Allergies May Boost Severity of Lung Disease

Study finds hay fever increases frequency of respiratory problems in COPD patients

By Robert Preidt

HealthDay Reporter

FRIDAY, May 10 (HealthDay News) -- Hay fever and similar allergies increase the frequency and severity of respiratory problems in people with chronic obstructive pulmonary disease (COPD), a new study shows.

COPD is a progressive lung disease that makes it difficult to breathe.

In this study, researchers looked at more than 1,400 patients with COPD, and found that those with allergies were much more likely than those without allergies to wheeze, to have chronic cough and chronic phlegm, to awake during the night because of cough, and to have a worsening of COPD symptoms that required antibiotics or a visit to the doctor.

The study by the Johns Hopkins University researchers was published online May 10 in the American Journal of Respiratory and Critical Care Medicine.

The findings suggest that treating allergies or avoiding allergy triggers may help reduce the number and severity of respiratory problems in people with COPD, Dr. Nadia Hansel, an associate professor of medicine at the Johns Hopkins Asthma and Allergy Center in Baltimore, said in a journal news release.

She added that current COPD treatment guidelines do not deal with the management of allergies and said additional research of the link between allergies and COPD is needed.

View the original article here

My husband was diagnosed with Parkinson’s disease — what symptoms can we expect?

Posted June 25, 2013, 2:00 am

My husband was just diagnosed with Parkinson’s disease. Can you discuss it in your column? I don’t know anything about it.

Parkinson’s disease (PD) is a disease of the central nervous system. It causes problems with body motions and movement. PD worsens over time.

Brain cells “talk” to each other by making and releasing chemicals called neurotransmitters. When one cell releases a neurotransmitter, another picks up the signal. One type of neurotransmitter is dopamine.

Dopamine is made in an area deep in the brain called the basal ganglia. That is also where movements are coordinated. The dopamine made by cells in the basal ganglia is necessary for the basal ganglia to function properly.

PD develops when dopamine-producing nerve cells (neurons) in the brain die and not enough dopamine is produced. This affects movement. (I’ve put an illustration of this process below.)

In people with Parkinson’s disease, dopamine-producing nerve cells die. As a result, not enough dopamine is produced, making it difficult to control muscle movement.

(Image courtesy of Krames Staywell.) 

PD usually begins as a slight tremor or stiffness that is most obvious at rest. When the hands of a PD sufferer are resting in his lap, they may tremble. But when he reaches for a cup of coffee, for instance, his hands may stop trembling.

As the illness worsens, tremors become more widespread. PD also causes rigidity and a slowing of body movements. A person’s face slowly becomes expressionless. Initiating a movement, like sitting up from a chair, may take many seconds to start. A person walks slowly, with short, quick steps.

If your husband’s PD gets much worse, he will likely have difficulty walking and performing daily activities such as dressing or using utensils. But in some people PD progresses very slowly.

There is no cure for PD, but symptoms can be treated with medications. Medication may not be necessary at first. Treatment usually begins when symptoms interfere with work or home life, or when it becomes difficult to walk or maintain balance.

Medications used to treat PD either boost levels of dopamine in the brain or mimic the effects of dopamine. The most commonly used medication is levodopa. It is usually prescribed in combination with another drug called carbidopa. Other medications can also be used, either alone or in combination with levodopa.

Nearly all patients improve after they start taking levodopa. But long-term use often causes side effects and complications.

Depression is fairly common in people with PD. Antidepressant medications can help. Regular exercise and a balanced diet also may help to improve a patient’s sense of well-being and body control. The type of exercise called tai chi has been shown to help.

Surgery is considered only when medications are no longer effective. Surgical options include deep brain stimulation in which electrical stimulation is delivered to targeted areas of the brain to control symptoms. Another option involves destroying precisely targeted areas of the brain that are responsible for the most troubling symptoms.

We can do a great deal more to help people with PD today than when I was in medical school. Based on the progress of research, I expect more effective treatments in the future.

window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

View the original article here

Muhammad Ali's Daughter Champions Fight Against Parkinson's Disease

By Barbara Bronson Gray
HealthDay Reporter

FRIDAY, May 3 (HealthDay News) -- At 71, boxing legend Muhammad Ali -- the only three-time World Heavyweight Champion -- continues to fight his most challenging opponent ever: Parkinson's disease. And according to his daughter, he's still facing life straight on.

"This is the man who when he was fighting would say 'I'm going to knock the other guy out in five,'" said Maryum (May May) Ali. "That personality translates to how he deals with Parkinson's. No one's really been that confident as an athlete, and that's how he is with the disease."

May May is Ali's first child. Married four times, the former champion has six other daughters and two sons.

Thinking back, May May believes Ali was showing signs of Parkinson's in his second-to-last fight, a few years before his 1984 diagnosis. "You lose your [sense of] smell, get constipation issues," she said. "Most people have those non-motor symptoms first. But no one knew that back then."

Initially, in 1981, Ali was told he had a form of the condition that would not progress, May May said. But it did. As time went by, Ali learned how to manage the symptoms of his disease. He took his medications a couple of hours before working out, and he saw a neurologist who specialized in movement disorders, she explained.

Parkinson's disease belongs to a group of conditions called motor system disorders, which result from the loss of dopamine-producing brain cells, according to the U.S. National Institute of Neurological Disorders and Stroke. The four primary symptoms of Parkinson's are trembling in the hands, arms, legs, jaw, and face; stiffness of the limbs and trunk; slowness of movement; and impaired balance and coordination. As the disease progresses, patients may have difficulty walking, talking or completing other simple tasks. In the United States, about 500,000 people have the disease.

"Don't wait until you can't walk down the hallway to get the right advice. You may be able to slow the progression of the disease," May May advised. "Make it your business to know everything you can about what it is that's affecting your life." She also encourages people with Parkinson's to work with a neurologist who specializes in movement disorders.

Committed to raising people's understanding of the disease, May May, 44, has supported the Parkinson Alliance as a spokesperson since 2002. This includes helping publicize its annual Unity Walk, which was held Saturday in New York's Central Park. She also works as a program manager in Los Angeles' gang reduction and youth development program. Divorced, with no children, she said she's committed to helping others and is also studying organizational management at Antioch University.

While some promising new approaches to treating Parkinson's loom on the horizon, researchers say the condition is still poorly understood.

"We have no solid theory of what causes Parkinson's disease," said James Beck, director of research for the Parkinson's Disease Foundation. "We still know so little about the disease. A lot of basic science needs to be funded."

Beck said the drugs available now are designed to help reduce disease symptoms but don't attack their cause. Late-stage clinical trials are looking at what role so-called "A2A receptor antagonists" might play in reducing movement problems. Scientists are also testing possible gene therapy and stem cell applications, and looking at mutations in cell proteins associated with Parkinson's to understand what part they might play. They're also looking at what role, if any, the immune system might have in fighting development of the disease, he explained.

"There's a lot of hope for people with Parkinson's disease -- and progress is being made -- but it needs to be measured hope," Beck said.

Ali, now in the later stages of Parkinson's, has 24-hour care. His personality hasn't changed and "there's no doom and gloom with him," said May May. "He'll look at you, nod his head, and sometimes he can talk a bit, depending on the time of day and when he last took his medications."

Ali flies to his homes in Arizona, Kentucky and Michigan, and loves going to baseball games, May May said. "He's still enjoying life."

"As for spending time with my Dad, I enjoy his company still," she added.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Maryum (May May) Ali, Los Angeles, Calif.; James C. Beck, Ph.D., director of research, Parkinson's Disease Foundation, New York City, and adjunct assistant professor, department of physiology and neuroscience, New York University

View the original article here

Ingredient in New MS Drug Linked to Serious Brain Disease

Reports found four psoriasis patients who took similar drug developed rare but sometimes deadly condition

By Brenda Goodman

HealthDay Reporter

WEDNESDAY, April 24 (HealthDay News) -- The active ingredient in a drug that's expected to become a popular treatment for multiple sclerosis has been linked to four European cases of a rare but sometimes fatal brain disease called progressive multifocal leukoencephalopathy (PML).

The ingredient, dimethyl fumarate, is used in a drug called Fumaderm that was approved in Germany in 1994 to treat the skin condition psoriasis. It is also in a different but closely related medication called Tecfidera, which was just approved by the U.S. Food and Drug Administration in March for the treatment of multiple sclerosis (MS). It is known as a fumaric acid ester, which is commonly used as a food additive and has been used to treat psoriasis in Germany for 30 years.

According to reports published in the April 25 issue of the New England Journal of Medicine, however, four patients who were taking Fumaderm to treat their psoriasis developed PML.

In a letter responding to the reports, Biogen, the company that makes both drugs, said Tecfidera may be safer because it contains only dimethyl fumarate, while Fumaderm also contains three other fumaric acid esters.

The company also noted that none of the patients taking Tecfidera during clinical trials (then known as BG-12) developed PML. Since Tecfidera is a pill rather than an injection, and was effective and well-tolerated by patients in clinical trials, analysts have predicted it would soon become the top-selling multiple sclerosis treatment.

But the German doctor who treated one of the psoriasis patients who got PML thinks there is still cause for concern.

Dr. Jorg Schulz, a neurologist at Rheinisch-Westfaelische Technische Hochschule Aachen, a research university in Aachen, said the two drugs are virtually identical once they are broken down in the body.

"The problem is that the studies with BG-12 covered a two-year period, but no longer periods," Schulz said, and he believes it may take prolonged treatment with the drug for PML to surface.

"With the publication of our case, we wish to create awareness that treatment with any form of fumaric acid may bear the risk of developing PML," Schulz said.

PML is caused by the JC virus, which normally lies dormant in the body and causes no harm. About half of multiple sclerosis patients have antibodies to the JC virus in their blood, suggesting a current or former infection. When the immune system is depleted by illnesses like cancer or AIDS or suppressed by certain medications, the virus can flare and destroy nerve cells in the brain.

Ironically, PML is a lot like multiple sclerosis, but it progresses more rapidly as it causes weakness, paralysis, confusion, memory loss and loss of vision or speech. Quick treatment can stop the damage, although patients may be permanently disabled.

View the original article here

Health Tip: Signs of Periodontal Disease

(HealthDay News) -- Gum disease, also called periodontal disease, is an infection of the tissues that surround the teeth. Potential risk factors include poor dental hygiene, smoking or chewing tobacco, and your family history of the disease.

The American Dental Association says potential warning signs of periodontal disease include:

Gums that bleed easily, or are swollen, red or tender.Gums that are receding from the teeth.Frequent bad breath or a bad taste in your mouth.Loosening or separating of permanent teeth.A change in the way teeth align when you bite.A change in the way dentures fit.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

View the original article here

U.S. Doctors' Group Labels Obesity a Disease

Advocates say AMA's move will boost resources to fight weight-gain epidemic, but others question decision

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- In an effort to focus greater attention on the weight-gain epidemic plaguing the United States, the American Medical Association has now classified obesity as a disease.

The decision will hopefully pave the way for more attention by doctors on obesity and its dangerous complications, and may even increase insurance coverage for treatments, experts said.

"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans," AMA board member Dr. Patrice Harris said in a statement Tuesday. "The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity."

One expert thinks the AMA's decision, approved Tuesday at the group's annual meeting, could lead to greater coverage by insurance companies of treatments for obesity.

"We already treat obesity as a chronic illness," said Dr. Esa Matius Davis, an assistant professor of medicine at the University of Pittsburgh. "But this decision will bring more resources into the picture because it will, hopefully, allow for more insurance coverage and that really has been the issue of getting people the help that they need," she said.

Treatments for obesity -- including drugs, nutritional counseling and surgery, if needed -- often don't get reimbursed by insurance companies, Davis said. That means many patients aren't getting the care they need because they can't afford to pay the out-of-pocket costs, she said.

If insurance covered these services "it would increase referrals and treatment and that would be a huge step in the right direction," Davis said.

Right now, Davis gets insurance coverage for her obese patients by diagnosing them with high blood pressure or high cholesterol or diabetes, or other obesity-related conditions. But, that still leaves many obese patients out in the cold, she said.

The Obesity Society, which calls itself the leading scientific society dedicated to the study of obesity, applauded the AMA's decision. "The passage of a new American Medical Association policy classifying obesity as a disease reinforces the science behind obesity prevention and treatment," Theodore Kyle, advocacy chair, said in a statement.

"This vital recognition of obesity as a disease can help to ensure more resources are dedicated to needed research, prevention and treatment; encourage health care professionals to recognize obesity treatment as a needed and respected vocation; and, reduce the stigma and discrimination experienced by the millions affected," he said.

Kyle said the AMA has now joined a number of organizations that have previously made this classification, including the U.S. National Institutes of Health, the Social Security Administration, and the Centers for Medicare and Medicaid Services.

View the original article here

Hard Physical Labor May Boost Risk of Heart Disease, Stroke: Studies

THURSDAY, April 18 (HealthDay News) -- Demanding physical work may boost a person's risk of heart disease, two new studies suggest.

"Physicians know that high stress can be associated with increased risk of heart disease," said one expert not connected to the study, Dr. Lawrence Phillips, a cardiologist at NYU Langone Medical Center in New York City. "These two studies suggest that, in addition to normal life stressors, the physical demands a person experiences in the workplace can independently increase their risk as well."

"The reason for this [labor-linked risk] is unclear, but might be related to higher stress levels," Phillips said.

In one study, researchers looked at 250 patients who had suffered a first stroke and 250 who had suffered a first heart attack or other type of heart event. They were compared to a control group of 500 healthy people.

Stroke and heart patients were more likely to have physically demanding jobs than those in the control group, researchers found. After adjusting for age, sex and a number of lifestyle and health factors, they concluded that having a less physically demanding job was associated with a 20 percent lower risk of a heart event or stroke.

The findings suggest that people with physically demanding jobs should be considered an important target group for prevention of cardiovascular disease, said study author Dr. Demosthenes Panagiotakos, an associate professor of biostatistics and epidemiology at Harokopio University in Athens, Greece.

The results seem to conflict with recommendations that people should exercise to reduce their risk of heart trouble. But Panagiotakos said the increased risk of stroke and heart events among people with physically demanding jobs may be due to mental stress, while exercise helps reduce stress. He also said people with physically demanding jobs tend to have lower incomes, which might limit their access to health care.

The study suggests that leisure-time exercise might be important to "balance out" the physical stress encountered in laborious jobs, said Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City. She was not connected to the study.

"This delicate interaction between work and leisure-time activity warrants further research in order to appropriately guide public health," she said.

The study was presented at a meeting of the European Society of Cardiology, taking place this week in Rome.

In a second study presented at the same meeting, researchers looked at more than 14,000 middle-aged men who did not have heart disease and were followed for about three years on average. The investigators found that physically demanding work was a risk factor for developing coronary heart disease.

They also found that men with physically demanding jobs who also did moderate to high levels of exercise during their leisure time had an even greater risk (more than four-fold higher) of developing coronary heart disease.

Phillips, who also is an assistant professor in the department of medicine at NYU Langone, said the finding was a bit surprising. "This is a new finding that was not previously seen," he said. "Further studies to support this finding will be needed. As with many areas of medicine, a one-size-fits-all approach to leisure exercise might not work."

Study author Dr. Els Clays, of the department of public health at the University of Ghent, in Belgium, weighed in on the study in a society news release.

"From a public health perspective, it is very important to know whether people with physically demanding jobs should be advised to engage in leisure-time activity," Clays said.

"The results of this study suggest that additional physical activity during leisure time in those who are already physically exhausted from their daily occupation does not induce a 'training' effect but rather an overloading effect on the cardiovascular system," Clays said.

On the other hand, the study did find that men with less physically demanding jobs were 60 percent less likely to develop heart disease if they exercised during their leisure time.

"Further studies will be needed to find out the cause of increased heart disease in those people who have high physical job demands," Phillips said.

Both studies could point only to an association between hard physical labor and increased heart risk, not a cause-and-effect. Studies presented at a medical meetings typically are viewed as preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Lawrence Phillips, M.D., assistant professor, department of medicine, Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York City; Tara Narula, associate director, cardiac care unit, Lenox Hill Hospital, New York City; European Society of Cardiology, news release, April 18, 2013

View the original article here

Infection, autoimmune disease linked to depression

Posted June 17, 2013, 5:47 am

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. In some people, a serious infection or autoimmune disease could be the trigger.

A report published online in JAMA Psychiatry explores this hypothesis. Researchers turned to comprehensive Danish databases that include all Danes born in the country, each identified by a unique registration number. One of the databases stores health-related information, including records of hospitalizations. Among Danes born between 1945 and 1995, almost 92,000 had a mood disorder. Of these, 36,000 had suffered a severe infection or developed an autoimmune disease (such as type 1 diabetes, celiac disease, lupus, and the like) at some point before being diagnosed with the mood disorder.

People who had been treated for a severe infection were 62% more likely to have developed a mood disorder than those who never had one. An autoimmune disease increased the risk by 45%. Multiple infections or the combination of severe infection and an autoimmune disease boosted the odds of developing depression, bipolar disorder, or another mood disorder even further.

The researchers estimated that in the Danish population, severe infection and autoimmune disease account for 12% of mood disorders.

“A link between infection and depression and mood disorders is intriguing,” says Dr. Michael C. Miller, assistant professor of psychiatry at Harvard Medical School and a member of JAMA Psychiatry’s editorial board. “But it’s important to keep in mind that both infections and mood disorders are very common, making it difficult to tease out what causes what.”

He ticks off three possible explanations for the results:

Severe infection and autoimmune disease may cause mood disorders.Mood disorders may create a susceptibility to infection or autoimmune disease.Mood disorders, severe infection, and autoimmune disorders may share common triggers.

The Danish study isn’t the first to explore links between infection or autoimmune diseases and depression. Much of the evidence supports a connection.

Depression isn’t the only mental health issue that may be related to infections and autoimmune condition. Writing last year in the Harvard Health blog, Dr. Jeff Szymanski described how some children with strep throat suddenly develop obsessive-compulsive disorder. It’s one manifestation of pediatric acute-onset neuropsychiatric syndrome. Quick treatment with antibiotics can reverse the problem.

How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

The connection between infection, autoimmune disease, inflammation, and mood disorders has prompted some researchers to wonder “Can we vaccinate against depression?” The short answer, at least for now, is “no.”

But there are things you can do. “Healthy living has all sorts of benefits,” says Dr. Miller. It can help you fight infection, reduce inflammation, ease stress, and make you feel better day to day, all of which work against the development of a mood disorder.”

View the original article here

Fecal Transplant Studied for Kids With Bowel Disease

WEDNESDAY, April 17 (HealthDay News) -- Fecal transplantation -- an innovative enema treatment -- may help reduce or eliminate symptoms of ulcerative colitis in most children and young adults, according to a small study.

The process, formally called fecal microbial transplantation, involves placing stool from a healthy donor into a recipient's intestines in order to restore healthy bacteria.

The early clinical trial -- the first in the United States to study the process in children -- was conducted by a team at Helen DeVos Children's Hospital in Grand Rapids, Mich.

The study included 10 participants, aged 7 to 20 years, with mild to moderate ulcerative colitis. Enemas were used to give the patients lab-prepared stool samples from a healthy adult donor. Each patient received five such treatments within one week.

Seventy-eight percent of the patients had a reduction in ulcerative colitis symptoms within a week, and 67 percent still had reduced symptoms a month after fecal transplantation. Thirty-three percent of the patients no longer had any symptoms of ulcerative colitis after the process.

No serious side effects were noted, according to the study, which was published online and in the June print issue of the Journal of Pediatric Gastroenterology & Nutrition.

Ulcerative colitis is a type of inflammatory bowel disease that affects the lining of the large intestine, or colon, and rectum, according to the U.S. National Institutes of Health. Symptoms can include abdominal pain, cramping, bloody diarrhea, pus in the stool, fever, rectal pain, weight loss, nausea, vomiting, joint pain, mouth sores, skin lesions and slow growth in children.

The disease often forces children to miss school and limit their social activities.

Fecal transplantation "has been proposed as a promising new treatment option for recurrent C. difficile infection and possibly for ulcerative colitis," lead investigator and pediatric gastroenterologist Dr. Sachin Kunde said in a hospital news release.

"We believe that the procedure may restore 'abnormal' bacteria to 'normal' in patients with ulcerative colitis," Kunde said. "Our short-term study looked at the safety and tolerability of [fecal microbial transplantation] for these patients."

Larger and longer studies are needed before the process could be recommended for clinical practice, the researchers said.

As many as 700,000 Americans have ulcerative colitis, and approximately 25 percent are diagnosed during childhood, according to the Crohn's and Colitis Foundation. Kunde said fecal transplantation could offer patients a natural, inexpensive treatment option.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Helen DeVos Children's Hospital, news release, April 2013

View the original article here

How will the doctor determine if my father’s forgetfulness is Alzheimer’s disease?

Posted June 14, 2013, 2:00 am

My father’s memory has worsened lately, and we suspect he may have Alzheimer’s disease. Can you tell us what is involved in making a diagnosis?

There is no single test for Alzheimer’s disease. Diagnosing it begins with identifying symptoms associated with Alzheimer’s and ruling out other possible causes of memory loss.

Your father should begin with his primary care physician. This doctor can combine his knowledge of your father and his medical history with results from a physical exam and blood tests. He may discover that your father’s symptoms are related to medications he’s taking or perhaps a medical condition.

There are many causes of forgetfulness, confusion and inattentiveness besides Alzheimer’s disease. Most of the patients I have seen who start to worry that they may be developing Alzheimer’s never actually develop the disease.

Your father should expect a lot of questions about his memory. And since answering questions about memory and thinking requires memory and thinking, the doctor might want a family member who knows your father well in the room. The questions the doctor is likely to ask include:

How long have you been having problems?Did the trouble come on gradually or suddenly?What sorts of things have become hard to remember?Are your difficulties preventing you from doing ordinary things like cooking or paying the bills?

Your father (or his spouse/caretaker) may need to track his symptoms for several months. This will show if his symptoms are improving, staying the same or getting worse.

The physician may refer your father to a neuropsychologist. Neuropsychologists typically use a battery of paper-and-pencil tests, or computer-administered tests, to evaluate cognitive function. The tests assess attention, memory, executive function, language, spatial ability and even mood.

A brain scan — usually either computed tomography (CT) or magnetic resonance imaging (MRI) — may also be done. These scans can help rule out other conditions that could contribute to memory loss. They also can show shrinkage of the brain in areas that tend to shrink with Alzheimer’s disease, but they cannot identify Alzheimer’s with certainty.

However, the ability of other types of brain scans to diagnose Alzheimer’s has improved greatly in recent years. Especially promising is a positron emission tomography (PET) scan that uses a chemical tracer known as PiB.

In Alzheimer’s disease, a substance called amyloid-beta slowly gets deposited in the brain. It is invisible on most types of brain scans. However, when PiB is injected into a person’s blood, it binds to amyloid deposits in the brain. When the PET scan is done, it can see all the places where there are amyloid deposits.

Tests of chemicals in the spinal fluid, the liquid that surrounds the brain and spinal cord, also show promise in diagnosing Alzheimer’s. Most of these new technologies are still used largely for research. I predict they are going to become important in regular clinical medicine very soon.

window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

View the original article here

Hard Physical Labor May Boost Risk of Heart Disease, Stroke: Studies

Researcher says higher mental stress, lower income could be factors

By Robert Preidt

HealthDay Reporter

THURSDAY, April 18 (HealthDay News) -- Demanding physical work may boost a person's risk of heart disease, two new studies suggest.

"Physicians know that high stress can be associated with increased risk of heart disease," said one expert not connected to the study, Dr. Lawrence Phillips, a cardiologist at NYU Langone Medical Center in New York City. "These two studies suggest that, in addition to normal life stressors, the physical demands a person experiences in the workplace can independently increase their risk as well."

"The reason for this [labor-linked risk] is unclear, but might be related to higher stress levels," Phillips said.

In one study, researchers looked at 250 patients who had suffered a first stroke and 250 who had suffered a first heart attack or other type of heart event. They were compared to a control group of 500 healthy people.

Stroke and heart patients were more likely to have physically demanding jobs than those in the control group, researchers found. After adjusting for age, sex and a number of lifestyle and health factors, they concluded that having a less physically demanding job was associated with a 20 percent lower risk of a heart event or stroke.

The findings suggest that people with physically demanding jobs should be considered an important target group for prevention of cardiovascular disease, said study author Dr. Demosthenes Panagiotakos, an associate professor of biostatistics and epidemiology at Harokopio University in Athens, Greece.

The results seem to conflict with recommendations that people should exercise to reduce their risk of heart trouble. But Panagiotakos said the increased risk of stroke and heart events among people with physically demanding jobs may be due to mental stress, while exercise helps reduce stress. He also said people with physically demanding jobs tend to have lower incomes, which might limit their access to health care.

The study suggests that leisure-time exercise might be important to "balance out" the physical stress encountered in laborious jobs, said Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City. She was not connected to the study.

"This delicate interaction between work and leisure-time activity warrants further research in order to appropriately guide public health," she said.

The study was presented at a meeting of the European Society of Cardiology, taking place this week in Rome.

In a second study presented at the same meeting, researchers looked at more than 14,000 middle-aged men who did not have heart disease and were followed for about three years on average. The investigators found that physically demanding work was a risk factor for developing coronary heart disease.

They also found that men with physically demanding jobs who also did moderate to high levels of exercise during their leisure time had an even greater risk (more than four-fold higher) of developing coronary heart disease.

View the original article here

Compound in Red Meat, Energy Drinks May Have Heart Disease Link

Gut bacteria break down carnitine into another substance that damages blood vessels, study finds

By Robert Preidt

HealthDay Reporter

SUNDAY, April 7 (HealthDay News) -- A compound found in red meat and added as a supplement to popular energy drinks promotes hardening and clogging of the arteries, otherwise known as atherosclerosis, a new study suggests.

Researchers say that bacteria in the digestive tract convert the compound, called carnitine, into trimethylamine-N-oxide (TMAO). Previous research by the same team of Cleveland Clinic investigators found that TMAO promotes atherosclerosis in people.

And there was an another twist: The study also found that a diet high in carnitine encourages the growth of the bacteria that metabolize the compound, leading to even higher TMAO production.

"The [type of] bacteria living in our digestive tracts are dictated by our long-term dietary patterns. A diet high in carnitine actually shifts our gut microbe composition to those that like carnitine, making meat eaters even more susceptible to forming TMAO and its artery-clogging effects," study leader Dr. Stanley Hazen, head of preventive cardiology and rehabilitation in Cleveland Clinic's Heart and Vascular Institute, said in a clinic news release.

Hazen's team looked at nearly 2,600 patients undergoing heart evaluations. The researchers found that consistently high carnitine levels were associated with a raised risk of heart disease, heart attack, stroke and heart-related death.

They also found that TMAO levels were much lower among vegetarians and vegans than among people with unrestricted diets (omnivores). Vegetarians do not eat meat while vegans do not eat any animal products, including eggs and dairy.

Even after consuming a large amount of carnitine, vegans and vegetarians did not produce significant levels of TMAO, while omnivores did, according to the study in the current issue of the journal Nature Medicine.

Although the new study could not prove any cause-and-effect relationship between carnitine and heart damage, the findings may provide a new understanding of the benefits of vegan and vegetarian diets, the researchers said.

"Vegans and vegetarians have a significantly reduced capacity to synthesize TMAO from carnitine, which may explain the cardiovascular health benefits of these diets," said Hazen, who is also vice chair of translational research for the clinic's Lerner Research Institute.

Two heart disease experts said the study yields up important new insights.

According to Dr. Robert Rosenson, it appears that poor eating habits could raise TMAO levels and "increase the ability of the cholesterol to get into our arteries and interfere with the ability of our body to eliminate that excess cholesterol." Rosenson, director of cardiometabolic disorders at the Icahn School of Medicine at Mount Sinai, in New York City, said the study "sheds important new information on the association between diet, atherosclerosis and cardiovascular events."

Another expert pointed the finger specifically at red meat and energy drinks.

"Most Americans have heard the famous saying 'you are what you eat,'" said Dr. Tara Narula, associate director of the Cardiac Care Unit at Lenox Hill Hospital, New York City. "This phrase may be more true and different than we might have imagined."

The new study "brings awareness that many 'supplements' like energy drinks can have the same [vessel-damaging] compounds as red meat," she said. "Energy drinks may not be harmless and can have unseen side effects that consumers should recognize."

As for beef, pork and the like, Narula said that the "real take-away message is the reinforcement of the current recommendations that a heart-healthy diet should have little to no red meat consumption."

View the original article here

U.S. Spends More on Dementia Care Than Heart Disease or Cancer: Study

Annual bill now tops $200 billion, largely for long-term care, researchers say

By Amy Norton

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- The cost of caring for Americans with Alzheimer's and other forms of dementia may now be as high as $215 billion a year -- more than the cost of caring for heart disease or cancer, a new study finds.

And that number is expected to escalate as the elderly population grows.

In 2010, the United States spent somewhere between $157 billion and $215 billion on dementia care, researchers reported in the April 4 issue of the New England Journal of Medicine. That includes direct medical expenses and the costs of caring for people with dementia -- both professional care and the "informal" care that families provide.

Dementia is a progressive deterioration in memory, thinking ability, judgment and other vital brain functions.

Alzheimer's disease is the most common form of dementia, and a recent study estimated that with the aging baby boom generation, the number of Americans with Alzheimer's could triple by 2050, to nearly 14 million.

The new study tried to take a "comprehensive look" at the financial impact -- including the costs to family caregivers, said lead researcher Michael Hurd, a senior principal researcher at the nonprofit research institute RAND.

"It's not a happy situation," Hurd said. "A lot of the costs fall on families, and right now, there's no solution in sight."

The researchers based their estimates on a government study of older Americans, plus Medicare records and other data sources. Of the billions spent on dementia in 2010, only a small portion went to medical treatments, the study found.

Instead, long-term care -- either nursing homes, or home care provided by professionals or family members -- was the big expense, accounting for up to 84 percent of the total.

Per person, the costs ranged from about $41,700 to $56,300, depending on how the researchers calculated the cost of family caregiving. In the first case, they considered only family members' lost wages; in the second, they gave family members' time the same value as formal paid care.

As for who paid, Medicare foot the bill for $11 billion out of the up to $215 billion in total expenses, Hurd's team said.

It's a small share because Medicare does not usually cover nursing home or other long-term care. Medicaid, the government health insurance program for the poor, will cover it -- but only after certain patient assets have been spent down.

"A large part of the burden is borne by families," said Dr. Richard Hodes, director of the U.S. National Institute on Aging, which funded the study.

Hodes noted that things could get tougher in the years to come. The younger baby boomers had fewer children compared with past generations -- so along with the rise in the number of elderly adults with dementia, there will be fewer family members to care for them.

View the original article here

People With Type 1 Diabetes at Risk of Thyroid Disease

Link between 'sister diseases' is rooted in immune system problem, expert says

By Serena Gordon

HealthDay Reporter

FRIDAY, March 15 (HealthDay News) -- People who have type 1 diabetes are more likely than others to develop an autoimmune thyroid condition.

Though estimates vary, the rate of thyroid disease -- either under- or overactive thyroid -- may be as high as 30 percent in people with type 1 diabetes, according to Dr. Betul Hatipoglu, an endocrinologist with the Cleveland Clinic in Ohio. And the odds are especially high for women, whether they have diabetes or not, she said, noting that women are eight times more likely than men to develop thyroid disease.

"I tell my patients thyroid disease and type 1 diabetes are sister diseases, like branches of a tree," she said. "Each is different, but the root is the same. And, that root is autoimmunity, where the immune system is attacking your own healthy endocrine parts."

Hatipoglu also noted that autoimmune diseases often run in families. A grandparent may have had thyroid problems, while an offspring may develop type 1 diabetes.

"People who have one autoimmune disease are at risk for another," explained Dr. Lowell Schmeltz, an endocrinologist and assistant professor at the Oakland University-William Beaumont School of Medicine in Royal Oak, Mich.

"There's some genetic risk that links these autoimmune conditions, but we don't know what environmental triggers make them activate," he explained, adding that the antibodies from the immune system that destroy the healthy tissue are different in type 1 diabetes than in autoimmune thyroid disease.

Hatipoglu said that people with type 1 diabetes are also more prone to celiac disease, another autoimmune condition.

Type 1 diabetes occurs when the immune system mistakenly attacks the insulin-producing cells in the pancreas, destroying them. Insulin is a hormone that's necessary for the metabolism of carbohydrates in foods. Without enough insulin, blood sugar levels can skyrocket, leading to serious complications or death. People who have type 1 diabetes have to replace the lost insulin, using shots of insulin or an insulin pump with a tube inserted under the skin. Too much insulin, however, can also cause a dangerous condition called hypoglycemia, which occurs when blood sugar levels drop too low.

The thyroid is a small gland that produces thyroid hormone, which is essential for many aspects of the body's metabolism.

Most of the time, people with type 1 diabetes will develop an underactive thyroid, a condition called Hashimoto's disease. About 10 percent of the time, Schmeltz said, the thyroid issue is an overactive thyroid, called Graves' disease.

In general, people develop type 1 diabetes and then develop thyroid problems at some point in the future, said Hatipoglu. However, with more people being diagnosed with type 1 diabetes in their 30s, 40s and 50s, Schmeltz said, it's quite possible that thyroid disease can come first.

View the original article here

Tai chi improves balance and motor control in Parkinson’s disease

Posted May 03, 2013, 8:30 am

It isn’t every day that an effective new treatment for some Parkinson’s disease symptoms comes along. Especially one that is safe, causes no adverse side effects, and may also benefit the rest of the body and the mind. That’s why I read with excitement and interest a report in the New England Journal of Medicine showing that tai chi may improve balance and prevent falls among people with Parkinson’s disease.

This degenerative condition can cause many vexing problems. These range from tremors and stiffness to a slowing or freezing of movement, sleep problems, anxiety, and more. Parkinson’s disease may also disrupt balance, which can lead to frightening and damaging falls.

A team from the Oregon Research Institute recruited 195 men and women with mild to moderate Parkinson’s disease. They were randomly assigned to twice-weekly sessions of either tai chi, strength-building exercises, or stretching. After six months, those who did tai chi were stronger and had much better balance than those in the other two groups. In fact, their balance was about two times better than those in the resistance-training group and four times better than those in the stretching group. The tai chi group also had significantly fewer falls, and slower rates of decline in overall motor control. In addition, tai chi was safe, with little risk of Parkinson’s disease patients coming to harm.

Other smaller studies have reported that tai chi can improve quality of life for both people with Parkinson’s disease and their support partners.

These studies are significant because they suggest that tai chi can be used as an add-on to current physical therapies and medications to ease some of the key problems faced by people with Parkinson’s disease.

Parkinson’s disease affects more than one million Americans. This brain disorder interferes with muscle control, leading to trembling; stiffness and inflexibility of the arms, legs, neck, and trunk; loss of facial expression; trouble swallowing; and a variety of other symptoms, include changes in memory and thinking skills. These changes can greatly reduce the ability to carry out everyday activities and reduce quality of life. Medications can help, but they sometimes have unwanted side effects.

Since the appearance of the New England Journal of Medicine study, tai chi classes specifically for Parkinson’s disease patients have sprung up across the country, and the benefits of tai chi for Parkinson’s disease have been endorsed by the National Parkinson’s Foundation. (You can see a video of a tai chi class at Brigham and Women’s Hospital for people with Parkinson’s disease at the bottom of this post.)

Several colleagues and I have developed a tai chi program for people with Parkinson’s disease. It brings together Harvard Medical School doctors and other clinicians with tai chi experts. The 12-week program uses the traditional tai chi principles that I describe in my newly released book, The Harvard Medical School Guide to Tai Chi: 12 Weeks to a Healthy Body, Strong Heart & Sharp Mind. This program is jointly sponsored by the Parkinson’s Disease and Movement Disorders Center at Beth Israel Deaconess Medical Center and the Osher Center for Integrative Medicine at Brigham and Women’s Hospital and Harvard Medical School. So far, about 50 people have completed the program.

We have also begun a small, preliminary study across multiple Harvard Medical School hospitals focused on understanding the interactions between cognitive function, mobility, and motor function in early stage Parkinson’s disease. The idea is to examine how the mind-body connection of tai chi slows the loss of mobility and cognitive function in individuals recently diagnosed with Parkinson’s disease. The results of this pilot study will be used to guide randomized trials to further test the impact of tai chi.

I foresee a growing number of hospitals in the country developing similar tai chi programs for individuals with Parkinson’s disease. In addition to easing balance problems, and possibly other symptoms, tai chi can help ease stress and anxiety and strengthen all parts of the body, with few if any harmful side effects. I look forward to the day when evidence-based tai chi programs become widely available and used by individuals with Parkinson’s disease world-wide.

Peter Wayne, PhD, is an Assistant Professor of Medicine at Harvard Medical School and the Director of Research for the Osher Center for Integrative Medicine, jointly based at Harvard Medical School and Brigham and Women’s Hospital. He is also the author of The Harvard Medical School Guide to Tai Chi: 12 Weeks to a Healthy Body, Strong Heart & Sharp Mind.

View the original article here

Tooth Loss Associated With Higher Risk for Heart Disease

Reason for link between teeth, gums and heart health is still unclear, researcher says

By Robert Preidt

HealthDay Reporter

THURSDAY, March 7 (HealthDay News) -- For adults, losing teeth is bad enough, but tooth loss is also associated with several risk factors for heart disease, a large international study suggests.

These heart disease-related risk factors include diabetes, obesity, high blood pressure and smoking.

For the study, researchers analyzed data from nearly 16,000 people in 39 countries who provided information about their remaining number of teeth and the frequency of gum bleeds. About 40 percent of the participants had fewer than 15 teeth and 16 percent had no teeth, while 25 percent reported gum bleeds.

For every decrease in the number of teeth, there was an increase in the levels of a harmful enzyme that promotes inflammation and hardening of the arteries. The study authors also noted that along with fewer teeth came increases in other heart disease risk markers, including "bad" LDL cholesterol levels and higher blood sugar, blood pressure and waist size.

People with fewer teeth were also more likely to have diabetes, with the risk increasing 11 percent for every significant decrease in the number of teeth, the investigators found.

Being a current or former smoker was also linked to tooth loss, according to the study scheduled for presentation Saturday at the annual meeting of the American College of Cardiology (ACC), in San Francisco.

Gum bleeds were associated with higher levels of bad cholesterol and blood pressure.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The researchers added that it is still unclear what is behind the association between tooth loss, gum health and heart health.

"Whether periodontal disease actually causes coronary heart disease remains to be shown. It could be that the two conditions share common risk factors independently," Dr. Ola Vedin, from the department of medical sciences at Uppsala University in Sweden, said in an ACC news release. "Those who believe that a causal relationship exists propose several theories, including systemic inflammation, the presence of bacteria in the blood from infected teeth and bacteria invading coronary plaques."

View the original article here

Tooth Loss Associated With Higher Risk for Heart Disease

Title: Tooth Loss Associated With Higher Risk for Heart Disease
Category: Health News
Created: 3/7/2013 12:36:00 PM
Last Editorial Review: 3/8/2013 12:00:00 AM

View the original article here

Daily Dialysis Has Risks, Benefits for Kidney Disease Patients

Title: Daily Dialysis Has Risks, Benefits for Kidney Disease Patients
Category: Health News
Created: 2/7/2013 6:36:00 PM
Last Editorial Review: 2/8/2013 12:00:00 AM

View the original article here

A Pill So People With Celiac Disease Can Eat Freely?

By Barbara Bronson Gray

HealthDay Reporter

FRIDAY, Feb. 8 (HealthDay News) -- For people with celiac disease, everyday foods such as bread, pizza crust and muffins are potential enemies. But scientists anticipate that some day a simple pill could help prevent the digestive upsets caused by ingesting the gluten in wheat, rye or barley products.

The only current treatment for celiac disease is a gluten-free diet. A new study, however, offers some potential for hope. Researchers have re-engineered a naturally occurring enzyme, kumamolisin-As, to break down gluten in the stomach into much smaller protein pieces, called peptides. They say these are less likely to trigger the autoimmune response that can create a wide range of painful and irritating symptoms.

The re-engineered enzyme, named KumaMax, appears to be highly effective, at least in a test tube. It dismantled more than 95 percent of a gluten peptide that is thought to cause celiac disease, according to the study, which was published recently in the Journal of the American Chemical Society.

Ideally, the team could develop the enzyme into a food additive such as the gas remedies Beano or Gas-X and offer it without a prescription, said lead study author Justin Siegel, assistant professor of chemistry and biochemistry at the University of California, Davis. But this could take a few years to develop. If the researchers opt to make a prescription drug, the process of clinical trials and obtaining U.S. Food and Drug Administration approval could take a decade or more, he said.

An enzyme is a protein that performs a chemical reaction. Proteins are the workhorses in every cell of every living thing, and their function is defined by their shape and structure.

In this case, the researchers re-engineered the natural enzyme to recognize the peptide that triggers celiac disease and modified the protein in the laboratory so it would survive the acidic stomach environment. "We did the engineering to change the genes and sent that into standard microorganisms to create the protein," Siegel said.

The next step is to show that the enzyme is not toxic and functions as designed in animals. "It shouldn't be toxic; it's just a protein you're eating," Siegel said.

How effective might the enzyme be? "For some people, even flour in the air makes them stop breathing. Some are very sensitive, and in some it just upsets their stomach a little," Siegel said. "For those who are hypersensitive, this probably is not going to solve the problem, but it would allow them to go to dinner, and in case any gluten ended up in their meal, they wouldn't have to worry about it."

"For those less sensitive, they could pop one before each meal and eat anything they want," he added.

View the original article here

Calcium Supplements May Raise Men's Death Risk From Heart Disease

By Steven Reinberg

HealthDay Reporter

MONDAY, Feb. 4 (HealthDay News) -- Men taking calcium supplements may be running a nearly 20 percent increased risk of dying from cardiovascular disease, a new study suggests.

Both men and women take calcium supplements to prevent bone loss. In this study of calcium intake, the risk of dying from heart disease was higher for men but not for women.

"Increasing evidence indicates that too much supplemental calcium might increase the risk of cardiovascular disease," said Susanna Larsson, an associate professor at the Institute of Environmental Medicine at the Karolinska Institute, in Stockholm.

Larsson, who was not part of the study but wrote an accompanying journal editorial, added that "the paradigm 'the more the better' seems invalid for calcium supplementation."

The report was published in the Feb. 4 online edition of the journal JAMA Internal Medicine.

To find out if calcium supplements were associated with an increased risk of dying from cardiovascular disease, a team of scientists led by Qian Xiao, of the U.S. National Cancer Institute, collected data on more than 388,000 men and women, aged 50 to 71 years old. They took part in a study on diet and health conducted by the U.S. National Institutes of Health and the AARP from 1995 to 1996.

Over an average 12 years of follow-up, about 7,900 men died from cardiovascular disease, as did nearly 4,000 women. Among those who died, 51 percent of men and 70 percent of women were taking calcium supplements, the researchers found.

Xiao's group calculated that men taking 1,000 milligrams a day of a calcium supplement had a 20 percent increased risk of dying from heart disease. Men also had a 14 percent increased risk of dying from a stroke, but this was not statistically significant, the researchers said.

Among women, however, calcium supplements were not linked to an increased risk of dying from cardiovascular disease. And, calcium from diet didn't increase the risk of dying from cardiovascular disease for either sex, the researchers found.

The study authors said more research is needed to determine whether there is difference between men and women in the cardiovascular effects of calcium supplements.

"Given the extensive use of calcium supplements in the population[often for osteoporosis], it is of great importance to assess the effect of supplemental calcium use beyond bone health," the investigators concluded in the study.

Taylor Wallace, a representative of the supplement industry, faulted this and other studies because, he said, they were not specifically meant to address calcium supplements and heart disease.

Wallace, who is senior director for Scientific & Regulatory Affairs at the Council for Responsible Nutrition, said most studies of calcium supplements show no effects on the heart.

View the original article here