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Frequent visits to green space linked to lower use of certain prescription meds

Frequent visits to urban green spaces, such as parks and community gardens in Finland, rather than the amount, or views of them from home, may be linked to lower use of certain prescription meds, suggests research published online in Occupational & Environmental Medicine.

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The observed associations between frequent green space visits and lower use of drugs for depression, anxiety, insomnia, high blood pressure, and asthma were not dependent on socio-economic position.

Exposure to natural environments is thought to be good for health, but the evidence is inconsistent, say the researchers.

They wanted to find out if the amount of residential green and blue space (bodies of water), frequency of green space visits, and views of green and blue spaces from home might be separately associated with the use of certain prescription meds.

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New blood test more accurate in identifying osteoarthritis progression

A new blood test that can identify progression of osteoarthritis in the knee is more accurate than current methods, providing an important tool to advance research and speed discovery of new therapies.

The test relies on a biomarker and fills an important void in medical research for a common disease that currently lacks effective treatments. Without a good way to identify and accurately predict the risk of osteoarthritis progression, researchers have been largely unable to include the right patients into clinical trials to test whether a therapy is beneficial.

“Therapies are lacking, but it’s difficult to develop and test new therapies because we don’t have a good way to determine the right patients for the therapy,” said Virginia Byers Kraus, M.D., Ph.D., a professor in the departments of Medicine, Pathology and Orthopedic Surgery at Duke University School of Medicine and senior author of a study appearing online Jan. 25 in the journal Science Advances.

“It’s a chicken-and-the-egg predicament,” Kraus said. “In the immediate future, this new test will help identify people with high risk of progressive disease — those likely to have both pain and worsening damage identified on X-rays — who should be enrolled in clinical trials. Then we can learn if a therapy is beneficial.”

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Sleep disorders in parents and children associated with more parental stress – Study

The rate of parental stress is greater among parents who have sleep disorders themselves, or have children with sleep disorders, according to a new study published this week in the open-access journal PLOS ONE by Ray Merrill and Kayla Slavik of Brigham Young University, US, and colleagues.

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Sleep and stress disorders are known to have a two-way correlation, with stress promoting sleep disorders and sleep disorders promoting stress. Among parents, there is thought to be a complex interplay between their own sleep, stress, mood and fatigue and their children’s’ sleep.

In the new work, the researchers analyzed data on 14,009 employees insured by Deseret Mutual Benefit Administrator (DMBA) in 2020, all of whom had dependent children. Overall, 2.2% of the employees filed medical claims for treating stress and 12.5% filed claims for treating a sleep disorder, including insomnia, hypersomnia or sleep apnea. 2.0% of children filed one or more medical claims for a sleep disorder.

The researchers found that, after adjusting for age, sex and marital status, rates of stress are 1.95 (95% CI 1.67-2.28) times greater in employees with a sleep disorder. Specifically, rates of stress are 3.00 (95% CI 2.33-4.85) times greater for those with insomnia and 1.88 (1.59-2.22) times greater for those with sleep apnea. In addition, the rate of employee stress is 1.90 (95% CI 1.33-2.72) times greater if their child has any sleep disorder, and 2.89 (95% CI 2.20-3.80) times greater if their child has insomnia. The study also found that if a child has a sleep disorder, the rate of parental insomnia and sleep apnea are both nearly doubled.

The authors conclude that a better understanding of the connections between parent and child sleep quality and parent stress may help improve treatment and lower the risk of these disorders.

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Female and male hearts respond differently to stress hormone in mouse study

A new study published in Science Advances shows female and male hearts respond differently to the stress hormone noradrenaline. The study in mice may have implications for human heart disorders like arrhythmias and heart failure and how different sexes respond to medications.

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The team built a new type of fluorescence imaging system that allows them to use light to see how a mouse heart responds to hormones and neurotransmitters in real time. The mice were exposed to noradrenaline, also known as norepinephrine. Noradrenaline is both a neurotransmitter and hormone associated with the body’s “fight or flight” response.

The results reveal that male and female mouse hearts respond uniformly at first after exposure to noradrenaline. However, some areas of the female heart return to normal more quickly than the male heart, which produces differences in the heart’s electrical activity.

“The differences in electrical activity that we observed are called repolarization in the female hearts. Repolarization refers to how the heart resets between each heartbeat and is closely linked to some types of arrhythmias,” said Jessica L. Caldwell, first author of the study. Caldwell is a postdoctoral scholar in the UC Davis School of Medicine Department of Pharmacology.

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Head injury associated with doubled mortality rate long-term – Study

Adults who suffered any head injury during a 30-year study period had two times the rate of mortality than those who did not have any head injury, and mortality rates among those with moderate or severe head injuries were nearly three times higher, according to new research from the Perelman School of Medicine at the University of Pennsylvania, published in JAMA Neurology.

In the United States, over 23 million adults age 40 or older report a history of head injury with loss of consciousness. Head injury can be attributed to a number of causes, from motor vehicle crashes, unintentional falls, or sports injuries. What’s more, head injury has been linked with a number of long-term health conditions, including disabilitylate-onset epilepsydementia, and stroke.

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Studies have previously shown increased short-term mortality associated with head injuries primarily among hospitalized patients. This longitudinal study evaluated 30 years of data from over 13,000 community-dwelling  participants (those not hospitalized or living in nursing home facilities) to determine if head injury has an impact on mortality rates in adults over the long term.

Investigators found that 18.4 percent of the participants reported one or more head injuries during the study period, and o those who suffered a head injury, 12.4 percent were recorded as moderate or severe. The median period of time between a head injury and death was 4.7 years.Death from all causes was recorded in 64.6 percent of those individuals who suffered a head injury, and in 54.6 percent of those without any head injury. Accounting for participant characteristics, investigators found that the mortality rate from all-causes among participants with a head injury was 2.21 times the mortality rate among those with no head injury.

Further, the mortality rate among those with more severe head injuries was 2.87 times the mortality rate among those with no head injury.“Our data reveals that head injury is associated with increased mortality rates even long-term. This is particularly the case for individuals with multiple or severe head injuries,” explained the study’s lead author, Holly Elser, MD, PhD, MPH a Neurology resident at Penn. “This highlights the importance of safety measures, like wearing helmets and seatbelts, to prevent head injuries.”Investigators also evaluated the data for specific causes of death among all participants.

Overall, the most common causes of death were cancers, cardiovascular disease, and neurologic disorders (which include dementia, epilepsy, and stroke). Among individuals with head injuries, deaths caused by neurologic disorders and unintentional injury or trauma (like falls) occurred more frequently.When investigators evaluated specific neurologic causes of death among participants with head injury, they found that nearly two-thirds of neurologic causes of death were attributed to neurodegenerative diseases, like Alzheimer’s and Parkinson’s disease.

These diseases composed a greater proportion of overall deaths among individuals with head injury (14.2 percent) versus those without (6.6 percent).

“Study data doesn’t explain why the cause of death in individuals with head injuries is more likely to be from neurodegenerative diseases, which underscores the need for further research into the relationship between these disorders, head injury, and death,” said Andrea L.C. Schneider, MD, PhD, an assistant professor of Neurology at Penn.

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Frivolous Friday …

Tony

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My different kind of birthday celebration …

On past birthdays, I have shared pictures of meals enjoyed at fancy restaurants, or the steak house at my local casino. They were always very celebratory.

This year is different. Turning 83 today, I am in the process or recovering from lung cancer surgery which removed the upper lobe of my left lung. For details on my cancer experience, you can check out my Page – My experience with lung cancer.

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This year, the celebration was seriously subdued. Because of my surgery, I am still at a very low level on actual energy. I manage to walk the dog three times a day, just under a mile each time. That’s it. Otherwise, I am reading a book, watching TV or on my back in bed.

I am fortunate that here in Chicago we have a Joe’s Stone Crab restaurant. My girlfriend ordered in and we had an abbreviated feast in my dining room. Part of my recovery is that besides my energy being low, my appetite is also subdued. I enjoyed Joe’s excellent fare, just an abbreviated version.

On a further positive note I got a very nice phone call from my son, Andy, who lives in Tennessee, a retired policeman. We had been estranged for one reason or another for about 50 years, but he phoned a couple of weeks ago because he had heard about my cancer and was concerned. He called again today to wish me a happy birthday. We had a second really good conversation and plan to get together when he comes to Chicago next month.

Last, but not least, my daughter, Kate, called. She lives in Texas and is in the midst of a job search. She also played Florence Nightingale for me when I had the surgery, sitting in my hospital room till visiting hours ended. Her company made a painful, challenging 36 hours significantly less so. She also went to my apartment and walked my dog three times a day for me.

So, I had a lovely low key family-type celebration that ended up just perfect. Two weeks into surgical recovery, I simply don’t have the strength for much more.

Tony

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Orienteering can train the brain, may help fight cognitive decline

The sport of orienteering, which draws on athleticism, navigational skills and memory, could be useful as an intervention or preventive measure to fight cognitive decline related to dementia, according to new research from McMaster University.

Researchers hypothesized that the physical and cognitive demands of orienteering, which integrates exercise with navigation, may stimulate parts of the brain that our ancient ancestors used for hunting and gathering. The brain evolved thousands of years ago to adapt to the harsh environment by creating new neural pathways. 

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Those same brain functions are not as necessary for survival today due to modern conveniences such as GPS apps and readily available food. Researchers suggest it is a case of “use it or lose it.”

“Modern life may lack the specific cognitive and physical challenges the brain needs to thrive,” says Jennifer Heisz, Canada Research Chair in Brain Health and Aging at McMaster University, who supervised the research. “In the absence of active navigation, we risk losing that neural architecture.”

Heisz points to Alzheimer’s disease, in which losing the ability to find one’s way is among the earliest symptoms, affecting half of all afflicted individuals, even in the mildest stage of the disease.

In the study, published in the journal PLoS ONE, researchers surveyed healthy adults, ranging in age from 18 to 87 with varying degrees of orienteering expertise (none, intermediate, advanced and elite).

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… Lung cancer free!?

If an exclamation point and a question mark in the headline seem confusing to you, join the club, you are not alone.

A heads up here: I have written about my experience with lung cancer in a number of posts, all of which I gathered into one Page – My experience with lung cancer if you want to catch up.

I just had my first post-op visit with the surgeon who removed the tumor and part of my left lung on 11 January of this year. He said that there are currently no signs of cancer in my lung or system. That’s the good news – right now I am cancer free.

The picture is an x ray of my lung following the surgery.

After I met with my surgeon, I had a meeting with my oncologist. He gave me the not so good news – that the tumor removed was six centimeters which qualifies as ‘large.’ Because of that, there is a good chance that it left cancerous micro-organisms in my system that can trip me up in the days, weeks, months and years ahead. These cancerous organisms can be free to travel anywhere in my body to start another cancer attack.

So, while I may be cancer free at the moment, I need to guard against future attacks by the same organism. He recommended chemotherapy and immunotherapy in either order.

I confess to a great deal of ignorance about chemo. I have heard horror stories about side effects as well as simply after effects. I said that at this point I did not want to undergo chemotherapy.

Right now I am in the immunotherapy camp. The treatments and side effects seem less onerous. Also they actually use the body’s own immune system to do a better job finding cancer cells so it can attack and kill them. Chemotherapy kills fast-growing cells – both cancerous and non-cancerous.

This is day one of my new ‘after cancer’ life.

Anyone who has any suggestions or stories about folks in my situation and what they decided is welcome to share with me. I truly feel like a babe in the woods here.

Tony

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Eating in response to anxiety or sadness is linked with heart damage

It’s not just what we eat, but why we eat that’s important for heart health, according to research published in the European Journal of Preventive Cardiology, a journal of the ESC.1 The study found that emotional eating was associated with cardiovascular problems, and that stress contributed to this relationship.

“Emotional eaters consume food to satisfy their brains rather than their stomachs,” said study author Professor Nicolas Girerd, coordinator of the Clinical Investigation Centre (CIC-P) and a cardiologist at the University Hospital of Nancy, France. “Mindful eating can help break this habit. It means taking time out to eat, either alone or with others, being in the moment and aware of what you are doing, and not being distracted by your phone or the TV.”

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“Stress might be one of the reasons for eating in response to feelings instead of hunger,” said lead author Dr. Sandra Wagner, a nutritional epidemiologist at the CIC-P. “We know that emotional eaters are less aware of hunger and satiety but mindful eating brings attention to these physical sensations. Physical activity – either a walk or more intense exercise – is another way to avoid emotional eating because it relieves stress and provides a replacement activity. Just 10 minutes a day of meditation or breathing exercises can also help to recenter and reduce stress. To sum up, use the three Ms to kick the habit of emotional eating: move, meditate and mindful eating.”

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Recovering from lung cancer surgery …

I am writing this in late January 2023. My experience with lung cancer began in early November 2022. I have posted several times on it and rather than rehash those posts, I have collected them onto a Page entitled – My experience with lung cancer so you can go back to any part that may interest you.

The experience began in November and I had a ‘period of darkness’ that lasted eight weeks during which I knew that I had lung cancer, but had no idea how bad it might be. On December 20 I met my ‘cancer team’ and got a ton of information about cancer in general, my cancer, in particular, and my options going forward. They scheduled surgery for January 11. So, for more than two months, I lived with the idea that I was carrying cancer and now I might be getting free of it with the surgery.

Cut to today – late January. I have had the surgery and the upper lobe of my left lung was removed along with a larger than two inch sized tumor. I am now in RECOVERY. Having lived a relatively healthy life with very few serious encounters with doctors or hospitals, I really had no idea what to expect after major surgery. I thought, naively, that once I had the surgery I was done…. Not so.

Now, I have a much clearer idea. I have an incision in my left side through which the tumor and lobe were removed. The ribs needed to be separated for this to occur. So, when I was released from the hospital, 36 hours after the operation, I was given a prescription for painkillers and told to be sure to use them. As it turns out, the operation has left me with a really ugly scar on the left side of my chest (I’m doing you the favor of not showing a photo). Because of the surgical activity, my chest feels like a big guy wearing a Super Bowl ring punched my ribs several times. So, while I have a full range of motion with my arms and legs, my torso activity is highly restricted.

After 11 days, I am still taking the pain pills religiously. It hurts to turn my body in either direction.

The good news in all this, besides the fact that I think I am cancer-free, is that I am able to walk my dog three times a day. Walking was one of the recommendations upon my release. I don’t have a lot of energy, so the walks really make up the bulk of my exercise for the entire day. Also, I don’t have much of an appetite. I understand that is par for the course. I just have to wait this thing out one day at a time.

Besides walking, I was given an Incentive Spirometer which I use regularly throughout the day to build up my lungs.

So, nearly two weeks into RECOVERY, I have been enlightened as to the nitty gritty of recovering from major surgery.

Fingers crossed.

Tony

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What to Know About the Recently Approved Alzheimer’s Drug – Cedars-Sinai

The U.S. Food and Drug Administration (FDA) recently granted approval to Lecanemab, the first Alzheimer’s disease treatment to win approval since the largely failed rollout of Aduhelm two years ago. Sold under the brand name Leqembi, the new drug shows promise, but experts say making the treatment available to patients at academic medical centers like Cedars-Sinai will take time.

“The clinical data on Leqembi is solid and shows moderately less decline for those participants who received the drug compared to those who did not in the Phase III study,” said Sarah Kremen, MD, who leads the Alzheimer’s Disease Clinical Trial Program at Cedars-Sinai. “But before making this treatment available to patients, we have to take steps to ensure that we’re giving the drug as safely as possible to patients who will face the least risk and receive the greatest benefit—a critical process that takes time.”

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Kremen, director of the Neurobehavior Program in the Jona Goldrich Center for Alzheimer’s and Memory Disorders, sat down with the Cedars-Sinai Newsroom to explain the risks and benefits of Leqembi and what interested patients can expect that process to include.

What did clinical trials show about Leqembi’s benefits?

The data showed that the treatment can pull amyloid—a protein that forms plaques and disrupts brain function—out of the brain in a significant way. Patients receiving Leqembi during clinical trials also showed slowing in decline on tests of memory and functional ability. Leqembi also seems to decrease accumulation of tau protein, which forms tangles inside neurons of Alzheimer’s patients, particularly in the memory centers of the brain. It’s important to recognize that while these results are exciting, this medication does not reverse cognitive decline, it only slows it down.

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5 Heart Numbers You Need to Know – Johns Hopkins

Call it a health numbers game. Knowing just a few key metrics can provide a pretty accurate picture of your current cardiac fitness—and give you ongoing motivation to maintain healthy heart numbers and improve less healthy ones. 

“It’s important to remember that all of these numbers fall on a continuous scale,” says Johns Hopkins cardiologist Michael Blaha, M.D., M.P.H.“It’s not enough to say you have high or low blood pressure—your doctor is looking at how high or how low.”

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Five key things to track to know your numbers:

  1. How many steps you take per day? Moving a lot improves every other heart-health measure and disease risk, says Blaha. That’s why he often urges walking up to 10,000 steps a day, or almost five miles. Another rule of thumb is to exercise 150 minutes per week. “It’s better to be active than inactive,” Blaha says.
  2. Your blood pressure High blood pressure, or hypertension, has no symptoms; it can only be detected by being measured. A score of 120/80 is optimal, and 140/90 is normal for most people. Higher readings mean that arteries aren’t responding right to the force of blood pushing against artery walls (blood pressure), directly raising the risk of heart attack or stroke.
  3. Your non-HDL cholesterol That’s your total cholesterol reading minus your HDL (high-density lipoprotein) cholesterol, a measure of fats in the blood that can narrow and clog arteries to the heart. Lower is better: Aim for a score lower than 130 mg/dL or, if you’re at a high risk of heart disease, lower than 70–100 mg/dL.
  4. Your blood sugar High blood sugar ups your risk of diabetes, which damages arteries. In fact, type 1 and type 2 diabetes are among the most harmful risk factors for cardiovascular disease.
  5. How many hours of sleep a night you get Although there’s no one “right” answer for all, consistently getting the number of hours that works for you helps lower the risk of heart disease, Blaha says. Most people need to sleep six to eight hours a night.

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Frivolous Friday …

Tony

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AI-powered analysis accurately reflects risk of cognitive decline and Alzheimer’s disease based on brain age

The human brain holds many clues about a person’s long-term health — in fact, research shows that a person’s brain age is a more useful and accurate predictor of health risks and future disease than their birth date. Now, a new artificial intelligence (AI) model that analyzes magnetic resonance imaging (MRI) brain scans developed by USC researchers could be used to accurately capture cognitive decline linked to neurodegenerative diseases like Alzheimer’s much earlier than previous methods.

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Brain aging is considered a reliable biomarker for neurodegenerative disease risk. Such risk  increases when a person’s brain exhibits features that appear “older” than expected for someone of that person’s age. By tapping into the deep learning capability of the team’s novel AI model to analyze the scans, the researchers can detect subtle brain anatomy markers that are otherwise very difficult to detect and that correlate with cognitive decline. Their findings, published on Tuesday, January 2, in the journal Proceedings of the National Academy of Sciences, offer an unprecedented glimpse into human cognition.  

“Our study harnesses the power of deep learning to identify areas of the brain that are aging in ways that reflect a cognitive decline that may lead to Alzheimer’s,” said Andrei Irimia, assistant professor of gerontology, biomedical engineering, quantitative & computational biology and neuroscience at the USC Leonard Davis School of Gerontology and corresponding author of the study.

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Gut bacteria affect brain health- Study

A growing pile of evidence indicates that the tens of trillions of microbes that normally live in our intestines — the so-called gut microbiome — have far-reaching effects on how our bodies function. Members of this microbial community produce vitamins, help us digest food, prevent the overgrowth of harmful bacteria and regulate the immune system, among other benefits. Now, a new study suggests that the gut microbiome also plays a key role in the health of our brains, according to researchers from Washington University School of Medicine in St. Louis.

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The study, in mice, found that gut bacteria — partly by producing compounds such as short chain fatty acids — affect the behavior of immune cells throughout the body, including ones in the brain that can damage brain tissue and exacerbate neurodegeneration in conditions such as Alzheimer’s disease. The findings, published Jan. 13 in the journal Science, open up the possibility of reshaping the gut microbiome as a way to prevent or treat neurodegeneration.

“We gave young mice antibiotics for just a week, and we saw a permanent change in their gut microbiomes, their immune responses, and how much neurodegeneration related to a protein called tau they experienced with age,” said senior author David M. Holtzman, MD, the Barbara Burton and Reuben M. Morriss III Distinguished Professor of Neurology. “What’s exciting is that manipulating the gut microbiome could be a way to have an effect on the brain without putting anything directly into the brain.”

Evidence is accumulating that the gut microbiomes in people with Alzheimer’s disease can differ from those of healthy people. But it isn’t clear whether these differences are the cause or the result of the disease — or both — and what effect altering the microbiome might have on the course of the disease.

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