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Health Ministry order on "Patient and doctor safety in response to COVID-19 temporarily restricts planned healthcare services".

The Health Inspectorate, for the purpose of notification, sends to all medical treatment institutions the order No.59 issued by the Ministry of Health. on "Patient and doctor safety in response to COVID-19 temporarily restricts planned healthcare services"

https://likumi.lv/ta/id/313481-par-veselibas-aprupes-pakalpojumu-sniegsanas-ierobezosanu-arkartejas-situacijas-laika

Veselības inspekcija

Klijānu iela 7, Rīga, LV-1012

tālrunis 67081600, fakss: 67819672

vi@vi.gov.lv , http://www.vi.gov.lv

Hepatitis C is a serious disease, but the biggest threat to someone's health is not the virus itself. Rather, it is the diseases that can result from it such as reduced liver functioning, scar tissue in the liver and potentially cirrhosis.

A new study shows that the antiviral treatment which has been used to fight the disease over the last five years, also helps improve the complications which follow.

"It's really good news, because the treatment is effective on almost all patients with hepatitis C, but the fact that it also works against complications is new to us. And this is absolutely crucial for this group of patients, because they don't die from the hepatitis C virus, but in worst case scenarios, from the diseases that chronic liver damage can lead to," says Tea Lund Laursen, PhD student at the Department of Clinical Medicine at Aarhus University.

The results have just been published in the scientific journal Journal of Viral Hepatitis.

Less scar tissue and improved cognitive function
It can often take 20-30 years from being infected with hepatitis C until a person experiences the symptoms. During that period the liver inflammation becomes chronic for the majority of patients and serious damage develops.

"With the study, we now know that even though the patients discover the disease late, the new treatment gives them good chances of a more positive prognosis. Simply because the liver is on the mend when they become free of the virus," says Tea Lund Laursen.

The researchers followed 71 patients with chronic liver inflammation before, during and after treatment. The studies showed that the inflammation in their liver diminished, that there was less scar tissue, and that the liver improved its ability to break down various substances. At the same time, the researchers could measure that the patients reacted quicker to sounds than before they began the treatment.

"Chronic liver inflammation can also lead to cognitive problems where patients become tired, have poorer memory and also reduced response times. But we could also see an improvement in reaction times one year after the 12 week course of treatment. We therefore expect this to also be the case for the other cognitive functions," says Tea Lund Laursen.

Major perspectives in antiviral treatment
The Danish Health and Medicines Authority estimates that approx. 17,000 people are infected with hepatitis C in Denmark and that around half of them are not known in the healthcare system. The vast majority have been infected by sharing syringes. They include both former and current drug abusers and people who demonstrated high-risk behaviour in their youth 30-40 years ago - with many of them unaware that they are infected.

"If the people in the risk category contacted the healthcare system, we would be able to save or improve the lives of a great many people, and also more or less eradicate hepatitis C in Denmark in the long term," says Tea Lund Laursen.

While the number of people with the infection is relatively limited in Denmark, hepatitis C is a major problem globally with approx. 160 million people infected. The disease is particularly widespread in several West African countries, Russia and Greenland.

What is Great American Smokeout?
The American Cancer Society sponsors the Great American Smokeout on the third Thursday of November (November 21, 2019), challenging smokers to give up cigarettes for 24 hours. If you or a loved one smokes cigarettes, consider joining the movement, and take the first step toward quitting cigarettes forever!

History of Great American Smokeout
The inception of the Great American Smokeout stems from a 1970 event in Randolph, Massachusetts. High school guidance councilor Arthur P. Mullaney asked people to give up cigarettes for one day and donate the money they would have spent on buying cigarettes to a high school scholarship fund. A few years later in 1974, newspaper editor Lynn R. Smith led Minnesota’s first Don’t Smoke Day.

The two efforts caught on and on November 18, 1976, the California Division of the American Cancer Society got 1 million people to quit smoking for the day. This marked the first official Smokeout before the American Cancer Society took it nationwide in 1977. As a result, there was a dramatic change in the public view of tobacco advertising and use. Many public establishments and work places are now smoke-free to protect non-smokers and support people trying to quit.

Every year the Great American Smokeout draws attention to preventing deaths and chronic illnesses caused by smoking. From the late 1980s to the 1990s, many state and local governments have raised taxes on cigarettes, limited promotions, discouraged teen cigarette use, and taken further action to counter smoking. States with strong tobacco control laws saw up to a 42% decrease of smoking in adults.

Though smoking rates have dropped, almost 38 million Americans still smoke tobacco, and about half of all smokers will encounter smoking related deaths. Each year, more than 480,000 people in the United States die from a smoking related illness, meaning smoking causes 1 out of 5 deaths in the US alone.

21/10/2019
Lavender, fennel and chamomile among herbs discovered to act upon a shared therapeutic target in blood vessels.

Common herbs, including lavender, fennel and chamomile, have a long history of use as folk medicines used to lower blood pressure. In a new study, University of California, Irvine researchers explain the molecular mechanisms that make them work.

Published today in Proceedings of the National Academy of Sciences (PNAS), the study illustrates how many of the known traditional botanical plants used to lower blood pressure activate a specific potassium channel (KCNQ5) in blood vessels.

KCNQ5, together with other potassium channels including KCNQ1 and KCNQ4, is expressed in vascular smooth muscle. When activated, KCNQ5 relaxes blood vessels, making it a logical mechanism for at least part of the hypotensive actions of certain botanical folk medicines.

"We found KCNQ5 activation to be a unifying molecular mechanism shared by a diverse range of botanical hypotensive folk medicines. Lavandula angustifolia, commonly called lavender, was among those we studied. We discovered it to be among the most efficacious KCNQ5 potassium channel activators, along with fennel seed extract and chamomile," said Geoff Abbott, PhD, professor of physiology and biophysics at the UCI School of Medicine and senior investigator on the study.

Interestingly, the KCNQ5-selective potassium channel activation feature found in the botanicals is lacking in the modern synthetic pharmacopeia. Until now, it seems to have eluded conventional screening methods utilizing chemical libraries, which may account for why it is not a recognized feature of synthetic blood pressure medications.

"Our discovery of these botanical KCNQ5-selective potassium channel openers may enable development of future targeted therapies for diseases including hypertension and KCNQ5 loss-of-function encephalopathy," said Abbott. Documented use of botanical folk medicines stretches back as far as recorded human history.

There is DNA evidence, dating back 48,000 years, that suggests the consumption of plants for medicinal use by Homo neanderthalensis. Archaeological evidence, dating back 800,000 years, even suggests non-food usage of plants by Homo erectus or similar species.

Today, evidence of the efficacy of botanical folk medicines ranges from anecdotal to clinical trials, however the underlying molecular mechanisms often remain elusive.

As dementia progresses, the ability to participate in exercise programs declines. Sticking to a program also becomes challenging because of impaired cognition, mobility issues or risk of falls and fractures - some exercise regimens are just too complicated or physically demanding.

Although studies have shown the benefits of physical activity on dementia, few have included participants with moderate-to-severe dementia or examined the effects of gentle types of exercise on this population.

Researchers from Florida Atlantic University conducted a pilot study that is the first cluster, randomized controlled trial to examine the effects of chair yoga on older adults with moderate to severe dementia who are unable to participate in regular exercise or standing yoga due to cognitive impairment, problems with balance, or fear of falling.

The key aim of the study was to assess the likelihood of these individuals' ability to participate in non-pharmacological interventions as well as demonstrate the safety and effects of chair yoga on older adults with all levels of dementia.

For the study, published in the American Journal of Alzheimer's Disease & Other Dementias, researchers compared chair yoga with two other types of non-pharmacological interventions: chair-based exercise and music intervention. Participants in each of the three groups attended 45-minute sessions twice a week for 12 weeks.

Researchers collected data at baseline, after six weeks and after completing the 12-week intervention. Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions. More than 97 percent of the participants fully engaged in each session.

Study findings showed that the chair yoga group improved significantly in quality of life compared to the music intervention group. Both the chair yoga and chair-exercise groups showed improvement over time, while the music intervention group declined. In addition, both the chair yoga and chair-based exercise groups showed lower depression across all three time points when compared to the music intervention group.

Researchers examined the effects of chair yoga on physical function, including balance and mobility, and compared the effects with chair-based exercise and music intervention. They also looked at the effects of chair yoga on reducing psychological symptoms like anxiety and depression, behavioral symptoms like agitation or aggression, and improved quality of life. They also explored the effects of chair yoga on sleep problems.

Chair yoga provides a safe environment for stretching, strengthening and flexibility while decreasing the risk of falls by using a chair. It also provides important breathing and relaxation techniques utilizing stationary poses that use isometric contraction and guided relaxation of various muscle groups.

"We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study," said Juyoung Park, Ph.D., lead author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU's College for Design and Social Inquiry.

"It is fascinating that, although some participants showed mild levels of agitation or wandering in the intervention room prior to the yoga session, they became calm and attentive when the yoga interventionist started demonstrating yoga poses. Although they did not understand the interventionist's verbal instructions due to their cognitive impairment associated with advanced dementia, they followed the instructor's poses."

Park and collaborators did not find any differences in the three intervention groups on physical function, with the exception of handgrip strength, which was higher in the chair yoga group compared to the music intervention group. None of the three groups declined significantly in any of the investigated physical functional measures. Researchers also did not find any significant between-group differences in anxiety at any time point. There were no significant between-group differences in change in depression and anxiety.

The researchers also did not find significant differences among the three intervention groups for sleep quality at any of the three time points. "We did see an increase in agitation in the chair yoga group even though this group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, ability to participate in meaningful activities, and final situations," said Park.

"It's important to note that quality of life is a more comprehensive approach to biopsychosocial and behavioral function than a mere measure of agitation. Meditation and the mind-body connection component of the chair yoga program may have increased quality of life for participants in this study. This finding is consistent with our earlier studies that showed a targeted approach was successful in increasing quality of life in patients with dementia."

Study participants were 60 years or older (mean average age was 84 years-old) and diagnosed with dementia including Alzheimer's disease (the largest diagnostic group), Lewy Body dementia and Parkinson disease dementia. There were no significant demographic differences among intervention groups. More than half of the group (67.7 percent) were taking medication(s) to manage symptoms associated with dementia.

The herb kratom is increasingly being used to manage pain and treat opioid addiction, but it's not safe to use as an herbal supplement, according to new research led by faculty at Binghamton University, State University of New York.

William Eggleston, clinical assistant professor of pharmacy practice at Binghamton University, had been seeing more and more patients presenting with toxicity or withdrawal from kratom use. Kratom is an herbal supplement derived from a plant that grows throughout southeast Asia.

It is well-reported that the active chemicals in the plant act on opioid receptors in the body. Patients report using the supplement to treat/prevent withdrawal, treat opioid use disorder, or treat pain. Eggleston was curious to see what types of toxicities were being reported to Poison Centers nationally in order to better assess whether or not kratom is safe enough to be used as an herbal supplement.

His team conducted a retrospective review of kratom exposures reported to the National Poison Data System to determine the toxicities associated with kratom use. They also reviewed records from a County Medical Examiner's Office in New York State to identify kratom-associated fatalities.

A total of 2312 kratom exposures were reported, with 935 cases involving kratom as the only substance. Kratom most commonly caused agitation (18.6%), tachycardia (16.9%), drowsiness (13.6%), vomiting (11.2%), and confusion (8.1%). Serious effects of seizure (6.1%), withdrawal (6.1%), hallucinations (4.8%), respiratory depression (2.8%), coma (2.3%), and cardiac or respiratory arrest (0.6%) were also reported.

Kratom was listed as a cause or contributing factor in the death of four decedents identified by the County Medical Examiner's Office. The findings suggest kratom is not reasonably safe and poses a public health threat due to its availability as an herbal supplement. "Although it is not as strong as some other prescription opioids, kratom does still act as an opioid in the body," said Eggleston.

"In larger doses, it can cause slowed breathing and sedation, meaning that patients can develop the same toxicity they would if using another opioid product. It is also reported to cause seizures and liver toxicity. Kratom may have a role in treating pain and opioid use disorder, but more research is needed on its safety and efficacy. Our results suggest it should not be available as an herbal supplement."

Eggleston and his team are working with colleagues at SUNY Upstate Medical University to better assess how many patients are actually using kratom and if the risk for toxicity changes depending on the dose of kratom taken.

A recent study examines the health impact of consuming alcohol at different ages. The authors conclude that, for people over the age of 50, the health risks may be less severe.

Heavy drinking is linked to a range of serious health consequences. These include certain cancers, liver and heart disease, and damage to the nervous system, including the brain. However, as has been exhaustively covered in the popular press, drinking in moderation might have certain health benefits.

A number of studies have concluded that drinking alcohol at a low level could have a protective effect. One study, for instance, found that light and moderate drinking protected against all-cause mortality, as well as mortality related to cardiovascular disease. It is no surprise that these stories have been well-received and widely read, but not all researchers agree, and the debate is ongoing.

A recent study led by Dr. Timothy Naimi, of the Boston Medical Center in Massachusetts, adds further fuel to an already rampant blaze. The authors take aim at the methodology used in earlier studies, and they published their findings in the Journal of Studies on Alcohol and Drugs earlier this week.

A fresh approach
The researchers argue that the way that earlier studies measured alcohol's impact on health might be flawed. Specifically, they note that the studies are generally observational and usually recruit participants over the age of 50. The authors argue that this is problematic because it excludes anyone who might have died due to alcohol before the age of 50.

As they dryly point out, "Deceased persons cannot be enrolled in cohort studies." Dr. Naimi first outlined his concerns about this inherent selection bias in a paper published in the journal Addiction in 2017.

"Those who are established drinkers at age 50 are 'survivors' of their alcohol consumption who [initially] might have been healthier or have had safer drinking patterns." Dr. Timothy Naimi

According to the authors, almost 40 percent of deaths due to alcohol consumption occur before the age of 50.

This means that the vast majority of research into the potential risks of alcohol do not take these deaths into account and could underestimate the real dangers. To reinvestigate, the authors dipped into data from the Alcohol-Related Disease Impact Application which is maintained by the Centers for Disease Control and Prevention (CDC).

According to the CDC, this application "provides national and state estimates of alcohol-related health impacts, including deaths and years of potential life lost."

The difference of age
The analysis showed that the level of an individual's alcohol-related risk was heavily influenced by age. In total, 35.8 percent of alcohol-related deaths occurred in people aged 20–49.

When looking at deaths that were prevented by alcohol consumption, the scientists found only 4.5 percent in this age group. When they looked at individuals aged 65 or over, it was a different story: Although a similar 35 percent of alcohol-related deaths occurred in this group, the authors found a huge 80 percent of the deaths prevented by alcohol in this demographic.

The researchers also saw this stark difference between age groups when they looked at the number of potential years lost to alcohol. They showed that 58.4 percent of the total number of years lost occurred in those aged 20–49. However, this age group only accounted for 14.5 percent of the years of life saved by drinking.

The authors conclude that younger people "are more likely to die from alcohol consumption than they are to die from a lack of drinking," but older people are more likely to experience the health benefits of moderate drinking. Although the conclusions are not explosive, they bring us a more complete understanding of alcohol's impact on health: Moderate drinking may benefit people of a certain age group, but heavy drinking is harmful to all.

18/07/2019
Two experimental Ebola drugs have been found to be effective in treating the strain of the deadly virus responsible for the deaths of more than 1,600 people in the Democratic Republic of Congo, according to new research published Tuesday.

Laura McMullan, a microbiologist at the US Centers for Disease Control and Prevention who lead the research, said the two treatments were developed based on strains from previous outbreaks and this study was the first to test them on the current one, which researchers are calling the Ituri strain.

"It's vitally important to make sure existing treatments work against the virus that's making people sick now," she said. An antiviral drug called remdesivir and another antibody treatment called ZMapp both inhibited the growth of the virus strain in human cells in laboratory studies, according to the paper published in the medical journal Lancet Infectious Diseases.

"They're currently being tested in a clinical trial but we needed to verify and make sure that they were going to be as effective," she told CNN.

"Information that we knew about how well they worked was based on a different Ebola virus variant so we needed to make sure that, indeed, these compounds were going to bind and block the virus and measure that, and see if it worked as well in order for the clinical trials to proceed," she said.

According to the latest figures from the World Health Organization, the Ebola outbreak in Congo has killed 1,630 people, with 2,418 total cases of the deadly disease. It's the second biggest outbreak of the disease in history; the largest recorded was in West Africa from that killed more 11,000 people starting in 2014.

Experimental treatments
ZMapp and remdesivir are among four promising experimental treatments that have been used in the Congo under what's called a compassionate use framework, with doctors deciding the best treatment for each patient based, in part, on the complexity of administering and monitoring the drug, according to WHO.

In 2014, ZMapp became known when it was used to treat two American missionary workers, Dr. Kent Brantly and Nancy Writebol, who contracted Ebola in Liberia. Prior to that, the experimental drug had been tested only in monkeys.

However, a 2016 study that looked at 72 people who had had Ebola found that Zmapp might not have been a key factor in their survival. It found that although it was beneficial overall, ZMapp "did not meet the prespecified statistical threshold for efficacy."

"This work has benefits beyond the current study," said Inger Damon, chief strategy officer for the CDC's 2018 Ebola response and director of CDC's Division of High-Consequence Pathogens and Pathology.

"Having access to this virus will allow us to explore whether other compounds or potential therapies affect the virus in the lab." Health authorities have also made successful use of an experimental vaccine that has been found to be 97% effective in the Congo Ebola outbreak.

Because the treatments are experimental, meaning they are still being studied, they are administered with strict protocols and require informed consent. Despite the new drugs to fight the disease, Ebola is spreading to new parts of eastern Congo's North Kivu and Ituri provinces and re-infecting areas thought rid of the virus.

Last month, it also made the long-feared jump across the border to neighboring Uganda, though those isolated cases appear to have been contained. Deep mistrust of authorities, attacks on health care workers and simmering conflict in the region has meant that the outbreak has continued unabated 11 months after the first cases were confirmed.

In its latest update on July 4, WHO said that over the past four weeks a "general deterioration of the security situation and the persistence of pockets of community mistrust exacerbated by political tensions and insecurity" had led to delays and temporary suspensions in investigating suspected cases.

To establish the strength of the connection between the two conditions, the researchers - whose recent findings appear in Brain: A Journal of Neurology - worked with 1,280 people with REM sleep behavior disorder across 24 centers of the International RBD Study Group.

The researchers assessed the participants' motor function, cognitive abilities, and sensory abilities for a number of years. After a 12-year follow-up period, they found that 73.5 percent of the people involved in this study had developed Parkinson's disease.

Moreover, participants who had started experiencing motor function issues in this period had a threefold increase in the risk of developing Parkinson's disease or related conditions, such as dementia with Lewy bodies.

Also at high risk were participants who had developed cognitive impairment or started experiencing problems with their sense of smell. These findings confirm that the presence of RBD is, indeed, a strong predictor of Parkinson's disease.

All the more so, since the researchers conducted the study in centers across North America, Europe, and Asia, which means that the results apply to diverse populations.

12/04/2019
Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones, according to research from Mayo Clinic.

The results appear in Mayo Clinic Proceedings. Researchers at Mayo Clinic and elsewhere have described injuries from yoga. This study examines injuries in people with osteoporosis and osteopenia - conditions characterized by low bone density.

Osteoporosis is a disease in which bones become thinner and more porous from loss of mineral content. Bone loss that has not reached the stage of an osteoporosis diagnosis is called osteopenia.

Researchers reviewed the health records of 89 people - mostly women - referred to Mayo Clinic from 2006 to 2018 for pain they attributed to their yoga practice.

Some were new to yoga. Others had practiced for years. They had pain in the back, neck, shoulder, hip, knee or a combination. Patients identified 12 poses they said caused or aggravated their symptoms.

The most common postures involved extreme flexing or extending of the spine. Researchers used patients' health records, medical exams and imaging to confirm and categorize the injuries as soft tissue, joint or bone injuries.

Researchers identified 29 bony injuries, including degeneration of disks, slippage of vertebrae and compression fractures. The latter appeared to be related to postures that put extra pressure on the vertebra and disks.

"Yoga has many benefits. It improves balance, flexibility, strength and is a good social activity," says Mehrsheed Sinaki, M.D., a Mayo Clinic physical medicine and rehabilitation specialist and the study's senior author.

"But if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition. As people age, they can benefit by getting a review of their old exercise regimens to prevent unwanted consequences." Patients who incorporated recommendations to modify their movements reduced their pain and improved their symptoms.

In a separate commentary, Edward Laskowski, M.D., co-chair of Mayo Clinic Sports Medicine, called on providers, patients and yoga teachers to work together to produce an individualized exercise prescription that considers the yoga student's medical history to protect against injury and provide optimal benefit.

The authors noted study limitations. The patients were seen in a musculoskeletal clinic at a tertiary care center, which makes generalizations difficult.

Researchers received follow-up reports on 22 patients, as most lived out of state.

Cannabis resin and herbal cannabis have significantly increased in potency and in price, according to the first study to investigate changes in cannabis across Europe.

The study, published today (Sunday 30 December) in the journal Addiction by researchers from the University of Bath and King's College London, draws on data collected from across 28 EU Member states, as well as Norway and Turkey by the European Monitoring Centre for Drugs and Drug Addiction.

The findings show that for herbal cannabis, concentrations of delta-9-tetrahydrocannabinol ('THC' -- the main psychoactive constituent of cannabis) increased by a similar amount each year, from 5% in 2006 to 10% in 2016. For cannabis resin (or hash), THC concentrations were relatively stable from 2006 to 2011 (from 8% to 10%) but then increased rapidly from 2011 to 2016 (from 10% to 17%). The price of cannabis resin also increased, but to a lesser extent than for herbal cannabis.

Lead author Dr Tom Freeman from the Addiction and Mental Health Group within the Department of Psychology at the University of Bath, said: "These findings show that cannabis resin has changed rapidly across Europe, resulting in a more potent and better value product."

Unlike herbal cannabis, cannabis resin typically contains cannabidiol (CBD) in addition to THC. CBD has recently attracted considerable interest due to its potential to treat several medical conditions including childhood epilepsy syndromes, psychosis and anxiety. When present in cannabis, CBD may offset some of the harmful effects of THC such as paranoia and memory impairment.

Cannabis containing higher levels of THC and / or lower levels of CBD has been linked to greater long-term harms such as the development of cannabis dependence, and an increased risk of psychotic illness.

New resin production techniques in Morocco and Europe have increased levels of THC, but not CBD. Dr Freeman added: "CBD has the potential to make cannabis safer, without limiting the positive effects users seek. What we are seeing in Europe is an increase in THC and either stable or decreasing levels of CBD, potentially making cannabis more harmful.

These changes in the illicit market are largely hidden from scientific investigation and are difficult to target by policy-makers. An alternative option could be to attempt to control THC and CBD content through regulation." It is estimated that 24 million people (or 7.2%) of European adults used cannabis in the last year. Across the globe 192 million people use the drug in a variety of markets, ranging from heavily sanctioned prohibition to commercialised legal sale.

Cannabis policies are rapidly changing across the globe. Recreational use is now legalised in Canada and several US states, and medical use is permitted in many more countries, including very recently in the UK.

Humans are unable to reverse the effects of hearing loss, but a biological process found in other animal species may hold the key to reversing this widespread problem.

How the brain interprets sounds is a relatively simple process. First, a sound enters the ear via soundwaves. It then moves down the ear until it hits the eardrum. Next, the eardrum vibrates and sends these vibrations to bones in the middle ear, which then boost them.

Eventually, hair-like cells in the inner ear or cochlea pick up these vibrations and transform them into electrical signals that the brain can process. Age or excessive exposure to loud noise can damage the cochlea, resulting in permanent hearing loss.

According to the World Health Organization (WHO), hearing loss affects more than 400 million people around the world today. Some people experience more severe loss than others, and traditional treatment involves devices such as hearing aids. The effectiveness of these depends on the individual.

However, scientists have long known that animals such as fish and birds are able to keep their hearing intact by regenerating the sensory hair cells found in the cochlea. In fact, mammals are the only vertebrates that are unable to do this.

Testing the inner ear
In 2012, Dr. Patricia White's laboratory identified a group of receptors responsible for this regeneration process.

The researchers called this group the epidermal growth factor, or EGF, which switches on support cells in the auditory system of birds. These support cells then spark the production of new sensory hair cells.

Now, in a new study that they have published in the European Journal of Neuroscience, Dr. White - together with researchers from the University of Rochester and the Massachusetts Ear and Eye Infirmary - show how they tried to recreate this process in mammals.

07/12/2018
Human-induced climate change has made the United Kingdom's record-breaking 2018 summer heatwave around 30 times more likely than under normal conditions, the country's meteorological body has said.

The UK as a whole endured its joint hottest summer on record in 2018, and the hottest ever for England. Temperatures peaked in the east of England, reaching 35.6C (96F) in Felsham, Suffolk on July 27, and the UK's average temperature matched previous highs recorded in 2006, 2003 and 1976.

A new analysis from the UK's national weather service, the Met Office, presented at the United Nations' COP24 climate change conference in Katowice, Poland Thursday, has shown that the UK now has an approximately 12% chance of average summer temperatures being as high as in 2018.

Such temperatures would typically have a less than 0.5% chance of occurring under "natural" climate conditions. "Our provisional study compared computer models based on today's climate with those of the natural climate we would have had without human-induced emissions," said Professor Peter Stott from the Met Office and Exeter University.

Stott noted that the "rapidly increasing changes" stem from an increase in the concentrations of carbon dioxide and other greenhouse gases in the Earth's atmosphere. Carbon dioxide concentrations reached 405.5 parts per million (ppm) in the atmosphere in 2017, compared with an atmospheric concentration of around 280 ppm in the pre-industrial era (pre-1750).

A new report published this week by the Global Carbon Project, an international research project on global sustainability, revealed that fossil fuel emissions rose by 1.7% in 2017, and are set to rise further by 2.7% this year, to 37.1 billion tonnes of carbon dioxide. The Met Office warned that soaring temperatures are having an increasing impact on people's lives.

"The extreme temperatures experienced in the UK and around the world during summer 2018 had a significant impact upon many people's lives," Met Office chief scientist Professor Stephen Belcher said in a statement.

"We now live in a climate in which heatwaves occur more frequently and, depending on the choices we make around greenhouse gas emissions, we could reach a point in the future when we can expect a hot summer like that of 2018 to occur every year," he concluded.

A quarterly mortality report published by the UK's Office for National Statistics showed that there were 259 more deaths on June 25 and 26 this year compared with the five-year average of 2,146 for the two days.

Crop failures were also recorded across the country, Northern Ireland introduced its first hosepipe ban since 1995, and critical drinking-water reservoirs ran dry. Kathryn Brown, the head of adaptation in the UK's Committee on Climate Change, which advises the government, told CNN that the report reinforces that the government must redouble its efforts to address the impacts of high temperatures and lack of rain.

"The government must address the issue of greater shortages in water supplies for people, agriculture, industry and the natural environment, whilst improving shading and ventilation in new-build properties as well as reversing the decline of urban green spaces," she said.

"Without action, the number of heat-related deaths could increase from 2,000 per year today to 7,000 by the 2050s as a result of climate change and population growth."

Despite the importance that changes in muscle mass have in aging, overall body metabolism and in chronic disease, we still don't fully understand the mechanisms that contribute to the maintenance of adult muscle mass.

"A number of cell signaling and metabolic pathways have been studied regarding their involvement in sustaining adult muscle mass, but not alternative splicing," said Dr. Thomas Cooper, professor of pathology & immunology, of molecular and cellular biology and of molecular physiology and biophysics at Baylor College of Medicine.

Alternative splicing is a cellular mechanism that allows cells to produce many different proteins from a single gene. A gene can be visualized as a short string of 'beads' or exons. Each bead codes for a different piece of the final protein. Alternative splicing allows the cell to make different proteins by combining the 'beads' in different ways.

The researchers and other groups previously determined that alternative splicing regulators Rbfox1 and Rbfox2 were required for muscle development and function, but Cooper's group hypothesized that the two proteins worked together, and their combined role in adult muscle had not been studied before.

"To determine whether alternative splicing played a role in adult muscle maintenance, we disrupted the process in adult mice by knocking out the genes Rbfox1 and Rbfox2 only in skeletal muscles. Then, we looked at the effect this disruption had in muscles in the animals' limbs," said Dr. Ravi Singh, instructor of pathology & immunology at Baylor College of Medicine.

The critical role of alternative splicing

"We observed that the knockout mice rapidly lost about half of their skeletal muscle mass within four weeks," Singh said. "Two weeks after knocking out the genes Rbfox1 and Rbfox2, hundreds of other genes altered their expression and other genes their alternative splicing, including the capn3 gene, which switched splicing to produce an active form of a protease, an enzyme that degrades proteins."

"Taking all our observations together, we attributed the loss of muscle mass to an increase in degradation of muscle protein rather than a reduction of protein synthesis," said Cooper, who also is the S. Donald Greenberg and R. Clarence and Irene H. Fulbright Professor and a member of the Dan L Duncan Comprehensive Cancer Center at Baylor.

"The results indicate that the Rbfox splicing regulators, which are highly conserved from the worm C. elegans to humans, are essential for maintaining skeletal muscle mass in adult mice." "Our contribution has implications for studies on the role of muscle mass in metabolism and on muscle mass loss in aging and chronic disease," Singh said.

Read all the details of this study in the journal Cell Reports.

Listening to yoga music at bedtime is good for the heart, according to research presented today at ESC Congress 2018.

Dr Naresh Sen, study author, Consultant Cardiologist at HG SMS Hospital, Jaipur, India, said: "We use music therapy in our hospital and in this study we showed that yoga music has a beneficial impact on heart rate variability before sleeping."

Previous research has shown that music can reduce anxiety in patients with heart disease. However, studies on the effects of music on the heart in patients and healthy individuals have produced inconsistent results, partly they did not state what style of music was used.

The body's heart rate changes as a normal response to being in "fight or flight" or "rest and digest" mode. These states are regulated by the sympathetic and parasympathetic nervous systems, respectively, and together comprise the autonomic nervous system. High heart rate variability shows that the heart is able to adapt to these changes.

Conversely, low heart rate variability indicates a less adaptive autonomic nervous system. Low heart rate variability is associated with a 32-45% higher risk of a first cardiovascular event. Following a cardiovascular event, people with low heart rate variability have a raised risk of subsequent events and death. Failure of the autonomic nervous system to adapt may trigger inflammation, which is linked to cardiovascular disease.

Another possibility is that people with low heart rate variability already have subclinical cardiovascular disease. This study investigated the impact of listening to yoga music, which is a type of soothing or meditative music, before bedtime on heart rate variability.

The study included 149 healthy people who participated in three sessions on separate nights:
(1) yoga music before sleep at night;
(2) pop music with steady beats before sleep at night; and
(3) no music or silence before sleep at night.

At each session, heart rate variability was measured4 for five minutes before the music or silence started, for ten minutes during the music/silence, and five minutes after it had stopped. In addition, anxiety levels were assessed before and after each session using the Goldberg Anxiety Scale.

The level of positive feeling was subjectively measured after each session using a visual analogue scale. The average age of participants was 26 years. The researchers found that heart rate variability increased during the yoga music, decreased during the pop music, and did not significantly change during the silence.

Anxiety levels fell significantly after the yoga music, rose significantly post the pop music, and increased after the no music session. Participants felt significantly more positive after the yoga music than they did after the pop music.

Dr Sen noted that holistic therapies such as music cannot replace evidence-based drugs and interventions, and should only be used as an add-on.

He said: "Science may have not always agreed, but Indians have long believed in the power of various therapies other than medicines as a mode of treatment for ailments. This is a small study, and more research is needed on the cardiovascular effects of music interventions offered by a trained music therapist. But listening to soothing music before bedtime is a cheap and easy to implement therapy that cannot cause harm."

After suffering a severe cervical spinal cord injury from a bad fall at work, Scott McConnell had little function remaining in his hands and arms.

Loyola Medicine orthopaedic surgeon Michael Bednar, MD, was able to restore key functions with a series of operations called tendon transfers. Mr. McConnell now can open his fingers up much more than he could before, and he can close them in a tight grip. He can pinch with his thumb and extend his arms outward. He is able to more easily perform everyday tasks such as grasping a cup, brushing his teeth and using his cell phone.

"I have a lot more ability in both my hands and my arms," Mr. McConnell said. Depending on the extent of the spinal cord injury, tendon transfers can enable a patient to grasp objects, open the hand, pinch the thumb and straighten the elbow. In a tendon transfer, muscles that still work are redirected to do the jobs of muscles that are paralyzed.

For example, the surgeon may detach one of the working muscles that flexes the elbow and reattach it to a nonworking muscle that flexes the thumb. The number of functioning muscles a patient has will determine what tendon transfers the surgeon will perform.

The more working muscles available for transfer, the more functions can be restored. Tendon transfers typically involve two surgeries on each arm, performed three months apart. Arms are done one at a time. During rehabilitation, patients learn how to use the transferred muscles.

Dr. Bednar has performed tendon transfers on about 75 patients and is among the most skilled and experienced surgeons in the country doing the procedure.

"Performing tendon transfers on patients with cervical spinal cord injuries requires a team approach," Dr. Bednar said. "The team works with the surgeon to determine who is an appropriate candidate for surgery. The team then helps the patient through the surgeries and rehabilitation, thereby ensuring maximum benefit from the procedures."

Patients who potentially can benefit the most from tendon transfers have spinal cord injuries in the C5-C8 cervical nerves in the lower neck. Mr. McConnell's injury was C5-C6.

"These are the most satisfying patients with whom I get to work," Dr. Bednar said. "To do the operation and have them activate a muscle for the first time since their injury, and see the look in their eyes and their face light up when they realize the function is back, is one of the most rewarding things I get to do as a surgeon."

11/06/2018
Green tea could hold the key to preventing deaths from heart attacks and strokes caused by atherosclerosis, according to research funded by the British Heart Foundation and published in the Journal of Biological Chemistry.

Scientists from Lancaster University and the University of Leeds have discovered that a compound found in green tea, currently being studied for its ability to reduce amyloid plaques in the brain in Alzheimer's disease, also breaks up and dissolves potentially dangerous protein plaques found in the blood vessels.

Atherosclerosis is the build-up of fatty material inside our arteries that can reduce the flow of blood to the heart and brain. In advanced stages of the condition, a protein called apolipoprotein A-1 (apoA-1) can form amyloid deposits, which are similar in structure to those associated with Alzheimer's disease. These deposits build up within atherosclerotic plaques. Here, they increase the size of the plaques, further restricting blood flow, and may also make the plaques less stable, increasing the risk of a heart attack or stroke.

Researchers found that epigallocatechin-3-gallate (EGCG), most commonly associated with green tea, binds to the amyloid fibres of apoA-1. This converts the fibres to smaller soluble molecules that are less likely to be damaging to blood vessels. Now, the team are working on finding ways of introducing effective amounts of EGCG into the bloodstream without it being necessary to drink large and potentially harmful quantities of green tea.

This could involve modifying the chemical structure of EGCG, making it easier to be absorbed from the stomach and more resistant to metabolism, or developing new methods to deliver the molecule to the plaques -- such as via an injection.

David Middleton, Professor in Chemistry at Lancaster University, said: "The health benefits of green tea have been widely promoted and it has been known for some time that EGCG can alter the structures of amyloid plaques associated with Alzheimer's disease. "Our results show that this intriguing compound might also be effective against the types of plaques which can cause heart attacks and strokes."

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: "Our bodies are very good at breaking down EGCG so swapping your cuppa for green tea is unlikely to make a big difference with respect to your heart health. "But by engineering the molecule slightly, we might be able to make new medicines to treat heart attack and stroke."

Professor Sheena Radford, Director of the Astbury Centre for Structural Molecular Biology at the University of Leeds and co-author of the research, said: "The findings of this round of studies are very encouraging. We now need to apply the best scientific techniques to find how we can take the molecular EGCG element from green tea, and turn it into a functioning tool to combat life-limiting health issues."

A medicinal plant frequently used in Traditional Chinese Medicine (TCM) -- Evodia rutaecarpa -- contains substances that can cause cardiac arrhythmia.

This is what researchers from the Universities of Basel, Vienna and Utrecht have recently found out. Extracts of the plant Evodia rutaecarpa are used in Traditional Chinese Medicine for a variety of symptoms, such as headaches, nausea and vomiting as well as menstrual complaints and ulcers in the mouth area.

Researchers led by Professor Matthias Hamburger from the Department of Pharmaceutical Sciences at the University of Basel investigated the effect of Evodia extracts in collaboration with pharmacologists and toxicologists from the University of Vienna.

The natural substances dehydroevodiamine (DHE) and hortiamine isolated from the plant in Basel proved to be very potent inhibitors of potassium channels in the heart muscle.

If these channels are blocked, the excitation processes in the heart muscle change, which can trigger severe heart rhythm disturbances -- so-called Torsade de pointes (TdP) -- and ventricular fibrillation and lead to sudden cardiac death.

Effect confirmed in animal models
The development of severe TdP arrhythmias following the administration of DHE was confirmed by researchers at the University of Utrecht in ECG studies on dogs, a model that is also used to test drug safety in the industry.

Further investigations showed that the two natural substances cause oscillations in the heart muscle cells even in very low concentrations, which can cause cardiac arrhythmia.

For instance, these substances can get into a tea made from Evodia fruits. For drugs that may potentially trigger cardiac arrhythmias, it is typically required that a cardiac examination using ECG is carried out before medication.

This is especially true for heart disease patients for their risk to be assessed. To date, no clinical studies have been conducted to investigate the incidence of cardiac arrhythmias after taking Evodia preparations.

Re-evaluate security
Studies at the University of Basel have also shown that the DHE content of Evodia fruits is considerable. Hamburger currently investigates the extent to which these substances find their way into tea preparations.

"If DHE and hortiamine are detected, the safety of Evodia products has to be re-evaluated," says Hamburger. TCM medicinal plants and products reach the European market relatively uncontrolled, and they can also be purchased on the internet.

The authors of the study, therefore, call for increased vigilance regarding possible toxic effects of Evodia preparations.

"The popularization of medicinal plants from other cultures entails risks. These plants can contain highly active substances with side effects, as in the case of Evodia. A closer examination of such risks is therefore indispensable to protect the population," says Hamburger.

Tai Chi improves brain metabolism and muscle energetics in older adults, study finds.

A new Journal of Neuroimaging study provides insights into the biochemical mechanisms by which Tai Chi - a mind-body exercise - may provide both physical and psychological benefits.

Using magnetic resonance spectroscopy, a non-invasive method of measuring brain and muscle chemistry using MRI machines, tests conducted in 6 older adults enrolled in a 12-week Tai Chi program revealed significant increases in a marker of neuronal health in the brain and significantly improved recovery rates of a metabolite involved in energy production in leg muscles.

"The benefits of Tai Chi have been well known anecdotally; however recent research such as our study can quantify these improvements using objective measures," said senior author Dr. Alexander Lin, of Brigham and Women's Hospital and Harvard Medical School.

01/03/2018
The Food Safety and Technology Research Centre under the Department of Applied Biology and Chemical Technology of The Hong Kong Polytechnic University (PolyU) has developed a new method for rapid authentication of Chinese herbal medicines, including Ganoderma (known as Lingzhi in Chinese), and Gastrodiae Rhizoma (known as Tianma in Chinese).

The new method is quick and simple, which takes around 10 minutes to analyse one raw sample, achieving various ends including authentication of genuine and counterfeit species, classification of wild types and cultivated types, as well as differentiation of geographical origins. This method can be further applied to other herbal medicines.

Lingzhi and Tianma are two of the most popular and valuable Chinese medicines. Due to their high commercial values, problem of counterfeiting, adulterating and confusing Lingzhi and Tianma species is not uncommon in the market. Conventionally, fingerprint chromatography is adopted to authenticate and differentiate the species as it can provide comprehensive chemical composition of a sample.

However, it is a labor-intensive and time-consuming method as it takes several hours to undergo the sample preparation and separation process for one sample. Recently, the PolyU research team adopts the direct ionization mass spectrometry (DI-MS) method to detect the major active components of Lingzhi (ganoderic acids) and Tianma (gastrodin, parishin B/parishin C/and parishin).

By directly applying a high voltage on a small piece of raw sample with its surface loaded with solvents, spray ionization could be induced at the tip of the sample to generate corresponding mass spectra within minutes, as if they are fingerprints which helps identification. The presence of major active components in the DI-MS spectra authenticates genuine samples from counterfeit ones.

Moreover, with Principal Component Analysis (PCA), a commonly used dataset analytic tool, wild and cultivated types can be classified, while geographical origins could be differentiated. There are approximately 80 Lingzhi species while only two of them, known as Chizhi and Zizhi in Chinese, are described in Chinese Pharmacopeia. Some other Lingzhi species which have similar appearances are commonly found to be confused with the official species.

On the other hand, Tianma is easily confused with two counterfeit species, namely Cacalia davidii (Franch.) Hand.-Mazz. and Canna edulis Ker. Both wild Lingzhi and Tianma are very rare and cultivation has become the major source. In general, wild types have higher contents of major active components and thus better curative effect. Samples originated from different geographical locations also have variations in components due to varying cultivation conditions.

The method developed by PolyU is simple, rapid, reproducible and can be easily adopted by researchers in relevant fields as no additional specialized device is required. It has the potential to be further expanded for analysis of other herbal medicines, for example, Heshouwu and Wuweizi, and therefore is expected to bring positive impact on the Chinese herbal medicine industry.

07/02/2018
According to popular belief, the ancient practice of meditation makes us all happier, shinier, more compassionate human beings. Most of those things might be true – except the compassionate part, suggests new research.

"So... I'm driving, feeling really good about myself, and just like – just so much better than everyone else that's so mad. And that's what meditation's for, is to feel superior to others."

This is the set-up of a joke by one of my favorite stand-up comedians, the hilariously neurotic Jen Kirkman. After meditating for a whole 5 minutes one morning, Jen gets all contemplative in front of a green light, stops the car, and annoys the hell out of every driver behind her who's trying to get to work.

One driver starts yelling at her and calling her names, she lies and says her mother had just died, the whole thing escalates into a hilarious episode of road rage, which culminates with her standing in her seat, poking her head through the sunroof of her car and shouting at the guy: "I'm not crazy!!! I meditated, you... [insert profanity here]!!!"

"I didn't say I was a good person, I just said I meditated," Jen tells the audience, reminding us that the two are often mistakenly conflated. As her anecdote illustrates, meditation doesn't always make you a better person – in fact, according to a new study, it almost never does.

An international team of researchers examined 20 existing studies for evidence that mindfulness and loving-kindness meditation promote less aggression, more kindness, and more pro-social behavior. Contrary to the researchers' expectations, they didn't find any.

Meditation research is biased, study finds
Meditation practices, even devoid of the religious connotations, still "seem to offer the hope of a better self and a better world to many," says a co-author of the new study, Dr. Miguel Farias, from the Centre for Advances in Behavioural Science at Coventry University in the United Kingdom.

But, he continues, "Despite the high hopes of practitioners and past studies, our research found that methodological shortcomings greatly influenced the results we found."

Specifically, it turned out that the studies that reported a rise in levels of compassion among meditators were authored by the very same meditation teacher! "This reveals that the researchers might have unintentionally biased their results," says Dr. Farias.

"To understand the true impact of meditation on people's feelings and behavior further we first need to address the methodological weaknesses we uncovered," Dr. Farias adds, "starting with the high expectations researchers might have about the power of meditation."

So, the new analysis certainly casts some shadow over the much-hailed benefits of meditation, and the results could be used to give the self-righteous meditators that Kirkman was parodying a good reality check. That said, you can't help but wonder, as Kirkman herself does after the road rage episode: if all of this happened after she meditated, what would've happened if she hadn't?

07/01/2018
Researchers found working out in a group lowers stress by 26 percent and significantly improves quality of life, while those who exercise individually put in more effort but experienced no significant changes in their stress level and a limited improvement to quality of life, according to a study published in The Journal of the American Osteopathic Association.

"The communal benefits of coming together with friends and colleagues, and doing something difficult, while encouraging one another, pays dividends beyond exercising alone," said Dayna Yorks, DO, lead researcher on this study. "The findings support the concept of a mental, physical and emotional approach to health that is necessary for student doctors and physicians."

Dr. Yorks and her fellow researchers at the University of New England College of Osteopathic Medicine recruited 69 medical students -- a group known for high levels of stress and self-reported low quality of life -- and allowed them to self-select into a twelve-week exercise program, either within a group setting or as individuals.

A control group abstained from exercise other than walking or biking as a means of transportation. Every four weeks, participants completed a survey asking them to rate their levels of perceived stress and quality of life in three categories: mental, physical and emotional.

Those participating in group exercise spent 30 minutes at least once a week in CXWORX, a core strengthening and functional fitness training program. At the end of the twelve weeks, their mean monthly survey scores showed significant improvements in all three quality of life measures: mental (12.6 percent), physical (24.8 percent) and emotional (26 percent).

They also reported a 26.2 percent reduction in perceived stress levels. By comparison, individual fitness participants were allowed to maintain any exercise regimen they preferred, which could include activities like running and weight lifting, but they had to work out alone or with no more than two partners.

On average the solitary exercisers worked out twice as long, and saw no significant changes in any measure, except in mental quality of life (11 percent increase). Similarly, the control group saw no significant changes in quality of life or perceived stress.

"Medical schools understand their programs are demanding and stressful. Given this data on the positive impact group fitness can have, schools should consider offering group fitness opportunities," said Dr. Yorks.

"Giving students an outlet to help them manage stress and feel better mentally and physically can potentially alleviate some of the burnout and anxiety in the profession."

Green tea ingredient may ameliorate memory impairment, brain insulin resistance, and obesity.

New research identifies potential therapeutic intervention for memory impairment, neuroinflammation, and brain insulin resistance induced by high-fat, high-fructose diet. A study published online in The FASEB Journal, involving mice, suggests that EGCG (epigallocatechin-3-gallate), the most abundant catechin and biologically active component in green tea, could alleviate high-fat and high-fructose (HFFD)-induced insulin resistance and cognitive impairment.

Previous research pointed to the potential of EGCG to treat a variety of human diseases, yet until now, EGCG's impact on insulin resistance and cognitive deficits triggered in the brain by a Western diet remained unclear. "Green tea is the second most consumed beverage in the world after water, and is grown in at least 30 countries," said Xuebo Liu, Ph.D., a researcher at the College of Food Science and Engineering, Northwest A&F University, in Yangling, China.

"The ancient habit of drinking green tea may be a more acceptable alternative to medicine when it comes to combatting obesity, insulin resistance, and memory impairment."

Liu and colleagues divided 3-month-old male C57BL/6J mice into three groups based on diet:
1) a control group fed with a standard diet,
2) a group fed with an HFFD diet, and
3) a group fed with an HFFD diet and 2 grams of EGCG per liter of drinking water.

For 16 weeks, researchers monitored the mice and found that those fed with HFFD had a higher final body weight than the control mice, and a significantly higher final body weight than the HFFD+EGCG mice. In performing a Morris water maze test, researchers found that mice in the HFFD group took longer to find the platform compared to mice in the control group.

The HFFD+EGCG group had a significantly lower escape latency and escape distance than the HFFD group on each test day. When the hidden platform was removed to perform a probe trial, HFFD-treated mice spent less time in the target quadrant when compared with control mice, with fewer platform crossings.

The HFFD+EGCG group exhibited a significant increase in the average time spent in the target quadrant and had greater numbers of platform crossings, showing that EGCG could improve HFFD-induced memory impairment.

"Many reports, anecdotal and to some extent research-based, are now greatly strengthened by this more penetrating study," said Thoru Pederson, Ph.D., Editor-in-Chief of The FASEB Journal.

Heart disease patients who practice yoga in addition to aerobic exercise saw twice the reduction in blood pressure, body mass index and cholesterol levels when compared to patients who practiced either Indian yoga or aerobic exercise alone, according to research to be presented at the 8th Emirates Cardiac Society Congress in collaboration with the American College of Cardiology Middle East Conference October 19-21, 2017 in Dubai.

Lifestyle intervention has been shown to aid in reducing the risk of death and heart disease comorbidities when used alongside medical management. Indian yoga is a combination of whole exercise of body, mind and soul, and a common practice throughout India.

Researchers in this study looked specifically at Indian yoga and aerobic training's effect on the coronary risk factors of obese heart disease patients with type 2 diabetes. The study looked at 750 patients who had previously been diagnosed with coronary heart disease. One group of 225 patients participated in aerobic exercise, another group of 240 patients participated in Indian yoga, and a third group of 285 participated in both yoga and aerobic exercise.

Each group did three, six-month sessions of yoga and/or aerobic exercise. The aerobic exercise only and yoga only groups showed similar reductions in blood pressure, total cholesterol, triglycerides, LDL, weight and waist circumference. However, the combined yoga and aerobic exercise group showed a two times greater reduction compared to the other groups. They also showed significant improvement in left ventricular ejection fraction, diastolic function and exercise capacity.

"Combined Indian yoga and aerobic exercise reduce mental, physical and vascular stress and can lead to decreased cardiovascular mortality and morbidity," said Sonal Tanwar, PhD, a scholar in preventative cardiology, and Naresh Sen, DM, PhD, a consultant cardiologist, both at HG SMS Hospital, Jaipur, India.

"Heart disease patients could benefit from learning Indian yoga and making it a routine part of daily life."

The Nobel Prize for Medicine was awarded to three Americans on Monday for discoveries about the body's daily rhythms.

The laureates are Jeffrey C. Hall, Michael Rosbash and Michal W. Young. Rosbash is on the faculty at Brandeis University, Young at Rockefeller University and Hall is at the University of Maine.

The citation for the 9-million-kronor ($1.1 million) prize says the researchers isolated a gene that controls the normal daily biological rhythm.

They "were able to peek inside our biological clock and elucidate its inner workings."

Circadian rhythms adapt the workings of the body to different phases of the day, influencing sleep, behavior, hormone levels, body temperature and metabolism.

The winners have raised "awareness of the importance of a proper sleep hygiene" said Juleen Zierath of the Nobel academy.

Practicing brief sessions of Hatha yoga and mindfulness meditation can significantly improve brain function and energy levels, according to a new study from the University of Waterloo.

The study found that practicing just 25 minutes of Hatha yoga or mindfulness meditation per day can boost the brain's executive functions, cognitive abilities linked to goal-directed behavior and the ability to control knee-jerk emotional responses, habitual thinking patterns and actions.

"Hatha yoga and mindfulness meditation both focus the brain's conscious processing power on a limited number of targets like breathing and posing, and also reduce processing of nonessential information," said Peter Hall, associate professor in the School of Public Health & Health Systems.

"These two functions might have some positive carryover effect in the near- term following the session, such that people are able to focusmore easily on what they choose to attend to in everyday life."

Thirty-one study participants completed 25 minutes of Hatha yoga, 25 minutes of mindfulness meditation, and 25 minutes of quiet reading (a control task) in randomized order.

Following both the yoga and meditation activities, participants performed significantly better on executive function tasks compared to the reading task.

"This finding suggests that there may be something special about meditation - as opposed to the physical posing - that carries a lot of the cognitive benefits of yoga," said Kimberley Luu, lead author on the paper.

The study also found that mindfulness meditation and Hatha yoga were both effective for improving energy levels, but Hatha yoga had significantly more powerful effects than meditation alone.

"There are a number of theories about why physical exercises like yoga improve energy levels and cognitive test performance," said Luu.

"These include the release of endorphins, increased blood flow to the brain, and reduced focus on ruminative thoughts. Though ultimately, it is still an open question."

Hatha yoga is one of the most common styles of yoga practiced in Western countries. It involves physical postures and breathing exercises combined with meditation.

Mindfulness mediation involves observing thoughts, emotions and body sensations with openness and acceptance.

"Although the meditative aspect might be even more important than the physical posing for improving executive functions, there are additional benefits to Hatha yoga including improvements in flexibility and strength," said Hall.

"These benefits may make Hatha yoga superior to meditation alone, in terms of overall health benefits."

28/08/2017
When it comes to losing weight, it's not necessarily slow, but steady, that wins the race, according to new research from Drexel University.

In a study of 183 participants, those whose weights fluctuated the most during the first few weeks of a behavioral weight loss program ultimately had poorer weight loss outcomes one and two years later, compared to the men and women who lost a consistent number of pounds each week.

The results were published today in the journal Obesity. "It seems that developing stable, repeatable behaviors related to food intake and weight loss early on in a weight control program is really important for maintaining changes over the long term," said lead author Emily Feig, PhD, a former graduate student in the College of Arts and Sciences at Drexel University.

The psychologists were interested in studying what makes some people less successful in weight loss programs and identifying predictors that could improve treatment outcomes in the future. To find out, they enrolled individuals who were overweight or obese into a year-long weight loss program that used meal replacements along with behavioral goals such as self-monitoring, calorie monitoring and increasing physical activity.

The participants attended weekly treatment groups during which they were weighed, and returned for a final weigh-in two years from the start of the program. The participants also reported on food-related behaviors and attitudes like cravings, emotional eating, binge eating and confidence in regulating intake.

The researchers found that higher weight variability over the initial six and 12 weeks of weight loss treatment predicted poorer subsequent, long-term weight control at 12 and 24 months. For example, someone who lost four pounds one week, regained two and then lost one the next tended to fare worse than someone who lost one pound consistently each week for three weeks.

Exactly why some people have more weight variability than others is a question the researchers are interested in exploring in future studies. Though he is hesitant to equate correlation and causation in this case, principal investigator Michael Lowe, PhD, a psychology professor at Drexel, says the study does illuminate a potential method for sticking to weight loss goals.

"Settle on a weight loss plan that you can maintain week in and week out, even if that means consistently losing ¾ of a pound each week," he said. If future studies can replicate these results, then measuring weight variability may be a way to identify individuals who are less likely to achieve meaningful and sustainable weight loss, and who may benefit from a stronger, more tailored focus on consistency.

01/08/2017
In a study including 150 military veterans with chronic low back pain, researcher Dr. Erik J. Groessl and his team from the VA San Diego Healthcare System found that veterans who completed a 12-week yoga program had better scores on a disability questionnaire, improved pain intensity scores, and a decline in opioid use.

Groessl is a researcher with the VA San Diego Healthcare System and the University of California, San Diego School of Medicine. The study was published in the American Journal of Preventive Medicine on July 20, 2017. The study shows promise for non-drug treatment of chronic low back pain, said Groessl.

"To be able to reduce the reliance upon opioids and other medications with side effects, it is crucial to establish evidence showing mind-body practices like yoga provide benefit in both veterans and non-veterans with chronic pain," he said.

Veterans in the study who were randomized to the yoga group attended a 12-week yoga program immediately after randomization. Comparison participants were invited to attend the yoga intervention only after six months. The 12-week yoga intervention consisted of two 60-minute instructor-led yoga sessions per week, with home practice sessions encouraged.

The intervention was based on hatha yoga, which involves yoga postures and movement sequences, along with regulated breathing and mindfulness meditation. Outcomes were assessed at the baseline, six weeks, 12 weeks and six months. Both study groups had reductions in disability scores after 12 weeks.

However, notable differences emerged at the six-month assessment, with scores continuing to drop in the yoga group but increasing in the delayed-treatment group. Along with those improvements, pain intensity decreased in the yoga group at all three time periods, while the delayed-treatment group had negligible changes.

There was also a 20 percent drop in opioid pain medication use at 12 weeks in both groups as determined through self-report questionnaires and a review of medical records. Notably, reductions in disability and pain intensity were found despite the reductions in opioid use and other medical and self-help pain treatments at six months.

The trial confirms the findings of two prior randomized controlled trials with non-veterans showing that yoga is safe and can reduce pain and disability among adults with chronic low back pain. The study is one of the first to demonstrate the effectiveness of yoga specifically in military veterans, a population that faces more health challenges and may be harder to treat than non-VA populations, say the researchers.

They point out that as with other non-drug treatments for chronic low back pain, yoga may not help everyone or may not completely eliminate chronic low back pain, but reduced pain and disability can often maintained long-term with ongoing yoga home practice. Military veterans and active duty military personnel have higher rates of chronic pain than the general U.S. population, and the back is the area of the body that is most commonly affected.

In addition to pain, those with the condition also report increased disability, psychological symptoms, and reduced quality of life. In the U.S., chronic low back pain is the leading cause of lost productivity and the second most common cause for physician visits. Billions of dollars are spent each year in the U.S. on health care related to back pain.

The team says that given the results of their study, VA facilities nationwide may want to consider developing and expanding formal yoga programs to help veterans with back pain. Many VA facilities already do offer yoga classes, along with other complementary and integrative health programs.

20/06/2017
Traditional therapies for chronic low back pain are often ineffective. New research shows that yoga may be a good alternative for treating this condition.

According to the National Institutes of Health (NIH), approximately 80 percent of the American adult population will have low back pain at one point or another, with men and women being equally affected. For most of these people, the pain is acute and does not last very long. For others, however, it turns into chronic back pain - meaning that it lasts for at least 12 weeks, even when the cause of the pain has been dealt with.

Treatment options for low back pain include muscle strengthening exercises, physical therapy sessions, and analgesic medication. When these therapies fail, surgery is also an option. Unfortunately, none of the above therapies have proven highly successful. Between 25 and 80 percent of people who were treated for chronic low back pain experience a recurrence within a year from the treatment.

For this reason, people living with chronic pain often resort to alternative therapies, such as acupuncture or yoga. The NIH report that there is enough evidence to support the "short- and long-term benefits" of yoga for relieving chronic low back pain. Previous studies have indeed suggested that yoga and stretching help ease low back pain.

But chronic low back pain tends to affect racial and ethnic minorities in particular, as well as people with a lower socioeconomic background. In this population - as well as in those who have more severe pain - the benefits of yoga may not have been studied sufficiently.

So, researchers from the Boston Medical Center set out to examine the effect of yoga sessions on a group of 320 adults with chronic low back pain. The participants were of various races and ethnicities; overall, they also had an income equal to or lower than $30,000 per year.

The findings were published in the journal Annals of Internal Medicine. The first author of the study is Dr. Robert B. Saper. The 320 participants were randomly assigned to either attending 12 weekly yoga sessions, 15 physical therapy sessions, or just reading an educational book and newsletters on how to manage chronic low back pain.

After these interventions, the researchers continued to follow the participants for 1 year, which included a 40-week maintenance phase. During the maintenance phase, yoga participants either took yoga drop-in classes or practiced yoga at home. Physical therapy participants took part in physical therapy booster sessions or practiced physical therapy at home.

To assess the participants' functionality, Saper and colleagues used the Roland Morris Disability Questionnaire. To assess pain levels, they used an 11-point scale at 12 weeks. The trial determined that yoga was "statistically as effective" as physical therapy for alleviating pain, helping patients to be more functional, and to reduce their pain medication.

12/06/2017
A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments.

The pilot study conducted by investigators at Massachusetts General Hospital (MGH) and published in the Journal of Clinical Psychiatry enrolled members of Boston's Chinese community who had mild to moderate depression.

"While some previous studies have suggested that tai chi may be useful in treating anxiety and depression, most have used it as a supplement to treatment for others medical conditions, rather than patients with depression," explains Albert Yeung, MD, ScD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, lead and corresponding author of the report.

"Finding that tai chi can be effective is particularly significant because it is culturally accepted by this group of patients who tend to avoid conventional psychiatric treatment."

Participants were recruited through advertisements offering tai chi for stress reduction, and their eligibility for the study was determined based on in-person interviews and assessments of overall health and depression symptoms.

Eligible participants were Chinese-American adults fluent in either Cantonese or Mandarin, with a diagnosis of major depressive disorder in the mild to moderate range, no history of other psychiatric disorders, no recent practice of tai chi or other mind-body interventions, and no current use of other psychiatric treatments.

Participants were randomized into three groups - one that received the tai chi intervention; an active control group that participated in educational sessions that included discussions on stress, mental health and depression; and a passive control, "waitlist" group that returned for repeat assessments during and after the study period.

The tai chi intervention involved twice weekly sessions for 12 weeks, in which participants were taught and practiced basic traditional tai chi movements. They were asked to practice at home three times a week and to document their practice. The education group also met twice weekly for 12 weeks, and sessions for both groups were offered in Cantonese or Mandarin.

Members of both the education and waitlist groups were able to join free tai chi classes after the initial study period, something they were informed of at the study's outset. Of the 50 participants who completed the 12-week intervention period, 17 were in the tai chi group, 14 in the education group and 19 in the waitlist group.

The 12-week assessments showed that the tai chi group had significantly greater improvement in depression symptoms than did members of either control group.
Follow-up assessment at 24 weeks showed sustained improvement among the tai chi group, with statistically significant differences remaining compared with the waitlist group.

"If these findings are confirmed in larger studies at other sites, that would indicate that tai chi could be a primary depression treatment for Chinese and Chinese American patients, who rarely take advantage of mental health services, and may also help address the shortage of mental health practitioners," says Yeung, who is an associate professor of Psychiatry at Harvard Medical School.

"We also should investigate whether tai chi can have similar results for individuals from other racial and ethnic groups and determine which of the many components of tai chi might be responsible for these beneficial effects."

Pressures on primary care doctors to move away from opioid pain management are increasing, but practitioners need practical, evidence-based information on how to employ multidisciplinary pain care successfully in everyday clinical practice.

A senior investigator for Kaiser Permanente, speaking at the American Pain Society Annual Scientific Conference, believes wider use of practical clinical trials and more emphasis on patient self-management are key solutions for achieving wider use of multidisciplinary pain care to improve patient function and help lower use and misuse of opioids.

While the national death toll from opioid overdoses is staggering, Lynn DeBar, PhD, senior investigator, Kaiser Permanente Center for Health Research said that a small minority of pain patients are represented in the mortality data.

"Given the justified apprehensions of primary care doctors to continue prescribing opioids, the central question focuses on what can we do in primary care to help improve function for pain patients," said DeBar.

DeBar said the benefits of multidisciplinary pain care, which employs non-pharmacologic treatments, have been well documented in peer-reviewed studies but it still is not widely available due largely to inadequate insurance coverage.

"Medicare and other health insurance providers need value-based care metrics and outcomes, and more studies are needed to help implement evidence-based multimodal pain care with attention to feasibility and sustainability in everyday clinical practice," DeBar explained.

Widespread gaps in evidence-based knowledge about pain management underscore the need to conduct practical clinical trials designed to meet the needs of clinicians and answer their questions. Such trials are of increasing interest to the National Institutes of Health who are ramping up efforts to support pragmatic trial initiatives.

"Practical clinical trials can bridge the gap between research and clinical care," said DeBar. "Traditional randomized clinical trials are slow and expensive, and results often cannot be implemented easily in clinical practice. Findings can be difficult to translate into the real world because treatments are given to carefully selected populations in ideal conditions."

DeBar said practical clinical trials are designed to improve practice and policy and take place in settings where routine medical care occurs. They seek answers to real-world clinical questions and are designed to test what will work in everyday care. Also, practical clinical trials study diverse populations using broadly inclusive eligibility criteria.

The NIH Health Care Systems Research Collaboratory, is spearheading execution of pragmatic clinical trials in pain management by partnering with health systems and physician groups. "Engaging health systems, provider and patients as partners in pragmatic research accelerates realistic integration of research, policy and practice," said DeBar.

She reported that Kaiser Permanente is organizing a practical clinical trial in pain management involving 851 patients in the Portland, Ore. area. DeBar also spoke about the benefits of adopting alternative treatment approaches, such as virtual reality and patient-to-patient reinforcement methods.

"Remote interventions with cognitive behavioral therapies are proving effective and so are new smart phone apps that allow patients to transmit real-time information about their pain," said DeBar.

"Also, more attention should be given to patient-driven models of support, similar to programs like Weight Watchers, which empower patients to take more active roles in managing their care."

Materials provided by American Pain Society.

07/04/2017
Past studies have associated yo-yo dieting with increased risk of poor heart health.

For individuals with pre-existing heart disease, however, new research finds that the health consequences of repeatedly losing and gaining weight may be even more severe.

Researchers found that people with coronary heart disease who had experienced large fluctuations in weight over an average of 4.7 years were at much higher risk of heart attack, stroke, and death than people who experienced little change in body weight.

Lead study author Dr. Sripal Bangalore, of the Cardiovascular Clinical Research Center at NYU Langone Medical Center in New York, and colleagues recently reported their results in the New England Journal of Medicine. Yo-yo dieting - also known as "weight cycling" or the "yo-yo effect" - is defined as repeated cycles of weight loss and weight gain.

A number of studies have documented the possible health risks of yo-yo dieting. One study reported by Medical News Today last year, for example, uncovered a link between weight cycling and greater risk of death from heart disease.

The new research from Dr. Bangalore and colleagues builds on those findings, revealing how yo-yo dieting may impact the health of individuals who have pre-existing coronary heart disease.

Coronary heart disease (CHD) - also referred to as coronary artery disease - is the most common form of heart disease among men and women in the United States. Each year, the condition kills more than 370,000 people in the country.

CHD is characterized by atherosclerosis - the buildup of plaque in the coronary arteries, which are those that supply the heart with oxygen-rich blood. This plaque buildup may block the blood supply to the heart, which can lead to angina (severe chest pain) or heart attack.

Largest weight fluctuations linked to 124 percent more deaths
For their study, Dr. Bangalore and colleagues analyzed the data of 9,509 men and women with CHD aged between 35 and 75 years. As well as CHD, all subjects had high cholesterol levels and a history of other heart problems. Around half of the participants were undergoing intensive cholesterol-lowering therapy.

Over a median follow-up period of 4.7 years, participants were monitored for changes in body weight, and the researchers looked at whether these changes were associated with poorer outcomes.

Subjects with the greatest changes in body weight experienced a weight fluctuation of up to 3.9 kilograms (around 8.6 pounds) during follow-up, while those with the smallest body weight changes had weight fluctuations of 0.9 kilograms (around 2 pounds).

The team found that for individuals who were overweight or obese at study baseline, there were 117 percent more heart attacks, 124 percent more deaths, and 136 percent more strokes among those who experienced the largest changes in body weight, compared with those who experienced the smallest body weight changes.

Additionally, the researchers found a link between changes in body weight and increased risk of new-onset diabetes. These findings remained after accounting for participants' average body weight and the presence of common risk factors for heart disease, the authors note.

Findings raise concerns about weight fluctuation in people with CHD
Dr. Bangalore and team say that their study is only observational, so it is unable to prove cause-and-effect between yo-yo dieting and increased risk of heart attack, stroke, and death among people with CHD.

Additionally, the authors point to a number of limitations. For example, they were unable to pinpoint precisely why subjects lost or gained weight during follow-up. As such, it is possible that pre-existing heart problems led to weight changes. Still, the researchers believe that their results warrant further investigation.

06/03/2017
Chronic pain affects millions of people in the United States, and it can severely interfere with everyday functioning.

However, recent research suggests a new treatment strategy for the condition: shared reading. Shared reading is an interactive reading experience in which small groups of people gather to read short stories, poetry, and other literature aloud.

By using literature that triggers memories of experiences throughout life - such as childhood and relationships - researchers have found that shared reading might be a more effective strategy to help alleviate chronic pain than cognitive behavioral therapy (CBT).

Study leader Dr. Josie Billington, from the Centre for Research into Reading, Literature and Society at the University of Liverpool in the United Kingdom, and colleagues recently reported their results in the journal Medical Humanities. Chronic pain - defined as any form of pain that lasts for at least 12 weeks - is estimated to affect around 100 million people in the U.S.

Low back pain, severe headache or migraine, and neck pain are the most common forms of pain, with back pain being the leading cause of disability in the U.S. While there are a number of medications that can help with chronic pain management, they are not always effective.

Patients are increasingly turning to non-pharmacological strategies, such as CBT, to help alleviate pain. CBT is a form of talk therapy that aims to change the way people think and behave in order to better manage mental and physical issues. Studies have shown that the technique may be effective for chronic pain, but the results can be short-lived.

Shared reading 'could be an alternative to CBT' for chronic pain
For their research, Billington and colleagues wanted to compare shared reading with CBT for chronic pain, since shared reading is often used to help ease the symptoms of other chronic conditions, such as dementia.

Participants with severe chronic pain were recruited to the study. Some subjects completed 5 weeks of CBT, and parallel to this, the remaining subjects completed 22 weeks of shared reading. After 5 weeks, participants who completed CBT joined the shared reading group.

The shared reading strategy incorporated literature that was designed to prompt memories of relationships, family members, work, and other experiences that arise throughout a lifetime, as opposed to CBT, which focused on a single point in time at which the patient was affected by chronic pain.

Subjects were required to report pain severity and emotions before and after each intervention, and they also kept a diary, where they recorded their pain and emotions twice daily.

While CBT helped participants to "manage" their emotions using organized methods, the researchers found that shared reading helped patients to address painful emotions that might be contributing to their chronic pain. Furthermore, the researchers found that pain severity and mood improved for up to 2 days following shared reading.

While the findings show promise for shared reading as an alternative non-pharmacological approach for chronic pain management, the team says that further studies with larger sample sizes are warranted.

Hyperalgesia refers to an increased sensitivity to pain. It can occur during alcohol withdrawal, and may contribute to a relapse to drinking.

Alternative therapies such as acupuncture and electroacupuncture (EA, which combines acupuncture with electrical stimulation) are effective in reducing pain and, possibly, alcohol-withdrawal symptoms.

This rodent study investigated whether EA can alleviate hyperalgesia during alcohol withdrawal, potentially reducing the risk of a relapse to drinking, and whether it achieves this effect via action at mu opioid receptors (MORs) located in a brain region called the lateral habenula.

Researchers trained male rats to drink alcohol for eight weeks, after which they discontinued the alcohol supply, which led to withdrawal symptoms, including hyperalgesia.

To assess whether EA alleviated the hyperalgesia, they measured pain sensitivity using radiant heat (a light beam directed at the hind paw of each rat) and measured paw withdrawal latencies to the light stimulation, with and without EA.

The study showed that EA can lessen hyperalgesia during alcohol withdrawal, and that the effect may involve MORs in the habenula.

Although obtained in rodents, the findings suggest that EA is a potential therapy for hyperalgesia in humans.

If shown to be effective in humans, the use of EA to alleviate pain symptoms associated with alcohol withdrawal could potentially lessen the chances of a relapse to drinking in these individuals.

06/02/2017
Researchers have found that the microorganisms residing in the intestines (microbiota) play a role in the development of high blood pressure in rats.

The study is published in Physiological Genomics. It was chosen as an APS selectarticle for February.

Scientists studied two sets of rats, one group with high blood pressure ("hypertensive") and one with normal blood pressure ("normal").

The research team removed a portion of the biological material from the large intestine of each group.

All animals were then given antibiotics for 10 days to reduce their natural microbiota.

After the course of antibiotics, the researchers transplanted hypertensive microbiota to normal blood pressure rats and normal microbiota to the hypertensive group.

The researchers found that the group treated with hypertensive microbiota developed elevated blood pressure.

A more surprising result is that the rats treated with normal microbiota did not have a significant drop in blood pressure, although readings did decrease slightly.

This finding is "further evidence for the continued study of the microbiota in the development of hypertension in humans and supports a potential role for probiotics as treatment for hypertension," wrote the researchers.

"Studies showing that supplementing the diet with probiotics (beneficial microorganisms found in the gut) can have modest effects on blood pressure, especially in hypertensive models."

04/01/2017
A new study from The University of Nottingham has found that a certain type of yoga could potentially help to improve the health and psychological wellbeing of children in care.

The study, 'Kundalini Yoga as Mutual Recovery: A feasibility study including children in care and their carers,' published at The Journal of Children's Services, found that the practice of Kundalini yoga in care homes, when both staff and children are involved, can lead to both individual and social benefits.

Corporate care is far from perfect, with evidence showing that children in care are still among the most vulnerable in society. Research for the Department for Education has also shown that children in care have a higher degree of physical and mental health needs than their not-in-care counterparts, and in comparison to children who are in other forms of care, such as foster care.

'Creative practice as mutual recovery'
This new study was carried out under the belief of 'creative practice as mutual recovery', and looked at the idea that shared creativity, collective experience and mutual benefit can promote resilience in mental health and well-being among communities that have been traditionally divided (e.g. children's home staff and children).

The study was carried out by experts from The University of Nottingham's Institute of Mental Health in conjunction with external collaborators Mark Ball, Edge of Care Hub Manager at Nottingham City Council (Children and Families), Emily Haslam-Jones, Kundalini yoga teacher at Yoganova and David Crepaz-Keay from the Mental Health Foundation.

The experts tested a 20-week Kundalini yoga program in three children's homes situated in the East Midlands. The program was evaluated according to recruitment and retention rates, self-reporting questionnaires from the participants and semi-structured interviews.

The findings show that yoga practice in children's homes, especially when participation is high, has the potential to encourage togetherness and mutuality and improve health and psychological outcomes for children in care, as well as within the workforce.

All the participants reported that the study was personally meaningful and experienced both individual (i.e. feeling more relaxed) and social benefits (e.g. feeling more open and positive).

Far-reaching social benefits
Individuals reported that the yoga sessions helped to show them beneficial exercises that they could use in various contexts, such as before going to bed, or during emotionally challenging times at work as well as at home.

The social benefits were also far-reaching with some participants reporting that they felt more positive, open to others and, as a consequence, had seen an improvement in their social lives and out of work. Some staff and residents noticed that other people also interacted more positively with them.

Dr Elvira Perez, a Senior Research Fellow at Horizon, member of the Institute of Mental Health, and lead author of the study, says:

"The findings are very exciting as they suggest that the practice of Kundalini yoga, involving both staff and children in care, is a plausible intervention that can lead to individual and social benefits. This could have potentially huge, wide-reaching benefits for children in care as well as for all the staff working in residential settings. "

The study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for children in care and the staff working in these homes."

02/12/2016
Researchers with the UCI Susan Samueli Center for Integrative Medicine have found that regular electroacupunture treatment can lower hypertension by increasing the release of a kind of opioid in the brainstem region that controls blood pressure.

In tests on rats, UCI cardiology researcher Zhi-Ling Guo and colleagues noted that reduced blood pressure lasted for at least three days after electroacupuncture by increasing the gene expression of enkephalins, which one of the three major opioid peptides produced by the body.

Their study, which appears in the Nature's Scientific Reports, presents the first evidence of the molecular activity behind electroacupunture's hypertension-lowering benefits.

Last year, the UCI team reported patients treated with acupuncture at certain wrist locations experienced drops in their blood pressure.

The present study shows that repetitive electroacupuncture evokes a long-lasting action in lowering blood pressure in hypertension, suggesting that this therapy may be suitable for treating clinical hypertension.

Hypertension affects about one third of the adult population of the world, and its consequences, such as stroke and heart attacks, are enormous public health problems, and the potential advantages of acupuncture over conventional medical therapy include few, if any, of side effects.

04/11/2016
In-depth genetic research gives new insight into how smoking is capable of causing cancer in such a wide array of organs. The study provides a link between the number of cigarettes smoked and the number of mutations in tumor DNA.

The negative health consequences of smoking are well known and have been heavily studied. An estimated 6 million people die each year due to smoking-related illnesses. If trends continue, according to the World Health Organization (WHO), there will be 1 billion tobacco-related deaths this century.

Smoking is known to cause irreparable damage in a variety of organs. It sparks mutations in DNA via a number of mechanisms. However, it has not been clear how cancer generates so many different types of cancers in disparate body parts. To date, smoking has been associated with 17 types of cancer, but the genetic mechanisms behind this have remained hidden.

Researchers from the Wellcome Trust Sanger Institute and King's College London in the United Kingdom and the Los Alamos National Laboratory, NM, recently undertook a deep dive into the genetics of smoking-related cancers. Their results are published this week in the journal Science. n the most detailed investigation of its type, scientists delved into the the DNA of 5,000 tumors.

They compared tumors from nonsmokers with tumors from smokers and examined any genetic differences. The analysis allowed them to understand the molecular fingerprints of smoking-related DNA damage.

The researchers were able to study these mutational signatures and count the number of mutations in each tumor.

Counting tobacco-related tumor mutations
Once the data was in, the authors could measure the rate of mutations caused per cigarette smoked. They found that smoking a pack of cigarettes per day caused a predictable average number of mutations in the lungs over the course of a year.

"Before now, we had a large body of epidemiological evidence linking smoking with cancer, but now we can actually observe and quantify the molecular changes in the DNA due to cigarette smoking," says first author Dr. Ludmil Alexandrov, of the Los Alamos National Laboratory,.

"With this study, we have found that people who smoke a pack a day develop an average of 150 extra mutations in their lungs every year, which explains why smokers have such a higher risk of developing lung cancer."

The team also developed a clearer picture of the effects of cigarettes on mutations in other organs. They found that a pack a day led to:
* 97 mutations in each cell in the larynx
* 39 mutations in each cell in the pharynx
* 23 mutations in each cell in the mouth
* 18 mutations in each cell in the bladder
* 6 mutations in each cell in the liver.

As mentioned previously, how mutations affect organs of the body other than lungs has been difficult to understand. This new research uncovered ways in which tobacco can develop mutations in different tissues and organs.

Looking into the future of cancer research
The researchers were surprised by some of the results; smoking-related cancers are more complex than previously thought.

Prof. Sir Mike Stratton, from the Wellcome Trust Sanger Institute and joint lead author, says: "This study of smoking tells us that looking in the DNA of cancers can provide provocative new clues to how cancers develop and thus, potentially, how they can be prevented."

Medical News Today recently asked Dr. Alexandrov if they plan to carry out more research in a similar vein. He said: "This study has shown that molecular profiling of cancer patients can be used to identify the mechanisms by which different carcinogens cause cancer. We are planning future studies to reveal the mechanisms by which other known epidemiological factors cause cancer. For example, we are currently working on elucidating the mechanisms by which obesity causes cancer."

When MNT asked him what research he would carry out if he was given unlimited time, money, and resources, he said: "I would molecularly profile every single cancer patient across the world to better understand the causes of cancer and use this knowledge for developing future cancer prevention strategies."

The current results mark a milestone along the path to understanding how smoking-related cancers negatively influence DNA. There is still much to know, but investigations such as this will steadily bring us closer to understanding and preventing cancer on a molecular level.

13/10/2016
Calcium supplements might increase cardiovascular risk, whereas dietary calcium was associated with a protective effect, a new observational study found. Many people - in particular, older women - take calcium supplements to prevent or treat osteoporosis, though the supporting evidence for this use is quite thin.

In recent years, several studies have raised concerns that calcium supplements might be linked to increased cardiovascular risk. But the precise relationship between calcium - both from dietary sources and from supplements - and atherosclerosis has not been carefully studied in randomized trials.

In a paper published in the Journal of the American Heart Association, Erin Michos, MD, MHS, of Johns Hopkins, and colleagues analyzed data from more than 2,700 participants in the MESA (Multi-Ethnic Study of Atherosclerosis) study who did not have diagnosed cardiovascular disease.

Among the 1,567 participants who had no coronary artery calcium at baseline, the group in the highest quintile of calcium intake (as assessed by a food questionnaire and medication inventory) had a significant 27% lower likelihood of development of coronary artery calcium (CAC) at 10 years, after adjustment for differences in baseline risk.

But the investigators found a potentially important difference in effect based on the calcium source. Calcium from supplements was associated with a 22% higher risk of CAC. Any adverse effect of calcium supplements could have broad importance, because 43% of U.S. adults take calcium supplements.

Instead of helping to promote bone health, the authors speculated that excessive doses of calcium might "accrue in vascular tissue." But the authors warned that the study's findings might not be a reflection of the effect of calcium but rather a broader demonstration of the "healthy user effect."

People who consumed large amounts of dietary calcium "may have been engaging in other unmeasurable health-promoting behaviors (ie., the healthy user effect), which could potentially explain why a decrease in risk of CAC development was observed in the highest quintile of calcium intake.

Calcium-rich foods are associated with a healthy diet, and many of the participants with a high dietary calcium intake may be consuming vegetables, dairy, nuts, and fish - that provide cardioprotective benefits."

More generally, the authors cautioned in a press release that "their work only documents an association between calcium supplements and atherosclerosis, and does not prove cause and effect."

In an interview, Michos questioned why so many people are taking calcium supplements. "The fracture data is not very compelling," she noted. Besides the adverse cardiovascular effects suggested by her study, calcium supplements are also known to cause kidney stones, flatulence, and constipation.

"People think that because they can get it over the counter there is no harm." As "we saw no excess risk with diet, I tell my patients to take all their calcium through diet."

07/10/2016
Data from a review of U.S.-based clinical trials published in Mayo Clinic Proceedings suggest that some of the most popular complementary health approaches - such as yoga, tai chi, and acupuncture -- appear to be effective tools for helping to manage common pain conditions. The review was conducted by a group of scientists from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health.

Millions of Americans suffer from persistent pain that may not be fully relieved by medications. They often turn to complementary health approaches to help, yet primary care providers have lacked a robust evidence base to guide recommendations on complementary approaches as practiced and available in the United States. The new review gives primary care providers - who frequently see patients with chronic pain -- tools to inform decision-making on how to help manage that pain.

"For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to nondrug approaches to help manage their pain," said Richard L. Nahin, Ph.D., NCCIH's lead epidemiologist and lead author of the analysis.

"Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain." The researchers reviewed 105 U.S.-based randomized controlled trials, from the past 50 years, that were relevant to pain patients in the United States and met inclusion criteria. Although the reporting of safety information was low overall, none of the clinical trials reported significant side effects due to the interventions.

The review focused on U.S.-based trial results on seven approaches used for one or more of five painful conditions - back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine - and found promise in the following for safety and effectiveness in treating pain:

* Acupuncture and yoga for back pain
* Acupuncture and tai chi for osteoarthritis of the knee
* Massage therapy for neck pain with adequate doses and for short-term benefit
* Relaxation techniques for severe headaches and migraine.

Though the evidence was weaker, the researchers also found that massage therapy, spinal manipulation, and osteopathic manipulation may provide some help for back pain, and relaxation approaches and tai chi might help people with fibromyalgia.

"These data can equip providers and patients with the information they need to have informed conversations regarding non-drug approaches for treatment of specific pain conditions," said David Shurtleff, Ph.D., deputy director of NCCIH.

"It's important that continued research explore how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations."

Being pregnant during a heatwave is far from the most pleasant scenario for a woman, but new research finds such extreme temperatures may do more than make expectant mothers uncomfortable; they could increase the risk of preterm birth.

In a study published in the journal Environmental Health Perspectives, researchers from the National Institutes of Health (NIH) found that exposure to extreme cold or intense heat during pregnancy increased women's preterm birth risk by up to a fifth.

According to the Centers for Disease Control and Prevention (CDC), in 2014, around 1 in 10 infants in the United States were born preterm - defined as the birth of a baby before 37 weeks of pregnancy. Preterm birth is the leading cause of infant death in the U.S., and it is also a primary cause of long-term disabilities and neurological disorders, such as cerebral palsy and developmental delay.

There are a number of known risk factors for preterm birth, including a history of preterm delivery, smoking, alcohol, and drug use, and certain medical conditions, such as urinary tract infections and high blood pressure.

Now, senior author Pauline Mendola, Ph.D., of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues suggest extreme temperatures could also be a risk factor for preterm birth and early birth - delivery at between 37-38 weeks of pregnancy.

Mendola and team reached their findings by analyzing the medical records of 223,375 women from 12 medical centers across the U.S. who gave birth between 2002-2008. All women had singleton deliveries. These data were then linked with hourly temperature data - obtained from the Weather Research and Forecasting Model - for the regions surrounding each of the 12 medical centers, in order to determine whether temperatures influenced the women's risk of preterm birth.

Up to 21 percent greater preterm birth risk with extreme heat exposure

For the study, extreme heat was defined as above the 90th percentile of average temperatures, mild temperature was defined as between the 10-90th percentile, while extreme cold was defined as below the 10th percentile.

Overall, the team found that women exposed to extreme heat throughout the duration of pregnancy were 6-21 percent more likely to give birth at 34 weeks or 36-38 weeks of pregnancy, compared with those exposed to mild temperatures.

Compared with women who were exposed to mild temperatures in the first 7 weeks of pregnancy, those who were exposed to extreme cold were 20 percent more likely to give birth before 34 weeks of pregnancy, were 9 percent more likely to give birth at 34-36 weeks, and were 3 percent more likely to give birth at 37-38 weeks.

Women exposed to extreme heat in the first 7 weeks of pregnancy were 11 percent more likely to give birth before 34 weeks and 4 percent more likely to deliver at 37-38 weeks, compared with those exposed to mild temperatures.

The link between extreme cold and preterm birth diminished after 7 weeks, though exposure to extreme heat at 8-14 weeks of pregnancy increased women's risk of giving birth at 37-38 weeks by 4 percent.

Additionally, the researchers found women exposed to extreme heat between 15-21 weeks of pregnancy were 18 percent more likely to give birth at 34 weeks and between 34-36 weeks, and they were 4 percent more likely to give birth at weeks 37-38.

Pregnant women 'should minimize exposure to extreme temperatures'

The researchers are unable to conclude why exposure to extreme cold after 7 weeks of pregnancy did not increase preterm birth risk, but they suggest it is because the effects of cold weather are easier to escape - through seeking shelter, for example - while extreme heat is harder to avoid.

While it is unclear why extreme cold and heat appear to affect preterm birth risk, the team speculates that extreme temperatures might impair placental development or blood flow to the uterus, which can trigger early labor.

The researchers say further studies are needed to gain a better understanding of how extreme temperatures raise the risk of preterm birth, though these current findings should act as a warning for expectant mothers and healthcare providers.

The developing world is awash in substandard, degraded or falsified medications, which can either directly harm users or deprive them of needed treatment. And with internet sales of medications on the rise, people everywhere are increasingly at risk. So, a team of researchers has developed a simple, inexpensive paper-based device to screen suspicious medications.

The researchers will present their work today at the 252nd National Meeting & Exposition of the American Chemical Society (ACS). "People who don't have access to the best-quality medicines also don't have as many resources to buy the analytical instrumentation to detect the quality problems," says Marya Lieberman, Ph.D.

"Instead of a $30,000 instrument, we've developed a $1 paper card. We designed the card so it would be as easy and inexpensive to use as possible."

Medications can be compromised in many different ways. For example, they may be bulked up with fillers, or they can degrade because they are stored improperly. Identifying poor-quality medications is challenging, as inspectors may not know in advance what chemical adulterants or degradation products they need to look for.

Plus, bad-quality medications may contain at least some of the active ingredient, so simply detecting the presence of the real medication isn't enough to rule out issues.

In this study, Lieberman of the University of Notre Dame, along with Hamline University undergraduate Sarah Bliese, developed a card to detect falsified or degraded antibiotics such as ciprofloxacin or ceftriaxone, both of which the World Health Organization lists as "essential." To screen for a variety of potential quality issues, the researchers included 12 lanes separated by wax barriers on the paper device.

Each lane contained a different set of reagents to detect materials or functional groups found in active pharmaceutical ingredients, degradation products or common fillers. To run a sample, the researchers crush a pill and rub the resulting powder across all 12 lanes, and then dip the bottom of the paper card in water for three minutes.

The water wicks up the lanes, bringing reagents into contact with the powder. Colors are formed when the reagents interact with the pharmaceutical, filler or degradation product.

The researchers then compare the color pattern from the sample with the color patterns obtained from high-quality pharmaceutical products. The comparison can be done by eye or with an image-analysis program on a smartphone. Ceftriaxone is sensitive to heat and breaks down if storage temperatures climb too high.

As an experiment, the researchers subjected ceftriaxone to high temperatures and ran the card test, simultaneously analyzing the degradation products via liquid chromatography-mass spectrometry.

They verified that the colorimetric pattern for the degraded antibiotic was different from that of the correctly stored product. In addition to these tests on the pure active ingredient, Lieberman and Bliese analyzed dozens of real-world samples of ceftriaxone from Kenya and Uganda.

Unscrupulous makers of falsified medication sometimes add colorants containing toxic heavy metals to their products to make the illicit pills more closely resemble their legitimate counterparts, Bliese says.

So, in a related project at Hamline University, Bliese and Deanna O'Donnell, Ph.D., are exploring whether a portable X-ray fluorescence spectroscopy device can scan pills for these substances. In June, Lieberman and Bliese traveled to Kenya to test a new paper card which can detect substandard antibiotics.

While Lieberman is currently focusing her work on the developing world, she says her cards could be applicable worldwide to perform, for example, the analysis of herbal medicines and nutritional supplements. "Sometimes those 'herbal products' are actually spiked with pharmaceuticals," she explains.

"The paper test cards could be a defense against this." Bliese says her next project will be to develop a paper test card to help first responders identify drugs of abuse and differentiate them from household products or legitimate medicines.

19/07/2016
Marijuana often is used to self treat chronic pain and, with 24 states legalizing medical use of the herb, the American Pain Society published guidance in The Journal of Pain for physicians caring for patients who use cannabis.

The paper also identified opportunities for future research required to better understand the health effects of cannabinoids. The article is a consensus report with a balanced analysis from experts with diverse opinions about the value of cannabis as a pain treatment. The authors range from legalization advocates to opponents of using cannabis, even for medical purposes.

"We looked at the evidence that is available on the use of clinical cannabis and extrapolated to some degree on management strategies from our experiences with the prescribing of controlled substances," said lead author Seddon R. Savage, M.D., medical director, Silver Hill Hospital Chronic Pain and Recovery Center, in an interview with Medscape at the recent American Pain Society annual meeting.

The article reviews clinical, research and policy issues related to herbal cannabis to counsel clinicians in advising and caring for patients who use cannabis, while recognizing there is a broad range of opinion among pain clinicians and researchers regarding use of herbal cannabis.

However, the authors note that many pain clinicians and researchers agree that cannabinoids are clinically promising chemical compounds, and there is a critical need for robust research on herbal cannabis to identify targets for medical development.

Clinical practice recommendations include:

• Know the federal and state laws governing use of medical cannabis

• Be clear with patients about goals for therapeutic cannabis

• Counsel patients about routes of administration and potential benefits and risks, based on scientific evidence and individual symptoms, conditions and comorbidities

• Advise patients on cannabis strains, cannabinoid medications or extracts, explaining limitations due to lack of herbal/substance uniformity and regulatory oversight

• Monitor patients the same as for treatment with opioids or other controlled substances.

• Patient follow up should assess progress toward achieving treatment goals, incidence of side effects, and evidence of psycho-behavioral changes.

The authors strongly advocate that a robust research agenda is needed to fully realize the clinical potential of cannabinoid therapies.

• Increase federal funding for pain-related cannabis research

• Broaden pain conditions being studied to include cannabis for non-neuropathic pain

• Ease regulatory restrictions that impede approvals of cannabis and cannabinoid research

• Improve access to high-quality plant cannabis for research studies

• Encourage states to collect individual and population level data on patients receiving medical cannabis.

The authors concluded that research on the cultivation of cannabis also is needed. Expanded medical use will require high-quality medicinal grade cannabis with strict quality control and known constituents.

06/06/2016
Acupuncture treatments can reduce the number of hot flashes and night sweats associated with menopause by as much as 36 percent, according to researchers at Wake Forest Baptist Medical Center. The findings are published in the June issue of the journal Menopause.

"Although acupuncture does not work for every woman, our study showed that, on average, acupuncture effectively reduced the frequency of hot flashes and results were maintained for six months after the treatments stopped," said Nancy Avis, Ph.D., professor of public health sciences at Wake Forest Baptist and lead author of the study.

The study, which was funded by National Institutes of Health, included 209 women ages 45 to 60 who had not had a menstrual period for at least three months and had on average at least four hot flashes or night sweats per day in the previous two weeks. Participants received a baseline assessment and were then randomized to one of two groups.

The first group received acupuncture treatments during the first six months. They were then followed without receiving acupuncture for the second six months. The second group did not receive any acupuncture during the first six months, but did receive acupuncture for the second six months. The participants were allowed up to 20 treatments within six months provided by licensed, experienced acupuncturists in the community.

All participants kept a daily diary on the frequency and severity of their hot flashes. They also answered questionnaires about other symptoms every two months. Avis said the study was designed to make it more "real world" by leaving the frequency and number of the acupuncture treatments up to the study participants and their acupuncturists. After six months, the first group reported an average 36.7 percent decline in frequency of hot flashes compared to baseline measurements.

After a year, the benefits persisted, with the group members maintaining an average 29.4 percent reduction from baseline. The second group reported a 6 percent increase in symptom frequency during the six months when they were not getting acupuncture, but had similar results - an average 31 percent reduction in frequency - to the first group after receiving acupuncture during the latter part of the trial.

"There are a number of non-hormonal options for treating hot flashes and night sweats that are available to women," Avis said. "None of these options seem to work for everyone, but our study showed that acupuncture from a licensed acupuncturist can help some women without any side effects. Our study also showed that the maximum benefit occurred after about eight treatments."

Avis cautioned that the effect shown in the study could be due to non-specific effects such as the additional care and attention the study participants received or the expectation of a benefit. She also said that additional research is needed to identify individual differences in response to acupuncture.

18/05/2016
Exercise can have a positive influence on certain symptoms of multiple sclerosis: Patients who do yoga and aquatic exercise suffer less from fatigue, depression and paresthesia, as reported by researchers from the University of Basel and the Psychiatric University Clinics Basel in a joint study with colleagues in Iran.

Multiple sclerosis (MS) is a chronic progressive auto-immune disease in which the body's own immune system attacks the nervous tissue, potentially resulting in movement disorders. Other typical symptoms of MS include physical and mental fatigue as well as faintness, depression and paresthesia such as pins and needles, itchiness and numbness.

Increased risk of depression
In a random trial, researchers from Basel and Kermanshah (Iran) have now shown that these symptoms significantly improved after an eight-week program of yoga and aquatic exercise.

In comparison to the control group, fatigue, depression and paresthesia were significantly reduced in patients who took part in a three-times weekly training program. In the non-exercising group, the likelihood of moderate to severe depression was 35-fold higher than in the groups who had done yoga or aquatic exercise.

Fifty-four women with MS and an average age of 34 were assigned to one of three groups: yoga, aquatic exercise or no exercise. Before and after the trial, patients were asked to complete a questionnaire about their symptoms. All patients continued with their existing treatment, including any medication taken to regulate the immune system.

Exercise as a complementary therapy
"Exercise training programs should be considered in the future as possible complements to standard MS treatments," write the researchers.

Researchers from the Kermanshah University of Medical Sciences in Iran, the Psychiatric University Clinics (UPK Basel, Center for Affective, Stress and Sleep Disorders) and the University of Basel's Department of Sport, Exercise and Health took part in the study.

03/05/2016
For the first time, a team of international experts recommends that most people do not need to fast before having their cholesterol and triglyceride levels tested.

Fasting is a problem for many patients, they explain, and note the latest research shows that cholesterol and triglyceride levels are similar whether people fast or not. The experts represent the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) joint consensus initiative.

They refer to new research from Denmark, Canada, and the United States that included over 300,000 people and found it is not necessary to have an empty stomach to check cholesterol levels. Apart from Denmark, all countries require that patients fast for at least 8 hours before checking their cholesterol and triglyceride levels - referred to as "lipid profile." In Denmark, non-fasting blood sampling has been in use since 2009.

Arguing their case in a European Heart Journal article, the experts say fasting is a "barrier to population screening" and can be a problem for many patients, particularly children, older adults, diabetes patients, and workers.

"Interestingly, evidence is lacking that fasting is superior to non-fasting when evaluating the lipid profile for cardiovascular risk assessment," they note. "However, there are advantages to using non-fasting samples rather than fasting samples for measuring the lipid profile."

Non-fasting and fasting tests 'not mutually exclusive'
In the journal article, the researchers discuss fasting and non-fasting lipid profile testing and recommends non-fasting for most patients, but they note there are cases when fasting tests are sometimes required, and the two tests should be "viewed as complementary and not mutually exclusive."

Non-fasting is recommended for most patients, particularly if it is their first lipid profile test, if it is for cardiovascular risk assessment, or if patients express a preference for a non-fasting test. Non-fasting is also recommended for children, elderly patients, patients on stable drug therapy, and patients admitted with acute coronary syndrome - they will need repeated lipid profile testing later because the condition lowers lipid concentrations.

Diabetic patients should also have non-fasting tests because of higher risk of hypoglycemia, and because fasting can mask high levels of triglycerides (hypertriglyceridemia). A fasting test can sometimes be required if the non-fasting test shows triglyceride levels above 5 mmol/L (440 mg/dL). There will also be other specific cases, relating to hypertriglyceridemia, when fasting tests will be necessary.

For example, patients with known hypertriglyceridemia being followed in lipid clinic, starting on medications that cause severe hypertriglyceridemia, and recovering from pancreatitis caused by hypertriglyceridemia. There may also be specific cases where the lab test requires a fasting or morning sample - for example, to test fasting glucose or in monitoring certain drug effects.

However, even in the case of fasting glucose, the authors note that in many countries this measurement is being replaced by measurement of hemoglobin A1c without the need to fast.

Non-fasting testing 'will improve patient compliance'
The team says that in Denmark, patients, doctors, and testing labs have all benefited from non-fasting testing. It cuts the cost of return visits, emails, phone calls, and follow-up. Doctors also spend less time having to review tests at a later date.

First author Børge Nordestgaard, a professor in the Department of Clinical Medicine at Herlev Hospital, University of Copenhagen, says moving to a system of non-fasting lipid profile testing "will improve patients compliance to preventive treatment aimed at reducing number of heart attacks and strokes, the main killers in the world."

More patients having the tests also gives doctors opportunity to advise more people on how to prevent heart attacks and strokes, he says.

07/03/2016
For people who want to control their weight or reduce their intakes of sugar, sodium and saturated fat, tap water may be what the doctor ordered.

A new study that examined the dietary habits of more than 18,300 U.S. adults found the majority of people who increased their consumption of plain water - tap water or from a cooler, drinking fountain or bottle - by 1 percent reduced their total daily calorie intake as well as their consumption of saturated fat, sugar, sodium and cholesterol.

People who increased their consumption of water by one, two or three cups daily decreased their total energy intake by 68 to 205 calories daily and their sodium intake by 78 to 235 grams, according to a paper by University of Illinois kinesiology and community health professor Ruopeng An. They also consumed 5 grams to nearly 18 grams less sugar and decreased their cholesterol consumption by 7 to 21 grams daily.

"The impact of plain water intake on diet was similar across race/ethnicity, education and income levels and body weight status," An said. "This finding indicates that it might be sufficient to design and deliver universal nutrition interventions and education campaigns that promote plain water consumption in replacement of beverages with calories in diverse population subgroups without profound concerns about message and strategy customization."

An examined data from four waves (2005-12) of the National Health and Nutrition Examination Survey, conducted by the National Center for Health Statistics. Participants were asked to recall everything they ate or drank over the course of two days that were three to 10 days apart. An calculated the amount of plain water each person consumed as a percentage of their daily dietary water intake from food and beverages combined.

Beverages such as unsweetened black tea, herbal tea and coffee were not counted as sources of plain water, but their water content was included in An's calculations of participants' total dietary water consumption. On average, participants consumed about 4.2 cups of plain water on a daily basis, accounting for slightly more than 30 percent of their total dietary water intake.

Participants' average calorie intake was 2,157 calories, including 125 calories from sugar-sweetened beverages and 432 calories from discretionary foods, which are low-nutrition, calorie-dense foods such as desserts, pastries and snack mixes that add variety to but are not necessary for a healthy diet.

A small but statistically significant 1 percent increase in participants' daily consumption of plain water was associated with an 8.6-calorie decrease in daily energy intake, as well as slight reductions in participants' intake of sugar-sweetened beverages and discretionary foods along with their consumption of fat, sugar, sodium and cholesterol.

While An found that the decreases were greater among men and among young and middle-aged adults, he suggested they could have been associated with these groups' higher daily calorie intakes. The study was published in the Journal of Human Nutrition and Dietetics.

10/02/2016
Aggression can lead to generation of new nerve cells in the brain and also change the activity of existing cells, new research has found.

A team of neurobiologists from the US and Russia studied the changes that occurred in the brains of mice demonstrating aggressive behaviour, which attacked other mice and won in fights. After a win, these mice became even more aggressive, and new neurons appeared in their hippocampus - one of the key structures of the brain, the researchers found.

In addition to this, in mice that were allowed to continue fighting certain changes were observed in the activity of their nerve cells. The findings were published in the journal Frontiers in Neuroscience.

The scientists hope that the new information on the neurobiological bases of aggression will not only help in understanding this important phenomenon, but will also encourage research in other areas -- and even help in finding causes of autism and other similar disorders in humans.

Increased anxiety, stereotypical repetitive behaviour, impaired ability to communicate with others - symptoms partially similar to autism - were observed in the mice with more new neurons in the hippocampus.

"Once again I am amazed at how the basic building blocks that make up complex behaviour are similar in different organisms and it is truly fascinating how they can be combined with other blocks to create an enormous variety of behavioural reactions in animals and humans," said corresponding author of the study Grigori Enikolopov from Moscow Institute of Physics and Technology in Russia.

02/02/2016
A disease linked to the Zika virus in Latin America poses a global public health emergency requiring a united response, says the World Health Organization.

Experts are worried that the virus is spreading far and fast, with devastating consequences. The infection has been linked to cases of microcephaly, in which babies are born with underdeveloped brains. The WHO alert puts Zika in the same category of concern as Ebola. It means research and aid will be fast-tracked to tackle the infection. There have been around 4,000 reported cases of microcephaly in Brazil alone since October.

WHO director general, Margaret Chan called Zika an "extraordinary event" that needed a co-ordinated response.

"I am now declaring that the recent cluster of microcephaly and other neurological abnormalities reported in Latin America following a similar cluster in French Polynesia in 2014 constitutes a public health emergency of international concern."

She said the priorities were to protect pregnant women and their babies from harm and to control the mosquitoes that are spreading the virus. She advised pregnant women: to consider delaying travel to areas affected by Zika seek advice from their physician if they are living in areas affected by Zika, as well as protect themselves against mosquito bites by wearing repellent Dr Chan justified declaring an emergency even amid uncertainties about the disease, saying it was time to take action.

The WHO faced heavy criticism for waiting too long to declare the Ebola outbreak a public emergency. Currently, there is no vaccine or medication to stop Zika. The only way to avoid catching it is to avoid getting bitten by the Aedes mosquitoes that transmit the infection.

The WHO has already warned that Zika is likely to "spread explosively" across nearly all of the Americas. More than 20 countries, including Brazil, are reporting cases. Most infections are mild and cause few or no symptoms, although there have been some reported cases of a rare paralysis disorder called Guillain-Barre syndrome. The bigger health threat though is believed to be in pregnancy, to the unborn child.

Dr Jeremy Farrar, Director of the Wellcome Trust, said: "There is a long road ahead. As with Ebola, Zika has once again exposed the world's vulnerability to emerging infectious diseases and the devastation they can unleash. Alongside the emergency response that Zika necessitates, we must put in place the permanent reforms, health systems strengthening and proactive research agenda that are needed to make the global health system more resilient to the threat of future pandemics."

04/01/2016
Music therapy increases effectiveness of pulmonary rehabilitation for COPD patients.

Patients with Chronic Obstructive Pulmonary Disease (COPD) and other chronic respiratory disorders who received music therapy in conjunction with standard rehabilitation saw an improvement in symptoms, psychological well-being and quality of life compared to patients receiving rehabilitation alone, according to a new study by researchers at The Louis Armstrong Center of Music and Medicine at Mount Sinai Beth Israel (MSBI).

Study findings were published this week in Respiratory Medicine and suggest that music therapy may be an effective addition to traditional treatment. COPD is the fourth leading cause of death in the United States with symptoms including shortness of breath, wheezing, an ongoing cough, frequent colds or flu, and chest tightness. Patients with COPD are often socially isolated, unable to get to medical services and underserved in rehabilitation programs, making effective treatment difficult.

The 68 study participants were diagnosed with chronic disabling respiratory diseases, including COPD. Over the course of six weeks, a randomized group of these patients attended weekly music therapy sessions. Each session included live music, visualizations, wind instrument playing and singing, which incorporated breath control techniques.

Certified music therapists provided active music-psychotherapy. The music therapy sessions incorporated patients' preferred music, which encouraged self-expression, increased engagement in therapeutic activities and an opportunity to cope with the challenges of a chronic disease.

"The care of chronic illness is purposefully shifting away from strict traditional assessments that once focused primarily on diagnosis, morbidity and mortality rates," said Joanne Loewy, DA, Director of the Louis Armstrong Center for Music and Medicine at MSBI, where the study was conducted.

"Instead, the care of the chronically ill is moving toward methods that aim to preserve and enhance quality of life of our patients and activities of daily living through identification of their culture, motivation, caregiver/home trends and perceptions of daily wellness routines."

"Music therapy has emerged as an essential component to an integrated approach in the management of chronic respiratory disease," said Jonathan Raskin, MD, co-author of the study and Director of the Alice Lawrence Center for Health and Rehabilitation at MSBI.

"The results of this study provide a comprehensive foundation for the establishment of music therapy intervention as part of pulmonary rehabilitation care."

07/12/2015
New understanding of how nicotine causes addiction has emerged, according to research published in eLife.

Although smoking rates are declining, a consistent portion of the population continues to smoke, making continued research into tobacco addiction important. One reason people find it hard to quit smoking is that each time they have a cigarette, feelings of craving, irritability and anxiety melt away. This is known as negative reward and is partly controlled by a region of the brain called the habenula.

The neurotransmitters acetylcholine and glutamate are thought to influence nicotine dependence in the habenula, but the molecular details of this regulation are unclear. Neurotransmitters are the chemical messengers of the brain. They are packaged into spherical structures at the ends of neurons, called vesicles. On receiving certain signals, neurons release their vesicle contents into the synapse, sending the signal on to the next neuron.

Neurons can recycle neurotransmitters by reabsorbing them through reuptake, a process that allows them to control the exact number of neurotransmitters in the synapse. Even a small upset in the balance of neurotransmitters can affect behavior. In the case of acetylcholine, it can influence our ability to cope with addiction.

Ines Ibanez-Tallon, and colleagues from Rockefeller University in New York, knew that acetylcholine and glutamate played important roles in the neurons in the habenula - but not how they might interact to reinforce addiction.

Acetylcholine controls glutamate release

The researchers created a mouse model where a key gene involved in acetylcholine processing was missing; this prevented acetylcholine production in habenular neurons. The elimination of acetylcholine affected glutamate in the habenula in two ways. First, the amount of glutamate released by neurons was reduced; second, the reuptake of glutamate back into vesicles was impaired.

Both of these mechanisms disrupt normal signaling, thus affecting the excitability of neurons. Based on these findings, the researchers suggest that acetylcholine regulates how much glutamate is released into the synapse, and at what frequency. It also facilitates the packaging of glutamate into vesicles. Studies using electron microscopy confirmed that the neurotransmitters are in the same place at the same time and are able to affect one another.

Removing acetylcholine decreases sense of reward

When the researchers removed acetylcholine from the habenula of the mice, the mice became insensitive to the rewards of nicotine. They did not develop a tolerance to continued nicotine exposure, nor did they experience withdrawal symptoms, such as body shakes and scratching.

The findings suggest that without acetylcholine, nicotine addiction would not occur. They also reveal new clues about the brain circuitry involved in nicotine dependence, which is relevant to opioid and cannabinoid addiction. In future, the researchers hope to examine how the interaction between acetylcholine and glutamate might work in other areas of the brain.

24/11/2015
Three-month treatment with sildenafil (Viagra) improved insulin sensitivity in overweight patients with prediabetes, according to a small trial reported in the Journal of Clinical Endocrinology & Metabolism.

The treatment also lowered urinary albumin excretion and improved fibrinolytic balance, said senior investigator Nancy Brown, MD, of the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues.

"We need additional strategies to help slow the progression from prediabetes to diabetes," Brown said in a statement. "Weight loss and exercise regimens can be difficult to maintain, and some current medications have been limited by concerns about adverse effects. Sildenafil and related drugs could offer a potential avenue for addressing the rising number of diabetes diagnoses."

In addition, she said, "because existing drug therapies to prevent type 2 diabetes can have negative effects on the heart or be of limited use in patients with kidney disease, strategies to prevent diabetes without adversely affecting the risk of kidney and heart disease could have a large impact on public health."

Previous studies have reported that treatment with a phosphodiesterase-5 (PDE5) inhibitor improved measures of insulin sensitivity in insulin-resistant and severely obese patients, Brown and colleagues noted. The current study enrolled 51 overweight patients with prediabetes, about two-thirds of whom were women. The investigators collected blood samples and measured insulin resistance via hyperglycemic clamp at baseline.

The volunteers were then randomized to receive either sildenafil 25 mg three times per day or a matching placebo. Volunteers underwent a second hyperglycemic clamp and blood tests after 3 months.

The study's primary endpoints were measures of insulin resistance including the insulin sensitivity index, glucose-stimulated insulin secretion, and the disposition index, a composite measure of insulin sensitivity and secretion. Secondary endpoints included blood pressure, levels of tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1), urine albumin and creatinine, body weight, resting energy expenditure, and the incidence of side effects.

Key results included the following: The insulin sensitivity index was significantly greater in the treatment group compared to the placebo group by 1.84 mg/kg/min per µU/mL*100 (95% CI 0.01-3.67; P=0.049). There was a weak trend toward a higher disposition index in the treatment group by 83.5 mg/kg/min (95% CI -7.01-174.02 mg/kg/min; P=0.70.)

The investigators found no significant effect of treatment on first-phase or late phase glucose-stimulated insulin secretion. Sildenafil treatment also had no significant effect on body weight, resting energy expenditure, or blood pressure, Brown and colleagues reported. The urine albumin-to-creatinine ratio decreased in the treatment group from 12.67 ± 14.67 µg/mg to 6.84 ± 4.86 µg/mg.

In contrast, the ratio increased from 8.45 ± 14.17 µg/mg to 13.41 ± 17.71 µg/mg in the placebo group (P=0.036 for the treatment effect). Sildenafil also significantly reduced PAI-1 concentrations (P=0.01) without affecting t-PA.

These findings suggest PDE5 inhibition may improve glucose homeostasis while avoiding detrimental effects on fibrinolysis, Brown and colleagues wrote. Four patients in the treatment group and three in the placebo group discontinued because of side effects, a nonsignificant difference, the investigators said.

"In conclusion, our study suggests that chronic PDE5 inhibition improves insulin sensitivity, fibrinolytic balance, and albuminuria in subjects with prediabetes," Brown and colleagues wrote. "Larger randomized trials using clinical endpoints are needed to assess whether PDE5 inhibition can prevent the onset of diabetes in high-risk patients."

"The present study does not address the mechanism through which PDE5 inhibition improves tissue insulin sensitivity," Brown and colleagues noted, adding that, "In rodent models, sildenafil improves muscle glucose uptake through recruitment of vasculature and has no effect on insulin signaling in the muscle."

"Future studies of the effect of PDE5 inhibition on insulin signaling in muscle biopsies after hyperinsulinemia are needed to address this mechanism," they said. An important limitation of the study was the exclusion of patients with renal dysfunction.

"Studies are needed to assess the effect of long-term PDE5 inhibition on albuminuria in patients who are heterogeneous with respect to renal function," Brown and colleagues said.

Why did PDE5 inhibition improve insulin sensitivity but not glucose-stimulated insulin secretion? "Insulin sensitivity and insulin secretion are controlled by different factors," Brown told MedPage Today via email. "If insulin sensitivity improves, the body does not need to make as much insulin to maintain normal glucose."

"We plan a longer and larger study to look at effects [of PDE5 inhibition] on glucose, hemoglobin A1C, and urine albumin," Brown said.

Drugs produced using biotechnology are among the most expensive medicines available. Biosimilars that offer a real alternative are becoming increasingly available on the market.

The promise of biosimilars is that, once patent protection has elapsed for established biologics, more patients will be able to access effective and well-tolerated drugs. This is particularly true in relation to preparations used in the treatment of patients with cancer and autoimmune diseases, which also include drugs used for the treatment of rheumatic diseases.

In 2001, as part of a project led by the European Medicines Agency, step-by-step guidelines were introduced to regulate the approval of these products, and to acknowledge the specific differences that distinguish biosimilars from traditional medicines.

Biosimilars are complex proteins which, although not required to be identical to their originator products, have to be similar to them in terms of both effect and tolerability. One of the main differences is of course that biosimilars are, or are set to be, available at significantly lower prices than those of the originator products.

Prof. Dr. Thomas Dörner, from the Medical Department, Division of Rheumatology and Clinical Immunology at Charité, stresses that "the introduction of these medicines needs to be handled in a responsible manner, and requires the input of experienced practitioners."

Prof. Dörner adds that "the decision as to which medicine a patient is to be given should remain the responsibility of the treating physician. What must not be allowed to happen is what is currently happening with traditional generics, namely that pharmacies automatically substitute one product for another."

For their article, the authors analyzed a wealth of information on the development of biosimilars. Their review, which covers almost every biological drug available, also addresses the enormous variations currently seen in approval processes across the globe. Their findings suggest that the introduction of biosimilars into clinical practice must go hand-in-hand with the creation of national registers, which allow data on potential side effects to be collated.

The authors conclude that the approval and introduction of biosimilars offer access to both established and new treatment options. Biosimilars are also likely to reduce the costs associated with the treatment of inflammatory diseases in the fields of rheumatology, dermatology, and gastroenterology.

07/10/2015
Tai Chi linked to improved physical capacity in certain common long term conditions.

The ancient Chinese exercise Tai Chi is linked to improved physical capacity among older adults with certain common long term conditions, indicates a pooled analysis of the available evidence, published online in the British Journal of Sports Medicine.

Among people with breast cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD), these improvements were not at the expense of worsening pain or breathlessness, the findings show. Tai Chi consists of slow, gentle, flowing movements that aim to boost muscle power, balance, and posture. It also includes mindfulness, relaxation, and breath control.

The researchers wanted to find out how effective Tai Chi was in long term conditions that are common among older adults. So they trawled electronic research databases for relevant studies published up to 2014, on the use of Tai Chi in people with cancer, osteoarthritis, heart failure, and COPD. They wanted to find out if Tai Chi relieved symptoms, and improved physical capacity and quality of life in all four long term conditions.

Out of 1102 articles, 33, involving 24 studies and 1584 participants, were suitable for inclusion; 21 studies were included in the pooled analysis. The average age of participants ranged from the mid 50s to the early 70s, while the average length of the Tai Chi training programme was 12 weeks, with most sessions lasting an hour. Tai Chi training was usually offered two to three times weekly.

The results showed that Tai Chi was associated with trends, or definite improvement, in physical capacity and muscle strength in most or all four long term conditions. This included improvements in the six minute walking test; muscle strength, as measured by bending and stretching the knees; the time it takes to get up and move known as the TUG test; and quality of life.

Tai Chi was also associated with an improvement in the symptoms of pain and stiffness in osteoarthritis and in breathlessness in COPD. And it was associated with improved sit to stand times among patients with osteoarthritis. This is an observational study so no definitive conclusions can be drawn about cause and effect, added to which the only cancer included in the analysis was breast cancer.

But the findings back those of previous research, and provide a reasonable starting point to look at the value of exercise programmes, such as Tai Chi, for people with several co-existing long term conditions, say the researchers.

"Tai Chi can improve some physical performance outcomes in four chronic conditions...but not at the expense of worsening pain or dyspnoea [breathlessness]," they write, adding that it "may provide a suitable exercise stimulus for people with several comorbidities," and could be used as a complementary therapy in some long term conditions.

As more people live sedentary lifestyles, it seems that any type of movement may be good for us. A recent study published in the American Journal of Preventive Medicine suggests that fidgeting, traditionally considered unacceptable in some circles, could decrease the risk of mortality in those who sit for much of the day.

The study, led by researchers at Leeds University and University College London, both in the UK, builds on growing evidence suggesting that a sedentary lifestyle is bad for one's health, even if the individual is physically active outside work.

According to the American Heart Association, the number of sedentary jobs in the US has increased by 83% since 1950; in 1960, people working in physically active jobs represented 50% of the workforce, compared with less than 20% today.

Statistics show that even adults who meet recommended physical activity levels and who sleep for 8 hours per night may spend up to 15 hours a day sitting down. Previous research has indicated that breaks in sitting time are markers of good health, such as body mass index (BMI), glucose and insulin responses.

The current study follows on from a larger project, the UK Women's Cohort Study, which focused initially on the eating patterns of 35,000 women.

Women who fidget fare better with sedentary lifestyle

In 1999-2002, the team invited 12,778 of the same women, ages 37-78, to answer questions about health behaviors, diet, smoking status, alcohol consumption, chronic disease, physical activity levels and fidgeting.

Participants were followed up for mortality over an average of 12 years, and the relative risk of mortality was estimated in the high (vs. low) and medium (vs. low) sitting time groups. In women who sat for long periods but considered themselves "moderately or very fidgety," no increased risk or mortality was established as a result of the sitting.

The risk only appeared to increase in the case of "very occasional fidgeters." "While further research is needed, the findings raise questions about whether the negative associations with fidgeting, such as rudeness or lack of concentration, should persist if such simple movements are beneficial for our health."

Earlier this month, Medical News Today reported on research suggesting a link between sedentary behavior and nonalcoholic fatty liver disease.

09/09/2015
Alternative medicines are widely thought to be at least harmless and very often helpful for a wide range of discomforts and illnesses.

However, although they're marketed as "natural," they often contain active ingredients that can react chemically and biologically with other therapies. Researchers performed a comprehensive review of all of the medications taken by senior oncology patients and found that as 26 percent were using complementary or alternative medicines (CAM), in a report published August 12th, in the Journal of Geriatric Oncology.

"Currently, few oncologists are aware of the alternative medicines their patients take," says Ginah Nightingale, PharmD, an Assistant Professor in the Jefferson College of Pharmacy at Thomas Jefferson University. "Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn't specifically ask."

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Zika situation declared an emergency

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Fidgeting may be good for health

High use of alternative medicine in senior oncology patients

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Learning disability GP health checks show results

Yoga has potential to reduce risk factors of CVD

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Serotonin may not be a major factor in depression

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UN 'lacks resources' to fight deadly virus

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Study reveals how loud noises can damage hearing