Arthritis is a potential barrier to physical activity for adults with diabetes
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People with diagnosed diabetes are nearly twice as likely to have arthritis, and the inactivity caused by arthritis hinders the successful management of both diseases, according to a new Morbidity and Mortality Weekly Report (MMWR) study released today by the Centers for Disease Control and Prevention (CDC). This is one of the first studies of its kind to look at the relationship between arthritis and diabetes and the outcomes associated with physical activity.
The report finds that arthritis appears to be a barrier to being physically active for people with diabetes. Despite the fact that physical activity helps control blood glucose levels and reduces joint pain, people with both diseases are more likely to be physically inactive (29.8%) compared to those with diabetes alone (20.1%).
“Arthritis is a frequent co morbid condition for adults with diabetes,” said John H. Klippel, M.D., president and CEO, Arthritis Foundation. “But for both diseases, physical activity is key to effective management. A lack of physical activity actually results in undesirable consequences including increased pain, stiffness, inflammation, physical limitation and potential disability.”
CT Screening for Lung Cancer: Update 2007
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Screening is the pursuit of the early diagnosis of cancer before symptoms occur. The purpose of early diagnosis is to provide early treatment, which potentially prevents death from the cancer. The usefulness of screening depends on how early the cancer can be diagnosed and how many deaths can be prevented by early treatment as compared with later symptom-prompted diagnosis and treatment.
The goal of the Early Lung Cancer Action Project investigators was to develop an efficient methodology that would provide an ever-accumulating, continually updated body of evidence for evaluation of emerging new technologies for screening for cancer. This methodology recognizes that screening is a sequential process that starts with the pursuit of the early diagnosis of cancer followed by early treatment. It also recognizes that diagnostic research is fundamentally different from treatment research. To fully understand the current discussions on the evidence for lung cancer screening, key definitions are provided, including the differentiation between the first, baseline round of screening and all subsequent rounds of repeat screening and baseline and repeat cancers and their distribution by cell type. These definitions are critical in analyzing the results of various screening reports as they are not used by all.
Smoke, then Fire: Lung Cancer Screening Studies Under Further Scrutiny
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In the January 2008 issue of The Oncologist, we reported that the authors of a controversial article on CT screening for early detection of lung cancer had not revealed their financial interests in screening software and biopsy instruments [1]. We considered these interests relevant to the message of the article, and hence decided not to make the article available as a Continuing Medical Education (CME) course [2]. It was further revealed by Paul Goldberg, editor of The Cancer Letter, that the same authors, Claudia Henschke and David Yankelevitz of Weill Cornell Medical College, had not disclosed these interests in their many previous articles published in the New England Journal of Medicine (NEJM), the Journal of the American Medical Association, and elsewhere [3].
Goldberg [4] and, independently, Gardiner Harris of The New York Times [5] reported on March 25 and March 26, 2008, respectively, that Henschke and Yankelevitz financed some of their lung cancer screening work with a $3.6 million grant from Vector, the parent company of the Liggett Group, a major cigarette manufacturer. The tobacco money was filtered through a nonprofit foundation, the Foundation for Lung Cancer Early Detection, Prevention & Treatment, that was hastily established in late 2000. Henschke, Yankelevitz, Antonio Gotto (dean of Weill Cornell Medical College and a noted cardiology researcher), and Arthur Mahon (chair of the Weill Cornell Board of Overseers) are the foundation’s officers and directors. The foundation’s support was acknowledged in a few articles published by these authors, but the origin of the money was not obvious to the journals, as recently observed by Jeffrey Drazen, the editor-in-chief of the NEJM [6]. Goldberg further documents that the authors subsequently accepted grant support from the American Cancer Society and other sources that specifically prohibit projects that receive funding from tobacco companies. In fact, the authors neither acknowledged this funding from Vector nor their foundation in the paper published by The Oncologist [7].
Low Levels of Vitamin D Associated With Depression in Older Adults
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Older adults with low blood levels of vitamin D and high blood levels of a hormone secreted by the parathyroid glands may have a higher risk of depression, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
About 13 percent of older individuals have symptoms of depression, and other researchers have speculated that vitamin D may be linked to depression and other psychiatric illnesses, according to background information in the article. “Underlying causes of vitamin D deficiency such as less sun exposure as a result of decreased outdoor activity, different housing or clothing habits and decreased vitamin intake may be secondary to depression, but depression may also be the consequence of poor vitamin D status,” the authors write. “Moreover, poor vitamin D status causes an increase in serum parathyroid hormone levels.” Overactive parathyroid glands are frequently accompanied by symptoms of depression that disappear after treatment of the condition.
Botulinum Toxin Effective in Many Neurological Disorders, Not Headache
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New guidelines developed by the American Academy of Neurology confirm that the drug botulinum toxin is safe and effective for treating cervical dystonia, a condition of involuntary head tilt or neck movement, spasticity and other forms of muscle overactivity that interfere with movement in adults and children with an upper motor neuron syndrome, and excessive sweating of the armpits and hands. Botulinum toxin may also be used in hemifacial spasm (involuntary facial contractions), blepharospasm, (involuntary eye closure), some voice disorders (adductor laryngeal dystonia), focal limb dystonias (such as writer’s cramp), essential tremor and some forms of spastic bladder disorders.
This guidelines project was chaired by David M. Simpson, MD, Professor of Neurology at Mount Sinai School of Medicine in New York and Fellow of the American Academy of Neurology. To develop the guidelines, the authors reviewed and analyzed systematically all available scientific studies on the topic. The guidelines appear in the May 6, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.
Prolonged breastfeeding tied to higher IQ
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Children who are exclusively breastfed for at least 3 months tend to be more cognitively advanced at school age, according to findings from the Promotion of Breastfeeding Intervention Trial (PROBIT).
In the PROBIT Study, 31 maternal hospitals and affiliated clinics in the Republic of Belarus adopted a program supporting and promoting breastfeeding or continued their current practices and policies. More than 17,000 healthy newborns were enrolled between June 1996 and December 1997.
Significantly more infants born at the intervention hospitals were breastfed at 3 months (73 percent vs 60 percent), and remained so throughout their first year. The rate of exclusive breastfeeding was 7-fold higher in the intervention group at 3 months (43 percent vs 6 percent).
Low vitamin D boosts depression risk in seniors
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Older people with low blood levels of vitamin D and high blood levels of parathyroid hormone are more likely to be depressed, Dutch researchers report.
But it remains unclear whether these abnormalities are a cause or a consequence of depression, Dr. Witte J. G. Hoogendijk and colleagues from Vrije Universiteit in Amsterdam say.
Past studies have linked altered levels of vitamin D and parathyroid hormone with depression, but the relationship “has never been studied systematically,” Hoogendijk and colleagues note. To investigate, they looked at 1,282 men and women aged 65 to 95 years participating in a long-term study of aging.
Nearly 40 percent of the men and 57 percent of women had low levels of vitamin D in their blood.
Children and Video Games: How Much Do We Know?
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There is no shortage of hyperbole when politicians of all stripes describe the nature and effects of video games. Republican presidential candidate Mitt Romney proclaimed, “Pornography and violence poison our music and movies and TV and video games. The Virginia Tech shooter, like the Columbine shooters before him, had drunk from this cesspool.” Democratic presidential candidate Hillary Clinton spoke of the game, “Grand Theft Auto, which has so many demeaning messages about women, and so encourages violent imagination and activities, and it scares parents.”
Some researchers have echoed similar sentiments, noting that Columbine High School shooters Dylan Harris and Eric Klebold were avid computer gamers. Several television pundits quickly drew a link between the recent Virginia Tech shootings and video games, as well. (Ironically, Seung-Hui Cho’s college roommates found it odd that he never joined them in playing video games.)
Do these assumptions about video-game violence leading to similarly violent behavior among child and adolescent players make sense? A review of the research gives us insights into which patterns of video game play may serve as potential markers of more serious problems among children and adolescents, and which are normal or even possibly beneficial.
Study in 7,000 Men and Women Ties Obesity, Inflammatory Proteins to Heart Failure Risk
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Heart specialists at Johns Hopkins and elsewhere report what is believed to be the first wide-scale evidence linking severe overweight to prolonged inflammation of heart tissue and the subsequent damage leading to failure of the body’s blood-pumping organ.
The latest findings from the Multiethnic Study of Atherosclerosis (MESA), to be published in the May 6 issue of the Journal of the American College of Cardiology, appear to nail down yet one more reason for the estimated 72 million obese American adults to be concerned about their health, say scientists who conducted the research.
“The biological effects of obesity on the heart are quite profound,” says senior study investigator João Lima, M.D. “Even if obese people feel otherwise healthy, there are measurable and early chemical signs of damage to their heart, beyond the well-known implications for diabetes and high blood pressure.”
Advertisements Saying Dairy Products Help You Lose Weight Are Misleading
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There have been recent claims that dairy products can help people lose weight, and the dairy industry has hyped the assertion by investing millions of dollars in commercial advertising. However, a new review of the evidence published in the journal Nutrition Reviews reveals that neither dairy nor calcium intake promotes weight loss.
Amy Joy Lanou of the University of North Carolina at Asheville and Neal Barnard with the Physicians Committee for Responsible Medicine in Washington, DC, evaluated evidence from 49 clinical trials from 1966 to 2007 that assessed the effect of milk, dairy products, or calcium intake on body weight and BMI, with or without the use of dieting.
Heart failure patients may suffer similarly to advanced cancer patients
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Heart failure outpatients have similar numbers of symptoms and levels of depression and spiritual well-being as patients with advanced lung and pancreatic cancer, researchers reported at the American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
In their study, researchers from the University of Colorado Denver School of Medicine also found that heart failure patients with “poor” health status had greater symptoms and depression and worse spiritual well-being than patients with advanced cancer.
The study compared 60 ambulatory heart failure patients to 30 outpatients with advanced cancer being treated at Johns Hopkins Hospital or Bayview Medical Center in Baltimore, Md. Those with heart failure were outpatients, able to attend clinics and complete questionnaires.
Obesity worsens impact of asthma
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Obesity can worsen the impact of asthma and may also mask its severity in standard tests, according to researchers in New Zealand, who studied lung function in asthmatic women with a range of body mass indexes (BMIs).
This is the first prospective study to reveal a significant comparative difference in how the airways and lungs respond to a simulated asthma attack in obese and non-obese individuals.
The research is reported in the first issue for May of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. It establishes a direct link between obesity and the development of a phenomenon known as “dynamic hyperinflation”—when air breathed into the lungs cannot be exhaled. This often occurs with acute asthma, but is more frequent in obese individuals.
Haunted by hallucinations: Children in the PICU traumatized by delusions
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Nearly one in three children admitted to pediatric intensive care will experience delusions or hallucinations, which put them at higher risk for post-traumatic stress symptoms, according to a new study of children’s experiences in a pediatric intensive care unit (PICU).
The study, which appears in the first issue for May of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society, is believed to be the largest ever conducted on children’s memories of PICU.
The results confirmed the clinical experience of the study’s first author, Gillian Colville, B.Sc., M.Phil., a clinical psychologist, and underscore the need to look at this issue more closely. “I have worked for 16 years in pediatric intensive care and have seen a considerable number of children in distress, but have found that there is very little in the literature about children’s experiences,” said Ms. Colville.
Study raises questions about prostate cancer therapies targeting IGF-1
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Therapies under development to treat prostate cancer by inhibiting the ability of insulin-like growth factor (IGF-1) to activate its target receptor could have unexpected results especially if a major tumor suppressor gene – p53 – is already compromised, according to new research by investigators at Fred Hutchinson Cancer Research Center.
IGF-1 is a polypeptide hormone that can influence growth, differentiation and survival of cells expressing the type 1 receptor (IGF-1R). Past clinical, epidemiological and experimental studies have strongly implicated IGF-1 as a contributing factor in the natural history of prostate cancer. However, very little has been done to prove absolutely that the expression or activation of the IGF-1 signaling pathway at physiologically relevant levels is sufficient to cause a healthy prostate cell to become a cancer cell.
Norman Greenberg, Ph.D., and colleagues conducted a pair of experiments by manipulating gene expression directly in the epithelial compartment of the mouse prostate gland to better understand the role of IGF-1R. In contrast to studies that correlated elevated levels of IGF-1 with the risk of developing prostate cancer, Greenberg’s research showed that eliminating IGF-1R expression in an otherwise normal mouse prostate caused the cells to proliferate and become hyperplastic. Although persistent loss of IGF-1R expression ultimately induced cell stasis and death, both of these processes are regulated by the tumor suppressor gene p53 that is commonly mutated in human prostate cancers. Hence the researchers hypothesized that tumors with compromised p53 might not respond predictably to therapies targeting IGF1 signaling.
Alzheimer Disease Risks Are Gender Specific
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The risks of developing Alzheimer’s disease differ between the sexes, with stroke in men, and depression in women, critical factors, suggests research published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry.
The French researchers base their findings on almost 7000 people over the age of 65, drawn from the general population in three French cities.
None had dementia, but around four out of 10 were deemed to have mildly impaired mental agility (mild cognitive impairment) at the start of the study.
