Sleepless and depressed: postpartum depression

July 15, 2009 by  
Filed under DEPRESSION

motherly_lovePostpartum depression (PPD): only mothers have the bad luck of going through such an ordeal. Fortunately, in most cases, PPD is not permanent but rather reversible. Tell me about it. I’ve had it myself – an extended one actually because I had twins. A case of a double dose of stress perhaps?

Anyway, many hypotheses have been put forward as to what causes depression in postpartum women. Latest research suggests that sleep disturbances may play a key role in PPD. In a study of 2,830 Norwegian mothers, the following results were reported:

  • 60% of the participating women admitted to be suffering from sleep deprivation. Of these, 16.5 suffered from depressive symptoms.
  • 21% of women with PPD reported to have been already depressed during pregnancy.
  • 46% of those with PPD reported to have had at least 1 episode of depression before getting pregnant.
  • Average nightly sleep duration was reported to be 6.5 hours.
  • Sleep efficiency was 73%.

It seems that PPD is not only due to poor sleep quality but to a history of depression before and during pregnancy. Other factors such as a bad relationship and stressful life events may also play a role. However, tiredness and lack of sleep can aggravate the depressive symptoms. The association between depression and poor sleep was observe to set in about four months after delivery.

Experts find it is important to find out whether the depression causes the sleep disturbances or whether it is the tiredness that causes the depression. To complete the vicious cycle, babies of moms with PPD also tend to suffer from sleep disturbances from age two weeks to six months, according to another research.

According to lead researcher of the Norwegian study Dr. Karen Dørheim, psychiatrist at Stavanger University Hospital in Norway,

“It is important to ask a new mother suffering from tiredness about how poor sleep affects her daytime functioning and whether there are other factors in her life that may contribute to her lack of energy. There are also helpful depression screening questionnaires that can be completed during a consultation. Doctors and other health workers should provide an opportunity for postpartum women to discuss difficult feelings.”

In addition, the researchers also looked at the factors that affect sleep quality in postpartum moms and they’ve identified the following to cause poor sleep quality:

  • depression
  • history of sleep problems
  • having a younger or male infant
  • being a first time mother
  • not exclusively breastfeeding

Postpartum sleep quality seems to be better when the baby sleeps in another room.

Keeping sodium intake down: how difficult can it be?

July 14, 2009 by  

salt-and-lightWhy is sticking to a low sodium diet so difficult? Apparently it is difficult mainly because of problems with diet.

The recommended daily intake of sodium for patients with heart failure is 2 g or 2,000 mg. However, many patients take in more than that and only one-third can actually stick to a low sodium diet.

The study looked at 116 heart failure patients, their diet and their sodium intake. The study results showed that the average intake was 2,672 mg per day. This may seem high but looking at the range, the figures are even more shocking. The lowest intake was 522 mg whereas the highest was 9,251 mg per day – more than 4 times the recommended daily rate!

The researchers attribute this high sodium intake to poor diet. This typically consists of foodstuffs with hidden salt content, e.g. fast food meals, bread, pizza, and lunch meat. Furthermore these foods are also high on calories, thus adding insult to injury. The study results clearly indicate that

“Heart failure patients need individualized diet plans that lower sodium and enhance the overall quality of their diet.”

However, keeping sodium intake down is not only recommended for heart failure patients. Everybody has to watch their salt intake for the sake of their cardiovascular health. The American Heart Association (AHA) recommends the following:

  • 2,300 mg of salt per day for health people
  • 1,500 mg of salt per day for high risk individuals, e.g. middle aged and older adults, African Americans and those suffering from hypertension.

According to Dr. Carolyn M. Reilly, coauthor and researcher at Emory University in Atlanta

“The patients themselves were shocked to find out they were eating more than 2000 mg of sodium a day…There is so much salt hidden in foods that patients aren’t aware of. While they may have thrown away their salt shakers, they didn’t know that 70 percent of the sodium in the American diet is in the food, not the shaker. Everything processed has sodium in it to give it a longer shelf life. In addition to safety, sodium is also added to foods to enhance texture and mask bitterness. Some of the big culprits we have identified in this population are cured meats such as hot dogs and bacon, and other processed foods like canned soups, salad dressings and condiments.”

The study results also indicated that higher sodium intake was especially common among those who eat high-calorie diet and fast food, males, and those of lower economic status. Lower sodium intake was associated with low-calorie diet, less carbohydrate an fat intake (but not less protein), females, and those earning at least $35,000 a year.

Sunscreen: friend or foe?

July 14, 2009 by  
Filed under CANCER

suncreamSunscreens are supposed to protect our skin from the sun’s UV rays, thereby lowering the risk for skin cancer, especially the deadly melanoma. Now come these claims that sunscreens actually do just the opposite. Let us examine the evidence.

Many sunscreens contain zinc oxide and titanium oxide, compounds that are supposed to block the UV rays. Some studies suggest, however, that these compounds produce free radicals when exposed to sunlight, leading to cell damage.

In 2000, Swedish researchers  looked at 571 people with cutaneous malignant melanoma and compared them to 913 people without skin cancer (healthy controls). The analysis showed that the melanoma incidence was significantly associated with regular sunscreen use.

Many people are quick to conclude that it was the sunscreen that caused the melanoma. However, the researchers emphasized on the following key points:

  • The study was conducted during the 1990s when the sun protection factor (SPFs) for sunscreens was generally low. The SPF used by the study participants ranged from 2 to 25, with a median of 6.
  • Those who used sunscreens reported to have stayed longer under the sun.
  • The increased melanoma risk was especially significant among those who used products with SPF of 10 or lower and among men.

The study concluded

Our results are probably related mainly to earlier sunscreens of low SPF. They substantiate the hypothesis that sunscreen use, by permitting more time sunbathing, is associated with melanoma occurrence.

A 2007 review by French researchers gave the following information:

  • Frequent sunscreen users are usually those with higher natural sensitivity to the sun.
  • Sunscreen use led to longer exposure to the sun among people who did this intentionally in order to get a tan.

It seems that sunscreen use as such doesn’t increase the risk for melanoma. However, the tendency of people to stay longer under the sun, believing that their sunscreen provides them complete protection from UV rays does play a role in increasing the risk.

There have been changes in sunscreen labelling to give consumers more accurate and less misleading information about sunscreen. Especially important is the fact that the SPF of your sunscreen does not necessarily tell you how long you can stay in the sun. It depends on so many factors including skin type, geographic location, time of the day, and weather conditions.

In addition, a broad-spectrum sunscreen, one that filters UV A as well as UV B rays has been shown to “provide better protection from solar ultraviolet-simulated radiation and natural sunlight-induced immunosuppression in human beings.”

Photo credit: stock.xchng

Those who are battling cancer – now

July 13, 2009 by  
Filed under CANCER

Resource Post for Julypink-ribbon2

We’ve always heard stories of people who battled cancer and won or those who battled cancer and lost. There are people out there, however, who are still in the midst of the battle. I would like to take this opportunity to feature three people who are battling cancer, each one in a different way.

Patrick Swayze, actor

The actor best known for his dancing moves in Dirty Dancing and surfing tricks in Break Point was diagnosed with Stage IV pancreatic cancer in January 2008. While many celebrities chose to keep their cancer a secret, Patrick patrick_swayze_2006Swayze decided to battle the disease privately. He was quoted as saying

I will go so far as to say probably smoking had something to do with my pancreatic cancer.”

There are conflicting reports about how Swayze is responding to the treatments. He is suffering from a type of pancreatic tumor called Intraductal Papillary Mucinous Neoplasm (IPMN). He underwent Cyberknife radiotherapy cancer treatment last year. There were positive reports about his response to the treatment but there are also reports about his cancer having metastasized to his liver. Early this year, he was hospitalized for pneumonia, possibly a complication of chemotherapy. His TV series The Beast was cancelled early this year.

Current rumors suggest that Swayze has stopped his cancer treatment due to serious side effects. However, he reportedly is still chain smoking. Has Swayze given up on his battle against cancer?

Edward “Ted” Kennedy, US Senator

Last May 17, 2008, just after I started writing for Battling Heart and Stroke, there were ted_kennedy2c_official_photo_portraitreports that Senator Ted Kennedy was hospitalized due to a seizure. Stroke was initially suspected but he was later diagnosed with brain tumor, a malignant glioma.

Initial assessment indicated the tumor to be inoperable but alternative opinions were sought. Kennedy underwent brain surgery at Duke University Medical Center in June 2008 to remove whatever could be possibly removed of the tumor. This was followed by chemotherapy and radiation treatment. Kennedy’s prognosis is hard to predict. It could be months or it could be years. The senator managed to attend the presidential inauguration of Barack Obama but suffered a seizure during the inaugural luncheon. Despite his health problems, Senator Kennedy continued his legislative duties even from remote. Since his illness, he had been very active in the health care reform issues, referring to it as “the cause of my life.”

He played an instrumental role in the passage of the Family Smoking Prevention and Tobacco Control Act last month, a sweeping law that empowers the US FDA to regulate and control manufacturing, marketing, and sales of tobacco products.

According to the Boston Globe:

And except for carving out more time with his family, Kennedy decided to spend all his remaining workdays trying to give all Americans access to quality healthcare. It’s a goal he’s pursued for nearly five decades, always running up against critics who insisted that his plans were too costly, too complicated, too focused on government solutions. His approach has changed somewhat – he now vows to work with private insurers – but the country has changed more, in its willingness to accept a greater government role in the private sector.

No doubt about it. Senator Kennedy is a fighter and is determined to leave his mark in history.

Steve Jobs, technology icon and business man

He is one of the co-founders to the technology company Apple and has been instrumental in turning around the failing company with nifty gadgets such as iPod and iPhone. In 2stevejobsmacbookair004, Jobs announced that he was diagnosed with pancreatic cancer, a rare and less aggressive form known as islet cell neuroendocrine tumor. He underwent pancreaticoduodenectomy in July 2004 which successfully removed the tumor.

However, in January of this year, Jobs took a leave of absence for health reasons but no details were given except that

During the past week I have learned that my health-related issues are more complex than I originally thought.”

He didn’t appear at the trade show Macworld 2009 despite the fact that this will be the last time that Apple is participating. It was later reported that he underwent a liver transplant at the Methodist University Hospital in Tennessee due to an undisclosed medical condition. The doctors declared Jobs’ prognosis “good” and Apple has announced that its chief will be back to work soon. There are speculations about his cancer coming back but this hasn’t been confirmed. Unlike in the showbiz or politics, health issues can greatly affect business outcomes, hence the reason for limited disclosure.

Photo credits:

Steve Jobs, Patrick Swaye: Creative Commons/Wikimedia

Ted Kennedy: US Senate

Pink ribbon: stock.xchng

Another first: cardiac stem cells to treat heart attack

July 13, 2009 by  

laboratory2Stem cell research seems to be finally reaping fruits as more and more stem cell-therapies are being tested in clinical trials.

And here is another first one: injection of autologous heart-specific stem cells for the treatment of myocardial infarction or heart attack. So far, two patients have received the treatment and 22 more are expected to receive it as part of a Phase I clinical trial.

The cardiac-specific stem cells, also called cardiosphere-derived cells, have been observed to develop into mature heart cells.

According to researcher Dr Raj R Makkar  of Cedars Sinai Heart Institute, Los Angeles, CA:

“This is the first time we have injected cardiac-specific cells into a human. These cells are destined to be heart-muscle cells, so this is attractive in that sense-we are trying to obtain cardiogenesis.”

Here is how the procedure works:

Using a process called endomysocardial biopsy, a fine catheter is inserted in a vein in the neck or the groin up to the heart to obtain cells from the inner walls of the organ. The cells are then cultured in the lab for a period of four to six weeks until they have become cardiosphere-derived cells. A large number of these cells (12 to 25 million) are then injected back into the patients, at the sites of the artery that caused the heart attack, again a catheter.

The advantages of this technique is that

  • the cells are back into the area that caused the myocardial infarction
  • the cells are autologous, e.g. coming from the patient himself/herself (source and recipient is one and the same) so that the risk of rejection is very minimal.

According to lead investigator Dr Eduardo Marbán who developed the technique

“If it is successful, we hope the procedure could be widely available in a few years and could be more broadly applied to cardiac patients.

“This procedure signals a new and exciting era in the understanding and treatment of heart disease. Five years ago, we didn’t even know the heart had its own distinct type of stem cells. Now we are exploring how to harness such stem cells to help patients heal their own damaged hearts.”

The use of Autologous Stem Cell Treatment (ASCT) is the latest trend in stem-cell based therapy and its use is not only limited to heart disease but also to neurodegenerative disorders and cancer.

What’s the latest in health care, July 10

July 10, 2009 by  
Filed under HEALTHCARE

doctorsSchool vacations has started on my part of the world. Have fun!

What’s new with health insurance?

Study Finds Fewer Families Can Afford Health Insurance
If you are one of the lucky ones, then you and your family have insurance coverage through work. However, 30 million American families do not have access to health insurance through their employers. Many of them remain without coverage because they simply can’t afford it. This is the latest figures from the Agency for Healthcare Research and Quality (AHRQ) of the US Dept. of Health sand Human Services.

Uninsured with Asthma – Data Shows Many Less Likely To Take Daily Meds
Another sad report from AHRQ: Those with chronic health conditions but do not have health insurance coverage simply forego their medications. Take asthma, for example. According to this AHRQ study, “…about 6.7 million Americans with asthma take daily medicine to prevent asthma attacks. In comparison, those under 65 without insurance are only about half as likely to take the drugs they need to control their asthma symptoms.”

Who got busted?

Medicare Fraud Strike Force Operations Lead to Charges Against 53…
$ US 50 million worth of false Medicare claims have been uncovered by the Medicare Fraud Strike Force of the US HHS. Charged with fraud were 53 doctors, health care executives and beneficiaries.

What’s dangerous?

FDA strengthens Darvon, Davvocet warnings
The US FDA is requiring manufacturers of propoxyphene-containing drugs to include a boxed warning in the label that emphasizes the potential for overdose. Painkillers such as Darvon and Darvocet fall under this category of drugs. Propoxyphene has been on the market since 1957. It is a widely prescribed member of a group of drugs known as opioids and is used as a treatment for mild to moderate pain. Recent data show that overdose with propoxyphene can be fatal.

Warning on Testosterone Gel Products
Another FDA warning concerns two topical testosterone gels. Testim 1% and AndroGel 1% are indicated for men who don’t produce sufficient testosterone. The manufacturers are required to add a boxed warning about the danger of children getting in contact with the gel. Such incidents have been reported which resulted in abnormal enlargement of the genitals and premature development of public hair, and behavioural problems, among others.

What’s new?

FDA Approves Generic Prescription-Only Version of Plan B Emergency Contraceptive for Women Ages 17 and Under
Another victory for the “morning after” pill. It is now available in generic form, but for prescription only for women aged 17 and younger. The US FDA approved the first generic version of the emergency contraceptive Plan B (levonorgestrel) tablets.

Photo credit: stock.xchng

News from the cancer side, July 10

July 10, 2009 by  
Filed under CANCER

newspaper1July, she will fly, and give no warning to her flight…” sang Paul Simon and Art Garfunkel. So enjoy her why she’s still here!!! But before you start your weekend, here’s some cancer updates for you…

News from the drug regulators

FDA Approves First Maintenance Drug Therapy for Advanced Lung Cancer
The US Food and Drug Administration (US FDA) has just approved earlier this week the first ever maintenance drug for advanced non-small cell lung cancer. The drug pemetrexed (marketed as Alimta) is intended “to prevent the disease from progressing after the tumor has shrunk or the disease has stabilized in response to chemotherapy. Alimta disrupts metabolic processes that are dependent on the B-vitamin folate, a necessary ingredient for cell replication.”
Alimta was previously approved for mesothelioma, an asbestos-associated cancer, in 2004 . It is manufactured by Eli Lilly.

News from the stem cell research regulators

NIH Issues New Stem Cell Research Guidelines
The National Institutes of Health has issued new guidelines for human stem cell research. This is in response to US President Barack Obama’s Executive Order 13505: Removing Barriers to Responsible Scientific Research Involving Human Stem Cells. The new guidelines provide for permission to start new stem cell lines, establishment of a stem cell lines registry , as well as using existing stem cell lines for application for dederal research funding. However, this doesn’t mean that stem cell research in the US is now completely unregulated. They are still restrictions, albeit relatively looser than before. Creation of new stem cell lines, for example, is only allowed from left over embryos of in vitro fertilization, and only if the owners have signed over those embryos for research. In addition, the donors should be fully informed of the fate of the embryos but shouldn’t received any compensation at any time. The new guidelines took effect on July 7, 2009.

News from the cancer hunters

Cancer biology: At rest in the bones
Researchers at the Memorial Sloan-Kettering Cancer Center in New York have identified a protein that helps breast cancer cells to survive in the bone marrow for long periods of time. The cancer-promoting protein is called Src and are found in human breast cancer cells. Patient relapse after 5 years has been traced to “a unique pattern of Src-regulated gene expression.” The findings are published in the July issue of Cancer Cell.

News from the film makers

Stronger than ever
For its 6oth birthday, the Jimmy Fund of the Dana Farber Institute has added a short film masterpiece to its Jimmy Fund/Variety Children’s Charity Theatre Collections Program. Trailer of the short film will be shown in participating theatres in the states of Massachusetts, Rhode Island, Connecticut, New York and New Jersey.

College, alcohol and preventive measures

July 9, 2009 by  
Filed under ADDICTION

alcohol-barThere’s been a heated discussion going about the possibility of lowering the minimum legal drinking age in the US down to 18. There’s also been a surge of research studies that evaluated the consequences of such a change. Recently, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) released some statistics on college drinking.

  • The number of alcohol-related deaths in 2005 was 1,825, up from 1,400 in 1998. This is mainly due to traffic-related accidents involving 18 to 24-year old students.
  • Binge drinking (heavy episodic drinking) increased from 42% to 45%.
  • Incidence of drunk driving increased from 26.5% to 29%.

The figures were published in a supplement to the July issue of the Journal of Studies on Alcohol and Drugs.

According to NIAA acting director Dr. Kenneth Warren

“This supplement is a valuable resource that underscores the growing number of research-driven strategies that college administrators and health officials can put in place to address serious student drinking problems.”

The figures seem to indicate that despite having one of the highest minimum legal age for drinking alcohol in the world, the US seems to be having major alcohol-related problems among college students.

However, it’s not all bad news. It seems that preventing these problems is possible and prevention programs in the colleges themselves seem to be effective. Here are some examples of these programs:

  • On campus counseling. Northeastern University counselors report on the effectiveness of an assistance program that helps students with alcohol problems alter their behavior. The one-to-one counselling helped students use “coping skills.”
  • Community law enforcement. Two studies report the effective use of law enforcement – in the form of increased police patrols – on campus as well as off campus (surrounding community). These programs resulted in reduced drinking off campus.
  • On campus motivational enhancement. College officials at the University of Central Florida believe in motivational interviews which seem to work well among high risk drinkers. Researchers at the Loyola Marymount University in LA report that the long-term effectiveness of this approach is limited and needs to be regularly boosted up.

Many experts believe that a combination of these strategies will effectively counteract alcohol-related problems on as well as off campus.

Photo credit: stock.xchng

Stroke patients: the years after

July 9, 2009 by  

wheelchairOver the years, the methods in stroke treatment, management and rehabilitation have greatly advanced. However, there is very little data available on the outcomes of stroke victims, years after recovery. This recent study indicates that the prognosis for stroke survivors can be poor as their functional abilities decline with time even they have been declared “fully rehabilitated.” This decline was evident even if the patients did not suffer a subsequent stroke or any other cardiovascular event.

Ischemic stroke is cause by blood clots in the brain and the first line of treatment is the clot-busting agent tissue plasminogen activator (tPA). With tPA use coupled with improved physiotherapeutic techniques, survival and rehabilitation rates have greatly improved and many patients are considered “functionally recovered six months after the stroke.”

What is less known is the fact that stroke victim’s functional ability actually deteriorate with time at a rate of about 9% per year for the first 5 years after recovery. The likelihood of becoming severely disabled increased by 11% per year.

This poor prognosis is due to many predictive factors. The patients most likely to suffer from functional decline and disability are:

• were older at the time of the stroke.

• had diabetes.

• were unmarried.

• had a more severe stroke.

• had a right-sided stroke.

• had urinary incontinence within a week of the stroke.

In addition, the type of health insurance seems to make a difference. Those uninsured and covered by Medicaid (state-run coverage for low-income groups) showed significantly faster functional decline. Those who are privately insured or covered by Medicare (state-run coverage for the elderly) showed lesser decline.

According to researcher Dr. Mandip Dhamoon

“Access to health care is not just important around the time of the stroke but in the years following, when those with poor access do worse in their functioning and ability to be independent. We can speculate that they may be less likely to get ongoing rehabilitation and may be less able to manage their blood pressure and other risk factors.”

Gender and race did not seem to influence outcomes.

The results of the study highlight the need for long-term follow up of stroke victims. It suggests that a 6-month rehabilitation program may not be sufficient to ensure that stroke victims have a good quality of life, years after a stroke attack.

Canines to the rescue: how dogs sniff out health problems

July 8, 2009 by  
Filed under Featured

dog1Check out how dogs can sniff out hypoglycemic attacks before they happen and how are they are being trained to detect cancer.

Tumor sniffers: training dogs to detect cancer

July 8, 2009 by  
Filed under CANCER


A dog is a man’s best friend. Aside from this role, however, dogs also act as nurses to people with disabilities. So why not dogs detecting health problems?

Dogs have one of the most sensitive sense of smell among animals. But can they be trained to smell the scent of cancer accurately? Two research centers claim they have achieved this.

Pine Street Clinic, California

(Source: New York Times):

The clinic claims it has successfully trained 5 cancer-sniffing dogs consisting of three Labradors and two Portuguese water dogs. These dogs are supposedly able to detect lung cancer by sniffing the breath of the patients – with 99 percent accuracy! Their report was met with amazement (astounding!) as well as scepticism (too good to be true!).

According to Dr. Ted Gansler, director of medical content in health information for the American Cancer Society:

“It’s biologically plausible, but there has to be a lot more study and confirmation of effectiveness.”

The trained dogs were from different sources: from owners as well as from Guide Dogs for the Blind. The training was similar to that when dogs are trained to detect bombs, as follows:

The clinic collected breath samples in plastic tubes filled with polypropylene wool from 55 people just after biopsies found lung cancer and from 31 patients with breast cancer, as well as from 83 healthy volunteers. The tubes were numbered, and then placed in plastic boxes and presented to the dogs, five at a time. If the dog smelled cancer, it was supposed to sit.For breath from lung cancer patients, Mr. McCulloch reported, the dogs correctly sat 564 times and incorrectly 10 times.

Cancer and Bio-detection Dogs, UK

(Source: National Geographic News)

This non-profit cancer organization trains dogs to detect bladder cancer by sniffing urine samples. Here is how the dogs were trained: 8 urine samples were placed in a carousel and the dog has to sniff out the sample from a cancerous bladder. When it detects the cancerous sample successfully, the dog gets a food treat as a reward.

According to Claire Guest, head of the cancer center:

“Now that we know that dogs are able to detect human disease by its odor, and that different diseases have different odors, the potential is just incredible to help individuals with life-threatening conditions but also to have new ways of looking at diagnosis of life-threatening diseases such as cancer.”

So how do these amazing animals do it?

It is a known fact that tumors release very small amounts of compounds (e.g. alkanes and benzene derivatives) which are not in healthy tissues. The dogs highly sensitive olfactory nerves seem to be able to detect minute amounts (in parts-per-billion!) of these abnormal compounds in the breath, skin, and urine of cancer victims.

According to dog trainer Rob Harris

“Dogs have a highly-developed sense of smell. Their nose is in use every day. We just use that part of their nose to help us identify the odor of cancer.”

Also check out: dogs can detect (and therefore warn of) a hypoglycemic attack in patients with diabetes!


Photo credit: stock.xchng

Powerful noses: dogs can smell hypoglycemia attacks coming!

July 8, 2009 by  
Filed under DIABETES

dog2We all know that dogs have exceptional sense of smell. But do their olfactory powers extend to sniffing out health problems? Well, it seems that dogs can detect the smell of a hypoglycemia attack coming, probably in the form of chemicals given off by body during the attack. Several of these amazing stories are featured in this video in the National Geographic.

According to the British Paul Jackson, who is suffering from type 2 diabetes, his collie Tinker would get agitated when he was about to have a hypoglycaemic attack.

“It was his behavior around me when I was having a hypoglycemic attack. The way he would lick my face, or cry gently while I was sitting down, or bark even. And then we noticed that this behaviour was happening while I was having a hypoglycemic attack so we just put two and two together.”

This is one of the stories that prompted the UK organization Cancer and Bio-Detection Dogs to investigate and then make use of this astounding discovery.

One of the trainers at the cancer center, Kimberley Cox, also has diabetes. She trained a golden retriever named Rory by capturing her body odor during a hyploglycemic attack in a cotton wool and stored it in an air tight bottle. She then simulated the attack by opening the bottle in the presence of Rory. On this olfactory cue, Rory is trained to fetch an insulin kit which includes a blood sugar tester and insulin injections. For achieving his task, Rory gets a food treat as a reward.

Says Kimberley

“I’ve taught him to recognize the odor, and the odor signals to him a big reward, so he knows to come up to me and recognize that odor.”

These are not isolated incidents. Researchers from the Queen’s University in Belfast investigated 212 dog owners with type 1 diabetes. 138 of these canine lovers (65.1%) reported that their dogs showed some behavioral changes during hypoglycemic episodes. These behaviours are aimed to attract the attention of their owners and take the form of:

  • vocalizing (61.5%)
  • licking (49.2%)
  • nuzzling (40.6%)
  • jumping on top of them (30.4%)
  • staring intently at their faces (41.3%)
  • trembling (7.2%)
  • running away (5.1%)
  • hyperventilating (2.2%)

The study concludes

… behavioral reactions to hypoglycemic episodes in pet owners with type 1 diabetes commonly occur in untrained dogs. Further research is now needed to elucidate the mechanism(s) that dogs use to perform this feat.

But this is not the only health problem that dogs can sniff out. Check out our Battling Cancer site for a feature on cancer-sniffing dogs.

Photo credit: stock.xchng

Married at midlife: lowering your risk for dementia

July 7, 2009 by  
Filed under ALZHEIMER'S

married-handsSocial life is important for patients with Alzheimer’s disease and other forms of dementia, as many research studies have reported. A more recent study pinpointed something even more specific – that patients who are married or living with a partner at midlife have a much lower risk of developing dementia later in life. The research was conducted by Swedish researchers on more than 2000 Finnish adults.

Furthermore, the increase in risk seems to be dependent on the type of singlehood. The researchers reported that:

  • People who were single during their entire adult life were two more likely to develop some form of dementia compared to married or partnered people of similar age.
  • People who were married but were divorced at middle age have a three-fold increase in risk.
  • Those who were windowed or suffered through the death of a partner have an even higher risk for Alzheimer’s – almost 6 times higher than their married counterparts.

According to author Krister Håkansson of the well-known Karolinska Institute in Sweden “This suggests two influencing factors — social and intellectual stimulation and trauma. In practice, it shows how important it is to put resources into helping people who have undergone a crisis. If our interpretation holds, such an intervention strategy could also be profitable for society considering the costs for dementia care.”

So what does marriage and partnership have to do with cognitive decline?

Researchers believe that partnership and marriage provide social as well as intellectual stimulation that keep the brain functioning even in old age. The next step is to look into the effect of other types of relationships (children, grandchildren peer support groups) and the quality of the relationships (happy or not happy):

Previous studies have shown that an active social life help keep the mind and the memory sharp late in life. A study by Harvard researchers revealed that those who have the most social interaction within their social circle, be it with friends or family showed the slowest rate of memory decline.

These results give some important insights on currents standard of care for people with dementia and Alzheimer’s. In addition, it gives people who are approaching the middle age a strategy to counteract the cognitive decline that comes with age.

Depressed and single = chest pains

July 7, 2009 by  
Filed under DEPRESSION

heart-sickWhat do depression, chest pains, and being single have to do with each other? A study that followed up 191 patients with coronary artery disease (CAD) suggests that these three might be interrelated in this patient population. The results were based on answers to a questionnaire that determines the frequency of chest pain before and during physical stress testing as well as psychosocial assessments using a self reported anxiety and depression questionnaire.

Here are the key research findings:

  • 36% reported no chest pain during the past month;
  • 35% reported monthly symptoms of chest pains;
  • 30% had daily or weekly chest pain
  • 44% who reported daily or weekly chest pain had significant anxiety; two-thirds had severe depression.

The study results suggest that anxiety and depression are associated with higher incidence of angina pectoris among CAD patients, especially those who had surgical procedures to open blocked arteries.

Angina pectoris is mainly characterized by chest pain but can also include pain and discomfort in the jaw, shoulder, back and arm. The pain is caused by myocardial ischemia, a condition wherein the supply of oxygen-rich blood to the heart muscle is insufficient, which in CAD patients is mainly caused by narrowed or blocked arteries.

According to lead author Dr. Mark Sullivanof the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle.

“This study has identified a high-risk group for angina. Patients with daily or weekly angina are highly likely to have significant anxiety and depression.”

Other findings of the study are:

  • Patients who experienced angina more frequently were more likely to be younger and single.
  • Patients who experienced chest pain more often were also more likely to report the pain during a treadmill testing.

The reason behind the link between the frequency of angina and depression , as well as age and civil status is not clear. According to Dr. Sullivan

“It is unclear whether these psychosocial factors are truly affecting the anginal response to ischemia or if the increased chest pain burden is causing an intensification in psychosocial distress.”

I have previously posted on the link between depression and heart problems and how standard care for cardiac patients fails to take into consideration the psychosocial needs. It has also been shown that a stable life partnership helps in patient recovery.

In the US, the standard care for myocardial ischemia is medication and revascularization procedures. In Europe, on the other hand, treatments include aside from pharmacotherapy, cognitive-behavioral therapy and rehabilitation programs similar to those used for chronic pain.

D. Sullivan concludes:

“Physicians need to assess patients with frequent angina for anxiety and depression. It’s not all ischemia. There are other very important aspects to angina that can be diagnosed and treated either with psychotherapy or medication. Reducing anxiety and depression may be a cost-effective way to reduce angina.”

Photo credit: stock.xchng

Music for the heart and the vascular system

July 6, 2009 by  

heart_musicMusic can have power over us. The slow lullaby puts babies to sleep. The fast number perks us up to dance, and perform better during work out.

A research study by Italian researchers shows that music has a strong effect not only on our moods and emotions but on our cardiovascular system. In fact, our heart seems to go in sync with the music we are listening to.

The researchers looked at healthy whites aged 24 to 26 years old with and without previous musical training. The participants had to wear headphones and listened to the following:

Five random tracks of classical music were played – including selections from Beethoven’s Ninth Symphony; an aria from Puccini’s Turandot; a Bach cantata (BMW 169); Va Pensiero from Nabucco; Libiam Nei Lieti Calici from La Traviata – as well as two minutes of silence.

While listening, electrocardiogram (ECG), blood pressure, cerebral artery flow, respiration and narrowing of blood vessels on the skin of the study participants were monitored and recorded.

The effect of crescendos and descrescendos was especially monitored. Don’t worry. I am not music-literate myself so I looked it up. A crescendo is a gradual volume increase, and a decrescendo is a gradual volume decrease.

So here is how the volume changes the function of our cardiovascular system:

  • A crescendo results in vasoconstriction, e.g. narrowing of blood vessels under the skin, increased blood pressure and heart rate and increased respiration rate. Crescendos induce moderate arousal.
  • During the descrescendos down to the silent pause, the opposite effects were observed, e.g. vasodilation, lower blood pressure, heart and respiration rate. Descrescendos generally induce relaxation.

The effect of the volume change was proportional to the change in music profile.

According to lead researcher Dr. Luciano Bernardi, professor of Internal Medicine at Pavia University in Pavia, Italy.

“Music induces a continuous, dynamic – and to some extent predictable – change in the cardiovascular system. It is not only the emotion that creates the cardiovascular changes, but this study suggests that also the opposite might be possible, that cardiovascular changes may be the substrate for emotions, likely in a bi-directional way.”

So what does this tell us about music?

Music could be a potential therapeutic tool for cardiovascular diseases, e.g. blood pressure control, correction of abnormal rhythms (arrhythmias) and even rehabilitation of stroke patients.

Music therapy is used in many conditions including neurological impairments such as autism. In healthy people, studies have shown that music reduces stress and enhance athletic performance.

“The profile of music (crescendo or decrescendo) is continuously tracked by the cardiovascular and respiratory systems. This is particularly evident when music is rich in emphasis, like in operatic music. These findings increase our understanding of how music could be used in rehabilitative medicine.”

Phone and cancer Part 4: why the answer is hard to find

July 6, 2009 by  
Filed under CANCER

Resource post for July

So does mobile phone use cause cancer? You may ask yourself why, in spite of all the research on this topic going on out there, in cancercells-univ-birminghamspite of all the man-hours and millions of dollars spent, a clear cut “Yes” or “No” response can’t be given. In this fourth post on the mobile phone-cancer link series, we look at the reasons why the answer to this simple question remains elusive.

Short-term vs. long-term

Compared to more than half of this world’s population, mobile phone telephony is pretty young. Mobile phones became only widespread in the 90s. The effects of carcinogens take time to manifest in symptoms. Take the case of smoking and the increase in incidence of lung cancer – there was a time lag of 20 to 30 years till the link was prove being doubt. In the same way, the health effects of something new such as mobile telephony will take time to manifest. Most short-term studies on mobile phone use produced a “no” answer. However, it may be possible that in 30, 40, 50 years form the now, the answer would be different. A Swedish study, for example, found an increased risk of developing acoustic neuroma only after at least 10 years of phone use.

Unreliable data collection

Data on mobile phone use are mainly based on reports of the users themselves. Self-reports of any kind whatsoever, are notoriously unreliable and inaccurate. electricity_towerSome studies, for example, revealed that people tend to underestimate the number of calls they make in a certain period of time but tend to overestimate the duration of the calls.

No point of comparison

In a comparative study, there must be a study group (exposed) and a control group (unexposed). Unfortunately, electromagnetic field are so ubiquitous that almost every in this world has been or is exposed. Unless you live in a cave or in most remote parts of this world. Even the technophobes among us are still exposed to radiation from other household appliances indoors as well as to base stations and telecom masts outdoors. It is therefore extremely difficult to find “unexposed” people who can be used as study controls.

Data on children lacking

The brain and children and adolescents are still developing. In contrast, adult brains are not growing as much. Most data on exposure on phone radiation are on adult users. There is very little data available on the effect of exposure to the young, developing brain. But on the other hand, hey, what parent would sign an informed consent to turn their kids into guinea pigs?

So, will we ever get an answer?

According to the National Cancer Institute,

It may be years until scientists know whether cell phones are linked to cancer. Like other electronic devices, cell phones give off electromagnetic radiation, but the radiation they produce has not yet been proven to pose a cancer risk. Because so many people use cell phones and their use is radiationpredicted to keep growing, it is important to learn whether the radiation they emit affects health. Also, because cellular phone use is still relatively new, cancers that take a long time to develop would not have been picked up by studies done to date so it is important that further studies be conducted.

Photo credit: stock.xchng; Cancer cells: Univ. of  Birmingham

News from the cancer side, July 3

July 3, 2009 by  
Filed under CANCER

newspaperNews from the survivors

Lance Armstrong starts Tour de France
While fireworks go up in the US tomorrow, our favorite cancer survivor Lance Armstrong will start the first stage of Tour de France tomorrow in his bid for his 8th title. The 96th Tour goes till July 26 and covers a distance of 3,500 kilometers in 21 stages Go, Lance, Go!

News from the safety watch groups

Cancer concerns with insulin glargine
The European Association for the Study of Diabetes (EASD) has requested requesting further research to investigate a possible link between insulin glargine and cancer. Glargine is an insulin product marketed as Lantus by Sanofi-Aventis. The concerns came up when two studies by German and Swedish researchers showed a dose-dependent increase in cancer risk among glargine users. UK studies on the other hand gave inconclusive results. The American Diabetes Association said the findings “are conflicting and inconclusive” and “cautions against overreaction until more information is available.

News from the cancer researchers

Cancer biology: Double agent
The protein STAT3 plays the double agent. The protein regulates gene expression and is active in mitochondrial metabolism. However, STAT3 mutants seem to mediate metabolic changes necessary for cancer cell growth. This new development has been reported in the June issue of Science.

News from the endocrinologists

Endocrine-disrupting chemicals
In a recent meeting of the Endocrine Society, endocrinologists reported on several so-called endocrine disrupting chemicals. On top of the list is bisphenol A (BPA), the controversial plastic component. BPA exposure of pregnant mice led to loss of fertility in female offsprings. Dioxins, on the other hand, have been shown to interfere with the development of mammary cells and therefore milk production. Dioxins occur naturally but are also produced as industrial waste. They get into the water, soil and into the food chain. According to the World Health Organization, 90% of dioxin exposure occurs via the food chain. Both BPA and dioxin are potential carcinogens.

News from the drug developers

New Class of Drugs Promising for BRCA-Related Cancers
Good news for BRCA gene carriers. A new class of cancer drugs called PARP inhibitors show promising activity against inherited cancers caused by BRCA1 and BRCA2 cell mutations. PARP inhibitors work by blocking the action of poly (ADP-ribose) polymerase, an enzyme that helps repair DNA. In certain tumor cells, such as those from BRCA1 and BRCA2 mutation carriers, blocking this enzyme can lead to cell death.

CVD News Watch, July 3

July 3, 2009 by  

worldnewsHappy 4th of July to all Americans!

CVD heart victim watch

Mainly medical unknowns regarding Michael Jackson’s apparent cardiac arrest
A week after his death, there is still little known about the cause of Michael Jackson’s cardiac arrest. Here are some theories:

  • Overdose of prescription medications. This is the most popular theory but without a toxicology report, this remains speculative.
  • Heart attack. This is highly unlikely since initial autopsy reports do not support this.
  • Complications from lupus. Jackson had lupus, an inflammatory disease that can also affect the heart and lead to a heart block.
  • Stress. Some experts suggest that Jackson may have been under too much stress. Jackson was about to start a major concert tour in two weeks and has been having major financial problems.

Jackson’s personal physician Dr. Conrad Murray has been questioned by the police to shed light on the mysterious circumstances of his death.

CVD drug approval watch

FDA Approves Multaq to Treat Heart Rhythm Disorder
The US FDA has approved dronedarone, marketed under the brand name Multaq. Multaq is a pharmacological agent to maintain normal heart rhythms in patients with arrhythmias such as atrial fibrillation and atrial flutter. However, the drug carries a black box warning in its label because it can cause life-threatening adverse reactions in patients with heart failure.

CVD tobacco watch

FDA Seeks Public Input on Tobacco Regulation
With its new power in regulating tobacco products as provided for by the Family Smoking Prevention and Tobacco Control Act, the US FDA is not seeking input from the general public and consumer on the implementation of its new role. The public is invited to share their views on a wide range of issues, from marketing to advertising, to marketing, which will all be posted online.

“We’re interested in receiving input from across the country as the FDA begins to implement this important new authority intended to reduce the enormous toll of suffering and death caused by tobacco products in the United States,” said Dr. Margaret A. Hamburg, Commissioner of Food and Drugs. “We look forward to the public’s response.”

CVD chemical watch

BPA causes arrhythmias
The notorious plastic component bisphenol A (BPA) is back on the headlines again. The Endocrine Society has recently released its Scientific Statement on endocrine-disrupting chemicals and BPA is on top of the list. In addition to its hormonal effects, scientist reported that BPA exposure causes irregular heartbeats (arrhythmias) in female (but not male) mice. The society vowed to press for new government regulations to “decrease human exposure to the many. endocrine-disrupting agents.”

Fundraising for dementia research: a million for a million

July 2, 2009 by  
Filed under ALZHEIMER'S

plane-1When you think about companies giving to charity, you wouldn’t think of a budget airline company as being among the generous, right? Wrong! easyJet, one of Europe’s budget carrier has just announced its pledge of raising one million pounds for charity. The beneficiary of this corporate generosity is no other than the Alzheimer’s Society of the UK. The fund raising drive is called “a million for a million”, a million pounds for a million people who will suffer from some form of dementia in the next ten years.

According to Andy Harrison, CEO of easyJet

‘I was shocked to learn that one million people will develop dementia in the next 10 years. That’s why we have committed to raising a million for a million – one million pounds to help the million people who will be facing dementia.

Dementia is not a natural part of ageing but it is often still viewed in these terms, meaning it doesn’t get the attention it deserves. The government only invests 2% of its medical research budget on dementia. We call on the government to boost research funding and make this condition a priority.’

Hre’s how the fundraising will work: Passengers on board all easyJet flights will be asked to donate their spare or excess foreign currency to dementia research. A collection bag will probably be given out to each passenger and collected just before landing. In addition, the Alzheimer’s Society will receive a percentage of the sales of scratch cards sold on easyJet flights. Collection starts this summer.

I think this is a splendid idea to raise money for charity. Those of you who are travelling international would know the hassle of different currencies and all those small change that clutters your purse. This is a great way of getting rid of them. And if you have more to spare, you can give more, too.

Neil Hunt, CEO of Azheimer’s Society UK says

‘easyJet has set a fantastic example by boosting funding for dementia. Charities, companies and the government can all work towards the goal of defeating dementia. We look forward to the forthcoming Dementia Research Summit and hope to see the development of an ambitious plan that drives real change.’

Thank you and happy landings.

Photo credit: stock.xchng

Drugs that help quit but increase suicide risk

July 2, 2009 by  
Filed under ADDICTION

smokingAs anti-smoking laws sweep across the globe, more and more people are really trying to quit. There are many aids in helping to quit smoking cigarettes, from nicotine patches to smoking cessation drugs. Recently, the US Food and Drug Administration (US FDA) issued a safety alert on two of these drugs, namely:

  • Chantix (varenicline), manufactured by Pfizer
  • Zyban (bupropion), manufactured by GlaxoSmithKline (GSK).

The regulatory body warned that these two drugs increase the risk for mental disorder and suicide. The manufacturers of the said drugs have been asked to add a so-called black box warning to their labelling, explicitly warning against mental health events and suicide risks. A black box warning is displayed prominently on the packaging and is the highest level of safety warning on a drug.

It is not clear whether the psychiatric side effects are due to the drugs themselves or due to nicotine withdrawal which is characterized by depressive symptoms. However, some smoking cessation drugs are chemically similar to anti-depressants. Zyban, for example, is also marketed by GSK under the name of Wellbutrin for the indication of depression.

Aside from the black box warning, the two drug manufacturers are also asked to conduct clinical trials that will assess the psychiatric health of the two drugs, including how they could exacerbate already existing disorders such as schizophrenia, polar disorder, and clinical depression.

Smoking cessation drugs gained bad publicity in 2007 in Europe. As The New York Times report

In September of that year, Jeffrey Carter Albrecht, a keyboard player from the pop-music group Edie Brickell and New Bohemians, was killed by a neighbor who had complained that Mr. Albrecht was banging on his door, ranting. Mr. Albrecht’s girlfriend blamed Chantix, which she said had made him hostile.

Scrutiny by health officials showed the following figures:

  • 98 cases of suicides and 188 cases of suicide attempts among Chantix users
  • 14 cases of suicides and 17 cases of suicide attempts among Zyban users.

The US FDA safety warning gives the following guidelines:

Healthcare professionals should advise patients to stop taking varenicline or bupropion and contact a healthcare provider immediately if they experience agitation, depressed mood, and any changes in behavior that are not typical of nicotine withdrawal, or if they experience suicidal thoughts or behavior.

However, the regulatory emphasized that the smoking cessation drugs offer some health benefits, too. According to Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.

“The risk of serious adverse events while taking these products must be weighed against the significant health benefits of quitting smoking. Smoking is the leading cause of preventable disease, disability, and death in the United States and we know these products are effective aids in helping people quit.”

Photo credit: stock.xchng

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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.