abnormal ECG finding was an independent predictor of myocardial infarction, stroke, and coronary heart disease death in asymptomatic postmenopausal women, according to researchers here.
A post hoc analysis of data from more than 14,700 women enrolled in the Women's Health Initiative revealed that minor ECG abnormalities increased the risk of coronary heart disease by 55%, while major ECG abnormalities were associated with a three-fold increase in risk, said Pablo Denes, M.D., of Northwestern.
Women who developed new ECG abnormalities during the study had a hazard ratio of 2.60 (95% CI, 1.08-6.27) for coronary heart disease events and 2.86 (95% CI 1.69-4.83) for cardiovascular disease events, Dr. Denes and colleagues reported in the March 7 issue of the Journal of the American Medical Association.
Moreover, the risk associated with ECG abnormalities was incremental, so that when the ECG data were factored in to Framingham risk scores the area under the receiver operating characteristic curve (ROC) increased form 0.69 to 0.74, he said.
http://www.medpagetoday.com/Cardiology/CoronaryArteryDisease/tb1/5219
A post hoc analysis of data from more than 14,700 women enrolled in the Women's Health Initiative revealed that minor ECG abnormalities increased the risk of coronary heart disease by 55%, while major ECG abnormalities were associated with a three-fold increase in risk, said Pablo Denes, M.D., of Northwestern.
Women who developed new ECG abnormalities during the study had a hazard ratio of 2.60 (95% CI, 1.08-6.27) for coronary heart disease events and 2.86 (95% CI 1.69-4.83) for cardiovascular disease events, Dr. Denes and colleagues reported in the March 7 issue of the Journal of the American Medical Association.
Moreover, the risk associated with ECG abnormalities was incremental, so that when the ECG data were factored in to Framingham risk scores the area under the receiver operating characteristic curve (ROC) increased form 0.69 to 0.74, he said.
http://www.medpagetoday.com/Cardiology/CoronaryArteryDisease/tb1/5219
Atorvastatin Gets New Indications in Established Cardiovascular Disease
The FDA has approved five new indications for atorvastatin (Lipitor) in patients with cardiovascular disease, according to its manufacturer.
The company said in a press release Wednesday that atorvastatin has now been approved for reducing the risks for nonfatal myocardial infarctions, fatal and nonfatal strokes, certain types of heart surgery, hospitalization for heart failure, and angina in patients with established coronary heart disease. This is the first statin to be approved for reducing the risk for hospitalization because of heart failure, according to the press release.
The company said that the approval was based on results from the Treating to New Targets (TNT) and the Incremental Decrease in Endpoints through Aggressive Lipid Lowering (IDEAL) trials.
http://today.reuters.com/news/articleinvesting.aspx?view=CN&storyID=2007-03-07T170531Z_01_N07229356_RTRIDST_0_PFIZER-LIPITOR-UPDATE-1.XML&rpc=66&type=qcna
The company said in a press release Wednesday that atorvastatin has now been approved for reducing the risks for nonfatal myocardial infarctions, fatal and nonfatal strokes, certain types of heart surgery, hospitalization for heart failure, and angina in patients with established coronary heart disease. This is the first statin to be approved for reducing the risk for hospitalization because of heart failure, according to the press release.
The company said that the approval was based on results from the Treating to New Targets (TNT) and the Incremental Decrease in Endpoints through Aggressive Lipid Lowering (IDEAL) trials.
http://today.reuters.com/news/articleinvesting.aspx?view=CN&storyID=2007-03-07T170531Z_01_N07229356_RTRIDST_0_PFIZER-LIPITOR-UPDATE-1.XML&rpc=66&type=qcna
Wednesday, March 07, 2007
Radiotherapy for Breast Cancer Raises Heart Disease Risk
As a treatment for breast cancer, radiotherapy, even modern regimens, appears to increase the risk of cardiovascular disease, according to a report in the Journal of the National Cancer Institute for March 7.
Earlier reports have indicated that radiotherapy regimens used in the 1970s elevate cardiovascular risk, but it has been less clear if more recent regimens also increase the risk.
"Apart from the clear benefits of adjuvant radiotherapy, physicians should still be aware of the potentially increased risk of cardiovascular disease following specific radiotherapy regimens in long-term breast cancer survivors," senior author Dr. Flora E. van Leeuwen, from the Netherlands Cancer Institute in Amsterdam, and colleagues note.
http://www.medscape.com/viewarticle/553211?sssdmh=dm1.252891&src=nldne
Earlier reports have indicated that radiotherapy regimens used in the 1970s elevate cardiovascular risk, but it has been less clear if more recent regimens also increase the risk.
"Apart from the clear benefits of adjuvant radiotherapy, physicians should still be aware of the potentially increased risk of cardiovascular disease following specific radiotherapy regimens in long-term breast cancer survivors," senior author Dr. Flora E. van Leeuwen, from the Netherlands Cancer Institute in Amsterdam, and colleagues note.
http://www.medscape.com/viewarticle/553211?sssdmh=dm1.252891&src=nldne
Risk Factors Identified for Nonvertebral Fracture in Postmenopausal Women
Six risk factors are effective in identifying postmenopausal women at high risk for nonvertebral fractures, according to the results of a study reported in the February 21 Online First issue of Annals of the Rheumatic Diseases.
"Nonvertebral (NV) fractures are responsible for the greatest amount of morbidity, mortality and cost attributable to osteoporosis," write Christian Roux, of the Cochin Hospital in Paris, France, and colleagues. "The assessment of NV fracture risk in postmenopausal women is difficult and the relationship between risk factors and fractures differ by type of fracture."
The investigators analyzed data from 2546 osteoporotic postmenopausal women included in the placebo groups of 3 risedronate controlled trials. Mean age was 72 years, mean femoral T score was -2.5, and 60% and 53% of patients had prevalent vertebral and nonvertebral fractures, respectively. During a 3-year period, 222 nonvertebral fractures were reported. Logistic regression analysis included baseline data on 14 risk factors.
Six risk factors were associated with nonvertebral fracture risk: prevalent nonvertebral fracture (P = .004), number of prevalent vertebral fractures (P < .001), femoral T score (P = .031), serum level of 25-hydroxyvitamin D (25OHD3; P < .001), age (P = .012), and height (P = .037). A nonvertebral risk index was developed by converting the equation in a score. In the group of women with a score of 2.1 or higher, the incidence of nonvertebral fracture was 13.2% (11.1 - 15.3) or 1.5 times higher than in the overall population.
Study limitations include lack.
http://www.medscape.com/viewarticle/553172?sssdmh=dm1.252891&src=nldne
"Nonvertebral (NV) fractures are responsible for the greatest amount of morbidity, mortality and cost attributable to osteoporosis," write Christian Roux, of the Cochin Hospital in Paris, France, and colleagues. "The assessment of NV fracture risk in postmenopausal women is difficult and the relationship between risk factors and fractures differ by type of fracture."
The investigators analyzed data from 2546 osteoporotic postmenopausal women included in the placebo groups of 3 risedronate controlled trials. Mean age was 72 years, mean femoral T score was -2.5, and 60% and 53% of patients had prevalent vertebral and nonvertebral fractures, respectively. During a 3-year period, 222 nonvertebral fractures were reported. Logistic regression analysis included baseline data on 14 risk factors.
Six risk factors were associated with nonvertebral fracture risk: prevalent nonvertebral fracture (P = .004), number of prevalent vertebral fractures (P < .001), femoral T score (P = .031), serum level of 25-hydroxyvitamin D (25OHD3; P < .001), age (P = .012), and height (P = .037). A nonvertebral risk index was developed by converting the equation in a score. In the group of women with a score of 2.1 or higher, the incidence of nonvertebral fracture was 13.2% (11.1 - 15.3) or 1.5 times higher than in the overall population.
Study limitations include lack.
http://www.medscape.com/viewarticle/553172?sssdmh=dm1.252891&src=nldne
Treating depression improves diabetes control
NEW YORK (Reuters Health) - A study of type 2 diabetics with depression confirms that depression has a negative impact on glycemic (blood sugar) control, researchers report, and "affirms the importance of depression management in diabetic patients in its potential to improve glycemic control."
Researchers from Missouri treated 93 patients with type 2 diabetes and depression with the antidepressant bupropion (Wellbutrin).
"We selected bupropion because it is capable of reducing depression and weight simultaneously and hypothesized that these effects would be accompanied by improved glycemic control in diabetic patients with major depressive disorder," the team explains in the journal Diabetes Care.
In support of their hypothesis, "antidepressant treatment produced benefits beyond just mood improvement," first author Dr. Patrick J. Lustman from Washington University School of Medicine, St. Louis, told Reuters Health. "Patients also lost weight, improved self-management of their diabetes, and improved their glucose control (A1C levels)."
http://news.yahoo.com/s/nm/20070306/hl_nm/depression_diabetes_dc;_ylt=AmM8yY_RCG7XyJbzZyp.30UQ.3QA
Researchers from Missouri treated 93 patients with type 2 diabetes and depression with the antidepressant bupropion (Wellbutrin).
"We selected bupropion because it is capable of reducing depression and weight simultaneously and hypothesized that these effects would be accompanied by improved glycemic control in diabetic patients with major depressive disorder," the team explains in the journal Diabetes Care.
In support of their hypothesis, "antidepressant treatment produced benefits beyond just mood improvement," first author Dr. Patrick J. Lustman from Washington University School of Medicine, St. Louis, told Reuters Health. "Patients also lost weight, improved self-management of their diabetes, and improved their glucose control (A1C levels)."
http://news.yahoo.com/s/nm/20070306/hl_nm/depression_diabetes_dc;_ylt=AmM8yY_RCG7XyJbzZyp.30UQ.3QA
Lipid Spike Seen When Hormone Therapy Stops
ORLANDO, Fla., March 5 -- When post menopausal women stop hormone replacement therapy, LDL cholesterol levels are likely to spike, leading many physicians to prescribe statins that may be superfluous, according to researchers here. "Many of these women have no measurable evidence of athereosclerosis, and there is no clinical trial evidence of benefit or lack or benefit for these postmenopausal women," said Lewis H. Kuller, M.D., Dr. P.H., a professor of epidemiology at the University of Pittsburgh, School of Public Health.
Dr. Kuller and colleagues measured coronary artery calcium in women enrolled in the WOMAN (Women on the Move through Activity and Nutrition) trial and found that only two of 34 taking statins had coronary artery calcium scores that indicated atherosclerosis.
"So we don't know if it is really a good thing to put women on statins for the rest of their lives simply because their LDL went up when they stopped hormones," he and colleagues reported at the Conference on Cardiovascular Disease Epidemiology and Prevention, which is sponsored by the American Heart Association.
"What we need is a well designed study that will confirm that statin therapy in the absence of frank atherosclerosis will save women's lives," he said.
http://www.medpagetoday.com/MeetingCoverage/CDEP/dh/5175
Dr. Kuller and colleagues measured coronary artery calcium in women enrolled in the WOMAN (Women on the Move through Activity and Nutrition) trial and found that only two of 34 taking statins had coronary artery calcium scores that indicated atherosclerosis.
"So we don't know if it is really a good thing to put women on statins for the rest of their lives simply because their LDL went up when they stopped hormones," he and colleagues reported at the Conference on Cardiovascular Disease Epidemiology and Prevention, which is sponsored by the American Heart Association.
"What we need is a well designed study that will confirm that statin therapy in the absence of frank atherosclerosis will save women's lives," he said.
http://www.medpagetoday.com/MeetingCoverage/CDEP/dh/5175
Tuesday, March 06, 2007
FDA Okays First Direct Renin Inhibitor for Hypertension
ROCKVILLE, Md., March 6 -- The FDA said today it has approved aliskiren (Tektuma), the first oral direct renin inhibitor for treatment of hypertension.
Unlike angiotensin converting enzyme inhibitors that attack the middle of the renin-angiotensin cascade, or angiotensin receptor blockers (ARBs) that target the bottom of the cascade, aliskiren interferes at the top of the renin-angiotensin cascade -- before any disruption of blood pressure regulation.
In clinical trials reported at the American Society of Hypertension meeting in 2006, the drug was also touted for its ability to smooth out the daily peaks and troughs of blood pressure. Variations in blood pressure during the day are thought to increase the risk of end organ damage.
http://www.medpagetoday.com/ProductAlert/Prescriptions/tb1/5201
Unlike angiotensin converting enzyme inhibitors that attack the middle of the renin-angiotensin cascade, or angiotensin receptor blockers (ARBs) that target the bottom of the cascade, aliskiren interferes at the top of the renin-angiotensin cascade -- before any disruption of blood pressure regulation.
In clinical trials reported at the American Society of Hypertension meeting in 2006, the drug was also touted for its ability to smooth out the daily peaks and troughs of blood pressure. Variations in blood pressure during the day are thought to increase the risk of end organ damage.
http://www.medpagetoday.com/ProductAlert/Prescriptions/tb1/5201
The Difficult Patient, a Problem Old as History (or Older)
The sick man was a misery to himself and to everyone around him. For one thing, his personal hygiene was horrific. He stank. And he was constantly in pain, moaning and groaning until you began to wonder if he was doing it just for effect. Worst of all, he was a mean old cuss, angry and embittered after years of illness. All he did was complain.
A few dozen medical students, most of them in their first year at Weill Medical College of Cornell University, listened with concern to a presentation about him a few weeks ago. Eventually, they knew, they would run into difficult patients like this one.
The sick man had been a mover and shaker once, with a place in high government circles. But then he had the accident. His wound became infected. It was all downhill from there. He quickly became unable to work, and his distress upset everyone around him. Finally, his business associates forced him into long-term residential care.
Some of the faculty members in the conference room nodded in recognition. It was a case right out of a chronic-care ward in a Veterans Administration hospital.
http://www.nytimes.com/2007/03/06/health/06soph.html?_r=1&oref=slogin
A few dozen medical students, most of them in their first year at Weill Medical College of Cornell University, listened with concern to a presentation about him a few weeks ago. Eventually, they knew, they would run into difficult patients like this one.
The sick man had been a mover and shaker once, with a place in high government circles. But then he had the accident. His wound became infected. It was all downhill from there. He quickly became unable to work, and his distress upset everyone around him. Finally, his business associates forced him into long-term residential care.
Some of the faculty members in the conference room nodded in recognition. It was a case right out of a chronic-care ward in a Veterans Administration hospital.
http://www.nytimes.com/2007/03/06/health/06soph.html?_r=1&oref=slogin
Get with the tai chi program
Marianne Padgett, an 80-year-old from Atlanta, with her classmates in their Tai Chi class. New research shows that seniors who walk daily or those who practice the ancient Chinese martial arts form, Tai Chi, are fitter and less likely to lose their balance and fall.
http://www.usatoday.com/news/health/2007-03-04-tai-chi-cover_N.htm?csp=34
http://www.usatoday.com/news/health/2007-03-04-tai-chi-cover_N.htm?csp=34
Abdominal Obesity Is the Bane of Latin America
March 5, 2007 (Temuco, Chile) – A new analysis of the Latin American countries participating in the INTERHEART study shows that, in contrast to other areas of the world, abdominal obesity was the most important population-attributable risk (PAR) factor for acute MI [1]. Dr Fernando Lanas (Universidad de La Frontera, Temuco, Chile) and colleagues report their findings in the March 7, 2007 issue of Circulation, which has a Latin American theme.
A second paper in the same issue comes to a similar conclusion--abdominal obesity and smoking were the two leading PARs for MI among Hispanic Americans living in Costa Rica with no history of diabetes, hypertension, or medical therapy [2].
"These two articles call attention to the major problems of increased cardiovascular risk in Latin America, which is a cause for concern," accompanying editorialist Dr Sidney C Smith (University of North Carolina School of Medicine, Chapel Hill) told heartwire. The studies provides valuable insight into the risk factors for MI and emphasize "the need for major lifestyle and behavioral modification [there] if the growing toll of coronary heart disease is to be reversed," he comments in his editorial [3].
http://www.medscape.com/viewarticle/553152?rss
A second paper in the same issue comes to a similar conclusion--abdominal obesity and smoking were the two leading PARs for MI among Hispanic Americans living in Costa Rica with no history of diabetes, hypertension, or medical therapy [2].
"These two articles call attention to the major problems of increased cardiovascular risk in Latin America, which is a cause for concern," accompanying editorialist Dr Sidney C Smith (University of North Carolina School of Medicine, Chapel Hill) told heartwire. The studies provides valuable insight into the risk factors for MI and emphasize "the need for major lifestyle and behavioral modification [there] if the growing toll of coronary heart disease is to be reversed," he comments in his editorial [3].
http://www.medscape.com/viewarticle/553152?rss
Monday, March 05, 2007
Nine-Question Survey Identifies Patients at Risk of Having Chronic Kidney Disease
The Screening for Occult Renal Disease (SCORED) questionnaire, which contains questions about demographic variables and health conditions, but does not require any laboratory test values, might be useful to identify individuals who are highly likely to have underlying chronic kidney disease (CKD).
This screening tool developed by researchers at the University of North Carolina School of Medicine in Chapel Hill and at Weill Medical College of Cornell University in New York is discussed in an article in the February 26 issue of the Archives of Internal Medicine.
Coauthor Abhijit V. Kshirsagar, MD, at the University of North Carolina told Medscape, "The main message is that CKD is very common; about 1 in 10 people may have it, but don't know they have it. Just asking these simple questions — about yourself if you are a lay person, or, asking your patient, if you are a clinician — will quickly help you determine who has a high chance of having kidney disease."
http://www.medscape.com/viewarticle/553095?rss
This screening tool developed by researchers at the University of North Carolina School of Medicine in Chapel Hill and at Weill Medical College of Cornell University in New York is discussed in an article in the February 26 issue of the Archives of Internal Medicine.
Coauthor Abhijit V. Kshirsagar, MD, at the University of North Carolina told Medscape, "The main message is that CKD is very common; about 1 in 10 people may have it, but don't know they have it. Just asking these simple questions — about yourself if you are a lay person, or, asking your patient, if you are a clinician — will quickly help you determine who has a high chance of having kidney disease."
http://www.medscape.com/viewarticle/553095?rss
Long-Term Strenuous Physical Activity Lowers Risk of Breast Cancer
NEW YORK (Reuters Health) Mar 02 - Strenuous recreational exercise over a long period of time appears to protect women against breast cancer, according to data from the prospective California Teachers Study.
There is some evidence in the published literature that physical activity can reduce breast cancer risk, Dr. Leslie Bernstein and her associates note in their paper, published in the Archives of Internal Medicine for February 26. Purported biological mechanisms include physical activity's effect on endogenous hormones, metabolism and immune function.
Dr. Bernstein, from the University of Southern California, Los Angeles, and her associates examined the relationship between recreational physical activity and breast cancer in a large cohort of women.
http://www.medscape.com/viewarticle/553082?sssdmh=dm1.251887&src=nldne
There is some evidence in the published literature that physical activity can reduce breast cancer risk, Dr. Leslie Bernstein and her associates note in their paper, published in the Archives of Internal Medicine for February 26. Purported biological mechanisms include physical activity's effect on endogenous hormones, metabolism and immune function.
Dr. Bernstein, from the University of Southern California, Los Angeles, and her associates examined the relationship between recreational physical activity and breast cancer in a large cohort of women.
http://www.medscape.com/viewarticle/553082?sssdmh=dm1.251887&src=nldne
Low-fat dairy enhances weight loss in diabetics
NEW YORK (Reuters Health) - Research results suggest that a diet rich in low-fat dairy calcium boosts weight loss in overweight type 2 diabetics. "Such a diet should be tried in diabetic patients," researchers conclude, particularly in those individuals who have a tough time sticking to other weight loss diets.
The weight-loss promoting effect of dairy calcium came to light in ancillary analyses of data from a study in which 259 overweight diabetic patients were put on a mixed glycemic index diet, a low-glycemic index diet, or a modified Mediterranean diet.
http://news.yahoo.com/s/nm/20070302/hl_nm/weight_loss_diabetics_dc;_ylt=AlXoD4iFv7U_b0kar1ba9E0Q.3QA
The weight-loss promoting effect of dairy calcium came to light in ancillary analyses of data from a study in which 259 overweight diabetic patients were put on a mixed glycemic index diet, a low-glycemic index diet, or a modified Mediterranean diet.
http://news.yahoo.com/s/nm/20070302/hl_nm/weight_loss_diabetics_dc;_ylt=AlXoD4iFv7U_b0kar1ba9E0Q.3QA
Sunday, March 04, 2007
Falls And Hip Fractures Are Not Inevitable: A Return To Nature
Falls account for 70 percent of accidental deaths in persons 75 years of age and older. For many, this becomes the beginning of the end. But in a new study, researchers highlight the exercises and techniques needed to reverse this trend. Falls and hip fractures don't have to be inevitable, the researchers said. The study is published in the latest issue of Biofeedback.Hip fractures, more than 300,000 per year, are associated with the effects of aging: increased osteoporosis, loss of balance/increased postural sway, decreased mobility and strength, reduced visual acuity, and increased use of prescription medications. However, aging by itself may not be the sole factor. Increased falling and hip fractures may be a product of our industrial computerized age.An underlying concept that contributes to imbalance and falling is learned disuse. The popular phrase "use it or lose it" applies. Modern man has shifted to sitting most of the day in cars and in front of computers and TV unlike our prehistoric hunting and gathering ancestors who had to walk and climb over rocks and roots during the day.
http://www.medicalnewstoday.com/medicalnews.php?newsid=64432&nfid=crss
http://www.medicalnewstoday.com/medicalnews.php?newsid=64432&nfid=crss
Saturday, March 03, 2007
MINIMALLY INVASIVE LUMBAR SPINAL DECOMPRESSION IN THE ELDERLY: OUTCOMES OF 50 PATIENTS AGED 75 YEARS AND OLDER
Lumbar spinal stenosis and spondylosis are major causes of morbidity among the elderly. Surgical decompression is an effective treatment, but many elderly patients are not considered as candidates for surgery based on age or comorbidities. Minimally invasive surgical techniques have recently been developed and used successfully for the treatment of lumbar spinal disease. Our objective was to examine the safety and efficacy of minimally invasive lumbar spinal surgery for elderly patients
.http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200703000-00010.htm;jsessionid=FpnGlJtP24G2kQVn9TPrJ2xgvhCGJRdH0JtrrVS4pcQpKSjhysTL!-2026702318!-949856145!8091!-1
.http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200703000-00010.htm;jsessionid=FpnGlJtP24G2kQVn9TPrJ2xgvhCGJRdH0JtrrVS4pcQpKSjhysTL!-2026702318!-949856145!8091!-1
Androgen Receptor Test Predicts Risk of Prostate Cancer Metastasis
KISSIMMEE, Fla., Feb. 26 -- A test that tallies the number of androgen receptors in a single prostate cancer cell may be an effective predictor of disease metastasis, said researchers here.
The test, which relies on quantitative immunofluorescence to measure androgen receptors and other molecular markers, demonstrated a sensitivity of 84% and specificity of 75% for predicting clinical progression in five years of definitive surgery, said Michael Donovan, M.D., Ph.D., of Aureon Laboratories in Yonkers, N.Y., which developed the assay.
Dr. Donovan said his results were based on androgen receptor analyses conducted on prostate cancer tissue from 758 men who had a radical prostatectomy at Memorial Sloan-Kettering Cancer Center from 1985 through 2003. He reported the findings at a prostate cancer symposium.
http://www.medpagetoday.com/MeetingCoverage/ASCOProstate/tb1/5141
The test, which relies on quantitative immunofluorescence to measure androgen receptors and other molecular markers, demonstrated a sensitivity of 84% and specificity of 75% for predicting clinical progression in five years of definitive surgery, said Michael Donovan, M.D., Ph.D., of Aureon Laboratories in Yonkers, N.Y., which developed the assay.
Dr. Donovan said his results were based on androgen receptor analyses conducted on prostate cancer tissue from 758 men who had a radical prostatectomy at Memorial Sloan-Kettering Cancer Center from 1985 through 2003. He reported the findings at a prostate cancer symposium.
http://www.medpagetoday.com/MeetingCoverage/ASCOProstate/tb1/5141
Aging Gracefully: A Retrospective Analysis of Functional Status in Okinawan Centenarians
This study retrospectively explored the late-life functional status of Okinawan centenarians.
Methods: Activities of daily living were measured retrospectively at five time points (10, 5, 3, and 1 year prior and present) for 22 centenarians in relation to seven physical, two sensory, and two cognitive functions using the Inoue Index.
Results: In all, 82% of individuals were still functioning independently at a mean age of 92 years and almost two-thirds were still functioning independently at a mean age of 97 years.
Conclusion: Preliminary analyses suggest high functional status in Okinawan centenarians throughout their 90s. The genetic and environmental factors contributing to this successful aging phenomenon deserve further investigation.
http://ajgponline.org/cgi/content/abstract/15/3/252
Methods: Activities of daily living were measured retrospectively at five time points (10, 5, 3, and 1 year prior and present) for 22 centenarians in relation to seven physical, two sensory, and two cognitive functions using the Inoue Index.
Results: In all, 82% of individuals were still functioning independently at a mean age of 92 years and almost two-thirds were still functioning independently at a mean age of 97 years.
Conclusion: Preliminary analyses suggest high functional status in Okinawan centenarians throughout their 90s. The genetic and environmental factors contributing to this successful aging phenomenon deserve further investigation.
http://ajgponline.org/cgi/content/abstract/15/3/252
Screening Colonoscopy Linked to Earlier-Stage Diagnoses
In 2001, Medicare coverage for screening colonoscopy in average-risk older people was implemented. The effect of this policy on gastroenterology practices has been enormous; but, obviously, whether detection of colorectal cancer has been improved by the higher rate of screening colonoscopies is of greater consequence.
Researchers obtained rates of colonoscopy among older people (age, ≥67) from the Surveillance, Epidemiology, and End Results (SEER) data and a Medicare-linked database. Three periods were considered: 1992 through 1997 (no Medicare coverage for colonoscopy screening), January 1998 through June 2001 (limited coverage for screening), and July 2001 through December 2002 (full coverage for screening). The primary outcome was the stage of colorectal tumors at diagnosis.
http://www.medscape.com/viewarticle/552210?rss
Researchers obtained rates of colonoscopy among older people (age, ≥67) from the Surveillance, Epidemiology, and End Results (SEER) data and a Medicare-linked database. Three periods were considered: 1992 through 1997 (no Medicare coverage for colonoscopy screening), January 1998 through June 2001 (limited coverage for screening), and July 2001 through December 2002 (full coverage for screening). The primary outcome was the stage of colorectal tumors at diagnosis.
http://www.medscape.com/viewarticle/552210?rss
Hispanic women at higher risk for heart disease
ORLANDO, Fla., March 2 -- Hispanic women’s heart disease risk is comparable to the heart disease risk level of Caucasian women who are about a decade older. This disagrees with a long-held belief that Hispanic women have less heart disease than Caucasian women, researchers reported today at the American Heart Association’s 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
"The prevailing theme in medicine has been that Hispanic patients have fewer heart attacks and strokes than Caucasians, even though Hispanics seem to have equal, if not worse, cardiac risk factors and tend to be more socio-economically deprived," said John C. Teeters, M.D., study lead author and fellow in the department of cardiology, University of Rochester, Rochester, NY. "In clinical practice, however, we see the opposite, with Hispanic patients who seem to have heart disease earlier than Caucasians."
http://www.eurekalert.org/pub_releases/2007-03/aha-hwa022007.php
"The prevailing theme in medicine has been that Hispanic patients have fewer heart attacks and strokes than Caucasians, even though Hispanics seem to have equal, if not worse, cardiac risk factors and tend to be more socio-economically deprived," said John C. Teeters, M.D., study lead author and fellow in the department of cardiology, University of Rochester, Rochester, NY. "In clinical practice, however, we see the opposite, with Hispanic patients who seem to have heart disease earlier than Caucasians."
http://www.eurekalert.org/pub_releases/2007-03/aha-hwa022007.php
Friday, March 02, 2007
How Web 2.0 is changing medicine
Is a medical wikipedia the next step?
Few concepts in information technology create more confusion than Web 2.0. The truth is that Web 2.0 is a difficult term to define, even for web experts.1 Nebulous phrases like "the web as platform" and "architecture of participation" are often used to describe Web 2.0. Medical librarians suggest that rather than intrinsic benefits of the platform itself, it's the spirit of open sharing and collaboration that is paramount.2 The more we use, share, and exchange information on the web in a continual loop of analysis and refinement, the more open and creative the platform becomes; hence, the more useful it is in our work.
What seems clear is that Web 2.0 brings people together in a more dynamic, interactive space. This new generation of internet services and devices—often referred to as social software—can be leveraged to enrich our web experience, as information is continually requested, consumed, and reinterpreted. The new environment features a highly connected digital network of practitioners (medical or otherwise), where knowledge exchange is not limited or controlled by private interests. For me, the promise of open access in Web 2.0—freed of publishing barriers and multinational interests—is especially compelling
http://www.bmj.com/cgi/content/full/333/7582/1283
Few concepts in information technology create more confusion than Web 2.0. The truth is that Web 2.0 is a difficult term to define, even for web experts.1 Nebulous phrases like "the web as platform" and "architecture of participation" are often used to describe Web 2.0. Medical librarians suggest that rather than intrinsic benefits of the platform itself, it's the spirit of open sharing and collaboration that is paramount.2 The more we use, share, and exchange information on the web in a continual loop of analysis and refinement, the more open and creative the platform becomes; hence, the more useful it is in our work.
What seems clear is that Web 2.0 brings people together in a more dynamic, interactive space. This new generation of internet services and devices—often referred to as social software—can be leveraged to enrich our web experience, as information is continually requested, consumed, and reinterpreted. The new environment features a highly connected digital network of practitioners (medical or otherwise), where knowledge exchange is not limited or controlled by private interests. For me, the promise of open access in Web 2.0—freed of publishing barriers and multinational interests—is especially compelling
http://www.bmj.com/cgi/content/full/333/7582/1283
Thursday, March 01, 2007
Seniors' errors in drug use can cause harm
NEW YORK (Reuters Health) - Older adults with complex medication regimens may make potentially harmful mistakes in taking their drugs as prescribed, a new study shows.
They are particularly prone to these errors when their medication regimen has been modified, or if they are taking multiple drugs, Dr. Terry S. Field of the Meyers Primary Care Institute in Worcester, Massachusetts, and colleagues found.
The findings show how important it is for patients to understand exactly how they are supposed to be taking their prescription medications, and for doctors to make sure their patients are getting the message, Field told Reuters Health. "It's very easy to walk out the door and really not be certain what it is that you've heard."
http://www.reutershealth.com/archive/2007/03/01/eline/links/20070301elin003.html
They are particularly prone to these errors when their medication regimen has been modified, or if they are taking multiple drugs, Dr. Terry S. Field of the Meyers Primary Care Institute in Worcester, Massachusetts, and colleagues found.
The findings show how important it is for patients to understand exactly how they are supposed to be taking their prescription medications, and for doctors to make sure their patients are getting the message, Field told Reuters Health. "It's very easy to walk out the door and really not be certain what it is that you've heard."
http://www.reutershealth.com/archive/2007/03/01/eline/links/20070301elin003.html
Common Over-the-Counter Analgesics May Increase Hypertension Risk in Older Men
Regular use of common analgesics, such as aspirin, acetaminophen, or NSAIDs, appears to increase the risk for hypertension in older men, according to a study. The study, published in the February 26 issue of the Archives of Internal Medicine, was conducted by a group led by John Forman, MD, of the Brigham and Women's Hospital in Boston, Massachusetts.
They note that acetaminophen, ibuprofen, and aspirin are among the most commonly used drugs in the United States, and 2 large studies (the Nurses Health Study I and II) have recently suggested these agents may be associated with an increased risk for hypertension in women, but this association has not been extensively studied in men.
http://www.medscape.com/viewarticle/552850?rss
They note that acetaminophen, ibuprofen, and aspirin are among the most commonly used drugs in the United States, and 2 large studies (the Nurses Health Study I and II) have recently suggested these agents may be associated with an increased risk for hypertension in women, but this association has not been extensively studied in men.
http://www.medscape.com/viewarticle/552850?rss
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