TUESDAY, Aug. 4 (HealthDay News) -- The things that are bad for your heart in the middle years of life -- high blood cholesterol, high blood pressure, smoking, diabetes -- are bad for your brain in later years, new research indicates.
High cholesterol levels in midlife were associated with an increased risk of Alzheimer's disease and other forms of dementia many years later, according to scientists in California and Finland, who tracked almost 10,000 men and women for four decades.
"We found an association not only with high blood cholesterol, but also borderline high levels," said study senior author Rachel Whitmer, who is a research scientist and epidemiologist at the Kaiser Permanente division of research in Oakland. Researchers at the University of Kuopio in Finland also participated in the study.
Total cholesterol levels of 240 milligrams per deciliter or higher in middle age were associated with a 66% higher incidence of Alzheimer's disease decades later, the researchers found.
"But that wasn't a cutoff point," Whitmer said. "Around a level of 200, the risk of Alzheimer's disease started to go up."
For those in midlife with borderline-high readings between 200 mg/dl and 239 mg/dl, the increased incidence was 52%, according to the study, which was published online in the journal Dementia and Geriatric Cognitive Disorders and funded by the U.S. National Institutes of Health.
The Californians in the study were more ethnically diverse than the Finnish participants, and included blacks, Latinos and Asians, but "the association between high cholesterol and dementia was the same across all ethnic groups," Whitmer noted.
The other research, reported in the August issue of the Journal of Neurology, Neurosurgery and Psychiatry, followed more than 11,000 American participants in a study of atherosclerosis, the hardening of the arteries that can lead to heart attack, stroke and other major cardiovascular problems.
Researchers from the University of Minnesota, the University of North Carolina, John Hopkins and the University of Mississippi Medical Center measured smoking, high blood pressure and diabetes among the participants from 1990-1992. They then tracked them until 2004 to see how many were hospitalized for dementia.
Smokers were 70% more likely to develop dementia than nonsmokers; those with high blood pressure were 60% more likely, and those with diabetes were twice as likely as those without diabetes to develop dementia. However, there was no link between midlife obesity and later dementia.
The idea behind the study was that "if we find risk factors for dementia, maybe we can develop new treatments, preventive programs to reduce the risk of dementia later in life," said study author Dr. Alvaro Alonso, an assistant professor of epidemiology at the University of Minnesota's School of Public Health.
Post-mortem studies of brains of people who had dementia often show damage to small arteries, he said. "Maybe there have been small strokes, which are not great enough to cause clinical symptoms, but in time can lead to dementia," Alonso said.
Measures against dementia now usually start when its first signs are detected, Alonso said. "Showing that cardiovascular risk factors earlier in life have an impact on dementia later in life gives another reason why we need to intervene with those cardiovascular risk factors," he said.
The findings of both studies "are an extension of what already has been found," said Michelle Mielke, an assistant professor of psychiatry at Johns Hopkins University, who has done research on the causes of dementia.
"Both papers really point out the need to intervene in vascular factors in midlife," Mielke said. "They are as important in the risk of dementia as they are in the risk of heart disease and stroke."
No new approach is needed, she said, just a renewed emphasis on "exercise, diet, that kind of stuff."
SOURCES: Rachel Whitmer, Ph.D, research scientist, epidemiologist, Kaiser Permanente division of research, Oakland, Calif.; Alvaro Alonso, M.D., assistant professor, epidemiology, University of Minnesota School of Public Health, Minneapolis; Michelle Mielke, Ph.D, assistant professor, psychiatry, Johns Hopkins University, Baltimore; August 2009 Journal of Neurology, Neurosurgery and Psychiatry; Dementia and Geriatric Cognitive Disorders, online
Copyright © 2009 ScoutNews, LLC. All rights reserved.
10 Ağustos 2009 Pazartesi
Benefits of Omega-3 Fatty Acids Prompt New Dosage for Heart Health
By Jennifer Warner
WebMD Health News
Reviewed By Brunilda Nazario, MD
Aug. 3, 2009 -- A healthy dose of omega-3 fatty acids such as DHA and EPA not only prevents heart disease in healthy people, it also reduces the risk of heart attack in people with existing heart disease, according to a new study. That finding has researchers recommending people add a daily dose of omega-3 fatty acids to their diet.
Based on a review of several large studies involving more than 40,000 people, researchers say the benefits of omega-3 fatty acids to heart health are clear and merit taking action to prevent unnecessary deaths from heart disease.
The body doesn't produce fatty acids, so researchers recommend healthy people consume 500 milligrams daily of EPA plus DHA, and people with known heart disease or heart failure should aim for nearly twice that amount (at least 800 to 1,000 milligrams daily).
"There are clear health and heart benefits associated with increasing one's intake of foods that are rich in Omega-3s, including oily fish like salmon, sardines, trout, herring, and oysters" researcher Carl Lavie, MD, medical director of cardiac rehabilitation and prevention at Ochsner Medical Center in New Orleans, says in a news release. "Patients should talk with their doctors about whether a fish oil supplement is needed to get the right amount and, in turn, benefit from the associated cardiovascular protection."
DHA and EPA Help Heart
The study, published in the Journal of the American College of Cardiology, reviewed the findings of four studies comparing the benefits of omega-3 fatty acids in heart disease prevention over the past 30 years.
The results showed that omega-3 fatty acids' strongest protective effect appears to be in people with established heart disease after a heart attack. In these people, a daily dose of DHA and EPA is associated with a 30% reduction in the risk of heart-related death.
But researchers say healthy people can also benefit from including omega-3s in their diet. Research shows a diet rich in omega-3s can also reduce the risk of hardening of the arteries (atherosclerosis), irregular heartbeat (arrhythmia), heart attack, sudden cardiac death, and heart failure.
Most of the evidence for the benefits of fish oil comes from the use of DHA (docosahexaenoic acid) and EPA (eiosapentaenoic acid), which are the long-chain fatty acids in the omega-3 family.
Lavie says EPA and DHA work by getting into the membranes of cells and by doing so may help improve the heart's electrical activity, muscle tone, plaque stabilization, blood pressure, and other aspects of heart health.
The study also showed that there was a smaller benefit of omega-3 fatty acids in preventing 9% of heart failure deaths in people with heart failure who took omega-3 supplements. Given heart failure patients' grave prognosis, Lavie says this is impressive.
"If we translate this finding, it means that we only need to treat 56 patients for four years to prevent one death," Lavie says. "And we are talking about a very safe and relatively inexpensive therapy."
SOURCES: Lavie, C. Journal of the American College of Cardiology, Aug. 11, 2009; vol 54: pp 585-594. News release, American College of Cardiology.
©2009 WebMD, LLC. All Rights Reserved.
WebMD Health News
Reviewed By Brunilda Nazario, MD
Aug. 3, 2009 -- A healthy dose of omega-3 fatty acids such as DHA and EPA not only prevents heart disease in healthy people, it also reduces the risk of heart attack in people with existing heart disease, according to a new study. That finding has researchers recommending people add a daily dose of omega-3 fatty acids to their diet.
Based on a review of several large studies involving more than 40,000 people, researchers say the benefits of omega-3 fatty acids to heart health are clear and merit taking action to prevent unnecessary deaths from heart disease.
The body doesn't produce fatty acids, so researchers recommend healthy people consume 500 milligrams daily of EPA plus DHA, and people with known heart disease or heart failure should aim for nearly twice that amount (at least 800 to 1,000 milligrams daily).
"There are clear health and heart benefits associated with increasing one's intake of foods that are rich in Omega-3s, including oily fish like salmon, sardines, trout, herring, and oysters" researcher Carl Lavie, MD, medical director of cardiac rehabilitation and prevention at Ochsner Medical Center in New Orleans, says in a news release. "Patients should talk with their doctors about whether a fish oil supplement is needed to get the right amount and, in turn, benefit from the associated cardiovascular protection."
DHA and EPA Help Heart
The study, published in the Journal of the American College of Cardiology, reviewed the findings of four studies comparing the benefits of omega-3 fatty acids in heart disease prevention over the past 30 years.
The results showed that omega-3 fatty acids' strongest protective effect appears to be in people with established heart disease after a heart attack. In these people, a daily dose of DHA and EPA is associated with a 30% reduction in the risk of heart-related death.
But researchers say healthy people can also benefit from including omega-3s in their diet. Research shows a diet rich in omega-3s can also reduce the risk of hardening of the arteries (atherosclerosis), irregular heartbeat (arrhythmia), heart attack, sudden cardiac death, and heart failure.
Most of the evidence for the benefits of fish oil comes from the use of DHA (docosahexaenoic acid) and EPA (eiosapentaenoic acid), which are the long-chain fatty acids in the omega-3 family.
Lavie says EPA and DHA work by getting into the membranes of cells and by doing so may help improve the heart's electrical activity, muscle tone, plaque stabilization, blood pressure, and other aspects of heart health.
The study also showed that there was a smaller benefit of omega-3 fatty acids in preventing 9% of heart failure deaths in people with heart failure who took omega-3 supplements. Given heart failure patients' grave prognosis, Lavie says this is impressive.
"If we translate this finding, it means that we only need to treat 56 patients for four years to prevent one death," Lavie says. "And we are talking about a very safe and relatively inexpensive therapy."
SOURCES: Lavie, C. Journal of the American College of Cardiology, Aug. 11, 2009; vol 54: pp 585-594. News release, American College of Cardiology.
©2009 WebMD, LLC. All Rights Reserved.
Forehead Lift Cures Migraine Patients
Reviewed By Brunilda Nazario, MD
July 31, 2009 -- Stacy Porter, 29, can't remember a time when she didn't suffer from crippling, relentless migraines before having the surgery that changed her life eight years ago.
"I was diagnosed with migraines when I was 2 years old," the New Philadelphia, Ohio, marketing executive tells WebMD. "I had about 15 days a month of severe migraine pain."
Her symptoms included throbbing pain in her temples, nausea, and sensitivity to light so severe she remembers wearing sunglasses to more than one final exam in high school and college.
None of the drugs used to prevent migraines helped, so her only relief came from medications that eased the pain but left her feeling drugged and out of it.
That all changed at age 21 when she had a surgery similar to that typically performed to remove crow's feet.
"After that I never had another migraine," she says.
Plastic surgeon Bahman Guyuron, MD, of Case Western Reserve University, says Porter's results are common, and his newly published study backs up the claim.
Forehead Lift Lifts Migraines
Guyuron has treated more than 400 migraine patients with a modified version of a traditional forehead lift over the last decade, and he tells WebMD that the vast majority of them have shown dramatic improvement.
His newly published study was designed to convince critics still skeptical of using plastic surgery to treat migraines.
Guyuron and colleagues randomly assigned 75 patients with migraine trigger sites in just one area to receive either real or sham surgery. The patients were not told which type of surgery they were getting.
In the real surgery group, nerves were cut at specific migraine trigger sites. In some cases, like Porter's, the nerve was the same one cut to eliminate crow's feet. In others, the nerve was the same one cut to ease frown lines on the forehead.
The surgery works like Botox injections -- now widely used, though not approved, for the treatment of migraines.
In fact, patients in the active-surgery group got Botox injections first to determine if they were good surgical candidates.
In all, 49 patients had the actual surgery and 26 had the sham surgery.
One year later, 83% of the actual surgery group reported at least a 50% reduction in migraines, compared to 57% of the sham surgery group.
Even more surprising, 57% of actual surgery patients reported complete elimination of migraines, compared to just 4% of sham surgery patients.
The study appears in the August issue of the journal Plastic and Reconstructive Surgery.
"You don't see results like this in migraine studies," Guyuron says. "Even the most skeptical people will have to accept there is something to this."
Surgery Not for Everyone
But surgery is not a good option for patients who have infrequent migraines and those who respond to preventive treatments, he says.
"We are talking about 10% to 15% of migraine patients who would be good candidates for surgery," he says.
Neurologist Richard B. Lipton, MD, who directs the headache unit at Montefiore Medical Center in the Bronx, says the study's design and its dramatic outcome helped convince him the surgical approach is legitimate.
"I started out quite skeptical about this," he says. "But despite my best efforts not to be, I'm pretty excited about the results."
Lipton did express concern that the study participants may have actually known which treatment they were getting, which might have affected the results.
Alexander Mauskop, MD, who directs the New York Headache Center, had the same reservation about the trial.
Mauskop was one of the first headache specialists in the nation to routinely use Botox for migraines, and he now treats between 60 and 70 patients a month, with a 70% response rate.
Patients typically get Botox injections every three months, at a cost of $750 to $1,000 per injection.
"The problem I have with surgery is that headaches come and go," he says. "They may go away with menopause or at some other time. Surgery is a permanent treatment for a condition that is rarely permanent."
Mauskop offers his patients many treatment options ranging from traditional drug therapies to alternative approaches like acupuncture.
Robert Kunkel, MD, has treated migraines for four decades at the Cleveland Clinic, and he serves on the board of the National Headache Foundation.
He tells WebMD he has seen several surgical approaches come and go during his career.
"There is always a lot of excitement, but none has really lasted," he says.
But Porter says there is no doubt in her mind that, like her, many, many patients with intractable migraines can be helped with the surgery.
"It completely changed my life," she says. "I went back to see Dr. Guyuron for checkups for seven years, first every month and then less frequently. And he and I both got teary-eyed every time I went in."
SOURCES: Guyuron, B., Plastic and Reconstructive Surgery, August 2009; online edition. Bahman Guyuron, MD, professor and chairman, department of plastic surgery, University Hospitals Case Medical Center, Cleveland, Ohio. Richard B. Lipton, MD, director, Montefiore Headache Unit, Montefiore Medical Center, Bronx, N.Y. Alexander Mauskop, MD, director, New York Headache Center, New York. Stacy Porter, former migraine patient, New Philadelphia, Ohio. Robert Kunkel, MD, consultant, Cleveland Clinic; spokesman, National Headache Foundation.
July 31, 2009 -- Stacy Porter, 29, can't remember a time when she didn't suffer from crippling, relentless migraines before having the surgery that changed her life eight years ago.
"I was diagnosed with migraines when I was 2 years old," the New Philadelphia, Ohio, marketing executive tells WebMD. "I had about 15 days a month of severe migraine pain."
Her symptoms included throbbing pain in her temples, nausea, and sensitivity to light so severe she remembers wearing sunglasses to more than one final exam in high school and college.
None of the drugs used to prevent migraines helped, so her only relief came from medications that eased the pain but left her feeling drugged and out of it.
That all changed at age 21 when she had a surgery similar to that typically performed to remove crow's feet.
"After that I never had another migraine," she says.
Plastic surgeon Bahman Guyuron, MD, of Case Western Reserve University, says Porter's results are common, and his newly published study backs up the claim.
Forehead Lift Lifts Migraines
Guyuron has treated more than 400 migraine patients with a modified version of a traditional forehead lift over the last decade, and he tells WebMD that the vast majority of them have shown dramatic improvement.
His newly published study was designed to convince critics still skeptical of using plastic surgery to treat migraines.
Guyuron and colleagues randomly assigned 75 patients with migraine trigger sites in just one area to receive either real or sham surgery. The patients were not told which type of surgery they were getting.
In the real surgery group, nerves were cut at specific migraine trigger sites. In some cases, like Porter's, the nerve was the same one cut to eliminate crow's feet. In others, the nerve was the same one cut to ease frown lines on the forehead.
The surgery works like Botox injections -- now widely used, though not approved, for the treatment of migraines.
In fact, patients in the active-surgery group got Botox injections first to determine if they were good surgical candidates.
In all, 49 patients had the actual surgery and 26 had the sham surgery.
One year later, 83% of the actual surgery group reported at least a 50% reduction in migraines, compared to 57% of the sham surgery group.
Even more surprising, 57% of actual surgery patients reported complete elimination of migraines, compared to just 4% of sham surgery patients.
The study appears in the August issue of the journal Plastic and Reconstructive Surgery.
"You don't see results like this in migraine studies," Guyuron says. "Even the most skeptical people will have to accept there is something to this."
Surgery Not for Everyone
But surgery is not a good option for patients who have infrequent migraines and those who respond to preventive treatments, he says.
"We are talking about 10% to 15% of migraine patients who would be good candidates for surgery," he says.
Neurologist Richard B. Lipton, MD, who directs the headache unit at Montefiore Medical Center in the Bronx, says the study's design and its dramatic outcome helped convince him the surgical approach is legitimate.
"I started out quite skeptical about this," he says. "But despite my best efforts not to be, I'm pretty excited about the results."
Lipton did express concern that the study participants may have actually known which treatment they were getting, which might have affected the results.
Alexander Mauskop, MD, who directs the New York Headache Center, had the same reservation about the trial.
Mauskop was one of the first headache specialists in the nation to routinely use Botox for migraines, and he now treats between 60 and 70 patients a month, with a 70% response rate.
Patients typically get Botox injections every three months, at a cost of $750 to $1,000 per injection.
"The problem I have with surgery is that headaches come and go," he says. "They may go away with menopause or at some other time. Surgery is a permanent treatment for a condition that is rarely permanent."
Mauskop offers his patients many treatment options ranging from traditional drug therapies to alternative approaches like acupuncture.
Robert Kunkel, MD, has treated migraines for four decades at the Cleveland Clinic, and he serves on the board of the National Headache Foundation.
He tells WebMD he has seen several surgical approaches come and go during his career.
"There is always a lot of excitement, but none has really lasted," he says.
But Porter says there is no doubt in her mind that, like her, many, many patients with intractable migraines can be helped with the surgery.
"It completely changed my life," she says. "I went back to see Dr. Guyuron for checkups for seven years, first every month and then less frequently. And he and I both got teary-eyed every time I went in."
SOURCES: Guyuron, B., Plastic and Reconstructive Surgery, August 2009; online edition. Bahman Guyuron, MD, professor and chairman, department of plastic surgery, University Hospitals Case Medical Center, Cleveland, Ohio. Richard B. Lipton, MD, director, Montefiore Headache Unit, Montefiore Medical Center, Bronx, N.Y. Alexander Mauskop, MD, director, New York Headache Center, New York. Stacy Porter, former migraine patient, New Philadelphia, Ohio. Robert Kunkel, MD, consultant, Cleveland Clinic; spokesman, National Headache Foundation.
27 Temmuz 2009 Pazartesi
Behavioral Medicine (Collection: Mental Health )
Broadly, the branch of Clinical Psychology that deals with the use of psychological interventions in the 'physical health' aspect of life. Also called Health Psychology. Applications are many - for example, Behavioral Medicine psychologists foster wellness in healthy persons (developing programs to help people stick with exercise, lose weight and stop smoking), augment and extend medical treatments (developing treatments for chronic physical pain, for instance), and to help the relationship between medical patients and physicians to work better (developing programs to help patients take their medicines on schedule).
SPAIN JOINS GLOBAL HEALTH TERMINOLOGY EFFORT
§ 11 more countries apart from Spain belong to IHTSDO, an organisation aiming to spread the use of a standardised clinical terminology called SNOMED CT.
§ The use and diffusion of this terminology within health record systems will improve the accuracy of clinical information and its multilingual interpretation, which will contribute to improved patient safety.
§ The Ministry of Health and Social Policy, in coordination with the Regional Authorities, works in the development of Electronic Health Records within the National Health System.
July 14th, 2009. Spain, through the Ministry of Health and Social Policy, is now one in the group of countries that are part of International Health Terminology Standards Development Organisation (IHTSDO). Spain joins the global effort to develop, maintain and spread the use of a clinical terminology called SNOMED CT (Systematized Nomenclature of Medicine-Clinical Terms).
Spain is the third country joining IHTSDO after Charters Members (Australia, Canada, Denmark, Netherlands, United States of America, New Zealand, Lithuania, United Kingdom and Sweden) plus Singapore and Cyprus, that joined in 2008.
“We are delighted to welcome Spain as a new member of IHTSDO”, says Martin Severs, Chair of IHTSDO’s Management Board. He also added “Our work on health terminology standards is a global effort to respond to needs that we all share. By pooling our experiences and our resources, we can make more progress than any one country could do on its own, which benefits patients and health professionals in all of our nations”.
The use of a standardised clinical terminology like SNOMED CT, to describe the information that health records contains, promotes consistency, accuracy, and reliability of health information and contributes to improved patient safety.
“SNOMED CT is already being used in Spain in some specific cases by some professional groups and institutions. What we aim now is to boost the use in the Spanish health organizations and in coordination with the Regional Authorities” says Javier Etreros, director of the Project “Electronic Health Record within the National Health System”
In joining IHTSDO, Spain will be able to distribute the international core of this standard to all the public and private organizations that need to use it within the Spanish territory. Furthermore, Spanish experts’ participation in the different IHTSDO working groups and committees, will ensure that future versions of SNOMED CT give better support to the Spanish system’s unique characteristics.
All of this will permit that the main standardised health terminology in the world (used in more than 40 countries) will be available in the all Spanish territory to be used, in the electronic health records as well than in information systems that measure the health care assistance activity results, clinical investigation and other applications.
In the semantic interoperability roadmap, designed by the Ministry of Health and Social Policy at the beginning of 2008, the goals to enable exchange of information between different health record systems (including different languages) were identified. The use of SNOMED-CT terminology is one of these goals.
The Ministry keeps working in coordination with the Regional Authorities to develop the Electronic Health Record within the National Health System (EHRNHS). The objective of this project is to guarantee, to citizens and health professionals the access to all the relevant clinical information needed in the health care assistance process, from any point within the National Health System.
3 Temmuz 2009 Cuma
GENERIC NAME: HYDROXYPROPYLMETHYLCELLULOSE - OPHTHALMIC INSERT (hi-DROX-ee-pro-pull-meth-ill-CELL-you-lohss, off-THAL-mick)
BRAND NAME(S): Lacrisert
USES: This medication is a tear-like substance used in the treatment of dry eye syndromes.
HOW TO USE: The inserts are to be properly placed in the eye once or twice daily as directed. Your doctor will demonstrate how to place the insert into the eye and how to remove it. Practice inserting and removing the insert while in the doctor's office so any questions you have can be answered.
SIDE EFFECTS: Vision may be temporarily blurred or unstable for a period after applying the insert. Use caution if driving or performing duties requiring clear vision. Eye irritation or discomfort, sticking of eyelashes and sensitivity to bright light may occur when first using this medication. If these symptoms continue or become worse, inform your doctor. Notify your doctor immediately if you develop: itching, pain burning, redness, swelling in or around the eyes, vision problems. If you notice other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS: Tell your doctor if you have any of the following conditions: eye problems, any allergies. As with any medication, this should be used cautiously during pregnancy or while breast-feeding. Discuss the risks and benefits with your doctor.
DRUG INTERACTIONS: Tell your doctor of any over-the-counter or prescription medication you may take. Do not start or stop any medicine without doctor or pharmacist approval.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.
NOTES: If the condition for which this was prescribed does not improve or becomes worse after a few days, consult your doctor.
MISSED DOSE: Each insert is to be used for a 24 hour period. If you forget to replace an insert, do it as soon as remembered. Do not "double-up" the dose to catch up.
STORAGE: Store at room temperature between 59 and 86 degrees F (15 and 30 degrees C) away from heat. Check the expiration date on the box and discard any expired medication.
Definition of Vaccination, DT
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