Intuitively, it makes sense that depression and drinking go hand in hand, but when researchers try to pin down exactly how alcohol and depressive states interact, they’ve had mixed results. Some studies show a direct relationship between the two, while others aren’t as clear.

Now, researchers at the Center for Addiction and Mental Health at the University of Western Ontario think they know why. In a survey of over 14,000 men and women, they found that the relationship between drinking and depression depends on the type of drinking—occasional, heavy or binge drinking —and, surprisingly, whether you are a man or a woman. It turns out that depression is most strongly correlated with the volume of alcohol an individual consumes every time she drinks, as opposed to how often she drinks. And the effect is more prominent in women than in men. Binge drinking women, for example, were more likely to be clinically depressed than men who drank lower quantities of alcohol more regularly.

What it means: These findings hint at something that researchers have suspected for a long time— that the relationship between drinking and depression is a complex one. But the study reveals two factors that may clarify this interaction, and suggest that women may be using alcohol has a way to self-treat their depression. The authors suggest that future studies on drinking and depression take advantage of this data and clearly identify the pattern of alcohol consumption, and consider the fact that men and women may be drinking for different reasons.

From the Archive:

Jun. 6, 2006: Mental Illness and Bad Temper
Nov. 3, 2006: How Drinking Destroys Your Lungs

One of the many tragedies of Alzheimer’s disease is that doctors still don’t have a way of conclusively diagnosing the so-called ‘long goodbye’ until an autopsy is performed at death. Only after an analysis of the brain tissue reveals the hallmark protein plaques and tangles of the disease can physicians be sure that Alzheimer’s was at work.

Now researchers at UCLA report in the New England Journal of Medicine that they have developed a marker molecule that can bind to both the plaques and tangles present in the disease to identify patients at a much earlier stage of the disease than was ever possible before. Using the molecule and advanced positron emission tomography (PET) imaging which detects the presence of the molecule, the scientists tested 83 volunteers who reported having memory problems. Using current crude tests of the subjects’ cognitive abilities, doctors surmised that 25 likely had Alzheimer’s, 28 volunteers suffered from mild cognitive impairment (which can, in some cases, progress to Alzheimer’s disease), while 30 were normal, and probably only suffered from the senior moments associated with natural aging.

The researchers injected each subject with the molecule and scanned their brains using PET, then re-scanned the patients two years later. Those showing the most advanced symptoms of Alzheimer’s tended to have greater accumulation of the molecule, and therefore the plaques and tangles, in certain parts of the brain associated with cognitive functions such as memory and recall. Over the two year period, those who grew worse showed a five to 11% increase in the binding of the marker molecule. The doctors were able to confirm that one of these patients, who died 14 months after the initial screening and had shown high levels of the molecule, did indeed have the protein plaques and tangles of Alzheimer’s disease.

What it means: The results are tantalizing evidence that it might be possible to distinguish Alzheimer’s patients from those who suffer from normal memory lapses, and from those who show signs of the precursor to Alzheimer’s disease, known as mild cognitive impairment. If that’s possible, then these patients could be treated early enough to halt the gradual deterioration of brain neurons that make the condition for devastating. The effectiveness of the molecule to act as such a diagnostic marker, however, needs to be confirmed by other labs, and, as the authors of the paper themselves point out, additional testing should also be conducted on older Alzheimer’s patients as well, to determine how specific the molecule is for the disease’s damaging protein deposits. The strength of the results, however, suggest that it might be possible to finally diagnose the disease in living patients, and hopefully, even intervene before the symptoms become so debilitating.

From the Archive:

Dec. 12, 2006: An Alzheimer's Test?
Nov. 13, 2006: Eat Fish, Avoid Dementia

By now most women are probably familiar with the landmark 2002 study that showed that hormone replacement therapy (HRT) for women past menopause can lead to an increased risk of breast cancer. It turns out that the supplemental hormones estrogen and progestin in the HRT, while effective in controlling the hot flashes of menopause, also activated breast tissue sensitive to the hormones. Researchers at MD Anderson Medical Center report at conference today that the drop in HRT use may have resulted in as many as 14,000 fewer cases of breast cancer between 2002 and 2003.

The drop was most pronounced among women between the ages of 50-69 years old, and the researchers note that the difference could not be explained away by other factors known to affect cancer incidence, such as the role of anti-inflammatory drugs, newer forms of hormone supplements, or statins. Between 2002 and 2003, they say, the incidence of breast cancer dropped by 7%, and among post menopausal women who had had estrogen-positive breast cancers—the type whose growth is fueled by the estrogen hormone, the incidence declined by 12%.

What it means: The results underscore the important role that estrogen may have had in promoting the growth of certain types of breast tumors—those containing receptors for the estrogen hormone. They might also explain in part why breast cancer rates had been creeping up in the years prior to 2002 as more women chose to take HRT to relieve their menopause symptoms. But while the data indicate that the effect of HRT on breast cancer rates in these years may have been larger than doctors had thought, the study authors note that their analysis, which was purely statistical, does not mean that estrogen, or HRT, can explain away all forms of breast cancer.

From the Archive:

Feb. 23, 2004: HRT Takes Another Hit
July 22, 2002: The Truth About Hormones

For over a century, the best way to screen for genetic and chromosomal defects in a developing fetus involved inserting a long needle through a pregnant mom’s abdomen and into the amniotic sac cushioning the growing baby. By removing a small sample of the fluid and performing genetic tests, doctors and parents could detect the presence of defects, including the extra chromosome characteristic of Down syndrome.

Because the procedure requires inserting a needling into the protective amniotic sac, however, studies from the 1970s showed that one in 200 otherwise normal pregnancies ended in miscarriage after amniocentesis.

Researchers at Mount Sinai School Medicine decided to update the statistic, and studied a more contemporary patient population of pregnant women getting amniocentesis to detect Down syndrome. Reporting in the journal Obstetrics and Gynecology, they found that the risk of miscarriage associated with the test was actually lower. Among their 35,000 patients who underwent the screening, the amniocentesis-related miscarriage rate was 0.06%, or one in 1600 pregnancies.

What it means: The authors note that the lower miscarriage rate could be due to newer screening techniques, which could reduce the danger to mother and baby. And given that the often-quoted 0.5% risk rate was established several decades ago, it makes sense for moms-to-be to know about the updated statistics and ask their doctor about whether the test is worth the risk for them.

From the Archive:

Nov. 14, 2005: Down Syndrome Dilemma

There are a lot of good reasons to eat seafood—recent studies have linked the omega-3 fatty acids found in deep water fish to a lower risk of heart disease; fish are a good source of protein, and early studies hint that pregnant women who eat fish or take fish oil supplements are more likely to carry babies to full term, and to enhance their babies’ cognitive development.

But eating more fish isn’t easy. The healthy bonus that comes from fish, it seems, has a price. The same fats that make fish so good for the heart and the body also attract dangerous toxins, from dioxins to polychlorinated biphenyls (PCBs), the man-made byproducts of the electrical industry. (While PCBs have not been created since the 1970s, trace amounts still linger in waters.) In addition, the lean muscle of the ocean’s biggest and most powerful swimmers can become sinkholes for methylmercury, a potentially brain- and liver-damaging metal formed when salts are processed by certain anaerobic bacteria. Is it safe to eat fish at all? Are the benefits of eating fish enough to outweigh these risks? How much fish is safe to eat? Which kinds of fish and seafood have the most omega-3 fatty acids and the lowest levels of contaminants?

Two reports released this week may finally provide some answers for those trying to decide between surf or turf. Both the Institute of Medicine and researchers at Harvard School of Public Health report that more Americans could be benefiting from the high protein and healthier fat found in fish, and that for most people, these benefits do indeed outweigh the risks of consuming contaminants. Not surprisingly, both studies note that some populations, including pregnant women and young children who may be at greatest risk of suffering from contaminant poisoning, should avoid consuming too much of the larger fish species that are likely to have the highest levels of methylmercury or PCBs.

The IOM report, Seafood Choices, Balancing Benefits and Risks, provides recommendations for four populations—women who are or may become pregnant or who are breast-feeding; children younger than 12; adult women who are not planning to become pregnant and adult men; and adults at risk of heart disease—but the core advice for all groups is the same: it’s safe, and healthy, to eat up to two 3 oz. servings of fish each week. Young children and pregnant women, however, should make sure that these servings don’t include shark, swordfish, tilefish or king mackerel, the largest predatory species that contain the highest levels of methylmercury.

The Harvard authors, whose report appears in the Journal of the American Medical Association, also found that eating fish carries significant health benefits. Based on their review of several years of previously published studies, they found that eating 3 oz. of farmed salmon a week could reduce the risk of death from heart disease by 36% and the risk of overall death by 17%. While contaminants like methylmercury and PCBs can indeed cause neurological problems, the benefits gained from eating fish often outweigh the smaller risk these toxins pose.

What it means: While Americans are eating more fish on average today than at the turn of the century, we’re not eating the healthiest kinds of seafood. The most popular form of seafood, shrimp, is high in cholesterol and contains low levels of omega-3 fatty acids. And that cafeteria staple, fish sticks, contain very low levels of methylmercury but are equally poor sources of omega-3 oils; a 3.5 oz serving contains one-twelfth the amount of oils found in the same-sized portion of farmed salmon.

So if you’ve been eating too much of the less healthy offerings from the sea, or avoiding fish altogether because you’ve been worried about the contaminants they may contain, take some advice from the Harvard researchers. The best way to avoid the potential dangers of an all-surf diet, they say, is to vary the types of fish you eat. Atlantic herring, wild salmon, sardines and Atlantic cod are among the fish with the lowest methylmercury levels; while the larger species, like king mackerel and swordfish, contain some of the highest levels. For more on the IOM’s report, visit www.iom.edu.

From the Archive:

Jun. 19, 2006: The Benefits of Fish Oil
Jan. 8, 2006: Fish and Your Brain

It’s no secret that smoking is associated with a host of health risks, including lung cancer, respiratory problems and even heart disease. Even if you don’t smoke, inhaling second-hand smoke can increase your risk of getting these diseases. This risk, say researchers from the Harvard School of Public Health, may be even greater for small children, especially those riding in a car with a smoker.

Vaughan Rees and Gregory Connolly of Harvard’s division of Public Health Practice, conducted 45 driving trials, asking volunteers to drive for about an hour is Boston city traffic while smoking. The scientists placed an aerosol monitor in a baby seat secured to the rear passenger seat opposite from the driver. Even with the driver’s side window open by about two inches, the monitor recorded concentrations of second-hand smoke particles that exceeded the US Environmental Protection Agency’s safe levels. It didn’t matter how long the smoker smoked; a single cigarette smoked for five minutes produced a harmful level of particles.

What it means: Second hand smoke has been linked to a number of childhood health risks, including asthma, respiratory infections, ear infections and even sudden infant death syndrome. Doctors have warned that young children may be particularly sensitive to toxins in cigarette smoke, because of their still-developing immune systems, and because of their smaller airways, which gives them a higher respiration rate that increases their chances of ingesting second-hand smoke particles. While previous studies have documented the dangers of second-hand smoke in enclosed rooms, this is one of the first to show that even in a car with an open window, children can be exposed to potentially dangerous levels of cigarette smoke toxins, similar to those found in smoky bars. The authors urge policy makers to include car environments when they advocate to keep young children safe from second-hand smoke.

Poverty may be hard on more than just the bank book, according to new research from the University of Southern California. People living below the poverty line are more likely to have high levels of protein linked with heart disease and aging. Even after accounting for factors such as medical history and lifestyle and eating habits, the difference persisted. Among low income families, nearly 16% had high levels of C-reactive protein (CRP), a marker for the inflammation that can accelerate the risk of a heart attack, while only 9% of those living above the poverty line showed such elevated levels of CRP.

What it means: While CRP has become an important risk factor to consider for heart disease, this study is only the first step in determining whether there is something inherent about poverty that poses additional health risks. Researchers have yet to establish any cause and effect relationship, but note that obesity was the largest contributor to elevated CRP levels in their study population. These findings could lead to further research that explores which aspects of poverty—anxiety, stress, diet, and other lifestyle factors—contribute most to increased levels of CRP.

From the Archive:

Sept. 12, 2006: Where You Will Live the Longest
Sept. 14, 2006: Drinking to Wealth

If fifty million Frenchmen can’t be wrong, then enjoying a glass of wine every day can’t be all that bad for you. And recent studies have been bearing this out, documenting the possible health benefits of consuming a moderate amount of alcohol –- up to a glass of wine a day, for example. Libation in moderation, it seems, can help to keep the heart healthy and the circulatory system robust, as well as aid in digestion.

But economists have also been interested in the potential up side to imbibing, and researchers at San Jose State University report in the Journal of Labor and Research that people who drink socially make up to 14% more money than teetotalers. Using a national survey of Americans representing a cross section of different demographic and salary groups, the economists found that while drinkers in general made more money than non drinkers, men who drank socially in bars enjoyed a 7% additional boost in their salaries than men who drank alone or outside of bars. (Women hanging out in bars at least once a month did not gain any additional monetary advantage.)

What it means: Bethany Peters and Edward Stingham, the authors of the study, speculate that the added income of the drinkers comes from their greater social networking and social skills. People generally enjoy a beer or glass of wine with friends or colleagues, and those who drink may be building a network of potentially useful job contacts that enables them to not just remain employed but even upgrade their status to a higher paying job more easily. While the authors don’t address it, however, previous research on excessive drinking supports the fact that these benefits, as with the health benefits, drop off after a certain point. The study also doesn’t specific exactly how much drinking the over 8000 subjects did, and instead asked the respondents if they drank at all or abstained, and how often they visited a bar or tavern.

Peters and Stringham’s theory also assumes that there is a significant group of teetotalers; in other words, in order for the drinkers to benefit from their bigger Blackberry contacts, there have to be non drinkers who don’t enjoy the same advantage. After all, the average income in France, where alcohol is part of the culture, is around $25,000 while the average salary in the U.S. is nearly twice that amount.

From the Archive:

July 14, 2006: Who Becomes an Alcoholic?
Apr. 4, 2006: Is Alcohol Really Good For You?

It’s standard practice now to prescribe cholesterol-lowering drugs, known as statins, to patients who have had a heart attack or may be suffering from angina. And it makes sense; heart attacks and episodes of chest pain occur when cholesterol-driven plaques build up and narrow the vessels feeding the heart muscle. But what about strokes, which some have called heart attacks in the brain? Could statins help to prevent constrictions of brain blood vessels as well?

That’s what doctors at 205 sites in five continents wanted to find out five years ago. They started the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, the first trial to look specifically at whether a popular statin, Lipitor, could reduce the risk of recurrent strokes in patients who have already had a stroke, but have no history of heart disease. (Previous studies in heart disease patients had shown, as a bonus, that patients on statins tended to have fewer strokes, but none of the trials had specifically studied stroke patients.) The doctors report in the New England Journal that in over 4700 patients who had suffered a stroke, the group taking Lipitor reduced their risk of having another one by 16% compared to those taking a placebo.

What it Means: While these results are exciting, it’s helpful to remember that while heart attacks can generally be traced to narrowed vessels, or atherosclerosis, not all strokes are due to shrunken vessels in the brain. Strokes can be caused by burst vessels in the brain as well, called hemorrhagic strokes, and indeed, the small number of patients in the trial who had had hemorrhagic strokes and were taking Lipitor increased their risk of having another stroke by 66%. In the interest of full disclosure, it’s also useful to know that the study was sponsored by Pfizer, which makes Lipitor.

Still, doctors note that too little is done today to help prevent recurrent strokes, and stress that follow up studies to confirm the benefits of statin therapy need to be done. If doctors can determine that the cause of a patient’s stroke is a blocked vessel in the brain due to high blood levels of cholesterol, then prescribing a statin might keep that patient from suffering another stroke.

From the Archive:

Feb. 9, 2006: Grapefruit and Statins for High Cholesterol
Aug. 29, 2005: Statins as Heart Attack Treatment

Just two weeks ago, the Food and Drug Administration approved the first vaccine against cervical cancer, a disease that is primarily caused by infection with the human papillomavirus (HPV)--which in turn is most commonly transmitted during intercourse. The approval was good news for women, since doctors had been telling them that asking their partners to use condoms wasn’t enough to protect them from infection.

Well, it turns out that condoms may be more effective than both doctors and women had given them credit for. Researchers at the University of Washington, Seattle report in the New England Journal of Medicine that women whose partners used condoms were 70% less likely to get new HPV infections than women whose partners only used condoms in less than 5% of their encounters. The scientists studied 82 college women who had either never had intercourse, or had their first sexual experience with a single male partner in the three months prior to enrolling in the study.

What it Means:  The results suggest that HPV infections may join HIV, Chlamydia, gonorrhea and herpes simplex viruses as STDs that can  be prevented with the use of condoms. But doctors warn that neither men nor women should become complacent about HPV. If condoms are not used properly, they can expose partners to the virus and put women at risk of developing cervical cancer.

From the Archives:
June 21, 2006:  Defusing the War Over the "Promiscuity" Vaccine"
June 19, 2006: A Shot Against Cancer
June 9, 2006 Who Will Get, and Pay for, the Cervical Cancer Vaccine?

It makes sense that meditating can relax you; after all, it’s a way to corral careening thoughts in your head and  reduce stress. Studies have documented that people who engage in transcendental meditation (TM), a deep form of the practice that comes from ancient traditions in India, can reduce their blood pressure. But no controlled trials had looked at TM’s effect on other risk factors in heart disease – such as insulin resistance, a major contributor to obesity and diabetes which can lead to heart disease.

So scientists at Cedars Sinai Medical Center took over 100 patients, gave half of them instruction on TM, and provided the other half, who acted as the controls, with basic health instruction on heart disease risk factors. They report in the Archives of Internal Medicine that after 16 weeks, the group using TM had lower blood pressure, less insulin resistance and better response to stress than the control group.

What it Means:
While these results suggest that TM may help patients to control their response to stress better – in other words, help their bodies to reduce the negative impact that stress can have on the heart and cardiovascular system. The number of subjects was small, however, and it’s not clear that all people will receive the same benefits from TM. The results are certainly not strong enough for TM to replace current therapies for heart disease risk factors, which include medications to control blood pressure, cholesterol and blood sugar levels. But they might be worth considering as part of a balanced approach to avoiding heart disease.

FROM THE ARCHIVES:

Jan. 16, 2006 How to Get Smarter, One Breath at a Time
Aug. 4, 2003  Just Say Om

After Today show anchor Katie Couric famously received a colonoscopy live on-air in 2000, the number of people signing up for the colon-cancer-screening test shot up dramatically. Even elderly patients got in line, after Medicare began covering the test in 2001. Current guidelines recommend that everyone over age 50 get screened, but doctors are beginning to wonder whether the invasive procedure isn’t for everyone—especially those older patients.

Physicians in Seattle studied 1244 people ranging in age from 50 to over 80, who had no signs of colon cancer but came in for routine colonoscopy screening for the disease. As expected, the number of abnormally growing cells was higher in the older patients (28.6% in those over age 80, compared to 13.8% in the 50-54 year old group), but it turns out that elderly patients don’t enjoy the same benefit of greater life expectancy that younger patients do. That’s because so many of colon-cancer growths are slow-growing. The researchers also found that older patients experience more complications from the procedure, and because of discomfort and potential risk, more of the older patients can’t complete the 30-60 minute test.

What it Means: While getting screened for colon cancer is certainly a good idea, there may be an age ceiling beyond which the risks start to outweigh the benefit. The goal of any screening is to detect disease early and get it treated. And because abnormal growths in the colon are so slow-growing, this study suggests that colonoscopy may not provide the same extended life in the eldest segment of the population as it does for younger folks.

From the Archive:
04/10/2006 Katie's Cure
12/15/2003 An Easier Colon Test
03/13/2000 Katie's Crusade

With the summer travel season just around the corner, millions of people will be taking to the skies, and 4% of them will find themselves faced with economy-class syndrome—a condition caused by blood clots that can form in the legs when you’ve been sitting too long under cramped conditions. In some cases, the syndrome can be fatal if the clots travel into the tiny vessels that feed the lungs or heart and block blood flow.

While recent studies found a genetic reason to explain some of the cases, doctors have wondered whether it’s more than just the inactivity that triggers the clots. Could the altitude and low pressure environment in plane cabins—which results in air that is not as oxygen-rich as it is on land—have anything to do with promoting clot formation?

To get an answer, researchers in England, Scotland and Amsterdam gathered 73 healthy subjects and for eight hours, placed them in a special pressure chamber that simulated air pressure at an altitude of nearly 8,000 feet—close to what passengers feel in a pressurized plane cabin.

Investigators took blood samples and recorded levels of critical blood clotting factors, then compared results of the same tests for each subject sitting for eight hours at ground level conditions. They concluded, in a study published in the Journal of the American Medical Association, that there were no significant differences among the subjects’ ability to form or break down clots between the low pressure, low-oxygen condition and the normal pressure environment.

What it Means: This is one of the few studies in which doctors studied the effects of low pressure on people and compared them to normal pressure situations. While the results suggest that slight decreases in oxygen and pressure don’t encourage clots, the researchers point out that the combination of sitting in one position several hours at a time and the low pressure environment of a plane cabin may together contribute to blood clotting in some people. (The JAMA study subjects were allowed to stand up and stretch for five minutes every hour.)

So the researchers recommend that travelers try to stretch as often as they can on a long plane trip— even if it means disturbing your neighbor.

From the Archive:
03/10/2006 Flying and Blood Clots
04/15/2002 Is There a Doctor on Board?

The fight to legalize the medical use of marijuana was dealt a blow Thursday when the Food and Drug Administration contradicted an earlier review by the respected Institute of Medicine and concluded that “no sound scientific studies supported medical use of marijuana.”

This finding, based on past studies by the FDA and other government health agencies, will further muddy the already confusing messages coming from scientists, doctors and legal agencies. Eleven states have legalized the use of marijuana if prescribed by a physician for medical conditions such as relieving nausea after chemotherapy, and AIDS-related wasting. But the Supreme Court last year decided that federal law enforcement officials can arrest anyone using the potentially addictive drug, even if it’s for medical reasons and in a state that has legalized this use.

WHAT IT MEANS: Critics of the FDA see this announcement as the latest in a string of decisions that they claim are more political than scientific in nature – some see the influence of the Drug Enforcement Agency, whose director has opposed laws legalizing medical marijuana use, while scientists attempting to study the drug in controlled trials find themselves in a Catch-22. They claim that the government stymies their efforts to document the medical effects of marijuana by noting that there is little evidence to support its medical use, while the reason for the dearth of studies is that few agencies, including the National Institutes of Health, the largest source of research funding in the US, are willing to fund the work. Small studies funded by states or non-government interests have begun to show some potential benefits of smoking marijuana in alleviating pain, but it seems that documenting these effects in large, controlled trials may may just get more challenging.

From the Archive:
Legalizing Marijuana: Is America Going to Pot?

With picnic season and beach barbecues just weeks away, it’s important to know how safe your food is. Fortunately, the Centers for Disease Control reports that cases of food poisoning from food contaminated with bacteria or viruses have declined by anywhere from 9% to 49% over the past decade. The study, which was published in the CDC's Morbidity and Mortality Weekly Report, is based on preliminary results that are drawn from a network of 44.5 million people in 10 states and that focus on Salmonella, Listeria, Shigella, Vibrio and E. coli 157. These microbes are commonly transmitted to people from undercooked shellfish, meat and poultry or unpasteurized milk and juices.

What it Means: Contaminated food can cause diarrhea, fever and abdominal pain and sometimes even death (particularly in children). While the decline in infections is good news, experts warn that with some pathogens, the number of infections still exceeds the national health objective. Safe food practices that could bring contamination cases down further include making sure that perishable items such as egg- and potato- salads are kept refrigerated and that raw hamburgers and chicken are kept separate from other foods.

From the Archive:
03/23/2003 Can Cold Cuts Kill?
09/30/2002 What to Do About Listeria

The Source: Experimental Biology 2006 meeting

The Studies: Two studies that looked at the effects of cinnamon and cloves on cholesterol and glucose levels suggest that the popular spices may help both diabetics and heart patients.

In the study involving cinnamon, researchers found that cinnamon can mimic insulin in controlling glucose levels, and can also reduce inflammation, a risk factor for heart disease.

In the study on cloves, which was the first to look at the effect on insulin function in human patients, researchers gave 36 patients with type 2 diabetes clove capsules for 30 days. At the end of the month, these patients had dropped their blood glucose levels by an average of 75 mg/dL and their total cholesterol levels by an average of 34 mg/dL. A control group that took dummy capsules showed no differences in their glucose and cholesterol levels.

What it Means: No one should throw away any insulin vials or anti-cholesterol drugs in favor of these natural compounds—particularly on the basis of such small studies. Isolating the health boosters in these spices and figuring out the correct and safe doses needed to help patients will require additional rigorous research.

From the Archive:
01/16/2006  You (and Your Brain) are What You Eat
05/03/2004 Spicing Up Your Life

The Source: National Sleep Foundation

The Study: In a national survey of teens aged 11-17 years in more than 1000 households, researchers found that only 20% of adolescents get the nine hours of sleep during school nights that experts recommend.

There were some surprises in the study. Although more than half of the teens said they realized they weren’t getting enough sleep, their parents thought their children were well rested. (Indeed, 90% of parents thought their kids were getting sufficient sleep on most school nights) More than half of the teens admitted to driving while they were drowsy over the past year, while almost a third said they fell asleep in school at least once a week. The survey found that teens who didn’t get enough sleep were more likely than their more alert peers to get lower grades. Among those who felt unhappy, tense or nervous, more than 70% felt they were not getting enough sleep at night.

What it Means: Smaller studies have begun to document both the shrinking time that teens spend sleeping, as well as the serious consequences that shortened sleep time can have on their performance in school, in athletics and behind the wheel. But this poll highlights a startling gap between how adolescents and their parents view sleep.

Some school systems have moved back class times for older teens, whose internal body clocks make them more alert at the end of the day. But doctors say that parents need to be more aware of the sleep habits of their teens. They can help kids to get the sleep they need by limiting the teens' television viewing and use of cell phones, video games and other electronic devices around bedtime, as well as by restricting their consumption of caffeinated beverages after lunch.

From our Archive:
03/27/2006  The Multitasking Generation
03/27/2006 Sleeping-Pill Puzzler

The Source: American College of Cardiology annual meeting

The Study: Researchers presented evidence that placing stents—tiny mesh like tubes—into the carotid arteries of the neck may help prevent stroke in a wider variety of people than was once thought likely. The procedure still has certain risks but may be safer than more invasive operations.

Stroke is the third leading killer in the U.S. About a quarter of cases can be traced to a buildup of fat in the carotid arteries, which  feed oxygen-rich blood to the brain. In 2004, the FDA approved the placing of stents into the arteries to prop them open and to filter out any deposits that could break off and block the thread-like vessels in the brain. However, the agency signed off on the procedure only for patients who showed signs of artery blockage—dizziness, blurred vision, numbness on one side of the body.

Investigators at Columbia University and other medical centers around the U.S. looked at a group of 2500 patients who had significant blockages in their carotid arteries—and so were at increased risk of stroke—but who were not yet showing any symptoms. The investigators found that stenting this group of patients is safe and effective at reducing the chances of developing a blocked vessel in the brain.

What it Means: This is the first study to demonstrate the effectiveness of “pre-emptive” stenting to prevent stroke and may provide an viable alternative for at least some patients who are not good candidates for surgery.

From Our Archive:
02/20/2006 The Real Story About Low Fat

The Journal: Journal of the American Medical Association

The Study: Living in a city can expose you to some pretty harmful things. Some are invisible, like the microscopic particles spewed out by cars, buses and steam grates. Researchers at the Johns Hopkins University Bloomberg School of Public Health analyzed the hospital admission rates for 11.5 million Medicare enrollees between 1999 and 2002, to see if exposure to such air pollution contributed to heart or respiratory problems. They found that these particulates did indeed lead to a short-term increase in hospital admissions for cardiovascular and lung-related health problems.

What it Means: In 1997, the US revised its standard for acceptable levels of airborne particulate matter and created a new measure for detecting fine particulates, which have a greater chance of reaching and causing havoc in the tiny airways and sacs of the lung. This is one of the first studies to document exactly how much exposure to this type of fine air pollution can affect health and suggests that pollution may be triggering inflammation in the lungs and cardiovascular system that can be serious enough to require a hospital visit. More studies will surely follow to determine which particles are the worst offenders and to figure out how their harmful effects can be minimized.

From the Archive:
02/13/2006 The Political Science Test
10/23/2005 Coal is Back

The Journal: Journal of the American Medical Association

The Study: Conventional wisdom holds that pregnancy, with its flood of feel-good hormones, might protect moms-to-be from bouts of depression. This study of 201 pregnant women with a history of the disease found that isn’t the case.

Some of the women in the group stopped taking anti-depressants, or at least tried to, as close as possible to the time of conception because they were concerned about the effects the drugs might have on the developing fetus. The others continued with their medication. Researchers from Harvard and Massachusetts General Hospital then looked to see how many of the women suffered a release of their depression.

Depression returned in both cases but at very different rates. The investigators found that 68% of the women who stopped taking their anti-depressants during pregnancy suffered a relapse compared to 26% of the women who continued to take medication during pregnancy.

What it Means: Women with a history of depression who are contemplating pregnancy should consult with their doctor about how best to proceed. They may be able to adjust their therapy to avoid relapses during the first trimester, when a fetus' critical development takes place. In this study, for example, half of women who stopped their antidepressant medication before conception did not relapse until after the first trimester.

The Journal: Journal of the American Medical Association

The Study: This was a review of 38 large studies that had each tried to determine whether consuming omega-3 fatty acids, which are naturally-occurring compounds found in fish, have any effect on cancer rates.

Doctors already know that these fats can reduce heart disease, but preliminary research suggests that omega-3 fats may also inhibit some of the wayward cell processes that lead to cancer. In total, over 700,000 patients who took either omega-3 supplements or ate regular helpings of fish were studied for their risk of developing 11 different types of cancer. Taken together, the studies showed no significant effect of omega-3 fatty acids in reducing cancer risk.

What It Means: If eating fish prevents cancer, it’s probably not a very strong effect. The results of the 38 studies were all over the map. Some showed a reduction in cancers, while others revealed an increased risk, and still others showed no association at all.

That doesn't mean that omega-3 fatty acids have no effect on cancer; it just means that it may take more than a fish oil capsule to hold off the disease. Eating fish is still good for your heart.

From our archive:
01/16/2006 You (and Your Brain) are What You Eat

The Journal: The New England Journal of Medicine

The Study: A new combination of potent anti-viral drugs can fight HIV infection better than an existing cocktail that is currently preferred by the U.S. Department of Health and Human Services. The new combination also leads to fewer side effects in patients.

That's the conclusion a group of international researchers reached after they randomly assigned 517 untreated, newly infected patients to two different treatment regimens. The control group took the most commonly prescribed combination of drugs for first-time HIV patients: zidovudine, lamivudine and efavirenz. The test group took a different combination: efavirenz plus tenofovir, disoproxil fumarate and emtricitabine.

After eight months of treatment, the viral load in the bloodstream of 84% of the patients in the test group dropped to undetectable levels. By contrast, 73% of those in the control group saw their viral load become undetectable. In addition, study subjects taking the newer combination bounced back faster than those taking the older one. Finally, the tenofovir mixture seemed to lead to fewer side effects such as anemia, fatigue and nausea.

What It Means: This is the first study to demonstrate the effectiveness of a new first-line anti-HIV drug regimen. That’s a pretty big deal for patients who cannot take the most commonly prescribed combination of drugs because of their side effects.

Whether this blend will become the new gold standard of treatment will depend on further study of the new cocktail. What are its long-term effects? Will it lead to greater drug resistance? Those are the kinds of questions the authors plan to explore for at least another two years.

From our archive:
02/06/2001: Paying for AIDS Cocktails
01/15/2001: AIDS: Still No Vaccine But Better Antiviral Drugs Are on the Way

The Source: NeuroImage

The Study: Doctoral students in psychiatry at University of Alberta asked 23 male and 10 female volunteers to perform a group of similar tasks while their brains were monitored using functional magnetic imaging (fMRI), a technique that detects which parts of the brain are active. While performing identical verbal, visual spatial and motor tasks, the men and women used different parts of the brain.

What it Means: While it’s not proof that men are from Mars and women are from Venus, the study does hint at why men and women process identical information differently. Using different regions of the brain to perform tasks may influence how men and women prioritize and solve problems. While the study was small, the authors stress that their results highlight the need to consider gender issues in future research on the biology of psychiatric conditions.

The negative impact  of excessive alcohol consumption on your liver, your heart, and even your ability to think clearly are well established. Now, it turns out that over-imbibing can also hamper your immune system, making alcoholics more vulnerable to complications after surgery than their sober counterparts.

To study the immune systems of excessive drinkers, researchers at the University of Berlin tracked 44 patients undergoing elective heart surgery, 10 of whom were long term alcoholics. The doctors took five blood samples from each of the patients - upon admission to the hospital, on the morning before surgery, when they were brought to the intensive care unit for recovery, and on the first and third days after surgery. The alcoholics had a four-fold greater risk of contracting an infection after their surgery than the non-alcoholics, and the blood samples explained why. The  blood of the 10 drinkers had higher levels of two compounds, cortisol and interleukin-10, both of which are known to suppress the immune system. The scientists suspect that continued exposure to alcohol - along the lines of three glasses of beer or wine a day - alters the levels of immune system agents in the body, making heavy drinkers especially vulnerable to a wide variety of infections. Their findings suggest that when alcoholics require any sort of surgery, doctors should first run a blood test to determine the health of the patients' immune systems,  and prescribe immunotherapy agents to boost the body's defense system before, during and after surgery.

Parents have always been concerned about the danger of their kids using illegal drugs, but psychiatrists say they may have cause for concern about the prescription medications their kids take with parental blessing. The number of children under the age of 18 who are taking two or more drugs for psychiatric conditions is on the rise, say researchers from Rhode Island, raising the chances that they will suffer from adverse reactions and unexpected interactions among the medications. In addition, they warn, there are few studies documenting potential adverse consequences.

In a report in the journal Psychiatry 2005, psychiatrists from Bradley Hasbro Children's Research Center and Brown Medical School reviewed a decade's worth of studies documenting the use of prescription medicines for psychiatric disorders among children. The prescription of combinations of psychotropic medications for youngsters increased eight-fold from 1987 to 1996. The most common combinations involved a stimulant, such as methylphenidate or dextroamphetamine (used to treat attention deficit hyperactivity disorder) and an anti-depressant.

The researchers note that many psychotropic drugs are not FDA-approved for use in children, meaning their side effects and long term impact on the health of youngsters is not well known. The uncertainty only multiplies when these medications are prescribed in combination, as is increasingly the case. "The FDA recently questioned whether there is a link between the use of antidepressants in children and suicidal thoughts," says Dr. Joseph Penn, a psychiatrist at Hasbro and a co-author of the study. "If there is so much concern over the effects of a single drug, how much riskier is it to prescribe multiple drugs?" As doctors continue to write multiple prescriptions for psychiatric medications for their younger patients, says Penn and his colleagues, they need the answer to that question.

Women didn't always give birth in state-of-the-art hospitals, strapped to fetal monitors and steps away from an operating room equipped to handle any labor emergency. But a new study suggests that giving birth the old-fashioned way, at home under the care of a midwife, may be just as safe as having a baby in a hospital. And the birthing experience of women who choose to deliver their babies at home may be less likely to include such medical intervention as forceps, caesarean section and epidurals.

In the largest international study of its kind, researchers in Canada analyzed labor-and-delivery records of more than 5,000 planned home births in the U.S. and Canada, comparing them to over three million singleton, low-risk births at U.S. hospitals in 2000. More than 87% of the women who delivered at home, with the help of trained midwives, did not need to go to the hospital during labor or delivery. Among those women, the incidence of medical interventions, including forceps, epidural, and caesarean section, were lower than for the women giving birth in hospitals. Only 9% of women delivering at home required help stimulating labor, while 19% of women giving low-risk births at hospitals needed this assistance. The researchers found an even larger difference over the use of episiotomy, the widening of the vaginal opening with scissors to ease the passage of the baby's head—33% of hospital-delivering women underwent this procedure, while only 2% of midwives used it in their home deliveries. The authors caution, however, that home births aren't for everyone—but for women with uncomplicated pregnancies who are expected to have a low-risk delivery, many believe there's no place like home.

We may not like to admit it, but most of us have probably been guilty of making snap decisions about people - whether we like them, whether we trust them, or whether they’re reliable - on the basis of their appearance. In fact, say researchers from Princeton University, a survey of such first impressions accurately predicted the outcome of almost 70% of recent US Senate races.

Researchers provided participants in the study with black-and-white photos of Senate race winners and their runners-up from three of the most recent election cycles, and asked the subjects to evaluate which candidate appeared more competent. In a majority of the cases, the one deemed to look more capable had actually won the election. This makes sense, the authors argue, when you consider that evolution has programmed most of us to assess a person by means of certain physical facial cues. Signs of experience - in the form of wrinkles and more angular feaures - are translated as indicating more maturity and competence. Baby-faced features, on the other hand - a round face, large eyes, small nose and chin, and high forehead - are read as signals of immaturity, which can prompt the snap judgment that a baby-faced person is less competent and experienced. That first impression may well be false, of course: other studies have found that younger-looking people actually tended to be better educated , more assertive and more likely to be recognized for their performance than their mature counterparts. Still, the tendency to judge people this way is likely to be a holdover from times when it was important to quickly determine which people were more likely to be good leaders whose experience could help communities survive. When it comes to chosing leaders, it seems, age-old habits, are hard to unlearn.

More Daily Rx