Soccer-related facial fractures examined

Fractures of the nose and other facial bones are a relatively common and potentially serious injury in soccer players, reports a Brazilian study in Plastic and Reconstructive Surgery — Global Open , the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).On the eve of the 2014 World Cup, a group of Brazilian plastic surgeons review their experience with soccer-related facial fractures requiring surgery. Dr. Dov Charles Goldenberg, MD, PhD, of University of So Paulo and colleagues write, “Due to exposure and the lack of protection for the face, the occasional maxillofacial trauma sustained during soccer games often entails serious facial injuries requiring hospital admissions and invasive procedures.”Soccer Players at Risk of Nasal and Other Facial FracturesThe researchers assembled data on 45 patients undergoing surgical treatment for soccer-related facial fractures at two large university hospital centers in So Paulo between 2000 and 2013. The 45 soccer injuries accounted for two percent of surgically treated facial fractures during that time. Forty-four of the patients were male; the average age was 28 years. All of the injured players were amateurs.The nose and upper jaw (maxilla) accounted for 35 percent of fractures and the cheekbone (zygomatic bone) for another 35 percent. Most of the remaining fractures were of the lower jaw (mandible) and eye socket (orbit). Eighty-seven percent of the injuries were caused by collision with another player; the rest occurred when the player was struck by the ball.Nasal fractures were treated by repositioning (reducing) the fractured bones to their proper place and splinting until they healed. Other types of facial fractures required open surgery and internal fixation (plates, screws) to reposition the bones. The patients remained in the hospital for about five days on average, and were told they could return to play after six to eight weeks of healing.Emphasis on Awareness and Examination to Detect Soccer-Related FracturesThe results are consistent with previous studies of soccer-related facial injuries. …

Read more

Ceremonial PTSD therapies favored by Native American veterans

Native American veterans battling Post Traumatic Stress Disorder find relief and healing through an alternative treatment called the Sweat Lodge ceremony offered at the Spokane Veterans Administration Hospital.In the Arizona desert, wounded warriors from the Hopi Nation can join in a ceremony called Wiping Away the Tears. The traditional cleansing ritual helps dispel a chronic “ghost sickness” that can haunt survivors of battle.These and other traditional healing therapies are the treatment of choice for many Native American veterans, — half of whom say usual PTSD treatments don’t work — according to a recent survey conducted at Washington State University. The findings will be presented at the American Psychological Association conference in Washington D.C. this August.The study is available online at https://www.surveymonkey.com/s/nativeveterans.Led by Greg Urquhart and Matthew Hale, both Native veterans and graduate students in the College of Education, the ongoing study examines the attitudes, perceptions, and beliefs of Native American veterans concerning PTSD and its various treatment options. Their goal is to give Native veterans a voice in shaping the types of therapies available in future programs.”Across the board, Native vets don’t feel represented. Their voices have been silenced and ignored for so long that they were happy to provide feedback on our survey,” said Hale.Historically, Native Americans have served in the military at higher rates than all other U.S. populations. Veterans are traditionally honored as warriors and esteemed in the tribal community.A 2012 report by the Department of Veterans Affairs showed that the percentage of Native veterans under age 65 outnumbers similar percentages for veterans of all other racial groups combined.The WSU survey provides a first-hand look at the veterans’ needs, but more importantly, reveals the unique preferences they have as Native American veterans, said Phyllis Erdman, executive associate dean for academic affairs at the college and mentor for the study.Cultural worldviewUrquhart said many Native veterans are reluctant to seek treatment for PTSD because typical western therapy options don’t represent the Native cultural worldview.”The traditional Native view of health and spirituality is intertwined,” he explained. “Spirit, mind, and body are all one — you can’t parcel one out from the other — so spirituality is a huge component of healing and one not often included in western medicine, although there have been a few studies on the positive effects of prayer.”For many years, the U.S. government banned Native religious ceremonies, which subsequently limited their use in PTSD programs, said Urquhart. …

Read more

Slow walking speed, memory complaints can predict dementia

A study involving nearly 27,000 older adults on five continents found that nearly 1 in 10 met criteria for pre-dementia based on a simple test that measures how fast people walk and whether they have cognitive complaints. People who tested positive for pre-dementia were twice as likely as others to develop dementia within 12 years. The study, led by scientists at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, was published online on July 16, 2014 in Neurology, the medical journal of the American Academy of Neurology.The new test diagnoses motoric cognitive risk syndrome (MCR). Testing for the newly described syndrome relies on measuring gait speed (our manner of walking) and asking a few simple questions about a patient’s cognitive abilities, both of which take just seconds. The test is not reliant on the latest medical technology and can be done in a clinical setting, diagnosing people in the early stages of the dementia process. Early diagnosis is critical because it allows time to identify and possibly treat the underlying causes of the disease, which may delay or even prevent the onset of dementia in some cases.”In many clinical and community settings, people don’t have access to the sophisticated tests — biomarker assays, cognitive tests or neuroimaging studies — used to diagnose people at risk for developing dementia,” said Joe Verghese, M.B.B.S., professor in the Saul R. Korey Department of Neurology and of medicine at Einstein, chief of geriatrics at Einstein and Montefiore, and senior author of the Neurology paper. “Our assessment method could enable many more people to learn if they’re at risk for dementia, since it avoids the need for complex testing and doesn’t require that the test be administered by a neurologist. The potential payoff could be tremendous — not only for individuals and their families, but also in terms of healthcare savings for society. All that’s needed to assess MCR is a stopwatch and a few questions, so primary care physicians could easily incorporate it into examinations of their older patients.”The U.S. …

Read more

Prematurity linked to altered lung function during exercise, high blood pressure in adults

Advances in medicine have greatly contributed to the survival of extremely preterm infants in the US. However, the picture of long-term health effects related to prematurity is still unclear. Researchers at the University of Oregon compared lung function among adults who were born extremely preterm (at less than 28 weeks), very preterm (at less than 32 weeks), and full term (~39-40 weeks). Steven Laurie, PhD, will present the research team’s findings in a poster session on Tuesday, April 29, at the Experimental Biology meeting.Experimental Biology is an annual meeting comprised of more than 14,000 scientists and exhibitors from six sponsoring societies and multiple guest societies. With a mission to share the newest scientific concepts and research findings shaping current and future clinical advances, the meeting offers an unparalleled opportunity for exchange among scientists from throughout across the United States and the world who represent dozens of scientific areas, from laboratory to translational to clinical research. www.experimentalbiology.orgLaurie et al. studied three groups at rest and during exercise: young adults who were born extremely to very preterm and developed a lung condition called bronchopulmonary dysplasia (BPD), preterm adults who didn’t develop BPD (PRE), and full-term adult control subjects (CONT). They found that the PRE subjects had a harder time handling the increased blood flow from the heart during exercise than the BPD and CONT subjects. The vascular function of the lungs during exercise suggested that the PRE adults may also be at increased risk of developing high lung blood pressure.”Healthy young humans have lungs designed to easily handle the increased blood flow from the heart during exercise. However, adults born extremely to very preterm have abnormally developed lungs, which may result in lungs that are unable to handle the demands of exercise. …

Read more

Novel drug cocktail may improve clinical treatment for pancreatic cancer

Pancreatic cancer is the fourth leading cause of cancer deaths in the U.S. and has the lowest overall survival rate of all major cancers (~6%). With current treatment options being met with limited success it is anticipated that pancreatic cancer will move up to the second leading cause of cancer deaths by as early as 2015. Surgical removal of the tumor presents the best chance of survival, however only 15% of patients are eligible due to the late stage of diagnosis common with this disease. With very limited improvements in patient outcome over the last two decades there remains an enormous need for new therapies and treatment options.David Durrant, a Ph.D. student in the laboratory of Dr. Rakesh Kukreja from the Pauley Heart Center at Virginia Commonwealth University’s School of Medicine, is studying a novel combination therapy for the treatment of pancreatic cancer. The traditional chemotherapy drug, doxorubicin (DOX), has long been used in the treatment of several cancers. However, patients commonly acquire resistance to DOX because of increased activation of specific survival proteins or through increased expression of drug transporters which reduce cellular levels of the drug. This is especially true for pancreatic cancer, which does not respond to multiple treatment strategies, including those that contain DOX. …

Read more

Sugar-sweetened beverages contribute to U.S. obesity epidemic, particularly among children

In response to the ongoing policy discussions on the role of sugar-sweetened beverages (SSBs) on weight and health, The Obesity Society (TOS) concludes that SSBs contribute to the United States’ obesity epidemic, particularly among children. Based on an in-depth analysis of the current research, TOS’s position statement unveiled today provides several recommendations for improving health, including that children minimize their consumption of SSBs.”There’s no arguing with the fact that the high rates of obesity in the U.S. are troubling for our nation’s health, specifically the recently reported rise in severe obesity among children in JAMA Pediatrics,” said TOS spokesperson Diana Thomas, PhD, Professor at Montclair State University and Director of the Center for Quantitative Obesity Research. “Following a thorough review and analysis of the existing research, TOS concludes that, by adding more non-nutritious calories to the American diet, SSBs have contributed to the U.S. obesity epidemic. Further, we recommend that to maintain and improve health children minimize drinking SSBs and adults reduce or avoid SSB consumption as part of an overall strategy to reduce calories.”According to the position statement posted online, TOS defines SSBs as sodas, sports drinks and other types of beverages that are primarily made up of water and added sugar. Consumption of these drinks in the U.S. remains high — Americans report that SSBs comprise 6-7% of overall calorie intake.”Despite the challenges researchers have faced with isolating the impact of specific foods or beverages on body weight, the studies conducted on SSBs thus far have generated important and meaningful data leading to our conclusion,” said Dr. Thomas. “The evidence shows that individuals with a higher BMI consume more SSBs than their leaner counterparts, and that decreasing SSB consumption may reduce overall calorie intake and help individuals with obesity or overweight reach healthy weight goals.”Weight gain occurs when total energy intake exceeds energy expenditure for extended periods of time. …

Read more

BOSS quasars track the expanding universe: Most precise measurement yet

The Baryon Oscillation Spectroscopic Survey (BOSS), the largest component of the third Sloan Digital Sky Survey (SDSS-III), pioneered the use of quasars to map density variations in intergalactic gas at high redshifts, tracing the structure of the young universe. BOSS charts the history of the universe’s expansion in order to illuminate the nature of dark energy, and new measures of large-scale structure have yielded the most precise measurement of expansion since galaxies first formed.The latest quasar results combine two separate analytical techniques. A new kind of analysis, led by physicist Andreu Font-Ribera of the U.S. Department of Energy’s Lawrence Berkeley National Laboratory (Berkeley Lab) and his team, was published late last year. Analysis using a tested approach, but with far more data than before, has just been published by Timothe Delubac, of EPFL Switzerland and France’s Centre de Saclay, and his team. The two analyses together establish the expansion rate at 68 kilometers per second per million light years at redshift 2.34, with an unprecedented accuracy of 2.2 percent.”This means if we look back to the universe when it was less than a quarter of its present age, we’d see that a pair of galaxies separated by a million light years would be drifting apart at a velocity of 68 kilometers a second as the universe expands,” says Font-Ribera, a postdoctoral fellow in Berkeley Lab’s Physics Division. “The uncertainty is plus or minus only a kilometer and a half per second.” Font-Ribera presented the findings at the April 2014 meeting of the American Physical Society in Savannah, GA.BOSS employs both galaxies and distant quasars to measure baryon acoustic oscillations (BAO), a signature imprint in the way matter is distributed, resulting from conditions in the early universe. While also present in the distribution of invisible dark matter, the imprint is evident in the distribution of ordinary matter, including galaxies, quasars, and intergalactic hydrogen.”Three years ago BOSS used 14,000 quasars to demonstrate we could make the biggest 3D maps of the universe,” says Berkeley Lab’s David Schlegel, principal investigator of BOSS. “Two years ago, with 48,000 quasars, we first detected baryon acoustic oscillations in these maps. Now, with more than 150,000 quasars, we’ve made extremely precise measures of BAO.”The BAO imprint corresponds to an excess of about five percent in the clustering of matter at a separation known as the BAO scale. …

Read more

The mammography dilemma: 50 years of analysis

A comprehensive review of 50 year’s worth of international studies assessing the benefits and harms of mammography screening suggests that the benefits of the screening are often overestimated, while harms are underestimated. And, since the relative benefits and harms of screening are related to a complex array of clinical factors and personal preferences, physicians and patients need more guidance on how best to individualize their approach to breast cancer screening.The results of the review by researchers at Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital are published today in JAMA.The American Cancer Society estimates that about 40,000 U.S. women will die of breast cancer this year. In 2009, based on evidence that the benefit-risk ratio for mammography screening is higher among women over 50 and with less frequent screening, the U.S. Preventive Services Task Force (USPSTF) reversed its previous recommendation of mammography every one to two years beginning at age 40, and recommended routine screening every two years starting at age 50, the researchers noted. The recommendations remain controversial among the general public and the medical community. Recent evidence suggests that use of mammography in the U.S. has not changed following the updated recommendations.”What I tell my patients is that the mammogram is not a perfect test,” said Nancy Keating, co-author of the report, associate professor of Health Care Policy at HMS and associate professor of medicine at Brigham and Women’s. “Some cancers will be missed, some people will die of breast cancer regardless of whether they have a mammogram, and a small number of people that might have died of breast cancer without screening will have their lives saved.”The authors report that the best estimate of the reduction in mortality from breast cancer due to annual screening for women overall is about 19 percent. For women in their 40s, the reduction in risk was about 15 percent, and for women in their 60s, about 32 percent. …

Read more

The science of champagne fizz: How many bubbles are in your bubbly?

The importance of fizz, more technically known as effervescence, in sparkling wines and champagnes is not to be underestimated — it contributes to the complete sensory experience of a glass, or flute, of fine bubbly. A scientist has now closely examined the factors that affect these bubbles, and he has come up with an estimate of just how many are in each glass. The report appears in ACS’ The Journal of Physical Chemistry B.Grard Liger-Belair notes that effervescence plays an important role in the look, taste, aroma and mouth feel of champagne and other sparkling wines. Wine journalists and bloggers often cite 15 million as the average number of bubbles fizzing in a single glass of champagne, based on some simple mathematics. Sounds impressive, but Liger-Belair suspected that the formula leading to this estimate oversimplified the matter. It didn’t take into account the fact that some of the dissolved carbon dioxide escapes from a glass without forming bubbles. Also, the size of the bubbles changes over time, and this could affect the final number. Liger-Belair wanted to set the record straight.Taking into consideration temperature, bubble dynamics and the tilt of a flute, Liger-Belair came up with a new way to calculate the number of bubbles in a glass of champagne. And the result is far lower than what has been cited. “One million bubbles seems to be a reasonable approximation for the whole number of bubbles likely to form if you resist drinking champagne from your flute,” he concludes. …

Read more

‘3-D’ test could reduce reliance on animals for testing asthma and allergy medications

To determine whether new medicines are safe and effective for humans, researchers must first test them in animals, which is costly and time-consuming, as well as ethically challenging. In a study published in ACS’ journal Molecular Pharmaceutics, scientists report that they’ve developed a simple, “3D” laboratory method to test asthma and allergy medications that mimics what happens in the body, which could help reduce the need for animal testing.Amir Ghaemmaghami and colleagues note that respiratory conditions, such as asthma and allergies, are becoming more common. These conditions affect the lungs and the airway leading to the lungs, making it difficult to breathe. Every year, respiratory symptoms lead to expensive hospital visits, as well as absences from work and school. Better drugs could provide relief, but before giving new medicines to people, researchers must first test them in animals — a costly and laborious process. Sometimes, researchers will use “2D” tests in which they apply the drug to a layer of human cells in a lab dish instead, but this isn’t an adequate way to tell how a medicine will work in a whole animal or a whole person. So, Ghaemmaghami’s team developed a new, 3D alternative.Their test includes three types of human cells that are typically in a person’s airway. In the body, these cells are close together and are involved in the development of respiratory conditions. The 3D “model” reacted just like a real person’s airway when they exposed it to allergens and bacterial extract. They say that the model has the potential of reducing the need for some animal testing of new drugs for respiratory conditions.Story Source:The above story is based on materials provided by American Chemical Society. …

Read more

Coffee Consumption Reduces Mortality Risk from Liver Cirrhosis

New research reveals that consuming two or more cups of coffee each day reduces the risk of death from liver cirrhosis by 66%, specifically cirrhosis caused by non-viral hepatitis. Findings in Hepatology, a journal published by Wiley on behalf of the American Association for the Study of Liver Diseases, show that tea, fruit juice, and soft drink consumption are not linked to cirrhosis mortality risk. As with previous studies heavy alcohol use was found to increase risk of death from cirrhosis.A 2004 report from The World Health Organization (WHO) estimates that each year 1.3% of total death worldwide is caused by liver cirrhosis. Previous research shows that 29 million Europeans have chronic liver disease, with 17,000 deaths annually attributed to cirrhosis. Further WHO reports state that liver cirrhosis is the 11th leading cause of death in the U.S.”Prior evidence suggests that coffee may reduce liver damage in patients with chronic liver disease,” said lead researcher, Dr. Woon-Puay Koh with Duke-NUS Graduate Medical School Singapore and the National University of Singapore. “Our study examined the effects of consuming coffee, alcohol, black tea, green tea, and soft drinks on risk of mortality from cirrhosis.”This prospective population-based study, known as The Singapore Chinese Health Study, recruited 63,275 Chinese subjects between the ages of 45 and 74 living in Singapore. Participants provided information on diet, lifestyle choices, and medical history during in-person interviews conducted between 1993 and 1998. Patients were followed for an average of nearly 15 years, during which time there were 14,928 deaths (24%); 114 of them died from liver cirrhosis. The mean age of death was 67 years.Findings indicate that those who drank at least 20 g of ethanol daily had a greater risk of cirrhosis mortality compared to non-drinker. …

Read more

New human trial shows stem cells are effective for failing hearts: Bone marrow-derived stem cells injected directly into heart muscle

Patients with severe ischemic heart disease and heart failure can benefit from a new treatment in which stem cells found in bone marrow are injected directly into the heart muscle, according to research presented at the American College of Cardiology’s 63rd Annual Scientific Session.”Our results show that this stem cell treatment is safe and it improves heart function when compared to placebo,” said Anders Bruun Mathiasen, M.D., research fellow in the Cardiac Catherization Lab at Rigshospitalet University Hospital Copenhagen, and lead investigator of the study. “This represents an exciting development that has the potential to benefit many people who suffer from this common and deadly disease.”Ischemic heart disease, also known as coronary artery disease, is the number one cause of death for both men and women in the United States. It results from a gradual buildup of plaque in the heart’s coronary arteries and can lead to chest pain, heart attack and heart failure.The study is the largest placebo-controlled double-blind randomized trial to treat patients with chronic ischemic heart failure by injecting a type of stem cell known as mesenchymal stromal cells directly into the heart muscle.Six months after treatment, patients who received stem cell injections had improved heart pump function compared to patients receiving a placebo. Treated patients showed an 8.2-milliliter decrease in the study’s primary endpoint, end systolic volume, which indicates the lowest volume of blood in the heart during the pumping cycle and is a key measure of the heart’s ability to pump effectively. The placebo group showed an increase of 6 milliliters in end systolic volume.The study included 59 patients with chronic ischemic heart disease and severe heart failure. Each patient first underwent a procedure to extract a small amount of bone marrow. Researchers then isolated from the marrow a small number of mesenchymal stromal cells and induced the cells to self-replicate. Patients then received an injection of either saline placebo or their own cultured mesenchymal stromal cells into the heart muscle through a catheter inserted in the groin.”Isolating and culturing the stem cells is a relatively straightforward process, and the procedure to inject the stem cells into the heart requires only local anesthesia, so it appears to be all-in-all a promising treatment for patients who have no other options,” Mathiasen said.Although there are other therapies available for patients with ischemic heart disease, these therapies do not help all patients and many patients continue to face fatigue, shortness of breath and accumulation of fluid in the lungs and legs.Previous studies have shown mesenchymal stromal cells can stimulate repair and regeneration in a variety of tissues, including heart muscle. Mathiasen said in the case of ischemic heart failure, the treatment likely works by facilitating the growth of new blood vessels and new heart muscle.The study also supports findings from previous, smaller studies, which showed reduced scar tissue in the hearts of patients who received the stem cell treatment, offering additional confirmation that the treatment stimulates the growth of new heart muscle cells.The researchers will continue to monitor the patients to assess their long-term outcomes.”We hope that the improvements in heart pump function will not only improve the patients’ symptoms but also will result in increased survival for these severely diseased patients,” Mathiasen said.A larger, Phase III clinical trial will be needed to move toward approval of this treatment as a more widely used therapy for ischemic heart failure.”Our results should offer sufficient evidence that a larger trial is indeed warranted as a next step,” Mathiasen said.Story Source:The above story is based on materials provided by American College of Cardiology. Note: Materials may be edited for content and length.

Read more

Medication does not reduce risk of recurrent cardiac events among patients with diabetes

Use of the drug aleglitazar, which has shown the ability to lower glucose levels and have favorable effects on cholesterol, did not reduce the risk of cardiovascular death, heart attack or stroke among patients with type 2 diabetes and recent heart attack or unstable angina, according to a JAMA study released online to coincide with presentation at the 2014 American College of Cardiology Scientific Sessions.Cardiovascular disease remains the dominant cause of death among patients with type 2 diabetes. No drug therapy specifically directed against diabetes nor strategy for tight glucose control has been shown to unequivocally reduce the rate of cardiovascular complications in this population, according to background information in the article. In phase 2 trials, aleglitazar significantly reduced glycated hemoglobin levels (measure of blood glucose over an extended period of time), triglycerides, and low-density lipoprotein cholesterol and increased high-density lipoprotein cholesterol (HDL-C).A. Michael Lincoff, M.D., of the Cleveland Clinic, and colleagues conducted a phase 3 trial in which 7,226 patients hospitalized for heart attack or unstable angina with type 2 diabetes were randomly assigned to receive aleglitazar or placebo daily. The AleCardio trial was conducted in 720 hospitals in 26 countries throughout North America, Latin America, Europe, and Asia-Pacific regions.The trial was terminated early (July 2013) after an average follow-up of 104 weeks, due to lack of efficacy and a higher rate of adverse events in the aleglitazar group.The researchers found that although aleglitazar reduced glycated hemoglobin and improved serum HDL-C and triglyceride levels, the drug did not decrease the time to cardiovascular death, nonfatal heart attack, or nonfatal stroke (primary end points). These events occurred in 344 patients (9.5 percent) in the aleglitazar group and 360 patients (10.0 percent) in the placebo group.Aleglitazar use was associated with increased risk of kidney abnormalities, bone fractures, gastrointestinal bleeding, and hypoglycemia (low blood sugars).”These findings do not support the use of aleglitazar in this setting with a goal of reducing cardiovascular risk,” the authors conclude.Story Source:The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.

Read more

TV linked to poor snacking habits, cardiovascular risk in middle schoolers

Middle school kids who park themselves in front of the TV for two hours or more each day are more likely to consume junk food and have risk factors for cardiovascular disease, even compared to those who spend an equal amount of time on the computer or playing video games, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.”While too much of both types of screen time encourages sedentary behavior, our study suggests high TV time in particular is associated with poorer food choices and increased cardiovascular risk,” said Elizabeth Jackson, M.D., M.P.H., associate professor, Division of Cardiovascular Medicine, University of Michigan Systems, Ann Arbor, Mich., and the senior author of the study.In fact, sixth-graders who reported watching between two and six hours of TV a day were more likely to have higher body mass index, elevated systolic and diastolic blood pressure and slower recovery heart rate compared with those reporting low screen time or kids who had comparable computer/video game use. This is the first time researchers have looked at the impact of different kinds of screen time kids get in relation to snacking habits and physiological measures associated with heart health, according to the authors.The study included 1,003 sixth-graders from 24 middle schools participating in Project Healthy Schools across five diverse communities in Southeast Michigan. Researchers used standardized questionnaires to collect information about health behaviors including the type and frequency of screen time, snacking habits, and food and beverage choices in the last 24 hours. Physiological measurements were also assessed, including blood pressure, cholesterol, heart rate recovery after exercise (a marker of fitness), height and weight. Students were divided into three groups: low screen time (less than one-half hour a day), high TV time (two to six hours a day) and high computer/video games (two to six hours a day). Self-reported snack behavior and physiologic markers were then compared.The research found that kids who spent more time in front of a screen — regardless of the type — snack more frequently and are more likely to choose less healthy snacks. High TV viewers and computer/video game users both reported eating roughly 3.5 snacks a day — one full snack more than kids who had minimal exposure to these technologies. But children who watched two to six hours a day of TV were more likely than the high computer/video game group to eat high-fat foods such as French fries and chips.Jackson said this is likely because these kids are bombarded by TV commercials that tend to reinforce less healthy foods — often higher in sugar, salt and fats. In addition, kids tend to have free hands while watching TV as opposed to when they are on the computer or playing video games, which provides more opportunity for mindless snacking. Earlier studies have also shown that children tend to eat more when they watch TV.”Snacks are important, and choosing a piece of fruit rather than a bag of chips can make a really big difference for one’s health,” Jackson said. …

Read more

US, European cholesterol guidelines differ in statin use recommendations

Application of U.S. and European cholesterol guidelines to a European population found that proportions of individuals eligible for statins differed substantially, with one U.S. guideline recommending statins for nearly all men and two-thirds of women, proportions exceeding those of the other guidelines, according to a JAMA study released online to coincide with the 2014 American College of Cardiology Scientific Sessions.The common approach in cardiovascular disease (CVD) primary prevention is to identify individuals at high enough risk to justify more intensive lifestyle interventions, treatment with medications, or both. The CVD prevention guidelines developed by the National Cholesterol Education Program expert panel, the American College of Cardiology/American Heart Association (ACC/AHA) task force, and the European Society of Cardiology (ESC) are the major guidelines influencing clinical practice. “Varying approaches to CVD risk estimation and application of different criteria for therapeutic recommendations would translate into substantial differences in proportions of individuals qualifying for treatment at a population level,” the authors write.Maryam Kavousi, M.D., Ph.D., of Erasmus MC-University Medical Center, Rotterdam, the Netherlands, and colleagues conducted a study to determine population-wide implications of the ACC/AHA, the Adult Treatment Panel III (ATP-III), and the ESC guidelines, using 4,854 Dutch participants from the Rotterdam Study (a population-based study of patients 55 years of age or older). The researchers calculated 10-year risks for “hard” (major) atherosclerotic cardiovascular disease (ASCVD) events (including fatal and nonfatal coronary heart disease [CHD] and stroke) (ACC/AHA); hard CHD events (fatal and nonfatal heart attack, CHD mortality) (ATP-III); and atherosclerotic CVD mortality (ESC). The proportions of individuals for whom statins would be recommended were calculated per guideline.The average age of the participants was 65.5 years; 54.5 percent were women. The researchers found that application of the ACC/AHA guideline recommended treatment for 96.4 percent of men and 65.8 percent of women; for the ATP-III guideline, the portion was 52 percent of men and 35.5 percent of women; and for the ESC guideline, 66.1 percent of men and 39.1 percent of women were included in the category where treatment was recommended.With the ACC/AHA approach, average predicted risk vs observed major ASCVD events was 21.5 percent vs 12.7 percent for men and 11.6 percent vs 7.9 percent for women. Similar overestimation occurred with the ATP-III and ESC model.”Improving risk predictions and setting appropriate population-wide thresholds are necessary to facilitate better clinical decision making,” the authors conclude.Story Source:The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.

Read more

Analysis supports use of risk equations to guide statin therapy

In an analysis of almost 11,000 patients, an assessment of equations that help guide whether a patient should begin taking a statin (cholesterol lowering medication) found that observed and predicted 5-year atherosclerotic cardiovascular disease risks were similar, suggesting that these equations are helpful for clinical decision making, according to a JAMA study released online to coincide with presentation at the 2014 American College of Cardiology Scientific Sessions.The American College of Cardiology (ACC) and the American Heart Association (AHA) recently published the 2013 Guideline on the Assessment of Cardiovascular Risk. As part of this guideline, a group of experts developed the Pooled Cohort risk equations, which were designed to estimate 10-year risk for nonfatal myocardial infarction (MI; heart attack), coronary heart disease (CHD) death, and nonfatal or fatal stroke, according to background information in the article.Paul Muntner, Ph.D., of the University of Alabama at Birmingham, and colleagues examined the Pooled Cohort risk equations in adults (age 45 to 79 years) enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study between January 2003 and October 2007, and followed up through December 2010. The researchers studied participants for whom atherosclerotic CVD risk may trigger a discussion of statin initiation (patients without clinical atherosclerotic CVD or diabetes, low-density lipoprotein cholesterol level between 70 and 189 mg/dL, and not taking statins; n = 10,997). Additional analyses, limited to Medicare beneficiaries (n = 3,333), added atherosclerotic CVD events identified in Medicare claims data.Among the study population (n=10,997) for whom statin treatment should be considered based on atherosclerotic CVD risk there were 338 events (192 CHD events, 146 strokes). The researchers found that the observed and predicted 5-year atherosclerotic CVD incidence rates were similar.There were 234 atherosclerotic CVD events (120 CHD events, 114 strokes) among the subset of Medicare beneficiaries and the observed and predicted 5-year atherosclerotic CVD incidence rates were also similar for the various risk categories in this population.”These findings support the validity of the Pooled Cohort risk equations to inform clinical management decisions,” the authors write. “Because the Pooled Cohort risk equations were designed to estimate 10-year atherosclerotic cardiovascular disease risk, studies are needed to ensure its accurate calibration over a longer duration.”Story Source:The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.

Read more

Migraine attacks increase following stress ‘let-down’

Migraine sufferers who experienced reduced stress from one day to the next are at significantly increased risk of migraine onset on the subsequent day, according to a new study conducted by researchers at the Montefiore Headache Center and Albert Einstein College of Medicine at Yeshiva University. Stress has long been believed to be a common headache trigger. In this study, researchers found that relaxation following heightened stress was an even more significant trigger for migraine attacks. Findings may aid in recommending preventive treatments and behavioral interventions. The study was published online in Neurology, the medical journal of the American Academy of Neurology.Migraine is a chronic condition that affects approximately 38 million Americans. To examine headache triggers, investigators at the Montefiore Headache Center and Einstein conducted a three month electronic daily diary study which captured 2,011 diary records and 110 eligible migraine attacks in 17 participants. The study compared levels of stress and reduction in stress as predictors of headache.”This study demonstrates a striking association between reduction in perceived stress and the occurrence of migraine headaches,” said study lead author Richard B. Lipton, M.D., director, Montefiore Headache Center, professor and vice chair of neurology and the Edwin S. Lowe Chair in Neurology, Einstein. “Results were strongest during the first six hours where decline in stress was associated with a nearly five-fold increased risk of migraine onset. …

Read more

New approach to leukemia testing may better define prognosis, treatment

Nearly half of patients with the most common form of adult leukemia are said to have normal chromosomes but appear instead to have a distinct pattern of genetic abnormalities that could better define their prognosis and treatment, researchers report.Using microarray technology that probes millions of genes within chromosomes, researchers found the unique pattern in the leukemia cells of 22 patients diagnosed with cytogenetically normal acute myelogenous leukemia, said Dr. Ravindra Kolhe, molecular pathologist at the Medical College of Georgia at Georgia Regents University.”This is a total game changer,” Kolhe said. “We have to use more sensitive tests to give patients the proper answer.”Kolhe, Director of the Georgia Esoteric, Molecular Labs, LLC, Department of Pathology, presented the findings March 29 during the American College of Medical Genetics and Genomics Annual Clinical Genetics Meeting in Nashville.Acute myelogenous leukemia, the most common type of acute leukemia in adults, has about 20 subtypes, according to the National Cancer Institute. Patients with cytogenetically normal acute myelogenous leukemia experience widely varying outcomes following chemotherapy and bone marrow transplants. Ideally, identifying the causative genes will lead to a more targeted therapy and definitive prognosis, Kolhe said.”The technology we currently use can’t identify specifically what’s wrong,” Kolhe said. Patients have high percentages of cancer-producing cells called blasts in their blood and bone marrow but they do not show the distinctive chromosomal alterations that typically help characterize the leukemia and strategize therapy.Genetic abnormalities, inherited and/or caused by environmental exposures — including previous chemotherapy and radiation treatment — are thought to cause leukemia. The result is that a disproportionate number of stem cells get stuck in the blast, or cancerous, stage, rather than maturing to white blood cells that actually fight cancer and other invaders.Patients often feel tired and feverish and blood tests reveal high blast levels. Pathologists then take about 20 leukemia cells, chemically block their constant division, open the nucleus, and spread the chromosomes on a slide. They examine the chromosomes with a microscope and in-situ hybridization technology, which helps detect small deletions or rearrangements.”(Cytogenetically normal patients) show a normal chromosomal picture but they are clearly sick,” Kolhe said. Frustrated at being unable to give these patients better information, he partnered with California-based Affymetrix to look directly at the genes within chromosomes using CytoScanHD microarray technology.When he put cell contents instead on a computer chip with 2.7 million genetic probes, small, previously undetectable changes in the DNA became apparent in patients who had been classified as cytogenetically normal. …

Read more

Public smoking bans linked with rapid fall in preterm births, child hospital visits for asthma

The introduction of laws banning smoking in public places and workplaces in North America and Europe has been quickly followed by large drops in rates of preterm births and children attending hospital for asthma, according to the first systematic review and meta-analysis examining the effect of smoke-free legislation on child health, published in The Lancet.The analysis of 11 studies done in North America and Europe, involving more than 2.5 million births, and nearly 250 000 asthma exacerbations, showed that rates of both preterm births and hospital attendance for asthma were reduced by 10% within a year of smoke-free laws coming into effect.Currently only 16% of the world’s population is covered by comprehensive smoke-free laws, and 40% of children worldwide are regularly exposed to second-hand smoke. To date, most studies have looked at the impact of smoking bans on adult outcomes, but children account for more than a quarter of all deaths and over half of all healthy years of life lost due to exposure to second-hand smoke.After searching systematically for both published and unpublished studies over 38 years (1975-2013) reporting on the impact of public smoking restrictions on health outcomes in children aged 12 years or younger, Dr Jasper Been from the Maastricht University Medical Centre, in the Netherlands, and colleagues identified 11 suitable studies — five North American studies describing local bans and six European studies looking at national bans.”Our research found significant reductions in preterm birth and severe asthma attacks in childhood, as well as a 5% decline in children being born very small for gestational age after the introduction of smoke-free laws,” says Dr Been.”Together with the known health benefits in adults, our study provides clear evidence that smoking bans have considerable public health benefits for perinatal and child health, and provides strong support for WHO recommendations to create smoke-free public environments on a national level.”*”This research has demonstrated the very considerable potential that smoke-free legislation offers to reduce preterm births and childhood asthma attacks,” says study co-author Professor Aziz Sheikh, of Brigham and Women’s Hospital, USA, and the University of Edinburgh, UK. “The many countries that are yet to enforce smoke-free legislation should in the light of these findings reconsider their positions on this important health policy question.”*Writing in a linked Comment, Sara Kalkhoran and Stanton Glantz from the University of California San Francisco in the USA point out that, “Medical expenses for asthma exceeded US$50 billion in the USA in 2007, and US$20 billion in Europe in 2006. If asthma emergency department visits and admissions to hospital decreased by even 10%, the savings in the USA and Europe together would be US$7 billion annually.”They conclude, “The cigarette companies, their allies, and the groups they sponsor have long used claims of economic harm, particularly to restaurants, bars, and casinos, to oppose smoke-free laws despite consistent evidence to the contrary. By contrast, the rapid economic benefits that smoke-free laws and other tobacco control policies bring in terms of reduced medical costs are real. Rarely can such a simple intervention improve health and reduce medical costs so swiftly and substantially.”Story Source:The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.

Read more

Exercise training improves health outcomes of women with heart disease more than of men

In the largest study to ever investigate the effects of exercise training in patients with heart failure, exercise training reduced the risk for subsequent all-cause mortality or all-cause hospitalization in women by 26 percent, compared with 10 percent in men. While a causal relationship has previously been observed in clinical practice between improved health outcomes and exercise, this trial is the first to link the effects of exercise training to health outcomes in women with cardiovascular disease. This study, an exploratory analysis, recently was published in the Journal of the American College of Cardiology: Heart Failure.”This trial was uniquely positioned to review results of exercise training in women compared with men since we included a pre-specified analysis of women, we used the largest testing database ever acquired of women and the population was optimized with medical therapy,” said Ileana Pia, M.D., M.P.H., associate chief, Academic Affairs, Division of Cardiology, Montefiore Medical Center, professor of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, the NHLBI-sponsored clinical trial investigator and chair of the Steering Committee. “Heart disease has a major impact on women. Our goal is for these findings to greatly impact the management of this challenging syndrome.”Heart disease is the leading cause of death for women in the United States, responsible for one-in-four female deaths. Although women are twice as likely as men to develop heart failure following heart attack or cardiac ischemia, they are less often directed to complete an exercise program.Women with cardiovascular disease are largely underrepresented in past exercise research, and no large trial has previously studied the impact of exercise training on health outcomes for women with heart failure. The randomized, multicenter, international HF-ACTION (The Heart Failure — A Controlled Trial Investigating Outcomes of Exercise Training) trial included the largest cohort of women with heart failure to undergo exercise training, and examined potential gender differences that could affect physical exercise prescription.”These findings are significant because they represent important implications for clinical practice and patient behaviors,” said Dr. Pia. “Findings suggest physicians should consider exercise as a component of treatment for female patients with heart failure, as they do for male patients.”The clinical trial randomized 2,331 patients with heart failure and a left ventricular ejection fraction of less than or equal to 35 percent to either a formal exercise program plus optimal medical therapy, or to optimal medical therapy alone. Prior to randomization, patients underwent symptom-limited cardiopulmonary exercise tests to assess exercise capacity, as measured by peak oxygen uptake (VO2). …

Read more

Utilizzando il sito, accetti l'utilizzo dei cookie da parte nostra. maggiori informazioni

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close