Wednesday, December 13, 2017

Even Non-Heart Surgery May Harm Your Heart


Older adults commonly suffer damage to heart cells during various types of surgery – even non-heart related surgeries – and it can significantly raise their risk of dying from the procedure, a new study finds.

The research looked at a phenomenon called perioperative myocardial injury, or PMI. It refers to subtler heart damage that can happen during or soon after any type of surgery. Old patients and those who already have heart disease are at increased risk.

However, the condition is easily missed because most of the affected patients have no chest pain or other symptoms, according to Dr. Christian Puelacher, the first author on the new study. He’s a clinical researcher at Cardiovascular Research Institute Basel in Switzerland.

Puelacher’s team found that PMI may happen more often than doctors have typically thought: Of more than 2,000 high-risk patients screened, 1 in 7 developed PMI after a non-cardiac surgery, the study found.

“This suggests we’ve underestimated the number of myocardial [heart] injuries that occur during non-cardiac surgery,” said Dr. Alistair Phillips, co-chair of the surgeons’ section leadership council for the American College of Cardiology.

The cases were found because all of the patients – treated at the University Hospital Basel in Switzerland – were screened for PMI with a newer blood test: a so-called “high sensitivity” troponin test, which detects elevations in the heart protein troponin. When troponin levels rise, it’s a sign of heart damage, Phillips explained.

Monday, December 11, 2017

Birth Control Pill Tied to Slight Rise in Breast Cancer Risk

Newer versions of the birth control pill carry a similar increased risk of breast cancer as earlier ones that were abandoned in the 1990s, a new study reveals.

Woman taking modern formulations of the pill have a 20% increased risk of breast cancer compared with those who’ve never been on hormonal contraception, the study of almost 2 million Danish women found.

“The risk increases with increasing duration of use and persists for more than five years, if used for longer than five years,” said study author Lina Morch, a senior epidemiologist with the University of Copenhagen in Denmark.

Still, experts cautioned that the absolute risk of breast cancer for any one women on the Pill remains very low.

Nevertheless, a similar amount of risk prompted the U.S. Food and Drug Administration to yank high-estrogen formulations of the pill off the market back in the early 1990s, said Mia Gaudet, strategic director of breast and gynecologic cancer research for the American Cancer Society.

“There had been some changes to oral contraceptive formulations in the ‘90s, and there was the hope those formulations would result in a lower risk of breast cancer,” said Gaudet, who was not part of the study. “We see from this data that is not the case.”

The first wave of birth control pills contained doses as high as 150 mg of estrogen. As research began to link estrogen to breast cancer, the FDA took off the market any formulations that had more than 50 mg of estrogen, Gaudet said.

Friday, December 8, 2017

Intense Workouts May Boost Memory

The study of 95 healthy young adults showed that six weeks of 20-minute bouts of interval training led to significant improvements in what’s called high-interference memory. An example of this type of memory is distinguishing your car from another of the same make and mode.

Canadian scientists also found these workouts led to increases in a protein involved in the growth, function and survival of brain cells. The results were published in the November issue of the Journal of Cognitive Neuroscience.

The findings could prove important as an aging population leads to higher rates of Alzheimer’s disease and other types of dementia, according to the researchers from McMaster University in Hamilton, Ontario.

“Improvements in this type of memory from exercise might help to explain the previously established link between aerobic exercise and better academic performance,” said study author Jennifer Heisz. She’s an assistant professor in the department of kinesiology at McMaster.

“At the other end of our lifespan, as we reach our senior years, we might expect to see even greater benefits in individuals with memory impairment brought on by conditions such as dementia,” she added in a university news release.

The researchers are now assessing how exercise and metal training affects high-interference memory in older adults. “One hypothesis is that we will see greater benefits for older adults, given that this type of memory declines with age,” Heisz said.

Wednesday, December 6, 2017

Wisdom Wednesday: DAO Deficiency


Diamine oxidase (DAO) is the major enzyme involved in histamine metabolism and is responsible for ensuring a steady histamine level required for the balance of numerous chemical reactions taking place in the body.

DAO is the key enzyme responsible for the degradation of extracellular (free) histamine, regardless of whether the histamine originates from allergy-induced processes in the body or is consumed with food.

Histamine exerts its effects by binding to its 4 receptors: H1R, H2R, H3R and H4R on target cells in various tissues. Histamine receptors are located all over the body and have many important functions including:
  • H1 receptors: Smooth muscle and endothelial cells affecting skin; blood vessels (Benadryl and Claritin block activity of these receptors)
  • H2 receptors: Cells in the intestines control acid secretion, abdominal pain, and nausea; heart rate
  • H3 receptors: Central nervous system controlling nerves, sleep, appetite and behavior.
  • H4 receptors: Thymus, small intestine, spleen, colon, bone marrow and white blood cells; inflammatory response

The DAO gene is also involved in the metabolism of glutamate, an excitatory neurotransmitter found to be elevated in those with schizophrenia and bipolar disorders. The DAO snippet can be identified in genetic testing, like 23andme. If you have a primary deficiency it can lead to significantly reduced DAO enzyme activity. Individuals with a DAO gene mutation may have a tendency towards high histamine.

The DAO enzyme is dependent on vitamin B6, B12, iron, copper and vitamin C. Excess zinc will prevent copper absorption and may also be an issue in the diet.

Monday, December 4, 2017

Hospital Midwives, Lower C-Section Rates?

Expectant mothers seeking to lower their risk of a cesarean delivery might want to consider getting a midwife involved, a new study suggests.

In addition, midwives were tied to less need for a surgical incision called an episiotomy during childbirth, the researchers reported.

“More midwife-attended births may correlate with fewer obstetric procedures, which could lower costs without lowering the quality of care,” wrote study co-authors Laura Attanasio, of the University of Massachusetts Amherst, and Katy Kozhimannil of the University of Minnesota School of Public Health.

The study findings are based on 126 hospitals in New York state.

About 25% of those hospitals had no midwives. About half had midwives, but they attended less than 15% of births. At 7% of the hospitals, however, midwives attended more than four out of 10 births, according to the study.

In 2014, when the research was conducted, midwives were present at only 9% of U.S. births, the researchers noted. In other western countries – such as Australia, France and the United Kingdom – midwives attend two-thirds of births.

“This study is contributing to a body of research which shows that good outcomes for women at low risk in childbirth go hand-in-hand with lower use of medical procedures,” Attanasio said in a news release from the universities.

Friday, December 1, 2017

It’s the Latest Diet Craze, But Is It Safe?

A nutritional fad called CICO – short for “Calories In, Calories Out” promises you can eat whatever you want, junk food included, and still shrink your waistline – as long as every day you expend more calories than you consume.
It’s a simplified approach to eating that essentially views fruits and vegetables through the same prism as candies and soda. All that matters is the total caloric tally.

Perhaps not surprisingly, many nutritional experts disagree. “Be healthy isn’t just about weight loss alone,” noted Lona Sandon, program director and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. “You have to consider the whole package.”

Sandon acknowledged that those who adopt a CICO approach to eating “might actually lose weight.” But there’s a downside: “nutrient deficiencies or even malnutrition,” she warned.

“You may not be providing all the nutrients your body needs if you are not paying attention to the types of foods you are putting in your body,” Sandon Said. “This could mean osteoporosis later in life, increased risk of cancer, heart disease, etcetera.”

Dietitian Connie Diekman added, “Weight loss, in an unhealthy way, is never a good idea.” She’s director of university nutrition at Washington University in St. Louis. “Managing calories to achieve weight loss is important, but if important nutrients are missing, then muscle mass will decline, bone health, mental acuity and many other essential functions will be compromised,” Diekman said.

Wednesday, November 29, 2017

Wisdom Wednesday: Taking Four or More Prescription Meds? Consider Scaling Back


More than half of Americans regularly take about four prescription medications, increasing the likelihood that mistakes could occur, according to Consumer Reports.

People taking multiple prescription medications should visit their doctor for a “medication checkup.”

By showing their doctor or pharmacist a comprehensive list of every drug they are taking, including vitamins and other dietary supplements, patients can be warned about potentially harmful interactions. They can also find out if any of these medications are no longer necessary, which would save them money.

Consumer Reports encourages patients to have this type of medication review at least once a year.

“Much medication use is lifesaving, without a doubt. But some drugs can potentially do more harm than good,” said Lisa Gill, deputy editor of Consumer Reports. “Our concern is that inappropriate prescribing can lead to unnecessary risk, including trips to the emergency room,” she said in a news release from the organization. “We hope to encourage consumers to talk with their health care providers about the meds and supplements they take, so they can ultimately lower their risk,” Gill said.

Use of prescription drugs has surged over the past 20 years. The U.S. population has increased just 21%, but the total number of prescriptions filled by Americans has surged 85% - from 2.4 billion prescriptions in 1997 to 4.5 billion in 2016, Consumer Report said.

“There are many root causes, including a ‘culture of prescribing.’ Perhaps most worrisome is prescribing for pre-disease stages of a condition, such as pre-osteoporosis or pre-diabetes, where the medications offer limited benefit for people,” Gill said. “And we’ve seen a push to treat common problems like back pain, heartburn and insomnia with medication before trying effective, non-drug measures first,” she said.

People who are on multiple medications also need to be extra careful about possible interactions.