HHAL MEDICAL NEWS JANUARY 2014

Testosterone Therapy Adds MI Risk, Especially in Older Men

Risk for incident myocardial infarction increases significantly in the months after starting testosterone therapy, particularly among older men, according to a PLoS ONE study.

Using insurance claims data, researchers compared the incidence of nonfatal MI in some 55,000 men in the year before their first prescription for testosterone therapy with the rate in the 90 days after filling that prescription. As a check, they also compared post- and pre-therapy MI rates for a separate cohort of 165,000 men taking drugs for erectile dysfunction.

In the testosterone cohort, the post-/pre-rate ratio for MI was 1.36, increasing to 2.19 in those 65 and older, and to 3.43 in those 75 and older. Younger men with a history of heart disease also showed an increased risk. The cohort taking sildenafil or tadalafil showed no post/pre effect.

The authors note that their study is limited in that they did not have information on the "serologic or diagnostic indications" for therapy. Nonetheless, they advise clinicians to include serious cardiovascular risks in their discussions with patients when prescribing testosterone.

PLoS ONE article

Testosterone May Undermine Flu Vaccine Effectiveness for Men

 (HealthDay News) – Differences in expression of genes involved in lipid metabolism regulated by testosterone may explain why men have less robust immune responses than women, according to a study published online Dec. 23 in the Proceedings of the National Academy of Sciences.

David Furman, PhD, from the Stanford University School of Medicine in California, and colleagues analyzed the neutralizing antibody response to a trivalent inactivated seasonal influenza vaccine and various immune parameters in 53 women and 34 men of various ages.

The researchers found that women had higher serum expression of inflammatory cytokines and elevated antibody responses to the vaccine regardless of age. A cluster of genes involved in lipid biosynthesis known to be up-regulated by testosterone correlated with the poor antibody response, and men with higher serum testosterone levels and associated gene signatures had the lowest antibody response. The gender-specific differences in immune responses were greatest for the H3N2 influenza strain.

"These results demonstrate a strong association between androgens and genes involved in lipid metabolism, suggesting that these could be important drivers of the differences in immune responses between males and females," Furman and colleagues conclude.

Abstract

Calcium Density of Coronary Artery Plaque and Risk of Incident Cardiovascular Events

Importance  Coronary artery calcium (CAC), measured by computed tomography (CT), has strong predictive value for incident cardiovascular disease (CVD) events. The standard CAC score is the Agatston, which is weighted upward for greater calcium density. However, some data suggest increased plaque calcium density may be protective for CVD.

Objective  To determine the independent associations of CAC volume and CAC density with incident CVD events.

Design, Setting, and Participants  Multicenter, prospective observational MESA study (Multi-Ethnic Study of Atherosclerosis), conducted at 6 US field centers of 3398 men and women from 4 race/ethnicity groups; non-Hispanic white, African American, Hispanic, and Chinese. Participants were aged 45-84 years, free of known CVD at baseline, had CAC greater than 0 on their baseline CT, and were followed up through October 2010.

Main Outcomes and Measures  Incident coronary heart disease (CHD) and all CVD events

Results  During a median of 7.6 years of follow-up, there were 175 CHD events and an additional 90 other CVD events for a total of 265 CVD events. With both lnCAC volume and CAC density scores in the same multivariable model, the lnCAC volume score showed an independent association with incident CHD, with a hazard ratio (HR) of 1.81 (95% CI, 1.47-2.23) per standard deviation (SD = 1.6) increase, absolute risk increase 6.1 per 1000 person-years, and for CVD an HR of 1.68 (95% CI, 1.42-1.98) per SD increase, absolute risk increase 7.9 per 1000 person-years. Conversely, the CAC density score showed an independent inverse association, with an HR of 0.73 (95% CI, 0.58-0.91) per SD (SD = 0.7) increase for CHD, absolute risk decrease 5.5 per 1000 person-years, and an HR of 0.71 (95% CI, 0.60-0.85) per SD increase for CVD, absolute risk decrease 8.2 per 1000 person years. Area under the receiver operating characteristic curve analyses showed significantly improved risk prediction with the addition of the density score to a model containing the volume score for both CHD and CVD. In the intermediate CVD risk group, the area under the curve for CVD increased from 0.53 (95% CI, 0.48-0.59) to 0.59 (95% CI, 0.54-0.64), P = .02.

Conclusions and Relevance  CAC volume was positively and independently associated with CHD and CVD risk. At any level of CAC volume, CAC density was inversely and significantly associated with CHD and CVD risk. The role of CAC density should be considered when evaluating current CAC scoring systems .

http://jama.jamanetwork.com/article.aspx?articleID=1780017&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=MASTER%3AJAMALatestIssueTOCNotification01%2F14%2F2014

Garcinia Cambogia: A Safe Supplement for Obesity?

Fighting Obesity with Garcinia Cambogia: Is It Worth the Risks?

Garcinia cambogia is yet another entrant in the growing list of natural supplements being marketed as the answer to obesity. G. cambogia is most well-known for its use as a spice. This product, which is classified as a fruit, is naturally found throughout southeastern Asia, India and western Africa.¹

RELATED: Metabolic Disorders Resource Center

One of nearly 300 species of Garcinia, G. cambogia is the one most studied for its weight-loss potential.¹G. cambogia grows as a small tree and produces a rusty-red round fruit.² It is the rind of this fruit that is used for both culinary and therapeutic purposes.²

Background


Obesity is a tremendous health problem, not just in the United States but globally as well. An estimated 1 billion adults worldwide are overweight, and nearly one-third of those are considered clinically obese.³ In the United States alone, the overall cost of obesity was estimated by the CDC to be nearly $150 billion per year.⁴ 


G. cambogia became popular as a weight-loss aid when it was noted to enhance satiety in its native regions.⁵ A secondary effect of the fruit is its potent laxative action.⁶ The active ingredient of G. cambogia is hydroxycitric acid (HCA).⁵ 



Science


The mechanism of fat metabolism is complex, and the role of G. cambogia in this process is debatable. 

Metabolically, HCA appears to be the source of early satiety. This acid enters the energy-production process of the Kreb's cycle and ultimately increases hepatic glycogen synthesis and inhibits formation of low-density lipoproteins.⁵

This is thought to signal to our brains that we have had enough to eat. Some suggest that HCA interacts with the production of the adipose-controlling hormone leptin, but these claims have yet to be substantiated by clinical trials.


In a meta-analysis literature review, researchers identified only 23 trials that met review criteria.⁷Fewer than half of those ultimately met the proper standards for well-done randomized, placebo-controlled trials. 

After the final data analysis, use of G. cambogia was associated with a very slight (0.88 kg) weight loss over control groups, but also with twice the number of adverse GI effects. 


Korean researchers studied the effects of G. cambogia, placebo, and another weight-loss supplement in 86 overweight adults in a 10-week randomized trial.⁸ At the end of the study, no statistically significant weight loss was found in any of the three groups. 


In another small trial, researchers studied 24 overweight adults over two weeks of daily intake of G. cambogia HCA extract.⁵ In addition to actual weight loss being monitored, 24-hour energy intake was tracked. By the end of the trial, energy intake was reduced by 15% to 30% in the 
G. cambogia group over placebo, with a very modest trend in weight loss. 


Finally, a study in India focused on 60 obese individuals who were randomized to HCA plus two other supplements, or placebo.⁹ At the end of eight weeks, both HCA groups had a 5% to 6% reduction in weight and BMI. Food intake, total cholesterol, LDL cholesterol, and triglycerides all decreased in the HCA groups, and HDL levels increased. 



Safety


Unfortunately, evidence-based literature demonstrates the potential for adverse events in G. cambogia/HCA. In addition to significant GI upset, increasing reports of hepatic injury are surfacing. 

For example, researchers found that daily feeding with HCA supplement did result in decreased fat accumulation and glucose resistance in obese mice, but at the expense of significant hepatic fibrotic changes and inflammation.¹

This article originally appeared on Clinical Advisor.

Green coffee extract: A weight-loss aid?

Green coffee is simply coffee that has not been "cooked." Green coffee products are made from unroasted coffee beans, usually from the plant Coffea arabica.¹ Most of the world enjoys coffee products that are manufactured from roasted coffee beans.

The most widely known natural component of coffee is caffeine but, in reality, coffee contains hundreds of bioactive chemicals, many of which are more significant than caffeine.¹ Green coffee products have become widely popular as a potential weight-loss aid. 


Background


Green coffee extract contains chlorogenic acid, which is derived from a major group of phenolic compounds.² Green coffee beans contain nearly twice the concentration of chlorogenic acid as do roasted beans. Chlorogenic acid is a major component of many OTC weight-loss products and acts independently of caffeine.²

The theorized mechanism of action by which green coffee produces weight loss is through the inhibition of the enzyme glucose-6-phosphatase.³ In vitro, glucose-6-phosphatase induces the enzymatic process of glucose production in the liver.³ It is this step in the metabolic pathway that researchers attribute to the known reduction of glycemic disorders in long-term coffee-

drinkers.⁴ 


Science 


Green coffee extract is believed to aid weight loss. One trial evaluated the responses of 16 overweight adults who had been randomized to high-dose extract, low-dose extract, or placebo in a 22-week study.⁵ Body weight decreased by a mean of 8 lbs, with a mean drop in body fat of more than 4%.⁵ 


In another study, 50 volunteers with body mass indices >25 were randomized to placebo or to treatment with green coffee extract.⁶ After 60 days, members of the treatment group had lost an average of 5.7% of their body weight, with a shift in the muscle-mass-to-fat-mass ratio of +4.1%/-0.7% from baseline.⁶ 


In a trial designed to compare the effect of green coffee vs. roasted coffee on BP measurements, researchers randomized more than 200 subjects to either a placebo coffee drink or a drink with low, medium, or high chlorogenic-acid content.⁷

Each participant drank one cup of the treatment coffee per day and recorded BP readings for one month. At the end of the trial, not only were the BP readings of the placebo group higher than the BP readings of the treatment group, but a definite dose-response curve for the three treatment dose levels also was seen.

This indicates that the beneficial effect of coffee intake on BP has nothing to do with caffeine, but rather with the chlorogenic acid content. These findings have been validated by multiple studies examining different green coffee extract concentrations and populations.^{8, 9} In each trial, a statistically significant reduction of systolic BP was seen with no documented adverse effects. 


Researchers looking at human vasoreactivity monitored nitric oxide activity in individuals after daily intake of a measured amount of green coffee extract. For four months, parameters indicative of endothelial function were monitored daily. At the end of the test period, the vasodilatory response was found to be significantly higher in the test group than in the placebo group, and total plasma homocysteine levels were also lower than at baseline.¹⁰ 


A small lab study using human cell culture lines focused on the chemoprotective and antigenotoxic activities of green coffee extract.¹¹ Human colon and liver cells were treated with a dose-calculated solution of chlorogenic acid and cultured under the same conditions as the placebo cell cultures. Both cell lines were then tested for levels of oxidative stress, such as membrane disruption, DNA damage, and cell death.

Cells exposed to the chlorogenic acid solution showed markedly lower levels of these oxidative injuries than did the untreated cells. 



Safety, how supplied, dose, 
and cost


Few adverse reactions have been noted with green coffee extract use. The extract is supplied in a variety of ways, including as liquid extract, powder or liquid-filled capsules, or a drink. The dose is widely variable based both on body mass and age.

Marketed green coffee extract is often standardized to contain more than 50% chlorogenic acid. Average cost for a typical month's supply ranges from $20 to $30, regardless of the dosage form. 



Summary 


While further study is needed, green coffee extract appears to be safe and somewhat effective in increasing the efficacy of regular weight-loss methods.  


http://www.clinicaladvisor.com/green-coffee-extract-a-weight-loss-aid/article/319635/?webSyncID=5474ae4c-339b-edd5-c640-c400c05a2045&sessionGUID=5bc12687-60d0-5ca2-2b03-5acb01680c08&spMailingID=7662377&spUserID=MzI0NDY5MDgwODUS1&spJobID=108867153&spReportId=MTA4ODY3MTUzS0

Mediterranean Diet Protects Against Diabetes, Regardless of Weight Loss

Even if it doesn't lead to weight loss, a Mediterranean diet could help prevent type 2 diabetes, according to a subanalysis of the PREDIMED study published in the Annals of Internal Medicine.

Some 3500 adults without diabetes but at high cardiovascular risk were randomized to a Mediterranean diet supplemented by either extra-virgin olive oil or nuts or to a low-fat diet (control). Calorie restriction or increased physical activity was not advised.

After 4 years, diabetes had developed in 6.9% of the olive oil group, 7.4% of the nuts group, and 8.8% of controls. After multivariable adjustment, there was a significant, 40% reduction in diabetes risk in the olive oil group, but no such reduction in the nuts group. The differences in outcome appeared unrelated to weight loss.

The authors conclude that PREDIMED "provides strong evidence that long-term adherence to a Mediterranean diet supplemented with [olive oil] without energy restrictions ... results in a substantial reduction in the risk for type 2 diabetes among older persons with high cardiovascular risk."

Editor's note: Adapted with permission from CardioExchange.

Annals of Internal Medicine article

Mediterranean Diet + Extra-Virgin Olive Oil Cuts Diabetes Risk

 (HealthDay News) – A Mediterranean diet enriched with extra-virgin olive oil (EVOO) is associated with reduction in the risk of new-onset diabetes among older adults at high risk for cardiovascular disease, according to a study published in the Jan. 7 issue of the Annals of Internal Medicine.

Jordi Salas-Salvadó, MD, PhD, from the Instituto de Salud Carlos III in Madrid, and colleagues examined the efficacy of Mediterranean diets for the primary prevention of diabetes in a cohort of 3,541 patients without diabetes, aged 55–80 years, at high cardiovascular risk. Participants were randomly assigned and stratified to receive one of three diets: Mediterranean diet supplemented with EVOO, Mediterranean diet supplemented with nuts, or a control diet (low-fat dietary advice). No weight loss or physical activity interventions were included.

The researchers found that, during follow-up, the rates of new-onset diabetes were 16, 18.7, and 23.6 per 1,000 person-years, respectively, for the Mediterranean diet supplemented with EVOO, Mediterranean diet supplemented with nuts, and control diet. After multivariate adjustment, the hazard ratios for Mediterranean diet supplemented with EVOO and for the Mediterranean diet supplemented with nuts were 0.6 (95% confidence interval, 0.43–0.85) and 0.82 (95% confidence interval, 0.61–1.1), respectively, compared with the control diet.

"A Mediterranean diet enriched with EVOO but without energy restrictions reduced diabetes risk among persons with high cardiovascular risk," the authors write.

The Fundación Patrimonio Comunal Olivarero and Hojiblanca, the California Walnut Commission, the Borges Mediterranean Group, and Morella Nuts donated the olive oil, walnuts, almonds, and hazelnuts used in the study, respectively.

U.S. News names DASH diet best in 2014 
U.S. News & World Report ranked the Dietary Approaches to Stop Hypertension diet as the best diet for 2014, followed by the low-fat TLC Diet, Weight Watchers and the Mediterranean diet. The high-protein Paleo and Dukan diets tied for last place in the rankings, which rated plans on a five-point scale for short- and long-term weight loss, safety, nutrition and ease of compliance. The Washington Post (tiered subscription model) (1/6), U.S. News & World Report

Skip the Soda to Avoid Cancer

The most common type of endometrial cancer occurred almost 80% more often in postmenopausal women who regularly consumed sugar-sweetened drinks.

A number of previous studies link the consumption of sugar-sweetened beverages to an increased risk of obesity and type-2 diabetes.  Maki Inoue-Choi, from the University of Minnesota School of Public Health (Minnesota, USA), and colleagues analyzed data collected by the Iowa Women's Health Study, involving women ages 55 to 69 years. The final analysis included 23,039 women who had a mean age of 61.6 at enrollment. During follow-up from 1986 to 2010, 592 women had diagnoses of invasive endometrial cancer, consisting of 506 type 1 (endometroid) cancers and 89 type II (nonendometroid) cancers. The team found that factors associated with endometrial cancer were older age, higher BMI, higher waist-hip ratio, history of diabetes, early menarche, delayed menopause, any estrogen therapy. Smoking and increasing number of live births were associated with lower risk. In an unadjusted analysis, the researchers calculated that an increasing intake of sugar-sweetened drinks (excluding fruit juices) had a dose-dependent association with type I endometrial cancer/  Women in the highest quintile of sugared beverage consumption had a 72% higher risk of type I endometrial cancer, as compared with women in the lowest quintile. After adjustment for BMI, the resulting relative risk for comparison of the highest and lowest quintiles of consumption increased to 78%.  A separate analysis of fruit juice consumption yielded relative risks that were 38% and 48% higher in the unadjusted and adjusted models.  The study authors submit that: “Higher intake of [sugar-sweetened beverages] and sugars was associated with an increased risk of type I, but not type II, endometrial cancer.”

http://www.medpagetoday.com/HematologyOncology/OtherCancers/43086

Junk Food May Compromise Brain Functions

Consuming foods abundant in fats or sugar may have a detrimental and damaging effect on cognitive skills, suggests a lab animal model.

A plethora of previous studies suggest deleterious effects of routine consumption of fat-or sugar-laden foods. Margaret J. Morris, from the University of New South Wales (Australia), and colleagues studied the impact of a diet high in fat and sugar on laboratory rats. The researchers observe that such foods resulted in memory impairments, after just one week. Specifically, the cognitive impairment was related to place recognition – where the animals showed poor ability to notice when an object have been moved to a new location. The animals also had inflammation of the hippocampal region of the brain, which is associated with spatial memory. Study authors report that: "These results show that relatively short exposures to diets rich in both fat and sugar or rich in sugar, impair .... memory … and suggest a role for oxidative stress and neuroinflammation in this impairment.”

http://www.foodnavigator-asia.com/Policy/Junk-food-can-junk-your-memory-in-a-week-suggests-new-study

Low Vitamin B12 Levels Raise Bone Risks

Older men with low levels of vitamin B12 may be at increased risk for bone fractures.

While most commonly associated with postmenopausal women, bone fractures can occur in older men.  Catharina Lewerin, from the University of Gothenburg (Sweden), and colleagues assessed vitamin B12 levels in 1000 Swedish men, average age 75 years. The team observed that those subjects with low B12 levels were more likely than those with normal levels to suffer a bone fracture. Specifically, men with the very lowest B12 levels were 70% more likely to incur a bone fracture, with a propensity for the fracture of the lumbar spine, where there was up to 120% greater chance of fracture.  The study authors cite their "novel data showing that low levels of [vitamin B12] in predicting incident fracture in elderly men.”

http://consumer.healthday.com/senior-citizen-information-31/misc-aging-news-10/briefs-emb-12-10-older-men-b12-fractures-u-gothenburg-release-batch-1058-683015.html

Progesterone May Preserve Memory & Cognition

Levels of progesterone may correlate to verbal memory and global cognition, among women who were newly postmenopausal.

Previous studies have suggested that changes in hormone levels that occur after menopause may influence cognition and mood.  Victor Henderson, from Stanford University (California, USA), and colleagues analyzed data collected on 643 healthy postmenopausal women, ages 41 t0 84 years who were not on hormone replacement therapy, who were enrolled in the Early Versus Late Intervention Trial with Estradiol (ELITE) study.  The researchers conducted neuropsychological tests to gauge memory and cognition, and screened for various hormone levels: estradiol, estrone, progesterone, testosterone, and sex hormone-binding globulin.  They found that levels of progesterone appeared to be tied to verbal memory and global cognition among women who were in early postmenopause. The higher the levels of progesterone, , the better the outcomes on tests of verbal memory and global cognition in these younger women.

http://www.medpagetoday.com/Endocrinology/GeneralEndocrinology/43123

Shingles an Independent Predictor of Vascular Disease

People who experience herpes zoster (HZ), especially in young adulthood, face increased risks for transient ischemic attack (TIA), stroke, and myocardial infarction (MI), according to a retrospective study in Neurology.

Using a U.K. general practice database, researchers matched some 105,000 zoster cases with 210,000 controls. Vascular events were recorded for up to 24 years after zoster occurrence.

After adjustment for vascular risk factors, herpes zoster was associated with significantly increased risks for TIA and MI but not stroke. In analyses limited to zoster before age 40, risk increases were significant for TIA (hazard ratio, 2.4), MI (HR, 1.5), and stroke (HR, 1.7).

The researchers suggest that the herpes zoster vaccine be offered to adults with risk factors for vascular disease, "irrespective of age, to reduce the associated risk of HZ." They also advocate screening for vascular risk factors in patients with zoster, particularly younger adults "in whom intervention may have the most impact."

Neurology article 

Psoriasis and cardiovascular risk 
Mounting evidence has emerged demonstrating that psoriasis not only is associated with increased prevalence of cardiovascular risk factors, but also is an independent risk factor for the development of cardiovascular disease. The American Journal of Medicine

Aspirin in type 2 diabetes, a randomised controlled study: effect of different doses on inflammation, oxidative stress, insulin resistance and endothelial function 
International Journal of Clinical Practice, 12/27/2013  Clinical Article

Raghavan RP, et al. – The effect of aspirin upon platelet function is well documented although experimental studies suggest that aspirin may also affect oxidative stress, vascular inflammation, endothelial dysfunction and dysglycaemia. The optimal dose of aspirin for cardiovascular protection in type 2 diabetes is still debated. The authors examined the effects of different doses of aspirin upon these novel markers of cardiovascular risk and any association between aspirin–mediated changes in these markers. Aspirin exhibited no significant dose–dependent effect on markers of vascular inflammation, oxidative stress, insulin resistance and endothelial function (photoplethysmography) when used in type 2 diabetes over a 2–week period.

Methods

• Subjects with type 2 diabetes attended for baseline evaluation including BMI, glycaemic and lipid markers, endothelial function (photoplethysmography), insulin resistance (HOMA), inflammation (sVCAM-1 and Hs-CRP) and markers of oxidative stress [total anti-oxidant status (TAOS and FRAP), whole blood total glutathione (GSH) assays].
• Subjects then received in random, sequential, blinded fashion aspirin 75 mg day^-1, aspirin 300 mg day^-1, aspirin 3.6 g day^-1 or placebo for 2 weeks with a 2-week washout.
• The above investigations were repeated after each intervention.
• Aspirin-related changes compared with placebo were analysed using repeated measures ANOVA.

Results

• Subjects = 17 (M – 12; F – 5), mean age – 57.4 ± 9.1 years (mean ± 1 SD), HbA1c – 63 ± 13 mmol mol^-1(7.9 ± 1.2%), total cholesterol 4.57 ± 1.01 mmol l^-1.
• At baseline TAOS value was 59.3 ± 9.7 μM AEAC (Ascorbate Equivalent Anti-oxidant Concentration), glutathione 302.2 ± 183.3 mmol l^-1 and FRAP 0.86 ± 0.23 mM FeII.
• None of the aspirin doses had a significant impact upon BMI, blood pressure, lipid parameters, insulin sensitivity (HOMA), FRAP, TAOS, GSH, endothelial function, glycaemic control (fructosamine) or inflammation (sVCAM-1 and HsCRP).

http://www.ncbi.nlm.nih.gov/pubmed/24372992

Transfer of omega-3 fatty acids across the blood-brain barrier after dietary supplementation with a docosahexaenoic acid (DHA)-rich omega-3 fatty acid preparation in patients with Alzheimer's disease: the OmegAD study 
Journal of Internal Medicine, 01/12/2014  Evidence Based Medicine  Clinical Article

Levi YF, et al. – Little is known about the transfer of essential fatty acids (FAs) across the human blood–brain barrier (BBB) in adulthood. In this study authors investigated whether oral supplementation with omega–3 (n–3) FAs would change the FA profile of the cerebrospinal fluid (CSF). Oral supplementation with n–3 FAs conferred changes in the n–3 FA profile in CSF, suggesting transfer of these FAs across the BBB in adults.

Methods

• A total of 33 patients (18 receiving the n–3 FA supplement and 15 receiving placebo) were included in the study.
• These patients were participants in the double–blind, placebo–controlled randomised OmegAD study in which 204 patients with mild Alzheimer's disease (AD) received 2.3 g n–3 FA [high in docosahexaenoic acid (DHA)] or placebo daily for 6 months.
• CSF FA levels were related to changes in plasma FA and to CSF biomarkers of AD and inflammation.

Results

• At 6 months, the n–3 FA supplement group displayed significant increases in CSF (and plasma) eicosapentaenoic acid (EPA), DHA and total n–3 FA levels (P < 0.01) whereas no changes were observed in the placebo group.
• Changes in CSF and plasma levels of EPA and docosapentaenoic acid were strongly correlated, in contrast to those of DHA.
• Changes in DHA levels in CSF were inversely correlated with CSF levels of total and phosphorylated tau, and directly correlated with soluble interleukin–1 receptor type II.
• Thus, the more DHA increased in CSF, the greater the change in CSF AD/inflammatory biomarkers.

http://www.ncbi.nlm.nih.gov/pubmed/24410954

Effect of vitamin E and memantine on functional decline in Alzheimer disease: The TEAM-AD VA cooperative randomized trial 
JAMA, 01/12/2014  Evidence Based Medicine  Clinical Article

Dysken MW, et al. – Although vitamin E and memantine have been shown to have beneficial effects in moderately severe Alzheimer disease (AD), evidence is limited in mild to moderate AD. To determine if vitamin E (alpha tocopherol), memantine, or both slow progression of mild to moderate AD in patients taking an acetylcholinesterase inhibitor. Among patients with mild to moderate AD, 2000 IU/d of alpha tocopherol compared with placebo resulted in slower functional decline. There were no significant differences in the groups receiving memantine alone or memantine plus alpha tocopherol. These findings suggest benefit of alpha tocopherol in mild to moderate AD by slowing functional decline and decreasing caregiver burden.

Methods

• Double–blind, placebo–controlled, parallel–group, randomized clinical trial involving 613 patients with mild to moderate AD initiated in August 2007 and concluded in September 2012 at 14 Veterans Affairs medical centers.
• Participants received either 2000 IU/d of alpha tocopherol (n = 152), 20 mg/d of memantine (n = 155), the combination (n = 154), or placebo (n = 152).
• Alzheimer’s Disease Cooperative Study/Activities of Daily Living (ADCS–ADL) Inventory score (range, 0–78).
• Secondary outcomes included cognitive, neuropsychiatric, functional, and caregiver measures.

Results

• Data from 561 participants were analyzed (alpha tocopherol = 140, memantine = 142, combination = 139, placebo = 140), with 52 excluded because of a lack of any follow–up data.
• Over the mean (SD) follow–up of 2.27 (1.22) years, ADCS–ADL Inventory scores declined by 3.15 units (95% CI, 0.92 to 5.39; adjusted P = .03) less in the alpha tocopherol group compared with the placebo group.
• In the memantine group, these scores declined 1.98 units less (95% CI, -0.24 to 4.20; adjusted P = .40) than the placebo group’s decline.
• This change in the alpha tocopherol group translates into a delay in clinical progression of 19% per year compared with placebo or a delay of approximately 6.2 months over the follow–up period.
• Caregiver time increased least in the alpha tocopherol group.
• All–cause mortality and safety analyses showed a difference only on the serious adverse event of “infections or infestations,” with greater frequencies in the memantine (31 events in 23 participants) and combination groups (44 events in 31 participants) compared with placebo (13 events in 11 

http://www.ncbi.nlm.nih.gov/pubmed/24381967

Serum lycopene, lutein and zeaxanthin, and the risk of Alzheimer's disease mortality in older adults 
Dementia and Geriatric Cognitive Disorders, 01/12/2014  Clinical Article

Lycopene S, et al. – Oxidative stress is implicated in the pathogenesis of Alzheimer's disease (AD). Accumulating evidence shows that antioxidant–rich food reduces the risk of AD by inhibiting oxidative stress. This study investigates whether serum levels of carotenoids were associated with the risk of AD mortality in a nationally representative sample of US adults. High serum levels of lycopene and lutein+zeaxanthin are associated with a lower risk of AD mortality in adults. The findings suggest that a high intake of lycopene– or lutein+zeaxanthin–rich food may be important for reducing the AD mortality risk.

http://www.ncbi.nlm.nih.gov/pubmed/24247062

Music-Based Multitasking Training Improves Cognition & Mental Health

Six months of a music-based multitasking training regimen exerts beneficial effects on thinking, memory, mood, and anxiety.

Developed in the early 1900s, music-based multitasking training is a specific regimen which has been shown to be effective in improving gait and reducing falls.  Melany Hars, from Geneva University Hospitals (Switzerland), and colleagues studied 134 men and women, average age 75 years, who were all at increased risk for falls but who did not live in a nursing home or other facility. These subjects were randomly divided into a study group that attended hour-long music-based multitasking sessions once a week for 25 weeks, or a comparison group that just kept up their normal lifestyles and did not attend training sessions.  At the beginning of the study, both groups underwent assessments of mental function and mood. After six months, the 66 adults who participated in the music training sessions showed improved cognitive function, particularly on a test of their degree of sensitivity to interference, and decreased anxiety, as compared to the group that had not done the training. 

http://www.reuters.com/article/2013/11/29/us-seniors-brain-idUSBRE9AS0SW20131129

Mechanisms of spontaneous resolution of acute gouty inflammation 
Current Rheumatology Reports, 01/05/2014  Review Article

Steiger S, et al. – Acute gout is an auto–inflammatory disease characterized by self–limiting inflammation in response to the deposition of monosodium urate (MSU) crystals in the joints or tissues. This review will highlight mechanisms that limit acute inflammation triggered by MSU crystals and suggests areas for further research.

http://www.ncbi.nlm.nih.gov/pubmed/24343224

Increased cardiovascular mortality associated with gout: A systematic review and meta-analysis 
European Journal of Preventive Cardiology, 01/05/2014  Evidence Based Medicine  Review Article

Clarson LE, et al. – Hyperuricaemia, the biochemical precursor to gout, has been shown to be an independent risk factor for mortality from cardiovascular disease (CVD), although studies examining the clinical phenomenon of gout and risk of CVD mortality report conflicting results. This study aimed to produce a pooled estimate of risk of mortality from cardiovascular disease in patients with gout. Gout increases the risk of mortality from CVD and CHD, but not myocardial infarction, independently of vascular risk factors.

http://www.ncbi.nlm.nih.gov/pubmed/24281251

Musculoskeletal pain linked to greater cardiovascular risk 
Among more than 5,300 adults ages 45 and older, those with a history of chronic musculoskeletal pain were more likely to suffer from cardiovascular disease than those without pain, a U.K. study showed. The link between chronic musculoskeletal pain and heart problems was more pronounced among people older than 65, researchers reported in the European Journal of Pain. MedWire News (U.K.)

Early Vitamin D Status in Multiple Sclerosis Predicts Course

Higher vitamin D levels within a year after the early manifestations of multiple sclerosis are linked to better clinical outcomes, according to aJAMA Neurology article.

For 5 years, investigators followed over 400 patients suspected to be in the early stage of MS. Those with serum 25-hydroxyvitamin D levels of 50 nmol/L (20 ng/mL) or more during the first year, when compared with patients having lower values, showed less progression during the 5 years' observation. The higher-level patients had "a 4-times lower change in T2 lesion volume, a 2-fold lower rate of brain atrophy, and lower disability."

The authors note that their findings concur with earlier evidence although they don't offer a possible explanation for the effect. They say the results "suggest that identification and correction of vitamin D insufficiency has an important role in the early treatment of MS."

JAMA Neurology article

Access to Firearms Linked to Elevated Mortality Risk

Firearm access in the U.S. is associated with increased risk for death, both by suicide and homicide, according to a meta-analysis in the Annals of Internal Medicine.

Researchers analyzed the results of 15 observational studies that looked at firearm ownership or availability in the home. People with access to firearms had an increased risk for suicide (odds ratio, 3.24), compared with people without access. Firearm access was also associated with being the victim of a homicide (OR, 1.94), and for women, the risk was even higher (OR, 2.84).

An editorialist says that the meta-analysis likely underestimates mortality from firearm access because the authors did not include population-level studies.

Annals of Internal Medicine article (Free)

Annals of Internal Medicine editorial (Subscription required)

High Cholesterol Feeds Breast Cancer

A byproduct of cholesterol fuels the growth and spread of estrogen receptor (ER)-positive breast cancers.

Previously, a number of studies have suggested a connection between elevated cholesterol and breast cancer risk, but the mechanism for this action has remained unclear.  Donald McDonnell, from Duke University School of Medicine (North Carolina, USA), and colleagues studied whether an estrogen-like cholesterol compound, that 27-hydroxycholesterol – or 27HC, exerts a role in estrogen receptor (ER)-positive breast cancers. Using mouse models, the team demonstrated that the direct involvement of 27HC in breast tumor growth, as well as the aggressiveness of the cancer to spread to other organs. They also noted that the activity of this cholesterol metabolite was inhibited when the lab animals were treated with anti-estrogens or when exposure to 27HC was halted. The studies were substantiated using human breast cancer tissue. Additionally, the researchers found that the human tissue showed a direct correlation between the aggressiveness of the tumor and an abundance of the enzyme that makes the 27HC molecule. The study authors submit that: " lowering circulating cholesterol levels or interfering with its conversion to 27HC may be a useful strategy to prevent and/or treat breast cancer.”

http://www.eurekalert.org/pub_releases/2013-11/dumc-hcf112113.php

Acute effects of red wine on cytochrome P450 eicosanoids and blood pressure in men 
Journal of Hypertension, 12/28/2013  Clinical Article

Barden AE, et al. – The vasodilation accompanying acute alcohol ingestion is hard to reconcile with the strong evidence linking chronic alcohol consumption with hypertension. Cytochrome P450 (CYP450) eicosanoids derived from arachidonic acid include vasodilator epoxyeicosatrienoic acids (EETs) and the vasoconstrictor 20–hydroxyeicosatrienoic acid (20–HETE). Acute consumption of alcohol as red wine results in a relative increase in plasma levels of the vasoconstrictor 20–HETE over 24 h without affecting EETs, and may contribute to the BP elevation that associates with a binge drinking pattern or be a homeostatic response to the acute fall in BP induced by alcohol.

Methods

• Twenty–five normotensive men were randomly assigned to drink either 375 ml of red wine (41 g of alcohol) or the equivalent volume of DRW or water, with a light meal on 3 separate days.
• Ambulatory BP and heart rate were measured over 24 h.
• Blood samples were obtained before and 2, 4 and 24 h after beverage consumption.

Results

• Blood pressure fell in the first 4 h after red wine consumption (P=0.001), but was significantly higher after 20 h (P=0.037).
• Plasma 20–HETE fell in the 2 h after consumption of all beverages, but over the 24–h period was relatively higher after red wine consumption (P=0.025).
• The largest difference in 20–HETE was 2 h after consuming red wine and coincided with the highest blood alcohol level.
• There were no significant effects of red wine on plasma EETs.

http://www.ncbi.nlm.nih.gov/pubmed/24096258

South American Berry May Protect from Alzheimer’s

An extract of the palm acaí berry (Euterpe oleraceae Mart.) inhibits beta-amyloid protein aggregation, in a lab model.

The South American palm acaí berry (Euterpe oleraceae Mart.) is abundant in polyphenols and other antioxidants.  Daphne Wong, from the University of Adelaide (Australia), and colleagues employed a laboratory model of Alzheimer's Disease, in which cells were pretreated with acai extract and then exposed to a specific form of beta-amyloid. The team found that the acai extract inhibited the aggregation of beta-amyloid proteins, thereby preventing brain cell damage and death from oxidative stress. The study authors report that: "In comparison with other phenolics, acaí was most effective at inhibiting [beta-amyloid] aggregation. Inhibition of β-amyloid aggregation may underlie a neuroprotective effect of acaí.”

http://www.nutraingredients-usa.com/Research/Acai-and-brain-health-Has-study-unlocked-Amazonian-fruit-s-neuroprotective-effects /

Heart Disease Risk Rises with Osteoarthritis

People who are affected by osteoarthritis of the hip or knee are at elevated risk for ischemic heart disease and congestive heart failure.

Recently, scientists suggest that inflammation plays a role in osteoarthritis, considered most often to be a disease of "wear and tear."  M. Mushfiqur Rahman, from the University of British Columbia (Canada), and colleagues analyzed data collected from 600,000 men and women. The team found that men older than 65 years with osteoarthritis were at 15% increased risk for hospitalization for cardiovascular disease. In addition, women older than 65 years had a 17% increase in cardiovascular risk; women younger than 65 years were 26% increased risk.  The study authors submit that: "This prospective longitudinal study suggests that I osteoarthritis] is associated with an increased risk of [cardiovascular disease]."

http://www.medpagetoday.com/Rheumatology/Arthritis/43277

High Fiber, Fruit/Vegetable Intake Cuts Stroke Risk in T2DM

 (HealthDay News) – For Japanese patients with type 2 diabetes, increased dietary fiber and fruit and vegetable intake is associated with reduced risk of stroke, according to a study published in the December issue of Diabetes Care.

Shiro Tanaka, PhD, from Kyoto University in Japan, and colleagues examined the correlation between fiber-rich food consumption and cardiovascular disease in a cohort of 1,414 patients with type 2 diabetes without history of cardiovascular disease, aged 40–70 years, and whose hemoglobin A1c values were ≥6.5%. Participants completed a dietary survey.

During a median follow-up of 8.1 years, the researchers identified 68 strokes and 96 cases of coronary heart disease. Intake of dietary fiber in the fourth vs. the first quartile was associated with a hazard ratio of 0.39 for stroke (P=0.12); for fruits and vegetable intake, the hazard ratio was 0.35 (P=0.04). No significant associations were observed for coronary heart disease. Per 1g increase, the hazard ratio for soluble fiber was smaller (0.48; P<0.01) than for total or insoluble dietary fiber (0.82 and 0.79, respectively; P<0.01).

"Increased dietary fiber, particularly soluble fiber, and vegetables and fruits were associated with lower incident stroke but not coronary heart disease in patients with type 2 diabetes," the authors write.

Abstract

Daily Walking Linked to Decreased Cardiovascular Risk

 (HealthDay News) – For adults at high cardiovascular risk with impaired glucose tolerance, baseline and change in objectively-assessed ambulatory activity are associated with reduced risk of cardiovascular events, according to a study published online Dec. 20 in The Lancet.

Thomas Yates, PhD, from the NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit in the United Kingdom, and colleagues examined the correlation between baseline and change in ambulatory activity and the risk of cardiovascular events. The authors used data from 9,306 participants from the NAVIGATOR trial with impaired glucose tolerance and with existing cardiovascular disease or with at least one cardiovascular risk factor. Participants were followed for an average of six years for cardiovascular events (defined as cardiovascular mortality, non-fatal stroke, or myocardial infarction). Ambulatory activity was measured at baseline and 12 months by pedometer.

The researchers identified 531 cardiovascular events during 45,211 person-years of follow-up. Both baseline ambulatory activity and change in ambulatory activity correlated inversely with cardiovascular event risk (hazard ratios per 2,000 steps per day, 0.90 and 0.92, respectively). The association for change in ambulatory activity persisted after adjustment for changes in body mass index and other potentially confounding variables at 12 months.

"In individuals at high cardiovascular risk with impaired glucose tolerance, both baseline levels of daily ambulatory activity and change in ambulatory activity display a graded inverse association with the subsequent risk of a cardiovascular event," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which funded the study.

Abstract

Which Diet Plan Is Right for Your Patient? The Evidence Behind the Most Popular Diets

http://www.empr.com/which-diet-plan-is-right-for-your-patient-the-evidence-behind-the-most-popular-diets/article/328025/1/

Body-mass index and mortality among adults with incident type 2 diabetes 
New England Journal of Medicine, 01/18/2014  Evidence Based Medicine  Clinical Article

Tobias DK, et al. – The relation between body weight and mortality among persons with type 2 diabetes remains unresolved, with some studies suggesting decreased mortality among overweight or obese persons as compared with normal–weight persons (an “obesity paradox”). Authors observed a J–shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. They found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal–weight counterparts, or of an obesity paradox.

Methods

• They studied participants with incident diabetes from the Nurses' Health Study (8970 participants) and Health Professionals Follow–up Study (2457 participants) who were free of cardiovascular disease and cancer at the time of a diagnosis of diabetes.
• Body weight shortly before diagnosis and height were used to calculate the body–mass index (BMI, the weight in kilograms divided by the square of the height in meters).
• Multivariable Cox models were used to estimate the hazard ratios and 95% confidence intervals for mortality across BMI categories.

Results

• There were 3083 deaths during a mean period of 15.8 years of follow–up.
• A J–shaped association was observed across BMI categories (18.5 to 22.4, 22.5 to 24.9 [reference], 25.0 to 27.4, 27.5 to 29.9, 30.0 to 34.9, and >=35.0) for all–cause mortality (hazard ratio, 1.29 [95% confidence interval {CI}, 1.05 to 1.59]; 1.00; 1.12 [95% CI, 0.98 to 1.29]; 1.09 [95% CI, 0.94 to 1.26]; 1.24 [95% CI, 1.08 to 1.42]; and 1.33 [95% CI, 1.14 to 1.55], respectively).
• This relationship was linear among participants who had never smoked (hazard ratios across BMI categories: 1.12, 1.00, 1.16, 1.21, 1.36, and 1.56, respectively) but was nonlinear among participants who had ever smoked (hazard ratios across BMI categories: 1.32, 1.00, 1.09, 1.04, 1.14, and 1.21) (P=0.04 for interaction).
• A direct linear trend was observed among participants younger than 65 years of age at the time of a diabetes diagnosis but not among those 65 years of age or older at the time of diagnosis (P<0.001 for interaction).

http://www.ncbi.nlm.nih.gov/pubmed/24428469

Anti-Cancer Effects of Grape Seed Extract

An active component of grape seed extract induces cell death in prostate cancer cells, in a laboratory model.

Previously, a number of studies have suggested that grape seed extract may have anti-cancer effects.  Chapla Agarwal, from the University of Colorado Cancer Center (Colorado, USA), and colleagues studied the effects of the most active component of grape seed extract, B2G2, showing that the compound induces cell death (apoptosis) in prostate cancer cells while leaving healthy cells unharmed, in a laboratory model.  The team submits that: "we report B2G2 chemical synthesis at gram-quantity with equivalent biological efficacy against human [prostate cancer) cell lines and same molecular targeting profiles at key transcription factors level. The synthetic B2G2 will stimulate more research on prostate and possibly other malignancies in preclinical models and clinical translation.”

http://www.coloradocancerblogs.org/active-component-grape-seed-extract-effective-cancer-cells/

Exercise May Improve Prostate Cancer Outcome

By reducing adverse changes to the shape of blood vessels, exercise may improve outcomes in men with prostate cancer.

Previously published studies report that men who engage in higher levels of physical activity are at a lower risk of prostate cancer recurrence and mortality, as compared with men who participate in little or no physical activity. Erin Van Blarigan, from the University of California/San Francisco (UCSF; California, USA), and colleagues investigated whether prediagnostic physical activity was associated with prostate tumor blood vessel regularity among 572 men enrolled in the Health Professionals Follow-up Study. Prediagnostic physical activity was determined through analysis of questionnaire answers. Blood vessel regularity was established by semiautomated image analysis of the tumor samples. Blood vessels that are perfect circles are considered the ideal shape and given a score of 1. Higher values indicate less regular blood vessels.  The researchers found that men with the fastest walking pace (3.3 to 4.5 miles per hour) prior to diagnosis had 8% more regularly shaped blood vessels compared with men with the slowest walking pace (1.5 to 2.5 miles per hour).  The lead author comments that: "In this study, we found that men who reported walking at a brisk pace had more regularly shaped blood vessels in their prostate tumors compared with men who reported walking at a less brisk pace.  Our findings suggest a possible mechanism by which exercise may improve outcomes in men with prostate cancer.  Our study supports the growing evidence of the benefits of exercise, such as brisk walking, for men with prostate cancer."

http://www.eurekalert.org/pub_releases/2014-01/aafc-rip011314.php

Caffeine Enhances Memory

Whether present in coffee or tea, caffeine exerts a positive effect on long-term memory.

A number of previous studies have reported cognitive-enhancing effects of caffeine.  Michael Yassa, from Johns Hopkins University (Maryland, USA), and colleagues explored the effect of caffeine to strengthen memories to reduce forgetting over a 24-hour period.  The researchers conducted a double-blind trial; participants who did not regularly eat or drink caffeinated products received either a placebo or a 200-milligram caffeine tablet five minutes after studying a series of images. Salivary samples were taken from the participants before they took the tablets to measure their caffeine levels. Samples were taken again one, three and 24 hours afterwards. The next day, both groups were tested on their ability to recognize images from the previous day's study session. On the test, some of the visuals were the same as from the day before, some were new additions and some were similar but not the same as the items previously viewed. More members of the caffeine group were able to correctly identify the new images as "similar" to previously viewed images versus erroneously citing them as the same. The team submits that the brain's ability to recognize the difference between two similar but not identical items, called pattern separation, reflects a deeper level of memory retention. Observing that: “Caffeine enhanced performance 24 h after administration,” the study authors: “conclude that caffeine enhanced consolidation of long-term memories in humans.”

http://www.eurekalert.org/pub_releases/2014-01/jhu-iac010914.php

Olive Oil May Protect Against Diabetes

Consuming a Mediterranean diet that is rich in extra virgin olive oil may be an effective way to protect people at high-risk for heart disease against diabetes.

Previously, a number of studies have shown that adherence to a Mediterranean diet – rich in olive oil, nuts, as well as fruits, vegetables, and legumes, and limited amounts of dairy products, red meat, soda drinks, processed meats, and sweets – inversely associates with cardiovascular risks.   Jordi Salas-Salvado, from the Hospital de Sant Joan de Reus (Spain), and colleagues studied data collected on 3,541 men and women, ages 55 to 80 years, at high cardiovascular risk but without diabetes at the study’s start.  Subjects were randomly assigned to 1 of 3 diets: a Mediterranean diet supplemented with extra-virgin olive oil; a Mediterranean diet supplemented with nuts; or a control diet (advice on a low-fat diet). No intervention to increase physical activity or lose weight was included.  The researchers observed that those subjects on the Mediterranean diet supplemented with extra-virgin olive oil were the least likely to develop type-2 diabetes, at a 30% reduced likelihood over the next 4 years (as compared to the control diet).   The study authors report that: “A Mediterranean diet enriched with [extra-virgin olive oil] but without energy restrictions reduced diabetes risk among persons with high cardiovascular risk.”

http://www.reuters.com/article/2014/01/06/us-mediterranean-diet-diabetes-idUSBREA0513C20140106

The Avocado Advantage

Adding just one-half of a fresh avocado to a lunch can promote feelings of satiety, among healthy but overweight men and women.

Fresh Hass avocados have 3 grams of total carbohydrate, less than 1 gram of natural sugar per one ounce serving (the least amount of sugar per serving than any other fresh fruit) and contribute 8% of the daily value (DV) for fiber. Each serving of nutrient dense fresh avocado is also a source of naturally good fats. Previously, a number of studies have suggested that avocado consumption may reduce a person's risk factors for heart disease and diabetes, while supporting weight management goals.  Joan Sabate, from Loma Linda University (California, USA), and colleagues asked 26 healthy but overweight adults to incorporate fresh avocado into a lunch – either by replacing other foods or by simply adding it to the meal. The team found that those subjects who added half of a fresh avocado to their lunch reported a significantly decreased desire to eat by 40% over a three-hour period, and by 20% over a five-hour period after the meal, as compared to their desired CE after a standard lunch without avocado. Additionally, the subject reported increased feelings of satisfaction by 26% over the three hours following the meal.  The study authors write that: "The addition of approximately one half of a Hass avocado at a lunch meal can influence post-ingestive satiety over a subsequent 3 and 5 hour period in overweight adults.”

http://www.worldhealth.net/news/avocado-advantage/www.eurekalert.org/pub_releases/2014-01/fl-nre010714.php

Tree Nuts Reduce Heart Disease & Diabetes Risks

People who consume pistachios, cashews, almonds, pecans and walnuts may be less obese and have fewer risk factors for heart disease and diabetes.

Now known to be a good source of unsaturated (“good”) fat, and high in protein, tree nuts – which include pistachios, cashews, almonds, pecans and walnuts – may help people to manage their weight.  Joan Sabate, from Loma Linda University (California, USA), and colleagues analyzed the dietary habits of 803 adults enrolled in the Adventist Health Study-2.  The data revealed that those subjects who ate about 16 grams (half an ounce) per day – were only slightly over their normal weight, on average, compared to those who ate few or no nuts and were seriously overweight or obese.  As well, those who ate the most nuts had an average body mass index (BMI) of 27, as compared to those who ate the fewest (less than 5 grams daily) at an average BMI of 29-30.  Identifying that one-third of the study subjects had metabolic syndrome, which raises the risks of heart disease and diabetes risk, the team found that every one-ounce serving of tree nuts consumed per week, reduced that risk by 7%.  The study authors submit that: “Tree nuts appear to have strong inverse association with obesity, and favorable though weaker association with [Metabolic Syndrome] independent of demographic, lifestyle and dietary factors.”

http://www.reuters.com/article/2014/01/10/us-eating-tree-nuts-obesity-risk-idUSBREA081KS20140110

The Secret to a Good Night’s Sleep

Variety might be the spice of life, but to what extent does a consistent daily routine serve as a staple for quality sleep?

How important are scheduled activities?  Natalie D. Dautovich, from the University of Alabama (Alabama, USA), and colleagues sought to examine the extent to which a person’s daily routine affects sleep. The team completed an observational study design involving 14 consecutive days of diaries kept by 100 community-dwelling adults. Fifty subjects between the ages of 18 and 30 years, and another 50 subjects between the ages of 60 and 95 years, recorded their patterns of daily activities and sleep. The researchers analyzed 3 activities (going outside, starting work, and eating dinner) and 5 sleep (sleep onset latency, wake time after sleep onset, number of awakenings, total sleep time, and sleep quality rating) variables.   The team found that containing a consistent daily routine associated with better quality sleep. Young adults who went to work and ate dinner at the same time every day typically slept better and wake up fewer times during the night; they also fell asleep more quickly at that time.  Interestingly, the researchers observe that among older adults, inconsistent daily schedules were sometimes linked with better sleep:  older subjects whose dinnertime varied tended to sleep longer at night, and those who started home activities or began work at different times each day fell asleep more quickly. 

http://www.reuters.com/article/2014/01/02/us-sleep-routine-idUSBREA010QL20140102

Dietary Choices May Defeat Diabetes

What foods contain a specific compound that lowers insulin resistance and reduces inflammation?

Flavanoids are a type of antioxidant – compounds shown to be effective in counteracting oxidative damage.  Anthocyanins are a subgroup of flavanoids, for which a number of previous studies suggest beneficial health effects.  Aedin Cassidy, from the University of East Anglia (United Kingdom), and colleagues studied the dietary intake of 1997 women, ages 18 to 76 years, enrolled in the TwinsUK study, and conducted blood tests to assess glucose regulation and inflammation.  The team also calculated insulin resistance, a marker of type-2 diabetes.   Those women who consumed foods abundant in anthocyanins – such as chocolate, tea, and  berries – had lower insulin resistance.  These subjects also were also less likely to suffer chronic inflammation, which can contribute to diabetes, cardiovascular disease, and cancers.

http://www.eurekalert.org/pub_releases/2014-01/uoea-iic011714.php

More Fish May Lower Diabetes Risk

Salmon, herring, and sardines are among good sources of omega-3 fatty acids that may help to reduce the risk of Type-2 diabetes.

Type-2 diabetes is becoming increasingly widespread throughout the world.  In that previous studies posit that overweight is a significant risk factor, diet and other lifestyle factors may have potential as interventive approaches to reduce a person’s risk of Type-2 diabetes. Jyrki K. Virtanen, from the University of Eastern Finland (Finland), and colleagues analyzed data collected in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), determining the serum omega-3 fatty acid concentrations of 2,212 men, ages 42 to 60 years age at the onset of the study, in 1984–1989. During a follow-up of 19.3 years, 422 men were diagnosed with type 2 diabetes.  The team found that men in the highest serum omega-3 fatty acid concentration quarter were at 33% lower risk of developing type 2 diabetes, as compared to those men in the lowest quarter.  The study authors report that: “Serum long-chain omega-3 [fatty acid] concentration, an objective biomarker for fish intake, was associated with long-term lower risk of type 2 diabetes.”

http://www.eurekalert.org/pub_releases/2014-01/uoef-fds011414.php

Oranges May Help to Protect Vision

Antioxidant-rich foods – including oranges, whole grains, coffee, and tea – may help to lower the risk of cataracts, among aging women.

A cataract is a clouding of the lens in the eye that affects vision. Previous studies have suggested that oxidative damage of the eye's lens, caused by free radicals, may be a critical aspect in the development of cataract. Antioxidant compounds, which are thought to counteract free radical activity, are present in abundant amounts in foods such as oranges, whole grains, coffee, and tea. Susanne Rautiainen, from the Karolinska Institutet (Sweden), and colleagues examined the diets of 30,607 Swedish women, ages 49 to 83 years, enrolled in the Swedish Mammography Cohort study, who were observed for age-related cataract incidence for a mean of 7.7 years. The team utilized the total antioxidant capacity (TAC) value of various foods, as were consumed by the study subjects. The researchers found that the women who ate foods rich in antioxidants experienced a lower risk of cataracts as they age. Specifically, the study authors noted that: "Dietary [total antioxidant capacity] was inversely associated with the risk of age-related cataract."

http://www.reuters.com/article/2013/12/31/us-antioxidants-diet-cataract-idUSBRE9BU0IT20131231

Vitamin E Slows Functional Decline

One of the largest and longest-treatment trials involving Alzheimer’s patients supports the utility and efficacy of alpha-tocopherol to slow functional decline.

A major burden in Alzheimer's Disease is the potential loss of the ability to complete the activities of daily living, and thus to live independently.  Maurice Dysken, from the Minneapolis VA Health Care System (Minnesota, USA), and colleagues enrolled 613 patients with mild to moderate Alzheimer' Disease and randomly assigned each to one of four groups: the first group received 2,000 IU per day of vitamin E (as alpha-tocopherol); the second group received 20 mg per day of an Alzheimer's medication (memantine);  the third group received a combination of vitamin E and memantine; and the fourth group served as placebo. Subjects were followed for an average of 2.5 years. At the end of the study period, the team observed a clinically significant delay in functional decline of 6.2 months in the vitamin E group, compared with placebo. No benefits were observed in the drug group or in the combination vitamin-drug group.   Writing that: "Among patients with mild to moderate [Alzheimer's Disease], 2000 IU/d of alpha tocopherol … resulted in slower functional decline,” the study authors submit that their data “suggest[s] benefit of alpha tocopherol in mild to moderate [Alzheimer's Disease] by slowing functional decline and decreasing caregiver burden.”

http://www.nutraingredients-usa.com/Research/Significant-Vitamin-E-may-slow-functional-decline-in-moderate-Alzheimer-patients/

Vitamin E Supplementation Linked to Better Functional Outcomes in Alzheimer's Patients

Vitamin E supplementation is associated with slower functional decline among patients with mild-to-moderate Alzheimer disease, according to a JAMA study.

Over 600 Veterans Affairs patients with mild-to-moderate Alzheimer's who were taking an acetylcholinesterase inhibitor were randomized to receive synthetic vitamin E (2000 IU/day) plus placebo, memantine plus placebo, vitamin E plus memantine, or double placebo.

After a mean follow-up of roughly 2 years, patients assigned to vitamin E alone had better scores on their ability to perform activities of daily living, translating to a 6-month delay in disease progression, compared with patients given placebo. Patients taking memantine — either alone or with vitamin E — did not see a similar benefit. Neither treatment was associated with increased risk for adverse events, including all-cause mortality.

Editorialists stress the importance of not extrapolating the current findings to the "use of vitamin E at different dosages, among people with different [Alzheimer's] severity levels, or in combination with different agents."

JAMA article

“E”asy Way to Reduce Bone Fracture Risk

Dietary supplementation of Vitamin E as alpha-tocopherol may reduce the risk of bone fractures, among aging men and women.

An effective antioxidant, Vitamin E  is thought to exert  positive effects on both bone and muscle mass.  Karl Michaelsson, from Uppsala University (Sweden), and colleagues studied data collected on 14,738 women, followed for 19 years, and found that those subjects with the lowest consumption of alpha-tocopherol were at an 86% increased risk of hip fracture; and those who consumed a dietary supplement containing alpha-tocopherol were at 22% reduced risk of hip fracture.  Among 1,138 men studied, low levels of alpha-tocopherol more than tripled the rate of hip fracture.  The study authors write that: “Low intakes and low serum concentrations of [alpha]-tocopherol are associated with an increased rate of fracture in elderly women and men.”

http://www.nutraingredients-usa.com/Research/Vitamin-E-supplements-may-reduce-bone-fracture-rate-in-the-elderly-Study

Higher Magnesium Intake May Lower Diabetes Risk

 (HealthDay News) – Higher magnesium intake may lower risk of incident diabetes, particularly among those at highest risk, according to a study published online Oct. 2 in Diabetes Care.

Based on magnesium intake, Adela Hruby, PhD, from Tufts University in Boston, and colleagues assessed the risk of incident "metabolic impairment," defined as impaired fasting glucose (≥5.6 to <7mmol/L), impaired glucose tolerance (two-hour post-load glucose, ≥7.8 to <11.1mmol/L), insulin resistance (IR), or hyperinsulinemia (≥90th percentile of homeostasis model assessment of IR or fasting insulin, respectively). Study participants included 2,582 community-dwelling individuals aged 26–81 years old.

The researchers found that those with the highest magnesium intake had a 37% lower risk of incident metabolic impairment (Ptrend=0.02) compared to those with the lowest magnesium intake. In those with baseline metabolic impairment, higher intake was associated with a 32% lower risk of incident diabetes (Ptrend=0.05). In the combined population, the risk for those with the highest intake was 53% (Ptrend=0.0004) of those with the lowest intake. The association in the normal population was attenuated with adjustments for risk factors and dietary fiber while the association was not substantially affected in the metabolically impaired. Higher magnesium intake was linked to lower long-term changes in fasting glucose and IR, but no significant trends were observed in fasting insulin, post-load values, or insulin sensitivity.

"Magnesium intake may be particularly beneficial in offsetting risk of developing diabetes among those at high risk," the authors write.

Abstract

Exposure to Sunlight May Help Lower Blood Pressure

 (HealthDay News) – Exposure to sunlight causes arterial vasodilation and lowers blood pressure (BP), according to research published online Jan. 20 in the Journal of Investigative Dermatology.

Donald Liu, MB, ChB, PhD, of the University of Edinburgh in the United Kingdom, and colleagues exposed the skin on the forearms of 24 participants to ultraviolet A (UVA) wavelengths of sunlight to investigate the effects of UVA on nitric oxide (NO) availability and the resulting cardiovascular effects.

The researchers found that exposure to UVA lowered BP, with concomitant decreases in circulating nitrate and increases in nitrite concentrations. Because dietary intervention to modify the availability of systemic nitrate did not affect these UV-induced hemodynamic changes, it appears that they are not mediated by the direct utilization of circulating nitrate. UVA irradiation of the forearm increased blood flow independently of NO-synthase activity, indicating that pre-formed cutaneous NO stores were involved. Studies with confocal fluorescence microscopy revealed that UVA irradiation causes NO-synthase-independent, dose-dependent release of NO. The majority of light-sensitive NO was pooled in the upper epidermis.

"Collectively, our data provide mechanistic insights into an important function of the skin in modulating systemic NO bioavailability which may account for the latitudinal and seasonal variations of BP and cardiovascular disease," the authors write.

Abstract

Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion Full Text 
Cardiovascular Diabetology, 01/19/2014  Clinical Article

Shen Y, et al. – The authors investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion. Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.

Abstract

BACKGROUND:

We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion.

METHODS:

Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3).

RESULTS:

For diabetic patients, GA (21.2 ± 6.5% vs. 18.7 ± 5.6%, P < 0.001) but not HbA1c levels (7.0 ± 1.1% vs. 6.8 ± 1.3%, P = 0.27) was significantly elevated in low collateralization than in high collateralization group, and correlated inversely with Rentrop score (Spearmen's r = -0.28, P < 0.001; Spearmen's r = -0.10, P = 0.09, respectively). There was a trend towards a larger area under the curve of GA compared with that of HbA1c for detecting the presence of low collateralization (0.64 vs. 0.58, P = 0.15). In non-diabetic patients, both GA and HbA1c levels did not significantly differ regardless the status of coronary collateralization. In multivariable analysis, female gender, age > 65 years, smoke, non-hypertension, duration of diabetes > 10 years, metabolic syndrome, eGFR < 90 ml/min/1.73 m2, and GA > 18.3% were independently determinants for low collateralization in diabetic patients.

CONCLUSIONS:

Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.

Low resting heart rate associated with decreased all-cause mortality

As reported in Mayo Clinic Proceedings, a resting heart rate < 60 bpm is associated with increased cardiorespiratory fitness and decreased all-cause mortality, while a resting heart rate ≥ 80 bpm was associated with decreased cardiorespiratory fitness and increased all-cause mortality. The study involved 53322 patients with cardiovascular disease or cancer.

Saxena A, et al. – The aim is to study the protective role of lower resting heart rate (RHR) in cardiovascular disease (CVD) and all–cause mortality. Lower cardiorespiratory fitness levels and higher RHRs are linked to greater CVD and all–cause mortality.

Methods

• Patients (n=53,322) who received a baseline medical examination between January 1, 1974, and December 31, 2002, were recruited from the Cooper Clinic, Dallas, Texas.
• They completed a medical questionnaire and underwent clinical evaluation.
• Patients with CVD or cancer or who had less than 1 year of mortality follow–up were excluded from the study.
• Relative risks and 95% CIs for all–cause and CVD mortality across RHR categories were estimated using Cox proportional hazards models.

Results

• Highest cardiorespiratory fitness with lower mortality was found in individuals with an RHR of less than 60 beats/min.
• Similarly, patients with a higher RHR (>=80 beats/min) were at greater risk for CVD and all–cause mortality compared with an RHR of less than 60 beats/min.
• This analysis was followed by stratification of the data by hypertension, where hypertensive individuals with high RHRs (>=80 beats/min) were found to be at greater risk for CVD and all–cause mortality compared with those with hypertension and lower RHRs (<60 beats/min).
• In addition, unfit individuals with high RHRs had the greatest risk of CVD and all–cause mortality.
• The unfit with low RHR group had a similar risk for CVD and all–cause mortality as the fit with high RHR group.

http://www.ncbi.nlm.nih.gov/pubmed/24290115

Comparison of the effects of amlodipine and losartan on blood pressure and diurnal variation in hypertensive stroke patients: a prospective, randomized, double-blind, comparative parallel study 
Clinical Therapeutics, 12/28/2013  Clinical Article

Kwon HM, et al. – This study was conducted to compare the BP–lowering and diurnal BP variation effects of amlodipine and losartan on acute stroke patients. The noninferiority of amlodipine was not confirmed by the per–protocol analysis. However, amlodipine showed a favorable effect on the morning surge.

Methods

• Seventy–seven hypertensive patients with acute stroke were enrolled in this randomized, double–blind, single–center clinical trial.
• They were randomly assigned to receive either amlodipine or losartan daily.
• To evaluate whether amlodipine was noninferior to losartan, ambulatory BP monitoring was performed before the drugs were first administered and at the end of week 8.
• BP variables analyzed included the mean awake, sleep, morning, evening, and prewake BP values; the nocturnal dipping status; and the morning surge.

Results

• Thirty–nine patients in the amlodipine group and 38 patients in the losartan group completed the follow–up.
• In the baseline characteristics, mean age was 63.6 years, and 68.8% were male.
• In the intention–to–treat analysis, the mean (SD) systolic BP decreased 14.82 (11.71) mm Hg in the amlodipine group and 13.11 (12.69) mm Hg in the losartan group, and amlodipine proved noninferior to losartan (mean difference, 1.71 mm Hg [95% CI, –3.83 to 7.26]).
• However, in the per–protocol analysis, noninferiority was not proven (BP reduction, 16.06 [11.33] vs 17.17 [11.85] mm Hg; mean difference, –1.11 mm Hg [95% CI, –6.88 to 4.65]).
• Amlodipine had a greater tendency than losartan to produce a blunt morning surge.

http://www.ncbi.nlm.nih.gov/pubmed/24296324

Telomere Length Prognostic for 50 to 75 Year-Old Men With ACS

 (HealthDay News) — For men aged 50–75 years with acute coronary syndrome, shorttelomeres are independently associated with worse prognosis, according to a study published in the February 1 issue of The American Journal of Cardiology.

Jose-Angel Perez-Rivera, MD, from the University Hospital of Salamanca in Spain, and colleagues assessed the prognostic value of telomere length, measured by quantitative polymerase chain reaction in peripheral blood leukocytes of 203 men admitted with acute coronary syndrome. The men were classified into two groups according to age: 50–75 years, and >75 years. Patients underwent more than 600 days of clinical follow-up and a prognostic combined event was defined.

The researchers found that for men aged 50–75 years, those with short telomeres had significantly worse prognosis (P<0.05), but this association was not seen for men aged older than 75 years (P =0.91). For men aged 50–75 years, Cox analysis confirmed short telomeres as an independent prognostic risk factor.

"In conclusion, telomere length is a good predictor of cardiovascular prognosis in men admitted for acute coronary syndrome, but this relation depends on the chronological age of the population studied," the authors write.

Abstract

BMI Thresholds Predict Metabolic Syndrome in Teens

 (HealthDay News) — The US Centers for Disease Control and Prevention and FITNESSGRAM (FGram) body mass index (BMI) thresholds are predictive of metabolic syndrome in U.S. adolescents, according to a study published online January 27 in Pediatrics.

Kelly R. Laurson, PhD, from Illinois State University in Normal, and colleagues analyzed data from 3,385 adolescents participating in the National Health and Nutrition Examination Surveywho were measured for anthropometric variables and metabolic risk factors. Weight status was categorized using CDC and FGram thresholds.

The researchers found that the prevalence of metabolic syndrome was <2 percent in the normal-weight groups and ranged from 19–33% in obese youth, with odds of metabolic syndrome 46–67% and 19–22 times higher for obese boys and girls, respectively, versus normal-weight youth. Based on receiver operating characteristic analyses, the optimal thresholds were similar to the CDC standards and the FGram standards, for boys and girls, respectively. The association between BMI thresholds and metabolic syndrome was stronger in boys than in girls.

"Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls," the authors conclude. "The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice."

One author serves as the Scientific Director and oversees the activities of the Scientific Advisory Board of the FITNESSGRAM program.

Abstract

Markers Other Than HbA1c Useful for Monitoring Diabetes

 (HealthDay News) – Fructosamine and glycated albumin are markers of glycemic control that may complement hemoglobin A1c (HbA1c) in identifying risk of diabetes and its complications, according to research published online Jan. 15 in The Lancet Diabetes & Endocrinology.

Elizabeth Selvin, PhD, MPH, of the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues measured levels of fructosamine and glycated albumin in 11,348 adults without diabetes and 958 with diagnosed diabetes. The authors sought to assess their value in predicting risk of incident diabetes and its complications during two decades of follow-up.

The researchers found that, similar to HbA1c, fructosamine and glycated albumin were strongly associated with retinopathy. Compared with individuals with no diabetes and marker levels less than the 75th percentile, patients with fructosamine and glycated albumin levels greater than the 95th percentile had significantly higher risk for chronic kidney disease (multivariable-adjusted hazard ratios (HRs), 1.5 and 1.48, respectively) and incident diabetes (HRs, 4.96 and 6.17, respectively). Prediction of incident diabetes was strongest for HbA1c (C-statistic, 0.76) compared with fructosamine (C-statistic, 0.706) and glycated albumin (C-statistic, 0.703). Prediction of incident chronic kidney disease was almost as strong for fructosamine and glycated albumin (C-statistic for both, 0.717) as for HbA1c (C-statistic, 0.726).

"Fructosamine and glycated albumin were strongly associated with diabetes and its microvascular complications and complemented the prognostic utility of HbA1c," the authors write.

Abstract

Mediterranean Diet Lowers Risk of Peripheral Artery Disease

 (HealthDay News) – A Mediterranean diet supplemented with extra-virgin olive oil or nuts is associated with a lower risk of peripheral artery disease (PAD), according to a research letter published in the Jan. 22/29 issue of the Journal of the American Medical Association.

Miguel Ruiz-Canela, PhD, from the University of Navarra in Pamplona, Spain, and colleagues conducted a multicenter, randomized, primary prevention feeding trial between October 2003 and December 2010. Eligible participants (men aged 55–80 years and women aged 60–80 years, without clinical PAD or baseline cardiovascular disease, but with type 2 diabetes or ≥3 cardiovascular risk factors) were randomized to either Mediterranean diet supplemented with extra-virgin olive oil; Mediterranean diet supplemented with nuts; or low-fat diet counseling (control group).

The researchers found that both Mediterranean diet interventions correlated with reduced risk for PAD compared with the control group, with hazard ratios of 0.34 for the Mediterranean diet plus extra-virgin olive oil and 0.50 for the Mediterranean diet plus nuts, after adjustment for classic atherosclerotic risk factors. There was no significant difference between the active intervention groups (hazard ratio, 0.71; 95% confidence interval, 0.38–1.33). To prevent one case of PAD per year, the number needed to treat was 336 for the Mediterranean diet plus extra-virgin olive oil and 448 for the Mediterranean diet plus nuts group.

"To our knowledge, this is the first randomized primary prevention trial to suggest an association between a dietary intervention and PAD," the authors write. "These results are consistent with previous observational studies and relevant from a public health perspective."

Two authors disclosed financial ties to the International Nut Council. Supplemental foods used in the study were donated by Patrimonio Comunal Olivarero and Hojiblanca, the California Walnut Commission, Borges SA, and La Morella Nuts.

Cure for Baldness on the Horizon?

 (HealthDay News) — Scientists might be able to offer "hair-challenged" males a new glimmer of hope when it comes to reversing baldness, according to a study published online January 28 inNature Communications.

Xiaowei Xu, MD, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues say they've gotten closer to being able to use stem cells to treat thinning hair – at least in mice. In the new study, Xu's team converted induced pluripotent stem cells (iPSCs) – reprogrammed adult stem cells with many of the characteristics of embryonic stem cells – into epithelial stem cells.

The epithelial stem cells were mixed with certain other cells and implanted into mice. They produced the outermost layers of skin cells and follicles that are similar to human hair follicles. This suggests that these cells might eventually help regenerate hair in people, the researchers said.

"This is the first time anyone has made scalable amounts of epithelial stem cells that are capable of generating the epithelial component of hair follicles," Xu said in a university news release.

Full Article
Abstract

Obesity Related to High BPA Levels in Teens

 (HealthDay News) – Increased urinary phthalates are associated with increased insulin resistance in adolescents; and higher bisphenol A (BPA) levels are associated with obesity and abnormal waist circumference-to-height ratio in children, according to two studies published online Aug. 19 in Pediatrics.

Leonardo Trasande, MD, MPP, from New York University in New York City, and colleagues used cross-sectional-data from 766 fasting youth (aged 12–19 years) from the National Health and Nutrition Examination Survey (NHANES) 2003–2008 to examine the correlations of phthalate metabolites with measures of homeostatic model assessment of insulin resistance (HOMA-IR). The researchers found that after adjustment for confounding variables there was a 0.27 increase in HOMA-IR with each log increase in di-2-ethylhexylphthalate metabolites. The correlation persisted even after controlling for BPA.

Donna S. Eng, MD, from the University of Michigan in Ann Arbor, and colleagues used NHANES 2003–2008 data to examine the correlation between urinary BPA levels and measures of adiposity, cholesterol, insulin, and glucose among 6- to 18-year-olds. The researchers found that the odds of obesity were higher with increasing quartiles of BPA (quartiles 2, 3, and 4 vs. 1 odds ratios, 1.74, 1.64, and 2.01, respectively). The odds of an abnormal waist circumference-to-height ratio were also increased (quartiles 2, 3, and 4 vs. 1 odds ratios, 1.37, 1.41, and 1 55, respectively). There were no significant associations between BPA and other chronic disease risk factors.

"Longitudinal analyses are needed to elucidate temporal relationships between BPA exposure and the development of obesity and chronic disease risk factors in children," Eng and colleagues conclude.

Abstract - Trasande 

DIY Cognitive Screening

A self-administered test can help spot early symptoms of cognitive issues.

Researchers at The Ohio State Universityt (Ohio, USA) have developed a do-it-yourself test that can help doctors spot early symptoms of cognitive issues in their patients. The Self-Administered Gerocognitive Examination (SAGE test) can also be taken at home by patients, who can then share the results with their physicians to promote early disease detection.  Taking less than 15 minutes to complete, Douglas Scharre and colleagues posit that the SAGE test enables doctors to get a baseline of cognitive function in their patients, so they can be followed for a later onset of Alzheimer’s Disease.  As well, the team suggests that the SAGE test could also provide health care providers and caregivers an earlier indication of life-changing events that could lie ahead. Earlier research by Scharre found that four out of five people (80%) with mild thinking and memory (cognitive) issues will be detected by this test, and 95% of people without issues will have normal SAGE scores. Observing that: “From … 1,047 individuals over age 50 screened with SAGE …cognitive impairment was identified in 28%,” the study authors submit that: “Community cognitive screening using SAGE was found to be feasible and efficient in diverse settings with both small and large groups.”

http://www.eurekalert.org/pub_releases/2014-01/m-sat010714.php

Enduring Effect of Cognitive Training in Older Adults

Benefits persisted at 10 years in a randomized trial.

 Wayne PM et al., J Am Geriatr Soc 2014 Jan 62:25

The ACTIVE study was initiated in 1998 to determine whether cognitive training could improve outcomes in 2800 older adults without significant cognitive deficits at baseline. Participants (age, >65; mean age, 74) were randomized to undergo memory training, reasoning training, speed-of-processing training, or no intervention. Training consisted of 10 hour-long small-group training sessions during a 5- to 6-week period following randomization; participants were reassessed periodically during 10 years of follow-up. At 10 years, those who underwent reasoning and speed-of-processing training had persistent, statistically significant, small-to-moderate improvements in their respective domains compared with controls; in contrast, those in the memory-training group experienced no long-term improvement in memory. All three treatment groups reported significantly less difficulty with activities of daily living than did the control group.

Tai chi, a so-called mind-body activity, is another increasingly popular approach to address both physical and cognitive decline in older adults. Researchers conducted a meta-analysis of 11 randomized trials of tai chi in which cognition was assessed and found that tai chi (compared with control interventions or no intervention) improved cognition moderately in both normal and impaired older adults. Duration of these studies was generally short (≤1 year).

High (and Low?) Endogenous Estradiol Linked to Increased Dementia Risk in Postmenopausal Women

High levels of endogenous estradiol are associated with increased risk for incident dementia among postmenopausal women, especially among those who have diabetes, a Neurology study finds.

Using data from a French prospective cohort, researchers identified some 130 postmenopausal women who developed dementia and 540 who remained dementia-free over a 4-year period. Endogenous estradiol was measured at baseline. None were using hormone therapy.

After multivariable adjustment, researchers found a J-shaped association between estradiol and dementia: Compared with women with moderate estradiol levels, those with the highest levels had a 2.4-fold risk for dementia, and those with the lowest levels had a 2.2-fold risk. In an analysis stratified according to diabetes status, diabetic women with high estradiol had a 14-fold increase in dementia risk.

The researchers attribute the increased risk at low estradiol levels to possible reverse causation. Regarding the link between high estradiol and dementia in diabetic women, they write: "It is plausible that higher endogenous [estradiol] together with diabetes promote a set of unfavorable vascular processes to increase risk of dementia in postmenopausal women."

Neurology article

Three Reasons to Take A Stand

Why is prolonged sitting bad for your health?

By opting to stand, instead of sitting for an extended period of time, and increasing physical activity throughout the day, we can improve health and quality of life while reducing the risks for chronic diseases such as cardiovascular disease, diabetes, heart disease, stroke, breast cancer and colon cancer, among others.  Richard R. Rosenkranz, from Kansas State University (Kansas, USA), and colleagues studied data collected on 194,545 men and women, ages 45 to 106, who were enrolled in Australia’s 45 and Up Study.  Positing that prolonged sitting reduces muscle contractions and shuts off the activity of lipoprotein lipase (LPL), which helps to process fat into energy, these study authors write that their data adds to the evidence to support efforts “to increase [physical activity] and decrease sitting time toward the achievement of better population health and the pursuit of successful aging. “  Among postmenopausal women, Rebecca Seguin, from Cornell University (New York, USA), and colleagues found that those with the highest amounts of sedentary time – defined as sitting and resting, excluding sleeping – died earlier than their most active peers. Further, the researchers found that women with more than 11 hours of daily sedentary time faced a 12% increase in all-cause premature mortality, as compared with the most energetic group – those with four hours or less of inactivity. The sedentary group also upped their odds for death due to cardiovascular disease, coronary heart disease and cancer by 13, 27 and 21%, respectively.  Importantly, the team also observed that excess sedentary time tends to make it harder to regain physical strength and function.  These study authors warn that: “There [is] a linear relationship between greater amounts of sedentary time and mortality risk.”  Among men, sitting for long periods increases heart failure risk in men – even for those who exercise regularly. Deborah Rohm Young, from Kaiser Permanante (California, USA), and colleagues followed a racially diverse group of 84,170 men, ages 45 to 69 years, without heart failure. Exercise levels were calculated in METs (metabolic equivalent of task), a measure of the body's energy use. Sedentary levels were measured in hours. After an average of nearly eight years of follow-up, researchers found that those men with low levels of physical activity were 52% more likely to develop heart failure than men with high physical activity levels, even after adjusting for differences in sedentary time. Further, outside of work, men who spent five or more hours a day sitting were 34%  more likely to develop heart failure than men who spent no more than two hours a day sitting, regardless of how much they exercised. The team also reveraled that heart failure risk more than doubled in men who sat for at least five hours a day and got little exercise, as compared to men who were very physically active and sat for two hours or less a day. These authors urge that: “Both physical activity and sedentary time may be appropriate intervention targets for preventing [heart failure].”

http://www.k-state.edu/media/newsreleases/jan14/rosenkranz11514.html

Assessing the Clinical Benefits of Lipid-Disorder Drugs 

W.R. Hiatt and R.J. Smith | N Engl J Med 2014;370:396-399

Should All Patients with COPD Exacerbations Be Treated with Antibiotics?

Miravitlles M et al., Chest 2013 Nov 144:1571

In those with mild-to-moderate chronic obstructive pulmonary disease, only purulent sputum and high C-reactive protein levels predicted need for antibiotics.

Early vs. Delayed Cholecystectomy for Acute Cholecystitis

de Mestral C et al., Ann Surg 2014 Jan 259:10

Early surgery is the better choice for patients who aren't critically ill.

Vitamin E Supplementation for Mild-to-Moderate Alzheimer Disease

Dysken MW et al., JAMA 2014 Jan 1; 311:33

A modest benefit was noted in a 2-year randomized trial.

Digoxin effect on readmission for heart failure 
In Medicare beneficiaries with systolic heart failure, a discharge prescription of digoxin was associated with lower 30-day all-cause hospital readmission, which was maintained at 12 months, and was not at the expense of higher mortality. Future randomized controlled trials are needed to confirm these findings. The American Journal of Medicine 

 
 Breast cancer vs heart disease mortality in women 
The clinical implications of the findings of this study are confirmatory and reinforce the importance of promoting women's health during their entire life span, as it may well affect them adversely later in life. The authors highlight the importance of considering age-specific analyses when examining mortality among women. They encourage women to be passionate about coronary heart disease (CHD) awareness, with vigor equal to that of breast cancer awareness, and to talk with their doctors about CHD risk factors, taking action to prevent or control these risk factors when present. The American Journal of Cardiology

Postmenopausal hormone therapy tied to increased pancreatitis risk 
Postmenopausal women who used hormone therapy were more likely to develop acute pancreatitis than those who had never used hormone treatments, according to a study involving 31,494 women ages 48 to 83 in Sweden. The risk of acute pancreatitis was greater with systemic therapy compared with local therapy and among those who used hormone therapy for more than 10 years, researchers reported in the Canadian Medical Association Journal. Healio (free registration)/Endocrine Today

CHA2DS2-VASc score predicts pulmonary embolism 
CHA2DS2-VASc score is directly associated with the incidence of pulmonary embolism in atrial fibrillation. The American Journal of Medicine

Circulating Uric Acid May Play Protective Role in Obesity

 (HealthDay News) — Circulating uric acid affects non-enzymatic antioxidant capacity (NEAC) and markers of oxidative stress in obese subjects, according to a study published online December 18 in Diabetes.

Elisa Fabbrini, MD, PhD, from the Washington University School of Medicine in St. Louis, and colleagues assessed whether alterations in circulating uric acid affect systemic NEAC, markers of systemic and muscle oxidative stress, and whole-body insulin sensitivity using data from obese subjects with high (15 subjects) or normal (16 subjects) serum uric acid. Thirteen of the subjects with high uric acid underwent reduction of serum uric acid to zero by infusion of recombinant urate oxidase and were studied again.

The researchers found that, compared to those with normal uric acid, individuals with high uric acid had 20 to 90% increased NEAC, 40% lower insulin sensitivity, and 30%lower levels of markers of oxidative stress (all P<0.05). Reduction of uric acid resulted in a decrease of 45 to 95% in NEAC and increases of 25–40% in systemic and muscle markers of oxidative stress (all P<0.05), but the reduction had no impact on insulin sensitivity.

"These results demonstrate that circulating uric acid is a major antioxidant, and might help protect against free-radical oxidative damage," the authors write. "However, oxidative stress is not a major determinant of insulin action in vivo."

The study was partially funded by a grant from Sanofi-Aventis.

Abstract

USPSTF Finalizes Recommendation for Lung Cancer Screening

Moyer VA et al. Ann Intern Med 2013 Dec 31. Detterbeck FC and Unger M. Ann Intern Med 2013 Dec 31. Allan S. Brett, MD Older people (age range, 55–80) with 30–pack-year smoking histories are eligible. Allan S. Brett, MDSponsoring Organization: U.S. Preventive Services Task Force (USPSTF)Target Audience: Primary care providersBackground and Objective: Evidence-based recommendation on screening to prevent lung cancer deaths among people with long smoking histories Key Points The USPSTF recommends annual screening with low-dose computed tomography (LDCT) in older adults (age range, 55–80) with 30–pack-year smoking histories who smoke currently or have quit within the past 15 years. Screening should be discontinued if a person has not smoked for ≥15 years; screening is not warranted for patients with medical conditions that limit life expectancy. - See more at: http://www.jwatch.org/na33375/2014/01/28/uspstf-finalizes-recommendation-lung-cancer-screening?query=etoc_jwgenmed#sthash.xLCB8ahd.dpuf      

2013 Heart Failure Guidelines

Background and ObjectiveThis document is a thorough revision of the 2005 ACC/AHA HF guidelines (updated in early 2009). The writers reviewed studies published through October 2011 (with selected additional data published before April 2013).Key RecommendationsClass I recommendations for initial evaluation include: History and physical examination Family history in patients with dilated cardiomyopathy Weight and volume status Complete blood count, urinalysis, electrolytes, lipids, liver panel, and thyroid-stimulating hormone Electrocardiogram Chest radiograph 2-dimensional echocardiogram with assessment of left ventricular (LV) systolic function. Class I recommendations for the use of B-type natriuretic peptide (BNP) or N-terminal pro-BNP include: Assessing the likelihood of HF in ambulatory patients with dyspnea or patients with possible acute decompensated HF when the diagnosis is uncertain Establishing prognosis or disease severity Patients with asymptomatic LV systolic dysfunction (LVSD) should receive an angiotensin-converting enzyme (ACE) inhibitor and a β-blocker to prevent symptomatic HF (Class I).In the absence of contraindications, patients with symptomatic LVSD should receive guideline-directed medical therapy (GDMT) consisting of ACE inhibitor (or angiotensin-receptor blocker), β-blocker, and: Loop diuretics, if needed for volume overload Aldosterone antagonists in patients with symptoms of any severity or following acute myocardial infarction (MI), provided that estimated glomerular filtration rate is >30 mL/min/1.73m2 and potassium levels are <5 mEq/dL. Hydralazine and nitrate combination in black patients with severe symptoms despite other therapy (all Class I). Only those β-blockers proven to improve HF outcomes — long-acting metoprolol, carvedilol, or bisoprolol — should be used in patients with LVSD (Class I).In the absence of contraindications, patients with HF and atrial fibrillation (AF) with an additional risk factor for stroke should receive systemic anticoagulation with warfarin or other approved agents (Class I). The value of anticoagulation in other circumstances is less clear.Agents that are not beneficial or harmful for LVSD include statins (solely for HF), nutritional supplements, hormonal therapies, calcium channel blockers, nonsteroidal anti-inflammatory drugs, thiazolidinediolnes, and long-term infused inotropic drugs (all Class III).Evidence-based approaches to HF patients with preserved systolic function are lacking; recommendations for this group are generic and target coexisting conditions (e.g., hypertension and AF).Recommendations for implantable cardioverter-defibrillator therapy (in many patients with LV ejection fractions <35%) and cardiac resynchronization therapy (CRT; in those with LVSD and QRS prolongation) are consistent with current device-based therapy guidelines (NEJM JW Cardiol Oct 3 2012) and include expanding CRT consideration to patients with New York Heart Association class II symptoms (Class I).Transplantation should be considered in patients with stage D HF that is refractory to GDMT, device, and surgical therapies (Class I).Transitional care at hospital discharge, palliative care, care coordination (all Class I), and participation in quality-improvement initiatives (Class IIa) are encouraged. - See more at: http://www.jwatch.org/na33364/2014/01/28/2013-heart-failure-guidelines?query=etoc_jwgenmed#sthas

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USPSTF Issues Draft Recommendations on Abdominal Aortic Aneurysm Screening

The U.S. Preventive Services Task Force now says that the evidence is insufficient to weigh the benefits and harms of screening for abdominal aortic aneurysm (AAA) in women aged 65 to 75 who've ever smoked. The so-called "I statement," published as part of the group's draft recommendation statement on Monday, updates its 2005 guidance, which clearly advised against screening for all women.

As in 2005, the task force continues to recommend:

• one-time ultrasound screening for AAA in men aged 65 to 75 who've ever smoked (grade B recommendation).
• selective screening of men in that age group who've never smoked (grade C); never-smokers who might warrant screening include those with a history of vascular aneurysm or a first-degree relative with AAA.
• no screening for women who've never smoked (grade D).

The recommendations apply to asymptomatic adults aged 50 and older. The draft statement is available for public comment until Feb. 24 at the link below.

USPSTF draft recommendation statement (Free)

USPSTF evidence review in the Annals of Internal Medicine (Free)

Body-mass index and mortality among adults with incident type 2 diabetes.

Tobias DK, Pan A, Jackson CL, O'Reilly EJ, Ding EL, Willett WC, Manson JE, Hu FB.

Author information

• From the Departments of Nutrition (D.K.T., A.P., C.L.J., E.J.O., E.L.D., W.C.W., F.B.H.) and Epidemiology (W.C.W., J.E.M., F.B.H.), Harvard School of Public Health, and the Channing Division of Network Medicine (E.J.O., E.L.D., W.C.W., F.B.H.) and the Division of Preventive Medicine (J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School - all in Boston; and Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (A.P.).

Abstract

BACKGROUND:

The relation between body weight and mortality among persons with type 2 diabetes remains unresolved, with some studies suggesting decreased mortality among overweight or obese persons as compared with normal-weight persons (an "obesity paradox").

METHODS:

We studied participants with incident diabetes from the Nurses' Health Study (8970 participants) and Health Professionals Follow-up Study (2457 participants) who were free of cardiovascular disease and cancer at the time of a diagnosis of diabetes. Body weight shortly before diagnosis and height were used to calculate the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). Multivariable Cox models were used to estimate the hazard ratios and 95% confidence intervals for mortality across BMI categories.

RESULTS:

There were 3083 deaths during a mean period of 15.8 years of follow-up. A J-shaped association was observed across BMI categories (18.5 to 22.4, 22.5 to 24.9 [reference], 25.0 to 27.4, 27.5 to 29.9, 30.0 to 34.9, and ≥35.0) for all-cause mortality (hazard ratio, 1.29 [95% confidence interval {CI}, 1.05 to 1.59]; 1.00; 1.12 [95% CI, 0.98 to 1.29]; 1.09 [95% CI, 0.94 to 1.26]; 1.24 [95% CI, 1.08 to 1.42]; and 1.33 [95% CI, 1.14 to 1.55], respectively). This relationship was linear among participants who had never smoked (hazard ratios across BMI categories: 1.12, 1.00, 1.16, 1.21, 1.36, and 1.56, respectively) but was nonlinear among participants who had ever smoked (hazard ratios across BMI categories: 1.32, 1.00, 1.09, 1.04, 1.14, and 1.21) (P=0.04 for interaction). A direct linear trend was observed among participants younger than 65 years of age at the time of a diabetes diagnosis but not among those 65 years of age or older at the time of diagnosis (P<0.001 for interaction).

CONCLUSIONS:

We observed a J-shaped association between BMI and mortality among all participants and among those who had ever smoked and a direct linear relationship among those who had never smoked. We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox. (Funded by the National Institutes of Health and the American Diabetes Association

Modeling Study: Similar Effects for Statin or Apple a Day

 (HealthDay News) – An apple a day or a statin a day are equally likely to keep the doctor away, according to a modeling study published online Dec. 17 in BMJ.

Adam D.M. Briggs, from University of Oxford in the United Kingdom, and colleagues modeled the effect on vascular mortality if all adults in the United Kingdom over age 50 years were prescribed a statin (for those not already taking one) or an apple a day for everyone, regardless of whether they were taking a statin or not. Compliance of 70% was estimated.

The researchers found that for a statin a day the estimated annual reduction in mortality from vascular disease was 12% per 1mmol/L reduction in low-density lipoprotein cholesterol, or 9,400 deaths. Using a PRIME model (assuming an apple weighs 100g and that overall calorie consumption remains constant) the equivalent reduction from an apple a day was found to be 8,500.

"With similar reductions in mortality, a 150 year old health promotion message is able to match modern medicine and is likely to have fewer side effects," the authors conclude.

Full Text

Low Vitamin B₁₂ Linked to Postural Orthostatic Tachycardia

 (HealthDay News) – During adolescence, low vitamin B₁₂ levelsare associated with postural orthostatic tachycardia syndrome (POTS), according to a study published online Dec. 23 inPediatrics.

Taliha Öner, MD, from Dr. Behçet Uz Children's Hospital in Izmir, Turkey, and colleagues examined the correlation between vitamin B₁₂ levels and POTS during adolescence. Serum vitamin B₁₂, folic acid, and ferritin levels were assessed in 125 patients (mean age, 11.1 years; 60% female) reporting short-term loss of consciousness and diagnosed with vasovagal syncope, and 50 control subjects (mean age, 10.94 years; 62% female).

The researchers found that patients had significantly lower levels of vitamin B₁₂ vs. controls (352.75 vs. 411.32pg/mL; P<0.001), and that a low vitamin B₁₂ level was significantly more prevalent in the patient vs. the control group (47.2 vs. 18%; P<0.001). Within the patient group, vitamin B₁₂ levels were significantly lower in children with the POTS pattern than those without the POTS response (P=0.03).

"Our study shows the association between the etiopathogenesis of POTS and the vitamin _B12deficiency-induced sympathetic nervous system-baroreceptor dysfunction," the authors write.

Abstract

New Ragweed Allergy Immunotherapy Gets Votes of Confidence from FDA Advisers

By the Editors An FDA advisory committee voted on Tuesday in support of the safety and efficacy of an experimental sublingual tablet to treat ragweed allergy. Adults with ragweed allergy would take Ragwitek — made up of ragweed pollen extracts — daily beginning at least 12 weeks before the start of ragweed pollen season until the season ends.The FDA typically follows the advice of its advisory panels when making drug approval decisions, but is not required to do so. Link(s): Reuters story (Free) FDA advisory committee briefing document (Free PDF) Background: Physician's First Watch recent coverage of advisory committee recommendations on other allergy drugs (Free) - See more at: http://www.jwatch.org/fw108409/2014/01/29/new-ragweed-allergy-immunotherapy-gets-votes-confidence?query=pfw#sthash.YbPIkP7s.dpuf

Beta blockers and atrial fibrillation: Hypertension and other medical conditions influencing their use 
Canadian Journal of Cardiology, 12/28/2013  Clinical Article

Dorian P, et al. – Beta blockers are amongst the most frequently used drugs in patients with atrial fibrillation. They are often used for ventricular rate control and occasionally to prevent the first occurrence or recurrence of atrial fibrillation, particularly in patients with hypertension. They are also indicated in patients with heart failure or coronary artery disease and atrial fibrillation; the choice of beta blockers in these conditions should be guided by evidence, tolerability and effects on symptoms.

• Beta blockers are amongst the most frequently used drugs in patients with atrial fibrillation.
• They are often used for ventricular rate control, both acutely in emergency situations and chronically, in patients with persistent or permanent atrial fibrillation.
• They are also used, with less evidence of benefit, to prevent the first occurrence or recurrence of atrial fibrillation, particularly in patients with hypertension.
• They are effective in reducing ventricular rate, potentially leading to an improvement in symptoms and well–being.
• They are particularly indicated in patients with heart failure and atrial fibrillation; the choice of beta blockers in this condition should be guided by tolerability and effects on symptoms and well–being.

http://www.onlinecjc.ca/article/S0828-282X(13)01558-4/abstract?rss=yes

Effects of changing guidelines on prescribing aspirin for primary prevention of cardiovascular events Full Text 
Journal of the American Board of Family Medicine, 01/07/2014  Clinical Guideline

Hissett J, et al. – The use of low–dose aspirin for primary prevention of cardiovascular events in patients at elevated risk for cardiovascular disease (CVD) is increasingly being questioned. Aspirin may not benefit this population and may increase the risk of major bleeding events. Data support aspirin use in patients with known CVD. Primary care clinicians have a central role in providing evidence–based preventive services and should integrate revised information into their practice to improve outcomes. Even with new evidence against the use of aspirin for primary prevention, it is difficult to change beliefs about the effectiveness and safety of aspirin, as reflected in the behavior of physicians and patients.

http://www.ncbi.nlm.nih.gov/pubmed/24390889

Green Tea May Interfere With Antihypertensive

 (HealthDay News) – Drinking green tea may lessen the effects of the antihypertensive medication nadolol (Corgard), according to research published online Jan. 13 in Clinical Pharmacology & Therapeutics.

Shingen Misaka, PhD, from Fukushima Medical University in Japan, and colleagues gave 10 volunteers a single dose of 30mg of nadolol after they had consumed either water or about three cups of green tea daily for 14 days.

The researchers found that blood levels of the drug were 76% lower in the group that drank green tea compared to the water-drinking group.

"Individuals who take nadolol and also consume green tea should be aware of this potential interaction and discuss this with their physician," Gregg Fonarow, MD, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association, told HealthDay. He reviewed the findings but did not take part in the study.

Abstract

Chinese Herbals Delay Progression to Type 2 Diabetes

By Amy Orciari Herman

A combination of Chinese herbal medicines can delay progression to diabetes in high-risk patients, according to a small study in the Journal of Clinical Endocrinology and Metabolism.

Some 400 patients in China with impaired glucose tolerance were randomized to receive Tianqi -- a capsule containing 10 Chinese herbal medicines -- or placebo for 12 months (5 capsules 3 times daily). All participants also received lifestyle education.

At the end of the study, significantly fewer Tianqi patients than placebo recipients had progressed to diabetes (18% vs. 29%). In addition, significantly more Tianqi recipients had achieved normal glucose tolerance (63% vs. 47%). Adverse events did not differ between groups.

The researchers say Tianqi offers similar benefits to metformin and may be better tolerated. Calling for larger clinical trials, they conclude: "Tianqi holds promising potential as an effective and practical means to prevent [type 2 diabetes]."

Journal of Clinical Endocrinology and Metabolism article

----------------------------------------------
** ALLERGY News **

Short course immunotherapy effective in reducing ragweed pollen allergy
http://mnt.to/l/4kcc

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** ALZHEIMER'S / DEMENTIA News **

A byproduct of the pesticide DDT increases risk of Alzheimer's
http://mnt.to/l/4kcr

Our ability to form spatial memories is damaged by infections
http://mnt.to/l/4kbQ

Scripps Florida scientists find regulator of amyloid plaque buildup in Alzheimer's disease
http://mnt.to/l/4k9v

Men are more forgetful than women, study shows
http://mnt.to/l/4k8K

Researchers discover a simple amoeba holds the key to better treatment for Alzheimer's disease
http://mnt.to/l/4k8L

New global partnership aims to accelerate dementia drug discovery
http://mnt.to/l/4k8F

Alzheimer's trial disappointing but yields new ideas
http://mnt.to/l/4k7L

Alzheimer's defense: omega-3s linked to larger brain volume
http://mnt.to/l/4k6G

Epigenetic lesion discovered in the hippocampus of Alzheimer's patients
http://mnt.to/l/4k69

----------------------------------------------
** ANXIETY / STRESS News **

PTSD treatment progress impacted by depression symptoms and emotional support
http://mnt.to/l/4k9V

40% of minors in Lorca suffer post-traumatic stress a year after earthquake
http://mnt.to/l/4k8d

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** ARTHRITIS / RHEUMATOLOGY News **

New cause identified for children and adults with joint, skeletal and skin problems
http://mnt.to/l/4kbh

Levels of depression and anxiety in people with severe rheumatoid arthritis higher than previously reported
http://mnt.to/l/4k68

----------------------------------------------
** BONES / ORTHOPEDICS News **

Scientists identify cause of joint, skeletal and skin problems in children and adults: Leri's pleonosteosis
http://mnt.to/l/4kbP

Conceptions about the determinants of skull development and form changed by new study
http://mnt.to/l/4kbF

"Whole spine" approach to neck and back problems
http://mnt.to/l/4kbc

'Watch' cites concern about femoral neck fractures in long-necked modular implants
http://mnt.to/l/4k8G

Gene therapy restored muscle function and prolonged lives in animals with a condition similar to X-linked myotubular myopathy in children
http://mnt.to/l/4k7M

How marriage affects bone health
http://mnt.to/l/4k7n

HRT cuts risk of repeat knee/hip replacement surgery by 40%
http://mnt.to/l/4k5D

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** BREAST CANCER News **

New classification system for breast cancers
http://mnt.to/l/4kcR

Breast cancer survivors benefit from yoga
http://mnt.to/l/4kcx

Second breast cancers may be prevented by moderate doses of radiation therapy to unaffected breast
http://mnt.to/l/4k9X

Long-living breast stem cells give clues to cancer cells of origin
http://mnt.to/l/4kcb

Compound trialed on mice showed a complete halt in spread of metastatic breast tumors
http://mnt.to/l/4kc3

Personalized cancer care may be improved by new computer model
http://mnt.to/l/4k9P

Scientists aiming to prevent tumor spread
http://mnt.to/l/4k9L

Novel approach to stay a step ahead of breast cancer
http://mnt.to/l/4k95

Researchers discover new hormone receptors to target when treating breast cancer
http://mnt.to/l/4k8z

Patterns of cancer screening in Appalachian women examined
http://mnt.to/l/4k8k

Folic acid linked to breast cancer growth in animal study
http://mnt.to/l/4k7T

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** CANCER / ONCOLOGY News **

Disrupted sleep speeds up cancer
http://mnt.to/l/4kcw

Cracks in the cellular transport system can be key to a new generation of cancer therapies
http://mnt.to/l/4kc4

Music therapy improves coping skills in young cancer patients
http://mnt.to/l/4kbq

The scent of cancer
http://mnt.to/l/4kbn

Simple protein test could improve prediction of survival rates for patients with head and neck cancer
http://mnt.to/l/4kbj

Rivals' relative expression levels in cancer cells could be biomarkers for prognosis, treatment
http://mnt.to/l/4k9B

How will the Affordable Care Act affect cancer survivors?
http://mnt.to/l/4k9z

Genetic changes mapped that drive tumors in a common pediatric soft-tissue cancer rhabdomyosarcoma
http://mnt.to/l/4k9s

Inovio Pharmaceuticals unveils potent new immune activator
http://mnt.to/l/4k7W

Potential new target in Ewing's Sarcoma
http://mnt.to/l/4k7d

Cancer diagnosis doesn't increase a child's risk of post-traumatic stress disorder
http://mnt.to/l/4k6x

FAK inhibitors may prevent tumor cells entering the bloodstream
http://mnt.to/l/4k5s

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** CARDIOVASCULAR / CARDIOLOGY News **

Developing heart valves may be sensitive to environmental chemicals
http://mnt.to/l/4k9S

Heart attack survival 'significantly lower' in UK than Sweden
http://mnt.to/l/4k6z

Heart attack mortality higher for patients at night and weekends
http://mnt.to/l/4k59

Mediterranean diet may reduce the risk of peripheral artery disease
http://mnt.to/l/4k4S

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** CHOLESTEROL News **

Bad version of 'good' cholesterol causes disease
http://mnt.to/l/4kbX

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** DEPRESSION News **

Targeting symptoms, rather than disorders, might help to lessen work impact of mental health issues
http://mnt.to/l/4k9h

In African-American women, link discovered between depressive symptoms and adult-onset asthma
http://mnt.to/l/4k5S

News from Annals of Family Medicine: January/February 2014
http://mnt.to/l/4k5t

----------------------------------------------
** DERMATOLOGY News **

Birch helps wounds heal faster
http://mnt.to/l/4k9C

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** DIABETES News **

Motivational health coaching empowers diabetic patients, improves dental health
http://mnt.to/l/4kbY

Flu vaccine suggested for working-age adults with diabetes
http://mnt.to/l/4kby

Diagnosis by 'smart' holograms
http://mnt.to/l/4k8n

Research presents new hope of early diagnosis of major cause of blindness
http://mnt.to/l/4k7H

Care managers in patient centered medical homes increase improvements in diabetes patients
http://mnt.to/l/4k7C

Does your spouse have type 2 diabetes? You could also be at risk
http://mnt.to/l/4k5J

Diabetes the top health concern for Latino families
http://mnt.to/l/4k76

----------------------------------------------
** FLU / COLD / SARS News **

The difficulties encountered seeking a better flu vaccine
http://mnt.to/l/4k94

Fever-reducing medications may aid spread of influenza
http://mnt.to/l/4k6j

----------------------------------------------
** HYPERTENSION News **

Elevated blood pressure at home but not in clinic can indicate increased heart attack risk
http://mnt.to/l/4k6m

----------------------------------------------
** INFECTIOUS DISEASES / BACTERIA / VIRUSES News **

Scientists discover deadly plague cause
http://mnt.to/l/4kc6

Progress reported in national plan for preventing healthcare-associated infections
http://mnt.to/l/4k9Z

Pandemic concerns prompt experts to seek better understanding of Middle East Respiratory Syndrome (MERS)
http://mnt.to/l/4kbd

How drugs that limit the damage caused by disease could affect how infections spread and evolve
http://mnt.to/l/4k7w

Novel biosensor developed to target salmonella
http://mnt.to/l/4k7q

Recommendations to help prevent health-care-associated infections transmitted through clothing
http://mnt.to/l/4k6b

Bacteria contaminates hospital water taps, may threaten patient safety
http://mnt.to/l/4k63

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** MEN'S HEALTH News **

What is the average penis size?
http://mnt.to/l/4k8Q

Health disparities among U.S. African-American and Hispanic men cost economy more than $450 billion over four years
http://mnt.to/l/4k8f

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** MENTAL HEALTH News **

New national alliance aims to reduce suicide in England
http://mnt.to/l/4kbp

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** NEUROLOGY / NEUROSCIENCE News **

Do brain connections help shape religious beliefs?
http://mnt.to/l/4kcv

Animate, inanimate, but also social
http://mnt.to/l/4kch

Imaging technique identifies delays in premature infants
http://mnt.to/l/4kbz

Research into timing mechanisms for memory formation
http://mnt.to/l/4k9k

Breakthrough allows scientists to probe how memories form in nerve cells
http://mnt.to/l/4k8X

Humans can use smell to detect levels of dietary fat
http://mnt.to/l/4k8D

Scientists find neuron that controls how much we eat
http://mnt.to/l/4k7G

Eye movement speed linked to impulsive decision making
http://mnt.to/l/4k6Q

Sigma-1 receptor implicated in cell survival of rare neurodegenerative diseases
http://mnt.to/l/4k8N

Adults still think about numbers like kids
http://mnt.to/l/4k8h

How does the brain link different memories?
http://mnt.to/l/4k8g

Blocking NMDA receptors to limit neurotoxicity
http://mnt.to/l/4k8b

Improved understanding of how our brains control our arms may lead to design of better brain controlled prosthetic limbs
http://mnt.to/l/4k86

Growth chart for the brain may pave the way for preventive early interventions
http://mnt.to/l/4k6V

Brain development: Researchers identify key protein
http://mnt.to/l/4k6N

Brain works like a radio receiver
http://mnt.to/l/4k6C

New brain-imaging technique offers brain training potential
http://mnt.to/l/4k64

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** NUTRITION / DIET News **

What are the health benefits of kiwis (kiwifruit)?
http://mnt.to/l/4jYn

Study seeks to explain what drives our appetites
http://mnt.to/l/4kbt

Looking inside food microstructures
http://mnt.to/l/4kbm

Dietary treatment shows potential in a mouse model of Alzheimer's disease
http://mnt.to/l/4k9x

Surprising research results for one type of omega-3 fatty acid: DHA
http://mnt.to/l/4k9q

What are the health benefits of grapes?
http://mnt.to/l/4jWP

Caffeine: how does it really affect our health?
http://mnt.to/l/4kb4

Lingonberries halt effects of high-fat diet
http://mnt.to/l/4k8M

Clasado and University of Oxford demonstrate effect of prebiotics on brain and gut in pre-clinical study
http://mnt.to/l/4k8J

Study questions health benefits of vitamin D supplementation
http://mnt.to/l/4k7F

Study of evolution of lactase persistence in Europeans debunks calcium assimilation hypothesis
http://mnt.to/l/4k6g

Combining health and environment
http://mnt.to/l/4k5G

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** OBESITY / WEIGHT LOSS / FITNESS News **

Obesity rates stabilized by better eating habits, not bad economy
http://mnt.to/l/4k9y

Maternal high-fat diet alters metabolism in offspring, leading to greater risk of obesity
http://mnt.to/l/4k8Z

New genes linked to abdominal fat uncovered
http://mnt.to/l/4k8H

Boosting weight loss by exposing our bodies to cold temperatures
http://mnt.to/l/4k7V

Are policymakers, the food industry, or individuals to blame for obesity?
http://mnt.to/l/4k7v

Effective physical activity whilst sitting using small elliptical exercise device
http://mnt.to/l/4k73

Children with high BMIs exposed to high levels of air pollutants had nearly triple asthma risk
http://mnt.to/l/4k6Y

New web-based course to prevent excessive weight gain may improve health in young adults
http://mnt.to/l/4k6B

Disadvantaged, non-college bound young adults at risk for excessive weight gain
http://mnt.to/l/4k6y

Broad public health interventions essential to tackle childhood obesity
http://mnt.to/l/4k6f

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** PRIMARY CARE / GENERAL PRACTICE News **

Many internists don't feel equipped to manage care of adults who had cancer as children
http://mnt.to/l/4kbL

Gazing at electronic health records diverts doctors' attention from patients
http://mnt.to/l/4kbK

Disclosure leads to avoidance of conflicts of interest
http://mnt.to/l/4k7h

----------------------------------------------
** PROSTATE / PROSTATE CANCER News **

New prostate cancer model, known as RapidCaP, reveals a cancer-gene 'switch' that drives metastasis
http://mnt.to/l/4kbB

New Prostate Cancer drugs may not target root cause of the disease, York scientists warn
http://mnt.to/l/4kbr

When undergoing androgen deprivation therapy, prostate cancer patients should be counseled to improve mental and emotional well-being
http://mnt.to/l/4k9K

Patients receiving androgen deprivation therapy should be counseled to improve mental and emotional well-being
http://mnt.to/l/4k9w

----------------------------------------------
** SENIORS / AGING News **

Greater experience causes older brains to slow down, study shows
http://mnt.to/l/4k83

Scripps Florida scientists offer new insight into neuron changes brought about by aging
http://mnt.to/l/4k7Q

Study examines outcomes, volume of geriatric trauma cases
http://mnt.to/l/4k56

----------------------------------------------
** ALZHEIMER'S / DEMENTIA News **

Autophagy - or how cells tidy up
http://mnt.to/l/4k43

Study uncovers role of Neuroligin-1 protein in Alzheimer's-related memory loss
http://mnt.to/l/4k4v

Association between gene variation and brain atrophy in mild cognitive impairment
http://mnt.to/l/4jYb

Anavex agreement with The Roskamp Institute to advance the clinical development of ANAVEX PLUS
http://mnt.to/l/4jXV

----------------------------------------------
** ANXIETY / STRESS News **

How ecstasy acts on the brain has implications for anxiety and PTSD therapy
http://mnt.to/l/4k4k

Troubling relationship revealed in college students between drinking and PTSD symptoms
http://mnt.to/l/4k3M

----------------------------------------------
** ARTHRITIS / RHEUMATOLOGY News **

Smart gels deliver medicine on demand
http://mnt.to/l/4jZj

Study finds shoulder replacement eases pain, improves motion in rheumatoid arthritis
http://mnt.to/l/4jXd

Pursuing arthritis protein
http://mnt.to/l/4jW8

----------------------------------------------
** BONES / ORTHOPEDICS News **

Muscle is three times better than fat for bones
http://mnt.to/l/4k4R

Mesenchymal stem cells have the potential to improve the overall condition of the knee joint
http://mnt.to/l/4k3j

Guidance on drug holidays from popular osteoporosis treatments
http://mnt.to/l/4jZ4

Exercise simulated in cartilage cells by chemical signaling
http://mnt.to/l/4jWX

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** BREAST CANCER News **

Key mechanisms found to inhibit metastasis of deadly "triple negative" breast cancers
http://mnt.to/l/4k3m

VHIO genomic study identifies subgroups of HER2+ breast cancer with varying sensitivities to anti-HER2 treatment
http://mnt.to/l/4k2N

Masquerading as neurons enables breast cancer cells to spread to the brain
http://mnt.to/l/4jZv

Two types of breast cancer stem cells identified; both necessary to create metastasis
http://mnt.to/l/4jYx

----------------------------------------------
** CANCER / ONCOLOGY News **

Is Europe equipped with enough medical oncologists to face the increasing cancer burden? The horizon is still unknown
http://mnt.to/l/4k4K

New biomarker test identifies resistance to chemotherapy and radiation in esophageal cancer patients
http://mnt.to/l/4k4H

Most women undergoing conservative surgery for vulvar cancer maintain healthy body image and sex life
http://mnt.to/l/4k3G

Monoclonal antibody therapy enhances removal of circulating tumor cells
http://mnt.to/l/4k32

Coevolution between humans and bacteria found to reduce gastric cancer risk
http://mnt.to/l/4k2q

Fewer years of life lost to cancer
http://mnt.to/l/4k2p

NORD commends expansion of SSA's "Compassionate Allowances" list
http://mnt.to/l/4k2B

World's tiniest drug cabinets could be attached to cancerous cells for long term treatment
http://mnt.to/l/4jYR

Fresh insight into cancer offered by cell division discovery
http://mnt.to/l/4jYj

Viral microRNAs responsible for causing Kaposi's sarcoma, an AIDS-related cancer
http://mnt.to/l/4jXJ

Intensity-modulated radiation therapy reduces side effects, improves outcomes in patients with head and neck cancers
http://mnt.to/l/4jWW

BRAF mutation associated with other cancers appears to drive papillary craniopharyngiomas
http://mnt.to/l/4jWh

----------------------------------------------
** CARDIOVASCULAR / CARDIOLOGY News **

Pulmonary embolism trial comparing endovascular ultrasound to standard of care anticoagulation published in the American Heart Association's journal
http://mnt.to/l/4k5f

New coroners' advice could save hundreds of lives, UK
http://mnt.to/l/4k54

New training approach improves pediatric survival rates following cardiac arrest
http://mnt.to/l/4k3L

What is blood pressure? How is it measured?
http://mnt.to/l/4jKn

How heart arrhythmia occurs
http://mnt.to/l/4k4w

Researchers find cause of calcium-triggered arrhythmias
http://mnt.to/l/4k4m

First therapy to target damage after heart attack could transform field
http://mnt.to/l/4jZw

Key proteins identified that are responsible for electrical communication in the heart
http://mnt.to/l/4jXP

Factors that may affect adherence to medication following heart attack
http://mnt.to/l/4jXb

How to make PET imaging even sweeter
http://mnt.to/l/4jX7

Diagnosing heart problems earlier by tweaking MRI to track creatine
http://mnt.to/l/4jWd

----------------------------------------------
** COLORECTAL CANCER News **

Vitamin B3, fiber 'protects against colon cancer and inflammation'
http://mnt.to/l/4k3V

Regorafenib: hint of minor added benefit
http://mnt.to/l/4jW6

----------------------------------------------
** DEPRESSION News **

New UK initiative launched to end the loneliness and isolation associated with depression
http://mnt.to/l/4k3C

Does the gloomy winter weather have you depressed? Researchers looking for study participants
http://mnt.to/l/4jZ7

----------------------------------------------
** DERMATOLOGY News **

'Molecular scaffolding' discovered that maintains skin structure and organisation
http://mnt.to/l/4k3k

----------------------------------------------
** DIABETES News **

British Muslims with diabetes need more healthcare support during Ramadan
http://mnt.to/l/4k52

Potential future cure for diabetes
http://mnt.to/l/4k3H

Chocolate, wine and berries may protect against type 2 diabetes
http://mnt.to/l/4k4F

Fending off diabetes with ingredients in chocolate, tea and berries
http://mnt.to/l/4k4s

Diabetes patients will likely benefit from the targeting of a cell cycle inhibitor to promote beta cell replication
http://mnt.to/l/4k2Y

Progression of diabetes stalled by traditional Chinese medicines
http://mnt.to/l/4k2T

Articles in Health Affairs examine the toll of diabetes, both in the US and abroad
http://mnt.to/l/4k2s

Discovery could lead to a test to predict later development of type 2 diabetes
http://mnt.to/l/4k23

Google unveils 'smart contact lens' to help diabetics
http://mnt.to/l/4k3z

New research offers alternative to daily injections for diabetics
http://mnt.to/l/4k2J

The importance of fiber in the prevention of diabetes and obesity
http://mnt.to/l/4jZQ

In 'walkable' densely populated neighborhoods the risk of diabetes and obesity is often reduced
http://mnt.to/l/4jZD

Being overweight or obese confers no survival advantage in type 2 diabetes
http://mnt.to/l/4jZx

Metabolomics study examines factors that may lead to diabetic kidney failure
http://mnt.to/l/4jZ8

How insulin-producing cells may fail in diabetes and how they might someday be restored
http://mnt.to/l/4jYH

Serum omega-3 fatty acids derived from fish help reduce the risk of type 2 diabetes
http://mnt.to/l/4jYz

Women who practice muscle-strengthening and conditioning reduce their risk of diabetes
http://mnt.to/l/4jYt

ACell initiates post-market comparative study of Matristem&reg; versus Dermagraft&reg; in patients with diabetic foot ulcers
http://mnt.to/l/4jXX

----------------------------------------------
** ENDOCRINOLOGY News **

Federal ban leads to a fall in exposures to some phthalates
http://mnt.to/l/4jZ2

----------------------------------------------
** FLU / COLD / SARS News **

Enzyme identified that plays crucial role in resistance to flu
http://mnt.to/l/4k2m

----------------------------------------------
** GOUT News **

UK rates of gout soaring, but treatment remains poor
http://mnt.to/l/4jXt

----------------------------------------------
** HYPERTENSION News **

Can sunlight protect against heart attack and stroke?
http://mnt.to/l/4k42

News from the Annals of Internal Medicine, Jan. 14, 2014
http://mnt.to/l/4jX3

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** INFECTIOUS DISEASES / BACTERIA / VIRUSES News **

Better outcomes when hospitals deal with high volume of severe sepsis patients
http://mnt.to/l/4k4f

Predicting disease outbreak through internet surveillance
http://mnt.to/l/4k46

Risk factor identified for life-threatening disease in preemies
http://mnt.to/l/4k3y

Steps leading to necrotizing fasciitis revealed, opening way to possible new treatments for bacterial infections
http://mnt.to/l/4k3v

Drug-induced paralysis is an effective way of clearing worm infections
http://mnt.to/l/4k33

Salmonella biofilms incredibly resistant to powerful disinfectants
http://mnt.to/l/4k2f

148 cases of Guinea worm disease remain worldwide
http://mnt.to/l/4k2z

New method developed for tracking viruses
http://mnt.to/l/4jZ9

Small RNAs coordinate bacterial attack on epithelial cells
http://mnt.to/l/4jY3

A study analyses the health status of immigrant population in Raval neighbourhood in Barcelona
http://mnt.to/l/4jXT

Freshwater turtles from wetlands can transmit Salmonella to humans
http://mnt.to/l/4jXy

----------------------------------------------
** MENTAL HEALTH News **

Mental health of Spanish men worsened with the economic crisis
http://mnt.to/l/4k3n

----------------------------------------------
** NEUROLOGY / NEUROSCIENCE News **

Hydrocephalus: sensors monitor cerebral pressure
http://mnt.to/l/4k5b

The importance of arm length in depth perception
http://mnt.to/l/4k4c

Gaucher patients offered new hope
http://mnt.to/l/4k4r

Neurons can use 2 different strategies when responding to sound
http://mnt.to/l/4k3q

2 proteins discovered that control chandelier cell architecture
http://mnt.to/l/4k3c

How the architecture of the brain shapes its functioning has implications for Alzheimer's, schizophrenia
http://mnt.to/l/4k34

Our brains 'tune' to activity like a radio
http://mnt.to/l/4k3R

Evaluating the expertise of humans and computer algorithms
http://mnt.to/l/4k2G

Young adults 'recall memories in high definition'
http://mnt.to/l/4k2C

Activity 'tuned' in brain regions to enable attention
http://mnt.to/l/4k2b

Study assesses sleep-disordered breathing and ventilation changes comparing two different levels of spinal cord injury
http://mnt.to/l/4k24

Speech uses both sides of brain
http://mnt.to/l/4k2P

Discovery of quantum vibrations in "microtubules" in side brain neurons corroborates controversial 20-year-old theory of consciousness
http://mnt.to/l/4k2M

Researchers reveal that both sides of our brains are required for speech
http://mnt.to/l/4jZB

Brain can classify images seen for only 13 milliseconds
http://mnt.to/l/4k2r

Some families would consider terminal sedation for brain injured relatives in a permanent vegetative state
http://mnt.to/l/4jZp

Why is it that parents accidentally confuse their children's names?
http://mnt.to/l/4jXQ

Traumatic brain injury linked with increased risk for premature death
http://mnt.to/l/4jXW

Ultrasound directed at human brain improves sensory perception
http://mnt.to/l/4jXK

How tissue microenvironment affects gene expression in healthy and diseased cells
http://mnt.to/l/4jWg

Researchers aim to use ultrasound to boost sensory performance
http://mnt.to/l/4jWf

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** NUTRITION / DIET News **

High-quality whey proteins for foodstuffs
http://mnt.to/l/4k3W

Dietary fibre and how we metabolise it
http://mnt.to/l/4k4t

Popular blood type diet claims are 'not valid,' researchers find
http://mnt.to/l/4k2L

Scientists develop first comprehensive test to detect genetic modification in food
http://mnt.to/l/4jZX

Research in fruit flies suggests a new mechanism explaining how diet may affect cancer, obesity and adaptations to malnutrition
http://mnt.to/l/4k2y

How a fiber-rich diet protects against obesity and diabetes
http://mnt.to/l/4jY7

Caffeine enhances memory
http://mnt.to/l/4jWj

----------------------------------------------
** OBESITY / WEIGHT LOSS / FITNESS News **

Childhood obesity can only be tackled with broad public health interventions
http://mnt.to/l/4k57

Football fans get FFITer and lose weight
http://mnt.to/l/4k4J

Anti-bullying efforts may boost physical fitness
http://mnt.to/l/4k3P

Paternal obesity may cause altered gene expression in pancreas and fat of offspring
http://mnt.to/l/4k3F

Two million people in England eligible for weight loss surgery
http://mnt.to/l/4k2D

Study suggests that fast food is not the major cause of rising childhood obesity rates
http://mnt.to/l/4jZL

Metabolic damage caused by high calorie diet reversed by multi-hormone
http://mnt.to/l/4jZf

3 risk factors most highly correlated with child obesity
http://mnt.to/l/4jYJ

Day-care children learn to respond to hunger cues when allowed to pass bowls family-style
http://mnt.to/l/4jXF

Study points to 'growing class gap' in US teen obesity
http://mnt.to/l/4jYp

----------------------------------------------
** PRIMARY CARE / GENERAL PRACTICE News **

Multiple medication use 'not always hazardous,' say researchers
http://mnt.to/l/4jZm

UK GPs make youth mental health a priority
http://mnt.to/l/4jZb

Can patients trust doctors with ties to drug companies?
http://mnt.to/l/4jYG

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** PROSTATE / PROSTATE CANCER News **

Possible explanation for link between exercise & improved prostate cancer outcomes
http://mnt.to/l/4k4p

Prostate cancer risk may be reduced by melatonin
http://mnt.to/l/4k4n

----------------------------------------------
** SENIORS / AGING News **

Enjoy life more - your body will age better, study shows
http://mnt.to/l/4k5y

Forget about forgetting - The elderly know more and use it better
http://mnt.to/l/4k53

Delirium screening lacking in the emergency department
http://mnt.to/l/4jYT

----------------------------------------------
** SEXUAL HEALTH / STDS News **

Higher socioeconomic status has been associated with a more satisfying sex life
http://mnt.to/l/4jZh

----------------------------------------------
** SLEEP / SLEEP DISORDERS / INSOMNIA News **

Night shifts and jet lag disrupt genetic rhythm
http://mnt.to/l/4k5g

Adolescents' sleep and daytime functioning improved by later school start times
http://mnt.to/l/4jZR

----------------------------------------------
** STATINS News **

Continuing statins in critically ill patients reduces delirium
http://mnt.to/l/4k45

ALZHEIMER'S / DEMENTIA News **

Validation of two families of brain-enriched microRNAs as highly promising blood-based biomarkers of mild cognitive impairment
http://mnt.to/l/4jML

Alzheimer's: where it starts, why it starts there, and how it spreads
http://mnt.to/l/4jJf

Vitamin E may combat functional decline from Alzheimer's disease
http://mnt.to/l/4jLG

----------------------------------------------
** ANXIETY / STRESS News **

Academics' occupational stressors
http://mnt.to/l/4jPb

----------------------------------------------
** ARTHRITIS / RHEUMATOLOGY News **

Breastfeeding associated with lower risk of rheumatoid arthritis, according to new study
http://mnt.to/l/4jPc

Researchers complete a milestone in defining the genetic basis of rheumatoid arthritis
http://mnt.to/l/4jKQ

----------------------------------------------
** BONES / ORTHOPEDICS News **

Surgery vs. non-invasive treatment - Which is better for herniated discs?
http://mnt.to/l/4jLn

----------------------------------------------
** BREAST CANCER News **

New cell mechanism discovery key to stopping breast cancer metastasis
http://mnt.to/l/4jN2

Study identifies factors associated with pain 1 year after breast cancer surgery
http://mnt.to/l/4jMB

Novel noninvasive therapy prevents breast cancer formation in mice
http://mnt.to/l/4jMv

Both real and sham acupuncture treatments may help alleviate side effects of breast cancer drugs
http://mnt.to/l/4jK5

----------------------------------------------
** CANCER / ONCOLOGY News **

Scientists make advance in cancer research
http://mnt.to/l/4jNN

Anticancer properties of novel compound 'confirmed'
http://mnt.to/l/4jMT

Research into fruit fly cells could lead to cancer insights
http://mnt.to/l/4jMs

UTSW study identifies potential therapeutic target for incurable, rare type of soft-tissue cancer
http://mnt.to/l/4jLf

----------------------------------------------
** CARDIOVASCULAR / CARDIOLOGY News **

Cerenis reports top-line phase II results for its HDL mimetic CER-001
http://mnt.to/l/4jMM

Doxorubicin-associated mitochondrial iron accumulation promotes cardiotoxicity
http://mnt.to/l/4jNv

Heart surgeons find they can rely on less blood stock
http://mnt.to/l/4jLT

Transitioning epithelial cells to mesenchymal cells enhances cardiac protectivity
http://mnt.to/l/4jJX

----------------------------------------------
** COLORECTAL CANCER News **

Online colorectal cancer risk calculator created
http://mnt.to/l/4jNJ

----------------------------------------------
** DERMATOLOGY News **

Gene therapy for human skin disease produces long-term benefits
http://mnt.to/l/4jKZ

Johns Hopkins review throws doubt on wound care treatment
http://mnt.to/l/4jJT

----------------------------------------------
** DIABETES News **

Mediterranean diet linked to reduced risk of type 2 diabetes
http://mnt.to/l/4jPm

Dysfunction in a single gene linked to diabetes in mice
http://mnt.to/l/4jNH

Single faulty gene causes major type 2 diabetes symptom in mice
http://mnt.to/l/4jNS

More evidence suggests type 2 diabetes is an inflammatory disease
http://mnt.to/l/4jN5

New genetic risk factor for type 2 diabetes revealed
http://mnt.to/l/4jKS

Powerful new screening strategy may lead to treatment for obesity-linked diabetes
http://mnt.to/l/4jJd

A wrong molecular turn leads down the path to type 2 diabetes
http://mnt.to/l/4jHX

----------------------------------------------
** ENDOCRINOLOGY News **

Testosterone in male songbirds may enhance desire to sing but not song quality
http://mnt.to/l/4jLD

----------------------------------------------
** FERTILITY News **

New clinical data on day 3 embryo transfers using Eeva&trade; technology presented
http://mnt.to/l/4jP9

----------------------------------------------
** FLU / COLD / SARS News **

PDL-1 antibody could help immune system fight off influenza viral infection, study suggests
http://mnt.to/l/4jJR

----------------------------------------------
** HYPERTENSION News **

High blood pressure in women 'more dangerous' than in men
http://mnt.to/l/4jMt

----------------------------------------------
** INFECTIOUS DISEASES / BACTERIA / VIRUSES News **

New protein discovery 'could help treat toxoplasmosis and malaria'
http://mnt.to/l/4jP5

Quarter of health care workers carry diarrhea spores on their hands
http://mnt.to/l/4jNG

Genetically identical bacteria can behave in radically different ways
http://mnt.to/l/4jMW

Hebrew University researchers reach breakthrough on understanding persistent bacteria
http://mnt.to/l/4jLQ

Scientists discover how some bacteria avoid antibiotics
http://mnt.to/l/4jMp

New imaging technology set to reveal secret life of virus in cells
http://mnt.to/l/4jMn

Infectious diarrhea germs stick to healthcare worker hands
http://mnt.to/l/4jK2

----------------------------------------------
** NEUROLOGY / NEUROSCIENCE News **

Brain rest may speed concussion recovery in teens
http://mnt.to/l/4jPj

Brain training works, but just for the practiced task, say Oregon researchers
http://mnt.to/l/4jNg

Researchers report technique that enables patient with 'word blindness' to read again
http://mnt.to/l/4jMZ

Targeting glycine receptors in hyperekplexia, startle disease
http://mnt.to/l/4jMF

Mass spectrometer detection of 10 protein spots after acute high-altitude HBI
http://mnt.to/l/4jNf

Diffusion tensor MRI-based tractography in evaluation of nerve root function
http://mnt.to/l/4jNc

PLGA tubes are superior to autologous nerve graft for repaired sciatic nerve
http://mnt.to/l/4jMf

Fetal umbilical vein for reconstruction of middle cerebral artery
http://mnt.to/l/4jMc

Normobaric oxygen preconditioning for cerebral ischemic injury
http://mnt.to/l/4jLp

Molecular markers used for assessment of early sciatic nerve injury
http://mnt.to/l/4jKW

Activating P300 protein contributes to repair of hippocampal neuronal DNA injuries
http://mnt.to/l/4jKN

Transient receptor potential channel A1 may contribute to hyperalgesia
http://mnt.to/l/4jK6

Study finds axon regeneration after Schwann cell graft to injured spinal cord
http://mnt.to/l/4jJW

Genetic brain development 'peaks before birth and in adolescence'
http://mnt.to/l/4jLB

Even or odd: No easy feat for the mind
http://mnt.to/l/4jHW

----------------------------------------------
** NUTRITION / DIET News **

Nutrition recommendations not adhered to by majority of those with metabolic syndrome
http://mnt.to/l/4jNP

Researchers say fructose does not impact emerging indicator for cardiovascular disease
http://mnt.to/l/4jLx

Who is using MyPlate?
http://mnt.to/l/4jLk

Most clinical studies on vitamins flawed by poor methodology
http://mnt.to/l/4jM4

----------------------------------------------
** OBESITY / WEIGHT LOSS / FITNESS News **

Age-related weight gain put down to brown fat failure
http://mnt.to/l/4jNV

Overweight and obesity in developing countries 'alarming'
http://mnt.to/l/4jNC

Scientists explain age-related obesity: Brown fat fails
http://mnt.to/l/4jNb

Cholesterol study shows algal extracts may counter effects of high fat diets
http://mnt.to/l/4jHZ

----------------------------------------------
** PRIMARY CARE / GENERAL PRACTICE News **

BMJ investigation reveals tensions over future of 111 urgent medical helpline
http://mnt.to/l/4jLt

----------------------------------------------
** SENIORS / AGING News **

Computer algorithm developed by TAU researchers identifies genes that could be transformed to stop the aging process
http://mnt.to/l/4jNm

Many chronic diseases associated with aging are due to parasitic DNA
http://mnt.to/l/4jJ6

----------------------------------------------
** SLEEP / SLEEP DISORDERS / INSOMNIA News **

Study supports a causal role in narcolepsy for a common genetic variant
http://mnt.to/l/4jNk

Want a good night's sleep? Quit smoking
http://mnt.to/l/4jN9

Good night's sleep good for brain health
http://mnt.to/l/4jMS

----------------------------------------------
** STROKE News **

Contralateral needling at unblocked collaterals for post-stroke hemiplegia
http://mnt.to/l/4jLy

Shingles rash linked to higher risk of stroke
http://mnt.to/l/4jLK

Stroke researchers report improvement in spatial neglect with prism adaptation therapy
http://mnt.to/l/4jLs

----------------------------------------------
** TROPICAL DISEASES News **

The importance of sex for microbes
http://mnt.to/l/4jNL