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Saturday, November 20, 2010

THE MAGIC PILL- live longer

A Harvard Medical School professor believes that the day is not far when just popping a pill could make you live longer and healthier.
Associate Professor of Pathology David Sinclair said his work to activate the sirtuin genes, which control ageing "could expand lifespan by five to 10 healthy years."
It wouldn't stop you getting old, he said, but instead would push back the point at which you become impaired before "hopefully, [you] immediately drop dead," reports The Sydney Morning Herald.
He suggested that activating the sirtuins increases memory and endurance but also slow ageing and alleviate the impact of a high-fat diet.
"If the animal studies are borne out in humans, you would have a pill for arthritis that would prevent Alzheimer's, cardiac arrest, would slow down heart disease and even protect you against cataracts," Sinclair said.
"Within scientific circles this is as cutting edge as stem cell research," he added.
Sinclair also pioneeered the use of resveratrol - and now synthetic compounds up to 10,000 times more potent - which have been shown to slow the ageing process and prevent the onset of many diseases in animals.
However, he admitted that there was a risk because the effects of long-term doses in humans were not known, but no side effects in either animals or humans had been found

Thursday, November 18, 2010

Lifestyle changes curb overnight bathroom trips

If you're frequently bothered by waking in the middle of the night to empty your bladder, there may be some simple and drug-free lifestyle adjustments that can help, a small study suggests.

So-called "nocturia" is the complaint of getting up at least once a night to urinate -- either due to a heightened production of urine or the inability of the bladder to hold it, sometimes as a result of an underlying medical problem. The condition can contribute to fatigue and depression, and raise the risk of heart disease and gastrointestinal disorders.

However, as experts note, nocturia is also very normal, especially as people age. And not everyone affected is bothered by it.

The standard treatments for frequent nighttime urination include "medical therapy as well as lifestyle modifications such as fluid restrictions," senior researcher Dr. Koji Yoshimura of Kyoto University Graduate School of Medicine in Kyoto, Japan, told Reuters Health in an email. "However, the efficacy of the lifestyle therapy has not been established so far."

Yoshimura and his colleagues studied 56 people complaining of nocturia who were about 75 years old, on average. They tested the effects of four easy lifestyle changes: fluid restriction, limiting any excess hours in bed, moderate daily exercise and keeping warm while sleeping.

Each patient was advised of the benefits of each modification, including a recommendation to limit their fluid intake to about 2 percent of their body weight during the day -- avoiding too much in the evening. This translates to about one and a half quarts of water for a 165-pound person.

After four weeks, the participants' average number of nighttime bathroom trips dropped. More than half of the patients experienced an improvement of more than one episode a night, Yoshimura and colleagues report in The Journal of Urology. Total urine volume also decreased (from 923 to 768 milliliters).

Dr. Serge Marinkovic of St. Francis Hospital, in Indianapolis, who was not involved in the study, noted that the effectiveness of the lifestyle changes was comparable to that of drug interventions.

Current medication options for nocturia include a synthetic version of a hormone that keeps the body from making urine at night, a drug that blocks the ability of the bladder muscles to contract, and antidepressants that make it harder to urinate by increasing tension at the bladder neck, he told Reuters Health.

"None of these medications are a great cure, and all have side effects, including dry mouth, constipation and heartburn," Marinkovic said. "They're significant enough for up to 70 percent of patients to stop using the drug within 6 months."

A limitation of the current study, Marinkovic noted, is the fact that patients were not monitored to determine how well they actually adhered to each of the behavior modifications. Another limitation is the lack of an untreated control group, which means a placebo effect can't be ruled out.

In his practice, Marinkovic typically starts off with his nocturia patients by going over a medical history to rule out underlying conditions such as diabetes or renal problems. Then he has them keep a diary of fluid intake and nighttime symptoms, which helps him prescribe behavioral changes such as fluid restriction. On top of this, he often adds medications, he said.

But again, not everyone is bothered by frequent trips to the bathroom during the night, Marinkovic emphasized.

"I saw a guy two weeks ago who gets up four times a night, and it's not a problem for him," he said. "He told me he does some of his best thinking when he's walking to the bathroom."

SOURCE: The Journal of Urology, September 2010. (Reuters Health)

Quitting smoking helps after serious heart attack damage

It's never too late for smokers to do their hearts good by kicking the habit -- even after a heart attack has left them with significant damage to the organ's main pumping chamber, a new study suggests.

Past studies have found that smokers who kick the habit after suffering a heart attack have a lower rate of repeat heart attacks and live longer than their counterparts who continue to smoke.

But little has been known about the benefits of quitting among heart attack patients left with a complication called left ventricular (LV) dysfunction -- where damage to the heart's main pumping chamber significantly reduces its blood-pumping efficiency.

So it has been unclear whether that dysfunction might "drown out" the heart benefits of smoking cessation, said Dr. Amil M. Shah, the lead researcher on the new study and a staff cardiologist at Brigham and Women's Hospital in Boston.

But in their study, Shah and his colleagues found that heart attack survivors with LV dysfunction may stand to benefit as much from smoking cessation as other heart attack patients do.

The researchers found that among 2,231 patients with LV dysfunction, those who quit smoking within six months of their heart attack were less likely to die within five years or suffer a repeat attack than smokers who continued the habit.

Of all patients, 463 were smokers at the time of the heart attack but had quit six months later; 268 were still smoking at the six-month mark. Among quitters, 15 percent died or suffered another heart attack by the end of the study, which followed the patients for up to five years.

That compared with a rate of 23 percent among patients who were still smoking six months after their initial heart attack.

When Shah's team accounted for a number of other factors -- including age, medical history and body weight -- smoking cessation itself was linked to a 40 percent reduction in the risk of death compared with persistent smoking.

Quitters were about 30 percent less likely to die, suffer a repeat heart attack or be hospitalized for heart failure during the study period.

"The findings aren't completely surprising," Shah told Reuters Health. But, he said, they offer reassurance to patients with LV dysfunction that they can benefit from smoking cessation -- and the magnitude of that benefit is similar to what has been seen among heart attack survivors without LV dysfunction.

"I've had patients who say, 'What's the point of quitting now?'" Shah noted. "But it's never too late to benefit from smoking cessation."

Some studies have found that smoking-cessation counseling begun in the hospital, and continued after discharge, may be particularly effective for heart attack patients.

Patients at hospitals that do not offer such counseling should speak with their cardiologist or primary care doctor about smoking cessation, Shah advised. Behavioral counseling will generally be the first step, he noted -- though for patients who ultimately need more, nicotine-replacement products or medications such as Zyban or Chantix may be options.

A number of studies have suggested that these products are generally safe for people with heart disease -- though, Shah pointed out, most of the data come from patients with stable heart disease, and not those who have just recently suffered a heart attack or other complication.

SOURCE: American Journal of Cardiology, published online August 13, 2010. (Reuters Health)

allergies and heart disease

Common allergies that bring on wheezing, sneezing and watery eyes could be next to join the list of factors linked to heart disease, suggests a large new study.

However, the researchers stress that the findings do not prove that allergies actually cause heart disease, the leading cause of death in the U.S.

To look for ties between common allergic symptoms and heart disease, Dr. Jongoh Kim of Albert Einstein Medical Center in Philadelphia, Pennsylvania and colleagues analyzed data on more than 8,600 adults aged 20 or older who participated in the National Health and Nutrition Examination Survey conducted between 1988 and 1994.

They found that common allergies and heart disease frequently paired up.

Eighteen percent of the adults reported wheezing and 46 percent suffered bouts of a stuffy nose or itchy and watery eyes -- a combination of allergic symptoms known as rhinoconjunctivitis.

Heart disease was present in 6 percent of the adults overall. It was found in 13 percent of wheezing cases, 5 percent of rhinoconjunctivitis cases and 4 percent of people without any allergic symptoms.

After adjusting for other related factors, such as age and asthma, there was a 2.6-fold increased risk of heart disease with wheezing and a 40 percent increased risk with rhinoconjunctivitis, compared to no allergies. The association was mainly seen in women younger than age of 50.

Kim suggests that the intermittent inflammation that comes with allergies may lead to the thickening of artery walls, and eventually heart disease. It could also be that some people simply carry genes that are linked to the development of both allergies and heart disease, Kim added.

But given the nature of the study, the researchers are not yet able to say if allergies truly have a role to play in the development of heart disease.

Much more study is needed to "clearly see" whether there is a cause and effect relationship, Kim said. "And even if there is a cause and effect, it is not clear whether treating allergic disease can reduce the risk," Kim noted.

Dr. Carlos Iribarren, a research scientist at Kaiser Permanente in Oakland, California, who was not involved in the study, said: "Because common allergic symptoms are highly prevalent in asthma, these findings are consistent with prior research conducted at Kaiser Permanente showing a significant association between self-report of asthma and future risk of coronary disease, particularly among women."

But he cautioned, in an email to Reuters Health, against jumping to any "premature conclusion, consumer-level advice or public health recommendation based on these findings."

Iribarren also noted that study subjects with allergy (particularly wheezing) had a greater burden of heart disease risk factors (for example, smoking, obesity, high blood pressure), compared with allergy-free subjects. Therefore, "allergists, internists and cardiologists should be made aware of this link and intensify cardiovascular risk profile assessment and modification among patients presenting with allergy."

Dr. Viola Vaccarino, of the Rollins School of Public Health at Emory University School of Medicine in Atlanta, told Reuters Health that the current findings also fit with studies she and her colleagues have done, "finding of an association of chronic inflammatory conditions such as asthma and other allergic conditions with coronary disease in women but not in men."

"Young women may have a stronger inflammatory response due to allergic conditions than men, perhaps due to estrogens," explained Vaccarino, who was also not involved in the current study.

It's also possible, she said, that "people with history of coronary heart disease are sicker with respiratory symptoms just because they have coronary heart disease and not vice-versa."

"I really wouldn't draw any strong message from this study," said Vaccarino. "I would not alarm the public with the news that common allergic symptoms (other than asthma) increase the risk of coronary heart disease in women, based on this study."

SOURCE: The American Journal of Cardiology, online August 13, 2010. (Reuters Health)

Young Parents May Be Especially Prone to Depression

Many parents experience depression during the first 12 years of their children's lives and the risk is highest during the first year after birth, a new study has found.

Researchers in the United Kingdom examined data from 86,957 families seen in primary-care clinics between 1993 and 2007 in order to identify parents with depression. They found that more than one-third of mothers and about one-fifth of fathers had an episode of depression between their child's birth and their 12th birthday -- 19,286 mothers had a total of 25,176 episodes of depression and 8,012 fathers had a total of 9,683 episodes of depression.

Overall, the depression rates were 7.53 per 100 mothers and 2.69 per 100 fathers per year. But the rates during the first year after the birth of a child were 13.93 per 100 mothers and 3.56 per 100 fathers.

"These high rates of depression in the postpartum period are not surprising owing to the potential stress associated with the birth of a baby, [for example,] poor parental sleep, the demands made on parents and the change in their responsibilities, and the pressure this could place on the couple's relationship," wrote Shreya Dave, of the Medical Research Council in London, and colleagues.

Depression was most likely to occur in parents with a history of depression, those who were aged 15 to 24 when their child was born, and those who were more socially deprived, according to the report, which was released online Sept. 6 in advance of publication in the November print issue of the journal Archives of Pediatrics & Adolescent Medicine.

"There is a well-established link between depression and social and economic deprivation both in the general population and among parents. This finding may reflect the stresses of poverty, unemployment, low employment grade and lower social support among people of lower socioeconomic status," the researchers concluded.

In addition, "younger parents may be less prepared for parenthood with more unplanned pregnancies and may be less able to deal with the stresses of parenthood compared with older parents," Dave and colleagues wrote.

SOURCE: JAMA/Archives journals, news release, Sept. 6, 2010

Statins May Guard Against Rheumatoid Arthritis

Statins, lauded for their ability to lower cholesterol and prevent heart attacks and strokes, may also reduce the risk of developing rheumatoid arthritis, Israeli researchers report.

"We found that statin users who purchased their medication persistently were less likely to develop rheumatoid arthritis over a long follow-up period," said lead researcher Gabriel Chodick, from Maccabi Healthcare Services in Tel Aviv.

For example, compared with patients who took statins less than 20 percent of the time, patients who took statins for 40 percent to 59 percent of the time had a 23 percent lower risk of developing rheumatoid arthritis, he said.

"Patients who were covered for more than 80 percent of the time, had a 40 percent lower risk of developing rheumatoid arthritis," Chodick said. "The effect was stronger in younger patients and in patients using more effective statins."

The report was published online Sept. 7 in PLoS Medicine.

For the study, Chodick's team collected data on 1.8 million patients who got their health care through the Maccabi Healthcare Services, an HMO in Israel.

The researchers looked for connections between statin use and the development of both rheumatoid arthritis and osteoarthritis, a degenerative joint disease that is unlikely to be affected by statins, the researchers noted.

Over nine years of follow-up, 2,578 people developed rheumatoid arthritis and 17,878 developed osteoarthritis.

When Chodick's group looked at statin use, they found that those not taking statins had a 51 percent higher risk of developing rheumatoid arthritis over about 80 percent of the follow-up period.

After looking for other possibilities, those who took statins regularly had a 41 percent lower risk of developing rheumatoid arthritis compared with people who were not taking statins regularly.

Among those taking statins, there was only a small, short-term reduction in risk of development of osteoarthritis.

"Although the study does not have immediate clinical implications, our findings may suggest that patients who were prescribed statins and take it persistently may benefit from the many effects of statins, which go far beyond cholesterol reduction, including the reduction of rheumatoid arthritis risk," Chodick said.

A previous study on the same group indicated that persistent use of statins was associated with substantially lower all-cause mortality, which could not be explained only by the prevention of cardiovascular disease, he said.

"We believe that a major part of the improved survival among statin users comes from the anti-inflammatory effects demonstrated by lower risk of rheumatoid arthritis. Unfortunately, our previous study indicated that, despite their benefits, many patients on statins discontinue their treatment," Chodick said.

This work received no outside or corporate finding, the researchers noted.

Dr. Robert Myerburg, a professor of medicine and physiology at the University of Miami Miller School of Medicine, stressed that "this is a study looking for an association, and it doesn't prove that starting statins early in life will prevent or delay the onset of rheumatoid arthritis."

The only way to prove the connection is with a clinical trial, Myerburg said. "At this point, I would not use a statin for that [prevention of rheumatoid arthritis] indication," he said.

SOURCES: Gabriel Chodick, Ph.D., Maccabi Healthcare Services, Tel Aviv, Israel; Robert Myerburg, M.D., professor, medicine and physiology, University of Miami Miller School of Medicine; September 2010, PLoS Medicine, online (HealthDay)

Dementia Warning Signs Identified in Type 2 Diabetics: Study

Three factors linked to cognitive deficits in older adults with type 2 diabetes have been identified in a new study.

Canadian researchers looked at 41 adults, ageds 55 to 81, with type 2 diabetes and found that those who had high blood pressure, walked slowly or had balance problems, or believed they were in bad health were much more likely to have poorer memory and slower, more rigid cognitive processing than those without these three problems.

The study appears in the September issue of the journal Neuropsychology.

While these factors may not actually cause cognitive deficits, their presence could alert doctors that such problems may exist or soon develop, the researchers said.

"Awareness of the link between diabetes and cognition could help people realize how important it is to manage this disease -- and to motivate them to do so," study co-author Roger Dixon, of the University of Alberta, said in an American Psychological Association news release.

Previous research has shown that type 2 diabetes nearly doubles the risk of dementia and Alzheimer's disease. Increasing rates of diabetes among older people in Western nations could lead to a dramatic increase in the number of people with dementia, Dixon noted.

In the United States, 23 percent of people older than 60 have diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCE: American Psychological Society, news release, Sept. 1, 2010 (HealthDay)

B vitamins found to halve brain shrinkage in old

Daily tablets of large doses of B vitamins can halve the rate of brain shrinkage in elderly people with memory problems and may slow their progression toward dementia, data from a British trial showed on Wednesday,

Scientists from Oxford University said their two-year clinical trial was the largest to date into the effect of B vitamins on so-called "mild cognitive impairment" -- a major risk factor for Alzheimer's disease and other forms of dementia.

Experts commenting on the findings said they were important and called for larger, longer full-scale clinical trials to see if the safety and effectiveness of B vitamins in the prevention of neurodegenerative conditions could be confirmed.

"This is a very dramatic and striking result. It's much more than we could have predicted," said David Smith of Oxford's department of pharmacology, who co-led the trial.

"It is our hope that this simple and safe treatment will delay development of Alzheimer's in many people who suffer from mild memory problems."

Mild cognitive impairment (MCI) affects around 16 percent of people aged over 70 worldwide and is characterized by slight problems with memory loss, language or other mental functions.

MCI does not usually interfere with daily life, but around 50 percent of people diagnosed with it go on to develop the far more severe Alzheimer's disease within five years. Alzheimer's is a mind-wasting disease for which there are few treatments and no cure, and which affects 26 million people around the world.

Smith and colleagues conducted a two-year trial with 168 volunteers with MCI who were given either a vitamin pill containing very high doses of folic acid, vitamin B6 and vitamin B12, or a placebo dummy pill.

These B vitamins are known to control levels of an amino acid called homocysteine in the blood, and high blood levels of homocysteine are linked to an increased risk of developing Alzheimer's disease.

Helga Refsum, who also worked on the trial, stressed that vitamins were given in extremely high doses.

"This is a drug, not a vitamin intervention," she said.

The pills, called "TrioBe Plus" contained around 300 times the recommended daily intake of B12, four times daily advised folate levels and 15 times the recommended amount of B6.

Brain scans were taken at the beginning and the end of the trial to monitor the rate of brain shrinkage, or atrophy.

The results, published in the Public Library of Science (PLoS) One journal, showed that on average the brains of those taking the vitamin treatment shrank at a rate of 0.76 percent a year, while those taking the dummy pill had an average brain shrinkage of 1.08 percent.

People who had the highest levels of homocysteine at the start of the trial benefited the most from the treatment, with their brains shrinking at half the rate of those on the placebo.

Although the trial was not designed to measure cognitive ability, the researchers found those people who had lowest rates of shrinkage had the highest scores in mental tests.

Commenting on the study, Paul Matthews, a professor of clinical neurology at Imperial College London said that although the vitamins used are generally safe and inexpensive, the study "should not drive an immediate change in clinical practice"

"Instead, it sets out important questions for further study and gives new confidence that effective treatments modifying the course of some dementias may be in sight," he said.

Air/Gas Embolisms with Pressurized Spray Devices

FDA is advising operating room personnel about the importance of using gas or air-pressurized sprayers properly. These products are used to deliver hemostatic agents, including fibrin and non-fibrin sealants.

FDA has reports in which gas and air embolisms occurred during or immediately after using the sprayers to apply a hemostatic agent. The adverse events appear to be associated with not using the devices according to their labeling and instructions. In some reports, the device was used at higher than the recommended pressure, or too close to the bleeding site.

Given the life-threatening consequences of a gas or air embolism, FDA recommends that clinicians using these sprayers take certain precautions. Use the sprayer device that is recommended by the manufacturer of the hemostatic agent. Select an air or gas pressure setting that is within the range recommended by the manufacturer of the sprayer, and keep the distance between the spray head and the tissue surface above the minimum recommended by the manufacturer.

Clinicians should also monitor patients for signs of an air or gas embolism, and be sure that the regulators are maintained properly and checked regularly for safe performance.

First Test to Detect Both HIV Antigen and Antibodies

FDA recently approved the first diagnostic test that simultaneously detects HIV antigen and antibodies. The test, called the ARCHITECT HIV Ag/Ab Combo assay, is made by Abbott Laboratories.

Most tests that are presently used in diagnostic settings only detect antibodies to HIV. The new test is more sensitive in detecting HIV infection, because it actually detects the p24 antigen of the virus. That means it can help diagnose HIV infection before antibodies appear in the blood. The test is approved for use with adults, including pregnant women, as well as children as young as two years old.

The test can be used in clinical and public health labs. It should not be used for routine screening of blood donors, except in urgent situations where licensed screening tests aren't available, or using them is impractical.

Working Overtime Adds to Heart Risk

Out-of-shape men who work long hours more than double their risk of dying from heart disease compared to non-fit men working fewer hours, researchers report.

The study also found that when men are fit, working long hours doesn't boost heart risk at all.

The new study included 5,000 Danish men, aged 40 to 59 years, who worked at 14 different companies. Their fitness levels were assessed at the start of the study and they were followed-up for more than 30 years. During that time, 587 (about 12 percent) of the men died as result of narrowed and hardened arteries (also known as ischemic heart disease).

The study, released online Sept. 6 in advance of publication in an upcoming print issue of the journal Heart, also found the following:

Compared with men who worked less than 40 hours per week, unfit men who worked 41 to 45 hours a week were 59 percent more likely to die of heart disease, although they were not more likely to die of other causes.
Compared with unfit men, those who were physically fit and worked longer hours were 45 percent less likely to die of heart disease and 38 percent less likely to die of other causes.
Being both unfit and working more than 45 hours per week more than doubled a man's risk of dying of heart disease compared with those who worked less than 40 hours per week.
"The finding that working more than 45 hours a week is associated with more than a doubled risk of [death from heart disease] among men with low physical fitness, and not among men with moderate or high physical fitness, is a new observation," Andreas Holtermann, of the National Research Centre for the Working Environment in Copenhagen, and colleagues said in a news release from the journal's publisher.

"If the relationship is causal, it obviously has major implications for the prevention of heart disease," they added.

SOURCE: Heart, news release, Sep

Smoking Could Harm Sperm

Two new studies provide evidence that smoking can harm sperm - both in smoking men who may become fathers, and in sons born to women who smoked during pregnancy.

The research also suggests that both men and women who hope to conceive should kick the habit.

"The results of the present study suggest a negative biological effect of smoking on spermatozoa DNA integrity," said the lead author of one study, Dr. Mohamed E. Hammadeh, head of the assisted reproductive laboratory in the department of obstetrics and gynecology at the University of the Saarland in Saar, Germany.

Research by Hammadeh and his colleagues showed that men who smoke heavily may experience fertility problems stemming from a drop in levels of a protein crucial to sperm development, as well as damage to sperm's DNA.

Another study suggests that women who smoke early in their pregnancy may ultimately compromise their sons' reproductive health.

Both studies are published in the Sept. 8 online issue of Human Reproduction.

In the first study, Hammadeh's team compared sperm from 53 heavy smokers (more than 20 cigarettes a day) against that of 63 nonsmokers.

After three to four days of sexual abstinence, a single semen sample was taken from all study participants, to measure levels of two forms of a specific type of protein found in sperm, called protamines. According to the researchers, protamines are key players in sperm development, helping to spur on the process by which chromosomes are formed and packaged during cell division.

Hammadeh and colleagues found that in the smoking group, one form of protamine appeared at levels that were 14 percent below concentrations observed in the sperm of nonsmoking men. This was enough to constitute a form of "protamine deficiency" and, in turn, raise risks for infertility among the smokers.

What's more, smoking-linked "oxidative stress" appeared tied to an increase in damage to sperm DNA, the team reported.

According to Hammadeh, past attempts to clarify the relationship between cigarette smoking and male infertility have had trouble identifying a molecular mechanism underlying any such link. So he believes the new finding should help convince male smokers struggling with infertility to kick the habit.

"Because of the fact that cigarette smoke contains mutagens and carcinogens, there have been concerns that smoking may have adverse effects on male reproduction," Hammadeh noted. The new findings help bear that out, he said.

The second study was led by Dr. Claus Yding Andersen, a professor of human reproductive physiology at the University Hospital of Copenhagen in Denmark. It focused on the impact of maternal smoking during the first trimester of pregnancy upon the development of the male fetus.

In this case, the authors analyzed tissue from the testes of 24 embryos that had been aborted between 37 and 68 days following conception.

After classifying the prospective mothers according to smoking habits, the research team found that the number of so-called "germ cells" -- cells that develop into sperm in males and eggs in females -- were 55 percent lower in the testes of embryos obtained from women who smoked. This observation held regardless of the mother's alcohol and coffee consumption habits.

As well, embryonic levels of so-called "somatic cells" (those that go on to form other types of tissue) were 37 percent lower among those women who smoked.

In both the case of germ and somatic cells, drop-offs in levels appeared to be "dose-dependent," meaning that the more the prospective mother smoked, the lower the number of cells grown by the embryo.

Based on these findings early in fetal growth, Anderson and his colleagues conclude that the apparent impact of smoking on cellular production might continue in male offspring carried to term. And that could mean a higher risk of impaired fertility in sons.

According to the Danish team, their earlier research involving female embryos also revealed "germ cell" reductions of about 40 percent for embryos taken from women who smoked during pregnancy. This suggests that maternal smoking in pregnancy may harm the reproductive health of both male and female offspring.

"Our results provide health care professionals who talk to women who are considering conceiving, or have conceived just recently, with a 'here and now' argument to convince them to stop smoking," Anderson said. "Because the negative effect of smoking appears to take place right from conception and during the early days [of gestation], when the human embryo becomes differentiated into either a girl or a boy."

SOURCES: Mohamed E. Hammadeh, M.D., department of obstetrics and gynecology, University of the Saarland, Saar, Germany; Claus Yding Andersen, M.D., professor, human reproductive physiology, and technology ambassador, University Hospital of Copenhagen, Laboratory, Copenhagen, Denmark; Sept. 8, 2010, Human Reproduction, online (HealthDay)

Dealing With Lower Back Pain

Suggestions to help ease the discomfort
The American Academy of Orthopaedic Surgeons offers this list of potential remedies to help ease the discomfort:

1) Hot or cold therapy.
2) Exercises to help relieve muscle spasms and strengthen the muscles.
3) A brace worn around the lower back to provide support and stability.
4) Chiropractic therapy. (manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling)
5) Traction.

Factors That May Aggravate Acne in Women

Acne, the most common skin disease, is not a dangerous condition. But it can lead to permanent scarring. says these factors can trigger bouts of acne in women:

1) Changes in hormone levels during puberty.
2) Changes in hormone levels during menstruation, or after discontinuing birth control pills.
3) Taking certain medications, including some antidepressants and epilepsy drugs.
4) Wearing makeup.
Friction or pressure applied to the skin.

In Elderly, Risks Differ for Indoor Versus Outdoor Falls

Different risk factors contribute to indoor and outdoor falls among the elderly and these differences need to be incorporated into fall prevention programs, a new study suggests.

U.S. researchers studied 765 people, aged 70 and older, in the Boston area. Over two years, the participants reported 598 indoor falls and 524 outdoors falls. After someone suffered a fall, they were interviewed about the circumstances.

The study found that those who fell indoors had inactive lifestyles, more physical disabilities, took more medications, and had lower cognitive function (or thinking skills) than those who fell outdoors.

Participants who fell outdoors were generally younger than those who fell indoors, were more likely to be male and better educated, and had lifestyles that indicated better health.

The study, published online Sept. 8 in the Journal of the American Geriatrics Society, has a number of implications, said senior author Marian T. Hannan, a senior scientist at the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School.

The findings show that falls are not necessarily an indication of poor health and that fall prevention programs require different approaches for those at risk for indoor or outdoor falls.

"Most fall prevention programs emphasize the prevention of indoor falls, particularly through strength, balance and gait training; use of assistive devices; treatment of medical conditions; reduction in the use of certain medications; improvement in vision; and the elimination of home hazards," Hannan and colleagues reported.

Most of these programs don't take into account causes of outdoor falls, which make up at least half of all falls suffered by seniors each year, according to the U.S. Centers for Disease Control and Prevention. Outdoor falls tend to occur on sidewalks, streets, curbs or in parking lots, Hannan pointed out in a news release from the institute.

"Healthy, active older people should be aware of their surroundings, especially when walking outdoors. More attention needs to be paid to the elimination of outdoor environmental hazards involving sidewalks, curbs and streets, such as repairing uneven surfaces, removing debris, installing ramps at intersections and painting curbs," Hannan recommended.

SOURCE: Institute for Aging Research of Hebrew SeniorLife, news release, Sept. 8, 2010.


Obesity Worsens Brain Damage of Heavy Drinking

 Obesity caused by heavy drinking can add to brain damage caused by drinking itself, says a new study.

Researchers examined the findings of different types of brain scans conducted on 54 men in an alcohol treatment program and compared them with each man's body mass index (BMI). BMI is a measurement that takes into account a person's height and weight. The study findings appear online and in the December print issue of Alcoholism: Clinical & Experimental Research.

"It is commonly believed that it is the large amount of consumed alcohol by itself that leads to brain injury in alcoholics," principal investigator Dieter J. Meyerhoff, a professor of radiology at the University of California, San Francisco and San Francisco VA Medical Center, said in a journal news release.

"This is only partly correct. In previous studies, we have shown that alcoholics who smoke cigarettes have greater brain injury than nonsmoking alcoholics. This new study suggests that a high BMI, independent of drinking and smoking, is also associated with brain injury," Meyerhoff said.

"In other words, weight also is related to brain health among those with alcoholism," Susan F. Tapert, a professor of psychiatry at the University of California, San Diego, and director of substance abuse/mental illness in the VA San Diego Healthcare System, said in the news release.

"BMI may be a very important factor to consider when examining other potential consequences of alcohol use. Since individuals who consume substantial amounts of alcohol are at risk for obesity, it is important to understand the influence of body fat deposition on the measures we are examining. It could be that metabolic changes resulting from or causing obesity cause harm to the brain, at least among alcoholics," Tapert said.

SOURCE: Alcoholism: Clinical & Experimental Research, news release, Sept. 7, 2010


10% of 2010 Winter Olympians Suffered Injuries

About one in 10 athletes who competed at the 2010 Winter Olympics suffered an injury and about one in 14 became ill, according to a new study.

Researchers analyzed reports from the 82 national team doctors who looked after a total of 2,567 athletes and found that there were 287 reported injuries and 185 illnesses. That works out to 111.8 injuries (11 percent) and 72.1 illnesses (7 percent) per 1,000 registered athletes at the games in Vancouver, Canada.

About 22 percent of the injuries resulted in athletes being unable to train or compete, according to the report in the September issue of the British Journal of Sports Medicine.

Athletes competing in bobsledding, ice hockey, short track skating, alpine freestyle skiing or snowboard cross were most likely to suffer an injury or illness (ranging between 15 percent and 35 percent). The lowest risk (less than 5 percent) was among athletes in Nordic skiing events (cross country skiing, biathlon, ski jumping and Nordic combined), luge, curling, speed skating and freestyle moguls.

The head, spine and knees were the most common injury sites, and these injuries were almost as likely to occur during training (46 percent) as during competition (54 percent). However, three out of four injuries suffered by snowboarding, freestyle cross skiing, short track skating, figure skating, skeleton and biathlon athletes occurred during training, reported Lars Engebretsen, of the Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences in Oslo, Norway, and colleagues.

Among the other findings:

The most common types of injuries were bruising, ligament and muscular sprains.
There was one death -- an athlete who died while training for luge.
Female athletes had a higher injury rate (131.1 per 1,000) than men (93.3 per 1,000). About 20 percent of female athletes in bobsled, ice hockey, snowboard cross and in freestyle cross and aerials suffered an injury. Just under 28 percent of male athletes were injured in short track, 17 percent in bobsled, and just under 16 percent in hockey.
About 10 percent of athletes in skeleton, figure and speed skating, curling, snowboard cross and biathlon had at least one illness, 62 percent of which were respiratory infections.
SOURCE: British Journal of Sports Medicine, news release, Sept. 7, 2010 (HealthDay)

Winter Sports Tourists at Higher Risk of Heart Attack

Too little conditioning, cold and high altitude all contribute to hazard, researchers say.

Skiers and other winter sports tourists who visit the Alps are at increased risk for heart attack due to low temperatures, high altitude and inadequate conditioning for intense physical exertion, finds a new study.

The risk is greatest during the first two days of vacation, said a research team of cardiologists at the Medical University of Innsbruck, Austria, who focused on winter tourists in the Tyrolean Alps.

"Every year, millions of tourists visit the Tyrolean Alps to participate in a variety of winter sports, each of which carries a certain risk of accident and injury," study senior author Dr. Bernhard Metzler, an associate professor of cardiology at the university, said in a news release from the European Society of Cardiology.

"Previously it had been shown that sudden cardiac death accounts for a staggering 40 percent of the total fatalities amongst winter sports tourists in the Austrian Alps and, of these, acute [heart attack] is the leading cause," he added.

Metzler and colleagues analyzed data from 170 patients who suffered a heart attack during a winter sports vacation between 2006 and 2010. About 56 percent of the patients suffered their heart attack within the first two days of beginning intense physical activity, although just 19 percent had a known cardiac condition.

Prior to their vacation, more than half of the patients got less than the minimum levels of physical activity recommended by the European Society of Cardiology.

Altitude may have been a major factor, the study authors noted. The patients' heart attacks occurred at a mean altitude of 1,350 meters (4,429 feet), compared to the mean altitude of 170 meters (557 feet) where they lived.

The researchers also found that about 70 percent of the patients had at least two risk factors for coronary artery disease, including smoking, diabetes or high cholesterol levels.

People planning winter sports holidays in the mountains need to prepare themselves with regular exercise beforehand, the study authors suggested. Once at the resort, they should increase their level of physical activity gradually, they added.

The researchers presented their findings last week at the European Society of Cardiology Congress, in Stockholm, Sweden.

SOURCE: European Society of Cardiology, news release, Aug. 20, 2010(healthday)

Obesity May Up Death Risk in Older Women With Colon Cancer

Women past menopause with a high BMI and large waists had increased risk of dying, study finds.

Here's yet another reason to avoid obesity throughout your life: Doing so may improve your chances of survival if you're diagnosed with colon cancer.

Women past menopause who are obese and diagnosed with colon cancer appear to face a greater risk of dying from all causes than those who are at a healthy weight or merely overweight, a new study shows.

And trying to lose weight after the diagnosis may be too late, researchers cautioned. Abdominal obesity even prior to the diagnosis of colon cancer was associated with an increased risk of dying after contracting the disease, according to study author Anna Prizment, a postdoctoral fellow at the University of Minnesota Masonic Cancer Center, in Minneapolis.

Body shape may play a role as well.

Women with the disease who have an unhealthy waist-to-hip ratio and a large waist are at increased risk of death, Prizment added.

The study is published in the September issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Colon cancer is the second leading cause of cancer-related death among women and men combined. It is expected to kill more than 51,000 people -- including nearly 25,000 women -- in the United States in 2010, according to the American Cancer Society.

Many studies have found a link between excess body weight and a higher risk of colon cancer. "But not so many studies have examined how obesity affects survival of the colon cancer patient," Prizment said.

So, with her colleagues, she evaluated women who had participated in the Iowa Women's Health Study, focusing on 1,096 women participants who were diagnosed with colon cancer between 1986 and 2005. Body and weight measurements were obtained before the colon cancer diagnosis.

The study was retrospective, meaning that the data used had been recorded for reasons other than research.

During the follow-up period of up to 20 years, 493 women died. Among this group, colon cancer was the underlying cause in 289 deaths.

Obese women -- those with a body-mass index (BMI) of 30 or higher -- had a 45 percent increase in all causes of death compared to women with a healthy weight, according to Prizment. Their risk of dying from colon cancer also climbed by 32 percent compared to healthy weight women, but that finding was not significant from a statistical point of view. However, the 45 percent increase in all causes of death was clinically significant.

The researcher also found that the risk of dying was higher among underweight women, those with a BMI below 18.5. "But we don't want to talk much about them because we had too few of them," Prizment said.

Prizment expanded on the unhealthy waist-to-hip ratio and large waist associations that she found were associated with a higher risk of dying from colon cancer.

A waist-to-hip ratio of 0.80 or below for women is considered low-risk. For instance, a woman with a waist of 27 inches and hips of 36 inches has a waist-to-hip ratio of .75.

Women with waists of 37.5 inches or higher had a higher death risk than those with a healthier waist size, she found.

Exactly why the obese women with unhealthy waist-to-hip ratios and big waists are at increased risk of death from colon cancer compared to slimmer women isn't known. "They may be diagnosed at an advanced stage," Prizment said. "They may have less access to health care. There could be a direct biological mechanism."

Her advice for women? "Maintain a healthy body weight is the only recommendation we can give for all postmenopausal women," she said.

Until the new study, findings about excess body size in colon cancer patients and risk of death have been mixed and conflicting, said Dr. Peter Campbell, director of the tumor repository for the American Cancer Society.

One strength of the new study, he said, is that "body size was measured before they had the diagnosis." Measuring after diagnosis may not give a true picture, he said, as weight loss can occur after the diagnosis.

"It's lifelong body size that's important [to know in gauging risk]," he said. "This study adds important new information to our understanding of body size and health."

He agreed with Prizment that the finding underscores the importance of maintaining a healthy body weight with age.

SOURCES: Anna E. Prizment, Ph.D., M.P.H., postdoctoral fellow, University of Minnesota Masonic Cancer Center, Minneapolis; Peter Campbell, Ph.D., director, tumor repository, American Cancer Society, Atlanta; September 2010 Cancer Epidemiology, Biomarkers & Prevention (Healthday)

Room Air Sometimes as Good as Oxygen Therapy

Oxygen therapy may be unnecessary for some terminally ill people who have trouble breathing, and could be replaced by treatment with ordinary room air, a new study suggests.

People who are near death often experience breathlessness, and the condition is common in terminally ill patients with conditions such as heart failure, lung cancer and chronic obstructive pulmonary disease, the study authors explained in the report published online Sept. 4 in The Lancet.

Oxygen therapy is normally used when people have low levels of oxygen in their bodies. But in terminally ill people, it's sometimes used even when their oxygen levels aren't dangerously low, Dr. Amy Abernethy, of Duke University Medical Center, and colleagues pointed out in a university news release.

In the study, the investigators randomly assigned terminally ill patients with breathlessness to receive treatment with oxygen or normal room air through prongs in the nose. The patients were told to take treatment for at least 15 hours a day. A total of 211 patients completed seven days of treatment.

The researchers found that there wasn't a statistically significant difference between the groups of patients in regards to breathlessness levels.

"Less burdensome strategies should be considered after brief assessment of the effect of oxygen therapy on the individual patient," the study authors concluded.

The study is valid and suggests the value of using room air instead of oxygen in some cases, Dr. R. Sean Morrison, director of the National Palliative Care Research Center at Mount Sinai School of Medicine in New York City, who was not involved with the study, said in an interview.

In addition to being expensive and often not covered by insurance, oxygen therapy "requires specialized equipment and can create anxiety about getting tanks refilled in time," Morrison said.

Still, he added, "we do know that in the setting of oxygen deficiency, oxygen is beneficial."

SOURCE: Duke University, news release, Sept. 3, 2010; R. Sean Morrison, M.D., director, National Palliative Care Research Center, Mount Sinai School of Medicine, New York City (Medline plus)

Tuesday, November 16, 2010

Sugary beverages and Gout

Women who drink fructose-rich beverages such as sugar-sweetened sodas and orange juice are at increased risk for gout, a new study finds.
The incidence of gout -- a painful type of inflammatory arthritis -- in the United States increased from 16 per 100,000 people in 1977 to 42 per 100,000 in 1996. That rise coincided with a large increase in soda and fructose consumption, the study authors noted.
Fructose-rich beverages can cause a buildup of uric acid in the blood, which leads to gout.
In this study, researchers analyzed data from 78,906 women who took part in the Nurses' Health Study between 1984 and 2006. The women had no history of gout at the start of the study.
Over the next 22 years, 778 of the women were diagnosed with gout. Compared with women who consumed less than one serving of sugar-sweetened soda per month, those who consumed one serving per day were 74 percent more likely to develop gout and those who consumed two or more servings per day had a 2.4 times higher risk.
In addition, the investigators found that compared with women who consumed less than a glass (six ounces) of orange juice per month, those who consumed one serving per day were 41 percent more likely to develop gout, and those who consumed two or more servings per day had a 2.4 times greater risk.
The study also found that women in the highest quintile (fifth) of fructose intake were 62 percent more likely to develop gout than those in the lowest quintile.
Doctors should be aware of the potential effect that fructose-rich beverages have on gout risk, said Dr. Hyon K. Choi, of Boston University School of Medicine, and colleagues.
The study, which was released online in advance of publication in the Nov. 24 print edition of the Journal of the American Medical Association, was presented this week at the American College of Rheumatology annual scientific meeting in Atlanta.
SOURCE: Journal of the American Medical Association, news release, Nov. 10, 2010

rapid testing tool for dimentia

-- In an effort to improve screening for dementia and mild cognitive impairment among seniors, a team of researchers has developed a test designed to spot problems in thinking, learning and memory skills in under three minutes.
Dubbed "The Sweet 16" for its 16-point scale, the test appears to quickly uncover telltale signs of dementia through a cognition ranking system that grades mental skills from a low of zero up to a high of 16.
The study team cautions that the test requires further scrutiny to establish its reliability, particularly as it compares to a well-established measure of cognitive impairment -- the Mini-Mental State Examination (MMSE) -- now currently in widespread use.
But if early positive results hold up, its creators hope that this new diagnostic tool will eventually boost the ability of physicians to identify the onset of dementia among older Americans.
"For many older adults, cognitive impairment contributes to loss of independence, decreased quality of life and increased health-care costs," the study authors, led by Dr. Tamara G. Fong, of Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, said in a news release.
"While the public health impact of cognitive impairment is clear, this condition is often under-recognized," the researchers added. "A simple, rapid cognitive assessment instrument is therefore a valuable tool for use in both clinical and research settings."
Fong and her team outline their new screening method online in the Archives of Internal Medicine.
The authors note that currently an estimated 3.4 million American seniors are diagnosed with dementia, while another 5.4 million are suffering from mild forms of cognitive impairment.
Fong and her team also point out that efforts to screen for either condition are imperfect under the MMSE, the current gold standard for dementia testing. That test has copyright controls that limit its availability, and the results it provides may be compromised by patients differing educational backgrounds, they noted.
To fashion an alternative screening mechanism, the authors first reviewed data collected from 774 patients who had been screened with the MMSE. Most of the results of that screening were further confirmed by two additional dementia/cognitive decline ranking systems.
Based on these analyses, the authors developed a series of questions focused on recall skills, verbal memory performance, and orientation issues such as the ability to identify a person, place, time and/or situation.
The final test was designed to be simple and fast. The screening involves no pencil or paper and can be completed in an average of two minutes.
When tried out, a score of 14 or less was found to detect 80 percent of cognitive impairment cases, compared with the 64 percent success score logged by the MMSE.
However, the MMSE outperformed the Sweet 16 with respect to correctly identifying patients with no cognitive impairment: 86 percent success vs. 70 percent, respectively.
Nevertheless, when compared with clinician assessments, Sweet 16 scores of 14 or less occurred in 99 percent of the patients diagnosed with cognitive impairment. Scores of 14 or less also occurred in 28 percent of people who were not diagnosed with cognitive impairment, suggesting a potentially high rate of false positives.
Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City, said that while better cognitive testing is needed, the jury is still out on whether or not the current innovation will fit the bill.
"Do we need something better than the MMSE?," he asked. "Absolutely. It's cumbersome to use. You need pencils and paper and props to administer it. And there are also a lot of difficulties with how to score it."
"And I would say that reading this description of the 'Sweet 16,' it sounds like it's much more easily administrated," Kennedy observed. "But still, I'm not convinced this is the answer to the problem. Because diagnosing cognitive impairment is not the same as diagnosing diabetes. It's much more complicated than that. People's cognition varies with life experience. It's not like simply testing for blood sugar levels. There isn't a single diagnostic marker."
SOURCE: Archives of Internal Medicine, November 8, 2010, news release; Gary J. Kennedy, M.D., director, geriatric psychiatry, Montefiore Medical Center, New York City

helping women through menopause- Positive thinking and planning

-- A positive attitude and a little preparation can help women deal with menopause, according to an expert.
Women should start preparing when they experience perimenopause, the stage before menopause. Perimenopause typically begins in the 40s, but can start as early as the 30s, according to Dr. Karen Deighan, chair of obstetrics/gynecology at Gottlieb Memorial Hospital, Loyola University Health System.
"I give my perimenopausal patients a pep talk so they don't get down on themselves," she said in a Loyola news release. "I tell them that they shouldn't just let this transition happen. Women can be proactive about their health and take steps to minimize the side effects of menopause before it occurs."
Deighan offered the following tips:
·         Start exercising in order to prevent the 5- to 10-pound weight gain typical of menopause. Fluctuations in hormones can contribute to this weight gain. It's more difficult to prevent or lose those extra pounds if you wait until menopause to begin an exercise program.
·         Begin pelvic-floor-strengthening exercises such as kegels. Proper kegel exercises contract the pelvic-floor muscles, not the abdomen, thighs or buttocks.
·         Do weight-bearing exercises to keep bones strong and reduce the risk of fractures.
·         Challenge your brain with memory exercises and crosswords and other types of word puzzles -- it may help lower the risk of memory loss during menopause.
·         Develop and maintain good sleep habits in order to counter potential sleep problems caused by dips in estrogen levels.
·         Try to get enough sleep -- lack of sleep in itself can contribute to mental fogginess and lower libido, which are often associated with menopause.
·         Consider estrogen suppositories to help treat vaginal dryness. Regular intercourse also improves sex drive and increases lubrication.
·         Get your recommended annual tests, including checks of blood glucose, cholesterol, vitamin D and calcium levels, as well as mammograms and pelvic exams. The results of a colonoscopy at age 50 will determine the frequency of future colonoscopies.
·         Don't neglect your teeth -- brush twice a day and floss daily to help prevent gum disease, which can affect your cardiovascular health.
·         Eat a diet rich in leafy greens and healthy fats such as salmon, avocado and olive oil in order to keep hair and skin healthy. Limit consumption of processed foods.
·         Premenopausal women should consume 1,000 to 1,200 milligrams of calcium daily (experts recommend taking the calcium in two to three smaller doses), and postmenopausal women should take 1,500 mg of calcium in 500 mg doses with magnesium and vitamin D for maximum absorption.
·         Hormone therapy should not be used by women at risk for breast cancer, blood clots or heart disease.
SOURCE: Loyola University Health System, news release, Nov. 3, 2010

pregnancy after 45- Unsafe for both mother and child

For the few women who manage to get pregnant after age 45, both they and their babies have a higher risk of complications, Israeli researchers have found.
For instance, they are about three times more likely than younger women to experience diabetes and high blood pressure during their pregnancies, the researchers report in the American Journal of Obstetrics & Gynecology.
Older women also have higher rates of preterm births and placenta previa, in which the placenta blocks the opening to the birth canal.
"Increasing age leads to less (healthy) individuals, and less healthy individuals do have higher pregnancy risks," Dr. Maximilian Franz of the Medical University of Vienna, who did not participate in the study, told Reuters Health.
More women are delaying pregnancy today, causing experts to question whether there are any consequences to mother or child. Some studies have suggested older mothers fare worse, but others have found no differences. Still, most of the research has focused on women 35 and older, not those over 40.
To better understand the risks involved in such pregnancies, Dr. Yariv Yogev and colleagues at Tel Aviv University looked at how women of varying ages fared while giving birth at a local hospital between 2000 and 2008.
Among nearly 80,000 women who gave birth during that time, only 177 (0.2 percent) were 45 or older.
The majority of older women conceived using donor eggs, and 80 percent delivered their babies by Cesarean section -- more than twice the overall rate.
Comparing older mothers to those 44 and younger, the researchers found that 17 percent and six percent were diabetic during their pregnancies, respectively.
Nine percent of older mothers had high blood pressure while pregnant, a condition that affected less than three percent of mothers overall. Placenta previa occurred in nearly six percent, or about six times the overall rate.
Advanced age also appeared to shorten pregnancies. More than one in five of the older mothers delivered their babies at less than 37 weeks' pregnancy (a normal pregnancy lasts 40 weeks), compared to only one in 10 of all the women.
Older mothers were more likely to experience fever and severe bleeding after birth. On average, they and their newborns needed longer hospital stays, and the babies more often landed in the intensive care unit. Some four percent of the newborns had metabolic problems such as low blood sugar, versus less than two percent of babies born to mothers of all ages.
For the 27 women who delivered at 50 years or older, the risks of complications and preterm birth were even higher.
In an e-mail, Franz said it may not always be women's age per se that's the problem, but rather that the older people get, the more likely they are to have underlying diseases that can complicate pregnancy.
Many women used assisted reproductive technology, such as donor eggs, which can also carry risks, Franz noted. But since egg donors are typically young women, those pregnancies may actually be healthier than if women used their own eggs, which likely have more genetic abnormalities, he added.
The high cesarean rate among older mothers likely has several explanations, Franz said. There's the desire for a safe birth, as well as the higher rate of premature births and breech births, for example.
But previous research has also shown that older women may be more at risk of problems with the muscles of their uterus, suggesting the increased risk of cesarean delivery "is likely to have a biological basis."

bracing helps reduce pain in osteoarthritis

Wearing a brace can help people with osteoarthritis better manage their pain, the Arthritis Foundation says.
The foundation mentions these possible benefits of bracing, which can improve pain and mobility:
·         Improve stability in weakened joints.
·         Improve distribution of weight and joint alignment.
·         Improve joint function.
·         Improve a person's risk of falling, providing an increased feeling of security.

cholesterol and dimentia

For years, doctors have been saying that keeping your cholesterol levels in check as you age is good for your brain as well as your heart, but a new study suggests the connection between cholesterol and dementia later in life isn't quite so clear-cut.

After more than 1,400 Swedish women followed for 32 years, Johns Hopkins researchers found that those with high cholesterol at mid-life were at no greater risk of developing Alzheimer's and other types of dementia than women with lower levels. In addition, the women whose cholesterol levels decreased the most from middle to older age were 2.5 times more likely to develop dementia than those whose levels increased or stayed the same.

Both cell and animal studies have suggested that high cholesterol contributes to Alzheimer's disease, the researchers noted, but they stressed that the relationship between cholesterol and dementia may vary over a lifetime.

"Our findings highlight how risk factors can change over the course of a person's life span," said Michelle M. Mielke, an assistant professor of psychiatry at Hopkins and lead author of the study, which was published online Nov. 10 in the journal Neurology.

"My biggest worry is that people will look at these results and decide that cholesterol doesn't matter, but that's not what we're saying," Mielke added. "We know that high cholesterol is a very strong risk factor for cardiovascular disease and still needs to be treated with diet, exercise and possibly medication."

Mielke added that it was unclear why a decline in cholesterol levels in old age was linked to a higher risk of dementia, but said it might be an early part of the disease process. "As people start to develop symptoms, they often forget to eat and start losing weight, and that may be why their cholesterol goes down."

For the study, Mielke and her colleagues examined data from the Prospective Population Study of Women, which began in 1968 and consisted of 1,462 Swedish women between the ages of 38 and 60. The women were given follow-up exams at four intervals, the last of which occurred in 2001. In addition to receiving various heart tests, chest X-rays and blood tests, the women were also assessed for dementia at each exam.

In 2001, 161 of the original group had been diagnosed with Alzheimer's or other forms of dementia. While there was no association between dementia and high cholesterol levels at mid-life when including all participants, the researchers did find that the risk of dementia increased from 8.9 percent for those who maintained or had increased cholesterol over the course of the study, while it increased 17.5 percent for people with the greatest decline in cholesterol.

The study teased out findings that echoed other studies: When including the baseline cholesterol levels of only the female participants who survived to old age, "there was a clear trend for high cholesterol to be associated with an increased risk of [Alzheimer's disease]," the researchers reported. Although women with the highest cholesterol levels showed a sixfold increase in risk for Alzheimer's disease compared to those with the lowest, researchers said that trend became statistically insignificant after adjusting for other variables.

Researchers also noted that their research was confined to Swedish women and might not be applicable to men and other ethnicities.

A leading dementia researcher praised the paper's design but had reservations about the findings. "This is a good study because one needs to take a life course trajectory when looking at these kinds of issues," said Lenore J. Launer, chief of the neuroepidemiology section at the National Institute on Aging. "But I think the results are a little bit inconclusive, mainly because of the small sample size."

Launer added that more studies are needed to "better understand how to interpret levels of plasma cholesterol in relation to what's going on in the brain."

In an editorial accompanying the paper, author Mary N. Haan said the findings suggest the need for different prevention strategies, depending on a person's life stage.

"Effective primary prevention of dementia may need to address early and midlife risk factors while, in late life, 'prevention' may necessarily focus on delaying progression of pathology and symptoms," noted Haan, who is a professor of epidemiology at the University of California, San Francisco School of Medicine.

"There a lot of interest right now in trying to prevent dementia, especially Alzheimer's, mainly because none of the treatments work very well," said Haan, who added that one important take-home message for middle-aged and younger people who want to reduce their risk of dementia is to focus on other known risk factors.

"For example, there's a relatively strong and consistent set of evidence linking hypertension with late-life dementia," she said. "So if someone is 45 or 50, and hasn't been screened for hypertension in a while, it's a good idea to do so."

source- healthday