January 21, 2010, 8:21 AM CT
COPD and heart function
A common lung condition, COPD (chronic obstructive pulmonary disease) diminishes the heart's ability to pump effectively even when the disease has no or mild symptoms, as per research reported in the Jan. 21 issue of the New England Journal (NEJM)
The study is the first time scientists have shown strong links between heart function and mild COPD. The research was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Scientists have long known that severe cases of COPD have harmful effects on the heart, decreasing its ability to pump blood effectively. The new results suggest that these changes in the heart occur much earlier than previously believed, in mild cases and even before symptoms appear. One in five Americans over the age of 45 has COPD, but as a number of as half of them may not even be aware of it.
"This study shows that COPD, even in its mildest form, is linked to diminished heart function," said NHLBI Acting Director Susan B. Shurin, M.D. "We now have evidence that the presence of even mild COPD may have important health implications beyond the lungs."
COPD is the fourth leading cause of death in the United States, and it is strongly linked to smoking. COPD often involves destruction of lung tissue, called emphysema, as well as narrowed airways, persistent cough, and mucus production, known as chronic obstructive bronchitis. These abnormalities impair the flow of air in the lungs and make breathing more difficult.........
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January 21, 2010, 8:20 AM CT
Herpes medication does not reduce risk of HIV transmission
A five-year international multi-center clinical trial has observed that acyclovir, a drug widely used as a safe and effective therapy taken twice daily to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2. The results of the study are reported in the New England Journal (NEJM)
online today, and will appear in the Feb. 4, 2010 issue of the publication.
Up to 90% of people with HIV infection also have HSV-2 infection. Most people who are infected with HSV-2 do not know they have the virus because symptoms can be mild or absent. HSV-2 infection can cause recurrent sores and breaks in the skin of the genital region, which can be mild and often go unnoticed. HSV-2 infection also attracts immune cells called CD4 T-cells to the genital region, which HIV uses to establish or pass infection.
Multiple studies have shown that frequent genital herpes recurrences increase the amount of HIV in the blood and genital tract. The HIV virus is also shed from genital herpes ulcers and persons with such ulcers transmit HIV to others more efficiently. Five preliminary studies showed that it is possible to decrease the amount of HIV in the blood and genital tract through therapy to suppress HSV-2, but these studies did not measure whether this translated into a reduction in HIV transmission. Scientists had hoped that acyclovir's ability to suppress the herpes virus, which causes symptomatic genital sores and breaks in the skin but also frequently is active without symptoms, could reduce the likelihood of sexual transmission of HIV from a person with HIV and HSV-2. The study is the first to determine whether twice daily use of acyclovir by individuals who are infected with both HSV-2 and HIV reduced the transmission of HIV to their sexual partners. The authors conclude that daily acyclovir treatment did not reduce the risk of transmission of HIV, in spite of the fact that acyclovir reduced plasma HIV RNA by a log and the occurrence of genital ulcers due to HSV-2 by 73%.........
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January 21, 2010, 8:19 AM CT
Dopamine Medications Affect Learning and Attention
A new brain-based computational model is helping to understand how Parkinson's disease and dopamine medications-used to treat motor symptoms caused by the disease- can affect learning and attention.
As reported in a forthcoming article in the Journal of Cognitive Neuroscience, http://www.mitpressjournals.org/doi/pdf/10.1162/jocn.2010.21420, a new computational model, developed by Drs. Ahmed Moustafa and Mark Gluck, at the Center for Molecular and Behavioral Neuroscience at Rutgers University, Newark, has shown how Parkinson's disease affects attentional performance during learning.
The same model also shows that dopamine medications enhance attentional performance in Parkinson's patients in agreement with past observations. Future lab experiments with Parkinson's patients will be conducted by Moustafa and Mark Gluck to test further model predictions.
Parkinson's is a disease that mainly affects dopamine levels in a brain area known as the basal ganglia, which is important for motor control. Hence, damage to this area leads to movement disorders, including shaking and difficulty moving--key symptoms of Parkinson's disease.
Over the past two decades, it became known to neurologists and experimental neuroresearchers that Parkinson's disease also affects non-motor functions, including memory, learning, and attention. Impairment in these processes affect the quality of life of the patients, thus, understanding the neural basis of motor and non-motor dysfunction in Parkinson's disease is equally important.........
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January 21, 2010, 8:18 AM CT
Stain repellent may cause thyroid disease
A study by the University of Exeter and the Peninsula Medical School for the first time links thyroid disease with human exposure to perfluorooctanoic acid (PFOA). PFOA is a persistent organic chemical used in industrial and consumer goods including nonstick cookware and stain- and water-resistant coatings for carpets and fabrics.
Reported in the journal Environmental Health Perspectives
, The study revealed that people with higher concentrations of PFOA in their blood have higher rates of thyroid disease. The scientists analysed samples from the US Centers for Disease Control and Prevention's nationally representative National Health and Nutrition Examination Survey (NHANES).
Tamara Galloway, a professor Ecotoxicology at the University of Exeter and the study's senior author, says: "Our results highlight a real need for further research into the human health effects of low-level exposures to environmental chemicals like PFOA that are ubiquitous in the environment and in people's homes. We need to know what they are doing".
"There have long been suspicions that PFOA concentrations might be associated with changes in thyroid hormone levels," adds study author, David Melzer, a professor of Epidemiology and Public Health at the Peninsula Medical School. "Our analysis shows that in the 'ordinary' adult population there is a solid statistical link between higher concentrations of PFOA in blood and thyroid disease."........
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January 21, 2010, 8:16 AM CT
Heart Attack Victims Who Have ECGs
A recent study observed that individuals experiencing chest pain who had electrocardiogram (ECG or EKG) evaluations previous to arriving at the hospital experienced a significantly reduced time-to-treatment or door-to-balloon (D2B) time. When EMS personnel responding to cardiac emergencies obtained ECGs of the subjects in the field, the mean D2B time was 60.2 minutes compared with 90.5 minutes for in-hospital ECGs. This advanced evaluation significantly reduced D2B by allowing patients to bypass the ER and be transported directly to the cardiac catheterization laboratory (CCL) for reperfusion therapy. Details of the study appear in the January 2010 issue of Catheterization and Cardiovascular Interventions, published by Wiley-Blackwell on behalf of The Society for Cardiovascular Angiography and Interventions.
ST-segment elevation myocardial infarction (STEMI), when a blood clot totally obstructs a coronary artery, is treated with reperfusion treatment to reestablish blood flow as quickly as possible. Previous studies showed that rapid time-to-treatment with primary percutaneous coronary intervention (PPCI), previously known as angioplasty, was linked to lower mortality rates, and for each 30 minutes of delay the relative risk of 1 year mortality increased by 7.5%. In an effort to improve patient survival rates, the American College of Cardiology (ACC) and the American Heart Association (AHA) developed national guidelines that state hospitals treating STEMI patients with PPCI should strive to achieve a median door-to-balloon time of less than 90 minutes.........
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January 19, 2010, 8:37 AM CT
Risks And Benefits of Bariatric Surgery
A computerized model suggests that most morbidly obese individuals would likely live longer if they had gastric bypass surgery, as per a report in the recent issue of Archives of Surgery
, one of the JAMA/Archives journals. However, the best decision for individual patients varies based on factors such as age, increasing body mass index and the effectiveness of surgery.
An estimated 5.1 percent of the U.S. population is morbidly obese, often defined as having a body mass index (BMI) of 40 or higher, as per background information in the article. Available evidence suggests that dietary, behavioral and pharmacologic therapys frequently do not result in meaningful weight loss for individuals in this group. Bariatric surgery may be the only effective treatment for promoting clinically significant weight loss and improving obesity-related health conditions for the morbidly obese. However, the procedure is not without risk, including in-hospital death.
Daniel P. Schauer, M.D., M.Sc., of the University of Cincinnati Academic Health Center, and his colleagues used two nationally representative surveys and a recent large observational trial to construct a model estimating the benefits and risks of gastric bypass surgery for individuals with morbid obesity. The model included data from almost 400,000 individuals nationwide to estimate the risk of death from obesity and its complications; data from 23,281 patients undergoing bariatric surgery to calculate in-hospital death rates following the procedures; and outcomes from participants in a seven-year study to determine the effects of surgery on survival and to calibrate and validate the model.........
Posted by: JoAnn Read more Source
January 19, 2010, 8:35 AM CT
Costs of psoriasis treatment
Findings from a cost model suggest that expenses for systemic psoriasis treatment appear to be increasing at a faster rate than inflation, and newer biologically derived therapys are more expensive than traditional systemic therapies, as per a report in the recent issue of Archives of Dermatology
, one of the JAMA/Archives journals.
Psoriasis is a chronic autoimmune disease that affects an estimated 4.5 million to 7.5 million Americans, costing the health care industry approximately more than $3 billion annually, as per background information in the article. The severity of the disease varies, as do the therapiessome patients with mild, localized disease can use creams or other topical agents, whereas those with more extensive disease typically require phototherapy (exposure to ultraviolet light) or systemic therapies (substances that travel through the bloodstream, such as oral medications).
Vivianne Beyer, M.D., now at St. Vincent Hospital, Indianapolis, and Stephen E. Wolverton, M.D., of the Indiana University School of Medicine, Indianapolis, constructed a cost model to analyze the current total cost of systemic treatment for psoriasis. Costs for each treatment were assessed by using the average wholesale price of each drug, as paid by third-party payers, and costs of related office visits, laboratory tests and related monitoring procedures were determined using Medicare fee schedules. Trends were analyzed by calculating the change in average wholesale price from the prior year and then were in comparison to the Consumer Price Index for urban areas.........
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January 19, 2010, 8:24 AM CT
Staring, sleepiness, other mental lapses
Cognitive fluctuations, or episodes when train of thought temporarily is lost, are more likely to occur in older persons who are in the process of developing Alzheimer's disease than in their healthy peers, as per researchers at Washington University School of Medicine in St. Louis.
Cognitive fluctuations include excessive daytime sleepiness, staring into space and disorganized or illogical thinking.
"If you have these lapses, they don't by themselves mean that you have Alzheimer's," says senior author James Galvin, M.D., a Washington University neurologist at Barnes-Jewish Hospital. "Such lapses do occur in healthy elderly adults. But our results suggest that they are something your doctor needs to consider if he or she is evaluating you for problems with thinking and memory".
The study appears in the Jan. 19 issue of Neurology
Earlier research had associated cognitive fluctuations with another form of dementia called dementia with Lewy bodies, but little information existed on the potential for links between Alzheimer's and such lapses.
Data for the newly released study came from Alzheimer's disease assessments of 511 elderly adults with memory problems. Average age of the participants was 78. Scientists gave participants standard tests of thinking and memory skills. They also interviewed participants and a family member, checking for prolonged daytime sleepiness, drowsiness or lethargy in spite of sufficient sleep the night before, periods of disorganized or illogical thinking, or instances of staring into space for long periods of time.........
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January 19, 2010, 8:20 AM CT
Would you experience appendicitis?
Would you experience appendicitis?.
And if you do, is it necessarily an emergency that demands immediate surgery?
Yes and no, as per a newly released study by UT Southwestern Medical Center surgeons and physicians.
The scientists reviewed data over a 36-year period from the National Hospital Discharge Survey and concluded in a paper appearing in the recent issue of Archives of Surgery
that appendicitis appears to be caused by undetermined viral infection or infections, said Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern and senior author of the report.
The review of hospital discharge data runs counter to traditional thought, suggesting that appendicitis doesn't necessarily lead to a burst appendix if the organ is not removed quickly, Dr. Livingston said.
"Just as the traditional appendix scar across the abdomen is fast becoming history, thanks to new single-incision surgery techniques that hide a tiny scar in the bellybutton, so too may the conventional wisdom that patients with appendicitis need to be operated on as soon as they enter the hospital," said Dr. Livingston. "Patients still need to be seen quickly by a physician, but emergency surgery is now in question".
Appendicitis is the most common reason for emergency general surgery, leading to some 280,000 appendectomies being performed annually.........
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January 18, 2010, 8:20 AM CT
Genetic Risk Factor for Parkinson's Disease
Scientists have identified a new genetic risk factor for Parkinson's disease. Photo: ABDA
An international team of doctors and human geneticists has identified a new genetic risk factor for Parkinson's disease. The institutions involved in the study were the Institute of Human Genetics of Helmholtz Zentrum München and Technische Universität München, the Neurological Clinic of Ludwig-Maximilians-Universität Munich (LMU) and the Mitochondrial Research Group of Newcastle University, Newcastle upon Tyne, UK.
"Our study reveals the interaction of genetic and environmental factors such as dietary habits in the pathogenesis of Parkinson's disease," explained Dr. Matthias Elstner of the Neurological Clinic of LMU and Helmholtz Zentrum München, main author of the study. In addition, this genome-wide expression and association study confirms that vitamin B6 status and metabolism significantly influence both disease risk and treatment response (Annals of Neurology, January, 2010).
Researchers of the two Munich universities and Helmholtz Zentrum München investigated neurons in the brain to determine which genes modify their activity in Parkinson's disease. Among other findings, the research group detected increased activity of the pyridoxal kinase gene. In a subsequent international cooperation project, the scientists compared this gene in over 1,200 Parkinson patients with the genetic data of more than 2,800 healthy test subjects. In doing so, they discovered a gene variant which increases the risk for Parkinson's disease and which may lead to a modified quantity or activity of the enzyme pyridoxal kinase (PDXK) in the brain. In combination with genetic association analysis, the innovative method used here - single cell expression profiling of dopaminergic neurons - opens up new possibilities for analyzing genetic risk factors.........
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