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Friday, July 22, 2011

Anti-Malaria Drug Chloroquine Finding May Lead to Treatments for Arthritis, Cancer and Other Diseases


Friday, July 22, 2011

ScienceDaily (July 22, 2011) — In a study published recently in the journal Science Signaling, Van Andel Research Institute (VARI) scientists demonstrate on the molecular level how the anti-malaria drug chloroquine represses inflammation, which may provide a blueprint for new strategies for treating inflammation and a multitude of autoimmune diseases such as arthritis, multiple sclerosis, and certain cancers.

Chloroquine is a widely used anti-malaria drug that inhibits the growth of parasites. For decades, chloroquine and its derivative amodiaquine have also been used as anti-inflammation drugs to treat diseases such as rheumatoid arthritis, though the exact mechanism of how chloroquine affects the immune system has remained unclear.

By providing an understanding of these basic functions, researchers may now have the necessary tools to develop improved treatments for a myriad of common autoimmune disorders.

"The implications of this study are significant," said Henry F. McFarland, Ph.D., former Chief of the Neuroimmunology Branch of the National Institute of Neurological Disorders and Stroke (NINDS). "These results provide a mechanistic basis for therapeutic strategies for treating inflammation and autoimmune diseases and should provide exciting new approaches which can be tested in clinical trials."

Autoimmune diseases arise when the body's immune system mistakes otherwise healthy cells, tissues, and organs for pathogens and attacks them. These diseases can afflict any part of the body, but one symptom common to most autoimmune diseases is that of inflammation.

The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and some types of cancers among many others.

Dr. H. Eric Xu, Head of the VARI Center for Structural Biology and Drug Discovery, and his colleagues showed that chloroquine represses inflammation through synergistic activation of glucocorticoid signaling. Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor present in almost every vertebrate animal cell. They are among the most potent and effective agents for treating inflammation and autoimmune diseases.

Synthetic glucocorticoids are used for treating asthma, allergies, and rheumatoid arthritis. Since glucocorticoids also interfere with some of the abnormal mechanisms in cancer cells, they are also used in high doses to treat certain cancers such as leukemia and lymphoma. However, at therapeutic dosages, glucocorticoids can cause a range of debilitating side effects including diabetes, osteoporosis, skin atrophy, and growth retardation.

"The discovery and development of novel uses of glucocorticoids that retain their beneficial therapeutic effects but reduce undesired adverse side effects remains a major medical challenge," said VARI Research Scientist Yuanzheng He, Ph.D., lead author of the study.

The VARI research revealed an unexpected regulation of glucocorticoid signaling by lysosomal functioning. Lysosomes are organelles found in animal cells that use enzymes to break down waste materials and cellular debris.

Researchers found that they could mimic the effect of chloroquine by inhibiting lysosomes in the cell. They believe that the development of new therapies for treating inflammation and autoimmune disease will involve strategies that combine both glucocorticoid and lysosomal inhibitors.

"We have known for some time that both steroids and lysosomes affect the immune system, but we didn't know that they worked together," said VARI President and Research Director Jeffrey Trent, Ph.D. "Researchers now have a clear path forward for undertaking projects to develop glucocorticoid and lysosomal inhibitors, and to improve the efficacy and potency of chloroquine as a therapeutic agent."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Van Andel Research Institute.

Journal Reference:

Y. He, Y. Xu, C. Zhang, X. Gao, K. J. Dykema, K. R. Martin, J. Ke, E. A. Hudson, S. K. Khoo, J. H. Resau, A. S. Alberts, J. P. MacKeigan, K. A. Furge, H. E. Xu. Identification of a Lysosomal Pathway That Modulates Glucocorticoid Signaling and the Inflammatory Response. Science Signaling, 2011; 4 (180): ra44 DOI: 10.1126/scisignal.2001450

Dolphins' Superior Ability to Heal May Help Humans

HealthDay News

Friday, July 22, 2011

FRIDAY, July 22 (HealthDay News) -- The ability of dolphins to resist infection and heal quickly from shark bites could offer new insight into the treatment of human wounds, a researcher suggests.

"Much about the dolphin's healing process remains unreported and poorly documented," Dr. Michael Zasloff, adjunct professor at Georgetown University Medical Center and former dean of research, said in a university news release.

"How does the dolphin not bleed to death after a shark bite? How is it that dolphins appear not to suffer significant pain? What prevents infection of a significant injury?" asked Zasloff in a letter published July 21 in the Journal of Investigative Dermatology. Similar injuries in people would be deadly, Zasloff said.

In an effort to answer these questions, Zasloff interviewed dolphin handlers and marine biologists from around the world and reviewed available research.

He concluded that dolphins' resistance to infection may be linked to their blubber. Dolphin blubber contains natural organohalogen compounds, which function like antibiotics and have antimicrobial properties, he said.

"It's most likely that the dolphin stores its own antimicrobial compound and releases it when an injury occurs," said Zasloff, who previously identified antimicrobial compounds in frog skin and dogfish sharks.

Dolphins also heal in a way that restores their body's original shape, a process more like regeneration than human healing, he noted.

"The repair of a gaping wound to an appearance that is near normal requires the ability of the injured animal to knit newly formed tissues with the existing fabric of adipocytes [fat cells], collagen and elastic fibers," explained Zasloff. "The dolphin's healing is similar to how mammalian fetuses are able to heal in the womb."

Also, their unique diving mechanism might stem blood flow and enhance healing, he said, explaining blood is diverted from the extremities when a dolphin plunges below the sea. This reflex could be triggered after an injury to prevent excessive blood loss, he suggested.

Although Zasloff asserted that dolphins' indifference to pain is an adaptation to ensure survival, he admitted that how they accomplish this remains unknown. More study of these marine mammals is needed, he added.

"My hope is this work will stimulate research that will benefit humans," said Zasloff. "I feel reasonably certain that within this animal's healing wounds we will find novel antimicrobial agents as well as potent analgesic compounds."

More information

The U.S. National Institutes of Health provides more information on wound care.

Obesity Accelerates Progression of Cirrhosis, Study Suggests


Friday, July 22, 2011

ScienceDaily (July 22, 2011) — Researchers from the United States and Europe involved in an NIH-funded multicenter study have determined that increased body mass index (BMI) is an independent predictor of clinical decompensation in patients with compensated cirrhosis, independent of portal pressure and liver function. The findings suggest obesity accelerates cirrhosis progression and measures to reduce BMI could improve the prognosis for patients with advanced liver disease.

Study details are available in the August issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases.

Obesity is a global health epidemic and according to a 2008 report by the World Health Organization (WHO), 1.5 billion adults, age 20 and older, were overweight and worldwide obesity more than doubled since 1980. Of those in the overweight population, WHO estimates more than 200 million men and close to 300 million women were obese. Prior studies have shown that obesity is a frequent cause of chronic liver disease that can progress to cirrhosis, and one study estimated that 17% of liver cirrhosis is attributable to excess body weight. Further studies found lower survival rates among patients with cirrhosis caused by obesity-related liver disease than from viral cirrhosis.

"Given the prior evidence of the detrimental effects of obesity on chronic liver disease, we hypothesized that increased BMI may increase the risk of transition from compensated to decompensated cirrhosis," said Dr. Guadalupe Garcia-Tsao, Professor of Medicine at Yale University School of Medicine in Connecticut. The research team recruited 161 patients with compensated cirrhosis from a trial of betablockers used for varices prevention. Participants were followed until clinical decompensation (ascites, hepatic encephalopathy or variceal hemorrhage) occurred, or until September 2002. Laboratory tests and portal pressure, assessed by the hepatic venous pressure gradient, were performed.

BMI analysis showed that 29% of participants were in normal range, 40% were overweight and 30% were obese. Study subjects were followed for a median of 59 months, with clinical decompensation occurring in 30% of patients. Decompensation of cirrhosis (that is, development of ascites, variceal hemorrhage or hepatic encephalopathy) was observed at higher rates in patients at the upper end of BMI -- 31% of overweight and 43% of obese patients -- compared to only 15% of patients with normal BMI. Researchers noted the probability of developing clinical decompensation was significantly higher in patients with abnormal BMI.

"Patients who are overweight or obese are at greater risk of accelerating the progression of cirrhosis," concluded Dr. Garcia-Tsao. "Weight reduction may improve patient outcomes in this high-risk population and studies addressing this specific issue are warranted."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS.

Journal Reference:

Annalisa Berzigotti, Guadalupe Garcia-Tsao, Jaime Bosch, Norman D. Grace, Andrew K. Burroughs, Rosa Morillas, Angels Escorsell, Juan Carlos Garcia-Pagan, David Patch, Daniel S. Matloff, Roberto J. Groszmann. Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis. Hepatology, 2011; DOI: 10.1002/hep.24418

A Novel and Potent Antioxidant Found in Tomato Plants, Initial Results Suggest


Friday, July 22, 2011

ScienceDaily (July 22, 2011) — A team of researchers from the Institute of Molecular and Cell Biology (IBMCP) -a joint centre of the Universitat Politècnica de València and CSIC, the Spanish National Research Council- have identified a novel and potent natural antioxidant occurring in tomato plants. It is a phenolic substance that is synthesised by the tomato plant when it is subjected to biotic stress. Until now, it was completely unknown.

The UPV and CSIC have registered the national and international patents of the new antioxidant and the laboratory procedures used to isolate and synthesise it chemically.

The finding was recently published in the journal Environmental and Experimental Botany.

IBMCP researchers point out that the antioxidant power of the new compound is much higher -14 times higher, to be precise- than, for example, that of resveratrol, a well-known antioxidant, found in red wine, which can delay cellular aging. In addition, it is 4.5 times more potent than vitamin E and 10 times more potent than vitamin C.

This substance could have multiple applications. For example, in the food industry it could be used as a preservative in food for human consumption and in animal fodder, because of its action as a retarder of lipid oxidation. This powerful antioxidant would prevent changes such as fats and oils becoming rancid, which strongly diminishes food quality. It could also be used as a supplement in certain products after careful processing.*

It should also be noted that antioxidants have beneficial health properties, such as helping to prevent coronary heart disease and cancer; therefore, the compound could have major applications in the pharmaceutical industry.

Other possible uses for it could be in the petrochemical industry, as a preservative of gasoline, and in the polymer industry, where it could be used in the manufacture of fibres, rubber products, geotextiles and others. In this case, the antioxidant would be used as a stabilizer in the production process, and also to increase the life of the final product.

In the cosmetic industry it could be used in products for skin care, given its possible properties related to delaying aging.

At the Polytechnic City of Innovation labs, researchers have discovered this substance, which is present in tomato plants subjected to biotic stress, and have developed a simple and economical process for synthesising it in the laboratory.

The IBMCP research team explains that when a plant is stimulated by a stressor, the plant reacts and activates mechanisms that alter the levels of certain compounds. "Many phenolic compounds are produced by plants in response to biotic or abiotic stress; these compounds have multiple effects, including antioxidant activity," said Vicente Conejero, the director of the research group.

It was while studying these anomalous circumstances -stress- of plants that they discovered the induction of this compound. "We all know that as fever is an alarm associated with defence mechanisms in humans. Well, diseased plants have a similar alarm, which is the synthesising of a number of chemical compounds. One of these, so far unknown, is the compound that we have discovered, which has extraordinary antioxidant capabilities. Besides, we are able to synthesise it in our lab," explained José María Bellés and M. Pilar López, both IBMCP researchers.

In this regard, it must be stressed that the synthesis process is simple and inexpensive; therefore, IBMCP experts point, the compound is now ready to be introduced in the market. Moreover, it presents significant advantages compared to other commercial antioxidants.

*It should be noted that leaves, stems, and green unripe fruit of the tomato plant contain small amounts of the poisonous alkaloid tomatine.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Asociación RUVID, via AlphaGalileo.

Journal Reference:

María Pilar López-Gresa, Cristina Torres, Laura Campos, Purificación Lisón, Ismael Rodrigo, José María Bellés, Vicente Conejero. Identification of defence metabolites in tomato plants infected by the bacterial pathogen Pseudomonas syringae. Environmental and Experimental Botany, 2011; DOI: 10.1016/j.envexpbot.2011.06.003

Thursday, July 21, 2011

Smartphones May Be Taxing Your Eyes

By By Amanda Gardner
HealthDay Reporter

HealthDay News

Thursday, July 21, 2011

THURSDAY, July 21 (HealthDay News) -- People reading text messages or browsing the Internet on their smartphones tend to hold the devices closer than they would a book or newspaper, forcing their eyes to work harder than usual, new research shows.

This closer distance -- plus the often tiny font sizes on smartphones -- could put added strain on people who already wear glasses or contact lenses, according to the study, which appears in the July issue of Optometry and Vision Science.

"The fact that people are holding the devices at close distances means that the eyes have to work that much harder to focus on the print and to have their eyes pointed in right direction," said study co-author Dr. Mark Rosenfield, a professor at the SUNY State College of Optometry in New York City. "The fact that the eyes are having to work harder means that people may get symptoms such as headaches and eye strain."

Texting and browsing the Web on smartphones can also result in dry eye, discomfort and blurred vision after prolonged use, the study authors point out. Previous studies have also found that up to 90 percent of people who use computers experience eye problems.

Rosenfield got the idea for the study while commuting to work on the train and noticing that people using smartphones seemed to be holding them very close to their eyes.

Given that more and more adults and children are using smartphones to write and receive messages or look up restaurant reviews, it made sense to measure exactly how close people were holding their phones.

The experiments were relatively simple ones. In the first, about 130 volunteers with an average age of 23.2 years were asked to hold their smartphone while reading an actual text message.

In a different experiment, 100 participants, whose average age 24.9, were next asked to hold their smartphone when reading a web page.

The researchers then measured the distance between the device and the eyes as well as the font size.

When reading printed text in newspapers, books and magazines, the average working distance is close to 16 inches from the eyes, but the study volunteers writing or sending text messages held their phones, on average, only about 14 inches away. In some people, it was as close as 7 inches, Rosenfield said.

When viewing a web page, the average working distance was 12.6 inches.

The font on text messages tended to be slightly larger (about 10 percent, on average) than newspaper print, but web-page font was only 80 percent the size of newspaper print and, in some cases, as small as 30 percent, Rosenfield said.

The findings hold messages for doctors and smartphone-users alike.

Given the ubiquitousness of these handheld devices, eye doctors might consider testing people's vision at closer distances and prescribing glasses for closer distances.

But there's a simple way for smartphone addicts to minimize eye strain: Increase the font size on your device, advised Dr. Scott MacRae, a professor of ophthalmology and of visual science at the University of Rochester Medical Center and an eye surgeon.

This is especially important for sustained reading, like reading a book on Kindle, he noted.

Font size on an e-book reader is usually pretty easy to do. For other handheld devices," MacRae said, "the problem is to figure out how to do it."

If you're a regular computer user, try using Verdana 12-point font, the only font designed specifically for computers, MacRae said.

The authors are now also assessing Kindles and IPads, but those results haven't been published.

More information

The American Academy of Ophthalmology has more on how to keep your eyes healthy.

Kidney Dopamine Regulates Blood Pressure, Life Span


Thursday, July 21, 2011

ScienceDaily (July 21, 2011) — The neurotransmitter dopamine is best known for its roles in the brain -- in signaling pathways that control movement, motivation, reward, learning and memory.

Now, Vanderbilt University Medical Center investigators have demonstrated that dopamine produced outside the brain -- in the kidneys -- is important for renal function, blood pressure regulation and life span. Their studies, published in the July Journal of Clinical Investigation, suggest that the kidney-specific dopamine system may be a therapeutic target for treating hypertension and kidney diseases such as diabetic nephropathy.

Previous studies had suggested a role for dopamine in regulating kidney function and total body fluid volume, "but how that mechanism works was not clear," said Raymond Harris, M.D., chief of the Division of Nephrology and Hypertension at Vanderbilt.

To explore dopamine's role in the kidney, Harris and Ming-Zhi Zhang, M.D., assistant professor of Medicine at Vanderbilt, eliminated kidney-specific dopamine production in mice (by knocking out a dopamine-generating enzyme only in the kidney) and studied the outcome.

They found that mice lacking kidney dopamine had high blood pressure at baseline and became more hypertensive when they consumed a high-salt diet, suggesting they may be a good model of salt-sensitive (essential) hypertension, Harris said. Alterations in the kidney dopamine system may predispose individuals to hypertension, he noted.

The investigators also showed that elimination of kidney dopamine increased renin production, which activates the angiotensin II system to increase salt and water reabsorption -- and produce hypertension.

"These animals retain salt and water when they don't have sufficient dopamine production in the kidney," Harris said. "Our studies highlight this whole other hormonal system that appears to balance or put the brakes on the renin-angiotensin system."

Currently, the renin-angiotensin system is the major target for treating chronic kidney diseases. Discovering another target -- the kidney dopamine system -- is exciting, the researchers said. They are exploring whether specific drugs that enhance the kidney dopamine system are effective in blocking hypertension and treating progressive kidney diseases.

The investigators predicted changes in kidney function in the mouse model, but they were "very surprised" to discover that the modified mice only lived about half as long as normal mice (15 months versus 30 months). They found increases in stress-related proteins in the kidney, heart and vasculature, suggesting that elimination of kidney dopamine causes systemic effects, Harris said.

"This kidney-specific dopamine system is not only important for kidney function and blood pressure regulation, but also for the overall health of the animal," Harris said. "If the dopamine system in the kidney is altered, the animals have a markedly shortened life span."

The research was supported by the National Institutes of Health, the Vanderbilt O'Brien Center and by the Veterans Administration. Harris is the Ann and Roscoe R. Robinson Professor of Nephrology.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Vanderbilt University Medical Center, via EurekAlert!, a service of AAAS.

Journal Reference:

Ming-Zhi Zhang, Bing Yao, Suwan Wang, Xiaofeng Fan, Guanqing Wu, Haichun Yang, Huiyong Yin, Shilin Yang, Raymond C. Harris. Intrarenal dopamine deficiency leads to hypertension and decreased longevity in mice. Journal of Clinical Investigation, 2011; 121 (7): 2845 DOI: 10.1172/JCI57324

Breast-feeding for 6 Months or More Protects Against Asthma

HealthDay News

Thursday, July 21, 2011 

THURSDAY, July 21 (HealthDay News) -- Babies who are exclusively breast-fed for six months or more are less likely to develop symptoms of asthma in early childhood, new research suggests.

Although previous studies have found a link between breast-feeding and a reduced risk for childhood asthma, this study also found the likelihood of developing asthma is also affected by how long a child is breast-fed. For instance, children who are breast-feed for a shorter length of time, or not exclusively, are more likely to experience asthma-related symptoms by the time they are 4.

Dutch researchers compiled information on how more than 5,000 children were fed during their first year of life. Specifically, they wanted to know if the children were breast-fed, and if so, for how long. The researchers also recorded if and when any other milk or solids were introduced.

The researchers examined the children each year until they turned 4 to check for any asthma-related symptoms.

The study, published online in the European Respiratory Journal, found that children who had never been breast-fed had an increased risk of wheezing, shortness of breath, dry cough and persistent phlegm during the first four years of life, compared to children who were breast-fed for more than six months.

In fact, children who were never breast-fed were up to 1.5 times more likely to develop wheezing and persistent phlegm.

Meanwhile, the children who were fed other milk or solids in addition to breast milk during the first four months of life were also more likely to experience wheezing, shortness of breath, dry cough and persistent phlegm during the first four years of life than children who were exclusively breast-fed for their first four months.

"The link of duration and exclusiveness of breast-feeding with asthma-related symptoms during the first four years was independent of infectious and [allergic diseases associated with an inherited predisposition to them]. These results support current health policy strategies that promote exclusive breast-feeding for six months in industrialized countries," study author Dr Agnes Sonnenschein-van der Voort, a researcher at Generation R, Erasmus Medical Center in The Netherlands, said in a news release from the European Lung Association.

The study authors noted that more research in needed to explore the protective effect of breast-feeding on the various types of asthma in later life.

More information

The U.S. Department of Health and Human Services provides more information on the benefits of breastfeeding.

Hospital Bacteria Outbreak Linked to Nasal Spray


Thursday, July 21, 2011

ScienceDaily (July 21, 2011) — Infection control researchers investigating a rare bacterial outbreak of Burholderia cepacia complex (Bcc) identified contaminated nasal spray as the root cause of the infections, leading to a national recall of the product. An article in the August issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), describes how researchers were able to trace the outbreak back to the nasal decongestant spray.

Bcc is a group of Gram-negative bacteria that can cause hard-to-treat infections. Patients with underlying medical conditions such as lung disease and weakened immune systems are at greater risk of contracting Bcc. When patients in a Denver children's hospital began testing positive for the bacteria in 2003, investigators suspected that a batch of Major Twice-a-Day Nasal Spray, a brand that each of the patients had used, might be to blame. However, standard tests of the spray did not find any bacteria initially.

Noticing some peculiarities in the initial tests, the investigators decided to retest the spray using a non-standard culture medium. The second set of tests was positive for Bcc, the same strain as was identified in patients. The nasal spray contained a preservative agent that can interfere with standard bacterial cultures and the second set of tests neutralized the preservative, allowing the detection of the bacteria.

The spray was voluntarily recalled by the manufacturer, but the findings raise lingering questions about how manufacturers should test nasal spray products before distribution. "If standard culturing methods were used by the manufacturer then they may not have [discovered] this organism," the researchers write.

"Nasal spray products are among the most widely used over-the-counter pharmaceuticals, but to date they are not required by the FDA to be sterile," said Susan Dolan, one of the article's authors. "Given the implications of Bcc infections we question this decision."

Other products, such as mouthwash, nebulization therapy, tap water, disinfectants, and reusable temperature probes have previously been implicated as Bcc outbreak sources.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Society for Healthcare Epidemiology of America, via EurekAlert!, a service of AAAS.

Journal Reference:

Susan A. Dolan, Elaine Dowell, John LiPuma, Sondra Valdez, Kenny Chan, and John F. James. An Outbreak of Burkholderia cepacia Complex Associated with Intrinsically Contaminated Nasal Spray. Infection Control and Hospital Epidemiology, 32:8 (August 2011)

Clogged Arteries Might Raise Risk of Dementia, Experts Warn

HealthDay News

Thursday, July 21, 2011

THURSDAY, July 21 (HealthDay News) -- Experts are warning that clogged arteries can do more than contribute to heart disease. They can also affect blood flow to the brain and cause dementia.

Signs of dementia include problems with thinking, reasoning and memory, a group of symptoms commonly called "cognitive impairment," according to information in a news release from the American Heart Association/American Stroke Association. The organizations published a new scientific statement on the topic in the July 21 online edition of the journal Stroke.

"We have learned that cerebrovascular disease and Alzheimer's disease may work together to cause cognitive impairment and the mixed disorder may be the most common type of dementia in older persons," Dr. Philip B. Gorelick, who helped write the new scientific statement, said in the news release. He is director of the Center for Stroke Research at the University of Illinois College of Medicine at Chicago.

Gorelick suggested that people may be able to reduce the risk of dementia by taking the same steps they would take to lower their risk of heart disease and stroke, including eating a healthy diet, maintaining a healthy weight and engaging in physical activity.

"Generally speaking, what is good for the heart is good for the brain," Gorelick said. "Although it is not definitely proven yet, treatment or prevention of major risk factors for stroke and heart disease may prove to also preserve cognitive function with age."

Some other steps people can take that might help reduce their risk of dementia include quitting smoking and controlling other factors such as high blood pressure, high cholesterol and abnormal blood sugar.

In addition, the authors suggested that screening to identify those at risk for cognitive impairment may help prevent or postpone the onset of dementia. "We encourage clinicians to use screening tools to detect cognitive impairment in their older patients and continue to treat vascular risks according to nationally- or regionally-accepted guidelines," they noted in the news release.

The statement authors also pointed out that dementia affects nearly one-third of those over the age of 80, and results in health costs of more than $40,000 per patient per year in the United States.

The new scientific statement has been endorsed by the American Academy of Neurology and the Alzheimer's Association.

More information

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

Seaweed as a Rich New Source of Heart-Healthy Food Ingredients


Thursday, July 21, 2011

ScienceDaily (July 21, 2011) — In an article that may bring smiles to the faces of vegetarians who consume no dairy products and vegans, who consume no animal-based foods, scientists have identified seaweed as a rich new potential source of heart-healthy food ingredients. Seaweed and other "macroalgae" could rival milk products as sources of these so-called "bioactive peptides," they conclude in an article in ACS's Journal of Agricultural and Food Chemistry.

Maria Hayes and colleagues Ciarán Fitzgerald, Eimear Gallagher and Deniz Tasdemir note increased interest in using bioactive peptides, now obtained mainly from milk products, as ingredients in so-called functional foods. Those foods not only provide nutrition, but have a medicine-like effect in treating or preventing certain diseases. Seaweeds are a rich but neglected alternative source, they state, noting that people in East Asian and other cultures have eaten seaweed for centuries: Nori in Japan, dulse in coastal Europe, and limu palahalaha in native Hawaiian cuisine.

Their review of almost 100 scientific studies concluded that that some seaweed proteins work just like the bioactive peptides in milk products to reduce blood pressure almost like the popular ACE inhibitor drugs. "The variety of macroalga species and the environments in which they are found and their ease of cultivation make macroalgae a relatively untapped source of new bioactive compounds, and more efforts are needed to fully exploit their potential for use and delivery to consumers in food products," Hayes and her colleagues conclude.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Chemical Society.

Journal Reference:

Ciarán Fitzgerald, Eimear Gallagher, Deniz Tasdemir, Maria Hayes. Heart Health Peptides from Macroalgae and Their Potential Use in Functional Foods. Journal of Agricultural and Food Chemistry, 2011; 59 (13): 6829 DOI: 10.1021/jf201114d

Return to smoking after heart attack ups death risk

By Eric Schultz

Reuters Health

Thursday, July 21, 2011

NEW YORK (Reuters Health) - After a heart attack, quitting smoking may offer a patient more benefits than any medication, but Italian researchers say the flipside is that resuming smoking after leaving the hospital can raise the same patient's risk of dying as much as five-fold.

On average, people who started smoking again after being hospitalized for acute coronary syndrome (ACS) -- crushing chest pain that often signals a heart attack -- were more than three times as likely to die within a year as people who successfully quit in a study led by Dr. Furio Colivicchi of San Filippo Neri Hospital in Rome.

"Relapse is a major risk factor for long term survival," said Dr. David Katz, associate professor of internal medicine at University of Iowa Carver College of Medicine in Iowa City.

Quitting smoking has a similar lifesaving effect for ACS patients as taking recommended drugs to lower blood pressure or cholesterol, added Katz, who was not involved in the new study.

To gauge the effects of resuming smoking after a heart "event," and to see how many people are likely to relapse, Colivicchi and his colleagues tracked 1294 patients who reported being regular smokers before they were hospitalized with ACS.

All the participants had ceased smoking while in the hospital and declared themselves motivated to continue abstaining once they were released. Patients received a few brief smoking-cessation counseling sessions while in the hospital, but no further counseling, nicotine replacement or other smoking-cessation help was provided after they left the hospital.

The researchers interviewed patients about their smoking status at one, six, and 12 months after their release from the hospital and found that a total of 813 (63 percent) had relapsed by the end of the first year. About half had begun smoking again within 20 days of leaving the hospital.

Within a year, 97 patients died, with 81 of those deaths attributed to cardiovascular causes, according to findings published in the American Journal of Cardiology.

After adjusting for patient ages and other variables, the researchers found that resuming smoking raised a person's risk of death three-fold compared to patients who didn't relapse.

The earlier a patient fell off the wagon, the more likely he or she was to die within a year -- those who resumed smoking within 10 days of leaving the hospital were five times as likely to die as those who continued to abstain.

Very few patients relapsed after being smoke-free for six months.

"If you manage to stay off cigarettes for six months, you probably have the addiction beat," said Dr. Nancy Rigotti, director of the Tobacco Research and Treatment Unit at Massachusetts General Hospital in Boston, who was not involved in the study.

Colivicchi's group did not measure how often the patients smoked -- an important predictor of relapse and early death, Katz noted.

Nonetheless, the results indicate a need to improve the way doctors help patients quit smoking, said Rigotti.

"People don't take treating tobacco use seriously in the medical setting," and recommended treatments have not made their way into practice, she said.

Colivicchi agreed. A successful program to help patients quit should take "a comprehensive long-term approach, including individual counseling, post-discharge support and pharmacological treatment," he told Reuters Health in an email.

A recent study from Harvard Medical School suggested that a comprehensive anti-smoking counseling program for heart attack patients could save thousands of lives at a relatively low cost.

These findings, along with the results of the Italian study, said Rigotti, suggest that hospitals and insurers should work together to implement comprehensive anti-smoking programs to continue to help patients after they leave the hospital.


 American Journal of Cardiology, online July 7, 2011.

Caffeine Consumption Linked to Female Infertility, Study Suggests


Thursday, July 21, 2011

ScienceDaily (July 21, 2011) — Caffeine reduces muscle activity in the Fallopian tubes that carry eggs from a woman's ovaries to her womb. "Our experiments were conducted in mice, but this finding goes a long way towards explaining why drinking caffeinated drinks can reduce a woman's chance of becoming pregnant," says Sean Ward, professor of physiology and cell biology, at the University of Nevada School of Medicine, who conducted the study.

Ward's study was recently published in the British Journal of Pharmacology.

Human eggs are microscopically small, but need to travel to a woman's womb if she is going to have a successful pregnancy. Although the process is essential for a successful pregnancy, scientists know little about how eggs move through the muscular Fallopian tubes. It was generally assumed that tiny hair-like projections, called cilia, in the lining of the tubes, waft eggs along assisted by muscle contractions in the tube walls.

By studying tubes from mice, Ward and his team discovered that caffeine stops the actions of specialized pacemaker cells in the wall of the tubes. These cells coordinate tube contractions so that when they are inhibited, eggs can't move down the tubes. In fact these muscle contractions play a bigger role than the beating cilia in moving the egg towards the womb.

"This provides an intriguing explanation as to why women with high caffeine consumption often take longer to conceive than women who do not consume caffeine," said Ward.

Discovering the link between caffeine consumption and reduced fertility has benefits.

"As well as potentially helping women who are finding it difficult to get pregnant, a better understanding of the way Fallopian tubes work will help doctors treat pelvic inflammation and sexually-transmitted disease more successfully," said Ward.

It could also increase our understanding of what causes ectopic pregnancy, an extremely painful and potentially life-threatening situation in which embryos get stuck and start developing inside a woman's Fallopian tube.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Nevada, Reno, via EurekAlert!, a service of AAAS.

Fewer people see heavy smoking as high risk: survey

By Wendell Marsh


Thursday, July 21, 2011

WASHINGTON (Reuters) - The perception by teenagers and young adults that heavy cigarette smoking is a high-risk activity has declined in many states, according to a study on substance abuse and mental health released on Thursday.

The perceived risks of smoking one or more packs of cigarettes a day dropped between 2007-2008 and 2008-2009 in 14 states among youths aged 12 to 17, and in 31 states among those aged 18 to 25.

Perceived smoking risks also dropped in nine states among those 26 and older, a statement from the Substance Abuse and Mental Health Services Administration said regarding the report.

"No state is free from the unique impact of mental and substance use disorders," SAMHSA administrator Pamela Hyde said in a statement.

"Data like these give states the information they can use to target their prevention and treatment activities for the greatest benefit to their residents," she said.

Results from the 2008-2009 National Surveys on Drug Use and Health offer data on the specific behavioral health issues that affect each state. Other data included information on illicit drug use and mental illness.

The study said illicit drug among adolescents between ages 12 and 17 dropped in 17 states between 2002-2003 and 2008-2009.

States with the highest marijuana use, like Alaska, Colorado, District of Columbia, Hawaii, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island and Vermont, were also the states with the highest rates of illicit drug use among people 12 or older.

Some 7.2 percent of Rhode Island's adults experience serious mental illness, the highest level in the nation. Hawaii and South Dakota shared the lowest rate of 3.5 percent.

(Reporting by Wendell Marsh; Editing by Cynthia Johnston)

Clogged Arteries Might Raise Risk of Dementia, Experts Warn

HealthDay News

Thursday, July 21, 2011

THURSDAY, July 21 (HealthDay News) -- Experts are warning that clogged arteries can do more than contribute to heart disease. They can also affect blood flow to the brain and cause dementia.

Signs of dementia include problems with thinking, reasoning and memory, a group of symptoms commonly called "cognitive impairment," according to information in a news release from the American Heart Association/American Stroke Association. The organizations published a new scientific statement on the topic in the July 21 online edition of the journal Stroke.

"We have learned that cerebrovascular disease and Alzheimer's disease may work together to cause cognitive impairment and the mixed disorder may be the most common type of dementia in older persons," Dr. Philip B. Gorelick, who helped write the new scientific statement, said in the news release. He is director of the Center for Stroke Research at the University of Illinois College of Medicine at Chicago.

Gorelick suggested that people may be able to reduce the risk of dementia by taking the same steps they would take to lower their risk of heart disease and stroke, including eating a healthy diet, maintaining a healthy weight and engaging in physical activity.

"Generally speaking, what is good for the heart is good for the brain," Gorelick said. "Although it is not definitely proven yet, treatment or prevention of major risk factors for stroke and heart disease may prove to also preserve cognitive function with age."

Some other steps people can take that might help reduce their risk of dementia include quitting smoking and controlling other factors such as high blood pressure, high cholesterol and abnormal blood sugar.

In addition, the authors suggested that screening to identify those at risk for cognitive impairment may help prevent or postpone the onset of dementia. "We encourage clinicians to use screening tools to detect cognitive impairment in their older patients and continue to treat vascular risks according to nationally- or regionally-accepted guidelines," they noted in the news release.

The statement authors also pointed out that dementia affects nearly one-third of those over the age of 80, and results in health costs of more than $40,000 per patient per year in the United States.

The new scientific statement has been endorsed by the American Academy of Neurology and the Alzheimer's Association.

More information

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

Alzheimer's debate: Test if you can't treat it?

By Marilynn Marchione

AP Medical Writer

The Associated Press

Thursday, July 21, 2011

PARIS (AP) — Picture yourself in Barbara Lesher's shoes: 54 years old and fearing you are developing Alzheimer's disease.

"I don't remember if I had a bath," said Lesher, who lives north of Harrisburg, Pa. "It took me two hours to follow a recipe. I drove to my childhood homestead the other week instead of my own home. It's really scary."

Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the results.

The debate raged this past week at the Alzheimer's Association International Conference in France, where research on new methods — easier brain scans, an eye test, a blood test — made it clear there soon may be more such tools available.

Here's why it's an issue: Many people have brain plaques, suggesting they might be developing Alzheimer's even if they don't have any symptoms. This plaque can be seen decades beforehand and does not ensure someone will get the disease. Many also won't live long enough to develop symptoms.

For those who do have Alzheimer's, there are no good treatments. Current drugs ease symptoms — they work for half who try them and for less than a year on average. Most experts think treatment starts too late, but there's no evidence that starting sooner or learning you have brain plaque will help. Experts are divided.

"We have to look for patients or signatures of the disease at earlier stages," urged Dr. Harald Hampel of the University of Frankfurt, Germany.

But Dr. Kenneth Rockwood of Dalhousie University in Halifax, Nova Scotia, Canada, says there is no data "to show that knowing makes any difference in outcomes. Until we do, this is going to be a tough sell."

More than 35 million people worldwide have Alzheimer's, the most common form of dementia. In the U.S., more than 5 million do — 13 percent of those 65 and over, and 43 percent of those 85 and up, a rapidly growing group.

Still, half of people who meet medical criteria for dementia have not been diagnosed with it, the Alzheimer's Association estimates. And many who are told they have Alzheimer's or are assumed to have it really don't.

Even when researchers use the best cognitive tests to enroll people in clinical trials, about 10 percent ultimately are discovered not to have the disease, said William Thies, the Alzheimer's Association's scientific director.

"The Alzheimer's drugs don't work in these folks, so there's no reason to expose them to those risks," said Thies, long an advocate of early diagnosis.

Misdiagnosis is a lost opportunity to help. A new medication or combination of medications may suddenly make someone appear demented. Brain fog can occur after surgery and abate over time. Sleep problems are common in older people and can cause profound confusion that can be misinterpreted as dementia, according to research presented at the conference by Dr. Kristine Yaffe of the University of California, San Francisco.

"Some of these are treatable" by avoiding naps during the day or treating sleep apnea, in which brief interruptions of breathing cause people to wake during the night, Yaffe said. Snoring is a big sign. Older people with sleep problems are more likely to be put in nursing homes, she said.

Dr. R. Scott Turner, director of the memory disorders program at Georgetown University Medical Center, has seen that all too often.

"I'm certainly in the camp that screening should be done," he said. Many patients are simply declared to have dementia without testing to see if they have another condition.

"Sometimes it's thyroid disease, or depression, or vitamin B-12 deficiency — something that's very treatable," he said.

Testing someone with symptoms is far less controversial than testing people with no symptoms but a lot of fear. Doctors worry that these newer methods, such as an easier type of brain scan that's expected to be available within months, will be directly marketed to the public, prompting expensive and excessive testing based on fear.

"The phrase you often hear is that the 'Big A' (Alzheimer's) has replaced the 'Big C' (cancer)" as a major source of fear, said Dr. Jason Karlawish, a University of Pennsylvania ethicist specializing in dementia issues.

Recent guidelines by the U.S. National Institute on Aging and the Alzheimer's Association say these tests should be used only in research until they have been standardized and validated as useful and accurate tools.

A researcher using one of these tests, such as a spinal fluid check for a substance that may predict Alzheimer's risk, has no obligation to disclose the results to a patient until there is a meaningful treatment for the disease, Karlawish argued at the conference.

The more symptoms a patient has, the more justified it is to help understand what is known about possible reasons, he said.

Lynda Hogg of Edinburgh, Scotland, is very glad her doctors diagnosed her Alzheimer's in 2006. She is doing exceptionally well on one of the existing drugs and is in a clinical trial for an experimental one she hopes will help her and help advance knowledge in the field.

At a discussion connected with the conference, she said the early diagnosis helped her get financial and legal matters in order and serve on the Scottish Dementia Working Group and the board of Alzheimer's Disease International.

"I am certain involvement keeps me focused and involved in society," she said.

The Alzheimer's Association says early diagnosis and evaluation can bring the following benefits:

  • Treatment of reversible causes of impairment.
  • Access to drugs that help treat symptoms.
  • Inclusion in clinical trials that give expert care.
  • Avoiding drugs that can worsen cognition.
  • Letting others know of a need for help managing medicines and daily life.
  •  Easing anxiety about the cause of symptoms.
  • Access to education, training and support services.
  • The ability to plan for the future.

Lesher, the woman from Pennsylvania, wishes she had a clearer picture of what lies ahead for her.

"Not being able to get diagnosed is the must frustrating thing in the world," she said.


National Institute on Aging:

Alzheimer's Association:

National Alzheimer's Plan:

Marilynn Marchione can be followed at

Optimism May Lower Stroke Risk

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Thursday, July 21, 2011

THURSDAY, July 21 (HealthDay News) -- The more optimistic you are, the lower your risk of having a stroke, a new study suggests.

"Optimism protects against stroke," said researcher Eric Kim, a doctoral student at the University of Michigan. While it is not cause-and-effect link, Kim and his colleagues did find a significant association.

The finding is published in the July 21 online issue of Stroke.

The possible stroke protection lengthens the list of health benefits tied to being optimistic, Kim said. Already, various studies have found more optimistic people have a healthier immune system, faster wound healing, a lower risk of heart disease and other benefits, he said.

For the new study, Kim and his colleagues looked at data from the Health and Retirement Study. This is a nationally representative sample of U.S. adults over the age of 50.

The team looked at the results of standard optimism tests for 6,044 men and women. All were free of stroke at the study's start. The optimism score was on a 16-point scale. The participants self-rated their health, and the team followed them for two years. During the follow-up period, 88 cases of stroke occurred.

After adjusting for age, each unit increase in their optimism score reduced stroke risk about 9 percent, Kim said.

The researchers also adjusted for other factors such as smoking, alcohol use, race, gender, marital status, blood pressure, chronic illness, mental illness, body mass index and level of physical activity. They found the association between optimism and reduced risk of stroke remained robust.

How to explain the association? One possibility is that those who expect the best things in life take steps to promote their health, Kim said.

Another possibility is a biological effect, he said. "In a similar way that depression can impact functioning, we think optimism can as well," he said.

A different study by Finnish researchers found a link between low pessimism and reduced risk of stroke, but not between optimism and stroke. Kim hopes to continue his research, including a focus on what drives the link between optimism and reduced risk of stroke.

The study was partially funded by the Robert Wood Johnson Foundation's Pioneer Portfolio through the Positive Psychology Center at the University of Pennsylvania.

Dr. Martin Seligman, who directs the center and is a long-time optimism researcher, calls the new finding ''a major new discovery."

Optimism has previously been linked to protection against heart attacks, he said.

"Since optimism is teachable, this implies that a trial that teaches optimism to pessimists at risk for stroke might be of real benefit to public health," he said.

Another expert, Hermann Nabi, of the French National Institute of Health & Medical Research, has studied pessimism and stroke risk.

He called the results interesting but also noted some limitations, such as the self-reported stroke history and the limited follow-up. Even so, he terms the new findings "an important contribution to this line of research."

Optimism can definitely be learned, Kim noted.

How to define optimism? "Optimism isn't just the lack of anxiety or depression," Kim said. Someone who seeks help for either anxiety or depression might be lifted from a negative 10 or so on a scale back to zero, or neutral, he said.

"Optimism can bring you back to positive numbers," he said.

More information

To take a test on how optimistic you are, visit Stanford University. 

Wednesday, July 20, 2011

Health Gains from Multiple Sclerosis Drugs Come at a High Price, Study Finds


Wednesday, July 20, 2011

ScienceDaily (July 20, 2011) — A new study shows that the health gains associated with a category of medications commonly used to treat Multiple Sclerosis (MS) -- know as disease modifying drugs -- come at a very high cost when compared to therapies that address the symptoms of MS and treatments for other chronic diseases.

The study -- which appears in the journal Neurology -- analyzed data from 844 individuals with early stage MS and projected health care costs, including the cost of the drugs, and lost productivity over a 10 year period. The study found that while MS patients using disease- modifying drugs experience modest health gains, the cost associated with using these drugs is more than 8 times higher than what is considered "reasonable" from a health economics cost-effectiveness perspective.

"While it is clear that disease-modifying drugs are beneficial to some MS patients, those gains come at a tremendous economic cost," said Katia Noyes, Ph.D., M.P.H., associate professor in the Department of Community and Preventive Medicine at the University of Rochester Medical Center and lead author of the study. "These results point to the need to continually evaluate the cost-effectiveness of new treatments in the interest of controlling health care costs."

MS is a disease of the central nervous system and is the most common cause of neurological disability in young adults. The disease causes muscle weakness, numbness or tingling in arms and legs, difficulty with coordination, balance and walking, blurred vision, and slurred speech. Early in the course of the disease the symptoms manifest themselves in cycles of acute symptoms followed by periods of remission and recovery. Over time these symptoms tend to become more permanent and debilitating.

In the 1990's several new drugs were introduced that modified the course of the disease, as opposed to traditional therapies that primarily treat the symptoms of MS. These drugs -- which include interferons and glatiramer acetate -- have been shown in large clinical studies to slow the progression of the disease and reduce relapses. However, these drugs are associated with side effects and are very expensive, costing as much as $30,000 per year.

The authors used data from an ongoing survey of MS patients funded by the National Multiple Sclerosis Society. Using this and several other sets of data, it projected the health care costs -- medications, hospital admissions, out-patient visits, diagnostic testing, and home and long term care -- over a 10 year period associated with individuals taking disease-modifying drugs and those who instead underwent other basic treatments to control their symptoms. Health care costs were generated using Medicaid and Medicare reimbursement rates. The study also calculated lost productivity -- interruptions in work or schooling -- and estimated these costs using Bureau of Labor Statistics data.

Noyes and her colleagues employed a method called quality-adjusted life years (QALY) to evaluate the health effects of the drugs. QALY is a standard tool used to evaluate disease burden by estimating the improved quality of life gained over time by taking a particular medication or course of therapy. A general rule of thumb among health policy experts is that for an intervention to be judged "cost-effective" it should cost $100,000 or less to produce an extra QALY. According to the study, disease-modifying drugs for MS cost more than $800,000 per QALY.

Individuals taking disease-modifying drugs experienced a modest improvement in health according to the study. For example, MS patients taking interferon beta-1a gained about 2 quality-adjusted months over 10 years compared to those who did not take disease modifying drugs. Patients taking interferon beta-1b had an average of 6 out of 10 free of relapses compared to 5 years for those not taking the drugs. The authors also found that the benefit to patients was greater if they began taking the drugs early during the onset of the disease.

The study's authors point out that in countries such as Britain, Canada, and Germany the cost of these drugs is 67 percent lower than the U.S. "If we could bring the cost of these drugs in line with what pharmaceutical companies are paid in other industrialized countries, we could significantly improve the cost-benefit ratio," said Noyes.

The study's co-authors include Robert Holloway, M.D., M.P.H., Steven Schwid, M.D. (deceased), and Alina Bajorska, M.S. with URMC, Lahar Mehta M.D. with Evergreen Neuroscience Institute, Bianca Weinstock-Guttman, M.D. with the University at Buffalo, and Andrew Dick, Ph.D. with the Rand Corporation. The study was funding with support from the National Center for Research Resources and the National Multiple Sclerosis Society.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Rochester Medical Center, via EurekAlert!, a service of AAAS.

Journal Reference:

K. Noyes, A. Bajorska, A. Chappel, S. R. Schwid, L. R. Mehta, B. Weinstock-Guttman, R. G. Holloway, A. W. Dick. Cost-effectiveness of disease-modifying therapy for multiple sclerosis: A population-based study. Neurology, 2011; DOI: 10.1212/WNL.0b013e3182270402

Study finds no statin, cancer link

By Amy Norton

Reuters Health

Wednesday, July 20, 2011

NEW YORK (Reuters Health) - People on cholesterol-lowering statins appear to be no more likely to develop cancer than non-users, a new study concludes -- adding to evidence that contradicts a widely publicized report of raised cancer risk from the popular medications.

Looking at medical records for nearly 92,000 Americans in the new study, researchers found that the half who were on statins were no more likely to develop cancer over five years than those not using the cholesterol fighters.

Just under 11.4 percent of statin users developed cancer, versus 11.1 percent of non-users -- with no statistically significant difference in the risk.

The findings, reported in the Journal of the American College of Cardiology, offer more reassurance that the drugs taken by millions worldwide do not boost cancer risk.

Most studies on the question have also found no statin-cancer link. But some evidence has suggested differently: a high-profile 2008 clinical trial, for instance, found that heart patients on the statin Vytorin had a higher cancer risk than those on a placebo.

At the time, though, researchers, including the ones who conducted the trial, said there was a high likelihood that the finding was the result of chance.

The main contribution of the new study is that it's based on a large group of patients in the "real world," rather than clinical trial participants, said Candace Gunnarsson of S2 Statistical Solutions, Inc. in Cincinnati, one of the researchers on the work.

"It's data from the real world, from physicians across the country," she told Reuters Health. "It's very reassuring that we were not able to show any kind of an association between statins and cancer."

A cardiologist not involved in the study agreed.

"I think this really puts to rest any lingering concerns," said Dr. Stanley Rockson, a professor at Stanford University School of Medicine in California.

Along with studies showing no higher cancer risk among statin users, there's also no known biological reason that statins would promote cancer, Rockson noted.

In fact, there is some early evidence from recent studies that statins could help treat or lower the risk of certain cancers, like prostate cancer.

In the U.S. alone, an estimated half of men age 65 and older, and 40 percent of women that age, use statins.

With such widespread use, it's important to answer the statin-cancer question "unambiguously," Gunnarsson and her colleagues note in their report.

To study the question, the researchers used a database with electronic medical records for about 11 million Americans.

They pulled information on 45,857 statin users and matched each of them with another patient who had never used a statin but had a similar "propensity" for using one -- based on factors like their weight, age, cholesterol levels and any medical conditions.

All men included in the study were age 45 or older; all women were 55 or more.

Overall, the study found no evidence that statin users had a heightened cancer risk over five years.

Similar studies, the researchers write, could be done to weed out any cancer risk connected to individual statins, since the drugs are not all alike in their chemistry.

But Rockson said he doesn't see a need for further studies.

"I think that if their doctor wants to prescribe a statin," he said, "patients can feel very comfortable that there is no increased risk of cancer."


Journal of the American College of Cardiology, online July 18, 2011.

Inherited Alzheimer's Detectable 20 Years Before Dementia


Wednesday, July 20, 2011

ScienceDaily (July 20, 2011) — Inherited forms of Alzheimer's disease may be detectable as many as 20 years before problems with memory and thinking develop, scientists will report July 20, 2011, at the Alzheimer's Association International Conference on Alzheimer's Disease in Paris.

Identifying Alzheimer's in its earliest stages is a top priority for researchers. Many think that by the time symptoms become apparent, Alzheimer's disease has already damaged the brain extensively, making it difficult or impossible to restore memory and other mental abilities.

"We want to prevent damage and loss of brain cells by intervening early in the disease process -- even before outward symptoms are evident, because by then it may be too late," says Alzheimer's researcher and physician Randall Bateman, MD, of Washington University School of Medicine in St. Louis and an associate director of the Dominantly Inherited Alzheimer's Network (DIAN), an international study of inherited forms of Alzheimer's.

Initial DIAN results confirm and expand upon earlier insights from studies of the more common sporadic forms of Alzheimer's, including data suggesting that changes in the levels of biological markers in the spinal fluid can be detected years before dementia.

Scientists say the results demonstrate the feasibility of clinical trials to prevent Alzheimer's in DIAN participants. Planning for those trials, which may start as early as next year, is currently under way.

"New treatments may have risks, so to treat patients prior to symptoms we must sure that we have a firm grasp on who will develop Alzheimer's dementia," says DIAN director John C. Morris, MD, Harvey A. and Dorismae Hacker Friedman Professor of Neurology at Washington University. "If we can find a way to delay or prevent dementia symptoms in DIAN participants, that would be a tremendous success story and very helpful in our efforts to treat the much more common sporadic form of the illness."

DIAN researchers are studying members of families who have mutations in one of three genes: amyloid precursor protein, presenilin 1 or presenilin 2. Participants with these mutations are certain to develop Alzheimer's disease early, with symptoms beginning in their 50s, 40s, or, in some rare cases, 30s.

DIAN, which includes research centers in the United States, the United Kingdom and Australia, is the largest study yet of these rare forms of dominantly inherited Alzheimer's. To date, 184 participants have been enrolled, nearly half the overall recruitment goal. This has allowed initial comparisons among participants who carry a genetic mutation for Alzheimer's but are still asymptomatic, those who have a mutation and have Alzheimer symptoms, and those who do not have a mutation and thus are unaffected.

By looking at the age of symptom onset in a parent who passed an Alzheimer's mutation to a DIAN participant, scientists can establish an estimated age of onset for a study participant. If a parent developed dementia at the age of 50, they would expect a child who inherited the mutation to develop dementia at roughly the same age. As a result, scientists can start amassing a detailed chronology of disease progression that covers the many years Alzheimer's is active in the brain but still before the onset of dementia.

"Based on what we see in our population, brain chemistry changes can be detected up to 20 years before the expected age of symptomatic onset," Bateman says. "These Alzheimer's-related changes can be specifically targeted for prevention trials in patients with inherited forms of Alzheimer's."

Washington University researchers, including Bateman, Morris and Anne Fagan, PhD, research professor of neurology, will report initial results from DIAN, including confirmation of the value of disease indicators from cerebrospinal fluid analyses. Participants who carry the mutations but are still asymptomatic have significantly lower levels of amyloid beta and higher levels of tau protein in their cerebrospinal fluid than participants without the mutations.

Amyloid beta normally is cleared from the brain and into the spinal fluid. Scientists theorize that decreases in spinal fluid levels of amyloid beta reflect a buildup of this sticky protein fragment in the brain, where it forms Alzheimer's plaques. Tau protein is a structural component of central nervous system cells. Its increase in cerebrospinal fluid is thought to be a byproduct of damage to brain cells.

DIAN is supported by funding from the National Institute on Aging.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Washington University School of Medicine, via EurekAlert!, a service of AAAS.

Offer women mammograms from age 40: doctor's group

By Genevra Pittman

Reuters Health

Wednesday, July 20, 2011

NEW YORK (Reuters Health) - Doctors should offer all women in their 40s the chance to get annual screenings for breast cancer, according to new guidelines from an organization of women's health professionals.

The recommendations from the American College of Obstetricians and Gynecologists (ACOG) will add to the debate over when screening should start, and how often it should be done, based on the chances of catching an early cancer and the risks inherent in any screening.

"We believe it is our job to help women make the best health decision for themselves," said Dr. Jennifer Griffin of the University of Nebraska Medical Center in Omaha, one of the authors of the new recommendations.

"We believe that many women will choose to have a screening mammogram every year, (and) of course there are women that will choose not to."

Other organizations such as the American Cancer Society and the National Comprehensive Cancer Network recommend that women start getting the breast scans at age 40.

But the U.S. Preventive Services Task Force, a federally -supported expert panel, said in 2009 that screening before 50 should be an individual decision because the benefit is very small compared with the risks. Even at age 50, it only recommended screening every other year.

Any screening decision is about balancing the benefits and harms of a test, said Dr. Michael LeFevre of the USPSTF.

One in eight women will get breast cancer during her life, experts agree. For every 1,000 women who are 40 years old, LeFevre said, 30 would be expected to die of breast cancer if they never have a mammogram.

If those 1,000 women are screened every other year between age 50 and 75, that number drops to 23 deaths. Starting screening in the same group at 40 would save one additional life, meaning 22 would die of breast cancer, on average.

But, LeFevre told Reuters Health, "that small benefit comes with a significant false positive rate, which results in additional testing, including unnecessary biopsies and associated pain and anxiety."

Half of women screened annually in their 40s will have a false alarm on a mammogram, he said, meaning the test shows something suspicious that turns out to be harmless. Follow-up biopsies can be painful, expensive and carry a small risk of infections or other adverse effects.

With his patients, LeFevre said, "my bottom line is that I will discuss mammography at age 40, I will recommend and encourage at age 50 and I will strongly encourage at age 60."

He added that screening every other year, instead of annually, gives women most of the benefit of yearly mammograms, but significantly cuts back on the risk of harm.

The new guidelines only apply to women who are at average risk of breast cancer -- not those with a gene that predisposes them to the disease, for example.

ACOG recommends that doctors perform regular breast exams on women and says that women should know what their breasts normally look and feel like.

"As with any screening test, there are cancers that are missed by screening," Griffin said. "Women should be aware that if something changes in their breast, even if they've had a normal screening mammogram, they should let their doctors know."

LeFevre said there isn't clear evidence that "breast awareness" can prevent breast cancer deaths, but that he would not discourage it.

The ACOG group did not analyze the cost of screening women for an extra decade, but Griffin said that mammograms compare favorably to other screening tests, such as Pap smears and colonoscopies, in their cost effectiveness. Mammograms typically cost about $100, but in most cases are covered by insurance.

Groups including the American College of Radiology, the Society of Breast Imaging and Susan G. Komen for the Cure came out in support of the new ACOG guidelines.

"When we think about women in their 40s we think about moms, we think about women who are active in the workforce," Griffin said. "I think they deserve the opportunity to really benefit from this test."

LeFevre concluded that women in their 40s should discuss the possible benefits and harms of mammography screening with their own doctors, and make a personal decision about when to start getting screened.


American College of Obstetricians and Gynecologists, July 20, 2011.

(Editing by Michele Gershberg and Robert MacMillan) 

Tuesday, July 19, 2011

Physical Activity Linked to Lower Rates of Cognitive Impairment


Tuesday, July 19, 2011

ScienceDaily (July 19, 2011) — Engaging in regular physical activity is associated with less decline in cognitive function in older adults, according to two studies published Online First by Archives of Internal Medicine, one of the JAMA/Archives journals. The articles are being released on July 19 to coincide with the International Conference on Alzheimer's Disease in Paris and will be included in the July 25 print edition.

According to background information provided in the articles, previous research has suggested that physical activity is associated with reduced rates of cognitive impairment in older adults. However, much of this research has apparently been conducted among individuals who are generally in good health. Further, many of these studies rely on self-reports of physical activity, which are not always accurate; and focus on moderate or vigorous exercise, instead of low-intensity physical activity. The two articles being presented July 19 seek to fill in these gaps in the research.

In one article, Marie-Noël Vercambre, Ph.D., from the Foundation of Public Health, Mutuelle Generale de l'Education Nationale, Paris, and colleagues examined data from the Women's Antioxidant Cardiovascular Study, which included women who had either prevalent vascular disease or three or more coronary risk factors. The researchers determined patients' physical activity levels at baseline (1995 to 1996) and every two years thereafter. Between 1998 and 2000, they conducted telephone interviews with 2,809 women; the calls included tests of cognition, memory and category fluency, and followed up the tests three more times over the succeeding 5.4 years.

The researchers analyzed data to correlate cognitive score changes with total physical activity and energy expenditure from walking. As participants' energy expenditure increased, the rate of cognitive decline decreased. The amount of exercise equivalent to a brisk, 30-minute walk every day was associated with lower risk of cognitive impairment.

In another report, Laura E. Middleton, Ph.D., from the Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, and colleagues utilized data from the Health, Aging, and Body Composition study, an ongoing prospective cohort study. The researchers measured participants' total energy expenditure by using doubly labeled water, a technique that provides evidence of how much water a person loses and thus serves as an objective measure of metabolic activity. The authors calculated participants' activity energy expenditure (AEE), defined as 90 percent of total energy expenditure minus resting metabolic rate. The 197 participants, with an average age of 74.8 years, had no mobility or cognitive problems when the research began in 1998 to 1999. At that time, researchers assessed participants' cognitive function, and followed up two to five years later with the Modified Mini-Mental State Examination (MMMSE).

The authors adjusted the data for baseline MMMSE scores, demographics, fat-free mass, sleep duration, self-reported health and diabetes mellitus. When these variables were accounted for, participants who had the highest AEE scores tended to have lower odds of incident cognitive impairment. The authors also noticed a significant dose response between AEE and incidence of cognitive impairment.

The authors of both articles suggest that there is more to be learned about the relationship between physical activity and cognitive function. "Various biologic mechanisms may explain the positive relation between physical activity and cognitive health," write Vercambre and colleagues. Middleton and co-authors state, "The mechanisms by which physical activity is related to late-life cognition are likely to be multifactorial." Both groups of researchers note that studies such as theirs point toward some possible answers. As Vercambre and co-authors comment, "If confirmed in future studies, physical activity recommendations could yield substantial public health benefits given the growing number of older persons with vascular conditions and their high risk of cognitive impairment." And Middleton and colleagues conclude, "We are optimistic that even low-intensity activity of daily living may be protective against incident cognitive impairment."

Commentary: Brains and Aging

In a commentary accompanying the articles, Eric B. Larson, M.D., M.P.H., from Group Health Research Institute, Seattle, notes that these studies serve to "buttress growing evidence that habitual physical activity and fitness are associated with age-related changes in cognition and risk of dementia." The key finding of the Vercambre and colleagues study, he writes, "is that older women with high levels of vascular risk constitute a major risk group and that vascular risk is linked to cognitive decline." Of the work published by Middleton and colleagues, Larson observes, "The fact that the study used a validated measurement of energy expenditure, not just self-report, makes the results of further importance." Such research, he states, is increasingly needed as the population ages and the health care field attempts to cope with higher rates of cognitive decline.

In this context, Larson suggests that articles such as the ones presented here "highlight a gradual but steady change in current thinking about risk factors for late-life dementias." Vascular risk factors such as limited physical activity may be modifiable and represent a way to reduce the incidence of cognitive impairment among older adults. Physical activity, growing scientific evidence suggests, could be one such avenue.

"I believe that these findings can inform practice and the advice that we give our aging patients," comments Larson. "We can tell them that ongoing maintenance of physical activity is definitely worthwhile and likely of increasing benefit as they advance into old age." In addition, Larson stresses the need for research into "programs that promote ongoing physical activity, especially in late life."

(Arch Intern Med. Published online July 19, 2011. doi:10.1001/archinternmed.2011.273. Available pre-embargo to the media at

Editor's Note: Dr. Larson is supported by a grant from the National Institute on Aging. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support,

To contact Jae H. Kang, Sc.D., call Lori Shanks at 617-534-1604 or e-mail To contact Laura E. Middleton, Ph.D., call Nadia Radovini at 416-480-4040 or e-mail To contact Eric B. Larson, M.D., M.P.H., call Joan DeClaire at 206-287-2653 or e-mail

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Marie-Noël Vercambre, Francine Grodstein, JoAnn E. Manson, Meir J. Stampfer, Jae H. Kang. Physical Activity and Cognition in Women With Vascular Conditions. Arch Intern Med., 2011 DOI: 10.1001/archinternmed.2011.282

Laura E. Middleton, Todd M. Manini, Eleanor M. Simonsick, Tamara B. Harris, Deborah E. Barnes, Frances Tylavsky, Jennifer S. Brach, James E. Everhart, Kristine Yaffe. Activity Energy Expenditure and Incident Cognitive Impairment in Older Adults. Arch Intern Med., July 19, 2011 DOI: 10.1001/archinternmed.2011.277

Stopping Daily Aspirin Boosts Heart Attack Risk: Study

By By Steven Reinberg
HealthDay Reporter

HealthDay News

Tuesday, July 19, 2011

TUESDAY, July 19 (HealthDay News) -- People with heart disease who stop taking their daily low-dose aspirin may put themselves at a greater risk of having a heart attack, a new study finds.

Aspirin taken daily in a low dose (typically between 75 and 300 milligrams) is recommended to help prevent blood clots in patients with heart disease. Yet as many as 50 percent of patients stop taking their aspirin, the researchers noted. This can result in an increased risk of heart problems, but little is known about whether there is an increased risk for heart attack specifically.

The new study suggests heart attack risk does rise when low-dose aspirin is discontinued. Therefore, patients "should be advised that unless there is a high risk of serious bleeding or otherwise recommended by a doctor, aspirin should never be discontinued given its overwhelming benefits," said lead researcher Dr. Luis Garcia Rodriguez, director of the Spanish Center for Pharmacoepidemiologic Research in Madrid.

"Also, patients who need to discontinue aspirin should do so for the minimum time necessary," he added.

The report was published in the July 19 online edition of the BMJ.

For the study, Rodriguez's team collected data on more than 39,500 patients, 50 to 84 years of age, who were part of the Health Improvement Network -- a large database of medical records in the United Kingdom.

Between 2000 and 2007, the patients were prescribed low-dose aspirin (75 to 300 milligrams per day) to prevent heart attack and other cardiac complications.

Over about 3 years of follow-up, Garcia Rodriguez's team found that those who stopped taking aspirin experienced a 60 percent rise in their risk of non-fatal heart attack. That result held true regardless of how long the patients had taken aspirin before they decided to stop.

According to the researchers, the finding translates into four additional heart attacks for every 1,000 patients during the year they stopped taking their aspirin.

"Our study highlights the need for greater awareness of the increased risk of cardiovascular events, such as [heart attack], that is associated with interruption of aspirin therapy," Garcia Rodriguez said.

"If adherence to low-dose aspirin could be improved, the benefit obtained with low-dose aspirin in the general population would be increased," he added.

Dr. Giuseppe Biondi-Zoccai, assistant professor of cardiology at the University of Modena and Reggio Emilia in Modena, Italy, and co-author of an accompanying journal editorial, said that "aspirin is indeed a wonderful drug."

Low-dose aspirin reduces illness and death from heart disease, pulmonary embolism (clots in the lung) and colorectal cancer, he said. It is also remarkably safe, if one avoids it in those at risk of allergic or bleeding complications, and it is cheap, which is also a major plus.

In addition, aspirin helps prevent recurrent events in patients who have already suffered from coronary artery disease, Biondi-Zoccai, said.

"Discontinuing aspirin in such patients is very harmful," he added. "Indeed, patients on aspirin, because they have already suffered from a coronary artery event, face a major health hazard if aspirin is discontinued, even only temporarily, and even if several months or years have passed from their initial heart problem."

Another expert, Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, agreed.

"While aspirin use can increase the risk of bleeding, for most patients with known vascular disease the benefits of daily low dose aspirin exceed the potential risks," he said. "Individuals with cardiovascular disease should understand the benefits of long term aspirin use and that discontinuing their aspirin regimen places them at increased risk for subsequent cardiovascular events. Patients should not discontinue aspirin therapy unless under the advice of their physician to do so."

More information

For more information on heart disease and aspirin, visit the American Heart Association.

Patients Who Use Anti-Depressants Are More Likely to Suffer Relapse, Researcher Finds


Tuesday, July 19, 2011

ScienceDaily (July 19, 2011) — Patients who use anti-depressants are much more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster researcher.

In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used anti-depressant medications can be nearly twice as susceptible to future episodes of major depression.

Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour, is the lead author of a new paper in the journal Frontiers of Psychology.

The meta-analysis suggests that people who have not been taking any medication are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.

Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used anti-depressants compared to those who used placebos.

They analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.

Andrews says anti-depressants interfere with the brain's natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.

Though there are several forms of anti-depressants, all of them disturb the brain's natural regulatory mechanisms, which he compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, leaving the person at increased risk of depression when the brain, like the compressed spring, shoots out before retracting to its resting state.

"We found that the more these drugs affect serotonin and other neurotransmitters in your brain -- and that's what they're supposed to do -- the greater your risk of relapse once you stop taking them," Andrews says. "All these drugs do reduce symptoms, probably to some degree, in the short-term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking anti-depressants to prevent a return of symptoms."

Andrews believes depression may actually be a natural and beneficial -- though painful -- state in which the brain is working to cope with stress.

"There's a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it's an evolved adaptation that does something useful," he says.

Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.

Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.

Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.

Not every case is the same, and severe cases can reach the point where they are clearly not beneficial, he emphasizes.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by McMaster University.

Journal Reference:

Michael C. Neale, Charles O. Gardner, Lisa J. Halberstadt, Susan G. Kornstein, Paul W. Andrews. Blue Again: Perturbational Effects of Antidepressants Suggest Monoaminergic Homeostasis in Major Depression. Frontiers in Psychology, 2011; 2 DOI: 10.3389/fpsyg.2011.00159

Over Half of Alzheimer's Cases May Be Preventable, Say Researchers


Tuesday, July 19, 2011

ScienceDaily (July 19, 2011) — Over half of all Alzheimer's disease cases could potentially be prevented through lifestyle changes and treatment or prevention of chronic medical conditions, according to a study led by Deborah Barnes, PhD, a mental health researcher at the San Francisco VA Medical Center.

Analyzing data from studies around the world involving hundreds of thousands of participants, Barnes concluded that worldwide, the biggest modifiable risk factors for Alzheimer's disease are, in descending order of magnitude, low education, smoking, physical inactivity, depression, mid-life hypertension, diabetes and mid-life obesity.

In the United States, Barnes found that the biggest modifiable risk factors are physical inactivity, depression, smoking, mid-life hypertension, mid-life obesity, low education and diabetes.

Together, these risk factors are associated with up to 51 percent of Alzheimer's cases worldwide (17.2 million cases) and up to 54 percent of Alzheimer's cases in the United States (2.9 million cases), according to Barnes.

"What's exciting is that this suggests that some very simple lifestyle changes, such as increasing physical activity and quitting smoking, could have a tremendous impact on preventing Alzheimer's and other dementias in the United States and worldwide," said Barnes, who is also an associate professor of psychiatry at the University of California, San Francisco.

The study results were presented at the 2011 meeting of the Alzheimer's Association International Conference on Alzheimer's Disease in Paris, France, and published online on July 19, 2011 in Lancet Neurology.

Barnes cautioned that her conclusions are based on the assumption that there is a causal association between each risk factor and Alzheimer's disease. "We are assuming that when you change the risk factor, then you change the risk," Barnes said. "What we need to do now is figure out whether that assumption is correct."

Senior investigator Kristine Yaffe, MD, chief of geriatric psychiatry at SFVAMC, noted that the number of people with Alzheimer's disease is expected to triple over the next 40 years. "It would be extremely significant if we could find out how to prevent even some of those cases," said Yaffe, who is also a professor of psychiatry, neurology and epidemiology at UCSF.

The research was supported by funds from the Alzheimer's Association, the National Alliance for Research on Schizophrenia and Depression, the UCSF School of Medicine and the National Institute on Aging.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - San Francisco, via EurekAlert!, a service of AAAS.

Journal Reference:

Deborah E. Barnes, Kristine Yaffe. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurology, 2011; DOI: 10.1016/S1474-4422(11)70072-2

Exposure to Secondhand Smoke Associated With Hearing Loss in Adolescents


Tuesday, July 19, 2011

ScienceDaily (July 19, 2011) — Exposure to secondhand smoke (SHS) is associated with increased risk of hearing loss among adolescents, according to a report in the July issue of Archives of Otolaryngology-Head and Neck Surgery, one of the JAMA/Archives journals.

Among U.S. children, approximately 60 percent are exposed to SHS, according to background information in the article. Studies have associated exposure to secondhand smoke prenatally or during childhood with various health conditions, from low birth weight and respiratory infections to behavioral problems and otitis media. Children exposed to SHS are more likely to develop recurrent otitis media, the authors note. "Secondhand smoke may also have the potential to have an impact on auditory development, leading to sensorineural hearing loss (SNHL)," they add.

Anil K. Lalwani, M.D., and colleagues from NYU Langone Medical Center in New York City examined the risk factors for SNHL, including SHS, among adolescents, stratified by demographic groups. They included 1,533 individuals from 12 years to 19 years of age who participated in the National Health and Nutrition Examination Survey from 2005 to 2006. Participants were interviewed about their health status and family medical history, exposure to SHS, and self-recognition of hearing impairment. In addition, they underwent a physical examination, including blood testing for cotinine (a by-product of nicotine exposure), and hearing tests.

Compared with teens who had no SHS exposure, those who were exposed to secondhand smoke exhibited higher rates of low- and high-frequency hearing loss. The rate of hearing loss appeared to be cumulative, increasing with the level of cotinine detected by blood tests. The results also demonstrated that more than 80 percent of participants with hearing loss did not realize they had impairment.

As hearing loss early in life can cause problems with development and functioning, the authors suggest that these results have "significant implications for public health in the United States." They note that most adolescents do not receive screening for hearing loss in the absence of risk factors; if further studies replicate these results, they state, SHS could be considered one such risk factor. "Adolescents who are exposed to SHS may need to be more closely monitored for hearing loss," the researchers conclude. "In addition, they should be educated about risk factors for hearing loss, such as recreational or occupational noise exposure and SHS."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

A. K. Lalwani, Y.-H. Liu, M. Weitzman. Secondhand Smoke and Sensorineural Hearing Loss in Adolescents. Archives of Otolaryngology - Head and Neck Surgery, 2011; 137 (7): 655 DOI: 10.1001/archoto.2011.109

Vegetarian Diet May Protect Against Common Bowel Disorder


Tuesday, July 19, 2011

ScienceDaily (July 19, 2011) — Vegetarians are a third less likely to get a common bowel disorder (diverticular disease) than their meat eating counterparts, finds a new study published on the British Medical Journal website.

Diverticular disease has been termed a "disease of western civilisation" because of the higher numbers of cases in countries like the UK and the US compared with parts of Africa. The condition affects the large bowel or colon and is thought to be caused by not consuming enough fibre. Typical symptoms include painful abdominal cramps, bloating, wind, constipation and diarrhea.

Previous research has suggested that a low fibre diet could lead to diverticular disease, and that vegetarians may have a lower risk compared with meat eaters, but there is little evidence to substantiate this.

So Dr Francesca Crowe and her team from the Cancer Epidemiology Unit at the University of Oxford set out to examine the link between a vegetarian diet and intake of dietary fibre with the risk of diverticular disease.

Their findings are based on 47,033 generally health conscious British adults who were taking part in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study. Of those recruited, 15,459 reported consuming a vegetarian diet.

After an average follow-up time of 11.6 years, there were 812 cases of diverticular disease (806 admissions to hospital and six deaths). After adjusting the factors such as smoking, alcohol and body mass index (BMI), vegetarians had a lower risk of diverticular disease compared with meat eaters.

Furthermore, participants with a relatively high intake of dietary fibre (around 25g a day) had a lower risk of being admitted to hospital with or dying from diverticular disease compared with those who consumed less than 14g of fibre a day.

Consuming a vegetarian diet and a high intake of dietary fibre are both associated with a lower risk of diverticular disease, say the authors. The 2000-1 UK National Diet and Nutrition Survey showed that 72% of men and 87% of women were not meeting the recommended average intake for dietary fibre of 18 g per day and so the proportion of cases of diverticular diseases in the general population attributed to a low fibre diet could be considerable, they add.

These findings lend support to the public health recommendations that encourage the consumption of foods high in fibre such as wholemeal breads, wholegrain cereals, fruits and vegetables, they conclude.

In an accompanying editorial, researchers from Nottingham University Hospital discuss the implications for the health of the population and the individual.

Based on these findings, David Humes and Joe West estimate that "about 71 meat eaters would have to become vegetarians to prevent one diagnosis of diverticular disease."

They add: "Overall the opportunity for preventing the occurrence of diverticular disease and other conditions, such as colorectal cancer, probably lies in the modification of diet, at either a population or an individual level." However, they stress that "far more evidence is needed before dietary recommendations can be made to the general public."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.

Journal References:

Francesca L Crowe, Paul N Appleby, Naomi E Allen and Timothy J Key. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ, 2011; 343:d4131 DOI: 10.1136/bmj.d4131

David J Humes and Joe West. Diet and risk of diverticular disease. BMJ, 2011; 343:d4115 DOI: 10.1136/bmj.d4115

Smoking, Diabetes, Obesity May Shrink Your Brain

By Maureen Salamon
HealthDay Reporter

HealthDay News

Monday, August 1, 2011

MONDAY, Aug. 1 (HealthDay News) -- As if there weren't already enough good reasons to avoid smoking and keep your weight, blood sugar levels and blood pressure all under control, a new study suggests these risk factors in middle age may cause your brain to shrink, leading to mental declines up to a decade later.

Evaluating data from 1,352 participants whose average age was 54 in the Framingham Offspring Study -- which began in 1971 -- researchers from the University of California, Davis found that smoking, high blood pressure, diabetes and being overweight were each linked to potentially dangerous vascular changes in the brain.

"We can't cure disease or cure aging, but the idea of a healthy body, healthy mind is very real," said study author Dr. Charles DeCarli, director of UC Davis' Alzheimer's Disease Center. "People should stop smoking, control their blood pressure, avoid diabetes and lose weight. It seems like a no-brainer."

The study is published Aug. 2 in the journal Neurology.

Participants were given blood pressure, cholesterol and diabetes tests and had their body mass and waist circumference measured. They also underwent MRI brain scans over the course of a decade, the first one about seven years after the initial risk factor exam.

Those with stroke and dementia were excluded at the outset, and between the first and last MRIs 19 participants suffered a stroke and two developed dementia.

Those with high blood pressure experienced a more rapid worsening of test scores of planning and decision-making, which corresponded to a faster rate of growth of small areas of vascular brain damage than those with normal blood pressure.

Those with diabetes in middle age experienced brain shrinkage in an area known as the hippocampus faster than those without, and smokers lost brain volume overall and in the hippocampus faster than nonsmokers, with a more rapid increase of small areas of vascular brain damage.

Meanwhile, participants who were obese at middle age were more likely to be in the top 25 percent of those with faster declines in tests of executive function, DeCarli said. Those with a high waist-to-hip ratio were more likely to be among the 25 percent with a faster drop in brain volume.

"I do think it's an important study and has practical importance in confirming there are things we can do in middle age that can have effects 10, 20 and 30 years down the line to improve cognitive health," said Dr. Raj Shah, medical director of the Rush Memory Clinic in Chicago. "It may seem we're talking about things that are somewhat common knowledge, but really, we always hypothesize these things could happen, but to show they actually do in a study is very important."

DeCarli noted that the effects of the risk factors studied are likely to be even more compelling in the general population, since study participants were largely healthy individuals with normal blood pressure and cholesterol levels and a low diabetes rate.

"It could be so much worse in a representative group of Americans," he said, adding that all study participants were white and only 5 percent were diabetics, compared to a nearly 50 percent rate for Hispanics over age 65. And, "the study certainly doesn't represent the growing obesity problem seen in the South."

One of the strengths of the research was that it used a large sample of people from a well-known study, said Catherine Roe, an assistant professor of neurology at Washington University School of Medicine in St. Louis. However, the results don't prove these risk factors caused the brain changes, she added.

"We know smoking and being overweight are bad for other parts of your health," Roe said. "This is just one more reason to get these things under control."

More information

The Alzheimer's Foundation of America has more about the warning signs of dementia.

DHA in moms may help babies fight infection: study

By Genevra Pittman

Reuters Health

Monday, August 1, 2011

NEW YORK (Reuters Health) - Giving pregnant moms omega-3 fatty acid supplements might help prevent infection in their infants, suggests new research.

But the benefit of docosahexaenoic acid, or DHA, wasn't always obvious in the study of Mexican moms, and researchers say not all babies will necessarily be better off because of it.

With a boost in moms' DHA, "there are not dramatic effects. What we did find, however, is a general trend toward benefit," said study author Usha Ramakrishnan, of Emory University in Atlanta.

Fatty acids like DHA are found in the body's disease-fighting cells. But studies that have looked at the effect of fatty acid supplements in kids or adults have shown "inconsistent effects" on the immune system, the authors explain in Pediatrics.

Whether giving pregnant women extra DHA could improve their infants' immune systems has been even less clear.

To investigate that question, Ramakrishnan and her colleagues recruited more than 1,000 pregnant women -- all four or five months along - who were receiving prenatal care at a hospital and several health clinics in Cuernavaca, Mexico.

Half the volunteers took two 200-milligram DHA supplements each day. The other half of the women, serving as a comparison group, took twice-daily placebo capsules containing a blend of corn and soy oils.

Women continued taking the supplements until they gave birth. Then, they brought their new babies back to the general hospital in Cuernavaca at one, three, and six months, and reported on the infants' recent sickness symptoms.

At one month, babies of moms who had taken DHA had a trend toward fewer total cold symptoms than babies of moms who weren't supplemented. About 38 percent of DHA group babies showed cold symptoms in the couple of weeks before that appointment, compared to 45 percent of placebo babies.

But the authors couldn't rule out that the difference was due to chance.

At three and six months, there was no clear distinction between the two groups of babies with regard to cold symptoms. But in babies that did get sick, those whose moms had taken DHA had a shorter duration of some symptoms, such as fever and runny nose at the last visit.

In a couple of cases, babies of DHA moms had suffered symptoms for longer than comparison babies. For example, at the three-month visit, babies with colds had been stuffed up for an extra day in the DHA group, on average, according to their moms' reports.

Ramakrishnan said that it generally seems safe to take DHA during pregnancy, at least in the doses her team examined. (At much higher doses, similar fatty acids have been linked to bleeding risks.) The 400-milligram daily dose is pretty typical of what would be in a prenatal vitamin or what moms could get in a couple of fish meals each week, she added.

Because of concerns about mercury exposure, the U.S. Food and Drug Administration recommends pregnant women limit their fish intake to two meals per week, choosing fish and shellfish that are low in mercury, such as salmon and shrimp.

DHA supplements can be bought for about $25 to $50 for a six-month supply. Some studies have also linked omega-3 fatty acids to lower cholesterol and a smaller risk of heart disease.

So should all pregnant moms be taking DHA to give their infants an infection-fighting boost?

"I think it may be variable -- not everybody may benefit," Ramakrishnan said. When it comes to infants' health, "It's not going to be that magic bullet."


 Pediatrics, online August 1, 2011.

Colon Cleansing Has No Health Benefit, May Harm: Report

HealthDay News

Monday, August 1, 2011

MONDAY, Aug. 1 (HealthDay News) -- Despite the popularity of colon cleansing, there's no evidence that the procedure -- which can be done at home or in day spas -- offers any health benefits, a new study finds.

However, colon cleansing can cause serious side effects ranging from vomiting to kidney failure and death, the authors of the report say.

Colon cleansing -- also called colonic irrigation or colonic hydrotherapy -- often involves the use of chemicals followed by flushing the colon with water through a tube inserted in the rectum, explained the Georgetown University researchers.

They analyzed 20 studies about colon cleansing that were published over the last decade and found little evidence that the procedure offers any benefits. Instead, a number of the studies noted side effects such as cramping, bloating, vomiting, electrolyte imbalance and kidney failure.

The findings appear in the August issue of The Journal of Family Practice.

"There can be serious consequences for those who engage in colon cleansing whether they have the procedure done at a spa or perform it at home," lead author Dr. Ranit Mishori, a family medicine physician at Georgetown University School of Medicine, said in a university medical center news release. "Colon cleansing products in the form of laxatives, teas, powders and capsules ... tout benefits that don't exist."

It's also important for consumers to know that the U.S. Food and Drug Administration has no authority to monitor these products, she added.

Mishori also noted that many colon cleansing services are offered by people who call themselves "colon hygienists," but have no significant medical training. She pointed out that the National Board for Colon HydroTherapy (NBCHT) and many other groups that promote colon cleansing require hygienists to have little more than a high school diploma.

But Dick Hoenninger, a spokesman for the International Association for Colon Hydrotherapy (I-ACT), which oversees the NBCHT, took issue with the findings.

"Colon hydrotherapy when performed by a trained therapist using FDA registered equipment and disposable speculums or rectal nozzles is safe," he said. According to Hoenninger, the study also "mixes up laxatives, both pharmaceutical and herbal; and colon hydrotherapy. Most of the studies referenced are for the use of laxatives, not colon hydrotherapy."

He also noted that, "I-ACT therapists are trained in the proper use of the [colon cleansing] equipment and are told to not make any statements or advertisements that cannot be verified in peer reviewed literature."

More information

The University of Texas MD Anderson Cancer Center has more about colon cleansing.

Nicotine Can Protect the Brain from Parkinson's Disease, Research Suggests


Monday, August 1, 2011

ScienceDaily (Aug. 1, 2011) — If you've ever wondered if nicotine offered society any benefit, a new study published in The FASEB Journal offers a surprising answer. Nicotine can protect the brain against Parkinson's disease, the research suggests, and the discovery of how nicotine does this may lead to entirely new types of treatments for the disease.

"This study raises the hope for a possible neuroprotective treatment of patients at an early step of the disease or even before at a stage where the disease has not been diagnosed according to motor criteria," said Patrick P. Michel, co-author of the study from the Institut du Cerveau et de la Moelle Épinière, Hôpital de la Salpêtrière, in Paris, France.

To make this discovery, scientists used mice genetically engineered without a specific nicotine receptor (the alpha-7 subtype) and mice with a functional receptor. Using tissue from mouse embryos, researchers prepared brain cultures using conditions that favor the slowly progressing loss of dopamine neurons, a hallmark of the disease. The scientists found that nicotine had the potential to rescue dopamine neurons in cultures from normal mice, but not in cultures from mice without the nicotine receptor. These findings suggest that it may be feasible to develop novel therapies for Parkinson's disease that target nicotine receptors, particularly the alpha-7 nicotine receptor.

"If you're a smoker, don't get too excited," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Even if smoking protects you from Parkinson's, you might not live long enough to develop the disease because smoking greatly increases the risk for deadly cancers and cardiovascular diseases. But now, we should be able find non-toxic ways to hit the same target."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Federation of American Societies for Experimental Biology, via EurekAlert!, a service of AAAS.

Journal Reference:

D. Toulorge, S. Guerreiro, A. Hild, U. Maskos, E. C. Hirsch, P. P. Michel. Neuroprotection of midbrain dopamine neurons by nicotine is gated by cytoplasmic Ca2. The FASEB Journal, 2011; 25 (8): 2563 DOI: 10.1096/fj.11-182824

Even a Little Exercise Helps the Heart, Study Finds

By By Jenifer Goodwin

HealthDay Reporter

HealthDay News

Monday, August 1, 2011

 MONDAY, Aug. 1 (HealthDay News) -- Take the stairs instead of the elevator. Go for a walk after dinner. Play tag with your kids at the park.

New research shows that even small amounts of exercise -- about 150 minutes, or 2.5 hours, of moderate activity a week -- can reduce the risk of heart disease by about 14 percent.

Those who did more -- about 300 minutes a week, or five hours -- reduced their risk of heart disease, including heart attacks, angina and bypass surgeries, by 20 percent compared to people who did no exercise, the study found.

"Some physical activity is better than none, and more is better," said lead study author Jacob Sattelmair, who was a doctoral candidate at Harvard University School of Public Health, Boston, when he conducted the research.

The benefits of even more exercise continue to add up. People who reported exercising for 750 minutes a week, or 12.5 hours -- had a 25 percent reduced risk of heart disease. But that's many more hours of working out for only a small additional risk reduction, Sattelmair noted.

"The biggest bang for your buck is at the lower ends of physical activity," said Sattelmair, now director of research and strategy at Dossia, an organization in Cambridge, Mass., whose goal is to improve employee health and health care, while reducing health care costs. "If you went from none to 2.5 hours a week, the relative benefit is more than if you went from, say, 5 to 7.5 hours a week."

In the study, published online Aug. 1 in Circulation, Sattelmair and colleagues analyzed the results of 33 studies that assessed the health benefits of exercise.

For reasons researchers aren't sure of, women saw even more protective benefits from exercise than men, although this could have been a quirk of the statistics, they said.

While 150 minutes of moderate to vigorous exercise a week is the minimum goal based on current U.S. guidelines, they found even people who did less than that (75 minutes weekly) had a decreased risk of heart disease compared to total coach potatoes.

"If you are doing nothing, do something. And if you are doing something, say, walking 10 or 15 minutes, two to three times a week, do more," said Barry Franklin, director of the preventive cardiology program at William Beaumont Hospital in Royal Oak, Mich., and an American Heart Association spokesman.

Moderate physical activity includes walking briskly, gardening, playing doubles tennis or dancing. Vigorous activity includes jogging, swimming laps, hiking uphill or jumping rope, although researchers did not analyze whether or not exercising vigorously was any better than moderate exercise for improving heart health.

Prior research has pointed to myriad benefits of physical activity, Franklin said. Getting up and moving strengthens the heart and the lungs.

Physically fit people also tend to have lower blood pressure and resting heart rate, which puts less demand on the heart. Exercise can increase insulin sensitivity, which is important in the prevention of diabetes, and can modestly boost HDL ("good") cholesterol.

Other studies suggest that exercise reduces inflammatory markers that may play a role in triggering heart attacks; may reduce the likelihood of clots that lead to heart attacks and stroke; and decreases the risk of life-threatening arrhythmias (irregular heart beat).

Yet physical activity, of course, isn't the sole key to preventing heart disease, the leading cause of death in the United States. Eating a healthy diet, maintaining a normal body weight, avoiding high levels of stress, and keeping blood pressure and cholesterol levels in a healthy range all play a role, he added.

Just as important as an exercise program is getting physical activity while going about your day, Franklin said. Recent research has suggested that it's not only structured exercise classes or sessions, but the incidental exercise you get when you walk around the mall, go up and down the stairs, clean the house, or mow the lawn that matters for health.

"In addition to your structured exercise program, where you drive to the gym and walk on the treadmill, disguised exercise can also have a profound impact on your cardiovascular risk," Franklin said. "The take-home message is: Move more. Sit less."

More information

The American Academy of Family Physicians has tips for starting an exercise program