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The sections below contain selected medical-health article links for our Featured InfoMedLinks, Inflammation and Oxidative Stress, and Patient Safety:
25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services (NEUROLOGY 2010) “Conclusions: Vitamin D insufficiency and deficiency was associated with all-cause dementia, Alzheimer disease, stroke (with and without dementia symptoms), and MRI indicators of cerebrovascular disease. These findings suggest a potential vasculoprotective role of vitamin D.”
Association of vitamin D deficiency with cognitive impairment in older women: Cross-sectional study (Neurology 2010) “Conclusions: 25-Hydroxyvitamin D deficiency was associated with cognitive impairment in this cohort of community-dwelling older women. “
Blinds Recalled Due to Strangulation Risk “The risk of strangulation in children has prompted the Consumer Product Safety Commission (CPSC) and the Window Covering Safety Council to issue a voluntary recall today for more than 50 million Roman-style shades and roll-up blinds.”
Chinese Herbal Tea Ingredient Linked to Cancer “Herbal teas may help you relax, but new studies show that an acid found in Chinese herbal teas may increase the risk of urinary tract cancer. The carcinogen aristolochic acid, which was found in many prescribed Chinese herbal products including Guan Mu Tong, was linked to a higher risk of cancer. “
Combined Effects of Cardiorespiratory Fitness, Not Smoking, and Normal Waist Girth on Morbidity and Mortality in Men (Arch Intern Med. 2009) “Conclusion Being physically fit, not smoking, and maintaining a normal waist girth is associated with lower risk of CHD events, and CVD and all-cause mortality in men.”
E. coli-tainted beef infects 21 people in 16 states “Mechanical tenderization softens tough cuts of beef by hammering the meat with metal needles or blades that break up muscle fibers and connective tissue. It is often used to improve the tenderness of roasts and steaks that are cooked at a processing plant before being sent to restaurants. In the meat industry, it is referred to as "needled" meat. Consumer advocates say mechanical tenderization poses contamination risks in meats that are served rare, such as steaks, because it can bring bacteria from the surface of meat to the center of the cut. A rare steak may be cooked enough so that bacteria on the surface are killed but those inside the meat survive.”
Functional MRI Shows Permanent Brain Damage From Lead Poisoning in Early Childhood “New research using functional magnetic resonance imaging (MRI) to evaluate brain function has found that adults who were exposed to lead as young children incur permanent brain injury.”
HER2-positive breast cancer: What is it? “HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor-2 (HER2), which promotes the growth of cancer cells. In about one of every three breast cancers, the cancer cells make an excess of HER2 due to a gene mutation. This gene mutation can occur in many types of cancer — not only breast cancer. HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. They're also less responsive to hormone treatment.“
High Waist-To-Hip Ratio in Midlife Linked to Later Dementia “"These data emphasize the importance of maintaining a healthy body weight throughout life, and that the prevention of Alzheimer's disease is a life-long process," lead author Dr. Deborah R. Gustafson, of the University of Gothenburg, Sweden, told Reuters Health.”
Largest Turtle-Linked Salmonella Outbreak Detailed “Two girls who swam with pet turtles in a backyard pool were among 107 people sickened in the largest salmonella outbreak blamed on turtles nationwide, researchers report. The 2007-08 outbreak involved mostly children in 34 states; one-third of all patients had to be hospitalized. In many cases, parents didn't know that turtles can carry salmonella. Despite a 1975 ban on selling small turtles as pets, they continue to be sold illegally. … Salmonella in turtle feces can end up on their shells and body, and can spread to people who handle them.“
Long-term Consequences of Childhood ADHD on Criminal Activities. (J Ment Health Policy Econ. 2009)
Medical complications after stroke (The Lancet Neurology 2009)
Moderate Fish Consumption May Lower Risk in Patients With a History of Heart Failure “Including fish in a balanced diet has long been associated with the prevention of heart disease, and scientists now believe that it can help preserve heart function in patients who have experienced heart failure.”
Pollution Linked to Pneumonia in Older Adults “"Our study found that among older individuals, long-term exposure to traffic pollution independently increased their risk of hospitalization for pneumonia," principal investigator, Mark Loeb, M.D., of McMaster University, Ontario, Canada, was quoted as saying. “
Safety of Beef Processing Method Is Questioned “Eight years ago, federal officials were struggling to remove potentially deadly E. coli from hamburgers when an entrepreneurial company from South Dakota came up with a novel idea: injecting beef with ammonia. … With the U.S.D.A.’s stamp of approval, the company’s processed beef has become a mainstay in America’s hamburgers. McDonald’s, Burger King and other fast-food giants use it as a component in ground beef, as do grocery chains. The federal school lunch program used an estimated 5.5 million pounds of the processed beef last year alone. But government and industry records obtained by The New York Times show that in testing for the school lunch program, E. coli and salmonella pathogens have been found dozens of times in Beef Products meat, challenging claims by the company and the U.S.D.A. about the effectiveness of the treatment.”
School Classroom Air May Be More Polluted With Ultrafine Particles Than Outdoor Air “The highest levels occurred during art activities such as gluing, painting and drawing when indoor levels were several times higher than outdoor levels. There also were significant increases in ultrafine particle levels when detergents were used for cleaning.”
Trichomoniasis in pregnancy and mental retardation in children. (Ann Epidemiol. 2009)
UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women. (Pigment Cell Melanoma Res. 2009)
Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial. (Int J Geriatr Psychiatry. 2009) “CONCLUSIONS: A 12-month EET intervention may reduce the progression of age-related cognitive decline in healthy older adults.”
How Much Omega-3 Fatty Acid Do We Need To Prevent Cardiovascular Disease? “A team of French scientists have found the dose of DHA (docosahexaenoic acid) that is "just right" for preventing cardiovascular disease in healthy men. In a research report appearing in the September 2009 print issue of The FASEB Journal, the scientists show that a 200 mg dose of DHA per day is enough to affect biochemical markers that reliably predict cardiovascular problems, such as those related to aging, atherosclerosis, and diabetes. This study is the first to identify how much DHA is necessary to promote optimal heart health.”
Lifelong Exercise Keeps Seniors Young at Heart “For example, those who exercised four to five times a week during their lives had about 54 percent of the benefit seen in "Master" athletes, while those who exercised two to three times a week had 42 percent of the benefit. Master athletes are seniors who've exercised six to seven times a week for 15 to 25 years and retained 100 percent of their heart's youthful characteristics and have hearts similar to those of 30-year-olds. “
Lifetime Vigorous But Not Light-To-Moderate Habitual Physical Activity Impacts Favorably on Carotid Stiffness in Young Adults (Hypertension. 2010) “Promoting vigorous intensity physical activities among the healthy young may, therefore, prevent arterial stiffness and related cardiovascular sequelae later in life, partly through its favorable impact on other biological cardiovascular risk factors.”
Long-Term Physical Activity Has an Anti-Aging Effect at the Cellular Level “Intensive exercise prevented shortening of telomeres, a protective effect against aging of the cardiovascular system, according to research reported in Circulation: Journal of the American Heart Association.”
Model Backs Green Tea And Lemon Claim, Lessens Need To Test Animals “The in vivo study backed up the model study that showed adding sugar and vitamin C to green tea enhanced the body's ability to absorb polyphenols. Ferruzzi said that adding lemon juice or other citrus juice to tea would do the trick, or consumers could look for ready-to-drink products that contain 100 percent of the recommended amount of vitamin C or ascorbic acid on the ingredient list. "Having that vitamin C seems to do it," Ferruzzi said. "And if you don't want to squeeze a lemon into your cup, just have a glass of juice with your green tea."”
Moderate Physical Exercise, DASH Diet Protective Against Age-Related Cognitive Decline “Regular physical exercise and a heart-healthy diet, 2 of the mainstays of good physical health, may also be protective against age-related cognitive decline and dementia, 2 new studies suggests.”
New Study Links DHA Type Of Omega-3 To Better Nervous System Function “The authors concluded that not enough DHA in the diet may reduce the ability to handle sensory input. "It only takes a small decrement in brain DHA to produce losses in brain function," said Salem. In humans, weak sensorimotor gating is a hallmark of many nervous-system disorders such as schizophrenia or ADHD. Given mounting evidence of the role omega-3s play in the nervous system, there is intense interest in their therapeutic potential, perhaps as a supplement to medicines. For example, people with schizophrenia have lower levels of essential fatty acids, possibly from a genetic variation that results in poor metabolism of these nutrients. More broadly, the typical American diet is much lower in all types of omega-3 than in omega-6 essential fatty acids, according to Salem. High intake of omega-6, or linoleic acid, reduces the body's ability to incorporate omega-3s. As a result, "we have the double whammy of low omega-3 intake and high omega-6 intake," he said.”
Omega-3s help stave off age-related vision loss “People who consumed the largest amounts of the two main dietary types of omega-3 fatty acids -- docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) -- were about 30 percent less likely to develop either wet or dry AMD than people with the lowest intake, the researchers found.”
Physical Activity and Rapid Decline in Kidney Function Among Older Adults (Arch Intern Med. 2009) “Conclusion Higher levels of PA are associated with a lower risk of RDKF among older adults.“
Young Adults Who Exercise Get Higher IQ Scores “The study shows a clear link between good physical fitness and better results for the IQ test. The strongest links are for logical thinking and verbal comprehension. But it is only fitness that plays a role in the results for the IQ test, and not strength. "Being fit means that you also have good heart and lung capacity and that your brain gets plenty of oxygen," says Michael Nilsson, professor at the Sahlgrenska Academy and chief physician at the Sahlgrenska University Hospital. "This may be one of the reasons why we can see a clear link with fitness, but not with muscular strength. We are also seeing that there are growth factors that are important."”
Inflammation and Oxidative Stress
Elevated C-reactive protein levels are associated with prevalent dementia in the oldest-old (The Lancet 2009) “Background C-reactive protein (CRP) is a nonspecific marker of inflammation that is increased in the brain and serum of patients with Alzheimer's disease (AD), and has been associated with increased risk of developing dementia. Inflammation increases with age, and the number of people reaching age 90 years and older is growing, making the association between inflammation and dementia increasingly relevant. Using a cross-sectional design, we examined whether high levels of serum CRP are associated with increased odds of prevalent dementia in the oldest-old.”
Exercise as a mean to control low-grade systemic inflammation. (Mediators Inflamm. 2008 (Epub 2009)) “Chronic noncommunicable diseases (CNCDs), which include cardiovascular disease, some cancers, for example, colon cancer, breast cancer, and type 2 diabetes, are reaching epidemic proportions worldwide. It has now become clear that low-grade chronic inflammation is a key player in the pathogenesis of most CNCDs. Given that regular exercise offers protection against all causes of mortality, primarily by protection against atherosclerosis and insulin resistance, we suggest that exercise may exert some of its beneficial health effects by inducing anti-inflammatory actions. Recently, IL-6 was introduced as the first myokine, defined as a cytokine, which is produced and released by contracting skeletal muscle fibres, exerting its effects in other organs of the body. We suggest that skeletal muscle is an endocrine organ and that myokines may be involved in mediating the beneficial effects against CNCDs associated with low-grade inflammation.”
Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. (J Am Diet Assoc. 2009) “CONCLUSION: Study results show that the beneficial effects of fruit and vegetable intake on markers of inflammation and oxidative stress are already present by early adolescence and provide support for the Dietary Guidelines for Americans "to consume five or more servings per day" of fruits and vegetables to promote beneficial cardiovascular health.”
How Inflammatory Disease Causes Fatigue “Chronic inflammatory diseases like rheumatoid arthritis, inflammatory bowel disease, psoriasis, and liver disease cause "sickness behaviors," including fatigue, malaise, and loss of social interest. However, it has been unclear how inflammation in other organs in the body can impact the brain and behavior. The researchers found that in mice with inflamed livers, white blood cells called monocytes infiltrated the brain. These findings support previous research demonstrating the presence of immune cells in the brain following organ inflammation, challenging the long-held belief that the blood-brain barrier prevents immune cells from accessing the brain.”
[Inflammation and C-reactive protein in cardiovascular disease.] (Tidsskr Nor Laegeforen. 2009) “INTERPRETATION: Individuals with chronic inflammatory disease and those with high risk and acute infection are at risk for cardiovascular events and should be evaluated for primary prevention. In patient groups at moderate risk for cardiovascular disease, hs-CRP can be a valuable supplement to established factors for risk stratification. Despite numerous studies confirming hs-CRP's role as an independent risk marker, hs-CRP has not found its place in international guidelines. This should be reconsidered on the background of new study results.”
Inflammation and pancreatic cancer: an evidence-based review. (Curr Opin Pharmacol. 2009)
Largest-Ever Meta-Analysis Finds CRP Is Unlikely to Be Causal for CVD “In the largest and most comprehensive meta-analysis to date looking at C-reactive-protein (CRP) levels and risk of coronary heart disease (CHD) and stroke, British researchers conclude that CRP is unlikely to be a causal factor for cardiovascular disease . Although CRP concentration was linearly associated with CHD, stroke, and vascular mortality, as well as nonvascular mortality, statistical adjustment for conventional cardiovascular risk factors "resulted in considerable weakening of associations," note the scientists of the Cambridge-based Emerging Risk Factors Collaboration (ERFC), who report their findings online December 21, 2009 in the Lancet. In an editorial accompanying the paper , Drs S Matthijs Boekholdt and John JP Kastelein (Academic Medical Center, Amsterdam, the Netherlands) say the UK authors "are to be commended for this impressive data set." Although the findings "add weight to the evidence of noncausality" for a role of CRP in the development of cardiovascular disease, "the debate can be resolved only by randomized trials with agents that specifically target CRP, and such compounds are currently under development," say the Dutch doctors.”
Mediterranean diet and inflammatory response in myocardial infarction survivors. (Int J Epidemiol. 2009) “CONCLUSIONS: Adherence to the traditional Mediterranean diet was associated with a reduction of the concentrations of inflammatory markers in MI survivors. This may, in part, explain the beneficial effects of this diet on various chronic diseases such as atherosclerosis and cancer, and expands its role to secondary prevention level.”
Mom’s Obesity Linked to Asthma in Kids “How would having a mother who was obese during pregnancy influence asthma risk in youngsters? The researchers explain excess fat produces pro-inflammatory cytokines and suppresses anti-inflammatory cytokines. Cytokines are known to play a role in asthma. “Therefore, when you have an obese person, you are not just looking at a problem of excess fat, but a problem of systemic inflammation,” study author Jet Smit, Ph.D., was quoted as saying. “This may affect the immunological and pulmonary development in the fetus and possibly result in a higher risk of asthma symptoms after birth.”“
Selenium and Inflammation: Underlying Anti-inflammatory Mechanisms. (Horm Metab Res. 2009)
Confusion About Epinephrine Dosing Leading to Iatrogenic Overdose: A Life-Threatening Problem With a Potential Solution. (Ann Emerg Med. 2009) “Epinephrine is indicated for various medical emergencies, including cardiac arrest and anaphylaxis, but the dose and route of administration are different for each indication. For anaphylaxis, it is given intramuscularly at a low dose, whereas for cardiac arrest a higher dose is required intravenously. … An e-mail survey of local hospitals in southeast Michigan revealed that 6 of 7 hospitals did not stock prefilled intramuscular dose syringes for emergency use in anaphylaxis. At our institution, we have introduced prefilled and appropriately labeled intramuscularly dosed epinephrine syringes in crash carts, which are easily distinguished from intravenously dosed epinephrine syringes. In this Concepts article, we describe the clinical problem of inadvertent epinephrine overdose and propose a potential solution. Epinephrine must be clearly packaged and labeled to avoid inappropriate usage and unnecessary, potentially lethal complications in patients with anaphylaxis.”
How Safe Are Popular Reflux Drugs? The drugs belong to a class of pharmaceuticals called "proton pump inhibitors," or PPIs, which are generally considered safe and effective. But lately these acid-reducing medications have been the subject of studies linking their use to a number of health risks, from an increased rate of hip fracture to a greater likelihood of diarrhea and community-acquired pneumonia. … Altman said he is mostly concerned about high-dose and long-term users of the drugs because their increased exposures boost the odds that they'll experience some unintended consequence. He's also worried about people who continue to use PPIs but don't get better. "They may not have acid reflux, or they may already have a more severe complication of acid reflux than they're aware of," he said. Patients who have concerns about the use of these drugs should speak with their physicians, Vaezi said. But he also said that people need to recognize that the findings of these studies merely suggest an association with a particular outcome -- not a cause.”
Incidence of and risk factors for nosocomial bloodstream infections in adults in the United States, 2003. (Infect Control Hosp Epidemiol. 2009) “RESULTS: The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50).”
International Study of the Prevalence and Outcomes of Infection in Intensive Care Units (JAMA. 2009) “Conclusions Infections are common in patients in contemporary ICUs, and risk of infection increases with duration of ICU stay. In this large cohort, infection was independently associated with an increased risk of hospital death.”
Invasive Fungal Infections in the ICU. (Intensive Care Med. 2009)
Killer superbug solution discovered in Norway “Twenty-five years ago, Norwegians were also losing their lives to this bacteria. But Norway's public health system fought back with an aggressive program that made it the most infection-free country in the world. A key part of that program was cutting back severely on the use of antibiotics.”
MRSA Leads to Worse Outcomes, Staggering Expenses for Surgical Patients “Post-surgical infections significantly increase the chance of hospital readmission and death and cost as much as $60,000 per patient, according to Duke University Medical Center researchers who conducted the largest study of its kind to date.”
Postmarketing Lessons to Learn From Vioxx Debacle “"If we are to detect harms early and protect the public's health while ensuring the availability of new clinically effective therapeutics, a system must be established that makes full use of all existing evidence," they add. Ross said that although the recent changes to US legislation go some way toward this goal, there is still much room for improvement. The Answer to a Question The tale of rofecoxib is inscribed in pharmaceutical history: an anti-inflammatory drug was introduced in 1999 and hawked as a safer alternative to traditional nonsteroidal anti-inflammatory drugs; its sales soon reached $2 billion annually. From 2000 onward, for four years, there were numerous analyses and endless rancorous debate about whether rofecoxib increased cardiovascular risk, with the company maintaining that it did not until, in September of 2004, the large APPROVE trial was terminated early because of an increased risk of cardiovascular events with rofecoxib compared with placebo; the drug was dramatically pulled from sale worldwide, the biggest withdrawal in pharmaceutical history. The results illustrate how critical it is to make all clinical-trial data available for independent research. "All along, Merck insisted there was no evidence that rofecoxib increased cardiovascular risk in comparison with placebo, until the APPROVE study," Ross explained to heartwire . "Our new analysis shows how the placebo-control-only clinical-trial data could have been used to identify the cardiovascular risk with the drug far sooner. The results illustrate how critical it is to make all clinical-trial data available for independent research," he stressed. “
Tylenol Arthritis Pain Caplet, 100 count bottles: Recall of all lots “In November 2009, 5 lots of this product were recalled due to consumer reports of an unusual moldy, musty, or mildew-like odor that was associated with nausea, stomach pain, vomiting and diarrhea. The odor is caused by the presence of a chemical 2,4,6-tribromoanisole, believed to be the breakdown of a chemical used to treat wooden pallets that transport and store packaging materials.”
Thousands of New Cancers Predicted Due to Increased Use of CT “Computed tomography (CT) scans are widely used and are an invaluable tool for medical imaging. However, the possible overuse of CT scans and the variability in radiation doses might subsequently lead to thousands of cases of cancer, according to findings from 2 new studies published in the December 14/28 issue of the Archives of Internal Medicine. In the first study, researchers found that radiation doses from common CT procedures are higher and more variable than what is typically cited. For example, the authors note that the median effective dose of an abdomen and pelvis CT scan is often cited as 8 to 10 mSv, but they found that the median dose of this type of scan was actually 66% higher, and the median dose of a multiphase CT scan of the abdomen and pelvis was nearly 4 times higher. The authors also found a considerable range in doses within and across the institutions included in their study, with a mean 13-fold variation between the highest and lowest dose for each CT type studied.”
When Did Merck Know Vioxx Was Deadly? “"By our analyses, the association is clear that by June 2001 -- more than three years before the drug was eventually taken off the market -- the risk could have been known," Ross tells WebMD. Merck took Vioxx off the market in November 2004, after the "APPROVe" study conclusively demonstrated that Vioxx users had more heart attacks and strokes than patients receiving a placebo.”
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