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January 12, 2006, 11:22 PM CT

Your Purse And Depression Treatment

Your Purse And Depression Treatment
Low-income people with depression are less likely to respond to therapy and more likely to be suicidal than those who have higher incomes, as per a studyin the recent issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Socioeconomic factors, including income, education and occupation, have long been linked to health status, illness and death. Research has shown that people with lower socioeconomic status (SES) are more likely to develop a depressive illness and that their depression is more severe than that of people higher on the SES scale. Several studies have hypothesized that socioeconomic factors, including income and education, would also affect how people respond to medications and other therapies for depression, but have ultimately proved inconclusive, according to background information in the article.

Alex Cohen, Ph.D., of Harvard Medical School, Boston, and his colleagues reanalyzed two prior clinical trials funded by the National Institute of Mental Health and conducted at the University of Pittsburgh. The 248 participants were all 59 years or older and receiving antidepressant medications combined with psychotherapy. Their education levels were assessed at the beginning of the original studies. Median annual household income for their areas was obtained from the U.S. Census Bureau. Low-income was defined as less than $25,000, middle-income between $25,000 and $50,000 and high-income more than $50,000. The subjects' depressive symptoms and response to therapy were measured weekly.........

Posted by: JoAnn      Permalink


January 12, 2006, 11:17 PM CT

Eating Disorders May Cause Problems In Infants

Eating Disorders May Cause Problems In Infants
Certain complications during and immediately after birth are associated with the development of the eating disorders anorexia nervosa and bulimia nervosa, as per a studyin the recent issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Eating disorders are believed to be caused by a complex interaction of genetic and environmental factors, according to background information in the article. Observational reports suggest that problems during neurodevelopment in the fetus might lead to anorexia nervosa or bulimia nervosa later in life, and some studies have found a correlation between obstetric complications and anorexia nervosa. "Obstetric complications might have more than one role in the etiopathogenesis of eating disorders; first, they may cause hypoxic-induced damage to the brain that impairs the neurodevelopment of the fetus, and second, the adequacy of nutrition during pregnancy and in the immediate postnatal period seems to influence the nutritional status of the adult and appetite programming throughout life," the authors write.

Angela Favaro, M.D., Ph.D., and his colleagues at the University of Padua, Italy, completed an analysis of 114 females with anorexia nervosa, 73 with bulimia nervosa and a control group of 554 without either condition, all born at Padua Hospital between Jan. 17, 1971, and Dec. 30, 1979. Fifteen of the people with anorexia, 22 with bulimia and all of the control subjects had participated in a prior study of the prevalence of eating disorders in Padua. The authors added in a sample of 99 people with anorexia and 51 with bulimia who had been referred to an outpatient clinic for their conditions. They then merged the samples and analyzed data about obstetric complications obtained from hospital archives.........

Posted by: JoAnn      Permalink


January 11, 2006, 8:13 PM CT

Resistant Bacteria In Intensive Care Units

Resistant Bacteria In Intensive Care Units
A dangerous drug-resistant bacterium is becoming more prevalent in a number of intensive care units, according to an article in the Feb. 1 issue of Clinical Infectious Diseases, now available online.

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a variety of infections that patients often acquire in the hospital. Skin infections are the most common, but MRSA can also infect the heart, the lungs, and the digestive tract. The emergence of MRSA and other drug-resistant bacteria may be due in part to over-prescribing and overuse of antibiotics.

Scientists at the Centers for Disease Control and Prevention examined MRSA data from more than 1,200 intensive care units (ICUs) from 1992 to 2003. They found that in 1992, 36 percent of S. aureus isolates were drug-resistant; but in 2003, 64 percent of isolates were MRSA, an increase of about 3 percentage points per year.

Despite the increase in MRSA prevalence, there was also a decrease in MRSA that was resistant to multiple drugs. The scientists hypothesize that the influx of MRSA strains from the community might have replaced those multidrug-resistant strains associated with the hospital.

"Unlike traditional MRSA the community strain is very fit - it causes infection in healthy people," said CDC epidemiologist Dr. Monina Klevens. "When it is introduced into a hospital, where ill patients are more vulnerable to infection, it has the potential to cause significant morbidity and mortality".........

Posted by: Mark      Permalink


January 11, 2006, 8:00 PM CT

Link Between High-Fat Diet and Type 2 Diabetes

Link Between High-Fat Diet and Type 2 Diabetes Jamey D. Marth, Ph.D.
Howard Hughes Medical Institute scientists have discovered a molecular link between a high-fat, Western-style diet, and the onset of type 2 diabetes. In studies in mice, the researchers showed that a high-fat diet interferes with a genetic mechanism they discovered that promotes insulin production, resulting in the classic signs of type 2 diabetes.

In an article published in the December 29, 2005, issue of the journal Cell , the scientists report that knocking out a single gene encoding the enzyme GnT-4a glycosyltransferase (GnT-4a ) disrupts insulin production. Importantly, the researchers showed that a high-fat diet suppresses the activity of GnT-4a and leads to type 2 diabetes due to failure of the pancreatic beta cells.

"We have discovered a mechanistic explanation for beta cell failure in response to a high-fat diet and obesity, a molecular trigger which begins the chain of events leading from hyperglycemia to insulin resistance and type 2 diabetes," said Jamey Marth, a Howard Hughes Medical Institute investigator at the University of California, San Diego (UCSD). Marth and first author Kazuaki Ohtsubo at UCSD collaborated on the studies with scientists from the Kirin Brewery Co. Ltd., and the University of Fukui, both in Japan.

The discovery of the link between diet and insulin production offers new information that may aid in the development of therapys that target the early stages of type 2 diabetes. In its earliest phases, the disease causes failure of insulin-secreting beta cells in the pancreas, which leads to elevated blood glucose levels. As the disease progresses, the insulin-secreting beta cells overcompensate for the elevated blood glucose, and eventually pump out too much insulin. This leads to insulin resistance and full-blown type 2 diabetes.........

Posted by: JoAnn      Permalink


January 11, 2006, 7:50 PM CT

How Seniors Sleep Without Drugs

How Seniors Sleep Without Drugs
A new study lays to rest the notion that sleepless seniors might respond poorly to therapys that emphasize behavioral treatment over drugs.

Behavioral interventions for insomnia offer "a very powerful strategy" in people over 55, said Michael Irwin, M.D., of UCLA, the lead author of a systematic evidence review. "Their benefits may be greater than pharmacologic therapys, because they can persist for a longer period of time."

Treating insomnia with drugs may impair functioning, create dependency and worsen sleep after they are discontinued, he says.

Poor sleep is one of the more common complaints among adults, and the prevalence rate among the elderly is almost double that of younger adults. Moreover, scientists are now recognizing the importance of sleep to overall health.

"Insomnia is increasingly implicated as a predictor of cardiovascular and noncardiovascular disease mortality," says the review.

This review is the first in a new series of would be published in Health Psychology. Each evidence-based review will center on a specific psychological assessment or therapy conducted in the context of a physical disease process or risk reduction effort.

The systematic review included 23 randomized controlled trials involving more than 500 participants. The various non-drug therapys - cognitive behavioral treatment, relaxation and changes in sleep behavior - yielded "robust improvements" in a variety of common problems such as poor sleep quality, difficulty falling asleep and awakening during the night.........

Posted by: Janet      Permalink


January 11, 2006, 7:42 PM CT

Reducing Secondhand Smoke in Homes

Reducing Secondhand Smoke in Homes
People who see news stories and advertisements about the dangers of secondhand smoke are more likely to feel that it is harmful, and may restrict smoking at home, according to new research published in the American Journal of Health Behavior.

The study by W. Douglas Evans, of the nonprofit research corporation RTI International, and his colleagues found that anti-secondhand smoke media messages have a strong indirect effect on smoking restrictions in the home.

Anti-secondhand smoke media account for 10 percent of people's negative attitudes about secondhand smoke, but these negative attitudes explain nearly 60 percent of home smoking restrictions, Evans said.

"Media work through changing people's attitudes to get them to change home smoking rules," he said.

People may "have to process the information" they get from the media through family discussions or through one person in a household taking a strong position on secondhand smoke before the change in attitude becomes a change in home restrictions, Evans suggested.

According to 2003 statistics compiled by the Centers for Disease Control and Prevention, secondhand smoke exposure is the third leading cause of preventable death in the United States. Secondhand smoke exposure has been linked to lung cancer and heart disease in adults and severe respiratory infections and asthma, especially in infants and young children.........

Posted by: Janet      Permalink


January 11, 2006, 7:37 PM CT

Elderly With Alcoholism And Heart Attack

Elderly With Alcoholism And Heart Attack
Older Americans with alcohol problems do not get worse therapy than their sober peers when they are hospitalized for a heart attack, according to new research on Medicare patients across the country.

Alcoholic patients were less likely than sober patients to receive beta-blocker drugs when they were discharged from the hospital, but there were no other significant therapy differences between the two groups. The study is published in the latest issue of the journal Alcoholism: Clinical and Experimental Research.

"Alcohol-related diagnoses are not a barrier to receiving most quality of care measures in elderly patients hospitalized" for heart attack, David Fiellin, M.D., of Yale University School of Medicine and his colleagues conclude.

The encouraging finding "speaks to the fact that there have been significant efforts across the board, in medicine in general, to monitor the provision of quality care," Fiellin said.

However, the scientists also note that the "overall provision of quality of care indicators was low," when measured across all patients.

Fiellin and his colleagues analyzed data for 155,026 Medicare patients age 65 and older admitted to a hospital with a heart attack. Only 1,284 of these patients also had an alcohol-related diagnosis on their medical records.........

Posted by: Daniel      Permalink


January 10, 2006, 6:39 PM CT

Americans Consume Too Much Salt

Americans Consume Too Much Salt
Despite counseling by physicians, Americans still consume far too much sodium, putting them at risk for high blood pressure, heart disease and stroke, according to a new study in the latest issue of the American Journal of Preventive Medicine.

Eventhough people who already have high blood pressure, or hypertension, generally consume less sodium than others, their average daily intake is still far higher than recommended levels, according to lead researcher Umed Ajani, an epidemiologist with the National Center for Chronic Disease Prevention and Promotion.

Ajani and his colleagues analyzed data collected in 1999 and 2000 from a random sample of more than 4,000 Americans who were part of a regular government health survey. They found that 42 percent of those surveyed had high blood pressure. Incidence of hypertension is commonly about one-third for an average group, Ajani said.

"Perhaps the most striking finding is that no difference in sodium intake was observed between those who received advice. and those who did not," Ajani said.

Participants' sodium intake was computed from what they reported having eaten and drunk during the 24 hours before their interview.

People with high blood pressure took in 3,330 mg of sodium a day and people without high blood pressure consumed 3,600 mg a day, far more than the 2,400 mg maximum recommended by the American Heart Association and other groups.........

Posted by: Daniel      Permalink


January 10, 2006, 6:24 PM CT

Treating Glaucoma Early

Treating Glaucoma Early
Treatments that delay the progression of glaucoma may significantly reduce the economic health burden on people with the disease and on the U.S. health system, according to a new study by scientists at Duke University Eye Center and elsewhere. Their findings appear in the January 9, 2006, issue of Archives of Ophthalmology.

The team determined that patients with early-stage or suspected glaucoma use approximately $623 per year in health care resources, while patients with end-stage disease consume approximately $2,511. The cost of medicine was responsible for one-third to half of the total direct cost to consumers.

"It is imperative that patients with glaucoma be well-monitored for changes in their disease," said Paul Lee, M.D., a glaucoma specialist at Duke University Eye Center and lead author on the study. "Our results prove what we've thought for a long time - that the disease gets more expensive as it worsens. With effective therapys at earlier stages, the progression of disease can be slowed or halted - saving both the patient and society from greater economic burden."

Glaucoma is a leading cause of blindness in the U.S., affecting an estimated 2.2 million adults, the scientists said. Experts anticipate the overall number of people living with glaucoma to rise as the number of elderly Americans increases. Glaucoma is a group of eye diseases that damage the cells and fibers of the optic nerve, interrupting the transmission of visual signals from the eye to the brain. The disease is believed to be caused by a level of intraocular pressure (IOP) that is too high, eventhough other mechanisms are likely to be involved since people can develop the disease and have a normal IOP. A number of people go undiagnosed during early stages of the disease because symptoms are virtually undetectable without an eye exam.........

Posted by: Mike      Permalink


January 10, 2006, 6:20 PM CT

Obesity And Prostate Cancer

Obesity And Prostate Cancer Harder
Obesity may make it harder to find prostate cancer, leading to delayed diagnosis and putting some men at an even greater risk for dying of the disease, according to a multi-university study led by a researcher from Duke University Medical Center and the Duke Prostate Center. As a result, the scientists are recommending that physicians be particularly thorough when examining obese men for prostate cancer.

The study showed that, up to a point, prostate gland size increases as body mass index (BMI) grows. BMI is a body fatness measurement based on weight adjusted for height. With larger prostate glands seen among obese men, doctors may be 20 percent to 25 percent less likely to identify prostate cancer when it is present, said Stephen Freedland, M.D., principal investigator and Assistant Professor in Duke's Department of Surgery-Urology. Freedland also holds an appointment in Surgery at the Durham VA Medical Center.

"Diagnosing prostate cancer is a bit like finding a needle in a haystack," Freedland said. "The bigger the haystack you have, the harder it is to find the needle, and in this case, we may be missing cancers in obese men".

Scientists published their findings in the February 2006 issue of the Journal of Urology.

Prostate cancer is the second most common type of cancer affecting men in the U.S., and a man has a one in six chance of being diagnosed with prostate cancer at some point during his life, according to the Prostate Cancer Foundation. Obese men diagnosed with the disease are 20 percent to 35 percent more likely to die from it than a man of normal weight. Individuals are characterized as obese if they have a BMI greater than 30. According to the Centers for Disease Control and Prevention, 30 percent of American adults are obese.........

Posted by: Mark      Permalink



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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.

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