Saturday, November 21, 2009

Strength Training May Aid in Type 2 Diabetes

Strength training might help women with type 2 diabetes improve their body's use of insulin, new research suggests.

In a small study of obese, postmenopausal women, investigators found that a regimen of aerobic exercise and strength training was better than aerobic activity alone when it came to improving insulin sensitivity.

Type 2 diabetes arises when the body loses sensitivity to insulin, a hormone that shuttles the sugars from food into body cells to be used for energy. Obesity is a major risk factor for insulin resistance and type 2 diabetes, and diet and exercise modification is one strategy for controlling the condition.

It's been unclear, though, whether there are added benefits from bulking up an exercise regimen with resistance training, which aims to build muscle. Such training could improve insulin sensitivity by boosting muscle mass and cutting fat stores in the body, according to the authors of the new study.

To test this idea, they randomly assigned 28 obese women to one of three groups: one that followed 16 weeks of supervised aerobic exercise and strength training; one that followed an aerobic regimen only; and one that continued with their usual diabetes care.

At the end of the study, women in both exercise groups had less abdominal fat and greater muscle mass. But only the strength-training group, which had a bigger increase in muscle density, showed improved insulin sensitivity in tests.
Darcye J. Cuff, of St. Paul's Hospital in Vancouver, Canada, and her colleagues report the findings in the November issue of Diabetes Care.

According to the researchers, the findings suggest that the changes resistance exercise produced in abdominal fat and muscle mass were behind the improvements in insulin sensitivity. Adding strength training to aerobic workouts, they conclude, might be the best exercise regimen for improving insulin resistance.

Thursday, November 19, 2009

Cluster Headache Linked to Heart Defect

New research suggests that cluster headache, a severe type of headache that usually begins around one eye, often occurs together with a heart defect called patent foramen ovale (PFO), in which blood can pass through a small hole from the right to the left side of the heart without going through the lungs first.

In the fetus, the hole (foramen ovale) is open, since blood does not need pass through the lungs to pick up oxygen while the baby is in the womb. After birth, the hole normally closes, but quite often this closure is incomplete. Since it is a small defect, people are often unaware that they have an open (patent) foramen ovale.

As reported in the medical journal Neurology, Dr. Cinzia Finocchi and colleagues, from the University of Genoa in Italy, used ultrasound to look for PFO in 40 people with cluster headache and 40 similar subjects without such headaches.
There was evidence of PFO in 17 patients with cluster headache compared with just 7 headache-free subjects. Having a cluster headache more than tripled the odds of having a PFO.

So, why do the two conditions often occur together? The reason is unclear, but it may relate to lower oxygen levels in the blood. With PFO, blood that bypasses lungs carries less oxygen than normal, and previous reports have suggested that poorly oxygenated blood may help induce cluster headaches.

Further studies are needed to better understand the association between cluster headache and PFO, the investigators conclude.

Sleep Loss linked to Teens' Suicide Behaviors

Teenagers who usually fall into bed at 2 a.m. each night and get up a few hours later to make their 8 a.m. classes are putting themselves at risk for more than chronic tiredness.

New findings show that adolescents who do not get enough sleep may be more likely to have suicidal thoughts and to attempt suicide than their more well-rested peers. Such suicidal behavior is also evident among those who experience frequent nightmares, according to the study of young Chinese people.

"These findings ... highlight the potential role of sleep intervention in the prevention of adolescent suicide," writes study author Dr. Xianchen Liu of Arizona State University's Prevention Research Center and Shandong University School of Public Health in the People's Republic of China.

While adults need eight hours of sleep on average, experts recommend that adolescents -- whose bodies undergo big growth spurts and hormonal changes -- sleep at least nine hours every night, Liu explained.

Yet many teenagers get far less sleep than they should, which, studies show, affects their thinking, concentration, school performance and behavior. It is also known that suicide risk increases during adolescence.

Two long-term studies of adults have found that completed suicide can be predicted by poor sleep quality and nightmares, but less information is known about the sleep-suicide association among adolescents.

To investigate, Liu analyzed survey responses from 1,362 students from three junior and two senior high schools in a rural area of a province in eastern China. The students were asked about their sleep patterns and problems and their suicidal behavior.

Nearly 20 percent of the students said they had thought about killing themselves, and 10.5 percent admitted attempting suicide at some point during the previous six months, Liu reports in the October issue of the journal Sleep.
About 17 percent reported having insomnia, and a small proportion (2.3 percent) said they had even taken pills to help them go to sleep.

The students generally reported getting about 7.6 hours of sleep each night. And, study findings show, the less sleep the adolescents had, the more likely they were to report having attempted suicide.

Those who slept less than eight hours each night were about three times more likely to attempt suicide than those who slept a minimum of nine hours.
This finding remained true even when Liu took into consideration the teenagers' depressive symptoms and other factors that could potentially skew the results, the report indicates.

In addition, adolescents who said they had experienced frequent nightmares during the past month were more than twice as likely to attempt suicide as those who rarely experienced nightmares.
Further, those who reported having frequent or occasional nightmares - as did almost half of the students - were up to 75 percent more likely to have suicidal thoughts than those who rarely had such frightening dreams.
Various researchers have reported that sleep loss may lead to anxiety, depression, aggressive behavior, decreased brain function and hormonal or immunological changes, Liu told.

"All of these impairments due to sleep loss may directly or indirectly lead to elevated risk for adolescent suicidal behavior," he said.

Parents who know their teen is getting only a few hours of sleep each night need not be alarmed about any potential suicidal behavior, according to the researcher, unless they notice warning signs such as their child giving away prized possessions or making out a will.

If those signs are present, Liu advises that parents "consult a clinical psychologist or psychiatrist, to assess the potential risk... and see a sleep specialist to look for the reasons of sleep loss if short sleep has impacted the child's daytime functioning."

Dr. Rosalind Cartwright, chair of the psychology department at Rush University Medical Center in Chicago, Illinois said that Liu's study shows that sleep deprivation among teens is a "worldwide problem."

Adolescents "need more and get less (sleep) than any other age group," said Cartwright, who was not involved with the study, but has conducted sleep-related research. She added that adolescents, and their parents, should "make sleep a priority."

Tuesday, November 17, 2009

Arthritis sufferers 'misusing painkillers'

Thousands of patients with severe arthritis are adding over-the-counter medication to prescrib drugs because GPs are limiting their doses amid safety fears.

The effectiveness of conventional painkillers is being hamstrung by concerns about their side effects, such as bleeding and other severe intestinal problems which can be fatal, according to researchers including Martin Green, chief executive of the charity Counsel and Care for the Elderly.

They report that GPs are not always prescribing to appropriate levels, meaning the drugs are not controlling pain as they should, and that doctors seem reluctant to use a new generation of drugs which have fewer side effects. Patients, therefore, are often turning to other pain-relieving drugs and creams instead.

Work by Mr Green and Brian Crichton, a GP and GP trainer in the West Midlands, suggests that a quarter of patients take over-the-counter medications as well as their prescriptions, and a quarter of doctors order low doses for drugs they prescribe, hoping they can control pain without side effects.

The pair report the findings from an electronic poll of 2,000 doctors and questionnaires returned by more than 3,100 patients with osteoarthritis in the journal Current Medical Research and Opinions. The research was funded by the drug company Merck Sharpe and Dohme.

It is thought that 2,000 people a year might die from complications linked to conventional treatments, still small compared with the millions suffering from osteoarthritis - many of whom are not on prescription drugs at all.

The research suggests patients are four times more likely to be dissatisfied with the poor pain relief caused by the drugs than by side effects such as stomach upsets.

The government's national institute for clinical excellence, which monitors the cost-effectiveness of treatments, last year endorsed the new generation of drugs only in those patients who might be at high risk of developing stomach side effects.

These included people over 65, those with gastrointestinal problems, and those already taking other medicines that could cause ulcers. The drugs themselves cost more money, but their supporters argue they more than make up for that by preventing return visits to GPs, hospital treatment and the need for other drugs to counter side effects.

Dr Crichton said: "If you are on a prescription painkiller and it is not working for you don't add another painkiller you have bought yourself. Always ask the advice of your doctor or local pharmacist."

The Better You Sleep, the Better You Work

Practice alone isn't quite enough to make you perfect. You need to get enough sleep, too.

A study by Harvard Medical School researchers that appears in the July 3 issue of the journal Neuron says your ability to learn motor skills is maximized when you get a full night's sleep.

The study involved teaching groups of people to type a sequence of keys on a computer keyboard as quickly and accurately as they could. One group was trained in the morning and then re-tested 12 hours later. They were able to improve their typing ability by about 2 percent in the re-test.

Another group was trained in the evening and then re-tested 12 hours later, after they'd had a full night's sleep. They had an average 20 percent improvement in their performance when they were re-tested.
The study also found that the amount of performance improvement was linked to the amount of Stage 2 sleep, called non-rapid eye movement (NREM), experienced by the participants, particularly late in the night.

"This is the part of a good night's sleep that many people will cut short by getting up early in the morning," says the study's senior author, Matter Walker, a clinical fellow in psychiatry at Harvard Medical School.

"In order for an individual to learn new things, they may require a good night's sleep before the maximum benefit of the time they spend practicing is realized," Walker adds in the Harvard press release.

Herbal medicines linked to liver inflammation

Some types of herbal medicines have been linked to liver inflammation in patients, suggesting the need for these products to be regulated to reduce further risks to consumers, UK researchers report.

"The preparation and prescribing of these medications urgently needs tighter control, as evidence of their potential toxicity has been recognized for some years and is a growing problem," according to Dr. Margaret F. Bassendine of the Center for Liver Research in Newcastle Upon Tyne and her colleagues.

In the latest issue of the European Journal of Gastroenterology and Hepatology, the researchers present the stories of two patients who experienced extensive liver inflammation after taking a mixture of Chinese herbal roots, one of whom died following a liver transplant.

Bassendine and her co-authors also conducted a review of medical literature written in English and identified 29 more patients with liver inflammation linked to herbal treatments.

Why certain herbal medicines can cause inflammation of the liver is, at present, unknown, the authors note. "It is difficult to provide conclusive evidence of what caused (liver inflammation) since traditional Chinese herbal medicines are sold in Europe as food supplements and therefore evade the controls that apply to conventional medicines," Bassendine's team writes. Some products are mixtures that contain adulterants.

However, certain herbal products are mentioned more frequently than others by people who experienced liver complications, the authors add. One product that was taken by 11 patients, called Jin bu huan, is an extract of a plant that behaves like an opiate. Six patients also reported taking Dictamnus dasycarpus, which is sometimes used to treat eczema.

In the first case the authors present, a 31-year-old woman who was given an infusion of Chinese herbal roots to help alleviate joint pain. The woman soon became jaundiced and developed dark urine. She stopped taking the medications 5 weeks after she began. She was not on any other medications, and tests found no signs of hepatitis virus in her blood, which can cause liver damage.

Nevertheless, her condition worsened. After doctors gave her an infusion of an antibody that improved the functioning of her liver, she fully recovered.

In the second case, a 32-year-old man began taking Chinese herb roots to treat benign tumors in his fatty tissue, and finished the entire nine doses of the treatment even after he began to feel unwell. After the treatment ended, he became jaundiced and also developed dark urine, and his condition began to deteriorate rapidly. He received a liver transplant, but died from an infection 13 days after the operation.

"Physicians and the general public should remain alert to the possibility of adverse effects from all herbal remedies, which are being used widely without definite evidence in common conditions such as asthma," Bassendine and her team conclude.

Child Vaccinations Do Not Cause Diabetes

Routine childhood vaccinations do not increase the risk of developing diabetes, according to a study of more than 700,000 Danish children.

The study, led by Anders Hviid of the Statens Serum Institute in Copenhagen, looked at all Danish children born from 1990 through 2000 and found that diabetes rates were not higher regardless of what types of vaccines were administered.

"The study will, one hopes, be the last one that is necessary to disprove an association between immunization and diabetes," said Dr. Lynne Levitsky of Massachusetts General Hospital.

In an editorial in the New England Journal of Medicine, where the study appears, Levitsky said researchers "should now move on to the most important tasks" of finding what actually causes the blood sugar disease and, perhaps, a way to prevent it.
In addition, the study found siblings of children who had diabetes -- and were therefore more likely to develop the condition themselves -- were not more likely to become diabetics if they were vaccinated.

The Hviid team also looked to see if the vaccinations increased the risk of diabetes two, three or four years later in life. They found it did not.

The fact that doctors are doing a better job of getting children immunized against a dozen often-serious diseases had prompted speculation vaccines might contribute to the growing incidence of childhood diabetes.

But there is already evidence from previous studies that a yet-to-be-discovered environmental factor makes the body stop producing the insulin it needs to process blood sugar.

Dark, leafy greens help shield eyes from cataracts

New research provides further evidence that substances in kale, spinach and other green vegetables help protect aging eyes from cataract.

In an experiment, investigators found that human eye cells treated with antioxidants called lutein and zeaxanthin showed less damage after being exposed to ultraviolet rays, the sunlight ingredient considered a major contributor to cataracts.

Cataracts occur when proteins in the eye's lens begin to clump together, forming a milky cloud that obscures vision. Currently, around 20 million Americans have cataracts, and research suggests that the more sunlight you are exposed to in life, the greater your risk.

It's hard to say how much of each antioxidant people should get in their diets, given that little is known about how antioxidants in the bloodstream reach the eyes, says study author Dr. Joshua A. Bomser.
"While the specific experiments haven't been done...we know generally: eat more fruits and vegetables," he said.

Foods that contain particularly high doses of lutein and zeaxanthin include kale, collard greens, broccoli, turnip greens and spinach.
Bomser explained that there is ample evidence to suggest that people who eat a lot of fruits and vegetables seem to have a lower risk of age-related cataracts.

To investigate why, Bomser and his colleagues at Ohio State University in Columbus grew human lens cells in a laboratory, then added lutein, zeaxanthin, vitamin E, or left the cells alone.

The researchers then exposed the eye cells to ultraviolet (UV) radiation, in order to mimic the effect of sunlight.

In an interview, Bomser explained that lens cells mixed with lutein and zeaxanthin showed significantly less damage following UV-exposure than cells that had no shielding from antioxidants.

And although vitamin E appeared to offer some protection from UV rays, it was surpassed by both lutein and zeaxanthin, he and his colleagues note in the Journal of Nutrition.

However, other research shows that both vitamins E and C appear to protect body cells from damage from free radicals, which are a normal byproduct of metabolism, Bomser noted.

He added that it's always better to eat antioxidant-rich foods than supplements, in order to get the benefits of other healthy substances present in foods. However, barring that, research does suggest that people can also benefit from taking lutein and zeaxanthin supplements, Bomser said.

Milk May Be Pleasant Alternative for CT Scans

Undergoing a scan of one's intestines isn't a pleasant experience for patients with conditions like Crohn's disease, especially since it means downing a concoction made with barium.

But a new study suggests there may be a more palatable alternative: milk.

Researchers found that milk coats the intestines well enough so that radiologists can properly view the organ in a CT scan.

The milk alternative "is interesting, and it's certainly cheap enough. Reading this, I might try it on regular patients," said Dr. Laurence Needleman, chief of CT at Thomas Jefferson University Hospital in Philadelphia.

Still, Needleman -- who's familiar with the study findings -- said milk may not be ideal for all patients, especially since it seems to produce images that are less precise.

Specific types of CT scans are often used to examine the intestines along with the liver and spleen, Needleman explained. Patients typically ingest one chemical and are injected with another; the two combine to create contrast and allow radiologists to better view the inside of the body.

In cases of Crohn's disease and other conditions, the purpose of these scans is to detect kinks or obstructions in the intestines, Needleman said.

Patients commonly drink a "contrast agent" called VoLumen, which includes barium. "I've tried it. It's one of the things I made sure I did," Needleman said. "It's not pleasant. It's not a positive experience to drink it. Drinking four glasses of milk probably will be easier."

In the new study, researchers compared VoLumen to milk in patients who were about to undergo CT scans of the abdominal/pelvic area.

Of those, 62 drank VoLumen, while 106 drank two doses of whole milk (one 400-600 milliliter glass, then a 200-400 milliliter glass -- a total of as much as one liter).

The study findings were to be presented Wednesday in Chicago at the annual meeting of the Radiological Society of North America.

The researchers found that VoLumen was better at allowing radiologists to view certain kinds of images. However, 42 percent of VoLumen patients reported abdominal side effects -- Needleman said it can cause diarrhea -- while only 25 percent of the milk patients did.

As to cost, VoLumen was $18 per patient compared to $1.39 for those who drank milk.

"We hope that substituting milk for other contrast agents will reduce the number of people who refuse imaging tests because they do not want to drink the oral contrast, especially children," Dr. Lisa Shah-Patel, a radiology resident at St. Luke's-Roosevelt Hospital in New York City, said in a statement. She is one of the study's authors.

But Dr. Raul N. Uppot, assistant radiologist at Harvard Medical School, is skeptical that milk will be a viable alternative. "I don't believe we should sacrifice image quality for improved tolerability," he said, adding that some patients may not be able to drink milk due to allergy, lack of ability to tolerate milk products, or existing bowel disease.

"This is only a small study, and when applied to the larger population of patients undergoing CT, I feel you will run into more complaints of discomfort and diarrhea (with milk)," he said.

In addition, Uppot said, "most patients at our institution tolerate the VoLumen with a few complaints of diarrhea."

Tea may help heal skin damage by radiation

Tea extracts can help heal skin damage caused by radiation treatment in cancer patients, say researchers.

Frank Pajonk from the University of California in Los Angeles and his colleagues from the University of Freiburg, Germany, studied the effects of green and black tea extracts on patients who had been treated with radiotherapy, which can damage the skin.

The researchers then analysed the effect of the same tea extracts on human and mice white blood cells in culture, which showed that tea acts at the cellular level by inhibiting inflammatory pathways to reduce inflammation, reported science portal EurekAlert.

This might partly be due to the anti-inflammatory properties of tea, the researchers said in the latest issue of the journal BMC Medicine. They also found that tea extracts reduce the duration of skin toxicity following radiotherapy of five to 10 days.

Both black and green teas inhibit a major inflammatory pathway in a mouse's white blood cells. However, green tea extracts are more effective than black tea extracts in some patients, they added.

Green leafy vegetable could reduce skin cancer risk

Green leafy vegetable may be as important as wearing a hat, sunscreen and protective clothing to reduce the risk of skin cancer, says a study that highlights the importance of eating a healthy, well-balanced diet.

Those who eat at least three serves of green leafy vegetables a week reduced their risk of skin cancer by up to 55 percent, the study by Jolieke van der Pols and other researchers involving 1,000 people in Nambour, on the Sunshine Coast found, according to ABC News online.

Green vegetables such as spinach contain a crucial cocktail of nutrients that can boost the skin's natural defence against sun damage, the 11-year study said.

"Other researches that have looked at individual nutrients haven't found very clear evidence, so it might be that actually the combination of nutrients as they occur normally in the foods that we eat, actually have the effect on the skin cancer," Pols said.

Pregnancy Ups Risk of Restless Leg Syndrome

Pregnancy increases the risk for the occurrence, or worsening, of restless legs syndrome, says an Italian study in the Sept. 28 issue of Neurology.

The study of 606 women found that at least one in four pregnant women experience the syndrome, a movement disorder characterized by an urge to move the legs, generally accompanied by numbness, tingling or burning sensations.
The women were assessed during pregnancy and six months after the birth of their babies. Of the 606 women in the study, 161 (26.6 percent) reported experiencing the problem during pregnancy. For 101 of the women, it was the first time they had experienced RLS. About 25 percent of the women experienced symptoms at least once a week, and 15 percent at least three times a week.

In general, symptoms appeared or worsened around the sixth month of pregnancy and reached a peak during the seventh and eighth months of pregnancy. Rates of restless leg syndrome among the women dropped dramatically around the time of delivery and affected 5 percent to 6 percent of the women six months after delivery.

"The pregnant women most affected by the [restless leg syndrome] were older, had lower values of iron storage indicators, a higher prevalence of insomnia, and snored more than the unaffected group," researcher Dr. Mauro Manconi said in a prepared statement.
This is the first study to show a significant correlation between low iron indicator values and restless leg syndrome risk.

Stress Tests Can Predict Heart Ills in Healthy Men

A treadmill stress test can predict heart attacks or other serious heart disease even in men without symptoms, U.S. researchers reported.

The findings, published in the journal Circulation, suggest that exercise tests may be able to help predict which men who already appear to have a moderate to high risk of heart disease really need to take care.

One of the two studies showed exercise tests may be used to judge who would receive an implanted pacemaker-like device called a defibrillator, researchers said.

In one study two measurements -- a change in electrocardiogram or ECG tracing called ST-segment depression and an inability to reach target heart rate -- more than doubled the 10-year risk of coronary events such as heart attacks.
Men who did well on the stress test had a lower-than-expected rate of heart attack and serious heart disease in the 10 years following.

"Our results suggest that exercise testing may be of benefit in asymptomatic men with intermediate to high risk," said Dr. Gary Balady, a professor of medicine at Boston University School of Medicine.
His team tested women, too, but so few women developed heart attacks or serious heart disease that they could not decide if the test was a good predictor for women.
The 1,431 men and 1,612 women were taking part in a bigger study called the Framingham Heart Study. They were 45 years old at the start on average and had been followed for more than 18 years.

The volunteers got a battery of tests when they began the study that included the stress test. In the 10 years following 224 men, or 15.7 percent, had chest pain, a heart attack or died from coronary heart disease.
Overall, there was a 9.6 percent risk of heart attack, chest pain or other serious heart disease for the 3,000 people in the study over 10 years.

The men who had the highest predicted risk anyway, based on cholesterol levels, high blood pressure, family history and other factors, were the most likely to have serious heart disease if they also did poorly on the stress tests, the researchers found.
They said such patients should get aggressive care, including drugs to lower blood pressure and cholesterol.

A second study in Circulation, done at Columbia University Medical Center, found that an exercise test looking for a certain heartbeat pattern, called a Microvolt T-Wave Alternanscan or MTWA, also shows who may benefit from an implantable defibrillator device.

"It's an exercise test with a smart computer," said Dr. Thomas Bigger, who led the study.
Every year 300,000 to 400,000 people in the United States die suddenly when the heart's rhythm is suddenly disrupted.
But there is controversy over how to decide who needs defibrillators implanted to prevent this, and debate over whether Medicare and other insurers should use certain tests to qualify patients for payment.

Medicare only pays if patients have an abnormal QRS test, but the Columbia team say the MTWA test is more accurate.

They tested 177 patients and followed them for an average of 20 months.
Three percent of patients identified as high-risk by the MTWA died during that time, compared with 12 percent identified as low-risk by the QRS test.
The researchers noted that the test could also show who would not be helped by a defibrillator, potentially saving money and trouble.

Arteries Already Stiff in Obese 7-Year-Olds

Obese children as young as 7 already have the beginnings of artery disease, Italian and U.S. researchers reported.

They found signs that the carotid arteries of 100 obese children were already becoming thick and stiff, as well as indications that the children may have a higher risk of diabetes.

"You can see vascular changes already this early in really obese children," said Dr. Maurizio Trevisan of the University at Buffalo in New York, who led the study.
"We know that obesity in childhood increases the risk of atherosclerosis and death in adulthood," he added. "It is important for parents of obese children to help their children control their weight and get early treatment for these obesity-associated risk factors."

Trevisan, Dr. Archangelo Iannuzzi of Cava de' Tirreni Hospital in Salerno, Italy, and colleagues report their findings in the October issue of Diabetes Care.
For their study they screened 100 children aged 6 to 14 brought to a clinic in Naples because they were overweight. They compared those children to 47 of normal weight.
On average the obese children had higher insulin resistance -- a measure of tendency to diabetes -- than children of normal weight.

They also had higher blood pressure and cholesterol. For instance, the obese children had an average blood pressure of 120/76 while the normal weight children had an average pressure of 98/65.

Importantly, ultrasound scans showed the obese children had thicker and stiffer carotid arteries, the researchers said. The carotid arteries carry blood to the head.
"In adults, arterial thickening has been shown to be a precursor of arterial narrowing and to predict clinical coronary artery disease," said Trevisan.
An estimated 15 percent of U.S. children are overweight or obese and children in many European countries are catching up.

The study shows that obesity acts quickly to damage the arteries of children and that parents and doctors need to act quickly to protect them, the researchers said.

Body Fat Reduces Ability to Control Blood Pressure

In response to a stressful event, it is normal for a person's blood pressure to rise and then fall after the event. Now, new research indicates that excess body fat impairs the body's ability to control blood pressure in this situation.

One key way that blood pressure is regulated is through the release of salt, or sodium chloride, in the urine, a process called natriuresis. In the current study, the amount of salt released in the urine dropped as body fat increased.

"Fitness facilitates the ability to regulate blood pressure; fatness impedes your ability to regulate blood pressure through your ability to regulate sodium," study co-author Dr. Gregory Harshfield, from the Medical College of Georgia in Augusta, said in a statement.

The findings, which appear in the American Journal of Hypertension, are based on a study of body composition and natriuresis in 127 African American and white subjects with an average age of 16 years. Stress was induced by having the subjects play a competitive video game for an hour.

As expected, stress was associated with an increase in blood pressure and natriuresis, the authors note. The magnitude of these changes deceased as body fat rose. Further analysis showed that a person's race predicted how high the blood pressure increased during stress.

"The major finding of this study is that body composition is related to the pressure natriuresis response to mental stress," the authors conclude.

Green Tea Seems to Stem Spread of Prostate Cancer

Green tea appears to inhibit the spread of prostate cancer in a number of ways, says a study in the Dec. 1 issue of Cancer Research.

In research with mice, scientists from the University of Wisconsin and Case Western Reserve University in Cleveland found green tea polyphenols (GTP) target molecular pathways that control the proliferation and spread of prostate tumor cells. The polyphenols also inhibit the growth of blood vessels that feed prostate tumors.

"Consumption of GTP led to reduced levels of IGF-1 (insulin-like growth factor-1)," study senior author Hasan Mukhtar, of the department of dermatology at the University of Wisconsin, said in a prepared statement.

"GTP also led to increased levels of one of the binding proteins for IGF-1, the insulin growth factor binding protein-3. These observations bear significance in light of studies that indicate increased levels of IGF-1 are associated with increased risk of several cancers, such as prostate, breast, lung and colon," Mukhtar said.

Multiple Births a Health Risk

Women pregnant with twins, triplets or quadruplets are at greater risk of serious health complications than are women carrying just one fetus, according to a Canadian study published on Wednesday.

Researchers at the Universities of Ottawa and Toronto, who studied 4.4 million records for obstetric deliveries in Canada, found that women who carry two or more fetuses are almost 13 times more likely to experience heart failure and more than twice as likely to develop clotting in the legs and lungs -- both leading causes of maternal death.
The findings published in this month's British Journal of Obstetrics and Gynecology surprised the study's lead author, Dr. Mark Walker, a scientist with the Ottawa Health Research Institute.

"These are young healthy women in the reproductive age window of 16 to 44 where you wouldn't expect to see these health problems," says Walker.

"And the implications of this are two-fold. With women who have multiple gestations, we need to counsel them about these risks and be vigilant for them," he said. "So, if the mother has leg pain, shortness of breath or chest pain, our urgency to look into other problems should be increased."

One obvious example is to consider administering blood thinners to women carrying multiple fetuses who are prescribed bed rest, he said.

Although the study did not distinguish between natural pregnancies and in vitro fertilization, Walker said he hopes his study will send a message to fertility clinics responsible for an explosion in multiple pregnancies in recent years.

"Here's one more cogent reason to develop techniques to ensure that only one baby results from the procedure. I may lose my business as an obstetrician, but it's absolutely safer to have one baby, then wait nine months to have another," he said.
Dr. Jeff Haebe, a reproductive endocrinologist at the University of Ottawa, said 60 per cent of the in vitro fertilizations at his infertility clinic result in only one baby, and he transfers a maximum of two embryos for women aged 37 and younger and no more than three for women 38 and older. "And rarely we might go to four," he said.
While there are no laws in North America limiting the number of embryo implants at one time, Haebe said Canada should follow the lead of some European countries that legislate a maximum of two embryos, regardless of age.

"And I think that's a very good way of handling the problem of multiple births," Haebe said.

Brain Scan Helps Diagnose Bipolar Disorder

Bipolar disorder, a sometimes misdiagnosed mental illness characterized by wide emotional swings, may be identifiable by chemical abnormalities visible in victims' brains, researchers said on Tuesday.

Detailed brain scans performed on 42 adults, half of whom had been previously diagnosed as bipolar, showed consistently different levels of five chemicals in areas of the brain that control behavior, movement, vision, reading and sensory information, they said.

The Mayo Clinic study used a high-power magnetic resonance imaging scanner that had twice the magnetic field strength of scanners previously used to examine the brains of bipolar patients.

"Bipolar disorder is challenging to diagnose because individuals can cover up the symptoms of the illness or may recognize only their depression, not the manic phase of the disorder," Mayo Clinic radiologist John Port said in a report delivered to the annual meeting of the Radiological Society of North America.

"The psychiatric community clearly needs a tool to help diagnose bipolar disorder," he said.

The types of therapy used with bipolar disorder differ from those employed to fight depression, so a correct diagnosis is important, Port said. Most diagnoses are made based on conversations with the patient.

Roughly 2.3 million Americans suffer from bipolar disorder, according to the National Institute of Mental Health.

High Cholesterol in Diabetes May Harm Vision

Aggressive treatment to lower high cholesterol in patients with type 1 diabetes, also known as "juvenile diabetes," an autoimmune disease that typically develops at a young age, could protect their vision as well as their cardiovascular health, a new study suggests.

Harvard researchers found that individuals with the highest levels of low-density lipoprotein (LDL), the "bad" cholesterol, had twice the risk of developing a visual problem called macular edema, or fluid in the macula of the eye, compared with those with the lowest LDL levels. Subjects with the highest ratio of total cholesterol to high-density lipoprotein (HDL), the "good" cholesterol had a fourfold increased risk of this eye disorder.

Clinically significant macular edema is the leading cause of vision loss in diabetics, Dr. Debra A. Schaumberg of Brigham and Women's Hospital and colleagues note. While high blood sugar has been tied to the development and progression of disease of the retina, the relationship between blood glucose control and clinically significant macular edema is not as clear.

Schaumberg and her colleagues analyzed data from the Diabetes Control and Complications Trial, which included 1,441 patients with type 1 diabetes followed for an average of 6.5 years. Study participants' cholesterol levels were checked annually.

The study, published in the medical journal Diabetes, is the largest investigation of its kind to-date to evaluate the relationship between clinically significant macular edema and blood cholesterol levels.

Patients in the top quarter of total-to-HDL cholesterol ratio had 3.84 times the risk of clinically significant macular edema compared with those in the lowest quarter. Those with the highest LDL levels were 1.95 more times likely to develop clinically significant macular edema.

When the patients' blood sugar levels were considered, the relationship between cholesterol levels and clinically significant macular edema was weaker, although the association remained significant.

However, no relationship was seen between cholesterol levels and the progression or development of diabetic retinopathy.

The results indicate that high cholesterol, especially the total-to-HDL cholesterol ratio, are risk factors for clinically significant macular edema, Schaumberg and her colleagues conclude. The findings may also lend further support to current treatment guidelines that recommend aggressive lowering of high cholesterol in diabetic patients, they add.

Dirty Teeth Can Kill You

Germs found in dental plaque can make their way into the lungs and cause potentially fatal pneumonia in elderly nursing home patients, U.S. researchers reported on Tuesday.

Though the study was small, the researchers said they found clear evidence in eight patients who developed pneumonia while in the hospital that had originated from their own dental plaque.

"This is the first study to establish unequivocally a link between dental hygiene and respiratory infection," said Dr. Ali El-Solh of the University at Buffalo in New York, who led the study.

Writing in the latest issue of the journal Chest, El-Solh and colleagues said they tested 49 nursing home residents who were admitted to a nearby hospital with a high risk of pneumonia. They made molecular fingerprints of the bacteria found in each patient's mouth before he or she developed pneumonia.

Of the 49 patients, 28 had germs known to cause respiratory disease in their dental plaque samples and 21 did not.

The patients were watched closely for pneumonia. The researchers said 14 eventually developed pneumonia and 10 of them had started out with respiratory disease-causing germs in their teeth.

Tests of germs from the lungs showed the DNA matched the DNA of plaque germs in eight of the patients -- more than half.

"These findings indicate that dental plaque is a reservoir of respiratory pathogens that can cause pneumonia in hospitalized institutionalized elders," said El-Solh.
Nursing homes need to help patients maintain clean teeth and dentures, he added.

Migraine sufferers more at risk of heart attack

Middle-aged men who suffer from migraine are more at risk of heart attacks, says a new study.

Migraine is a painful neurological condition, of which the most common symptom is an intense and disabling episodic headache.

Men with migraines were more likely to have high blood pressure or elevated cholesterol levels, compared to men who didn't have migraines, a study done on 20,084 men revealed.

Tobias Kurth, assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School, and other researchers had earlier shown that older women with migraines - especially those accompanied by neurological visual disturbances known as aura - had a higher risk of heart attacks and cardiovascular disease, reported the online edition of health magazine WebMD.

In the current study, the researchers did not have information on whether the men had auras. According to Kurth, the findings in women could be applied to men as well.

An aura occurs before the onset of a migraine. Aura symptoms can include, but are not limited to, light flashes, blind spots, blurred vision, and the formation of dazzling zigzag lines during the migraine. Aura can also include changes in sensation and smell.

"Until we understand more about the association between migraines and heart disease, patients with migraines should think about how to mitigate other known heart disease risk factors such as high blood pressure, diabetes, high cholesterol levels, smoking and obesity," the scientist said.

High doses of anaemia drug could be fatal

High doses of an anaemia drug used by kidney patients could be fatal, causing heart diseases and stroke, say new clinical studies.

Epoetin alfa, a drug often prescribed to treat anaemia in chronic kidney disease patients, has been shown to cause higher risk of death, heart failure, heart attack and stroke when taken in high doses, reported health magazine WebMD.

People with chronic kidney disease often suffer from anaemia. Anaemia has been linked to increased risk of heart disease complications and related death in people suffering from chronic kidney disease.

Epoetin alfa helps raise red blood cell levels back to normal.

Amgen sells the drug as Epogen and Johnson & Johnson as Procrit. Amgen also makes a similar drug, darbepoetin alfa, sold as Aranesp. Another similar drug, epoetin beta, is sold in Europe as NeoRecormon by Roche.

Researchers conducted a 16-month study on 1,432 patients and found that those whose red blood cell count was normalised with high doses of epoetin alfa have a 34 percent higher risk of death, heart attack, and stroke than patients who take lower doses.

Another study showed that when epoetin is used to normalise red blood cell counts in kidney patients, it does not reduce their risk of heart disease or stroke compared with patients who take lower doses.

Both studies appear in the Nov 16 issue of The New England Journal of Medicine.

Either way, the trials seem likely to put an end to routine, high-dose epoetin treatment in kidney patients.

Antibiotics ineffective for treating bronchitis

Doctors should stop routinely prescribing antibiotics to treat acute bronchitis as most cases are viral infections, says a study that recommends patients drink lots of fluids instead.

Acute bronchitis is an inflammation of the main airways to the lungs characterised by an irritating cough. The disease occurs in about five percent of adults each year and doctors prescribe antibiotics to 70-80 percent of patients for the condition.

But two doctors from Virginia Commonwealth University, Richard Wenzel and Alpha Fowler, say that in almost all cases it is caused by viral infections and does not respond to antibiotics, according to a report published in the New England Journal of Medicine.

The doctors found little evidence that the cough medicine prescribed in most acute bronchitis cases had any value, reported health portal News Medical.

The doctors examined research studies and clinical trials regarding acute bronchitis and any data supporting the potential benefits of anti-bacterial agents.

They say most cases will go away on their own after a few days or a week, and recommend rest and drinking lots of fluids.

Taking unnecessary antibiotics adds to the problem of bacteria becoming resistant to them, thus rendering them less useful for treatment of infections, Wenzel said. They produce unwanted side effects such as diarrhoea, gastric upset, rash, headaches and muscle aches.

Wenzel said doctors should think twice and spend a few minutes explaining to patients why it is unnecessary to take an antibiotic in these cases.

Monday, November 16, 2009

Exercise lowers stroke risk

Climbing stairs daily helps to lower the risk of suffering a stroke, according to the German Stroke Foundation. It noted that getting too little exercise and being overweight were among the risk factors for a stroke.

Regular exercise and a balanced diet could prevent half of the strokes in Germany, the foundation said, pointing out that cardiovascular events such as stroke were the third-most frequent cause of early retirement in the country.

The foundation said getting more exercise was simply a matter of making small changes in one's daily routine, for example by riding a bicycle to work instead of driving a car or taking public

transportation. In inclement weather, office workers who choose to drive rather than ride to work could park further away from the office and walk the rest of the way.

Many workers make the mistake of not leaving the office during lunch, the foundation noted. It cited a survey by the Berlin-based polling institute Forsa showing that a quarter of all workers in Germany work right through their break even though it presents a good opportunity to stretch their legs for at least 10 minutes.

Generally speaking, adults should exercise at least 30 minutes daily to keep healthy, the foundation said. It suggested that people monitor their exercise regimen with an "exercise book"

in which they jot down all of their physical activities, such as jogging or cycling.

According to the foundation, working up a sweat or exercising for 30 minutes at a time is not necessary since every physical activity lasting longer than 10 minutes is beneficial.

Low-calorie, low fat diet better for your mood

A low-calorie, low-fat diet does more good to a dieters' mood than a low-carbohydrate plan with the same number of calories, says a new study.

Obese individuals who lose weight tend to have an improved psychological state, including a better mood, according to the study report.

Grant D. Brinkworth of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) and colleagues conducted a randomised clinical trial involving 106 overweight and obese participants who aged 50.

Of these, 55 had been randomly assigned to follow a very low-carbohydrate, high-fat diet and 51 to a high-carbohydrate, low-fat diet for one year.

Changes in body weight, mood and well-being, and cognitive functioning (thinking, learning and memory skills) were assessed periodically during and following the one-year intervention.

After one year, the overall average weight loss was 13.7 kg, with no difference between the two groups. Both groups initially (after the first eight weeks) experienced an improvement in mood.

However, most measurements of mood revealed a lasting improvement in only those following the low-fat diet, while those on the high-fat diet returned to their initial levels (mood turned towards more negative baseline levels).

"The obesity epidemic has led to widespread interest in alternative dietary patterns for weight management," the authors write.

"While recent clinical studies have shown that low-carbohydrate diets can be an effective alternative dietary approach for weight loss, their long-term effects on psychological function, including mood and cognition, have been poorly studied.

"This outcome suggests that some aspects of the low-carbohydrate diet may have had detrimental effects on mood that, over the term of one year, negated any positive effects of weight loss," the authors write, according to a CSIRO release.

These findings were published in the November issue of Archives of Internal Medicine.

Keep heart attack victim cool for better survival chance

Rapid cooling of the body after a cardiac arrest seems to improve chances of survival without damaging the victim's brain, a new study has found.

"We now have a method that is safe and can be started within minutes of cardiac arrest to minimise damage during this very critical period," said study leader Maaret Castren, professor of emergency medicine at the Karolinska Institute, Stockholm.

For years, people hospitalised after cardiac arrest have been cooled to reduce damage to the brain and other tissues when blood circulation normalises after being temporarily halted.

In the Prince (Pre-Resuscitation Intra-Nasal Cooling Effectiveness) investigation, Castren and colleagues at 14 other centres across Europe used a new tool, RhinoChill, that cools the brain during ongoing cardiopulmonary resuscitation (CPR).

Researchers randomised 200 adults going into witnessed cardiac arrest to receive either standard resuscitation or resuscitation with cooling started as soon as possible during the arrest, with ongoing CPR.

All patients who survived until hospitalisation were further cooled according to standard criteria.

Eighteen patients were excluded from the analysis because a ?do-not-resuscitate' order was found or there was a non-cardiac reason for their cardiac arrest.

In the 182 patients reported, 83 (average age 66 years, 71 percent male) were randomised to receive nasal cooling (although two were not cooled because of user or device problems) and 99 (average age 64.8, 78 percent male) received standard care.

RhinoChill is a non-invasive device that introduces coolant through nasal prongs. The system is battery-powered and requires no refrigeration, making it suitable for emergency medical technicians to use while a person is receiving CPR.

In the total group, 46.7 percent of those cooled survived until hospital discharge, compared with 31 percent of those receiving standard care.

And 36.7 percent of those cooled were in good neurological condition on hospital discharge, compared with 21.4 percent of those receiving standard care, said a Karolinska Institute release.

In a time analysis, patients who received a combination of early CPR started within six minutes of collapse and cooling had the best outcomes.

These findings were presented at the American Heart Association's Scientific Sessions 2009.

Sunday, November 15, 2009

Drug therapy record 'encouraging'

One in three people addicted to heroin or crack cocaine in community drug treatment programmes in England stops using by six months, research suggests.

Results from 14,600 people in methadone or specialist counselling programmes suggested the rates were slightly lower for those dependent on both drugs.

There are about 140,000 people in such treatment programmes in England.

The study, in the Lancet, showed higher funding for treatment was effective, the Department of Health said.

The researchers said the figures were "encouraging".

Eight in every 1,000 15-64 year-olds are heroin users, statistics show.

or crack cocaine - the smokeable form of the drug - the figure is five in 1,000.

The latest analysis is the largest study done in England of 1,000 community treatment agencies - not including residential rehab schemes - and may be the largest internationally, the researchers said.

Data was collected as part of the National Drug Treatment Monitoring System, where 13,200 people had started on drug treatment such as methadone, and 1,400 people started on psychological treatments - the only current option for crack cocaine addiction.

Among those addicted to heroin, 37% said they were abstinent from the street drug for the month prior to their six-month review.

Another third were classed as "improving" because they had reduced their drug use, just under a third were unchanged and 3% had got worse.

For crack cocaine, 52% had stopped using at six months, 12% had improved, a third were unchanged and 3% had deteriorated.

Increased capacity

The number of people addicted to heroin and crack in treatment programmes in England has increased dramatically in recent years.

It has been estimated that in England around 60% of those in need of treatment are receiving it, at a cost of around £3,000 to £5,000 a year per person.

Colin Bradbury, head of delivery at the National Treatment Agency for Substance Misuse and one of the authors of the study, said: "There's no room for complacency, but we're very pleased and encouraged by the results.

"That is despite the fact we have had very rapid expansion in the treatment system, it's retained its quality and effectiveness."

He added there would be large local variation and services could use the study to benchmark how they were doing.

Study leader Dr John Marsden, from the Institute of Psychiatry at King's College London, said these were the most "severely addictive" drugs around and users could not stop even when their lives fell apart and it became completely illogical for them to use.

"These are encouraging rates but it is the beginning of a story."

He said they would be doing more work on long-term outcomes and different types of treatment.

"I think this is good evidence for a return of public investment in treatment."

He called for more attention on those who got worse during their treatment programmes and new strategies for the third of users addicted to both heroin and crack cocaine who seemed more resistant to treatment.


A Department of Health spokesperson said: "This study demonstrates that our strategy of increasing investment in treatment is effective and gives problem drug users faster access to help.

"Tackling drug misuse is a priority. High-quality drug treatment is the most effective way of reducing drug harms and every £1 spent on drug treatment saves £9.50 to the rest of society."

In an accompanying paper, Dr A Thomas McLellan, deputy director of the White House Office of National Drug Control Policy in Washington DC, said short-term interventions may not produce long-lasting, positive effects.

"It may be more reasonable to expect enduring improvements through sustained outpatient clinical management with drugs and behavioural therapies - like expectations we have for the management of diabetes and hypertension."

A spokesman for Addaction said the study highlighted the problems of "polydrug use".

"Many of the people Addaction helps use a wide range of substances, and treating their addictions is a complex business."

DrugScope chief executive Martin Barnes said drug treatment made a difference to thousands of people.

But he added: "Despite the improvements that can be made it is important to recognise that getting off drugs can be a long and complex process - there is no silver bullet for treating drug dependency."

Alcoholics sleep worse months after quitting booze

Recovering alcoholics sleep worse than people who have never had a drinking problem, and this difference persists after months or even years of abstinence, new research shows.

These changes probably worsen the problems with mental function that result from long-term heavy drinking, Dr. Ian M. Colrain of SRI International in Menlo Park, California and his colleagues say.

People who abuse alcohol complain of insomnia and other sleep problems, even after periods of abstinence, Colrain and his team note in the October 1 issue of SLEEP. But little is known about how alcoholism affects sleep in women, and whether the sleep changes persist long-term.

To investigate, the researchers monitored brain electrical activity during one night's sleep for 42 alcoholics and 42 people without alcohol problems. The alcoholics had been sober for 179 days, on average, with periods of abstinence ranging from 10 days to nearly two years. Fifteen of the alcoholics were women.

All had met criteria for alcohol dependence, and their average consumption was equivalent to about eight pints of whisky a week, Colrain told Reuters Health: "This is not social drinking."

The researchers looked at how long the subjects spent in two types of sleep: slow-wave and REM. Slow-wave sleep is essential for helping the brain to consolidate learning and memory, while REM sleep is when most dreaming happens.

Non-alcoholic men and women spent 12 percent of their sleeping time in slow-wave sleep, and around 20 percent in REM sleep, the researchers found.

But the time in slow wave sleep for alcoholic men was about 7 percent, and for women it was 11 percent. REM sleep represented 24 percent of total sleep time for alcoholic men and women.

Alcoholic individuals also spent a bit more time in stage 1 sleep, the lightest sleep stage, than non-alcoholics did.

While getting less slow-wave sleep is likely to be harmful, he added, getting more REM sleep "is probably a good thing, and certainly not a bad thing," Colrain said. But overall, the differences appear to reflect long-term changes in the brain that affect how sleep is regulated, and they seem to be similar in men and women.

Despite the findings, Colrain told Reuters Health, "it's likely that the sooner you stop drinking the less the impact will have been and the more likelihood you'll have to recover."

Smoking Spurs Snoring

Your chances of getting a peaceful night's sleep are better if you don't smoke, or spend time around anyone who does.

That's because smoking -- both active and passive -- makes it more likely you'll snore the night away, according to a study in the October issue of the American Journal of Respiratory and Critical Care Medicine.
"Smoking is a common cause of snoring. Even passive smoke can induce snoring," said study co-author Dr. Karl Franklin, a professor at University Hospital in Umea, Sweden, who added that the most important take-away message from this study is to stop smoking if you're a smoker.

Habitual snoring is a common problem. Between 16 percent and 33 percent of men and 8 percent and 19 percent of women are thought to be habitual snorers. Habitual snoring is defined as loud and disturbing snoring at least three times a week, the researchers said.

Along with being a well-known cause of marital strife, nighttime snoring can lead to excessive daytime sleepiness, which can put you at risk in situations that require attentiveness, such as driving. Snoring has also been linked to ailments such as diabetes, pregnancy-induced hypertension and increased mortality in men under 60, according to Franklin.

Snoring is caused by an obstruction in the nasal passages, said Dr. Marc Siegel, an internist at New York University Medical Center in New York City.

"Normally, air is getting pushed through a narrow tube as you breathe. If it's narrower than normal, there will be more noise," said Siegel, who pointed out that's one reason why obesity is strongly linked to an increase in snoring -- as you gain weight, your nasal passages become smaller.

Franklin said the researchers have three theories on why cigarette smoke increases the risk of snoring. The first is that smoking, whether active or passive, irritates and inflames and narrows the upper airways. Another theory is that nicotine withdrawal during sleep may cause certain physiological changes that make snoring more likely. And, finally, because nicotine is toxic to nerve cells, smoke may cause toxic lesions on the nerves in the muscles of the upper airways.

Franklin's study included more than 15,000 men and women between the ages of 25 and 54. They were from Denmark, Estonia, Iceland, Norway and Sweden. All answered a questionnaire that included questions on smoking, snoring, chronic bronchitis, obesity, gender and age.

Snoring was far more prevalent in smokers than in those who had never smoked, 24 percent versus 13.7 percent. Former smokers weren't off the hook either -- 20.3 percent of them snored. Nearly 20 percent of people who had never smoked, but were exposed to cigarette smoke on a daily basis at home, were habitual snorers.
After calculating for other snoring risk factors, such as obesity, gender and age, current smoking was responsible for a 17 percent increase in snoring, and passive smoking a 2.2 percent increase. Obesity increased the risk of snoring by 4.3 percent.

"Smoking does predispose you to snoring because it inflames the nasal passages, so it also makes sense that passive smoke can because passive smoke is unfiltered smoke," Siegel said.

However, Siegel added he had one problem with the study -- the information was gathered solely by questionnaire, which is generally not considered the most reliable way to collect information, especially if you're asking about behavior that goes on while you sleep.

"Your partner is probably a better judge of whether you snore or not," Siegel said.

But, he added, it would be very difficult and expensive to do a completely objective study on snoring.
If you'd like to stop your nocturnal noisemaking, Siegel suggests quitting smoking, staying away from people who smoke, losing weight, and treating sinus infections and any allergies you may have. Also, avoid eating just before going to bed and drinking excessive amounts of alcohol, he said.

Fruit, vegetable juice could help prevent Alzheimer's

A specific class of antioxidants found in fruit and vegetable juice could stave off Alzheimer's disease, say scientists.

Non-vitamin antioxidants - polyphenols - are abundant in the skin and peels of fruits and vegetables. They are also present in teas and wines.

Lab trials have earlier shown that polyphenols can have a potent effect on health, with the potential to significantly delay the onset of serious cognitive impairment.

Qi Dai and colleagues at the Vanderbilt University, Tennessee, studied 1,836 dementia-free subjects based in Seattle. They looked into their intake of fruit and vegetable juice over a 10-year period while monitoring cognitive function every two years, reported science portal Science a GoGo.

The team found that people who drank over three serves of fruit or vegetable juice a week reduced the risk of Alzheimer's by 76 percent compared to those who drank less than one.

The team also found that the beneficial effects were most pronounced in subjects who carried a genetic marker associated with Alzheimer's.

The researchers said the next stage was to test blood samples to discover whether elevated levels of polyphenols are directly linked to a reduced risk of Alzheimer's, and discover which types of juice are most effective in achieving this outcome.

Low birth weight babies could face cognitive problems

Low birth weight babies could face more physical, mental and cognitive difficulties as compared to those with normal weight, says a new study.

Low birth weight has been known to increase the risk of disabilities like cerebral palsy and mental retardation.

However, new research suggests that low birth weight may also contribute to minor difficulties in motor skills and cognitive abilities like thinking, learning and memory, reported the Newswise wire quoting a study published in the October issue of Archives of Paediatrics & Adolescent Medicine journal.

The study also said these problems could last till adolescence but added that enhanced maternal-foetal and neonatal care may help them improve.

Agnes H. Whitaker and colleagues at Columbia University Medical Center and New York State Psychiatric Institute studied 474 non-disabled adolescents who were born at or admitted to one of three New Jersey hospitals between 1984 and 1987 and weighed less than 2,000 grams at birth.

The participants, who had an average age of 16 at the time of assessment for the study, underwent intelligence and motor tests at their homes.

Compared with the standardisation sample, or the large group of teens used to provide a reference point for the assessments, the adolescents with low birth weight had more motor problems.

Their IQ scores were within the normal range, but on an average were significantly lower than the average for their age group.

Male participants, who had injuries to the white matter (nerve tissue) of the brain on neonatal ultrasound and who spent more days on a ventilator as infants, were more likely to have motor difficulties, the researchers said.

Social disadvantages, a lower foetal growth ratio (calculated by dividing birth weight by the median weight for the infant's age) and white matter injury, also predicted lower IQ scores.

But the researchers also noted that enhanced maternal-foetal and neonatal care have the potential to substantially improve cognitive and motor outcomes for non-disabled low birth weight children.

Girls Need Big Breakfast?

Girls need a more filling breakfast than boys if they are to do their best in school tests, according to researchers in Northern Ireland.

Health experts at the University of Ulster said memory and attention tests found boys did better when they were a little hungry while girls were best after a satisfying morning meal.

"The link between having breakfast and performance at school or work is well established," said Dr Barbara Stewart from the Northern Ireland Center for Diet and Health at the university.

"But this research suggests girls need a more satisfying breakfast than boys to perform at their best." During the project, pupils were fed a breakfast of toast, or beans on toast, and then tested on cognitive ability. As tests became more difficult, those who had eaten beans outperformed students who had been given just toast. The researchers suggested girls benefited most because a breakfast high in carbohydrate and protein helped counteract the effect of a negative mood on their academic performance.

"Due to the interaction between cognition and mood a satisfying, high carbohydrate/protein breakfast, such as beans on toast, helps the girls perform at their best," said Stewart.

"While boys perform better when their breakfast leaves them feeling a little hungry."

Feeding Cereal Too Soon Raises Diabetes Risk in babies

Babies with a family history of diabetes who were introduced to cereals before or after the recommended age of four to six months had a higher risk of developing a precursor to the disease, researchers said on Tuesday.

Two teams of researchers -- one from the University of Colorado at Denver and the other from the Diabetes Research Institute in Munich, Germany -- produced similar findings in multi-year studies of at-risk children that were both published in the Journal of the American Medical Association.

They found that infants at risk of diabetes who were fed fiber or rice cereals before they reached the recommended age of four months were four to five times more likely to develop an autoimmune response that destroys islet cells in the pancreas than babies introduced to cereal between four and six months.
The destruction of islet cells, which make insulin and other hormones, is thought to lead to Type I diabetes, which often runs in families and affects two out of 1,000 Americans.

The Colorado study also indicated that infants not fed cereal until age seven months or later -- beyond the four-to-six month recommended window -- were also at higher risk for developing the disease precursor, study author Jill Norris wrote.

There are various theories about why fiber and rice cereals might trigger cell destruction in the pancreas in infants at risk of diabetes, Norris wrote.

One theory is that the immature infant's gut reacts to the gluten in cereal with an excessive immune system response. In older infants with bigger appetites, the trigger may be the body's response to the larger amounts of cereal consumed.

Another theory posed is that infants not fed cereal during the critical developmental stage between four and six months lack key nutrients such as vitamin E and zinc, which causes the immune system to overreact.
An editorial in the journal said parents should not misconstrue the findings as saying that infant cereals cause diabetes, nor should they be overly concerned about feeding their children fiber or rice cereals.
"At this stage, cautious interest might seem the appropriate response" to the studies, wrote Mark Atkinson of the University of Florida, Gainesville, and Edwin Gale of the University of Bristol, England.
Some young children who develop the precursor condition do not develop diabetes, the editorial said.

Heart Disease Still Number-One Killer

Cardiovascular disease remains the leading cause of death in the world, according to a report released by the American Heart Association (AHA).

The AHA estimates that 61,800,000 Americans have cardiovascular disease, which can include high blood pressure, coronary heart disease (heart attack and chest pain), stroke, birth defects of the heart and blood vessels, and congestive heart failure.

Cardiovascular disease kills more people than the next seven causes combined--including cancer--the AHA report states.

``The most surprising finding is that heart disease and stroke numbers are not going down,'' says Dr. David Faxon, president of the AHA. ``For many years, they did, but now we are seeing a leveling off, and in fact, we are seeing an increase in some groups such as African-American women.''

According to Faxon, reasons for the leveling off in numbers include the aging of the population and the ``growing problem'' of diabetes and obesity, both of which greatly increase heart disease risk.

In 1999, the most recent year for which data is available, cardiovascular disease deaths totaled nearly 1 million--equivalent to 1 death every 33 seconds--and accounted for 40% of all deaths that year.

The new report also states that caring for people with cardiovascular disease costs billions of dollars and will get more expensive. Cardiovascular disease-related costs for 2001 were estimated at $298.2 billion and are expected to rise to $329.2 billion in 2002.

``The majority of the cost is for inpatient hospitalization so anything that prevent the disease and complications and the need for rehospitalization can reduce cost,'' Faxon said.

He pointed out that medication and lifestyle changes can have powerful benefits for people with heart disease. ``For instance, taking a beta-blocker, an ACE inhibitor or statin after a heart attack dramatically reduces the chance of another heart attack or death,'' he said.

According to Faxon, lifestyle changes have the greatest effect on preventing death and disease associated with cardiovascular disease. ``While we have made modest effects on smoking and cholesterol awareness, we are losing ground in high blood pressure awareness,'' he added.

``Both men and women need to stop smoking, eat right, exercise and know their blood pressure and cholesterol and keep them at target levels,'' he advised.

Study Finds No Link Between Diet, Colon Cancer

A large new study has found no link between eating patterns and colorectal cancer risk, suggesting that keeping one's weight down with exercise may be the best way to prevent this type of cancer, the study's lead author says.

Dr. Paul Terry of Albert Einstein College of Medicine in New York and colleagues analyzed eating patterns and the development of colorectal cancer in 61,463 Swedish women.

During the 10-year follow-up period, 460 of the women developed colorectal cancer.

The researchers found no significant association between colorectal cancer risk and three major dietary patterns. Namely, a ``healthy'' diet with high intakes of fruits, vegetables, fish and poultry, whole-grain breads and low-fat diary products; a ``Western'' diet including processed and red meats, soda, sweets, refined breads and high-fat dairy products; and a ``drinker'' diet, reflecting the intake of alcohol.

The findings suggest that eating ``low amounts'' of foods considered ``healthy'' might be associated with a higher risk of colon and rectal cancer, while a healthy diet may be protective among younger women.

Terry and colleagues acknowledge that research on this topic has yielded conflicting results. ``Perhaps it is that the association between diet and colorectal cancer risk is complex and that there are no easy answers here,'' Terry says.

``People seeking to lower their risk might hear a news report that 'a healthy diet' will lower the risk or that a 'modern diet' will increase the risk. Our data don't confirm either of these statements,'' he explained.

``The fact that colorectal cancer risk can vary up to 20-fold across geographical regions strongly suggests that environmental factors are important,'' he added, ``but which environmental factors?''

Additional studies, preferably ones structured similarly to this one, on the role of overall eating patterns in predicting colorectal cancer risk are clearly needed, Terry's team concludes.

Excess Caffeine May Make Seizure Control Tougher

When a person with epilepsy adequately controlled by medication suddenly begins having more frequent seizures, excess caffeine intake could be the culprit, a report suggests.

``This case presents the point that people with epilepsy should minimally use caffeine,'' says Dr. Kenneth R. Kaufman, associate professor of psychiatry at the Robert Wood Johnson Medical School in New Brunswick, New Jersey. ``One needs to avoid tea, coffee, chocolates, cocoa and many of the caffeinated sodas.''

Kaufman and his colleague Dr. Rajesh Sachdeo, clinical professor of neurology and director of the hospital's epilepsy program, presented a case study addressing the effect of caffeine on seizure frequency.

The researchers described the 49-year-old man who had been having seizures for 36 years. His convulsions had been successfully controlled with the drugs phenytoin and primidone.

The man began experiencing a sharp rise in the frequency of his seizures, even though he was continuing to take his medication and his sleep patterns and stress levels had not changed. Lack of sleep and increased stress are both known to make seizure control more difficult.

Several newer anticonvulsive drugs, which may have fewer side effects than older medications, have been introduced recently, Kaufman and Sachdeo noted. They considered switching the man to one of these medications until they reviewed his diet and discovered he had recently begun consuming 2 quarts a day of a popular caffeinated, bottled iced tea drink. After he switched to a decaffeinated drink, his seizures subsided.

The researchers explained that chemical substances known as methylxanthines, which include caffeine, have been reported to promote convulsions in animals. When a patient begins suffering more seizures, doctors should investigate the patient's diet for any recent changes before switching his or her medication, Kaufman and Sachdeo suggest.

``Beyond the medications, one has to ask the question, 'What types of seizure threshold-lowering behaviors might be occurring?''' Kaufman added. ``Caffeine (intake) may be a seizure threshold-lowering behavior.''

Steroid shots don't help hip pain long-term

Corticosteroid shots provide quick relief for people suffering from a common type of hip pain, but the benefits don't last, a new study in The American Journal of Sports Medicine shows.

Known as greater trochanter pain syndrome (the trochanter is the upper part of the femur where it joins the pelvis), this condition is typically treated with physical therapy, training error correction, and non-steroidal anti-inflammatory drugs, Dr. Jan D. Rompe of the OrthoTrauma Evaluation Center in Mainz, Germany and his colleagues note.

If these measures don't work-or even if they do-"a local corticosteroid injection is regarded as the standard of care," Rompe and his team say.

But there have been no studies comparing various approaches to treating the hip pain syndrome. To investigate, the researchers randomly assigned 229 people with greater trochanter pain syndrome that hadn't improved with standard treatment to home training, a single corticosteroid injection, or several low-energy shock-wave treatments, in which a machine is used to deliver energy pulses to the painful area.

After a month, 75 percent of the injection group reported significant improvements in pain, compared to 7 percent of those doing the home exercises and 13 percent of those who received the shock-wave therapy. But at four months, 51 percent of those given corticosteroid injections reported sustained improvements in pain, while 68 percent of patients in the shock wave group and 41 percent of the home training group reported significant improvements.

Finally, at 15 months, just 48 percent of patients given steroid shots said their pain was better, compared to 74 percent of the shock wave group and 80 percent of the home training group.

"The role of corticosteroid injection for greater trochanter pain syndrome needs to be reconsidered," Rompe and his colleagues say, adding that patients need to be informed of the "advantages and disadvantages of the treatment options, including the economic burden."

Given that shock wave therapy and home exercise training produced about the same results at 15 months, they add, the choice of which to offer patients could be made based on costs, because home exercise is less expensive.

Pregnancy complications tied to kids' poor thinking

Could high blood pressure-related complications during pregnancy be tied to thinking skills in children years later?

A study from Denmark hints at "a modest association" between such complications and poorer reasoning, intuition, and perception skills in young adult men, report Dr. Vera Ehrenstein, at Aarhus University Hospital, and colleagues.

The study compared intelligence tests measures for more than 17,000 men drafted into Danish military service. Of these men, tested at the age of 19, about 15 percent had poor thinking skills, measured by IQs below 85, the researchers report in the American Journal of Epidemiology.

The mothers of about 5 percent of the men in the study had either blood pressures above 140/90, protein in the urine, or swelling of the extremities. All of those are signs or symptoms of a life-threatening condition known as pre-eclampsia.

Poorer thinking skills were slightly more common among men whose mothers had any of those signs or symptoms. About 19 percent of the adults of affected mothers had poorer thinking skills, versus 15 percent among those whose mothers were not affected.

When the researchers accounted for being born small, which places infants at risk for delayed or impaired brain development, and for other factors, poor thinking skills were still as much as a third more likely among men whose mothers suffered from pre-eclampsia symptoms.

Ehrenstein's team notes the current findings cannot determine whether high blood pressure-related complications of pregnancy cause poorer thinking skills, nor why such complications would have any effect on those skills.

Coffee may lower endometrial cancer risk

Women dread a diagnosis of endometrial cancer, but those who drink at least two cups of caffeinated coffee a day may have a lower risk for this cancer of cells lining the uterus.

Coffee drinking seemed to particularly protect overweight and obese women, study co-author Dr. Emilie Friberg, at the Karolinska Intstituet in Stockholm, Sweden, told Reuters Health by email.

Friberg's team twice surveyed 60,634 Swedish women about their coffee intake - when they enrolled in the Swedish Mammography Cohort study between 1987 and 1990, and again in 1997.

During the 17 years, on average, that the researchers followed patients, 677 women - about 1 percent -- developed endometrial cancer. The average age at diagnosis was 67.

In the overall study group, those who daily drank 2 or more cups were significantly less likely to develop endometrial cancer, compared with those who drank fewer cups of coffee.

Each additional daily cup seemed tied to a 10 percent lower risk for endometrial cancer, after allowing for age and other factors potentially tied to endometrial cancer risk among all the women.

However, they observed the strongest effect among overweight and obese women, who, Friberg's team notes, have "the highest risk for endometrial cancer."

Each additional cup of coffee seemed to decrease endometrial cancer risk by 12 percent among overweight women and by 20 percent among obese women, Friberg and colleagues report in the International Journal of Cancer.

The investigators suggest that coffee may affect blood sugar, fat cells, and estrogen, all of which play a role in endometrial cancer. However, they write that the current findings should be confirmed in other populations.

In particular, "a study also including de-caffeinated coffee would make it possible to separate the effect of coffee and caffeine," Friberg said.

Pregnancy After Age 50 Poses Fetal Risks

Childbearing beyond maternal age 50 is associated with significantly increased risks for the fetus, suggest results of a study published Friday in the journal Obstetrics and Gynecology.

Women in the 50+ age range who are thinking of becoming pregnant should receive "special counseling both before and after conception so that they become informed of the increased risks involved," Dr. Hamisu M. Salihu and colleagues from the University of Alabama at Birmingham write.

There is a lack of reliable information on pregnant women in their fifties, Salihu told. He and his colleagues reviewed all 12,066,854 deliveries in the U.S. between 1997 and 1999, categorizing mothers as young (age 20-29), mature (age 30-39), very mature (age 40 to 49), and older (age 50 or more). There were 539 deliveries in the older group.

In this, the "first population-based nationwide study, we found that fetal growth, fetal maturity and survival were significantly compromised among 50-year old mothers in comparison to their younger counterparts, including women in their forties," Salihu said.

Older mothers were two to three times more likely to have infants that were growth-impaired, immature or stillborn.

"We were surprised with our findings," Salihu commented. "We had thought that 50-year-old moms would have the same level of risk as women in their forties."
"Pregnancy beyond age 50 may represent a distinct obstetric entity with a risk pattern that differs from that observed for mature and very mature mothers," the team writes.

While the researchers did not specifically address the use of assisted reproduction technologies in the study, most of the pregnancies in the 50+ group were artificially induced.

"Because of the risks, assisted reproduction technology clients need to be adequately informed of the possible implications of achieving pregnancy beyond age 50, so that they are well-equipped to make an informed decision," Salihu advised.
"Our study also highlights the need for a broad-based national policy discourse to generate guidelines that will eventually govern the use of assisted reproduction technologies among women in their fifties," he added.

It is also noteworthy that while most women in the 50+ group were married with at least 12 years of education, "surprisingly," only about half of them received adequate prenatal services.

Fruits, Veggies Cut Breast Cancer Risk

A diet rich in fruits and veggies can help protect against breast cancer.

A study by Oregon Health and Science University researchers found women who eat at least four servings of fruits and vegetables have a 50 percent lower risk of breast cancer than women who consume no more than two such servings each day.
They reached that conclusion after examining the diets of 378 women with breast cancer and the diets of 1,070 cancer-free women. All the women, living in Shanghai, China, filled out questionnaires that asked about their intake of 108 individual food items, fried and restaurant food, dietary changes, and the use of nutrient supplements and Chinese herbal medicines.

Along with its finding about the cancer benefits from eating more fruits and vegetables, the study also found that eating at least six eggs a week was also associated with reduced risk of breast cancer. But no association was found between intake of soy or soy products and breast cancer risk.

The study was presented this week at the American Association for Cancer Research conference in Phoenix.

"This study provides further evidence that low fruit and vegetable intake in the Western diet may be a major risk factor in developing breast cancer," lead author Jackilen Shannon, an assistant professor of public health and medicine, says in a prepared statement.

"Women should modify their diet to include more fruits and vegetables to help prevent breast cancer," Shannon says.

Faulty Gene Doubles Risk of Prostate Cancer

Men who are missing sections of the CHEK2 kinase gene -- which programs production of a chemical that alerts the body to DNA damage -- are nearly twice as likely to develop prostate cancer as other men, a new study finds.

Researchers assessed 2,000 Polish men who were diagnosed with prostate cancer between 1999 and 2005, and compared them to 5,500 healthy people.

The missing sections (exons 9 and 10) were noted in 15 (0.8 percent) of the prostate cancer patients and in 24 (0.4 percent) of the healthy people. In addition, the researchers noted the missing sections of the gene in four of the 249 men with a family history of prostate cancer.

The study authors calculated that the deletion of these sections of the gene nearly doubles risk of prostate cancer in general, and quadruples the risk in men with a family history of the disease.

This deletion may be fairly common among men from eastern Europe and the Balkans, the study authors added.

The research was published ahead of print in the Journal of Medical Genetics.

Fish oils supplements could cool violent children

Fish oil supplements could help cool and control the anger of children with behavioural problems, says a new study.

Researchers studied behavioural problems and emotional difficulties, including autism of 28 boys (10 to 16 years old) studying at Eaton Hall Special School in Norwich and found that they had fewer violent outbursts while taking daily doses of the fatty acids, reported the online edition of Daily Mail.

In the six months prior to the trial, students had 112 angry outbursts which required teachers to physically restrain them. This dropped to 36 during the six-month study, when they were given 'Eye q' supplements alongside healthier school meals.

The capsules, made by Equazen, contain omega-3 fish oils and omega-6 evening primrose oil.

The biggest impact was on pupils who had been involved in the most violent incidents. One youngster had to be restrained 10 times prior to the trial but recorded no incidents while taking the capsules, the researchers claimed.

The study suggests students become better able to control their anger, as teachers were less likely to have to intervene to calm them.

Lianne Quantrill, project co-coordinator at Eaton Hall, said: "These statistics suggest that as a result of the new health programme and supplements the children were able to control their anger better. So while outbursts still occurred, they were less extreme, requiring minimal physical intervention from a teacher."

Madeleine Portwood, an educational psychologist involved in a study in Durham, had earlier found the supplements significantly improved short-term memory among primary pupils and enhanced achievements in reading and spelling.

New device may help heal a failing heart

A new artificial pump along with the intake of certain drugs could enable a failing heart to rest and repair itself, say scientists in Britain.

The temporary pumps, known as Left Ventricular Assist Devices (LVADs), are currently used in patients with severe heart failure while they await transplantation, reported the online edition of BBC News.

The LVAD takes on the work of one of the heart's four chambers, the left ventricle, which pumps oxygen-rich blood from the heart around the body.

Experts from Imperial College London and the Royal Brompton and Harefield NHS Trust administered the combination therapy to 15 severely ill patients and found that 11 of them recovered.

Eight of these patients were alive, free of heart failure and did not need a transplant for more than four years.

Magdi Yacoub, from the Heart Science Centre at the Royal Brompton and Harefield NHS Trust, said: "We are impressed by the dramatic, sustained improvement in the condition of these severely ill patients. The improvement observed was far greater than what has been reported to date for any other therapy.

"The study also highlights the fact that 'end stage' heart failure can be reversed and that the heart has the capacity to regenerate itself."

Many patients are often unable to get a new heart due to a shortage of donor organs. The new therapy, however, has the potential to ease the pressure on the waiting list while also offering patients a better alternative to a donor heart - their own healthy heart.

The British Heart Foundation (BHF), which supported the research, stressed that the technique was only suitable for certain patients.

"It could help some who develop severe heart failure as a result of a disease that weakens their heart muscle, but not those with the more common coronary heart disease, which damages the heart as a result of a lack of blood supply," explained Peter Weissberg, medical director of the BHF.

He added: "The study raises several important questions which will need answering in future clinical studies - we need to know exactly what part of this treatment regimen is responsible for the recovery of heart function, and which patients can benefit from it."

High Cholesterol May Weaken Bones

It's no secret that high cholesterol increases the risk of heart disease, but new research from Italy suggests that it may also be bad for the bones.

In a study of postmenopausal women, those with higher levels of the "bad" form of cholesterol were much more likely to show signs of bone thinning than women with normal cholesterol.

The findings do not prove that high cholesterol is to blame for bone thinning, but the results do provide a possible explanation for studies suggesting that cholesterol-lowering drugs called statins protect bones, researchers report in the journal Obstetrics and Gynecology.

Very little is known about how cholesterol levels may affect the risk of developing the brittle-bone disease osteoporosis. Studies that have examined the relationship between levels of LDL cholesterol - the "bad" type of cholesterol - and the risk of bone thinning have produced mixed results.

In the new study, a team led by Dr. Andrea Poli at the University of Milan measured bone density and cholesterol levels in 1,303 women ages 45 to 65 who had been through menopause.

The women were divided into three groups based on LDL levels: normal (129 mg/dL or below), moderately high (130 to 159 mg/dL) and high (160 mg/dL and above).
Compared to women with normal LDL levels, women with high levels were 74 percent more likely to have osteopenia, a bone-thinning condition just short of osteoporosis, Poli's team reports.

Osteopenia was more common in older women and in those with a low body mass index, or BMI, which is a measure of weight in relation to height. And the longer it had been since menopause, the greater were a woman's odds of having bone thinning, according to the report.

High LDL levels may weaken bones by promoting the breakdown of bone, according to the report.

But Poli's team cautions that the study is not the final word on the relationship between LDL and bone thinning. In fact, one study found that men with higher LDL levels tended to have stronger bones.

In other findings, levels of HDL, or "good," cholesterol were not related to bone density.

Fatigue Often Precedes Heart Attacks in Women

Most women who have a heart attack have experienced telltale symptoms, such as extreme fatigue and sleep disturbance, during the weeks leading up to the attack, investigators report.

Chest pain, however, is not usually one of these symptoms.

According to their report the American Heart Association's journal Circulation, Dr. Jean C. McSweeney and her colleagues believe that doctors sometimes don't recognize that a woman is having a heart attack because the symptoms don't match those of men, who more commonly experience severe chest pain.

To further investigate, McSweeney, with the University of Arkansas for Medical Sciences, Little Rock, and colleagues telephoned 515 women who had had a heart attack within the previous 4 to 6 months. The women were asked what symptoms they experienced before and during the heart attack.

Ninety-five percent of the subjects reported unusual symptoms during the weeks leading up to the heart attack.

"These are symptoms that change in intensity or frequency, or they're a brand new appearance, starting in the period prior to their heart attack," McSweeney told.
The most frequently reported were unusual fatigue (71 percent) and sleep disturbance (48 percent). Shortness of breath, indigestion and anxiety were also common. Less than a third reported chest discomfort, and when they did it was most often described as pressure, aching or tightness.

"A lot of women ignore these symptoms, thinking it's just because they're 'getting older,"' McSweeney commented. "But even when they do go to a physician, their physicians may overlook these symptoms."

These warning signs can be overwhelming, she said, and shouldn't be shrugged off. Some of the subjects said they had been so tired they couldn't finish making a bed without having to rest. Others said they had trouble climbing stairs.
"Women need to explain to their doctor how these symptoms are impacting their daily life. They should specifically say what they can't do, so that physicians can judge how severe this fatigue is."

When the heart attack occurred, the acute symptoms most commonly reported were shortness of breath, weakness, unusual fatigue, cold sweat and dizziness. If they had chest discomfort, they rarely described is as "pain."

Most women also had conventional risk factors, such as a history of cardiovascular disease, diabetes and high blood pressure.

"I'm trying to get women and physicians to look not only at these symptoms but also at their cardiovascular risk factors, such as hypertension or a strong family history of heart disease," to decide what diagnostic tests should be performed, McSweeney concluded.

Steroids Help Diseased Lungs Breath Easier

While inhaled steroids undoubtedly help patients with asthma, doctors have seesawed on whether these drugs are useful for a common lung problem called chronic obstructive pulmonary disease (COPD).

Now, a new report suggests that such treatment -- particularly at high doses -- does, in fact, help patients breath better.

COPD encompasses a variety of lung diseases, the most common being emphysema and bronchitis. The condition is strongly tied to smoking and is currently the fourth leading cause of death in the US.

Dr. E. R. Sutherland, from the University of Colorado Health Sciences Center in Denver, and colleagues analyzed data from 8 studies to determine if inhaled steroids improved the breathing of COPD patients. Each trial lasted at least 2 years and nearly 4000 patients were included in the analysis.

The results are reported in medical journal Thorax.

Over time, COPD patients usually experience a drop in their ability to move air in and out of their lungs. The researchers found that treatment with inhaled steroids slowed the rate at which this ability fell. Moreover, the benefits were greatest when high steroid doses were used.

The researchers conclude that these findings suggest a potential role for inhaled steroids in modifying the natural course of COPD.

An accompanying editorial describes the current study as a welcome addition to the work on inhaled steroids in patients with COPD.

New studies should concentrate on the optimal steroid dose, when steroids should be started, and what other drugs work best with steroids, the editorial notes.
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