Health-related April events – check them out!

March 31, 2009 by  
Filed under HEALTHCARE

calendarOn this last day of March, I give you a list of health-related events for the coming month. April is going to be a busy month with several health observances ahead of us. Check them out. Support and join!

The U.S. National Health Information Center (NHIC) Office of Disease Prevention and Health Promotion describes health observances as days, weeks, or months devoted to promoting particular health concerns. Health professionals, teachers, community groups, and others can use these special times to sponsor health promotion events and stimulate awareness of health issues.

Cleveland Clinic’s Health Chats for April

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Experts: routine depression screening for teenagers

March 31, 2009 by  
Filed under DEPRESSION

teen-depressedIt is a problem that many parents face: clinical depression among teenagers.

As many as two million American teenagers suffer from depression and most go undiagnosed, thus untreated according to the United States Preventive Services Task Force. The task force has recently came up with guidelines recommending primary health care practitioners to routinely screen teenage patients for clinical depression. The new recommendations have been published in the April issue of the journal Pediatrics.

The guidelines apply to adolescents aged 12 to 18 years old. However, the task force found there is insufficient evidence to show the benefits of screening younger children for clinical depression

Depression in young people can lead to

  • poor health outcomes
  • difficulties in school
  • disruptions of family and social relationships
  • lowerquality of life
  • self-destructive behavior/suicide
  • depression in adulhood

It is therefore necessary that clinical depression be diagnosed as early as possible.

“Depression in adolescents has a significant impact on both mental and physical health, and adolescents with depression have more hospitalizations for psychiatric and medical issues than adolescents who are not depressed,” said Task Force Chair Ned Calonge, M.D., who is also chief medical officer for the Colorado Department of Public Health and Environment. “It is important that adolescents are diagnosed and treated for clinical depression in order to improve their health and quality of life, especially if they have a family history of depression.”

However, screening for clinical depression should only be done “when appropriate systems are in place to ensure accurate diagnosis, treatment and follow-up care.” Treatment of clinical depression among teenagers can be through by psychotherapy or by pharmacological means using selective serotonin reuptake inhibitors (SSRIs), or combined therapy (SSRIs plus psychotherapy). However, the prescription of anitdepressants SSRIs should be done with care as this class of drugs is associated with an increased risk of suicidality.

The new guidelines go further than the previous guideline issued by the Academy of Pediatrics which recommended pediatricians to ask their young patients questions about depression.

The new recommendarions cited using “two questionnaires that focus on depression tip-offs, like mood, anxiety, appetite and substance abuse.” The screening should be done by the family doctor or pediatrician who is known to the family and the patient.

Almost 6% of Amrican teenagers aged 13 to 18 are clinically depressed. A lot of cases do not show over symptoms and are therefore easily overlooked by parents and teachers. Suicide due to clinical depression is the 3rd leading cause of death in US adolescents in the age range 15 to 24 years old.

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Soy: good or bad for our health?

March 30, 2009 by  
Filed under CANCER

japanese_tofu-mealSoy is traditionally a part of a typical Asian diet. Researchers at the U.S. National Cancer Institute investigated whether soy consumption can render protection against breast cancer.

According to senior researcher Regina Ziegler

Historically, breast cancer incidence rates have been four to seven times higher among white women in the U.S. than in women in China or Japan. However, when Asian women migrate to the U.S., their breast cancer risk rises over several generations and reaches that of U.S. white women, suggesting that modifiable factors, rather than genetics, are responsible for the international differences.”

However, the lifestyle factors that predispose Asian women living in the US to breast cancer have never been identified.

The study looked at Asian women (of Chinese, Japanese and Filipino descent) living in California or Hawaii. The researchers interviewed 597 of these women (aged 22 to 55 years old) with breast cancer and case-matched with 966 controls. In addition, whenever possible, the mothers of the women were interviewed regarding the participants’ diet during their childhood.

The results of the study show:

  • Consumption of or large amounts of soy during childhood was linked to a 58% reduced risk for breast cancer
  • high soy consumption during adolescence and adulthood was linked to a 20 to 25% reduced risk.

The study authors concluded:

Soy intake during childhood, adolescence, and adult life was associated with decreased breast cancer risk, with the strongest, most consistent effect for childhood intake. Soy may be a hormonally related, early-life exposure that influences breast cancer incidence.

Soy is rich with isoflavones. The authors speculate that these compounds may have estrogenic properties that may cause changes in the mammary tissue. Animal studies have shown that soy consumption results in early maturation of breast tissue and increased resistance to carcinogens.

I myself am of Asian descent and therefore found this study rather interesting. We Asians consume soy in the form of tofu (coagulated soy milk) or soya sauce. Soya milk is also used as a substitute formula for lactose-intolerant infants. The food products come from the soya bean plant Glycine max.

Soy used to be considered the wonder superhealthy food but has become somewhat controversial lately as more and more research studies have linked soy consumption to adverse health effects ranging from memory decline to cancer. In 2007, the Cancer Council of New South Wales, Australia issued guidelines that warn cancer patients about the dangers of high-soy diets and soy supplements. The guidelines especially emphasized the dangers for those suffering from hormone-dependent cancers, including prostate and breast cancers.

Clearly there is a need for more studies before we can clearly say whether soy is beneficial or detrimental to our health.

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Watch your salt intake!

March 30, 2009 by  

Do you know how saltmuch salt you should take each day? The amount of daily recommended level of sodium is not more than 1,500 mg (equivalent to about 5 to 6 g of table salt). And it seems that most Americans consume more than double of that, according to a Centers for Disease Control and Prevention (CDC) press release.

But why should we pay attention to our daily salt intake?

A diet rich in sodium is not favourable for our cardiovascular health. It increases the risk of high blood pressure, a major risk factor for heart disease and stroke. These diseases are the first and third leading causes of mortality in the United States, respectively.

Researchers at the University of California, San Francisco report that even a small reduction in dietary salt can have far-reaching consequences. They estimate that ” cutting just 1 g of salt a day would prevent a quarter of a million new heart-disease cases and 200 000 deaths from any cause over a decade.”

We may not be aware of it, but most of the salt we consume does not come from our very own kitchen. 80% of salt in Western country’s diet comes from processed and prepared food. It is therefore difficult for people to keep track of their salt consumption.

According to the CDC.

Nationwide, 16 million men and women have heart disease and 5.8 million are estimated to have had a stroke.  People who reduce their sodium consumption benefit from improved blood pressure and reduce their risk for developing other serious health problems. Choosing foods like fresh fruits and vegetables, when eating out, asking that foods be prepared without added salt, and reading the nutrition label of foods before purchasing can improve health for all adults.

However, not all food labels reflect the real salt content and some labels are too complicated for consumers to understand.

The USCSF researchers recommend that public-health types of intervention such as

  • regulatory efforts to restrict salt
  • force labeling of foods based on their salt content
  • encouragement of food manufacturers to reduce salt.

The experience in other countries suggests that with these very small changes we are describing, we will not change the taste of foods or the profit margins of the food industry, but it would be a great benefit for public health.”

Some major players in the food industry have answered the public health issue of salt consumption. The food company Campbell’s has set a good example and came up with a special line of heart-friendly products that contains 50% less sodium. Let us hope that more food companies will follow suit.

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CVD Newswatch, March 27

March 27, 2009 by  

worldnews1Heart(y) news round up for you on this Friday morning.

CVD legislation news

Texas lawmakers once again mull controversial bill based on SHAPE cardiac-screening proposal
The Heart Attack Prevention Bill has been presented in the Texas legislature earlier this month. The bill mandates “private insurance companies to cover the cost of cardiac screening in people at intermediate risk of a cardiac event.” The bill is very similar to “the controversial Screening for Heart Attack Prevention and Education (SHAPE) task-force recommendations calling for blanket screening for subclinical atherosclerosis” that was rejected last year. The author of the two bills is representative René O Oliveira who just had CABG surgery.

CVD drug news

FDA postmarketing surveillance data show no cancer risk with ezetimibe
Good news for manufacturers of cholesterol-lowering drug Zetia (ezetimibe). US FDA postmarketing surveillance data indicate that ezetimibe use is not associated with cancer risk. This is true whether ezetimibe is used alone or in combination with Vytorin (simvastatin). The two drugs are produced by Merck/Schering-Plough.

CVD population news

Heart Failure Before Age 50 Substantially More Common in Blacks
NIH News reports that as many as 1 in 100 African American adults develop heart failure before the age of 50. This is 20 times higher than the rate reported in whites. The disease is linked it untreated risk factors such as high blood pressure, chronic kidney disease, and obesity that started 10 to 20 years earlier. These are the findings of the observational study Coronary Artery Risk Development in Young Adults study (CARDIA) and will bepublished in the March 19 issue of the New England Journal of Medicine.

CVD guidelines news

New Guidelines on Interpretation and Reporting of CCTA
New guidelines for the interpretation and reporting of coronary computed tomographic angiography (CCTA) studies will be published in the March/April 2009 issue of the Journal of Cardiovascular Computed Tomography. The guidelines were developed by the Society of Cardiovascular Computed Tomography (SCCT).

CVD clinical trial news.

CAPTIVATE published: Trial stopped early, and pactimibe development discontinued based on IVUS results
CAPTIVATE stands for Carotid Atherosclerosis Progression Trial Investigating Vascular ACAT Inhibition Treatment Effects. The 2-year trial was discontinued after 15 months when the drug pactimibe did not show any benefit or effect on thickness on maximum carotid intima-media thickness (IMT). The results of the trial have now been published Journal of the American Medical Association.

CVD innovation news

Brain surgery on Monday, home on Tuesday
A new, less invasive form of surgery can now repair life-threatening aneurysms of the brain. A new generation of neurologists use catheter technology to “repair aneurysms, open clogged arteries, extract blood clots and repair blood vessel malformations in the brain.” The catheter, a thin tube, is inserted in an artery in the patient’s leg and guided up to the brain. The technique is less invasive and presents less risks that conventional brain surgery which involves opening the skull.

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News from the cancer side, March 27

March 27, 2009 by  
Filed under CANCER

Some cancer news for you today. Hope your March weather is much warmer than mine.  Have a nice weekend.newspaper1

News from the cancer victim

Jade Goody funeral to be a public affair
The reality show celebrity Jade Goody lost the battle against cervical cancer last weekend. The funeral of the 27-year old TV star is scheduled in early April.

News from the academia

U-M launches new embryonic stem cell research consortium
The University of Maryland in Ann announced earlier this month the formation of a consortium on embryonic stem cell research. The recent lifting of the ban on this field of research has provided motivation to American research institutes to push forward in the search for cures and treatments using this biotechnology. The A. Alfred Taubman Medical Research Institute Consortium for Stem Cell Therapies is the first major embryonic stem cell research program launched in Michigan since the Nov. 4 passage of a state constitutional amendment allowing scientists to create new stem cell lines using surplus embryos from fertility clinics. According to university researchers “we believe stem cell research offers one of our best hopes for finding new treatments and cures for a wide variety of diseases.”

News from the geneticists

Pilgrims’ progress: Genetic data from 1630s backs health benefits of cancer screening
A gene mutation that increased the likelihood of colon cancer has been traced back to about 370 years ago to pioneers who arrived in the US in the 1630s. The researchers used “cancer records and massive genealogic archive known as the Utah Population Database (UPDB) to trace the genetic condition to a Utah pioneer family and their 7,000 descendents.” The mutation causes attenuated familial adenomatous polyposis (AFAP), a condition which in turn causes the growth of colorectal polyps which can potentially become cancerous. The AFAP mutation can be used as a genetic marker for individuals with predisposition to colon cancer.

News from the nutritionists

Soy May Help Shield Asian-American Girls From Breast Cancer
Can soya consumption protect you from breast cancer? A US National Cancer Institute study revealed that high amounts of soya in the diet of Asian-American women during childhood may reduce the risk for breast cancer. The results of the study have been published in the journal Cancer Epidemiology, Biomarkers & Prevention.

News from predictive medicine

Predicting which breast cancers will spread

Research studies report that it will soon be possible to predict which breast cancer tumors will metastasize and which ones will stay localized. This is good news for breast cancer patients who, even after a successful treatment, still have to worry about the possibility that the cancer may have already spread to other body organs. One study appears in the journal Clinical Cancer Research, the other in Nature Reviews Cancer.

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Depressed? Check your blood pressure!

March 26, 2009 by  
Filed under DEPRESSION

bpThe link between depression and cardiovascular health is well-known although the mechanism behind the relationship is not well-understood.

A study by Dutch researchers may just give us an idea of the complexity of that link. For one thing, contrary to the common perception that depression can lead to hypertension, depression, is, in fact, associated with low blood pressure. However, medications against depression – the so-called anti-depressants can increase blood pressure. In particular, tricyclic antidepressants (TCAs) can increase the risk for hypertension.

According lead author Carmilla Licht

Doctors should at least be aware of a potential blood-pressure rise that could be linked to TCA use, especially for patients with cardiovascular disease or high blood pressure or others who are at risk for hypertension…They may consider meticulously monitoring these patients’ blood pressure when they prescribe one of these antidepressants or consider prescribing another antidepressant medication.”

The results of the study are somewhat controversial because they contradict the current “depression-hypertension theory.”

The study was part of the Netherlands Study of Depression and Anxiety, and followed up 2618 participants aged 18 to 65 years old. The study participants were divided into 3 groups:

  • Control group without history of anxiety or depression
  • Patient group with a major depressive disorder (MDD) but not on antidepressants
  • Patients with MDD and on antidepressants

Patients were monitored for systolic blood pressure (SBP) and diastolic blood pressure (DBP) and distinction was made between different types of antidepressants, e.g. selective serotonin-reuptake inhibitors (SSRIs) vs tricyclic antidepressants (TCAs).

The study also observed that a typical patient with psychiatric disorder “were a little older, more likely to be female, less educated, less physically active, smoked more, and had a higher body-mass index and more diseases.”

The study results showed that compared with health controls, MDD patients have significantly lower blood pressure. However, MDD patients on TCA had significant higher blood pressure. The use of SSRIs doesn’t seem to be associated with blood pressure measurements.

So the next question is

Is it the depression that lowers the blood pressure or is it the low blood pressure that causes the depression?

The authors speculate that three things might influence the depression-low blood pressure link.

  • Use of anti-hypertensive drugs
  • Common causes of depression and low blood pressure, e.g. fluctuations in metabolites, hormones or neurotransmitters
  • Low blood pressure can cause depressive symptoms, e.g. fatigue, dizziness, low tolerance to cold temperatures, and concentration problems.

While depression is associated with low blood pressure, the study shows that anxiety is linked to high blood pressure. This, the authors say, might be due to continuous stress associated with anxiety.

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Stroke begins at 44 and beyond

March 26, 2009 by  

birthday_cakeThe 40s. It’s when life is really supposed to start. It’s also when people get into the so-called midlife crisis.

A recent Finnish study also suggests that the 40s is the age when we have to take care of our cardiovascular health because the rates of ischemic stroke increase dramatically beyond our 44th year of life. And most especially if you are male. The Finnish study looked at 1,008 ischemic stroke patients aged 15 to 49 years old. Here are some of the figures the researchers found:

The researchers looked at stroke incidence in different age groups and found that stroke under the age of 30 occurs more often in women. The incidence of stroke increases with age and by the age of 44, the incidence is almost equal between men and women. After this point, a sharp increase in first stroke incidence in males was observed.

Most of the risk factors observed were lifestyle related and modifiable, and the most frequent are:

  • dyslipidemia (60%)
  • smoking (44%)
  • hypertension (39%)

In addition, less frequent risk factors but nevertheless potentially dangerous were observed such as heavy alcohol consumption, which is common among men, migraine among women, use of illicit drugs among younger patients.

What surprised the researchers are the high number of silent as well as multiple ischemic strokes occurring, sometimes with the patient being aware of them.

Other key findings are:

As I approach that stage called midlife, I am very aware of the health problems that come with it and stroke is just one of them. The American Stroke Association gives a comprehensive patient-friendly overview of stroke and how we can prevent it.

EWG’s New Shoppers’ Guide to Pesticides

March 25, 2009 by  
Filed under CANCER

The Environmental Working Group (EWG) has recently released a guide dirty_dozen_pesticides_fruits_vegetables1listing the dirtiest and cleanest natural food products found in the supermarket. The Shoppers’ Guide to Pesticides show that not all food products were created equal. The “Dirty Dozen” are food stuffs found to be have the highest pesticide content while the “Clean 15” are those lowest in pesticides.

EWG analysts have developed the Guide based on data from nearly 87,000 tests for pesticide residues in produce conducted between 2000 and 2007 and collected by the U.S. Department of Agriculture and the U.S. Food and Drug Administration.

According to EWG research, when people eat the fruit and vegetables on the Dirty Dozen list, they are exposed to no less than 10 types of pesticides a day. When eating the Clean 15 each day, people are exposed to 2 or less types of pesticides.

The criteria used by EWG to develop these rankings plus the complete list of fruits and vegetables tested can be found at website,

Pesticides are used by farmers and food growers in preventing insects and other pests from attacking fruit and vegetables. They may make our food look good by pesticides can have adverse effects on our health, especially during fetal development and childhood. Long-term exposure to pesticides has been reported to cause different types of life-threatening conditions, including cancer.

In the landmark “10 Americans” study of EWG in 2005, no less than 287 industrial chemicals have been detected in the umbilical cord blood of newborn babies across the US. Almost half of the chemicals identified were carcinogens including dozens of widely used brominated flame retardants (PBDEs) and their toxic by-products, and numerous pesticides, including DDT and others, which were banned more than 30 years ago.

There are many ways to reduce pesticide exposure through the food. Using this guide to make intelligent and health choices is one of them. Other strategies are:

  • Washing can reduce but does not get rid of all pesticides.
  • Peeling can get rid of pesticides on the skin but a lot of nutrients and fibers are lost.
  • Buying organic products helps as long as you are sure that what is declared as organic is really organic. Beware of organic food scams.

The best approach, according to EWG, is a combination of different strategies, e.g. eating a varied diet, rinsing fresh produce thoroughly, and buying organic food when possible.

The Environmental Working Group (EWG) is a non-profit organization with the mission “to use the power of public information to protect public health and the environment.”

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In the making: blood test for Alzheimer’s disease

March 25, 2009 by  
Filed under ALZHEIMER'S

Diagnosing Alzheimer’s disease is often a problematic process. Over the blood-test1years, the field of biotechnology has tried to come up with screening and testing methods that can help identify this disease. While diagnostic biomarkers for many diseases can be identified in a blood sample, this has so far proved elusive for Alzheimer’s. However, there is a lot of promise in biomarkers found in the cerebrospinal fluid (CSF), which makes a lot of sense – considering the CSF’s proximity to the brain. CSF is a colorless liquid found in the central nervous system (brain and spinal cord).

Taking CSF samples however is a bit controversial since it entails a procedure called a lumbar puncture or spinal tap, which is basically done inserting a needle in the lower part of the spine to collect the fluid. A spinal tap is performed to diagnose diseases affecting the nervous system.

Many experts feel that a lumbar puncture can be painful and presents some risks, complicated by the type of patients – elderly and disoriented – one is dealing with. Others claim that a lumbar puncture is essentially safe and straightforward. This controversy in relation to the CSF has led many researchers to explore further the possible of developing a blood test for Alzheimer’s.

And it seems that their efforts are bearing fruit.

American researchers “have revealed a direct relationship between two specific antibodies and the severity of Alzheimer’s disease symptoms, raising hopes that a diagnostic blood test for the devastating disorder is within reach.”

The researchers focused on antibodies that the body produces in response to two Alzheimer-associated proteins. One of these proteins is the well-known amyloid-beta which is responsible for the formation of plaques in the brains of Alzheimer’s patients. The other protein is the less known RAGE which is involved in the normal human aging process. However, it has been observed the RAGE is expressed at higher levels in the brains of people with Alzheimer’s.

The researchers found that anti-amyloid beta and anti-RAGE antibodies are significantly higher in the group with Alzheimer’s compared to a control group without Alzheimer’s. Furthermore, the concentrations of the two antibodies in the blood seem to be significantly associated with the severity of the disease.

According researcher Shyamala Mruthint

“Alzheimer’s is an inflammatory disease of the brain, and these two antibodies give us a way to measure that inflammation. Using them as an early diagnostic marker may allow us to start drug treatment early, when it’s most effective, to increase the patient’s quality of life.”

Short sleep increases diabetes risk

March 24, 2009 by  
Filed under DIABETES

sleep-and-strokeDaylight savings time has started in the US. In Europe, we are only springing forward come end of March. In a previous post, I’ve discussed about the adverse effects of sleep disturbances on TMs-the-connection/”>cardiovascular health. Women’s hearts seem to be especially susceptible. Lack of sleep has also been linked to increased risk for breast cancer and weight problems in women. This study presented at the American Heart Association’s 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention gives us one more reason to watch our sleeping habits.

“Short sleepers” seemed to have a 4.56 higher risk for diabetes than those who sleep longer. Short sleepers were people who sleep less than 6 hours a night during a working week. Their shorter than normal sleep duration seem to affect their blood sugar, leading to impaired fasting glucose. This abnormality in fasting glucose levels can be a precursor to type 2 diabetes.

Type 2 diabetes, the most common form of diabetes, appears most often in middle-aged adults. Adolescents and young adults, however, are developing type 2 diabetes at an alarming rate. It develops when the body makes relatively too much insulin and doesn’t efficiently use the insulin it makes (insulin resistance).

The study looked at more than 300 participants, monitored their sleeping habits and blood glucose levels, and followed them up for six years.

The participants were categorized by their daily sleep duration in a work week (Sunday to Thursday) as follows:

  • short-sleepers (less than six hours, 25 participants),
  • long-sleepers (more than eight hours, 24 participants) and
  • mid-sleepers (six-to-eight-hour sleepers, 314 participants).

After adjusting for age, body mass index, glucose and insulin concentrations, heart rate, high blood pressure, family history of diabetes and symptoms of depression, the researchers found a significantly increased risk of developing impaired fasting glucose among short-sleepers compared to the mid-sleepers. Compared to the mid-sleepers, long-sleepers showed no association with impaired fasting glucose, the researchers report.

The mechanism behind the link between short sleep and abnormal fasting glucose is not clear, just as the importance of sleep on our health is poorly understood. The researchers, however, speculate that there might be a genetic basis for their findings but much bigger studies are warranted to confirm these results.

The STITCH study: hypertension management made simple

March 24, 2009 by  

“Less is better” might be the new strategy blood-pressurein treating high blood pressure, according a study by Canadian researchers. The study called “Simplified Treatment Intervention to Control Hypertension” (STITCH) was conducted by researchers at the Robarts Research Institute of the University of Western Ontario. The study followed up 2,104 participants with high hypertension, basically patients from 45 family practices in southwestern Ontario, Canada.

There are many different guidelines of the management of hypertension depending on the country and the medical group you are talking to. They can be complicated and confusing and can be challenging to both patients and doctors alike. Furthermore, they are frequently updated and amended.

The objective of the STITCH study is “to see if there are simpler ways to help patients (and their doctors) reduce their blood pressure to goal levels than by following national guidelines which can be complicated.”

The STITCH study came up with the following simplified treatment regime:

(1) initial therapy with a low-dose angiotensin-converting enzyme (ACE) inhibitor/diuretic or angiotensin receptor blocker/diuretic combination;

(2) up-titration of combination therapy to the highest dose;

(3) addition of a calcium channel blocker and up-titration; and

(4) addition of a non-first-line antihypertensive agent.

The results of the study suggest that starting with low doses of combination drug, then gradually increasing may actually be better for recently diagnosed hypertensive patients. “A half tablet of a single pill combination drug (e.g. an ACE-inhibitor/diuretic or angiotensin receptor blocker/diuretic combination) than the regular starting dose of a single drug” may actually be more effective. The results of the study will be published in the April edition of the journal Hypertension.

High blood pressure is a risk factor for heart disease and stroke. According to the most recent estimates (source: American Heart Association), one in three Americans have high blood pressure.

Aside from pharmacological therapy, lifestyle changes are necessary to prevent, manage and control high blood pressure. Some of these lifestyle changes are (Source: American Heart Association Scientiific Advisory):

  • Weight Loss
  • Dietary Salt Restriction
  • Moderation of Alcohol Intake
  • Increased Physical Activity
  • Ingestion of a High-Fiber, Low-Fat Diet

Honestly, even the “simplified” treatment regime of the STITCH study doesn’t look that simple to me. I’d rather go for the lifestyle changes and got for prevention.

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A therapy to get osteoarthritis patients moving

March 23, 2009 by  
Filed under ARTHRITIS

gymnastPhysical exercise is essential in maintaining joint health and in managing symptoms of osteoarthritis. But it doesn’t feel like it, as many arthritis patients would attest, making performance of simple daily activities challenging, much less compliance with prescribed exercise routines.

But a new type of therapy, the so-called activity strategy training might just be the help that patients with osteoarthritis of the hip and knee.

This is based on a study conducted by researchers at the University of Michigan Health System.

Taught by occupational therapists, this structured rehabilitation program is designed to educate patients about joint protection, proper body mechanics, activity pacing, and environmental barriers. For example, patients with joint pain caused by osteoarthritis learn techniques for walking around the house or outdoors, or even getting in and out of a car.

The study compared two strategies: the commonly prescribed regular exercise and health education sessions vs the activity strategy training (AST) plus regular exercise. The outcomes showed that AST was more effective in increasing and maintaining physical activity in osteoarthritis patients. The difference between the two strategies is probably that AST is more customized to the patients’ needs while structured exercise is not. Furthermore, AST addresses barriers to physical activity that may be specific to certain communities or environment, such as those found in senior homes, for example.

Osteoarthritis is “a degenerative disease that causes the breakdown of the cartilage in joints. Activity strategy training, however, is not commonly prescribed to patients with hip or knee osteoarthritis… Most physical activity programs for these patients only offer structured exercise, which has been shown to have short-term positive effects on arthritis pain and physical disability. But these effects usually fade soon after participation in the program ends.”

The researchers went on to urge osteoarthritis patients to take a proactive role in their therapy. According to lead author Susan L. Murphy

People with osteoarthritis need to be their own agents of change. They can do so much to manage symptoms and stave off functional decline caused by osteoarthritis just by being physically active. The bottom line is to find ways to help people create and maintain these healthy habits.”


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Screening for prostate cancer: the pros and the cons

March 23, 2009 by  
Filed under CANCER

Resource post for March

yes_no_3In almost all diseases, screening and early detection is the key to management and cure. What used to be fatal diagnoses of late stage breast and cervical cancer have now become uncommon as more and more cases are detected early by regular screening.

In men, prostate cancer is the third leading cause of cancer mortality. The Institute for Cancer Research (ICR) in the UK gives us the following statistics:

As many as 80% of men develop prostate cancer during their lifetime, but in most cases it does not cause any ill health. Around 6% of men experience symptoms of the disease, while 3% of men die of prostate cancer.

Screening for prostate cancer is done in two ways, namely:

PSA test. Prostate-specific antigen (PSA) is protein biomarker produced by prostate cells. PSA is normally present in blood in low amounts. Cancerous (malignablood-testnt) prostate cells are expected to produce more PSA than noncancerous cells, leading to elevated PSA levels in the blood. PSA testing consists mainly of testing for levels of the antigen in a blood sample. If PSA levels are found to be high, other tests, including a prostate biopsy may be deemed necessary. Currently, the American Urologic Association, the American Cancer Society, and the National Comprehensive Cancer Network recommend that all men 50 years and older should have annual PSA tests. Men with high risk profiles (e.g. of African American heritage, family history of prostate cancer) are advised to get tested starting at the age of 40.

Digital rectal examination. This examination is performed by a doctor by inserting a lubricated finger through the rectum. Through the walls of the rectum, the doctor can feel for structural abnormalities (bumps, growths, enlargement) in the prostate.

The usefulness of the PSA test in screening for prostate cancer has always been a subject of controversy. Some studies have produced inconclusive results regarding its benefits as well as its side effects. Potential risks include, unnecessary invasive testing (biopsy), and unnecessary treatment with serious side effects, and unnecessary expense. However, 95% of male urologists and 78% of male primary care clinicians admit to having had a PSA test themselves. PSA gives the potential benefits of catching cancer at its early stages, with better prognosis.

In the March issue of the New England Journal of Medicine, results of two studies on PSA screening were presented: one study conducted in the US, and one study conducted in Europe. Unfortunately, instead of resolving the controversy once and for all, the two studies actually produced contradicting results.

The American study:

Mortality Results from a Randomized Prostate-Cancer Screening Trial
This study is part of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The study looked at 76,693 men from 1993 to 2001. doubt2About 50% of the participants had PSA screening every year for 6 years and digital rectal examination for 4 years. The other half did not undergo screening for prostate cancer. The PLCO results showed that after 7 to 10 years the incidence of prostate cancer was 116 per 10,000 person-years in the screening group and 95 in the control group. The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group. Statistically speaking, there was no difference in cancer incidence and mortality between the screened group and the unscreened group.

The European study:

Screening and Prostate-Cancer Mortality in a Randomized European Study
The European Randomized Study of Screening for Prostate Cancer (ERSPC) started in the 1990s and followed up 182,000 men aged between 50 and 74 years old for about 12 years. The study had also two groups. In one group, PSA screening way conducted on average, once a year. The other group did not undergo PSA screening. The study was conducted in 8 European countries, namely Belgium, Finland, France, Italy, Netherlands, Spain, Sweden and Switzerland The results of the study showed that

PSA-based screening reduced the rate of death from prostate cancer by 20% but was associated with a high risk of overdiagnosis

Both studies will now look into the cost effectiveness and overall quality of life of the PSA testing. Although PSA testing itself is non-invasive, the subsequent confirmatory tests such as biopsy can be invasive and present with risks.

About PSA testing

Many expertbalance2s observe that PSA testing is not specific enough and has a 30% rate of false positives – e.g. cancers are non-aggressive and are indolent or slow-growing. It is sometimes difficult to decide which really cancer needs treatment which one doesn’t. While many would opt to be on the safe side and go for early treatment, the treatment comes with side effects such as impotence and incontinence.

A more conservative form of prostate cancer monitoring is called “Active Surveillance which aims to individualise the management of early prostate cancer by selecting only those men with significant cancers for curative treatment… Patients on active surveillance are closely monitored using PSA blood tests and repeat prostate biopsies. The choice between continued observation and curative treatment is based on evidence of disease progression during this monitoring.

It seems that prostate cancer screening by PSA testing have its pros and cons. In the end, it is always a question whether the benefits outweigh the costs.

Photo credit: stock.xchng

The Official Battling For Health Promotional Video

March 20, 2009 by  
Filed under . ANNOUNCEMENTS, Featured

I just put together a little promotional video for “Battling For Health” blog .. I hope you like it ….. // HART

Stock photos were taken from stock.xchng or created my HART

What’s the latest in Healthcare, March 20

March 20, 2009 by  
Filed under HEALTHCARE

doctorsEvery two weeks, I will be bringing you a news round up of what’s the latest in health care and the pharmaceutical industry. And it starts today.

What’s New?

Incoming chief to tackle woes of US food and drug agency
Margaret Hamburg, MD, has been nominated by President Obama to be the next US FDA head. She used to be the youngest health commissioner for New York City. “She would bring to the commissioner’s job a background of public-health experience that runs from working at the National Institute of Allergy and Infectious Diseases to advising the Centers for Disease Control and Prevention, and from bioterrorism planning to pandemic-flu preparation and tuberculosis control”, according to Nature News. The nomination still has to be approved by the Senate.

What’s Cool?

FDA Assessing Feasibility of Using Nanotechnology Test to Detect Anthrax Following a Bioterrorist Attack
A new nanotechnology-based test that can quickly and accurately detect anthrax toxin even to the very smallest amount is not so far away. The US FDA has announced it has just completed a “proof-of-concept” study on the test. The results of the study have been published in the March issue of Clinical and Vaccine Immunology.

Watch out!

FDA warns about risk of wearing medicated patches during MRIs
Adhesive patches are widely used nowadays to deliver medication transdermally. They range from smoking cessation drugs (nicotine patches) to vaccines. These patches, however, may contain metals that can interfere with magnetic resonance imaging (MRI) and some of these products do not contain warnings on their labels. Patients should report any patch use before a scheduled MRI.

What’s being discussed?

The Medical Device Safety Act of 2009
A landmark US Supreme Court decision that granted immunity to medical device companies against litigation by patients sparked a heated debate over patient safety. An editorial in the New England Journal of Medicine (Issue March 18, 2009) reviews the events that led to the introduction of The Medical Safety Act of 2009 to the US Congress. The Act aims to amend certain clauses in the Medical Device Amendment Act on which the court decision was based, thus reverse the medical device companies’ immunity.

What’s developing?

Big interest in heavy drugs
By simply switching atoms, pharma companies can come up with better and heavier drugs. Simply put, that is what “deuterated drugs” are all about. The trick is to replace a normal hydrogen atom with a heavier isotope – deuterium. A normal hydrogen atom has 1 proton and 1 electron. Deuterium has an extra neutron. It is heavier and can make stronger chemical bonds. These “heavier” deuterium versions of certain drugs are still being tested.

Photo credit: stock.chng

News from the cancer side, March 20

March 20, 2009 by  
Filed under CANCER

I have some interesting cancer news for you today. Check them out!

News from the statisticians

Hospitalizations for brain cancer 2006
“People in the Northeastern United States are one-third more likely than those in the South or West to be hospitalized for treatment of brain cancer or to have brain cancer when they are hospitalized for another illness or complication.” This is according to the recent statistical brief from the Agency for Healthcare Research and Quality (AHQR). 73,500 hospitalizations were related to brain cancer, which is 24.6 hospitalizations in 100,000, incurring $655.5 million in hospital costs.

News from the geneticists

U-M researchers ID gene involved in pancreatic cancer
This gene is called Ataxia Telangiectasia Group D Complementing gene (ATDC) and its expression means is on average having 20 times more in pancreatic cancer cells than in cells from a normal pancreas. It also makes pancreatic cancer cells resistant to current therapies, according to researchers at the University of Michigan. They found that ATDC is overexpressed in 90% of cases of pancreatic cancer.

News from the researchers

Mobile phone use not associated with melanoma of the eye
German researchers report that mobile phones do not cause melanoma of the eye (uveal melanoma) as previously feared. The study looked at 459 people with this type of melanoma and 1,194 without and followed them up to about 10 years. The authors concluded: “we observed no overall increased risk of uveal melanoma among regular mobile phone users or users of radio sets in Germany, where digital mobile phone technology was introduced in the early 1990s.”

News from the screening experts

Perspective Round Table: Screening for Prostate Cancer
Experts from Europe and North America have recently met to discuss the latest research results on the efficacy of screening for prostate cancer. This topic will be discussed in detail in a resource post on our Battling Cancer section next week. Stay tuned.


FDA Approved First DNA Test for Two Types of Human Papillomavirus
The US FDA announced the approval pf the first DNA test for the Human Papillomavirus (HPV) last week. The test can detect the DNA sequences for HPV type 16 and HPV type 18 in cervical cells. These two are the HPV types that commonly cause cervical cancers. The test, called Cervista HPV 16/18 is recommended for women aged 30 and above or those with “borderline cytology” e.g. suspicious but not so clear indication on the paps smear. It can be a very useful tool for risk assessment of cervical cancer.

Photo credit: stock.xchng

Sobriety Requires Surrender

March 19, 2009 by  
Filed under ADDICTION

Obstacles to lasting sobriety

What is it, that enables certain alcoholics and addicts to thrive in recovery, while others struggle for years – unable to establish any meaningful sobriety?

Anyone familiar with recovery knows the biggest battle for alcoholics and addicts – is the battle with our own minds. The way our disease affects the way we think and interpret the world, is the largest obstacle to lasting sobriety. The sick, troubled mind causes some to drink or use destructively for years. The alcoholic or addict will repeatedly fall victim to the mind’s tricks, as their disease relentlessly destroys them physically, mentally, and spiritually.

I’ve seen people with ten or fifteen years of sobriety, seeming to work a great program, always in meetings, and able to quote AA literature like scripture; suddenly start drinking or using again, lose everything they’ve gained – and die drunk or loaded. As if they never had any sobriety at all.

There are others who appear to take the program lightly, with little struggle, and live year after year in healthy sobriety. They seem to possess an inner strength that their recovery is built on. But what is it that gives them this strength? What’s the key that enables some to obtain healthy, long term sobriety, while others are stuck in a revolving door?

The alcoholic mind convinces us that it’s within our power to conquer our disease. We exhibit textbook cases of insanity, as we try the same methods that fail repeatedly – sometimes for years. Our diseased minds blind us to the futility of our efforts. We must reach a point of tremendous pain before we finally accept defeat. And when defeat is finally accepted, we can discover the key to real, healthy, long term sobriety – that key is complete surrender.

Admit we can’t conquer the disease on our own

For the alcoholic and addict; we can think all we want, gain all the knowledge there is, and work the most perfect recovery program possible. But the only way to achieve long lasting, meaningful sobriety, is to finally give up the fight, admit we can’t conquer our disease on our own – and surrender the fight to God. Without complete surrender; long term, happy sobriety isn’t possible. We may be able to quit drinking, but our disease will still control of our minds.

When I was growing up, my family had a friend who suffered from one of the worst cases of alcoholism I’ve ever seen. He battled everything in life, terrorized his family, and finally ended up in utter despair. After years of suffering, he finally reached a point where he admitted he had a problem, and decided to stop drinking – which he did. He was adamant that he could remain sober on his own, and refused to attend any type of recovery program, or accept outside help from anyone.

He managed to stay dry for quite a few years. But as time went by, he grew sicker, and more miserable – he lived in a dazed state of depression. Finally, one day, his pain became unbearable – so he went into his backyard, wrapped a towel around his head, put a pistol in his mouth, and gave his disease it’s final victory. He refused to surrender.

This man’s memory was clearly in mind when I decided I’d had enough of fighting my own disease. His example helped me realize how powerless I was in trying to recover on my own.

During my first year of sobriety, I was told there were certain things I should avoid doing. I was told not to make any drastic life changes that could cause stress, and to avoid any geographical changes that would take me away from my support group. It was recommended that I keep everything as low stress and easy going as possible for the first year or so.

Now, I don’t recommend this to anyone new to sobriety, but I didn’t follow some of the direction I was given. In my first year; I moved to another state, got divorced, and then moved to another country. My life was about as unstable as it could get. Based on the way I lived and worked my program – my chances of staying sober looked pretty slim.

But there is one thing that I did completely, from the beginning of my sobriety – I surrendered. I knew without a doubt that I was powerless over my disease – I’d tried for years and failed. The biggest relief for me, was to give up the fight, turn it all over to God, and pray for his help and guidance every day.

My own program for sobriety

For me, surrendering is my program. There are other aspects to my program, but they all center around ongoing surrender. My program doesn’t keep me sober – I wear it like a loose jacket, and it adds to the quality of my sobriety. Without surrender to God, the rest would be a waste of time.

If you’re new to sobriety, or in the midst of drinking and using – please don’t be afraid to admit your powerlessness to fight your disease. Finally turning the battle over to God completely, will give you the relief, guidance, and strength you need to start life over. You’ll find that life holds more promise than you ever dreamed possible.

Chad blogs over at The Effective Spirit. In recovery since 1992, .Chad writes about a variety of topics centered around recovery, Christianity, personal growth, overcoming adversity, and effective living.

Is there sex life after a heart attack?

March 19, 2009 by  

Resource Post for March

Now, more than ever, patients with heart disease are much longer but heart-giftunfortunately their quality of life is not necessarily better. The latest medical advances save people’s lives but the care in the life after – after heart surgery, after discharge, rehabilitation, etc. – sometimes fall short.

Depression is a common aftermath of heart surgery and other cardiac events. A previous study showed that depression is commonly reported among young people aged 18 to 49 years old. They are tended to be female, of African American or Hispanic ethnicity.

I imagine that young people would be depressed since these years are the most active and productive years of their lives. Young women of reproductive age would be worried about their ability to raise their families or even able to start a family at all.

Depression has also been reported among the elderly but not to the extent observed in young people.

It is to be expected that one main cause of depression among young cardiac patients is sex, rather lack thereof. Sexual satisfaction is a part of life. And for the sexually active, the question of whether sex after a heart attack is still possible is another big factor that may contribute to depression and overall poor quality of life. Unfomarried-handsrtunately, Hollywood has erroneously portrayed in films the horrors of having a heart attack in the act of sexual intercourse, scenes which can dampen the spirits of both the heart patient and his/her partner. A report presented at the European Cardiology Society last year stated that heart patients

…may have concerns about resuming sexual activity, feelings of sexual inadequacy, changes in sexual interest or changes in patterns of sexual activity…[They] are worried about chest symptoms during intercourse or even an acute ischemic event during sex. Many lack information about returning to sexual activity.

Researchers looked at the sexual satisfaction of 35 female with either non-STEMI or unstable angina and reported the following results::

  • 49% resumed sexual activity within 12 weeks of hospital discharge.
  • 35% reported being “sexually unsatisfied
  • 41% were “mostly dissatisfied
  • 24% were “somewhat dissatisfied
  • 83% reported sexual desire to be lower compared to desire before the cardiac event.

But is there really room for sexual activity in a heart patient’s life?

Apparently, the answer is a resounding “Yes” but with some caveats.

According to this WedMD article “it is important to remember that sex is a workout. So doctors typically tell patients to abstain from sex after heart disease until they can withstand the cardiac workout.”

gametesThis means that people who are sedentary may have to abstain from postcardiac event sex until they are back on their feet and have passed their stress tests. What the doctors are saying is that if a patient can handle climbing the stairs or light jogging around the block, then he or she is ready to resume sexual activity.

But sometimes fear and the uncertainty can interfere even if the body is physically ready. Here are some tips that you may try to counteract this problem:

Do not blame yourself. It is not your fault and it is alright to feel frustrated. So stop blaming yourself. Erectile dysfunction is linked to heart disease. Some cardiac medications can interefere with sexual drive and performance. Nothing you can do or have done could change this.  However, you have to do something about it and the first step is talk about it.

Talk to your doctor. I know that this topic maybe embarrassing for some people, depending on personality as well as cultural and religious backgrounds. However, your doctor is the best person who can tell you whether you are ready or not and what it takes to get you back into shape. Your doctor can give you all the information you need and can even refer you another professional if necessary.

Avoid self-medication. Be careful about performance enhancing and erectile dysfunction drugs. You see them advertised on the Internet all theone_pill_a_day___ time and your email Inbox is probably flooded by sales pitches on cheap Viagra and penis enlargement pills. However, these drugs may not be what they seem. They may be disguised in the form of dietary supplements, tea, herbal remedy, or energy drinks. Some of these substances can increase heart rates while others can interact with the other drugs you may already be taking. So before you resort to self-medication, talk to your doctor first. He would know which drug would be most appropriate and safest for you.

Talk to your partner. Be open about your fears and worries. For all you know, he or she also has some doubts and worries about the situation. Take him or her when you go talk to your doctor.

Give yourself time. Sex doesn’t have to start at day one. It doesn’t have to be perfect the first time around after surgery. Take your time. Give your body and mind the time to heal and recover.

Go for counselling. Professional help may be necessary and your doctor can refer you to a psychologists or a sex counsellor. These health professionals may also prescribe drugs, devices, as well as therapies that can help.

fruits1Live a healthy lifestyle. You can’t live on sex alone. And your body should be fit to perform normal daily tasks, including sex. That is why you shouldn’t forget to maintain a healthy lifestyle which includes physical activity and the proper diet. Remember: a healthy and active sex life depends on an active and healthy lifestyle.





Photo credits: stock.xchng

Computer Work and Computer Vision Syndrome

March 19, 2009 by  
Filed under VISION

I´ll bet you are doing what I am doing right at this very moment – sitting in front of the computer. Just like what millions of other people all over the computerworld are doing right now. Whether you are doing it for business or for fun, sitting in front of the computer for prolonged periods of time can have some health consequences that need to be taken seriously. And one of the consequences is the effect on our vision.

As part of the Save Your Vision Month campaign this month, the American Optometric Association (AOA) gives us information about the computer vision syndrome (CVS).

The AOA defines CVS as “the complex of eye and vision problems related to near work that are experienced during or related to computer use.

Here´s what happens when we work in front of a computer screen:

  • We look straight ahead for long stretches.
  • We blink less often.
  • We usually work indoors, in an environment of low air humidity – such as in an office or at home.

All these can contribute the CVS.

In addition, we also use specific vision skills that place extra demands on our already overworked visual system, namely:

The computer screen itself presents some physical barriers that affect our vision, namely:

  • Resolution
  • Contrast
  • Glare and reflections
  • Image refresh rates and flicker
  • Working distances and angles

Here are some tips from the AOA for a healthy, comfortable vision at the computer:

  1. Have a regular comprehensive eye exam to ensure your eyes are healthy and that you have the correct eyeglass or contact lens prescription (if necessary). Be certain to tell your optometrist about the computer work you do.
  2. Wear glasses that are specifically designed to function comfortably at the computer. The lenses you wear for day-to-day activities may not be the best for working at the computer. 
  3. Practice the following eye care tips:
  • Rest the eyes
  • Blink forcefully
  • Use a humidifier
  • Instill artificial tear

4. Set up your work station for comfortable and effective computer use, as recommended below.

o Feet should be flat on the floor (or on a slightly angled foot rest) with knees bent close to or greater than 90 degrees.

o Chair seat should support the legs without excessive pressure on the back of the thighs.

o The back should be snug against the seat to fit your spinal contour. Thigh-to-trunk angle should be 90 degrees or greater.

o Wrists and hands should extend nearly straight from the elbow to the home row of the keyboard.

o A commonly preferred work surface height for keyboard use is about 26″ as opposed to the conventional 29″ of most tables or desks.

o Place the monitor 20″-26″ from your eyes, depending on the size of the monitor and individual vision conditions.

o The monitor and keyboard should be straight ahead.

o The top of the monitor should be slightly below horizontal eye level. Tilt the top of the monitor away from you at a 10 degree to 20 degree angle. The center of the monitor should be 10 degrees to 20 degrees below your eyes. This is 4-9 below your eyes at a distance of 24″

o Keep the monitor free of fingerprints and dust. Both can reduce clarity.

o Place document holders close to the screen within the same viewing distance. Keep the keyboard and monitor in line.

o Adjust the keyboard tilt angle so that wrists are straight.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.