30 Mayıs 2012 Çarşamba
Pediatricians and Schools Partnering in Media Education for Children
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This year the American Academy of Pediatrics (AAP) have made “Children and the Media” one of its new strategic priorities. Our journal has published a host of studies on the effects of media — both good and bad — on children, which has helped the AAP as it turns attention to this topic. In addition to educating families about the media in our offices, we can advocate for homes and local schools to take a hard look at whether their media curriculum is being directed to better educate children and teens about the adverse — as well as beneficial — effects of media in shaping who they are and what they do with their lives. To help us think more about how pediatricians might partner with our school educators, Dr. Victor Strasburger, a national expert on the influence of media on children and teens, shares his thoughts in a commentary (doi: 10.1542/peds.2011-3213) this week. He challenges all of us to do more in regard to raising media awareness in our patients and families, and to join up with the schools in our community. If you haven’t thought about your role in raising media awareness in your community, this commentary will channel new energy into your efforts to do so. Read it instead of watching television, texting, or playing your favorite electronic game, and your patients will benefit as a result.
Vitamin D Deficiency as well as Thyroid Disease
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Vitamin D is definitely an important vitamin that not just regulates calcium, but additionally has many additional
beneficial actions. Very few endocrinologists realize this particular, but several content articles published
over two decades ago showed which patients with hypothyroidism possess low levels associated with vitamin D.
This can lead to some of the actual bone problems associated with hypothyroidism. It had been thought that
1 of 2 mechanisms may explain the reduced levels of vitamin D within patients with
hypothyroidism, 1) the reduced levels of vitamin D might be due to bad absorption of vitamin D
in the intestine or 2) the body might not activate vitamin D correctly. Other articles possess
demonstrated that sufferers with Graves disease also provide low levels associated with Vitamin D.
Importantly, each vitamin D and thyroid hormone hole to similar receptors known as steroid
hormone receptors. Another gene in the actual Vitamin D receptor was proven to predispose
people in order to autoimmune thyroid illness including Graves’ illness and Hashimoto’s
thyroiditis. Therefore, it is essential for patients with thyroid difficulties to
understand the way the vitamin D system functions.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
beneficial actions. Very few endocrinologists realize this particular, but several content articles published
over two decades ago showed which patients with hypothyroidism possess low levels associated with vitamin D.
This can lead to some of the actual bone problems associated with hypothyroidism. It had been thought that
1 of 2 mechanisms may explain the reduced levels of vitamin D within patients with
hypothyroidism, 1) the reduced levels of vitamin D might be due to bad absorption of vitamin D
in the intestine or 2) the body might not activate vitamin D correctly. Other articles possess
demonstrated that sufferers with Graves disease also provide low levels associated with Vitamin D.
Importantly, each vitamin D and thyroid hormone hole to similar receptors known as steroid
hormone receptors. Another gene in the actual Vitamin D receptor was proven to predispose
people in order to autoimmune thyroid illness including Graves’ illness and Hashimoto’s
thyroiditis. Therefore, it is essential for patients with thyroid difficulties to
understand the way the vitamin D system functions.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
Sources of Vitamin D
To contact us Click HERE
Vitamin D is actually two different substances, cholecalciferol (vitamin D2), discovered mainly in
vegetation and ergocalciferol (vitamin D3), discovered mainly in creatures. Both of these types of hormones
are collectively known as vitamin D, and they are able to either be acquired in two methods. One
is by exposure from the skin to the actual ultraviolet (UV) sun rays of sunlight or even also from nutritional intake.
Vitamin D is located naturally in seafood (such as fish and sardines) as well as fish oils, ova and
cod lean meats oil. However most Vitamin D is from foods fortified along with Vitamin D,
especially whole milk and orange liquid. Interestingly, as breast feeding is becoming more popular,
the actual incidence of Vitamin D deficiency offers increased as much less fortified milk is actually consumed.
Vitamin D deficiency could also occur in sufferers with malabsorption using their intestine,
such as with the autoimmune illness called Celiac Illness, which occurs often in
patients along with thyroid problems. Multi-vitamins also contain Vitamin D, because does some
calcium supplements such as Oscal-D and Citracal in addition D.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
vegetation and ergocalciferol (vitamin D3), discovered mainly in creatures. Both of these types of hormones
are collectively known as vitamin D, and they are able to either be acquired in two methods. One
is by exposure from the skin to the actual ultraviolet (UV) sun rays of sunlight or even also from nutritional intake.
Vitamin D is located naturally in seafood (such as fish and sardines) as well as fish oils, ova and
cod lean meats oil. However most Vitamin D is from foods fortified along with Vitamin D,
especially whole milk and orange liquid. Interestingly, as breast feeding is becoming more popular,
the actual incidence of Vitamin D deficiency offers increased as much less fortified milk is actually consumed.
Vitamin D deficiency could also occur in sufferers with malabsorption using their intestine,
such as with the autoimmune illness called Celiac Illness, which occurs often in
patients along with thyroid problems. Multi-vitamins also contain Vitamin D, because does some
calcium supplements such as Oscal-D and Citracal in addition D.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
Different Types of Vitamin D and How you can Diagnose Vitamin D
To contact us Click HERE
Vitamin D itself is actually inactive and must get converted towards the liver to 25-hydroxy vitamin D
(25-OH vitamin D) after which in the kidney to at least one, 25-hydroxy vitamin D. It's only the 1, 25-
OH vitamin D that is biologically active. This type of vitamin D acts to permit for
absorption of calcium in the intestinal tract. Consequently, patients with reduced vitamin D
levels may have low calcium as well as in severe instances get rickets (in children) or even osteomalacia (in
adults) that is when the bone fragments bows out and it is poorly formed. Within mild cases associated with vitamin D
deficiency, brittle bones occurs.
The conversion in the 25-OH vitamin D towards the 1, 25-OH vitamin D occurring in the
kidney is actually catalyzed by parathyroid hormone, also known as PTH. Therefore, sufferers with low
vitamin D levels may have relatively high PTH levels together with low calcium levels. This really is
similar to sufferers with primary hypothyroidism getting elevated TSH levels with
normal thyroid hormone levels. Furthermore, the 25-OH vitamin D form that is the
storage form and it is much more abundant how the 1, 25-OH vitamin D type which, although
is actually active, is much less abundant. Therefore, within states of vitamin D deficiency, reduced levels of 25-OH
vitamin D are simply, but the 1, 25-OH vitamin D levels tend to be either normal or even actually slightly
higher. They are slightly high since the excess PTH that's stimulated by the reduced 25-OH
vitamin D levels encourages the conversion as much as 25-OH vitamin D towards the 1, 25-OH vitamin
DEB. Thus, patients which are vitamin D deficient will often have a low 25-OH vitamin D degree, a
high PTH degree, a low regular calcium, and an ordinary or an raised 1, 25-OH vitamin D
degree.
Dr. Friedman generally recommends measuring PTH, calcium, as well as 25-OH vitamin D in order to
determine if someone does have vitamin D deficiency. The 25-OH vitamin D assay includes a
normal range of around 20-60 ng/dL. Nevertheless, this range might be too low for a lot of
patients. Additionally, the assay might not be that good at measuring the reduced levels of
vitamin D. Generally, Dr. Friedman would suggest treatment of patients which have a 25-
OH vitamin D of under 30 ng/dL, but these patients must have a PTH within the high
normal variety. Optimal levels associated with 25-OH Vitamin D with regard to patients with thyroid illnesses are
probably 35-60 ng/dL It's unclear how to proceed with a patient having a PTH in the actual high normal
range along with a completely normal 25-OH vitamin D level or another way around with regard to patients
with a minimal 25-OH vitamin D level but a totally normal PTH degree.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
(25-OH vitamin D) after which in the kidney to at least one, 25-hydroxy vitamin D. It's only the 1, 25-
OH vitamin D that is biologically active. This type of vitamin D acts to permit for
absorption of calcium in the intestinal tract. Consequently, patients with reduced vitamin D
levels may have low calcium as well as in severe instances get rickets (in children) or even osteomalacia (in
adults) that is when the bone fragments bows out and it is poorly formed. Within mild cases associated with vitamin D
deficiency, brittle bones occurs.
The conversion in the 25-OH vitamin D towards the 1, 25-OH vitamin D occurring in the
kidney is actually catalyzed by parathyroid hormone, also known as PTH. Therefore, sufferers with low
vitamin D levels may have relatively high PTH levels together with low calcium levels. This really is
similar to sufferers with primary hypothyroidism getting elevated TSH levels with
normal thyroid hormone levels. Furthermore, the 25-OH vitamin D form that is the
storage form and it is much more abundant how the 1, 25-OH vitamin D type which, although
is actually active, is much less abundant. Therefore, within states of vitamin D deficiency, reduced levels of 25-OH
vitamin D are simply, but the 1, 25-OH vitamin D levels tend to be either normal or even actually slightly
higher. They are slightly high since the excess PTH that's stimulated by the reduced 25-OH
vitamin D levels encourages the conversion as much as 25-OH vitamin D towards the 1, 25-OH vitamin
DEB. Thus, patients which are vitamin D deficient will often have a low 25-OH vitamin D degree, a
high PTH degree, a low regular calcium, and an ordinary or an raised 1, 25-OH vitamin D
degree.
Dr. Friedman generally recommends measuring PTH, calcium, as well as 25-OH vitamin D in order to
determine if someone does have vitamin D deficiency. The 25-OH vitamin D assay includes a
normal range of around 20-60 ng/dL. Nevertheless, this range might be too low for a lot of
patients. Additionally, the assay might not be that good at measuring the reduced levels of
vitamin D. Generally, Dr. Friedman would suggest treatment of patients which have a 25-
OH vitamin D of under 30 ng/dL, but these patients must have a PTH within the high
normal variety. Optimal levels associated with 25-OH Vitamin D with regard to patients with thyroid illnesses are
probably 35-60 ng/dL It's unclear how to proceed with a patient having a PTH in the actual high normal
range along with a completely normal 25-OH vitamin D level or another way around with regard to patients
with a minimal 25-OH vitamin D level but a totally normal PTH degree.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
Treatment of Vitamin D Deficiency
To contact us Click HERE
There are many ways to correct for that depletion of vitamin D, as well as these would include
either increasing sunlight publicity or increasing nutritional intake. In common, Dr. Friedman
feels there's an ongoing fight between endocrinologists as well as dermatologists about sunlight
publicity, and mild sunlight exposure probably doesn't have that much of the increased risk
of skin cancer yet will be helpful to avoid vitamin D deficiency. Because in our busy
schedule, a lot of us do not go outside throughout the day much and the sunlight exposure is actually
minimal. Blacks along with other dark skinned sufferers absorb less Vitamin D as well as need more
sunlight publicity. Dr. Friedman recommends someone to come in contact with the sun with regard to 15-30
minutes each day, especially in the actual morning, to proper for vitamin D deficiency. Nevertheless, in
northern latitudes, little light from the proper wavelength experiences the atmosphere within the
winter, so this exposure must occur in the actual spring and summer where time stores associated with
vitamin D are developed. The body has mechanisms to ensure that too much vitamin D cannot be
synthesized by extented sun exposure. An alternative is to visit a tanning beauty salon for
approximately 3 times. Another alternative with regard to replacing mild vitamin D deficiency would be to
take two multivitamins each day. Each multivitamin consists of 400 international models of vitamin
D so an overall total of 800 worldwide units of vitamin D may correct mild instances of low vitamin D
levels. For worse levels, the patient may take 50, 000 worldwide units of vitamin D
orally a couple of times a week. This must be given by the prescription. If laser hair removal
regimen is utilized, the patient must be monitored carefully along with calcium and 25-OH
vitamin D levels to ensure the patient isn't over replaced along with vitamin D. The individual
may need this degree of treatment for approximately 3 months and should end up being checked
monthly. The primary side effect associated with vitamin D therapy is overtreatment resulting in
hypercalcemia.
Patients with kidney difficulties cannot convert vitamin D towards the active 1, 25-OH vitamin D
levels and have to take calcitriol that is 1, 25-OH vitamin D. Furthermore, patients with
hypoparathyroidism are often placed on the calcitriol too.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
either increasing sunlight publicity or increasing nutritional intake. In common, Dr. Friedman
feels there's an ongoing fight between endocrinologists as well as dermatologists about sunlight
publicity, and mild sunlight exposure probably doesn't have that much of the increased risk
of skin cancer yet will be helpful to avoid vitamin D deficiency. Because in our busy
schedule, a lot of us do not go outside throughout the day much and the sunlight exposure is actually
minimal. Blacks along with other dark skinned sufferers absorb less Vitamin D as well as need more
sunlight publicity. Dr. Friedman recommends someone to come in contact with the sun with regard to 15-30
minutes each day, especially in the actual morning, to proper for vitamin D deficiency. Nevertheless, in
northern latitudes, little light from the proper wavelength experiences the atmosphere within the
winter, so this exposure must occur in the actual spring and summer where time stores associated with
vitamin D are developed. The body has mechanisms to ensure that too much vitamin D cannot be
synthesized by extented sun exposure. An alternative is to visit a tanning beauty salon for
approximately 3 times. Another alternative with regard to replacing mild vitamin D deficiency would be to
take two multivitamins each day. Each multivitamin consists of 400 international models of vitamin
D so an overall total of 800 worldwide units of vitamin D may correct mild instances of low vitamin D
levels. For worse levels, the patient may take 50, 000 worldwide units of vitamin D
orally a couple of times a week. This must be given by the prescription. If laser hair removal
regimen is utilized, the patient must be monitored carefully along with calcium and 25-OH
vitamin D levels to ensure the patient isn't over replaced along with vitamin D. The individual
may need this degree of treatment for approximately 3 months and should end up being checked
monthly. The primary side effect associated with vitamin D therapy is overtreatment resulting in
hypercalcemia.
Patients with kidney difficulties cannot convert vitamin D towards the active 1, 25-OH vitamin D
levels and have to take calcitriol that is 1, 25-OH vitamin D. Furthermore, patients with
hypoparathyroidism are often placed on the calcitriol too.
>> CLICK HERE FOR IMPORTANT INFORMATION <<
26 Mayıs 2012 Cumartesi
Jon's Health Tips - Latest health Research
To contact us Click HERE
I'm temporarily (I hope) off fiber:
Higher Intake of Fiber = Reduced Risk of Death
I'm temporarily (I hope) off my new found coffee habit:
Coffee drinkers have lower risk of death
I need to quit late-night snacking:
When you eat matters, not just what you eat
I quit taking each of these some time ago:
Dietary supplements increase cancer risk
I'm temporarily (I hope) off fish oil:
Why omega-3 oils help at the cellular level
I need to cut back on desserts:
Sugar makes you stupid
This isn't going to happen, but I will stay under 60%:
Waist Less Than Half Of Height Helps You Live Longer
A new supplement to add to my regimen? Maybe.
Rutin prevents the formation of blood clots
I need to check the ingredients in my sunscreen:
Sunscreen Ingredient May Increase Skin Cancer Risk
MY HDL is low, but trying to raise it may not be wise after all:
Some HDL, or 'good' cholesterol, may not protect against heart disease
I'm still taking Vitamin D:
Oral Vitamin D Supplements Fight Prostate Cancer
Higher Intake of Fiber = Reduced Risk of Death
Dietary fiber is defined as ingestible parts of a plant and can be found in foods such as grains, fruits and vegetables. Research has shown dietary fiber lowers the risk of cardiovascular diseases (CVD) and diabetes and even some cancers but the benefits of fiber do not stop here. Results from the NIH-AARP Diet and Health Study have shown that men and women consuming the most dietary fiber were 22% less likely to die from any cause compared to those consuming the least dietary fiber. Also, people with higher dietary fiber intake were less likely to die of CVD and infectious or respiratory diseases.
The USDA Dietary Guidelines for Americans recommends consuming 14g/1000 calories of dietary fiber per day and encourages people to eat more fruits, vegetables, beans, whole grains, and other foods with naturally occurring fiber to meet the recommendation.
I'm temporarily (I hope) off my new found coffee habit:
Coffee drinkers have lower risk of death
Older adults who drank coffee -- caffeinated or decaffeinated -- had a lower risk of death overall than others who did not drink coffee, according a study by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, and AARP.
Coffee drinkers were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, although the association was not seen for cancer. These results from a large study of older adults were observed after adjustment for the effects of other risk factors on mortality, such as smoking and alcohol consumption. Researchers caution, however, that they can’t be sure whether these associations mean that drinking coffee actually makes people live longer.
The researchers found that the association between coffee and reduction in risk of death increased with the amount of coffee consumed. Relative to men and women who did not drink coffee, those who consumed three or more cups of coffee per day had approximately a 10 percent lower risk of death.
I need to quit late-night snacking:
When you eat matters, not just what you eat
"Every organ has a clock." That means there are times that our livers, intestines, muscles, and other organs will work at peak efficiency and other times when they are—more or less—sleeping.
Those metabolic cycles are critical for processes from cholesterol breakdown to glucose production, and they should be primed to turn on when we eat and back off when we don't, or vice versa. When people eat frequently throughout the day and night, it can throw off those normal metabolic cycles
I quit taking each of these some time ago:
Dietary supplements increase cancer risk
Beta-carotene, selenium and folic acid – taken up to three times their recommended daily allowance, these supplements are probably harmless. But taken at much higher levels as some supplement manufacturers suggest, these three supplements have now been proven to increase the risk of developing a host of cancers.
I'm temporarily (I hope) off fish oil:
Why omega-3 oils help at the cellular level
For the first time, researchers at the University of California, San Diego have peered inside a living mouse cell and mapped the processes that power the celebrated health benefits of omega-3 fatty acids. More profoundly, they say their findings suggest it may be possible to manipulate these processes to short-circuit inflammation before it begins, or at least help to resolve inflammation before it becomes detrimental.
The therapeutic benefits of omega-3 fatty acids, which are abundant in certain fish oils, have long been known, dating back to at least the 1950s, when cod liver oil was found to be effective in treating ailments like eczema and arthritis. In the 1980s, scientists reported that Eskimos eating a fish-rich diet enjoyed better coronary health than counterparts consuming mainland foods.
"There have been tons of epidemiological studies linking health benefits to omega-3 oils, but not a lot of deep science," said Edward A. Dennis, PhD, distinguished professor of pharmacology, chemistry and biochemistry. "This is the first comprehensive study of what fish oils actually do inside a cell."
I need to cut back on desserts:
Sugar makes you stupid
Binging on soda and sweets for as little as six weeks may make you stupid. Eating a high-fructose diet over the long term alters your brain's ability to learn and remember information. But adding omega-3 fatty acids to your meals can help minimize the damage. We're not talking about naturally occurring fructose in fruits, which also contain important antioxidants,. We're concerned about high-fructose corn syrup that is added to manufactured food products as a sweetener and preservative.
This isn't going to happen, but I will stay under 60%:
Waist Less Than Half Of Height Helps You Live Longer
A new study reveals that waist-to-height ratio (WHtR) is a significantly better predictor of cardiometabolic risk than waist circumference (WC) and body-mass index (BMI). In other words, "Keep your waist circumference to less than half of your height." According to Ashwell, if a second level of increased risk is needed, keep your waist to below 60% of height (0.6).
A new supplement to add to my regimen? Maybe.
Rutin prevents the formation of blood clots
A compound called rutin, commonly found in fruits and vegetables and sold over the counter as a dietary supplement, has been shown to inhibit the formation of blood clots in an animal model of thrombosis.
"It's not always fully appreciated that the majority of Americans will die as the result of a blood clot in either their heart or their brain. Approximately half of all morbidity and mortality in the United States can be attributed to heart attack or stroke."
I need to check the ingredients in my sunscreen:
Sunscreen Ingredient May Increase Skin Cancer Risk
When exposed to sunlight, zinc oxide, a common ingredient in sunscreens, undergoes a chemical reaction that may release unstable molecules known as free radicals. Free radicals seek to bond with other molecules, but in the process, they can damage cells or the DNA contained within those cells. This in turn could increase the risk of skin cancer. The longer zinc oxide is exposed to sunlight, the greater the potential damage to human cells.
MY HDL is low, but trying to raise it may not be wise after all:
Some HDL, or 'good' cholesterol, may not protect against heart disease
A new study by Harvard School of Public Health (HSPH) researchers has found that a subclass of high-density lipoprotein (HDL) cholesterol, the so-called "good" cholesterol, may not protect against coronary heart disease (CHD) and in fact may be harmful.
I'm still taking Vitamin D:
Oral Vitamin D Supplements Fight Prostate Cancer
With fat: What's good or bad for the heart, may be the same for the brain
To contact us Click HERE
It has been known for years that eating too many foods containing "bad" fats, such as saturated fats or trans fats, isn't healthy for your heart. However, according to new research from Brigham and Women's Hospital (BWH), one "bad" fat—saturated fat—was found to be associated with worse overall cognitive function and memory in women over time. By contrast, a "good" fat—mono-unsaturated fat was associated with better overall cognitive function and memory.
This study is published online by Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, on May 18, 2012.
The research team analyzed data from the Women's Health Study—originally a cohort of nearly 40,000 women, 45 years and older. The researchers focused on data from a subset of 6,000 women, all over the age of 65. The women participated in three cognitive function tests, which were spaced out every two years for an average testing span of four years. These women filled out very detailed food frequency surveys at the start of the Women's Health Study, prior to the cognitive testing.
"When looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did," explained Olivia Okereke, MD, MS, BWH Department of Psychiatry.
Women who consumed the highest amounts of saturated fat, which can come from animal fats such as red meat and butter, compared to those who consumed the lowest amounts, had worse overall cognition and memory over the four years of testing. Women who ate the most of the monounsaturated fats, which can be found in olive oil, had better patterns of cognitive scores over time.
"Our findings have significant public health implications," said Okereke. "Substituting in the good fat in place of the bad fat is a fairly simple dietary modification that could help prevent decline in memory."
Okereke notes that strategies to prevent cognitive decline in older people are particularly important. Even subtle declines in cognitive functioning can lead to higher risk of developing more serious problems, like dementia and Alzheimer disease.
It has been known for years that eating too many foods containing "bad" fats, such as saturated fats or trans fats, isn't healthy for your heart. However, according to new research from Brigham and Women's Hospital (BWH), one "bad" fat—saturated fat—was found to be associated with worse overall cognitive function and memory in women over time. By contrast, a "good" fat—mono-unsaturated fat was associated with better overall cognitive function and memory.
This study is published online by Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, on May 18, 2012.
The research team analyzed data from the Women's Health Study—originally a cohort of nearly 40,000 women, 45 years and older. The researchers focused on data from a subset of 6,000 women, all over the age of 65. The women participated in three cognitive function tests, which were spaced out every two years for an average testing span of four years. These women filled out very detailed food frequency surveys at the start of the Women's Health Study, prior to the cognitive testing.
"When looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did," explained Olivia Okereke, MD, MS, BWH Department of Psychiatry.
Women who consumed the highest amounts of saturated fat, which can come from animal fats such as red meat and butter, compared to those who consumed the lowest amounts, had worse overall cognition and memory over the four years of testing. Women who ate the most of the monounsaturated fats, which can be found in olive oil, had better patterns of cognitive scores over time.
"Our findings have significant public health implications," said Okereke. "Substituting in the good fat in place of the bad fat is a fairly simple dietary modification that could help prevent decline in memory."
Okereke notes that strategies to prevent cognitive decline in older people are particularly important. Even subtle declines in cognitive functioning can lead to higher risk of developing more serious problems, like dementia and Alzheimer disease.
How Exercise Affects the Brain: Age and Genetics Play a Role
To contact us Click HERE
Exercise clears the mind. It gets the blood pumping and more oxygen is delivered to the brain. This is familiar territory, but Dartmouth's David Bucci thinks there is much more going on.
"In the last several years there have been data suggesting that neurobiological changes are happening -- [there are] very brain-specific mechanisms at work here," says Bucci, an associate professor in the Department of Psychological and Brain Sciences.
From his studies, Bucci and his collaborators have revealed important new findings:
* The effects of exercise are different on memory as well as on the brain, depending on whether the exerciser is an adolescent or an adult.
* A gene has been identified which seems to mediate the degree to which exercise has a beneficial effect. This has implications for the potential use of exercise as an intervention for mental illness.
Bucci began his pursuit of the link between exercise and memory with attention deficit hyperactivity disorder (ADHD), one of the most common childhood psychological disorders. Bucci is concerned that the treatment of choice seems to be medication.
"The notion of pumping children full of psycho-stimulants at an early age is troublesome," Bucci cautions. "We frankly don't know the long-term effects of administering drugs at an early age -- drugs that affect the brain -- so looking for alternative therapies is clearly important."
Anecdotal evidence from colleagues at the University of Vermont started Bucci down the track of ADHD. Based on observations of ADHD children in Vermont summer camps, athletes or team sports players were found to respond better to behavioral interventions than more sedentary children. While systematic empirical data is lacking, this association of exercise with a reduction of characteristic ADHD behaviors was persuasive enough for Bucci.
Coupled with his interest in learning and memory and their underlying brain functions, Bucci and teams of graduate and undergraduate students embarked upon a project of scientific inquiry, investigating the potential connection between exercise and brain function. They published papers documenting their results, with the most recent now available in the online version of the journal Neuroscience.
Bucci is quick to point out that "the teams of both graduate and undergraduates are responsible for all this work, certainly not just me." Michael Hopkins, a graduate student at the time, is first author on the papers.
Early on, laboratory rats that exhibit ADHD-like behavior demonstrated that exercise was able to reduce the extent of these behaviors. The researchers also found that exercise was more beneficial for female rats than males, similar to how it differentially affects male and female children with ADHD.
Moving forward, they investigated a mechanism through which exercise seems to improve learning and memory. This is "brain derived neurotrophic factor" (BDNF) and it is involved in growth of the developing brain. The degree of BDNF expression in exercising rats correlated positively with improved memory, and exercising as an adolescent had longer lasting effects compared to the same duration of exercise, but done as an adult.
"The implication is that exercising during development, as your brain is growing, is changing the brain in concert with normal developmental changes, resulting in your having more permanent wiring of the brain in support of things like learning and memory," says Bucci. "It seems important to [exercise] early in life."
Bucci's latest paper was a move to take the studies of exercise and memory in rats and apply them to humans. The subjects in this new study were Dartmouth undergraduates and individuals recruited from the Hanover community.
Bucci says that, "the really interesting finding was that, depending on the person's genotype for that trophic factor [BDNF], they either did or did not reap the benefits of exercise on learning and memory. This could mean that you may be able to predict which ADHD child, if we genotype them and look at their DNA, would respond to exercise as a treatment and which ones wouldn't."
Bucci concludes that the notion that exercise is good for health including mental health is not a huge surprise. "The interesting question in terms of mental health and cognitive function is how exercise affects mental function and the brain." This is the question Bucci, his colleagues, and students continue to pursue.
Exercise clears the mind. It gets the blood pumping and more oxygen is delivered to the brain. This is familiar territory, but Dartmouth's David Bucci thinks there is much more going on.
"In the last several years there have been data suggesting that neurobiological changes are happening -- [there are] very brain-specific mechanisms at work here," says Bucci, an associate professor in the Department of Psychological and Brain Sciences.
From his studies, Bucci and his collaborators have revealed important new findings:
* The effects of exercise are different on memory as well as on the brain, depending on whether the exerciser is an adolescent or an adult.
* A gene has been identified which seems to mediate the degree to which exercise has a beneficial effect. This has implications for the potential use of exercise as an intervention for mental illness.
Bucci began his pursuit of the link between exercise and memory with attention deficit hyperactivity disorder (ADHD), one of the most common childhood psychological disorders. Bucci is concerned that the treatment of choice seems to be medication.
"The notion of pumping children full of psycho-stimulants at an early age is troublesome," Bucci cautions. "We frankly don't know the long-term effects of administering drugs at an early age -- drugs that affect the brain -- so looking for alternative therapies is clearly important."
Anecdotal evidence from colleagues at the University of Vermont started Bucci down the track of ADHD. Based on observations of ADHD children in Vermont summer camps, athletes or team sports players were found to respond better to behavioral interventions than more sedentary children. While systematic empirical data is lacking, this association of exercise with a reduction of characteristic ADHD behaviors was persuasive enough for Bucci.
Coupled with his interest in learning and memory and their underlying brain functions, Bucci and teams of graduate and undergraduate students embarked upon a project of scientific inquiry, investigating the potential connection between exercise and brain function. They published papers documenting their results, with the most recent now available in the online version of the journal Neuroscience.
Bucci is quick to point out that "the teams of both graduate and undergraduates are responsible for all this work, certainly not just me." Michael Hopkins, a graduate student at the time, is first author on the papers.
Early on, laboratory rats that exhibit ADHD-like behavior demonstrated that exercise was able to reduce the extent of these behaviors. The researchers also found that exercise was more beneficial for female rats than males, similar to how it differentially affects male and female children with ADHD.
Moving forward, they investigated a mechanism through which exercise seems to improve learning and memory. This is "brain derived neurotrophic factor" (BDNF) and it is involved in growth of the developing brain. The degree of BDNF expression in exercising rats correlated positively with improved memory, and exercising as an adolescent had longer lasting effects compared to the same duration of exercise, but done as an adult.
"The implication is that exercising during development, as your brain is growing, is changing the brain in concert with normal developmental changes, resulting in your having more permanent wiring of the brain in support of things like learning and memory," says Bucci. "It seems important to [exercise] early in life."
Bucci's latest paper was a move to take the studies of exercise and memory in rats and apply them to humans. The subjects in this new study were Dartmouth undergraduates and individuals recruited from the Hanover community.
Bucci says that, "the really interesting finding was that, depending on the person's genotype for that trophic factor [BDNF], they either did or did not reap the benefits of exercise on learning and memory. This could mean that you may be able to predict which ADHD child, if we genotype them and look at their DNA, would respond to exercise as a treatment and which ones wouldn't."
Bucci concludes that the notion that exercise is good for health including mental health is not a huge surprise. "The interesting question in terms of mental health and cognitive function is how exercise affects mental function and the brain." This is the question Bucci, his colleagues, and students continue to pursue.
Regular Exercise May Increase Pain Tolerance
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Stories of athletes bravely "playing through the pain" are relatively common and support the widespread belief that they experience pain differently than non-athletes. Yet, the scientific data on pain perception in athletes has been inconsistent, and sometimes contradictory. Investigators from the University of Heidelberg have conducted a meta-analysis of available research and find that in fact, athletes can indeed tolerate a higher level of pain than normally active people. However, pain threshold, the minimum intensity at which a stimulus is perceived as painful, did not differ in athletes and normal controls. Their findings are published in the June issue of Pain®.
"Our analysis reveals that pain perception differs in athletes compared to normally active controls," says lead investigator Jonas Tesarz, MD. "Studies in athletes offer the opportunity for an evaluation of the physical and psychological effects of regular activity on pain perception, which might foster the development of effective types of exercise for relief in pain patients."
Researchers reviewed fifteen studies that evaluated experimentally induced pain threshold or tolerance in athletes compared to normally active controls. 568 athletes and 331 normally active controls were included. Eight of the studies were conducted in the USA, two in Canada, one in Australia, and four were conducted in Europe. The studies, which included both men and women, evaluated endurance sports, game sports, and strength sports. Twelve studies reported on pain tolerance, and nine studies examined pain threshold.
Athletes were found to have consistently higher pain tolerance in comparison to normally active adults. The magnitude of pain that athletes could withstand varied depending upon the type of sport in which they participate. For example, endurance athletes had a moderate tolerance for pain and their scores were fairly uniform. Athletes involved in game sports had a higher tolerance for pain than other athletes, but the results varied widely, suggesting that endurance athletes are more alike in their physical and psychological profiles, while athletes involved in game sports are more diverse.
The finding that regular exercise is clearly associated with higher pain tolerance, but pain thresholds are affected more ambiguously, likely has clinical implications, according to Dr. Tesarz. "Numerous studies of the effect of physical exercise in pain patients demonstrate a consistent impact on quality of life and functioning without an improvement in pain scores. It may be advisable in exercise treatment for pain patients to focus on the development of their pain-coping skills that would affect tolerance, rather than the direct alleviation of pain threshold," he notes.
"Further research is needed to clarify the exact relationship between physical activity and modifications in pain perception, and to identify the involved psychological factors and neurobiological processes. However, the observation that pain perception is modifiable by physical activity provides promise for the use of non-invasive methods with few side effects for patients with chronic pain conditions," concludes Dr. Tesarz.
Stories of athletes bravely "playing through the pain" are relatively common and support the widespread belief that they experience pain differently than non-athletes. Yet, the scientific data on pain perception in athletes has been inconsistent, and sometimes contradictory. Investigators from the University of Heidelberg have conducted a meta-analysis of available research and find that in fact, athletes can indeed tolerate a higher level of pain than normally active people. However, pain threshold, the minimum intensity at which a stimulus is perceived as painful, did not differ in athletes and normal controls. Their findings are published in the June issue of Pain®.
"Our analysis reveals that pain perception differs in athletes compared to normally active controls," says lead investigator Jonas Tesarz, MD. "Studies in athletes offer the opportunity for an evaluation of the physical and psychological effects of regular activity on pain perception, which might foster the development of effective types of exercise for relief in pain patients."
Researchers reviewed fifteen studies that evaluated experimentally induced pain threshold or tolerance in athletes compared to normally active controls. 568 athletes and 331 normally active controls were included. Eight of the studies were conducted in the USA, two in Canada, one in Australia, and four were conducted in Europe. The studies, which included both men and women, evaluated endurance sports, game sports, and strength sports. Twelve studies reported on pain tolerance, and nine studies examined pain threshold.
Athletes were found to have consistently higher pain tolerance in comparison to normally active adults. The magnitude of pain that athletes could withstand varied depending upon the type of sport in which they participate. For example, endurance athletes had a moderate tolerance for pain and their scores were fairly uniform. Athletes involved in game sports had a higher tolerance for pain than other athletes, but the results varied widely, suggesting that endurance athletes are more alike in their physical and psychological profiles, while athletes involved in game sports are more diverse.
The finding that regular exercise is clearly associated with higher pain tolerance, but pain thresholds are affected more ambiguously, likely has clinical implications, according to Dr. Tesarz. "Numerous studies of the effect of physical exercise in pain patients demonstrate a consistent impact on quality of life and functioning without an improvement in pain scores. It may be advisable in exercise treatment for pain patients to focus on the development of their pain-coping skills that would affect tolerance, rather than the direct alleviation of pain threshold," he notes.
"Further research is needed to clarify the exact relationship between physical activity and modifications in pain perception, and to identify the involved psychological factors and neurobiological processes. However, the observation that pain perception is modifiable by physical activity provides promise for the use of non-invasive methods with few side effects for patients with chronic pain conditions," concludes Dr. Tesarz.
Calcium Supplements May Increase Heart Attack Risk
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An analysis of data on nearly 24,000 people followed for over a decade suggests taking calcium supplements may increase the risk of having a heart attack. This is the main finding of a study published online this week in the journal Heart that also concludes boosting overall calcium intake through dietary sources brings no significant benefit in terms of reducing risk of heart disease or stroke.
The researchers say calcium supplements, which are often recommended to the elderly and women after the menopause to protect against bone thinning, should be "taken with caution". Some experts are saying we should wait for further research to corroborate these findings before acting on this advice, and people who take supplements who are concerned should talk to their doctor.
The findings also appear to go against previous studies that have shown a higher calcium intake is linked to a lower risk of a number of conditions that predispose to heart disease and stoke, namely high blood pressure, obesity, and type 2 diabetes.
The study is based on data collected on participants who were aged 35 to 64 years old between 1994 and 1998 when they joined one of the German arms of the EPIC (European Prospective Investigation into Cancer and Nutrition) study in Heidelberg.
At the start of the study the participants filled in questionnaires that assessed their diet for the previous 12 months, and they also answered questions about regular intake of vitamin and mineral supplements.
Their health was followed for an average of 11 years afterwards. During this time, the group experienced 354 heart attacks and 260 strokes, and 267 participants died of related causes.
When they analyzed the results, the researchers ranked them according to levels of calcium intake, and examined them from various points of view, such as calcium intake including supplements, and the effect of supplements alone. They also adjusted them to remove as far as possible effects from other known influencing factors.
They found participants with a moderate intake of calcium from all sources (820mg a day, including supplements) had a 31% lower risk of heart attack than the ones in the bottom 25% of calcium intake.
But those who calcium intake from all sources, including supplements, was higher than 1,100mg a day did not have a significantly lower risk of heart attack than the bottom intake group.
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Plus, the researchers found no link between raised or lowered risk of stroke for any level of calcium intake from all sources, which they say reflects the findings of other studies.
However, when they looked at the results for supplements only, they found the participants who took calcium supplements on a regular basis had an 86% higher risk of having a heart attack than those who did not take any supplements at all.
And for participants who only took calcium supplements (that is no other vitamins or mineral supplements), this figure shot up: they had more than double the risk of having a heart attack compared with those who took no supplements at all.
The researchers conclude that their findings suggest:
"... increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise [heart attack] risk, should be taken with caution."
The study has drawn a mixed response, with some saying it adds to those that are questioning the safety of calcium supplements, and others pointing to the study's limitations and calling for further studies to corroborate the findings.
In an editorial in the same issue of the journal, Professors Ian Reid and Mark Bolland from the Faculty of Medical and Health Science at the University of Auckland in New Zealand, write that calcium supplements are "now coming under increasing scrutiny".
They refer to studies that link them to kidney stones and problems with the gut and abdominal symptoms. They also point out that while there is evidence that they reduce levels of cardiovascular risk factors, this does not actually translate into reduction in heart attacks and strokes.
Another point they make is that women who take calcium supplements to protect against bone thinning are already healthier than the women who do not, and the effect is modest anyway, around 10% only.
They say dietary calcium is helpful because it is taken in small amounts that are absorbed throughout the day, whereas supplements tend to be taken all in one go, causing blood calcium levels to spike above normal, and it is this that causes harm, they suggest.
"It is now becoming clear that taking this micronutrient in one or two daily [doses] is not natural, in that it does not reproduce the same metabolic effects as calcium in food," they write, suggesting we should discourage taking supplements to boost calcium intake.
"We should return to seeing calcium as an important component of a balanced diet, and not as a low cost panacea to the universal problem of postmenopausal bone loss," they conclude.
Natasha Stewart, Senior Cardiac Nurse with the British Heart Foundation, said while this study suggests there may be an increased risk of having a heart attack for people who take calcium supplements, it doesn't mean the supplements cause heart attacks. She told the press:
"Further research is needed to shed light on the relationship between calcium supplements and heart health. We need to determine whether potential risks of the supplements outweigh the benefits calcium can give sufferers of conditions such as osteoporosis."
"If you've been prescribed calcium supplements, you should still keep taking your medication, but speak to your doctor if you have any concerns," she added.
This study was published in the journal Heart.
The supplement industry expresses a similar view. Dr Taylor C. Wallace is Senior Director for Scientific & Regulatory Affairs at The Council for Responsible Nutrition (CRN) in the US. He said in a statement issued from Washington on Wednesday that "the study itself is not reason enough to discount the important benefits of calcium".
He urges consumers with questions, and their doctors, to consider some of the study's limitations, for instance the fact it was not originally designed to measure cardiovascular events, so confounding factors were not distributed equally through the groups. As an example he points to the fact the calcium supplement group had more people with high cholesterol and more long-term smokers.
Wallace said consumers like the elderly who are at greater risk of falls and fractures due to weak bones, need calcium, and removing it from their diet could increase their risk of these problems.
"Our advice is for consumers to be aware of how much calcium they get from their diet, supplement with calcium if needed, and check with their doctor or other healthcare practitioner to determine their own personal needs," he urged.
An analysis of data on nearly 24,000 people followed for over a decade suggests taking calcium supplements may increase the risk of having a heart attack. This is the main finding of a study published online this week in the journal Heart that also concludes boosting overall calcium intake through dietary sources brings no significant benefit in terms of reducing risk of heart disease or stroke.
The researchers say calcium supplements, which are often recommended to the elderly and women after the menopause to protect against bone thinning, should be "taken with caution". Some experts are saying we should wait for further research to corroborate these findings before acting on this advice, and people who take supplements who are concerned should talk to their doctor.
The findings also appear to go against previous studies that have shown a higher calcium intake is linked to a lower risk of a number of conditions that predispose to heart disease and stoke, namely high blood pressure, obesity, and type 2 diabetes.
The study is based on data collected on participants who were aged 35 to 64 years old between 1994 and 1998 when they joined one of the German arms of the EPIC (European Prospective Investigation into Cancer and Nutrition) study in Heidelberg.
At the start of the study the participants filled in questionnaires that assessed their diet for the previous 12 months, and they also answered questions about regular intake of vitamin and mineral supplements.
Their health was followed for an average of 11 years afterwards. During this time, the group experienced 354 heart attacks and 260 strokes, and 267 participants died of related causes.
When they analyzed the results, the researchers ranked them according to levels of calcium intake, and examined them from various points of view, such as calcium intake including supplements, and the effect of supplements alone. They also adjusted them to remove as far as possible effects from other known influencing factors.
They found participants with a moderate intake of calcium from all sources (820mg a day, including supplements) had a 31% lower risk of heart attack than the ones in the bottom 25% of calcium intake.
But those who calcium intake from all sources, including supplements, was higher than 1,100mg a day did not have a significantly lower risk of heart attack than the bottom intake group.
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5 Foods you must not eat: - Cut down a bit of stomach fat every day by never eating these 5 foods. - Beyonddiet.com
Blood Pressure Study - Adults with High BP May Qualify. Learn More Online Today! - MyRangeStudy.com/HighBloodPressure
Osteoporosis Exercises - Increase Your Bone Density With These 6 Simple & Easy Exercises. - StayingFit.com
Plus, the researchers found no link between raised or lowered risk of stroke for any level of calcium intake from all sources, which they say reflects the findings of other studies.
However, when they looked at the results for supplements only, they found the participants who took calcium supplements on a regular basis had an 86% higher risk of having a heart attack than those who did not take any supplements at all.
And for participants who only took calcium supplements (that is no other vitamins or mineral supplements), this figure shot up: they had more than double the risk of having a heart attack compared with those who took no supplements at all.
The researchers conclude that their findings suggest:
"... increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise [heart attack] risk, should be taken with caution."
The study has drawn a mixed response, with some saying it adds to those that are questioning the safety of calcium supplements, and others pointing to the study's limitations and calling for further studies to corroborate the findings.
In an editorial in the same issue of the journal, Professors Ian Reid and Mark Bolland from the Faculty of Medical and Health Science at the University of Auckland in New Zealand, write that calcium supplements are "now coming under increasing scrutiny".
They refer to studies that link them to kidney stones and problems with the gut and abdominal symptoms. They also point out that while there is evidence that they reduce levels of cardiovascular risk factors, this does not actually translate into reduction in heart attacks and strokes.
Another point they make is that women who take calcium supplements to protect against bone thinning are already healthier than the women who do not, and the effect is modest anyway, around 10% only.
They say dietary calcium is helpful because it is taken in small amounts that are absorbed throughout the day, whereas supplements tend to be taken all in one go, causing blood calcium levels to spike above normal, and it is this that causes harm, they suggest.
"It is now becoming clear that taking this micronutrient in one or two daily [doses] is not natural, in that it does not reproduce the same metabolic effects as calcium in food," they write, suggesting we should discourage taking supplements to boost calcium intake.
"We should return to seeing calcium as an important component of a balanced diet, and not as a low cost panacea to the universal problem of postmenopausal bone loss," they conclude.
Natasha Stewart, Senior Cardiac Nurse with the British Heart Foundation, said while this study suggests there may be an increased risk of having a heart attack for people who take calcium supplements, it doesn't mean the supplements cause heart attacks. She told the press:
"Further research is needed to shed light on the relationship between calcium supplements and heart health. We need to determine whether potential risks of the supplements outweigh the benefits calcium can give sufferers of conditions such as osteoporosis."
"If you've been prescribed calcium supplements, you should still keep taking your medication, but speak to your doctor if you have any concerns," she added.
This study was published in the journal Heart.
The supplement industry expresses a similar view. Dr Taylor C. Wallace is Senior Director for Scientific & Regulatory Affairs at The Council for Responsible Nutrition (CRN) in the US. He said in a statement issued from Washington on Wednesday that "the study itself is not reason enough to discount the important benefits of calcium".
He urges consumers with questions, and their doctors, to consider some of the study's limitations, for instance the fact it was not originally designed to measure cardiovascular events, so confounding factors were not distributed equally through the groups. As an example he points to the fact the calcium supplement group had more people with high cholesterol and more long-term smokers.
Wallace said consumers like the elderly who are at greater risk of falls and fractures due to weak bones, need calcium, and removing it from their diet could increase their risk of these problems.
"Our advice is for consumers to be aware of how much calcium they get from their diet, supplement with calcium if needed, and check with their doctor or other healthcare practitioner to determine their own personal needs," he urged.
23 Mayıs 2012 Çarşamba
5 Diet Drug Many of the Most Wanted
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Health for human | 5 Diet Drug Many of the Most Wanted. Many people who want to diet. and there are many ways to go on a diet ... there are some people who go on a diet in aid with drugs. drug that works to lose weight a lot on the market. But only some of which are clinically proven effective and safe. In the land of uncle sam aka America, there are five drugs most sought-after diet. What are they?
Here are 5 best diet products that have proven effective to reduce weight users in the United:
1. Raztone, Raspberry Ketone
People who have used this product also recommended that the weight loss product works quickly, safely and effectively reduce fat.
Raztone supplements has become the number 1 product for weight loss. Raspberry ketone is a compound in raspberry fruit that has a distinctive aroma and can burn fat.
Each serving contains 300 mg RazTone raspberry ketone which is a product with the highest concentration currently available for other products that only offer 100 mg per serving of raspberry ketone.
"Many clients who use supplements raspberry ketones and weight loss in just five days," said Lisa Lynn, a nutrition expert.
Lynn stated that the compounds contained in Raztone very healthy, no side effects and allow the body to burn fat more easily, namely by stimulating the production of adiponectin, a hormone in fat tissue that increase the body's ability to metabolize fat.
The study shows that thin people have higher levels of adiponectin than overweight individuals. Researchers also suggested that the hormone adiponectin may improve insulin sensitivity and helps regulate body weight.
Americans can easily get the product Raztone in retail stores. In fact the product has started to circulate online and in stores in the UK.
2. African Mango Extract
African Mango Extrac today is one of the most popular products for weight loss in America. This product can help reduce your weight by 10 kg in a short time.
The active ingredient in African Mango Extract is a rare type of mango extract the original from rain forest in Cameroon, West Africa called Irvingia Gabonensis.
According to a new study published in the journal of lipids in Health and Disease, the extract can cause a decrease in the average weight of 8.9 kg in 28 days.
Moreover, this product can lower LDL cholesterol, triglycerides, and glucose levels. There are no negative side effects reported in clinical studies.
3. Phosphacore
Ranked third is Phosphacore product clinically proven to address the fat in the abdomen up to 1 inch in 28 days.
Phosphacore is the active ingredient in plant species Carthamus tinctorius, native to North and Central Africa.
According to a study by scientists from the Department of Public Health at Sweden's Uppsala University, this product can cope with fat stacks of up to 600 percent more than those taking placebo.
In another study published in The American Journal of Clinical Nutrition, scientists from the University of Wisconsin found that people who use these products decreased whole body fat to 900 percent more per week than those who took placebo.
4. Maqui-6
Clinical research has shown Maqui-6, also known as the Maqui Berry has the highest levels of anthocyanin, which is a powerful fat burner. In fact, these products contain anthocyanin as much as 10 times more than other food sources.
Studies show that anthocyanins have a remarkable ability to lose weight and burn fat. A new study from Japan showed that anthocyanins have the potential significantly to the fat cells and anti-obesity benefits.
According to Chris Kilham, a professor of ethnobotany at the University of Massachusetts Amherst, Maqui berry can help to eliminate fat by optimizing blood glucose.
5. Moyojava Organic Ethiopian Coffee
This product is not a pill but in the form of coffee beans used to make beverages. The researchers say the secret to the mysterious nature of this slimming coffee, which is only found in the red mountains of Ethiopia.
Red earth where the growth of the coffee beans are ground to a mysterious reddish color in the Red Sea.
This coffee has been consumed for centuries by the inhabitants of the mountains of Ethiopia and the Great Rift Valley along the Red Sea. This unique coffee is rich in phytonutrients, antioxidants and a compound called cholorgenic acid.
According to a new study published in the scientific journal Complementary and Alternative Medicine, the nutrients in coffee causes a decrease in weight up to 35 percent.Related Posts: ,,
Statins may slow prostate growth
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Statins drugs prescribed to treat high cholesterol may also work to slow prostate growth in men who have elevated PSA levels, according to an analysis led by researchers at Duke University Medical Center.
The finding, presented at the annual meeting of the American Urological Association, provides additional insight into the effects of cholesterol-lowing drugs such as statins on the prostate. Previous studies at Duke and elsewhere had found a link between statins and lower levels of PSA, a protein produced by the prostate that is often elevated by cancer or by non-lethal prostatic diseases.
In the current finding, prostatic growth rate diminished among men with elevated PSA levels who took statins, although that effect was relatively small and tapered off after about two years.
"Given that prostate enlargement is an important health problem in the United States and elsewhere, and will be a larger problem as the population ages, it's important to understand and treat its causes," said Roberto Muller, M.D., a urology fellow at Duke and lead author of the study.
Enlarged prostate, most commonly diagnosed as benign prostate hyperplasia, causes urinary problems that can escalate to bladder and kidney damage. Up to 90 percent of men over the age of 70 have some symptoms associated with enlarged prostate, according to the National Institutes of Health.
Muller and colleagues used data gathered for an unrelated, large trial originally testing whether a drug called dutasteride could help reduce the risk of prostate cancer. To test their hypothesis that statins may be associated with slower prostate growth, the researchers culled the data of more than 6,000 men, including 1,032 who also took statins.
Men on statins tended to be older than non-users, and thus were expected to have greater prostate sizes. But prostate sizes were actually similar between statin users and non-users at the start of the study. That finding provided the first suggestion that statins might affect prostate growth.
When changes in prostate growth were compared two years after the start of the trial, men in the study who took a statin drug had less prostate growth, regardless of whether they had been randomly assigned to take dutasteride or a dummy pill. Prostate growth was an average 5 percent less in men who took both a statin and dutasteride pill compared to men who took only dutasteride. For those taking a statin and a dummy pill, prostate growth was 3.9 percent less than for men taking only the placebo.
Those reductions, however, did not persist after two years.
"We don't yet understand the mechanisms that might be causing this," Muller said. "Some have suggested that statins may have anti-inflammatory properties, and inflammation has been linked to prostate growth, but this needs further study."
Muller said the findings in the current research also suggest that lifestyle choices such diet and exercise may not only affect cholesterol, but also prostate health.
"Prostate enlargement was once considered an inexorable consequence of aging and genetics, but there is growing awareness that prostate growth can be influenced by modifiable risk factors," Muller said. "In this context, the role of blood cholesterol levels and cholesterol-lowering drugs such as statins warrants further study."
Statins drugs prescribed to treat high cholesterol may also work to slow prostate growth in men who have elevated PSA levels, according to an analysis led by researchers at Duke University Medical Center.
The finding, presented at the annual meeting of the American Urological Association, provides additional insight into the effects of cholesterol-lowing drugs such as statins on the prostate. Previous studies at Duke and elsewhere had found a link between statins and lower levels of PSA, a protein produced by the prostate that is often elevated by cancer or by non-lethal prostatic diseases.
In the current finding, prostatic growth rate diminished among men with elevated PSA levels who took statins, although that effect was relatively small and tapered off after about two years.
"Given that prostate enlargement is an important health problem in the United States and elsewhere, and will be a larger problem as the population ages, it's important to understand and treat its causes," said Roberto Muller, M.D., a urology fellow at Duke and lead author of the study.
Enlarged prostate, most commonly diagnosed as benign prostate hyperplasia, causes urinary problems that can escalate to bladder and kidney damage. Up to 90 percent of men over the age of 70 have some symptoms associated with enlarged prostate, according to the National Institutes of Health.
Muller and colleagues used data gathered for an unrelated, large trial originally testing whether a drug called dutasteride could help reduce the risk of prostate cancer. To test their hypothesis that statins may be associated with slower prostate growth, the researchers culled the data of more than 6,000 men, including 1,032 who also took statins.
Men on statins tended to be older than non-users, and thus were expected to have greater prostate sizes. But prostate sizes were actually similar between statin users and non-users at the start of the study. That finding provided the first suggestion that statins might affect prostate growth.
When changes in prostate growth were compared two years after the start of the trial, men in the study who took a statin drug had less prostate growth, regardless of whether they had been randomly assigned to take dutasteride or a dummy pill. Prostate growth was an average 5 percent less in men who took both a statin and dutasteride pill compared to men who took only dutasteride. For those taking a statin and a dummy pill, prostate growth was 3.9 percent less than for men taking only the placebo.
Those reductions, however, did not persist after two years.
"We don't yet understand the mechanisms that might be causing this," Muller said. "Some have suggested that statins may have anti-inflammatory properties, and inflammation has been linked to prostate growth, but this needs further study."
Muller said the findings in the current research also suggest that lifestyle choices such diet and exercise may not only affect cholesterol, but also prostate health.
"Prostate enlargement was once considered an inexorable consequence of aging and genetics, but there is growing awareness that prostate growth can be influenced by modifiable risk factors," Muller said. "In this context, the role of blood cholesterol levels and cholesterol-lowering drugs such as statins warrants further study."
Dietary Fat Types And Cognitive Change
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According to a new study published in Annals of Neurology and conducted by researchers at Brigham and Women's Hospital (BWH), a certain type of saturated fat, or "bad fat", is worse for women's overall memory and cognitive function. On the other hand, "good fat", or monounsaturated fats, have been linked to better memory and overall healthier cognitive function.
For their study, the researchers looked at data from the Women's Health Study - 6,000 women ages 65 and older, and compared them to a cohort of 40,000 women over the age of 45. The women were asked to take three tests, every 2 years for an average of 4 years, to analyze their cognitive function. Before they were tested, the women all were asked to fill out detailed surveys about what they were eating.
Olivia Okereke, MD, MS, from Brigham and Women's Department of Psychiatry said:"When looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did."
The outcome of the study showed that women who admitted to eating high amounts of "bad fats" did not have as healthy of a cognitive function as the women who did not consume a lot of saturated fats. In contrast, the women who ate high amounts of monounsaturated fats had much healthier cognitive outcomes over a long period of time.
Examples of foods that are high in saturated fats include:
* Meat products, such as fatty beef, pork, lamb and poultry with skin
* Dairy products, such as cream, butter and cheese.
Examples of foods that are high in Monounsaturated fats include:
* Avocados/Guacamole
* Olive/Canola Oil
* Nuts
* Seeds
Okereke said:"Our findings have significant public health implications. Substituting in the good fat in place of the bat fat is a fairly simple dietary modification that could help prevent decline in memory."
According to a new study published in Annals of Neurology and conducted by researchers at Brigham and Women's Hospital (BWH), a certain type of saturated fat, or "bad fat", is worse for women's overall memory and cognitive function. On the other hand, "good fat", or monounsaturated fats, have been linked to better memory and overall healthier cognitive function.
For their study, the researchers looked at data from the Women's Health Study - 6,000 women ages 65 and older, and compared them to a cohort of 40,000 women over the age of 45. The women were asked to take three tests, every 2 years for an average of 4 years, to analyze their cognitive function. Before they were tested, the women all were asked to fill out detailed surveys about what they were eating.
Olivia Okereke, MD, MS, from Brigham and Women's Department of Psychiatry said:"When looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did."
The outcome of the study showed that women who admitted to eating high amounts of "bad fats" did not have as healthy of a cognitive function as the women who did not consume a lot of saturated fats. In contrast, the women who ate high amounts of monounsaturated fats had much healthier cognitive outcomes over a long period of time.
Examples of foods that are high in saturated fats include:
* Meat products, such as fatty beef, pork, lamb and poultry with skin
* Dairy products, such as cream, butter and cheese.
Examples of foods that are high in Monounsaturated fats include:
* Avocados/Guacamole
* Olive/Canola Oil
* Nuts
* Seeds
Okereke said:"Our findings have significant public health implications. Substituting in the good fat in place of the bat fat is a fairly simple dietary modification that could help prevent decline in memory."
Light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia
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Alzheimer's disease (AD) and other types of dementia are most common in the very elderly, and are associated with huge health costs. With a rapidly ageing population throughout the world, factors that affect the risk of cognitive decline and dementia are of great importance. A review paper by Kim JW et al published in Psychiatry Investig 2012;9:8-16 on the association between alcohol consumption and cognition in the elderly provides an excellent summary of the potential ways in which alcohol may affect cognitive function and the risk of dementia, both adversely and favourably as alcohol may have both a neuro toxic and neuro protective effect, depending on the dose and drinking pattern. Longitudinal and brain imaging studies in the elderly show that excessive alcohol consumption may increase the risk of cognitive dysfunction and dementia, but regular low to moderate alcohol intake may protect against cognitive decline and dementia and provide cardiovascular benefits.
Studies published from 1971 to 2011 related to alcohol and cognition in the elderly were reviewed using a PubMed search. At present, there are no proven agents to prevent cognitive decline or dementia, although a number of prospective epidemiologic studies have shown a lower risk of such conditions among light to moderate drinkers in comparison with non-drinkers. Other studies have found that beneficial effects are seen only among certain sub-groups of subjects. A recent meta-analysis by Peters et al of subjects over the age of 65 in longitudinal studies concluded that light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia.
This paper provides a summary of what is known about the mechanisms by which alcohol consumption, especially heavy drinking, can be neurotoxic, and how light-to-moderate drinking may help protect against cognitive decline and dementia. The authors state that their intent is to determine if there is an "optimal pattern of drinking" that may protect the elderly against such conditions.
At present, the mechanisms by which the moderate intake of wine and other alcoholic beverages reduces the risk of cardiovascular diseases are much better defined than they are for cognition. Forum members agree with the authors that further research is needed to evaluate a potential role that alcohol may play in reducing the risk of dementia.
Forum members also agree that, at present, the specific mechanisms of such putative protection are not well defined, and it would be premature to recommend light-to-moderate drinking for reducing the risk of dementia. On the other hand, current biomedical data supports the concept that regular, moderate intake of ethanol is not simply less dangerous for cognitive function, but is positively protective. This is the same conclusion reached by epidemiologic studies."
Alzheimer's disease (AD) and other types of dementia are most common in the very elderly, and are associated with huge health costs. With a rapidly ageing population throughout the world, factors that affect the risk of cognitive decline and dementia are of great importance. A review paper by Kim JW et al published in Psychiatry Investig 2012;9:8-16 on the association between alcohol consumption and cognition in the elderly provides an excellent summary of the potential ways in which alcohol may affect cognitive function and the risk of dementia, both adversely and favourably as alcohol may have both a neuro toxic and neuro protective effect, depending on the dose and drinking pattern. Longitudinal and brain imaging studies in the elderly show that excessive alcohol consumption may increase the risk of cognitive dysfunction and dementia, but regular low to moderate alcohol intake may protect against cognitive decline and dementia and provide cardiovascular benefits.
Studies published from 1971 to 2011 related to alcohol and cognition in the elderly were reviewed using a PubMed search. At present, there are no proven agents to prevent cognitive decline or dementia, although a number of prospective epidemiologic studies have shown a lower risk of such conditions among light to moderate drinkers in comparison with non-drinkers. Other studies have found that beneficial effects are seen only among certain sub-groups of subjects. A recent meta-analysis by Peters et al of subjects over the age of 65 in longitudinal studies concluded that light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia.
This paper provides a summary of what is known about the mechanisms by which alcohol consumption, especially heavy drinking, can be neurotoxic, and how light-to-moderate drinking may help protect against cognitive decline and dementia. The authors state that their intent is to determine if there is an "optimal pattern of drinking" that may protect the elderly against such conditions.
At present, the mechanisms by which the moderate intake of wine and other alcoholic beverages reduces the risk of cardiovascular diseases are much better defined than they are for cognition. Forum members agree with the authors that further research is needed to evaluate a potential role that alcohol may play in reducing the risk of dementia.
Forum members also agree that, at present, the specific mechanisms of such putative protection are not well defined, and it would be premature to recommend light-to-moderate drinking for reducing the risk of dementia. On the other hand, current biomedical data supports the concept that regular, moderate intake of ethanol is not simply less dangerous for cognitive function, but is positively protective. This is the same conclusion reached by epidemiologic studies."
Exercise Reduces Risk Of Psoriasis
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Psoriasis is one of those poorly understood, autoimmune diseases that can cause a person misery. Red and white hues of scaly, patchy skin appear on the top layer of the skin, known as the epidermis. Research published Monday in Archives of Dermatology, a JAMA Network publication, shows how to reduce the risk of Psoriasis.
It appears that vigorous activity can reduce the risk of the disease, which has been associated with type 2 diabetes, colon cancer, coronary artery disease and breast cancer.
Researchers go on to say:
"Our results suggest that participation in at least 20.9 MET (metabolic equivalent task)-hours per week of vigorous exercise, the equivalent of 105 minutes of running or 180 minutes of swimming or playing tennis, is associated with a 25 percent to 30 percent reduced risk of psoriasis compared with not participating in any vigorous exercise."
Hillary C. Frankel, A.B., of Brigham and Women's Hospital, Boston, and her colleagues used data from the Nurses' Health Study II. They looked at questionnaires of nearly 90,000 women completed in 1991, 1997 and 2001. The found just over 1,000 cases of Psoriasis, and went on to look at the link between physical activity and the occurrence of the disease. Those women who were physically active had a lower multivariate relative risk of psoriasis (0.72) compared with the least active. Walking was not associated with a reduced risk, it appears the exercise must be vigorous.
The authors comment: "Among the individual vigorous activities we evaluated, only running and performing aerobic exercise or calisthenics were associated with a reduced risk of psoriasis. Other vigorous activities, including jogging, playing tennis, swimming and bicycling were not associated with psoriasis risk ... The highly variable intensity at which these activities are performed may account for this finding."
They go onto note that the possibility of reduced psoriasis risk through physical activity, is one that merits further research, and they conclude:
"In addition to providing other health benefits, participation in vigorous exercise may represent a new preventive measure for women at high risk of developing psoriasis. Additional corroborative studies and further investigations into the mechanisms by which physical activity protects against new-onset psoriasis are needed."
Psoriasis is one of those poorly understood, autoimmune diseases that can cause a person misery. Red and white hues of scaly, patchy skin appear on the top layer of the skin, known as the epidermis. Research published Monday in Archives of Dermatology, a JAMA Network publication, shows how to reduce the risk of Psoriasis.
It appears that vigorous activity can reduce the risk of the disease, which has been associated with type 2 diabetes, colon cancer, coronary artery disease and breast cancer.
Researchers go on to say:
"Our results suggest that participation in at least 20.9 MET (metabolic equivalent task)-hours per week of vigorous exercise, the equivalent of 105 minutes of running or 180 minutes of swimming or playing tennis, is associated with a 25 percent to 30 percent reduced risk of psoriasis compared with not participating in any vigorous exercise."
Hillary C. Frankel, A.B., of Brigham and Women's Hospital, Boston, and her colleagues used data from the Nurses' Health Study II. They looked at questionnaires of nearly 90,000 women completed in 1991, 1997 and 2001. The found just over 1,000 cases of Psoriasis, and went on to look at the link between physical activity and the occurrence of the disease. Those women who were physically active had a lower multivariate relative risk of psoriasis (0.72) compared with the least active. Walking was not associated with a reduced risk, it appears the exercise must be vigorous.
The authors comment: "Among the individual vigorous activities we evaluated, only running and performing aerobic exercise or calisthenics were associated with a reduced risk of psoriasis. Other vigorous activities, including jogging, playing tennis, swimming and bicycling were not associated with psoriasis risk ... The highly variable intensity at which these activities are performed may account for this finding."
They go onto note that the possibility of reduced psoriasis risk through physical activity, is one that merits further research, and they conclude:
"In addition to providing other health benefits, participation in vigorous exercise may represent a new preventive measure for women at high risk of developing psoriasis. Additional corroborative studies and further investigations into the mechanisms by which physical activity protects against new-onset psoriasis are needed."
17 Mayıs 2012 Perşembe
How to safely administer cold and allergy medications to children at home - CDC video
To contact us Click HERE
In April 2012, a 5-year-old girl died after overdosing on two over-the-counter cold medications with dextromethorphan and cetirizine http://j.mp/HIAtQ7
This CDC video below offers some tips how to prevent such tragic events in the future:
Unlike first, old-generation H(1)-antihistamines introduced from 1942 to the mid-1980s, most of the second (new)-generation H(1)-antihistamines are relatively free from adverse effects. They are not causally linked with fatalities after overdose.
A lethal intoxication with diphenhydramine was described in a 1983 case report: The patient was a 28 year old male who went into hyperpyrexia and tachycardia and died from sudden cardiac arrest. Hemorrhagic pulmonary edema and renal shock were the most prominent pathomorphological findings. At the time of death, the concentration of diphenhydramine was 5 mg/l plasma and was particularly high in the lungs (55 mg/kg) and kidneys (50 mg/kg).
Here is a video demonstrating Opsoclonus Due to Diphenhydramine Poisoning:
From the NEJM YouTube channel: Opsoclonus consists of involuntary, irregular, back-to-back, multivectorial, saccadic eye movements while the gaze is fixed. It is seen primarily in association with autoimmune processes after viral infection and with paraneoplastic encephalitis but has also been described after ingestion of organophosphates, lithium, cetirizine, amitryptiline, and diphenhydramine.
The NEJM case report describes a 20-year-old woman was admitted 2 hours after ingesting 5 grams of diphenhydramine in a suicide attempt. She had several seizures. ECG showed sinus tachycardia at 172 beats per minute and opsoclonus.
She required intubation for airway protection. The opsoclonus resolved 8 hours after her admission.
Benadryl disoverer, George Rieveschl, realized the powerful potential of the 19-syllable antihistamine compound while researching muscle relaxants in 1940s.
References:
Opsoclonus Due to Diphenhydramine Poisoning. Shaun D. Carstairs, M.D., and Aaron B. Schneir, M.D. N Engl J Med 2010; 363:e40
George Rieveschl, Inventor of Benadryl, Dies at 91
Former Olympian and coach died of antihistamine overdose
This CDC video below offers some tips how to prevent such tragic events in the future:
Unlike first, old-generation H(1)-antihistamines introduced from 1942 to the mid-1980s, most of the second (new)-generation H(1)-antihistamines are relatively free from adverse effects. They are not causally linked with fatalities after overdose.
A lethal intoxication with diphenhydramine was described in a 1983 case report: The patient was a 28 year old male who went into hyperpyrexia and tachycardia and died from sudden cardiac arrest. Hemorrhagic pulmonary edema and renal shock were the most prominent pathomorphological findings. At the time of death, the concentration of diphenhydramine was 5 mg/l plasma and was particularly high in the lungs (55 mg/kg) and kidneys (50 mg/kg).
Here is a video demonstrating Opsoclonus Due to Diphenhydramine Poisoning:
From the NEJM YouTube channel: Opsoclonus consists of involuntary, irregular, back-to-back, multivectorial, saccadic eye movements while the gaze is fixed. It is seen primarily in association with autoimmune processes after viral infection and with paraneoplastic encephalitis but has also been described after ingestion of organophosphates, lithium, cetirizine, amitryptiline, and diphenhydramine.
The NEJM case report describes a 20-year-old woman was admitted 2 hours after ingesting 5 grams of diphenhydramine in a suicide attempt. She had several seizures. ECG showed sinus tachycardia at 172 beats per minute and opsoclonus.
She required intubation for airway protection. The opsoclonus resolved 8 hours after her admission.
Benadryl disoverer, George Rieveschl, realized the powerful potential of the 19-syllable antihistamine compound while researching muscle relaxants in 1940s.
References:
Opsoclonus Due to Diphenhydramine Poisoning. Shaun D. Carstairs, M.D., and Aaron B. Schneir, M.D. N Engl J Med 2010; 363:e40
George Rieveschl, Inventor of Benadryl, Dies at 91
Former Olympian and coach died of antihistamine overdose
Depression affects up to 9% of U.S. population - how to do effective screening?
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From American Family Physician:
Depression affects up to 9% of U.S. population.
The U.S. Preventive Services Task Force recommends screening in adolescents and adults but it does not recommend screening for depression in children 7-11 years of age, or screening for suicide risk in the general population.
The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used and validated screening tools.
The PHQ-2 has a 97% sensitivity and 67% specificity in adults. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day").
PHQ-9 has a 61% sensitivity and 94% specificity in adults. The PHQ-9 depression module scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).
If the PHQ-2 is positive for depression, the PHQ-9 should be administered.
In older adults, the 15-item Geriatric Depression Scale is an appropriate follow-up test.
If these screening tests are positive for depression, further evaluation is needed to confirm that the patient's symptoms meet the Diagnostic and Statistical Manual of Mental Disorders' (DSM) criteria for diagnosis.
References:
Screening for depression. Maurer DM. Am Fam Physician. 2012 Jan 15;85(2):139-44.
Image source: Vincent van Gogh's 1890 painting At Eternity's Gate. Wikipedia, public domain.
From American Family Physician:Depression affects up to 9% of U.S. population.
The U.S. Preventive Services Task Force recommends screening in adolescents and adults but it does not recommend screening for depression in children 7-11 years of age, or screening for suicide risk in the general population.
The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used and validated screening tools.
The PHQ-2 has a 97% sensitivity and 67% specificity in adults. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day").
PHQ-9 has a 61% sensitivity and 94% specificity in adults. The PHQ-9 depression module scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).
If the PHQ-2 is positive for depression, the PHQ-9 should be administered.
In older adults, the 15-item Geriatric Depression Scale is an appropriate follow-up test.
If these screening tests are positive for depression, further evaluation is needed to confirm that the patient's symptoms meet the Diagnostic and Statistical Manual of Mental Disorders' (DSM) criteria for diagnosis.
References:
Screening for depression. Maurer DM. Am Fam Physician. 2012 Jan 15;85(2):139-44.
Image source: Vincent van Gogh's 1890 painting At Eternity's Gate. Wikipedia, public domain.
Best of Medical Blogs - weekly review and blog carnival
To contact us Click HERE
The “Best of Medical Blogs - BMB weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.
A Medical Educator Joins Social Media: One Year Later
Dr. Djuricich, Program Director in Medicine-Pediatrics at the Indiana University, shares what he has learned in one short year: If physicians and other health care professionals are not becoming involved in social media, they are missing out on a “place” where many of the patients already are. There is a lot of misinformation floating around on the internet. It is a duty of physicians to combat this and provide correct information. Do not let social media take over your life. The important things (family, friends, etc.) are still the important things, so don’t lose the priorities. http://goo.gl/zNfpe
What explains blogging longevity? It's easy: blog for yourself, and share with others
Dr. Centor explains his blogging longevity after 10-years of blogging. I've been blogging for 8 years, and I agreee with him: Why you should write a blog for yourself rather than for a shifting audience http://goo.gl/P8xtz
Here's Dr. Centor again: Explaining longevity is subjective. Mostly, I like blogging. Basically I blog with myself in mind, and am gratified that others find my comments interesting. Blogging is never a chore. One cannot last 10 years doing a chore. http://goo.gl/Jyl2o
Cardiologist Dr. Wes nominates the hardest to read Abstract of the Year at 2012 Heart Rhythm Society
What is the abstract that contributes the smallest amount to our field while demonstrating the worst grammar, the most bureaucratic lingo and, of course, verbosity. The sentence that clinched it? "Conclusions: The harmonization of endpoint definitions, terminology, and clinical trial design paradigms provides consistency across clinical trial studies that can facility (sic) clinician acceptance of results and the evaluation of safety and effectiveness of devices and medicines for atrial fibrillation." http://goo.gl/ZstA0
Harvard Medical School Q&A blog doctor reflects on his readers’ feedback
Dr. Komaroff from the blog Ask Doctor K.: “Since I began this column last September, I’ve received a lot of mail — both emails and “snail mail.” Mostly it’s been health questions. I can’t answer them all, but I try to answer as many as I can. However, I’ve also received complaints. Sometimes they represent an honest difference of perspective. On occasion, they reflect the fact that I’m a man.” http://goo.gl/XK3O1
A complete list of all academic medical journals available for the iPad
The omnipresent blog iMedicalApps makes a good use of Google Docs spreadsheet to list the apps of many academic medical journals available for the iPad. I still have personal preference for the open web rather than apps but that’s just me. http://goo.gl/13Gjz
What is postinfectious cough and how to treat it?
From Dr. Matthew Mintz' blog: While the cause of the postinfectious cough is not known, it has been thought to be due to the extensive damage of cells lining the lung and widespread airway inflammation of the upper and/or lower airways. The good news is that this usually goes away by itself, the bad news is that it can take weeks or even months, and can be quite disruptive to patients lives. Since symptoms are caused primarily by inflammation and hyperresponsiveness/bronchoconstriction in the lungs (which is what we see in asthma), then treatment is likely best with something that treats both inflammation and bronchoconstriction in the lungs, such as an inhaled corticosteroid/long-acting beta agonist like Advair (which is commonly used in asthma). Use of Advair for postinfectious cough may be the single most common off-label use of any prescription product. Since inflammation can persist for weeks, it is important that Advair be used for at least 4 weeks. If symptoms return, the patient should be brought back for pulmonary function testing as this may be a new presentation of asthma. http://goo.gl/RgxLb
Reality Social Media: Live Tweeting Brain Surgery. What is the downside of this marketing push? Dr. Wes explains: http://goo.gl/XbKwv
"Healthcare Going To The Dogs" - a video for training hospital administrators http://goo.gl/hv40a and http://goo.gl/xsW4J
Science blogging and self-promotion? http://goo.gl/yGUqS
The “Best of Medical Blogs - BMB weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.A Medical Educator Joins Social Media: One Year Later
Dr. Djuricich, Program Director in Medicine-Pediatrics at the Indiana University, shares what he has learned in one short year: If physicians and other health care professionals are not becoming involved in social media, they are missing out on a “place” where many of the patients already are. There is a lot of misinformation floating around on the internet. It is a duty of physicians to combat this and provide correct information. Do not let social media take over your life. The important things (family, friends, etc.) are still the important things, so don’t lose the priorities. http://goo.gl/zNfpe
What explains blogging longevity? It's easy: blog for yourself, and share with others
Dr. Centor explains his blogging longevity after 10-years of blogging. I've been blogging for 8 years, and I agreee with him: Why you should write a blog for yourself rather than for a shifting audience http://goo.gl/P8xtz
Here's Dr. Centor again: Explaining longevity is subjective. Mostly, I like blogging. Basically I blog with myself in mind, and am gratified that others find my comments interesting. Blogging is never a chore. One cannot last 10 years doing a chore. http://goo.gl/Jyl2o
Cardiologist Dr. Wes nominates the hardest to read Abstract of the Year at 2012 Heart Rhythm Society
What is the abstract that contributes the smallest amount to our field while demonstrating the worst grammar, the most bureaucratic lingo and, of course, verbosity. The sentence that clinched it? "Conclusions: The harmonization of endpoint definitions, terminology, and clinical trial design paradigms provides consistency across clinical trial studies that can facility (sic) clinician acceptance of results and the evaluation of safety and effectiveness of devices and medicines for atrial fibrillation." http://goo.gl/ZstA0
Harvard Medical School Q&A blog doctor reflects on his readers’ feedback
Dr. Komaroff from the blog Ask Doctor K.: “Since I began this column last September, I’ve received a lot of mail — both emails and “snail mail.” Mostly it’s been health questions. I can’t answer them all, but I try to answer as many as I can. However, I’ve also received complaints. Sometimes they represent an honest difference of perspective. On occasion, they reflect the fact that I’m a man.” http://goo.gl/XK3O1
A complete list of all academic medical journals available for the iPad
The omnipresent blog iMedicalApps makes a good use of Google Docs spreadsheet to list the apps of many academic medical journals available for the iPad. I still have personal preference for the open web rather than apps but that’s just me. http://goo.gl/13Gjz
What is postinfectious cough and how to treat it?
From Dr. Matthew Mintz' blog: While the cause of the postinfectious cough is not known, it has been thought to be due to the extensive damage of cells lining the lung and widespread airway inflammation of the upper and/or lower airways. The good news is that this usually goes away by itself, the bad news is that it can take weeks or even months, and can be quite disruptive to patients lives. Since symptoms are caused primarily by inflammation and hyperresponsiveness/bronchoconstriction in the lungs (which is what we see in asthma), then treatment is likely best with something that treats both inflammation and bronchoconstriction in the lungs, such as an inhaled corticosteroid/long-acting beta agonist like Advair (which is commonly used in asthma). Use of Advair for postinfectious cough may be the single most common off-label use of any prescription product. Since inflammation can persist for weeks, it is important that Advair be used for at least 4 weeks. If symptoms return, the patient should be brought back for pulmonary function testing as this may be a new presentation of asthma. http://goo.gl/RgxLb
Reality Social Media: Live Tweeting Brain Surgery. What is the downside of this marketing push? Dr. Wes explains: http://goo.gl/XbKwv
"Healthcare Going To The Dogs" - a video for training hospital administrators http://goo.gl/hv40a and http://goo.gl/xsW4J
Science blogging and self-promotion? http://goo.gl/yGUqS
What it's like to study medicine at Cambridge (video)
To contact us Click HERE
What is "the favorite" for medical students in the UK at the moment? Going into General Practice (at minute 2:45 of the video). They are also "very keen into going into a specialty such as pediatrics". This is a night and day difference compared to their counterparts in the U.S.
From Cambridge University YouTube channel: "At Cambridge, we offer two medicine courses - the Standard Course and the Graduate Course. With both, our aim is to educate students to become compassionate, thoughtful, skilled members - and leaders - of the medical profession.
Success in medicine requires application and hard work, both while studying and when in practice. However, it brings great rewards in terms of job satisfaction, involving as it does a combination of science and human interactions, and numerous career opportunities."
To find out more about Medicine at Cambridge, see http://study.cam.ac.uk/undergraduate/courses/medicine
Comments from Twitter:
Nick Bennett @peds_id_doc: Best medical school in the world. Seriously.
From Cambridge University YouTube channel: "At Cambridge, we offer two medicine courses - the Standard Course and the Graduate Course. With both, our aim is to educate students to become compassionate, thoughtful, skilled members - and leaders - of the medical profession.
Success in medicine requires application and hard work, both while studying and when in practice. However, it brings great rewards in terms of job satisfaction, involving as it does a combination of science and human interactions, and numerous career opportunities."
To find out more about Medicine at Cambridge, see http://study.cam.ac.uk/undergraduate/courses/medicine
Comments from Twitter:
Nick Bennett @peds_id_doc: Best medical school in the world. Seriously.
Top articles in medicine in May 2012
To contact us Click HERE
Here are my suggestions for some of the top articles in medicine in May 2012 so far:
Point-of-care genetic testing for personalisation of antiplatelet treatment is effective http://goo.gl/ZWLvz
Patient empowerment - who empowers whom? Virtually all people are patients at some point in their lives http://goo.gl/4YKjq
Doctors' love-hate relationship with EHRs http://goo.gl/wd74F
Why U.S. spends more on healthcare than other developed countries: Higher prices, readily accessible technology, obesity http://goo.gl/cid6S
Austerely law transforms Spain’s health system from universal access to one based on employment | BMJ http://goo.gl/36u4C
Bevacizumab (Avastin) is as effective as ranibizumab (Lucentis) for wet AMD and could save NHS millions - NHS http://goo.gl/JJ8uV
Having 'Type D' Personality - a distressed and pessimistic outlook on life - May Affect Your Health http://goo.gl/kFbpA
New Cautions About Bisphosphonate Use - NYTimes http://goo.gl/PYiKy
How to Create Your Own Website using Blogger - Step-by-Step Guide for Physicians http://goo.gl/tCd37
Truvada (Emtriva + Viread), first drug to prevent HIV infection in healthy people at high risk (MSM, partners of HIV+) http://goo.gl/e1MJM
Can mobile phones give you brain cancer? The verdict's still on hold http://goo.gl/gI6Ta
Drink Water to Improve Test Scores http://goo.gl/MNB6k and http://goo.gl/EO12p
The articles were selected from my Twitter and Google Reader streams.
Here are my suggestions for some of the top articles in medicine in May 2012 so far:Point-of-care genetic testing for personalisation of antiplatelet treatment is effective http://goo.gl/ZWLvz
Patient empowerment - who empowers whom? Virtually all people are patients at some point in their lives http://goo.gl/4YKjq
Doctors' love-hate relationship with EHRs http://goo.gl/wd74F
Why U.S. spends more on healthcare than other developed countries: Higher prices, readily accessible technology, obesity http://goo.gl/cid6S
Austerely law transforms Spain’s health system from universal access to one based on employment | BMJ http://goo.gl/36u4C
Bevacizumab (Avastin) is as effective as ranibizumab (Lucentis) for wet AMD and could save NHS millions - NHS http://goo.gl/JJ8uV
Having 'Type D' Personality - a distressed and pessimistic outlook on life - May Affect Your Health http://goo.gl/kFbpA
New Cautions About Bisphosphonate Use - NYTimes http://goo.gl/PYiKy
How to Create Your Own Website using Blogger - Step-by-Step Guide for Physicians http://goo.gl/tCd37
Truvada (Emtriva + Viread), first drug to prevent HIV infection in healthy people at high risk (MSM, partners of HIV+) http://goo.gl/e1MJM
Can mobile phones give you brain cancer? The verdict's still on hold http://goo.gl/gI6Ta
Drink Water to Improve Test Scores http://goo.gl/MNB6k and http://goo.gl/EO12p
The articles were selected from my Twitter and Google Reader streams.
13 Mayıs 2012 Pazar
The View From the Inside
To contact us Click HERE
Dr. William V. Raszka, our Associate Editor, offers the following insight into a current topic in the news:
For a number of years, our kids have had pet fish. The fish have been housed in aquariums of various sizes; from those that hold a gallon or so to those that hold 40 or more. We had never really paid too much attention to the size of the aquarium but did notice that many of our fish seemed more aggressive than expected. Moreover, the life expectancy of our fish population has been less than anticipated despite paying close attention to the water temperature, pH, and feeding practices.
According to an article in The New York Times (Science: December 26, 2011), part of the problem may be the size of the fish tanks. Evidently, freshwater fish kept in small tanks are substantially more aggressive than those kept in larger ones. Researchers studied young common freshwater fish in two experiments. In one, fish were added to a tank while in the other, three fish were placed in larger tanks with more complex ecosystems. The behaviors were recorded for two hours after feeding. The fish subject to overcrowding became aggressive while the fish placed in the larger tanks demonstrated far less aggressive behavior. Researchers suspect that in their natural environment, fish have places to hide and are not in constant contact with each other.
While other studies have confirmed that overcrowding changes animal behavior, fish owners are unlikely to purchase 100 gallon tanks to keep their fish content. According to the article, even the Humane Society opted not to wade into the issue. On a more practical aspect, overcrowding can affect the health of a fish population. This is most important for commercial fish farms. While some species can tolerate dense living conditions, most do not. Overcrowding can lead to poor fish health and the rapid spread of disease. In Scotland, the farmed salmon are so riddled with sea lice that the government may ban coastal farms. We are not planning to eat any of our pet fish. Still, we avoid buying too many and are content with only two fish for every 20 gallons of water.
Noted by WVR, MD
*This filler excerpt can be found in the April 2012 Pediatrics print journal p. 763, or via online here.
Dr. William V. Raszka, our Associate Editor, offers the following insight into a current topic in the news:For a number of years, our kids have had pet fish. The fish have been housed in aquariums of various sizes; from those that hold a gallon or so to those that hold 40 or more. We had never really paid too much attention to the size of the aquarium but did notice that many of our fish seemed more aggressive than expected. Moreover, the life expectancy of our fish population has been less than anticipated despite paying close attention to the water temperature, pH, and feeding practices.
According to an article in The New York Times (Science: December 26, 2011), part of the problem may be the size of the fish tanks. Evidently, freshwater fish kept in small tanks are substantially more aggressive than those kept in larger ones. Researchers studied young common freshwater fish in two experiments. In one, fish were added to a tank while in the other, three fish were placed in larger tanks with more complex ecosystems. The behaviors were recorded for two hours after feeding. The fish subject to overcrowding became aggressive while the fish placed in the larger tanks demonstrated far less aggressive behavior. Researchers suspect that in their natural environment, fish have places to hide and are not in constant contact with each other.
While other studies have confirmed that overcrowding changes animal behavior, fish owners are unlikely to purchase 100 gallon tanks to keep their fish content. According to the article, even the Humane Society opted not to wade into the issue. On a more practical aspect, overcrowding can affect the health of a fish population. This is most important for commercial fish farms. While some species can tolerate dense living conditions, most do not. Overcrowding can lead to poor fish health and the rapid spread of disease. In Scotland, the farmed salmon are so riddled with sea lice that the government may ban coastal farms. We are not planning to eat any of our pet fish. Still, we avoid buying too many and are content with only two fish for every 20 gallons of water.
Noted by WVR, MD
*This filler excerpt can be found in the April 2012 Pediatrics print journal p. 763, or via online here.
The “Choking Game” Is Anything But a Game
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While we have previously published articles on the “choking game” and awareness of pediatricians about this form of asphyxia as a serious risk-taking behavior, we have not had information on the prevalence of this game – until now. Ramowski et al., (doi: 10.1542/peds.2011-2482) using a cross-sectional survey of more than 5,000 eighth graders, found a disturbing rate of a little more than 6% played this very dangerous “game” -- which is anything but. In that 6%, most participated more than once in association with other risk-taking behaviors. If eighth graders are playing the choking game, one can only imagine the prevalence at older ages. If you have not asked your teen patients what they know or whether they are playing it, you may be missing a chance to win this game by convincing your patients not to play it. Read this important study to learn more.
A Garden of Eden
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Dr. William V. Raszka, our Associate Editor, offers the following insight into a current topic in the news:
Every year we plant a garden. We don’t plant anything particularly exotic, just vegetables we like to eat. While we have fruit trees, the birds eat all our cherries before we can, the apples always have fungal infections, and the plums and apricots never fruit. Although each year I am a bit disappointed with my harvest, my frustrations are probably nothing like those who plant biblical gardens.
As reported in The Wall Street Journal (February 11, 2012), many individual gardeners, synagogues, and churches in different areas across the U.S. including Vermont have attempted to recreate gardens from herbs, fruit trees and flowers described in the Bible. Many, if not most, have learned that successful cultivation of plants native to the Middle East can be remarkably challenging when grown in the U.S. In this day of international commerce and internet access, purchasing the seeds or seedlings is easy. Specialized gardening groups with expertise in Middle Eastern plants offer advice and support. Books, in a range of prices, are available for the burgeoning biblical gardener. The hard part, however, is getting the plants to grow, survive the pests and weather of a very different environment, and finally fruit.
Many biblical gardeners have story after story of their failings. Occasionally, biblical gardens, such as the wonderful garden of the Cathedral of St. John the Divine in New York City, thrive. However, the annual maintenance budget for the Cathedral of St. John the Divine biblical garden is $20,000 and hordes of expert gardeners volunteer their time. For many gardeners, faith, hard work, and persistence are not enough to overcome the challenge of growing non-native species. Still, congregations persist in their efforts as a biblical garden can attract new members and help build stronger community bonds. As for me, I know that despite my best efforts I will never successfully cultivate a pomegranate or olive tree in northern Vermont. However, I will continue to battle the pests and weather for a crop of zucchini and tomatoes and strive to arrange a visit to the biblical gardens in New York.
Noted by WVR, MD
*This filler excerpt can be found in the April 2012 Pediatrics print journal p. 779, or via online here.
Dr. William V. Raszka, our Associate Editor, offers the following insight into a current topic in the news:Every year we plant a garden. We don’t plant anything particularly exotic, just vegetables we like to eat. While we have fruit trees, the birds eat all our cherries before we can, the apples always have fungal infections, and the plums and apricots never fruit. Although each year I am a bit disappointed with my harvest, my frustrations are probably nothing like those who plant biblical gardens.
As reported in The Wall Street Journal (February 11, 2012), many individual gardeners, synagogues, and churches in different areas across the U.S. including Vermont have attempted to recreate gardens from herbs, fruit trees and flowers described in the Bible. Many, if not most, have learned that successful cultivation of plants native to the Middle East can be remarkably challenging when grown in the U.S. In this day of international commerce and internet access, purchasing the seeds or seedlings is easy. Specialized gardening groups with expertise in Middle Eastern plants offer advice and support. Books, in a range of prices, are available for the burgeoning biblical gardener. The hard part, however, is getting the plants to grow, survive the pests and weather of a very different environment, and finally fruit.
Many biblical gardeners have story after story of their failings. Occasionally, biblical gardens, such as the wonderful garden of the Cathedral of St. John the Divine in New York City, thrive. However, the annual maintenance budget for the Cathedral of St. John the Divine biblical garden is $20,000 and hordes of expert gardeners volunteer their time. For many gardeners, faith, hard work, and persistence are not enough to overcome the challenge of growing non-native species. Still, congregations persist in their efforts as a biblical garden can attract new members and help build stronger community bonds. As for me, I know that despite my best efforts I will never successfully cultivate a pomegranate or olive tree in northern Vermont. However, I will continue to battle the pests and weather for a crop of zucchini and tomatoes and strive to arrange a visit to the biblical gardens in New York.
Noted by WVR, MD
*This filler excerpt can be found in the April 2012 Pediatrics print journal p. 779, or via online here.
The Electronic Medical Record: “Screen time” in the Waiting Room?
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With time always a factor in a health maintenance visit, and with so many preventive service guidelines to consider when educating our patients, what is the best way to make sure we identify those who screen positive for particular health risks so we can focus our discussion on those risks? Anand et al. (doi: 10.1542/peds.2011-2875) input some useful data regarding the use of a clinical decision support system (CDSS) that embeds clinical screening guidelines into a structured data intake format for families to complete in the waiting room, which then appears on a physician worksheet that can be addressed in the health maintenance visit. Use of such a system allows a clinician to quickly identify relevant areas for discussion and hopefully lead to better health outcomes. Login to this study and learn exactly how this system works and whether it makes sense to consider something similar for your own practice. Who would have imagined that when we look at our “computer screens”, “screen” means far more than just the image we are looking at, and it suggests a better way to render care to our patients through informatics!
Clinical Pediatric Research: How Many Registered Studies Are Never Published and Why?
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You may not know that when embarking on a clinical trial, it is important to register the trial on an approved clinical trials registry, ideally before data is collected. While rules have tightened up to require this for many journals (including our own), some studies may still not be registered until after a trial is completed (especially when results are found to be positive) or may not be registered at all. Even then when a trial is registered, and the results are not what was hypothesized, is that information ever shared with the public through published studies? Are you aware that you have access to these clinical registries to see if other studies on a published topic are also there but with different results?
To help sort through the issues of registration, completion of pediatric clinical studies and their publication, Shamliyan et al. (doi: 10.1542/peds.2010-2847) looked at a large number of closed studies at ClinicalTrials.gov (the United States trial registry) to see if they were ever completed, and whether their results were ever published. Unfortunately, this story does not currently have the happiest of endings, in that more than half the registered trials for children do not have results available through the registry or in publication. As an editor, I can only peer-review the manuscripts we receive for clinical studies, but this article will make you wonder what we never receive because investigators opted not to share results publicly. That in turn, introduces bias in the body of clinical research shared through journals like ours. Hopefully this bias will be reduced as a result of articles such as this and our own requirement that all studies we consider be registered before data collection begins.
A great example of whether or not all results have been published can be found in an article we are releasing this week online by Carrasco et al. (doi: 10.1542/peds.2011-3285) on the efficacy of serotonin receptor inhibitors (SRIs) in treating repetitive behaviors in autism spectrum disorders. The authors reviewed all registered randomized double-blind placebo-controlled studies of these drugs in this setting, and found some trials were never published. The findings in this article are not dramatic but important nonetheless because the authors use their findings to challenge those who study the use of pharmacotherapy for autism to be sure that all trials and results have been published or reported publicly. Without that happening, the efficacy of these SRIs cannot be accurately assessed.
Finally, a commentary by Scott Denne (doi: 10.1542/peds.2012-0621), stresses the need for improvement in registration and reporting of results in clinical trials. Read the above two interesting articles and the accompanying commentary to learn more about a problem you may not have thought about — that not all clinical studies get registered, completed, or published!
To help sort through the issues of registration, completion of pediatric clinical studies and their publication, Shamliyan et al. (doi: 10.1542/peds.2010-2847) looked at a large number of closed studies at ClinicalTrials.gov (the United States trial registry) to see if they were ever completed, and whether their results were ever published. Unfortunately, this story does not currently have the happiest of endings, in that more than half the registered trials for children do not have results available through the registry or in publication. As an editor, I can only peer-review the manuscripts we receive for clinical studies, but this article will make you wonder what we never receive because investigators opted not to share results publicly. That in turn, introduces bias in the body of clinical research shared through journals like ours. Hopefully this bias will be reduced as a result of articles such as this and our own requirement that all studies we consider be registered before data collection begins.
A great example of whether or not all results have been published can be found in an article we are releasing this week online by Carrasco et al. (doi: 10.1542/peds.2011-3285) on the efficacy of serotonin receptor inhibitors (SRIs) in treating repetitive behaviors in autism spectrum disorders. The authors reviewed all registered randomized double-blind placebo-controlled studies of these drugs in this setting, and found some trials were never published. The findings in this article are not dramatic but important nonetheless because the authors use their findings to challenge those who study the use of pharmacotherapy for autism to be sure that all trials and results have been published or reported publicly. Without that happening, the efficacy of these SRIs cannot be accurately assessed.
Finally, a commentary by Scott Denne (doi: 10.1542/peds.2012-0621), stresses the need for improvement in registration and reporting of results in clinical trials. Read the above two interesting articles and the accompanying commentary to learn more about a problem you may not have thought about — that not all clinical studies get registered, completed, or published!
Childhood Maltreatment and Long-term Outcomes
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We certainly suspect that patients who have experienced abuse and neglect in early childhood sustain long-term effects of this maltreatment as they become teens and adults — but documentation has not been easy to find — at least until this week’s study by Jonson-Reid et al. (doi: 10.1542/peds.2011-2529). A cohort of more than 3,500 children with child maltreatment reports in 1993-94 was followed through 2009 for substance abuse, mental health problems, sexually transmitted infections, suicide attempts and violent delinquency, as well as perpetration of abuse on other children, and ongoing mental health and substance abuse issues as adults. The multivariate relationships of all of these outcomes with the initial reports makes for some troubling yet important reading and gets us all thinking about tertiary strategies to lessen the severity of the adult outcomes that can ensue as a result of child maltreatment.
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