Washington D.C. [USA], Mar. 24 : Weight training, walking, hiking, jogging for 12 months may increase the particular hormone associated with bone growth, promoting bone formation, increasing bone density.
According to researchers from the University of Missouri-Columbia in the US, long-term, weight-bearing exercises decrease sclerostin, a protein made in the bone, in men and increase IGF-1, a hormone associated with bone growth an and prevent osteoporosis.
The study was published in the journal of Bone.
"People may be physically active and many times people know they need to exercise to prevent obesity, heart disease or diabetes," said Pamela Hinton, associate professor in the Department of Nutrition and Exercise Physiology.
"However, you also really need to do specific exercises to protect your bone health," Hinton added.
They analysed 25 to 60-years-old men, who had low-bone mass and were split into two groups.
One group performed resistance training exercises such as lunges and squats using free weights.
The other group performed various types of jumps, such as single-leg and double-leg jumps.
After 12 months of performing the exercises, the team then compared the levels of bone proteins and hormones in the blood.
The researchers noticed a decrease in the level of sclerostin in both of these exercise interventions in men.
"When sclerostin is expressed at high levels, it has a negative impact on bone formation. In both resistance and jump training, the level of sclerostin in the bone goes down, which triggers bone formation," Hinton explained.
To increase bone mass and prevent osteoporosis, Hinton recommended that exercising specifically to target bone health.(ANI)Region: WashingtonGeneral: Health
New Delhi [India], Mar. 24 : Tuberculosis can affect any age, caste or class and it is one of the top 10 causes of death across the globe, ranking above HIV and malaria.
According to the World Health Organization (WHO), in 2015, there were 10.4 million new cases of TB worldwide. Six countries account for 60% of the total TB deaths, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa.
As per WHO, each year about 2.2 million people develop TB in India and an estimated 220,000 die from the disease.
However, very few people know that the disease affects children too. In 2015, an estimated 1 million children became affected with TB and 170,000 children died of TB (excluding children with HIV) worldwide.
Almost 10% of total TB cases in India are among children, but only six percent are reported. Childhood TB is often not given adequate attention by healthcare providers as it is difficult to diagnose and treat.
This World TB Day, March 24, 2017, is an occasion to call for increased public awareness on the rising cases of TB among children.
According to Dr. Rahul Nagpal, Director, Pediatrics, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, "There has been a steep rise in TB cases among children in India. In a month, I see nearly seven to 10 new cases. It is sad to see children below the age of 5 years in the OPDs with TB but the most unfortunate part is the lack of awareness, proper diagnosis and treatment in case of childhood TB. The youngest TB case handled by me was a 1500 gm baby boy, who was born premature with congenital TB."
"I have seen other similar cases too but what makes me remember this one was that his mother had uterus TB and was unaware of it. Many people aren't aware that TB can happen anywhere and can transfer from anyone. While 60% of TB in children are pulmonary, the rest 40% are extra-pulmonary and are on rise by 20-30% each year, with people knowing very little about it," he added.
It is important to know that TB is a disease which is preventable and curable. Dealing with childhood TB is difficult and crucial because there are several challenges in diagnosis and treatment. At the time of birth, BCG vaccine is compulsory for children. In case a child under the age of 5 years develops TB symptoms, the mantaux test, a very economical and reliable screening test in adults, is done to detect the signs. However this test may have little value in a child who has already taken the BCG vaccine.
According to TB FACTS.ORG:
Signs and symptoms of TB disease in children include:
• Feelings of sickness or weakness, lethargy, reduced playfulness
• Weight loss or failure to thrive
• Fever, night sweats
Signs of TB in other parts of the body among children depend on the area affected. Infants, young children, and immunocompromised children (e.g., children with HIV) are at the highest risk of developing the most severe forms of TB such as TB meningitis or disseminated TB disease. A pediatric TB expert should be consulted in the treatment of TB in children and infants. It is very important that children or anyone being treated completes the course and takes the medicines exactly as instructed.
The medication for children is usually prescribed according to their weights and hence the treatment for each child needs to be customized. Taking blood repeatedly for tests is also a problem as the pain is not easy to bear for them or their parents.
According to Sandeep Guduru, Facility Director, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, "TB in children is ignored, goes unnoticed and is under-reported. While there are many campaigns to create awareness about pulmonary TB, we need to work more aggressively towards creating knowledge about extra-pulmonary TB cases. Also, the rise in Multi-Drug-Resistance (MDR-TB) among children has drawn very less attention of caregivers. The government and private sector healthcare providers need to come on a single platform to ensure the next generation is TB free."
While there has been significant progress in the fight against TB, with 43 million lives saved since 2000, the battle is only half-won: over 4 000 people lose their lives each day to this leading infectious disease. Many of the communities that are most burdened by tuberculosis are those that are poor, vulnerable and marginalized.
WHO is calling on countries and partners to "Unite to End Tuberculosis" this year. The call comes as we enter the era of the Sustainable Development Goals (SDGs). Ending tuberculosis (TB) by 2030 is a target of the SDGs and the goal of the WHO End TB Strategy. (ANI)Region: IndiaGeneral: Health
Washington D.C. [USA], Mar.23 : According to a new study, places which have weaker non-medical exemption policies for vaccinations can reduce the likelihood of a measles outbreak 140 to 190 percent by strengthening them.
The research was published in Academic Pediatrics.
The researchers also found, that the magnitude of these outbreaks can also be cut in half by strengthening exemption policies for children.
"In the year 2000 measles was no longer being transmitted in the U.S. Compare that to 2015 when we had over 150 cases in the first three months. Suddenly measles is an issue again despite having an effective vaccine," said the study's lead author Melanie Whittington, PhD., a health services researcher.
Using mathematical models, they simulated the magnitude, likelihood and cost of a measles outbreak under different non-medical vaccine exemption policies.
The states with "easy" exemption policies typically only require a parent signature on a standardized form.
Those, with "medium" exemption policies require parents to obtain a form from a health department and/or attend an educational session on vaccinations, or write a statement of objection.
Finally, states with "difficult" exemption policies require parents to get a standardized form or statement of objection notarized.
Using data from the Centers for Disease Control and Prevention's National Immunization Study, the researchers found easier non-medical vaccine exemption policies to be associated with a greater risk for outbreaks of vaccine-preventable diseases.
"We modeled an environment where the population had low vaccination coverage and then simulated measles outbreaks under different exemption policies," said Whittington.
Adding, "We found that a state like Colorado is 140 to 190 percent more likely to experience an outbreak with an easy exemption policy than if it had a medium or difficult non-medical exemption policy. The outbreak size can also be reduced nearly by half with stronger policies."
Colorado has one of the lowest vaccination rates for measles. Only 87.4 percent of children between the ages of 19-35 months are covered. And five percent of kindergartners report an exemption.
While the researchers focused on measles, strengthening exemption policies could benefit other vaccine-preventable diseases, such as mumps.
The researchers urged the strengthening of non-medical exemption policies as a way to increase vaccination coverage.
"We are not saying you can't have non-medical exemptions. But if we strengthen them, we can improve health and reduce the economic impact of a potential outbreak," said Campbell and Whittington. (ANI)Region: WashingtonGeneral: Health
New Delhi [India], Mar. 23 : Have you ever imagined of a chat in between watermelon sliders? Or Jalebi in form of churros with cinnamon sugar sprinkled on it?
If not, then get ready for experiencing a bounce on your palate, as 'Punjab Grill Tappa,' as the name suggests, brings to you a young, perky and unique restaurant, designed specially to appeal to the global bohemian travellers.
It is the newest addition by ' Lite Bite Foods,' one of India's largest F&B operators, in Gurgaon's Cyber Hub.
The restaurant stands out with its classy exteriors and a comfortable outdoor seating as well.
It presents a long bar and 'achaar tapas' space, which runs along the length of the interiors and is done in stylish geometric black and white setting. The decor is a perfect combo of lot of old school and modern elements and draws inspiration from global trends to truly carry the legacy of Punjab Grill and Indian cuisine in circa 2016.
'Punjab Grill Tappa' offers North Indian cuisine with an innovative, contemporary flair and a healthier twist.
The starters menu under 'Rock and DholChaalats' feature signature items, such as Watermelon Slider with Crisp Palak and Local Sprouts, Almond and Cucumber Koshimbirand Shrimp and PameloChaat with Ginger and Ambi Panna Glaze.
The appetizers also feature some unusual dishes such as Aampapad with Lettuce wrapped Kurkuri, Tandoori Norwegian Salmon and a healthy version of Chikken Tikka marinated with non-dairy green herb.
Story doesn't end here. For the main course, the Rum-soaked raisin and palak churchur naan have their perfect pairing with some Indian classics like Punjab Grill Dal Makhni or Halim Khao Suey. The Sabut Dana with Shrimp Pulao is a star in the range of Biriyanis on offer and is delicious with the Rehydrated Pineapple and Spinach Raita.
Tappa also has a decadent dessert menu with some unique offerings such as Jalebi Churros with Cinnamon sugar and MalaiRabri, Mango Saffor Creme Brulee and Snow Balls with Dark Chocolate Mousse. The classics also find a spot in the menu with Gulab Jamun and Rabri as well as a Trio of Kulfi on offer among others.
For those who want it all, Tappa has a Dessert Platter to satisfy your sweet tooth.
To sum it all, with an aim to look at Indian cuisine through global lens, Punjab Grill Tappa promises to give a perfect foodgasm, satisfying you to the core. (ANI)Region: IndiaGeneral: Health
Washington D.C. [USA], Mar. 22 : Turns out, your pre-pregnancy weight determines a lot more than the size of the maternity jeans you'll be wearing.
Specific messaging and resources are needed to promote healthy weight gain during pregnancy for young mothers, a new study suggested.
Weight gain during pregnancy is an issue every pregnant woman faces. After pregnancy, new research showed that for young mothers, , or BMI, and ethnicity might signal likelihood for obesity later in life.
After analyzing the medical records of more than 1,000 women who gave birth between the ages of 15 and 24, investigators from the University of Michigan concluded that physicians caring for adolescent women should use BMI before pregnancy as a strong predictor of whether a young mother will gain too much weight during pregnancy, a risk factor for later obesity. They also found that Hispanic women were less likely than non-Hispanic women to gain too much weight during pregnancy.
For the work, researchers reviewed information about the mothers' pregnancy and delivery, including pre-pregnancy BMI and the mother's weight gain during pregnancy. Follow-up interviews gathered additional information, including access to and use of health care and child care services; experiences with local welfare and child support agencies; parental conflict and domestic violence; and child health and well-being.
Researcher Tammy Chang believes getting young people to understand the importance of maintaining a healthy weight can lead to a healthier population in the future. Although getting adults to eat right, exercise and maintain a healthy lifestyle is difficult, she says pregnancy is a prime opportunity for patient education about diet and exercise. Women are often more concerned and invested in their health during pregnancy and have more face time and support from the health care system.
Chang also noted that interventions and programs promoting healthy weight gain during pregnancy must be designed to take adolescent-specific factors into consideration. Younger pregnant women face different issues, concerns and circumstances than older or more established pregnant women.
The results are published in the journal PLOS ONE. (ANI)Region: WashingtonGeneral: Health
New Delhi [India], Mar. 21 : Hair transplant surgery is changing lives and helping people look younger once again. All those people who have lost their hair can now reverse the process through hair transplant surgery. It is the ideal solution for men looking for a more youthful and attractive appearance. A lot of people lose their confidence because of excessive hair loss and as a result their personal and professional lives suffer. Hair surgery can help you roll back the years and give you the appearance that you desire. Hair loss is something that is very common in men, everyone at some point or the other suffers from it. But now you have a revolutionary solution at your disposal.
Dr Alia Rizvi, Dermatologist at Me Clinic, discuss the various benefits of hair transplant surgery.
- Natural Process: Some people have reservations about hair implants and they think of it as an unsafe process. But according to medical experts this is totally untrue because hair transplants are completely safe and natural. No special chemicals or medicines are used in this process that might damage your hair. Amongst all the hair growing methods hair transplant surgery is the most natural. The results are so good that majority of the people won't be able to tell that you got a hair transplant.
-Eliminate Balding: Once you get a hair transplant done you can say goodbye to all your hair related issues. You won't have to worry about a receding hairline or bald spots on your head because hair transplant surgery can solve all problems. The results from hair transplant surgery are highly effective and you are unlikely to see balding again. The hair growth after a transplant will not be as good as how it was naturally but it will be very close to it.
-Improve Your Looks: People who go bald at an early age are generally looked at in a negative manner by other people. These people may be subject to jokes from colleagues and others. This sort of treatment can lower your self esteem and make you feel older than you actually are. Hair transplant surgery will give you a full head of hair and also return your lost confidence. You will look and feel better too.
- Low Maintenance: Another benefit of hair transplant surgery is that you get hair that is very manageable. Transplanted hair works just like your naturally grown hair so you don't need to apply any special shampoos or chemicals to maintain its density. Hair transplantation is also a onetime process. You won't have to visit the doctor again and again. Transplanted hair generally lasts a lifetime so it is well worth the cost.
- Cost Effective: People might be thinking that how hair transplant surgery is cost effective! Well if you consider the costs of other treatments you will realize that those costs are although small but never ending. Over a long period of time the costs of temporary solutions will exceed that of a hair transplant. If you want a long term and permanent solution for your baldness then consider hair transplant surgery. (ANI)Region: IndiaGeneral: Health
Washington D.C. [USA], Mar. 20 : Dear adults, opioids prescribed cautiously for chronic pain should be stored up, away and out of sight of kids of all ages, in a locked cabinet is best, as a study finds most of the exposures occurred among children younger than five years were 60 percent and teenagers was 30 percent.
The researchers call for changes to prescribing practices, increased education about safe storage at home.
The findings, published online in the journal of Pediatrics, indicated more than 188,000 people called to US Poison Control Centers for pediatric exposure to opioids from January 2000 to December 2015, which is 32 calls a day or one every 45 minutes.
"The opioid crisis which has been affecting our adult population has now trickled down to our children," said Dr. Marcel Casavant, study author.
The study conducted by the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital in the US.
One notable exception is buprenorphine, a medication primarily used to treat people for addiction to heroin and other opioids.
"As physicians, we need to find a balance between making sure that we are helping our patients manage their pain and making sure we don't prescribe more or stronger medication than they need," said senior study suthor Gary Smith.
"We need to continue to examine our prescription practices and to increase education to parents about safe ways to store these medications at home to keep them out of the hands of children," Smith added.
The medications leading to the most calls were hydrocodone (29 percent), oxycodone (18 percent), and codeine (17 percent).
Among younger children (0-5 years), most opioid exposures occurred at home and were managed there without serious medical outcome.
Among teenagers, on the other hand, more than two-thirds of the exposures were intentional.
"The opioid crisis which has been affecting our adult population has now trickled down to our children," said study author Dr. Marcel Casavant.
"When adults bring these medications into their homes, they can become a danger to the children that live there. It is important that these medications are stored up, away and out of sight of kids of all ages, in a locked cabinet is best," Casavant explained. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 20 : A study finds that by combining two independent, scientifically-proven risk measurements, physicians can better predict a patient's irregular and often very fast heart rate risk of stroke or death.
According to researchers from the Intermountain Medical Center Heart Institute in Salt Lake City, US, these tools can help to determine the need for blood thinners in treatment.
The researchers combined the commonly used CHA2DS2-VASc tool - for Predicting Stroke Risk in Atrial Fibrillation - with an extensively validated tool, the Intermountain Mortality Risk Score, to improve stroke and mortality predictions in atrial fibrillation patients and provide a more individualised approach to a patient's need for blood thinners as part of treatment.
Blood thinners are used to prevent atrial fibrillation patients from a stroke.
The results of the study have been presented during the American College of Cardiology's 2017 Scientific Session in Washington D.C.
"The CHA2DS2-VASc score isn't terribly predictive of outcomes, but it's easy to use and so it has served as a guideline to help calculate stroke risk for many years," said lead author Benjamin Horne from the Intermountain Medical Center Heart Institute.
"But there are many variables not accounted for in the CHA2DS2-VASc score, so combining it with the Intermountain Mortality Risk Score provides a more complete predictive tool for physicians," Horne added.
The CHA2DS2-VASc score is an easy-to-use international guideline to determine a patient's need for blood thinner.
The points are added based on age, gender, history of stroke, hypertension, heart failure or diabetes.
The findings indicated that an atrial fibrillation patient, with a score of two or more, is placed on blood thinners.
The Intermountain Mortality Risk Score is based on lab values typically collected from a patient - a complete blood count and basic metabolic profile - which sync automatically to a patient's electronic medical record so physicians have the score readily available.
They found the Intermountain Mortality Risk Score offered a more accurate scale of low and high risk in patients with a CHA2DS2-VASc score of two, which provides physicians with a better guide for determining if a blood thinner is right for their patient. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 19 : Tennis elbow sufferers, if the idea of going under the knife is terrifying, then you can opt for non-operative approaches as a recent study has suggested that surgery may not offer additional benefit.
The study, a randomized, double-blinded clinical trial, explored patient responses to a common surgery aimed at repairing a damaged elbow, compared to a placebo procedure.
The study analyzed 13 patients who underwent surgery to remove a degenerated portion of their extensor capri radialis brevis (ECRB), compared to a group of 13 who received an incision over their lateral elbow and no further repair. Patients included had experienced symptoms of tennis elbow for more than 6 months, and attempted at least two non-surgical treatment approaches such as physical therapy, massage, acupuncture, or splinting/bracing, but had no symptom relief over that period.
"Our data shows both groups experienced significant improvements in pain measures by 26 weeks after surgery, including frequency of pain with activity," commented lead author Martin Kroslak from the Orthopaedic Research Institute in Sydney, Australia. "Further, these results were consistent or improved after 1-4 years of follow-up, with no significant difference between the two groups at any point."
"Managing chronic tennis elbow is a challenge for a large portion of the active population," noted Kroslak. "Our research demonstrates the challenges in outlining a treatment plan for these patients, and the continued work to be done in developing both surgical and non-operative approaches."
The study appears in the journal American Journal of Sports Medicine. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 19 : Ablation procedures may not always fix a patient's abnormal heart rhythm completely and now, a recent study has found as to why it is so.
Researchers from the Intermountain Medical Center Heart Institute in Salt Lake City have found that certain molecules are associated with the recurrence of atrial fibrillation in some patients after therapy.
These molecules, known as circulating microRNA, have the promise of becoming screening tools to help determine which patients will benefit from various therapies, the team found.
Circulating microRNA refers to microRNA that has spilled out of the cell into the blood and can be measured. MicroRNA is the name given to small, very stable non-coding RNA molecules that are involved in gene regulation.
Researchers used a series of blood markers to identify those patients whose ablations worked the first time. They compared 85 patients who had successful ablations with 55 patients whose atrial fibrillation recurred within a year.
The microRNA particles studied can impact inflammation, fibrosis, and the heart's electrical activity. Because RNA molecules are so small and stable, they can be detected in circulating biological fluids like saliva and blood.
The researchers found low levels of three microRNA molecules, designated as 21, 150, and 328, in patients whose atrial fibrillation came back after ablation. Those molecules have already been associated with ablation's atrial scarring, called remodeling and adverse electrical healing.
"Our genetic makeup is important in how we respond and heal from procedures," said senior investigator T. Jared Bunch. "MicroRNA particles are a direct result of our genetic make-up. As we try to identify treatments that are tailored to an individual person, microRNA has the promise to help us determine who may be a better candidate for ablation versus other therapies."
Researchers hope the study findings will help doctors determine which treatments are more likely to work for different patients with atrial fibrillation, including those who wouldn't benefit from ablation, which is expensive and carries some risks.
Results of the study have been presented at the American College of Cardiology's Scientific Session. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar.18 : According to a new study, veterans who have drug or alcohol problems are more than twice as likely to die by suicide as their comrades.
The research published in the journal Addiction finds highest suicide risks are among those, who misuse prescription sedative medicines, such as tranquilizers. Women veterans who misuse opioid drugs also have an especially high risk of suicide.
The study finds highest suicide risks are among those, who misuse prescription sedative medicines, such as tranquilizers. Women veterans who misuse opioid drugs also have an especially high risk of suicide.
The findings point to a need to focus more veteran suicide-prevention efforts on those, who have substance use disorders, especially if they also have depression, schizophrenia, bipolar disorder, post-traumatic stress disorder or anxiety.
These findings come from one of the largest-ever examinations of substance use disorders and suicide, involving more than 4.4 million veterans.
"We hope these findings will help clinicians and health systems care for people with substance use disorders, with mental health conditions, and with both -- and focus suicide prevention efforts accordingly. Substance use disorders may be important markers for suicide risk," says Kipling Bohnert, Ph.D., lead author of the study and researcher with the VA Center for Clinical Management Research who is also an assistant professor of psychiatry at the U-M Medical School.
Using statistical techniques, the team calculated suicide rates per 100,000 veterans, and then calculated those rates for veterans with substance use issues overall, and for specific substance use disorders.
In all, the suicide rate was 75.6 per 100,000 for veterans with any substance use disorder, compared with 34.7 for veterans overall.
A previous study led by Mark Ilgen, Ph.D., co-author on the new study, found similarly higher rates in veterans who were tracked from 1999 to 2006.
But the new study lets the researchers drill down to the specific substance that veterans had problems with, including alcohol, opioids, marijuana, and cocaine.
The study found the suicide risk was highest for veterans of both genders who misused sedatives -- 171.4 per 100,000 -- and markedly higher for women who misused opioids, at 98.6 per 100,000.
The researchers then took into account veterans' age and the overall severity of their medical conditions, and calculated the risk of suicide by type of substance use disorder.
Men who misused amphetamines also had a suicide rate of 95 per 100,000. Among women, only alcohol and opioid disorders remained associated with higher suicide risk, independent of mental and physical health.
Bohnert adds, "Assessment and treatment of co-existing psychiatric conditions, in addition to substance use, may be important in lowering the risk of suicide among individuals who have substance use disorders."
But both genders with substance use disorders had a higher rate of suicide even after differences in physical and mental health were factored in. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 18 : A new class of cholesterol-lowering drug can help patients cut their risk of cardiovascular disease, stroke and heart attack.
In a trial of more than 27,000 patients, researchers found that taking monthly or twice-monthly injections of the medication, called evolocumab, on top of statins could cut cholesterol levels by almost 60 percent on average in patients with an underlying risk of cardiovascular disease.
The international team, which includes researchers from Imperial College London, says the drug could provide added benefit to patients already taking statins by further reducing the levels of low-density lipoprotein (LDL) cholesterol in their blood.
"This is one of the most important trials of cholesterol-lowering since the first statin trial, published 20 years ago," said lead author Peter Sever, adding "Our results suggest this new, extremely potent class of drug can cut cholesterol dramatically, which could provide great benefit for a lot of people at risk of heart disease and stroke."
In the study, researchers looked at the protective effect of evolocumab on patients in 49 countries, with a history of atherosclerotic vascular disease, who were already taking statins to reduce their cholesterol.
At the end of the treatment period, researchers found that on average, patients taking evolocumab plus statins were able to reduce their LDL cholesterol levels by an average of 59 per cent, from 92 mg/dL to 30 mg/dL, compared to those taking placebo plus statins.
The group which had received evolocumab experienced fewer primary endpoint events, compared to the placebo arm of the study, with 1,344 (9.8 per cent) compared to 1,563 (11.3 per cent) respectively.
Overall, this equated to a 15 per cent reduction in the risk of serious cardiovascular events for patients taking the drug with statins. The benefits were seen across all subtypes of patients, even in those who started with low levels of cholesterol.
According to the researchers, the findings demonstrate the protective effect of the drug through lowering LDL cholesterol levels, with no significant difference in the occurrence of side effects between the treatment and placebo arms of the study.
The study is published in the New England Journal of Medicine. (ANI)Region: WashingtonGeneral: Health
Washington D.C [USA], Mar. 18 : If you are a low-risk atrial fibrillation patient, then you may want to steer clear of antithrombotic therapy as a recent study has suggested that it doesn't cut the chances of suffering a stroke within five years.
In fact, researchers at the Intermountain Medical Center Heart Institute in Salt Lake City found that low-risk patients fared better without any antithrombotic therapy.
Antithrombotic agents are drugs that reduce the formation of blood clots. Antithrombotics can be used therapeutically for prevention or treatment of a dangerous blood clots.
The study found that low-risk patients -- with a CHADS2 score of 0-1 or CHA2DS2 VASc score of 0-2 -- who received antithrombotic therapy experienced higher rates of stroke and significant bleeding.
CHADS2 is an acronym that helps clinicians recall major stroke risk factors, assigning one point for each letter: "C" for congestive heart failure, "H" for high blood pressure, "A" for age 75 or older and "D" for diabetes. "S" stands for stroke and the "2" denotes an extra point is assigned for a previous stroke. CHA2DS2-VASc builds on CHADS2, adding points for being female, being between the ages 65-75 and having vascular disease.
"There is still no consensus regarding the initiation of these therapies in low-stroke risk patients, but findings from our study add important insight into this issue," researcher Victoria Jacobs said.
The study involved 56,723 patients diagnosed with atrial fibrillation and a CHADS2 scores of 0-1 and CHADS2 VASc scores of 0-2. Patients were divided into groups receiving aspirin, Clopidogrel and Warfarin.
Follow-up after five years showed that 4.6 percent of aspirin-prescribed patients suffered a stroke versus 2.3 percent of those who weren't on it; 17.6 percent of those using aspirin experienced significant bleeding versus 11.5 percent not on it.
Of warfarin-prescribed patients, 5.7 percent suffered a stroke after five years versus 2.6 percent of those not on it; 22.3 percent of warfarin patients experienced significant bleeding versus 12.3 percent not on it.
The study concludes that anticoagulation or antiplatelet therapies don't lower stroke rates in low-risk patients, but rather increase their risk of significant bleeding and death.
The new findings have been presented at the American College of Cardiology's 66th Annual Scientific Session in Washington, D.C. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar.17 : According to a new study, living in urban areas can make asthma worse for your children.
These findings were published in Journal of Allergy and Clinical Immunology.
The study shows that urban living is a strong independent risk factor for increased asthma morbidity -- defined as higher rates of asthma-related emergency room visits and hospitalizations -- but urban living does not increase the risk for having asthma.
"Our findings serve as evidence that there are differences between risk factors linked to developing asthma and those linked to making asthma worse if you already have it," says Corinne Keet, M.D., Ph.D., associate professor of pediatrics at the Johns Hopkins University School of Medicine and the paper's lead author.
In the past, a few studies have been conducted on a national level to determine the effects of inner-city living on both asthma prevalence and severity.
While Keet's work published in 2015 using a national survey showed that living in an urban area was not a risk factor for having asthma, that study didn't allow for analysis of asthma morbidity.
The research team sought to determine those effects by analyzing information gathered by the U.S. Centers for Medicare and Medicaid Services on the health care utilization of 16,860,716 children ages 5 to 19, who were enrolled in Medicaid in 2009 and 2010.
The team first narrowed the pool of data to children who had at least one asthma-related outpatient or Emergency Department visit over the two-year period.
Based on the county they lived in, these 1,534,820 children were categorized by urbanization status and based on their ZIP code, categorized as living in a poor or not poor neighborhood.
The team excluded states that were missing more than 10 percent of data on race/ethnicity, states in which all major race/ethnicity groups were not represented and states that did not have urban areas.
The results for 18 states that met the study's final guidelines showed that children who lived in nonurban areas were 18 to 21 percent less likely to be at risk for hospitalizations, even after accounting for race/ethnicity.
The researchers also found that compared to non-Hispanic white children, black children and children of "other" races had 89 and 61 percent, respectively, higher risks of asthma-related hospitalizations.
Unlike other racial/ethnic groups, Hispanic children who live in a nonurban area did not experience reduced risks of emergency room visits or hospitalizations. And contrary to Keet's previous studies, which reported that poverty was protective against asthma prevalence rates for Hispanic children, the team found no similar association for asthma morbidity.
Keet says, "Among the Medicaid population she studied, 30 percent of asthma-related hospitalizations were likely attributable to socioeconomic, geographic and/or racial/ethnic disparities; 19 percent of hospitalizations were estimated to be attributable to black race/ethnicity; four percent were attributable to living in a poor area; and seven percent were attributable to living in an urban area."
Children who lived in inner-city areas had an overall 40 percent higher risk of asthma-related emergency room visits and 62 percent higher risk of asthma-related hospitalizations. After adjusting for race/ethnicity, risk was lowered to 14 percent and 30 percent higher for emergency room visits and hospitalizations, respectively.
"These results show that despite several decades of research on racial/ethnic and geographic disparities in asthma morbidity, there are still very large differences in rates of emergency room visits and hospitalizations by race and neighborhood characteristics. These findings emphasize that we need to redouble our efforts to find comprehensive solutions to address asthma disparities," concludes Keet.
The study's two main limitations were that not all states could be included because of differences in Medicaid data collection, and that it is possible that some of the differences in emergency room visits and hospitalizations could be related to how patients seek care for asthma, rather than only reflecting underlying disease severity. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar.17 : Dialysis Patients, we might have some good news for you.
A new research suggests that an alternative to warfarin, if given in low capacity to dialysis patients, can be maintained in the blood at safe levels to prevent higher risks of stroke.
The findings are published in Journal of the American Society of Nephrology (JASN).
The study, indicate that additional research warranted on the benefits of apixaban in patients with kidney failure. Kidney failure patients on dialysis have a very high prevalence of atrial fibrillation, a common heart arrhythmia. As a result, they are at higher risk of stroke than the general population.
The blood thinner warfarin prevents nearly two thirds of strokes in the general population of patients with atrial fibrillation, but because its effectiveness in dialysis patients is unclear, it is important to test alternative anticoagulants.
A team led by Thomas Mavrakanas, MD and Mark Lipman, MD (Jewish General Hospital at McGill University, in Canada) assessed the potential of apixaban, an oral drug that more directly inhibits coagulation than warfarin. For the study, seven patients received a low dose of apixaban (2.5 mg) twice daily.
When the researchers collected blood samples, they found significant accumulation of the drug between day one and eight. When apixaban levels were monitored hourly during dialysis, only four percent of the drug was removed.
After a five-day washout period, five patients received the currently recommended dose of five mg of apixaban twice daily for eight days. This led to dangerously high blood levels of the drug.
"This dosage should be avoided in patients on dialysis. On the contrary, drug exposure with the reduced dose of 2.5 mg twice daily may be considered in patients on dialysis with atrial fibrillation. No clinical data are yet available, however, and more evidence is necessary before recommending this drug at the 2.5 mg twice daily dose for stroke prevention in patients on dialysis with atrial fibrillation," said Dr. Mavrakanas, who is currently a research fellow at Brigham & Women's Hospital in Boston. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 17 : Turns out, it just takes a little empathy to halt infectious disease outbreaks.
The Georgia Institute of Technology researchers used a networked variation of game theory to study how individual behavior during an outbreak of influenza - or other illness - affects the progress of the disease, including how rapidly the outbreak dies out.
The study pitted the self-interests of susceptible individuals against those of infected persons, and found that only if sick persons took precautions to avoid infecting others could the illness be eradicated. Healthy people attempting to protect themselves couldn't, by themselves, stop the disease from spreading. Among the key factors was empathy of infected persons.
"We wanted to understand disease dynamics from an individual's perspective," said researcher Ceyhun Eksin. "In particular, we wanted to know what role individual behavior plays in disease spread and how behavior might affect forecasting and consequences in the long run when there is an outbreak."
The research used mathematical models that took into account how infectious diseases spread and the effects of measures taken to control them.
Public health initiatives against seasonal diseases like influenza tend to initially focus on immunization programs, which move individuals out of the "susceptible" category. Once an outbreak begins, health campaigns focus on encouraging susceptible persons to take precautions such as hand-washing and avoiding infected people.
The success of those measures may depend on individual perceptions of how great the risk of infection might be, Eksin noted. The more awareness individuals have of infected persons around them, the more likely they are to protect themselves. Perception can also affect the behavior of infected individuals, who may be more likely to stay home from work or cover their cough, for instance, if they believe their presence could infect a significant number of people.
"If an infected person really wants to attend a meeting at work, it's one thing if only one other person could be at risk," he said. "It may be a different thing if they could affect a whole office of susceptible people."
The empathy of sick persons becomes especially important toward the end of an outbreak, when the number of infected persons may be low, but still enough to sustain the illness. When the number of sick people is low, risk perception falls, leading susceptible people to reduce their precautions - and sick people to feel less concern about infecting others.
If those sick persons then decide to head off to work despite their illness, they may infect unsuspecting susceptible people, causing the outbreak to continue."The behavior of the infected individuals can be more important than the behavior of the susceptible individuals in eradicating the disease," said Eksin. "A little bit of empathy can be crucial at this point."
While the research examined the results of individual actions during an outbreak, those individual decisions were actually related because individuals are part of networks of contacts.
The study appears in the journal Scientific Reports. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 17 : A simple blood test that could detect autism in children has come closer to reality.
An algorithm based on levels of metabolites found in a blood sample can accurately predict whether a child is on the Autism spectrum of disorder (ASD), based upon a recent study. The algorithm, developed by researchers at Rensselaer Polytechnic Institute, is the first physiological test for autism and opens the door to earlier diagnosis and potential future development of therapeutics.
"Instead of looking at individual metabolites, we investigated patterns of several metabolites and found significant differences between metabolites of children with ASD and those that are neurotypical. These differences allow us to categorize whether an individual is on the Autism spectrum," said lead author Juergen Hahn. "By measuring 24 metabolites from a blood sample, this algorithm can tell whether or not an individual is on the Autism spectrum, and even to some degree where on the spectrum they land."
Big data techniques applied to biomedical data found different patterns in metabolites relevant to two connected cellular pathways (a series of interactions between molecules that control cell function) that have been hypothesized to be linked to ASD: the methionine cycle and the transulfuration pathway. The methionine cycle is linked to several cellular functions, including DNA methylation and epigenetics, and the transulfuration pathway results in the production of the antioxidant glutathione, decreasing oxidative stress.
In the study, Hahn described an application of Fisher Discriminant Analysis - a big data analysis technique - to data from a group of 149 people, about half on the Autism spectrum. Deliberately omitting data from one of the individuals in the group, Hahn subjected the dataset to advanced analysis techniques, and uses the results to generate a predictive algorithm. The algorithm then makes a prediction about the data from the omitted individual. Hahn cross-validated the results,swapping a different individual out of the group and repeating the process for all 149 participants. His method correctly identified 96.1 percent of all neurotypical participants and 97.6 percent of the ASD cohort.
"Because we did everything possible to make the model independent of the data, I am very optimistic we will be able to replicate our results with a different cohort," said Hahn. "This is the first physiological diagnostic and it's highly accurate and specific."
Researchers have looked at individual metabolites produced by the methionine cycle and the transulfuration pathways and found possible links with ASD, but the correlation has been inconclusive. Hahn said the more sophisticated techniques he applied revealed patterns that would not have been apparent with earlier efforts.
"A lot of studies have looked at one biomarker, one metabolite, one gene, and have found some differences, but most of the time those differences weren't statistically significant or the results could not be reliably replicated," Hahn said. "Our contribution is using big data techniques that are able to look at a suite of metabolites that have been correlated with ASD and make statistically a much stronger case."
The study appears in PLOS Computational Biology. (ANI)Region: WashingtonGeneral: Health
Washington D.C. [USA], Mar. 16 : Sending and receiving threatening, offensive comments, images or videos on social media can trigger negative perceptions for the importance of school and learning, especially among female teenagers, finds a study.
According to researchers from Nottingham Trent University in England, 11-15 year-old girls who were most involved in cyberbullying -- as perpetrator, victim, or both -- felt the least accepted by their peers.
The study, published in the Springer journal Sex Roles1, says cyberbullying can be extremely damaging and cause a great deal of stress for young people given its potential to occur around the clock.
"With the increasing amount of time they spend using digital technology, young people are at great risk of being involved in cyberbullying - as a victim, bully, or both," said lead researcher Dr. Lucy Betts.
"Our findings highlight that stressors outside the school grounds can have a negative impact on how young women perceive school," she continued.
They analysed 345 male and females and asked them to completed questionnaires which measured levels of cyberbullying involvement -- such as sending and receiving threatening or offensive comments, rumours and the sharing of images or videos -- over the last three months.
The findings indicated that females who reported the highest levels of involvement in cyberbullying felt the least accepted by the peers.
In terms of males, only boys who had been involved in cyberbullying as both bully and victim felt more negatively about school and learning, the study found.
Females who felt the least accepted felt more negatively about school and learning, while those who felt more accepted were more positive.
The more acceptance girls received from the peers, the more likely they were to shrug off the effects of cyberbullying and enjoy school and the less likely they were to participate in virtual attacks.
"Our work also contributes to the growing evidence that involvement in cyberbullying undermines peer relationships and highlights the importance of these relationships upon attitudes towards learning and school for young women," Betts noted. (ANI)Region: WashingtonGeneral: Health
Chances are that you might end your days slipping into dementia, but now, a recent study has suggested that it's possible to detect the onset of early memory loss.
In a joint Baycrest-University of Memphis study, scientists have discovered a new potential predictor of early dementia through abnormal functionality in regions of the brain that process speech (the brainstem and auditory cortex).
These brain regions are thought to be more resilient to Alzheimer's. However, this discovery demonstrates changes occur early in the brain's conversion of speech sound into understandable words.
This finding could be the first sign of decline in brain function related to communication that presents itself before individuals become aware of these problems.
Their research technique of measuring electrical brain activity using an electroencephalogram (EEG) in these brain regions also predicted mild cognitive impairment (MCI), a condition that is likely to develop into Alzheimer's, with 80 per cent accuracy. This test could be developed into a cost-effective and objective diagnostic assessment for older adults.
The study looked at older adults with no known history of neurological or psychiatric illnesses with similar hearing acuity.
The brain activity within the brainstem of these older adults demonstrated abnormally large speech sound processing within seven to 10 milliseconds of the signal hitting the ear, which could be a sign of greater communication problems in the future.
"This opens a new door in identifying biological markers for dementia since we might consider using the brain's processing of speech sounds as a new way to detect the disease earlier," said senior author Dr. Claude Alain. "Losing the ability to communicate is devastating and this finding could lead to the development of targeted treatments or interventions to maintain this capability and slow progression of the disease."
The study involved 23 older adults between the ages of 52 and 86. Participants were separated into two groups based on their results on a dementia screening test, the Montreal Cognitive Assessment (MoCA). Researchers measured brain activity in the brainstem while participants were watching a video. They measured brain activity in the auditory cortex while participants were identifying vowel sounds.
Statistical methods were used to combine both sets of brain activity to predict MCI.
"This could offer a new diagnostic assessment that tests a person's cognitive abilities, such as their ability to communicate, and objectively measure physiological changes in the brain that reflect early signs of dementia," said first author Gavin Bidelman.
The study is published online in the Journal of Neuroscience. (ANI)Region: United StatesGeneral: Health
Washington D.C. [USA], Mar. 15 : Researchers have identified a new mechanism, by which inflammation can spread throughout the brain after injury and may play a role in other neurodegenerative diseases.
The findings were published in the Journal of Neuroinflammation.
According to researchers from the University of Maryland School of Medicine in the US, this new understanding has the potential to transform, how brain inflammation is understood, and, ultimately, how it is treated.
"These results potentially provide a new conceptual framework for understanding brain inflammation and its relationship to brain cell loss and neurological deficits after head injury and may be relevant for other neurodegenerative disorders such as Alzheimer disease in which neuroinflammation may also play a role," said Dr Alan Faden.
"The idea that brain inflammation can trigger more inflammation at a distance through the release of microparticles may offer novel treatment targets for a number of important brain diseases," Faden added.
The researchers showed that microparticles derived from brain inflammatory cells are markedly increased in both the brain and the blood following experimental traumatic brain injury (TBI).
These microparticles carry pro-inflammatory factors that can activate normal immune cells, making them potentially toxic to brain neurons.
The researchers studied mice and found that in animals who had a traumatic brain injury, levels of microparticles in the blood were much higher because each kind of cell in the body has a distinct fingerprint and could track exactly where the microparticles came from.
In this study, the microparticles released from cells known as microglia, immune cells that are common in the brain. After an injury, these cells often go into overdrive in an attempt to fix the injury.
But this outsized response can change protective inflammatory responses to chronic destructive ones.
The research has found that neuroinflammation often goes on for years after TBI, causing chronic brain damage.
The chronic inflammation has been increasingly implicated in the progressive cell loss and neurological changes that occur after TBI.
These inflammatory microparticles may be a key mechanism for chronic, progressive brain inflammation and may represent a new target for treating brain injury. (ANI)Region: WashingtonGeneral: Health
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