Heart Patients Fare Better in 3-Year Program
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People recovering from acute heart problems such as heart attack and heart surgery are more likely to develop habits to control heart attack risk factors when they meet regularly with cardiac “disease managers,” according to researchers at Mayo Clinic in Rochester. These managers are nonphysician cardiac rehabilitation specialists who lead long-term follow-up programs that last three years. With these risk factors under control, heart patients are likely to live longer and have fewer heart problems, the Mayo researchers conclude.
The Mayo Clinic researchers studied the effects of a long-term cardiac disease manager model on 503 patients involved in cardiac rehabilitation. Their findings appear in The Journal of Cardiopulmonary Rehabilitation and Prevention. The disease manager’s role was to monitor the patient’s status, and to coach the patients in adopting heart attack prevention behaviors. At each meeting, the following factors were assessed and management strategies were discussed: blood lipid levels, blood pressure and body weight, tobacco use, cardiac medication compliance, exercise regimen and physical activity, nutrition and cardiopulmonary symptoms. After initial rehabilitation training about risk factor management, each patient met with a trained disease manager every three to six months for three years.
Extended Infant Antiretroviral Prophylaxis Reduces HIV Risk During Breastfeeding
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In many resource-poor countries, infants born to mothers with HIV receive a single dose of nevirapine (NVP) and a one-week dose of zidovudine (ZDV) to prevent transmission of HIV from the mother to her newborn. The results of a randomized trial led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of Malawi College of Medicine found that extending the routine antiretroviral regimen can significantly reduce the risk of mother-to-child HIV transmission. The study is available in the June 4 online edition of New England Journal of Medicine and will appear in the June 10 print edition.
The Malawi trial, known as PEPI (post-exposure prophylaxis of infants), followed 3,016 infants born to HIV-positive mothers. The infants and mothers were followed for 2 years. All infants received the standard care of a single dose of NVP and a one-week dose of ZDV to prevent HIV infection. One group received an additional 14-week prophylaxis with NVP, while another received 14-week regimens of both NVP and ZDV.
Throughout the trial, the children who received the extended prophylactic regimens had consistently lower rates of HIV infection compared to children who received the standard care. At 9 months, 5.2 percent of infants receiving extended NVP, and 6.4 percent of infants receiving extended NVP and ZDV contracted HIV, compared to 10.6 percent of infants receiving the standard of care regimen. The frequency at which the mothers breastfed their children was similar between all three treatment groups.
Genetically low HDL not tied to heart disease
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Lower levels of heart-healthy HDL cholesterol resulting from a gene mutation is not associated with an increased risk of heart disease involving ischemia—restriction of blood flow through the coronary arteries, according to a study.
This suggests that low HDL, in and of itself, is not a heart disease risk factor.
A number of studies have tied low blood levels of HDL (the “good” cholesterol) to an increased risk of ischemic heart disease. However, whether HDL cholesterol is a primary factor in the development of heart disease is unclear, in part because of other factors related to low HDL cholesterol levels, such as harmful triglycerides, which may contribute independently to increases in heart and vascular events.
Insuring your smile… the options in the UK
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As more and more dentists go private and the cost of treatment soars, a growing number of consumers are insuring their pearly whites.
A standard filling can cost anything into three figures in many British surgeries and even a routine check-up on the NHS can dent your bank balance.
The mounting costs are leading to a growing number of people to neglect their oral care: almost a third of 1,000 adults surveyed earlier this year say they have not visited the dentist in the past two years.
Telltale toenail nicotine predicts heart problems
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Analyzing the nicotine content of toenail clippings can help gauge a woman’s heart disease risk, a new analysis of findings from the Nurses’ Health Study shows.
Toenail analysis “could become a useful test to identify high-risk individuals in the future, especially in circumstances when smoking history is not available or is subject to bias,” Dr. Wael K. Al-Delaimy of the University of California in San Diego and colleagues say in the American Journal of Epidemiology.
Biomarkers of cigarette smoke exposure now used, such as the amount of cotinine (a nicotine breakdown product) in urine or saliva, only reflect exposure within the past few days, the researchers note. Because toenails grow slowly, they add, they may offer a longer-term, more stable estimate of a person’s total level of exposure to tobacco smoke.
Thinness vs. obesity not directly linked to eating habits, study suggests
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Whether you are fat or thin isn’t directly determined by your eating habits, suggest researchers who report new findings made in worms in the June issue of Cell Metabolism, a publication of Cell Press. While both feeding and fat in worms depends on serotonin levels in the nervous system, they found evidence that the nerve messenger acts through independent channels to control whether you eat versus what to do with those calories once you’ve eaten them.
“It says that the nervous system is a key regulator coordinating all energy-related processes through distinct molecular pathways,” said Kaveh Ashrafi of the University of California, San Francisco. “The nervous system makes a decision about its state leading to effects on behavior, reproduction, growth and metabolism. These outputs are related, but they are not consequences of each other. It’s not that feeding isn’t important, but the neural control of fat is distinct from feeding.”
If the results in worms can be extrapolated to humans, as Ashrafi suspects at a fundamental level they can given serotonin’s ancient evolutionary origins, then the finding may have clinical implications.
Paralysed Israeli paints with his eyes
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First his arms and legs stopped working, then his respiratory system. Now Rahamim Melamed-Cohen can hardly speak and sits motionless in a wheelchair except for the barely visible flicker of his eyes.
But thanks to technology and his own tenacity, the 70-year-old Israeli has harnessed the power of those tiny eye movements to write books, compose music, and now create pictures that have been made into a book and shown at a Jerusalem exhibition.
“Most people paint with their hands, some use their toes, others use their mouths - but I paint with my eyes,” Melamed-Cohen wrote in the forward to his recently published book “With a blink of an eye”.
Family therapy helpful in young children with OCD
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Many young children who suffer from obsessive-compulsive disorder may get better with the help of psychological therapy that involves their parents as well, a small study suggests.
Children as young as 3 have been diagnosed with obsessive-compulsive disorder, or OCD, an anxiety disorder in which people have persistent, intrusive thoughts that drive them to ritualistically perform certain actions.
Someone with an obsessive fear of germs, for example, might wash his or her hands over and over throughout the day. In a young child, the same obsession might cause the child to repeatedly lick his or her hands.
Obesity tough on the knees, and men’s hips
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Obesity raises the risk of severe knee arthritis and may do similar damage in the hips, but perhaps only in men, a new study suggests.
Researchers found that among nearly 2,600 older Icelandic adults, those who were overweight were more likely to have had a total knee replacement due to severe arthritis. Obese men and women were particularly at risk.
When it came to the odds of total hip replacement, obese men were again at greater risk. However, weight was not a factor for women, the researchers report in the Annals of Rheumatic Diseases.
Heart failure patients miscalculate life expectancy
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Many patients with heart failure – especially younger ones and those with more severe disease – significantly overestimate how long they going to live, say Duke University Medical Center researchers.
“It’s a bit of a puzzle,” says Dr. Larry Allen, a cardiologist at Duke and the lead author of the study. “As physicians, we know how important it is to talk with our patients about end of life issues, but this study suggests we may need to take another look at how we might do that better.”
The research showed that among 122 patients with heart failure enrolled in the Duke University Heart Failure Disease Management Program, the patients, on average, believed the would live about 40 percent longer than what accepted survival models predicted.
Synthetic molecules hold promise for new family of anti-cancer drugs
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Jerusalem, June 4, 2008—Synthetic molecules designed by two Hebrew University of Jerusalem researchers have succeeded in reducing and even eliminating the growth of human malignant tissues in mice, while having no toxic effects on normal tissue.
For their work in developing these harbingers of a possible new generation of anti-cancer drugs, Dr. Arie Dagan and Prof. Shimon Gatt of the Department of Biochemistry of the Hebrew University-Hadassah Medical School were among those receiving the Kaye Award for Innovation today during the 71st meeting of the Hebrew University of Jerusalem Board of Governors.
The molecules developed by Dagan and Gatt affected the metabolism of various sphingolipids and consequently those of cancer cells. Sphingolipids are a family of complex lipid molecules that are involved in signaling pathways that mediate cell growth, differentiation and death.
Genetic cause for type of childhood epilepsy identified
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Scientists have identified the mutated gene responsible for development of a type of epilepsy called childhood absence epilepsy, or CAE.
The condition is associated with frequent “absent” seizures where the patient’s consciousness is impaired leaving the child staring blankly ahead not aware or responsive for up to 10 seconds at a time. An inherited disorder, CAE accounts for 10 to 12 percent of epilepsy in children under age 16. CAE often disappears in adulthood.
The scientists studied the DNA of 48 patients with CAE and discovered that 4 patients had a genetic mutation occurring in the GABA receptor, which binds to a neurotransmitter of the brain called GABA that inhibits the excitation of nerve cells. When this regulation is lost or reduced, seizures develop.
Mood hormone may affect fat, U.S. study finds
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A brain chemical strongly linked to mood and appetite may also directly affect fat gain, U.S. researchers reported on Tuesday.
They said levels of serotonin, the nerve-signaling chemical targeted by many antidepressants, may also direct the body to put down fat regardless of how much food is eaten.
“It may be one reason diets fail,” metabolism expert Kaveh Ashrafi of the University of California, San Francisco, who led the study, said in a telephone interview.
Red wine compound seen protecting heart from aging
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A natural compound found in red wine may protect the heart against the effects of the aging process, researchers said on Tuesday.
In their study, mice were given a diet supplemented with the compound known as resveratrol starting at their equivalent of middle age until old age.
These mice experienced changes in their gene activity related to aging in a way very similar to mice that were placed on a so-called calorie restriction diet that slows the aging process by greatly cutting dietary energy intake.
Diabetes test targets high-risk patients
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The Finnish Diabetes Risk Score may help identify high-risk patients who are most likely to benefit from intensive lifestyle intervention to prevent type 2 diabetes, results of a study published in the May issue of Diabetes Care suggest.
“Intensive lifestyle intervention significantly reduced diabetes incidence among the participants in the Finnish Diabetes Prevention Study,” Dr. Jaana Lindstrom, of the National Public Health Institute, Helsinki, Finland, and colleagues write. The investigators examined whether and to what extent risk factors for type 2 diabetes and other characteristics of the study subjects modified the effectiveness of the lifestyle intervention.
The Finnish Diabetes Risk Score “combines the effects of eight risk characteristics,” the researchers explained—age, body mass index, waist circumference, drug treatment for high blood pressure, high blood sugar, or “glucose” levels, amount of fruits and vegetables in the diet, physical activity and family history of diabetes.
