HEALTH, HAPPINESS AND LONGEVITY

HHAL MEDICAL NEWS AUGUST 2012
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HHAL MEDICAL NEWS AUGUST 2012


Losing Twenty Pounds Can Help Obese Adults Gain 10 Years

According to a new study presented at the American Psychological Association's 120th Annual Convention, individuals who are overweight or obese could gain ten years worth of health benefits by simply losing 20 pounds. In addition, the researchers examined data that suggests foods may have addictive properties if they contain high levels of sugar and fat.

The study was presented by Rena Wing, Ph.D., professor of psychiatry and human behavior at Brown University's Alpert Medical School and director of the Weight Control and Diabetes Research Center at The Miriam Hospital in Providence, R.I., and Kelly Brownell, Ph.D., director of Yale University's Rudd Center for Food Policy and Obesity.

APA President Suzanne Bennet Johnson said in introducing Wing and Brownell:

"Obesity is the No.1 health challenge facing our country today. These psychologists have each contributed greatly in combating the obesity epidemic in different ways, one on the individual patient level and the other on the public policy level."

Wing referred to her work from the Diabetes Prevention Program, a nationwide study that involved 3,000 overweight individuals with impaired glucose tolerance.

Rather than receiving drugs, study participants were shown how to change their behavior. Results from the study revealed that modest weight loss (average 14 lbs) reduced the risk of individuals developing Type 2 diabetes by 58%.

Wing noted that the health benefits of losing weight lasted for up to a decade, even if the individual regained the weight during the 10 years.

Participants were asked to keep a record of everything they consumed and were required to reduce the amount of unhealthy foods in their home. In addition, study participants exercised more and met with coaches on a regular basis.

Wing explained: "Helping people find ways to change their eating and activity behaviors and developing interventions other than medication to reinforce a healthy lifestyle have made a huge difference in preventing one of the major health problems in this country. Weight losses of just 10% of a person's body weight (or about 20 pounds in those who weigh 200 pounds) have also been shown to have long-term impact on sleep apnea, hypertension and quality of life, and to slow the decline in mobility that occurs as people age."

Wing is currently conducting a 13-year clinical trial involving 5,000 individuals with Type 2 diabetes. The aim of the study is to determine whether an intensive behavioral intervention can reduce the risk of heart attacks and heart disease.

Wing explained: "We are trying to show that behavior changes not only make people healthier in terms of reducing heart disease risk factors but actually can make them live longer."

Brownell said: "Changing food policy is another prevention approach where behavioral science is addressing the U.S. obesity epidemic. We need to be courageous in establishing policies that address obesity and we need to use science to better inform public policy."

Brownell focused on the addictive impact of food. He explained: 

"The primary question is whether foods, particularly those high in sugar, act on the brain in ways that create signs of addiction. Craving and withdrawal signs can be seen in animal and human brain imaging studies conducted by investigators around the world. This could fundamentally change the debate about diet, nutrition and obesity in this country."

According to Brownell, if foods do have addictive properties, new laws may be created that would limit certain nutrients in food and reduce marketing of these types of food products to children.

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=248859

Sitting daily for <3 hours and watching TV for <2 hours extends life expectancy by an estimated 1 to 2 years.

Katzmarzyk PT and Lee I-M. BMJ Open 2012 Jul 9; 2:e000828



Glucocorticoid-Induced Cushing Syndrome Linked to Increased Risk for CV Events

Among patients taking glucocorticoids, those who develop iatrogenic Cushing syndrome have more than twice the risk for cardiovascular events as those who do not develop the condition, according to a BMJ study.

Using national U.K. databases, researchers studied some 550 patients who exhibited Cushing syndrome while taking glucorticoids, 3000 taking glucocorticoids who did not develop Cushing syndrome, and 3000 not taking the drugs. In adjusted analyses, the rate of cardiovascular events per 100 person-years was 15.1 among patients with Cushing syndrome, 6.4 among glucocorticoid users without Cushing syndrome, and 4.1 among nonusers.

The authors write: "Glucocorticoid induced cushingoid appearance should no longer be considered as a minor adverse event of glucocorticoids." They add that those who do exhibit Cushing syndrome "should be aggressively targeted for early screening and management of cardiovascular risk factors."

BMJ article

When Does Alzheimer Disease Start?

A study of familial AD suggests the disease starts more than 20 years before clinical symptoms develop.

The pathological process of Alzheimer disease (AD) begins before the clinical symptoms manifest. To identify the timing and stages of this process, researchers examined biological markers of AD in 128 individuals who had a parent with dominantly inherited AD (carriers of the APPPSEN1, or PSEN2gene mutation). The researchers tested the participants for carrier status of the relevant gene. Using the affected parent's age at onset and the participant's age at assessment, the researchers estimated the years to symptom onset and identified correlations with biological and clinical AD parameters.

Of the 128 participants, 88 were AD gene carriers (mean age at assessment, 39). Levels of amyloid-beta (Aβ)42 in the cerebrospinal fluid (CSF) appeared to decline in carriers compared with noncarriers 25 years before estimated symptom onset and were significantly different starting 10 years before estimated onset. Compared with noncarriers, carriers had significantly greater Aβ deposition in the precuneus (measured by positron emission tomography), significantly higher CSF tau levels, and hippocampal atrophy 15 years before estimated onset. Carriers also had cerebral hypometabolism in the precuneus 10 years before estimated onset and significantly more global cognitive impairment and logical memory impairment than noncarriers 5 years before estimated onset. The diagnosis of AD was made in 44 participants (43 carriers) an average of 3 years after estimated onset.





Diabetes in Normal-Weight Patients Associated with Higher Mortality Risk

People who are at a normal weight when they develop diabetes have higher rates of mortality than those who are overweight or obese when diagnosed, according to an analysis of five cohort studies in JAMA.

The studies included 2500 adults over age 40 with incident diabetes; roughly 10% were normal weight. During 27,000 person-years of follow-up, adjusted hazard ratios among normal-weight patients were significantly increased for total mortality (2.08) and noncardiovascular mortality (2.32), compared with the overweight and obese group. Cardiovascular mortality was also elevated (1.52), but not significantly so.

The mechanism for the paradoxical increase is unknown and may, according to editorialists, lie in a phenotype characterized as "metabolically obese normal weight."

JAMA article

Diabetic Women More Likely To Experience Sexual Dissatisfaction

Women with diabetes are just as likely to be interested in, and engage in, sexual activity as non-diabetic women, but they are much more likely to report low overall sexual satisfaction, according to a UCSF study. 

The researchers also found that diabetic women receiving insulin treatment were at higher risk for the specific complications of lubrication and orgasm. "Diabetes is a recognized risk factor for erectile dysfunction in men, but there have been almost no data to indicate whether it also affects sexual function in women," said senior author Alison J. Huang, MD, MAS, of the UCSF Women's Health Clinical Research Center and an assistant professor in the UCSF Department of Medicine. 

The study is available online in the journal Obstetrics and Gynecology

Huang, lead author Kelli Copeland, BA, of the UCSF Women's Health Clinical Research Center, and their colleagues sought to examine the relationship of diabetes to sexual function in an ethnically diverse group of middle-aged and older women. 

The disease has the potential to affect sexual function in women through a variety of mechanisms. These include vascular changes in the urogenital tissues affecting lubrication, and alterations in genital arousal response. Sexual function also may be adversely affected by diabetes medications or other interventions directed at monitoring or treating the disease, according to the research team. 

The researchers sent a questionnaire to 2,270 women aged 40 to 80 years who were insulin-treated diabetic, non-insulin-treated diabetic or non diabetic women, and then compared their self-reported sexual desire, frequency of sexual activity, overall sexual satisfaction, and specific sexual problems (difficulty with lubrication, arousal, orgasm, or pain). They also assessed the relationships between diabetic end-organ complications (heart disease, stroke, renal dysfunction, and peripheral neuropathy) and sexual function. 

Among the 2,270 participants, 486 (21.4 percent) had diabetes, and, of those, 139 (6.1 percent) were taking insulin. Overall, 63.7 percent of participants reported some sexual activity in the past three months. The odds of reporting low overall sexual satisfaction were more than two-fold higher in insulin-treated diabetic women, and more than 40 percent higher in non-insulin treated diabetic women, compared to non-diabetic women. 

No significant differences in sexual desire or frequency of sexual activity by diabetes status were observed, after the investigators took into account other differences in participants' demographic background and medical histories. 

Among sexually active women, insulin-treated diabetic women were more than twice as likely to report difficulty with lubrication, and 80 percent more likely to report difficulty achieving orgasm compared to non-diabetic women, after adjusting for the same demographic and clinical factors. 

Among all diabetic women, end-organ complications such as heart disease, stroke, renal dysfunction, and peripheral neuropathy were associated with decreased sexual function in at least one domain. 

The study did not examine whether the women had Type 1 or Type 2 diabetes, but the researchers assume that because of age of diagnosis, and when they started insulin, that the majority of participants had Type 2 diabetes. 

Previous studies have suggested that psychological factors, such as depression, play a role in sexual dysfunction among diabetic women. The UCSF team did not assess the impact of depression on female sexual function in this study, but did adjust for antidepressant use among participants since it can worsen sexual function. The team found that relationships between diabetes and sexual function were independent of anti-depression therapy. 

Diabetes is a common chronic condition in the United States. According to the American Diabetes Association, 12.6 million or 10.8 percent of all women aged 20 years or older have diabetes. 

"Based on this research, clinicians may want to consider assessing diabetic women for sexual problems, particularly among those taking insulin, and counsel them that prevention of end-organ complications may be important in preserving sexual function," said Copeland. 

The researchers used data from the Reproductive Risks of Incontinence Study at Kaiser 2, comprised of women enrolled in the northern California Kaiser system, in addition to the Northern California Kaiser Permanente Diabetes Registry.

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=248312

What's the Optimal HbA1c Level in Elders?

In an observational study, glycosylated hemoglobin between 8% and 9% was best.

Experienced clinicians have long recognized that tight glycemic control can be perilous in frail older patients with type 2 diabetes. Now, an observational study addresses that concern. Researchers in San Francisco studied 367 community-dwelling, older patients (mean age, 80) with diabetes who participated in a comprehensive adult day-care program and were unable to live independently. Glycosylated hemoglobin (HbA1c) levels were measured at baseline, and functional decline and death were tracked during 2 years of follow-up (during which, average HbA1clevels didn't change much).

Analyses were adjusted for potentially confounding variables. Compared with patients in the reference category (HbA1c levels, 7%–8%), patients whose HbA1c levels were between 8% and 9% had a significantly lower incidence of functional decline or death (relative risk, 0.88), and those with HbA1c levels <7% had a nearly significant higher incidence of functional decline or death. Overall, the relation between HbA1c level and functional decline or death was somewhat U-shaped, with the best outcomes among patients in the 8% to 9% range. These basic patterns were noted both among patients who took only oral antidiabetic drugs and those who took insulin.

Medline abstract 

http://general-medicine.jwatch.org/cgi/content/full/2012/809/1?q=etoc_jwgenmed



Moderate Alcohol Consumption Is Associated with Lower Risk for Rheumatoid Arthritis

In a prospective study, risk was 40% to 50% lower in older women who weren't teetotalers.

Alcohol consumption lowers production of proinflammatory molecules, and an inverse relation between alcohol consumption and risk for rheumatoid arthritis (RA) has been observed previously in case-control studies. To test this association prospectively, researchers conducted a population-based cohort study of more than 34,000 Swedish women (age, &ge;39 in 1987). Participants provided data on alcohol consumption in 1987 and 1997.

During follow-up from 2003 until 2009, 197 new cases of RA were identified. The multivariable adjusted relative risk for RA during follow-up was 37% lower in women who drank >4 glasses of alcohol (1 glass = 15 g of ethanol) weekly in 1997 than in women who drank <1 glass of alcohol weekly. Similarly, adjusted risk for RA was 52% lower in women who drank >3 glasses of alcohol weekly in both 1987 and 1997 than in never drinkers.




Does the Zoster Vaccine Prevent Recurrent Shingles?

A small study suggests its short-term effect is nil.

A matched cohort study suggests a low incidence of recurrent HZ among immunocompetent older patients, regardless of their vaccination status.

Tseng HF et al. J Infect Dis 2012 Jul 206:190





Regular Dietary Cocoa Flavanol Intake May Slow Memory Decline In Seniors

According to a new study published online in the journal Hypertension, researchers from the University of L'Aquila, Italy, have found convincing new evidence that cognitive function in elderly people with early memory decline can be improved by regular consumption of dietary cocoa flavanols.

The study shines new light on the benefits of flavanols, particularly with regard to regular cocoa flavanol consumption on cognitive function in people with Mild Cognitive Impairment (MCI).

Even though earlier research had indicated that the benefits of cocoa flavanols could also apply to the brain, it either consisted of short-term research or was unable to demonstrate a consistent cognitive benefit. The new study has done both, and the findings allow researchers to better understand the possibility of slowing or even reversing cognitive declines linked to aging by consuming these natural compounds.

Flavanols are natural compounds that are particularly abundant in cocoa; substantial evidence has shown that consuming cocoa flavanols helps support healthy circulation and cardiovascular health.

Study-author, Dr. Giovambattista Desideri, Director of the Geriatric Division of the University of L'Aquila, said:

"For the first time, regular cocoa flavanol consumption has been shown to positively affect cognitive function in older adults with early memory decline.

Importantly, the improvements in cognitive function were seen over a relatively short period of time; and, while further research is required to confirm and expand on these findings, this provides encouraging evidence that regular consumption of cocoa flavanols might be effective in improving cognitive function in elderly subjects with Mild Cognitive Impairment.

The findings provide promising indications that the development of novel dietary approaches for improving health as we age - especially cognitive health - is a real possibility."

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=249019


Physiologic function of dietary fiber
The health benefits of eating dietary fiber include the prevention and mitigation of type 2 diabetes mellitus, cardiovascular disease and colon cancer. By modulating food ingestion, digestion, absorption and metabolism, dietary fiber reduces the risk of hyperlipidemia, hypercholesterolemia and hyperglycemia. The authors describe the accepted physiologic functions of dietary fiber and explore their newly identified potential immune-based actions. Metabolism -- Clinical and Experimental


Study links low vitamin D levels with higher risk of death in seniors
Seniors with low levels of vitamin D had a 30% greater risk of death than those with higher levels, according to an analysis of data from a survey of more than 4,300 people older than 60. The risk of dying was higher among frail seniors. The findings appeared online in the European Journal of Clinical Nutrition. HealthDay News 


Slight anxiety linked to higher risk of dying, data show
An analysis of data from 1994 to 2004 from the National Health Survey in England found that mild levels of psychological distress were associated with an about 20% higher risk of death. Researchers noted that mild levels of distress were linked to an elevated risk of dying from cardiovascular disorders but not cancer. The findings appear in BMJ. WebMD


Utah is best place to live 5 years from now, Gallup says
Gallup used survey responses from more than half a million U.S. adults to rank Utah as the best place to live five years from now, based on metrics in economics, workplace, community and personal choices. The future livability ranking has Minnesota, Colorado, Nebraska and North Dakota rounding out the top five, while West Virginia, Mississippi, Kentucky, Arkansas and Nevada are at the bottom of the list. USA TODAY 


Weight Control Can Cut Women's Diabetes Risk, Study Shows

Exercise and healthy diet paid off regardless of race

FRIDAY, July 27 (HealthDay News) -- Weight control through diet and exercise can prevent most cases of type 2 diabetes in American women over age 50, a new study finds.

Researchers from the University of Massachusetts Medical School in Worcester, Mass., analyzed data from more than 150,000 postmenopausal women who were followed for more than 10 years. Hispanics and Asians were about twice as likely as whites to develop diabetes; blacks were two to three times as likely.

Those differences were largely due to modifiable lifestyle factors such as diet, physical activity and smoking, the researchers said.

The study also found that a large reduction in diabetes risk among women would occur in all four racial and ethnic groups if they maintained a healthy body weight, ate a healthy diet and were physically active.

Maintaining a body-mass index (BMI) of less than 25 appeared to be particularly important in reducing diabetes risk. BMI is a measure of body fat based on height and weight.

"Our work shows that among numerous races [and] ethnicities, the women with both high body-mass index and low levels of physical activity are far more likely to develop diabetes," primary investigator Dr. Yunsheng Ma said in a medical school news release. "A healthier diet and adequate levels of physical activity significantly lower that risk for most women."

The study was published July 23 in the journal Diabetes Care.

Type 2 diabetes, the more common type, means the body doesn't produce or properly use the hormone insulin, which is needed to convert food into energy. Untreated, type 2 diabetes can cause damage to the heart, eyes, kidneys and other organs.

http://consumer.healthday.com/Article.asp?AID=667007


Aspirin and Cancer Mortality: New Data Indicate Modest Benefit

Daily aspirin use is associated with a modest reduction in cancer mortality, but the benefit is not as great as that observed previously, according to a prospective study in the Journal of the National Cancer Institute.

Some 100,000 adults who were free of cancer at baseline were followed for 11 years. About a quarter reported taking aspirin daily at baseline, with most continuing its use during follow-up.

Overall, 5% died from cancer during follow-up. Current daily aspirin use was associated with a small but significant reduction in overall cancer mortality, compared with nonuse (relative risk, 0.84). The lower risk was largely driven by a reduction in gastrointestinal cancer mortality, although deaths due to liver and bladder cancers were also reduced significantly.

Aspirin's benefit was limited to nonsmokers. Duration of use showed no effect.

An editorialist, a consultant to Bayer, calls the results "an echo of other data on aspirin and cancer mortality, not a resounding confirmation." He adds: "Nonetheless, the big picture on aspirin use and cancer is very positive."

JNCI article 

JNCI editorial 

Study Finds No Link Between Migraine and Cognitive Decline in Women

Women who experience migraine — with aura or without — aren't at increased risk for cognitive decline, according to a prospective cohort study in BMJ.

Over 6300 women aged 65 and older participating in the Women's Health Study reported their experiences with migraine and then completed cognitive assessments during follow-up. About 13% reported ever having migraine; of these, about half had migraine in the previous year, while the rest were considered to have a past history of migraine.

At roughly 3.5 years' follow-up, women who reported migraine with aura, migraine without aura, or a past history of migraine showed no greater declines in cognitive function than those who'd never had migraine.

The researchers conclude that "patients with migraine and their treating doctors should be reassured that migraine may not have long term consequences on cognitive function."

BMJ article




Cochrane Review: Benefits of Treating Mild Hypertension Not Clear

The benefits of treating patients with mildly elevated blood pressure who are free of cardiovascular disease are unclear, according to a Cochrane review. These findings conflict with current hypertension treatment guidelines in the U.S., Canada, and Europe.

Researchers analyzed data from nearly 9000 participants in four trials and found no obvious benefit of drug treatment in patients with mild hypertension (systolic BP, 140 to 159 mm Hg and/or diastolic BP, 90 to 99 mm Hg) in terms of total mortality or cardiovascular events at 5 years' follow-up. They did, however, see an increased likelihood of drug withdrawal due to adverse effects (relative risk, 4.8).

Cochrane review 

Different Blood Types, Different Coronary Risks?

People with non-O blood types are at higher risk for developing coronary heart disease, according to a study in Arteriosclerosis, Thrombosis, and Vascular Biology.

Using data from both the Nurses' Health Study and the Health Professionals Follow-up Study (together comprising almost 90,000 participants), researchers found a significant increase in the hazard ratio for coronary disease among those with type AB blood (HR, 1.23), B (1.15), and A (1.08), relative to those with type O blood. They estimate that over 6% of coronary disease is attributable to the presence of a non-O blood group. The association was not modified by the presence of other known risk factors, such as smoking or diabetes.

The authors speculate higher levels of some clotting factors in people with non-O blood types may partially explain the association.

Arteriosclerosis, Thrombosis, and Vascular Biology article 

ACE Inhibitor Use Lowers Risks for Pneumonia

A meta-analysis showed that angiotensin-converting–enzyme inhibitors, but not angiotensin-receptor blockers, lowered risk.

Many patients (as many as one third) who take angiotensin-converting–enzyme (ACE) inhibitors develop coughs. However, an enhanced cough reflex might lower risk for pneumonia. In this meta-analysis of 37 studies (18 randomized trials, 11 cohort studies, and 8 case-control studies), investigators evaluated the association between use of ACE inhibitors or angiotensin-receptor blockers (ARBs) and risk for pneumonia.

Overall, use of ACE inhibitors was associated with a significant 34% lower risk for pneumonia compared with no use of ACE inhibitors and a significant 30% lower risk for pneumonia compared with ARB use. Subgroup analyses of patients with stroke or heart failure yielded similar results. Finally, use of ACE inhibitors compared with no use was associated with a significant 27% lower risk for pneumonia-related death.


Original article

Medline abstract

Statins were unlikely to be prescribed for patients 75 or older.

Previous research has shown that patients with known cardiovascular disease (CVD) are less likely to receive these drugs as they get older, and women are less likely than men to get these drugs. Whether the same is true for primary prevention of CVD is unclear. In this cross-sectional U.K. study, investigators assessed the effects of age and sex on primary prevention of CVD in 37,000 patients (age, 40).

The proportion of patients who received antihypertensive drugs increased with age from 5% among the youngest patients (age range, 40–44) to 57% among the oldest patients (age, 85). In fact, the likelihood of receiving an antihypertensive drug prescription increased significantly with each 5-year increment up to age 84 but not for age 85. The proportion of patients who received statins increased with age from 3% among the youngest patients (age range, 40–44) to 29% among patients who were 70 to 74. The likelihood of receiving a statin drug prescription increased significantly with each 5-year increment up to age 74 but decreased significantly with each 5-year increment thereafter. Treatment of women and men did not differ.

Comment: Increasing age increases risk for CVD, and many elders have high 10-year risk for CVD (20%). For some elders (age, 75), primary prevention with antihypertensive and statin drugs can lower this risk. However, fewer randomized trial data exist for this age group (and especially for age 85) than for age <75, and overall life expectancy and effects of polypharmacy should be considered in older populations. The researchers call for clinical trials of, and clarification of guidelines for using, these drugs in elders, especially those older than 75.

Sheppard JP et al. Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: Cross sectional study. BMJ 2012 Jul 12; 345:e4535. (http://dx.doi.org/10.1136/bmj.e4535)

Original article 

Medline abstract 



Retinopathy in Blacks Starts at Lower Levels of HbA1c Than in Whites

Although blacks generally have higher glycated hemoglobin levels than whites at the same blood glucose levels, they develop retinopathy at lower HbA1c levels than whites, an Annals of Internal Medicine study finds. The authors say this difference in retinopathy risk argues against setting higher diagnostic levels of HbA1c for blacks.

Researchers examined U.S. NHANES data on over 3000 people. They found that after adjustment for such factors as hypertension and BMI, higher risks for retinopathy started at HbA1c levels of 6.0% and higher in whites, but at levels of 5.5% and higher in blacks. The reasons underlying the risk difference are unknown.

The authors conclude that their results "suggest that the HbA1c levels at which the risk for prevalent retinopathy begins to increase are lower in black adults than in white adults, arguing against a higher HbA1c diagnostic cutoff for blacks."

Annals of Internal Medicine article

Chemical in Antibacterial Soap Linked to Muscle Weakness in Animal Studies

Patients may ask about reports that a chemical commonly used in antibacterial soaps and hand sanitizers may cause muscle weakness. The chemical — triclosan — is associated with impaired muscle function in vitro as well as in mice and minnows, according to study in theProceedings of the National Academy of Sciences.

The FDA in 2010 said that similar studies warranted "further review."

PNAS article 

Los Angeles Times story



Honey Helps Kids with Nocturnal Cough

In children with nighttime cough, honey appears to offer symptom relief and improve sleep quality, according to a study in Pediatrics. (The study was funded, in part, by the Honey Board of Israel.)

Nearly 300 children aged 1 to 5 years who presented to Israeli pediatric clinics with upper respiratory infections were randomized to a single, 10-g dose of honey or placebo within 30 minutes of bedtime. Their parents completed questionnaires before randomization and then the day after treatment.

Compared with baseline, cough symptoms and sleep quality improved significantly with honey and with placebo. However, improvements were greater in the honey groups than in the placebo group. Adverse events did not differ across the groups.

The researchers speculate that an interaction between fibers that control cough and those that taste sweetness may produce an antitussive effect. They conclude: "In light of this study, honey can be considered an effective and safe treatment [for nocturnal cough] of children >1 year of age."

Pediatrics article

Certain Antihypertensive Drugs Associated with Risk for Lip Cancer

Some commonly used antihypertensive drugs — hydrochlorothiazide and nifedipine — might increase the risk for lip cancer, according to a case-control study in the Archives of Internal Medicine.

Using a California-based cancer registry, researchers matched some 700 non-Hispanic white adults diagnosed with lip cancer to some 23,000 controls free of lip cancer. Patients who filled three or more prescriptions for hydrochlorothiazide, hydrochlorothiazide-triamterene, and nifedipine — all photosensitizing agents — had roughly double the risk for lip cancer relative to those with no prescriptions filled. Risks increased with duration of use. Atenolol, which is non-photosensitizing, was not associated with increased risk.

The authors write that photosensitizing drugs may absorb energy from sunlight, which leads to the release of electrons. This then produces free radicals that can cause inflammation.

An Archives' editor writes: "When initiating use of photosensitizing agents for our patients, we need to remind them of ... simple measures to avoid sun exposure."

Archives of Internal Medicine article

Repeat Screening for AAA Might Be Cost-Effective

In a hypothetical cohort, screening men twice for abdominal aortic aneurysms, at ages 65 and 70, cost US$15,500 per quality-adjusted life-year.

Søgaard R et al. BMJ 2012 Jul 5; 345:e4276



Does Spironolactone Raise Breast Cancer Risk?

In a large cohort study, risk was not higher in women who used this drug.

Mackenzie IS et al. BMJ 2012 Jul 13; 345:e4447

Muscle Atrophy: Researchers Identify Key Culprit
http://mnt.to/l/47Jc

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=248978

Cancer-Protective Effect Of Daily Aspirin Smaller Than Previously Thought
http://mnt.to/l/47Hn

Daily Aspirin May Decrease Cancer Mortality
http://mnt.to/l/47GT

Cancer Mortality Rates May Be Lowered By Daily Aspirin Usage
http://mnt.to/l/47HJ


Regular Dietary Cocoa Flavanol Intake May Slow Memory Decline In Seniors
http://mnt.to/l/47K3



Hypertension May Be Improved By Cocoa Compounds
http://mnt.to/l/47K8


 PSA Screening and Quality of Life

Using simulation modeling, researchers estimated potential gains in quality-adjusted life-years from prostate-specific antigen screening.

http://general-medicine.jwatch.org/cgi/content/full/2012/815/1


Allopurinol Starting Dose Might Affect Risk for Hypersensitivity Reactions

An initial allopurinol dose of 1.5 mg per unit of glomerular filtration rate seems reasonable.

Stamp LK et al. Arthritis Rheum 2012 Aug 64:2529

Adverse Cardiovascular Events in Patients with Iatrogenic Cushing Syndrome



Risks for coronary heart disease and congestive heart failure were higher.

Fardet L et al. BMJ 2012 Jul 30; 345:e4928



Using simulation modeling, researchers estimated potential gains in quality-adjusted life-years from prostate-specific antigen screening.

Heijnsdijk EAM et al. N Engl J Med 2012 Aug 16; 367:595

Sox HC. N Engl J Med 2012 Aug 16; 367:669



Stress May Cause Illness By Changing Genes
http://mnt.to/l/47P3


Density Of Breasts Does Not Impact Death Among Breast Cancer Patients
http://mnt.to/l/47Nv


Mouse Study Finds Clear Linkages Between Inflammation, Bacterial Communities And Cancer
http://mnt.to/l/47Nb


Two Approaches To Understanding The Basic Mechanics Of Cancer
http://mnt.to/l/47LC


Physical Activity In Premenopausal Women Reduces Hormone That Inhibits Bone Formation
http://mnt.to/l/47KM


Working Moms Are Healthier Than Stay-At-Home Moms, Sociologist Finds
http://mnt.to/l/47P7


Regular Exercise In Middle Age Protects Heart
http://mnt.to/l/47JC


Seniors Could Be More Steady On Their Feet After Consuming Red Wine Compound
http://mnt.to/l/47NX


A Mediterranean Diet Can Help Protect Bones
http://mnt.to/l/47L4



Foods That Elevate Moods
http://mnt.to/l/47NY


A Major Secret Of The Brain Discovered
http://mnt.to/l/47Ms


What Is Essential Tremor?
http://mnt.to/l/47P2

Evolutionary Increase In Size Of The Human Brain Explained
http://mnt.to/l/47MK

Secrets Of 'SuperAger' Brains - Elderly SuperAgers Have Brains That Look And Act Decades Younger Than Their Age
http://mnt.to/l/47N8


Eating 2.5 Ounces Of Walnuts Per Day Improves Semen Quality In Healthy Young Men
http://mnt.to/l/47L9


Hormone Levels Linked To Metabolic Disease
http://mnt.to/l/47Nk


Does A Statin A Day Keep The Doctor Away?
http://mnt.to/l/47Ff


Education Lengthens Life Expectancy
http://mnt.to/l/47D6


Losing Twenty Pounds Can Help Obese Adults Gain 10 Years
http://mnt.to/l/47FM


What Is Calcium? Why Do I Need Calcium?
http://mnt.to/l/47HN


Muscle Function May Be Impaired By Triclosan, A Chemical Widely Used In Antibacterial Hand Soaps
http://mnt.to/l/47HZ


Protein That Slows Aging May Protect Against Diabetes
http://mnt.to/l/47Cp


Weight Training May Lower Your Diabetes Risk
http://mnt.to/l/47FF


Recently Diagnosed Diabetes Patients Of Normal Weight Have Higher Death Risk
http://mnt.to/l/47Dn


Analysis Of Hemoglobin A1C Levels In Blacks, Whites Reveals Racial Differences In Diabetes Diagnostic Thresholds
http://mnt.to/l/47BT



How Stress And Depression Can Shrink The Brain
http://mnt.to/l/47Hw


Former Finasteride Users Found To Suffer Depressive Symptoms And Suicidal Thoughts
http://mnt.to/l/47Ct

Muscle-Building Dietary Supplement Creatine Can Fight Depression
http://mnt.to/l/47Cm


Tick Bites May Cause Red Meat Allergy
http://mnt.to/l/47py


Reducing The Risk Of Repeat Fractures From Osteoporosis
http://mnt.to/l/47vX


Sudden Cardiac Death In Black Athletes May Be Caused By Sickle Cell Trait
http://mnt.to/l/47qr


Minimizing Exposure To Artificial Light At Night May Improve Depressive Symptoms
http://mnt.to/l/47pQ


Benefits Of Mindfulness Meditation: Reduces Loneliness In Older Adults, Lowers Inflammation Levels And Alters Gene Expression
http://mnt.to/l/47q3

PSA Test Reduces Advanced Prostate Cancers
http://mnt.to/l/47tJ


Wakeful Resting Fights Memory Loss
http://mnt.to/l/47tb


What Is The Right Amount Of Fiber For Kids?
http://mnt.to/l/47vR

Raisins As Good As Sports Chews For Workout Boost
http://mnt.to/l/47tN


When Sodium Leaves The Body, It Takes Calcium Along With It, Potentially Depleting Calcium Stores In The Body
http://mnt.to/l/47pN


Ginseng-Fortified Milk Developed To Improve Cognitive Function
http://mnt.to/l/47nS


Study Suggests Obesity Is Due To Increased Food Consumption, Not Decreased Energy Expenditure
http://mnt.to/l/47qV


Protection Against UVA Rays Provided By Strawberry Extract
http://mnt.to/l/47zp


Smiling Reduces Stress And Helps The Heart
http://mnt.to/l/47v5


Study Helps Identify Cellular Mechanisms For Increased Bone Density Seen With Moderate Alcohol Consumption Post-Menopause
http://mnt.to/l/47ys



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