June

Office workers who spend long hours looking at computer screens have changes in their tear fluid similar to people with the disease known as dry eye, according to a study from Japan.

The protein MUC5AC, secreted by cells in the upper eyelid, makes up part of the normally occurring mucus layer, or “tear film,” that keeps the eye moist. But study participants with the most screen time had MUC5AC levels nearing those of people with diagnosed dry eye.

“To understand patients’ eye strain, which is one of major symptoms of dry eye disease, it is important that ophthalmologist pay attention to MUC5AC concentration in tears,” said Dr. Yuichi Uchino, an author of the new study.

Uchino is an ophthalmologist at the School of Medicine at Keio University in Tokyo.

“When we stare at computers, our blinking times decreased compared to reading a book at the table,” he told Reuters Health by email.

People staring at screens also tend to open their eyelids wider than while doing other tasks, and the extra exposed surface area in addition to infrequent blinking can accelerate tear evaporation and is associated with dry eye disease, he said.

Dry eye may be chronic for some but can be managed with over the counter or prescription eye drops.

Past research suggests that up to 5 million men and women over age 50 in the United States suffer from dry eye disease, the researchers write in their report. In Japan, tens of millions of people report some dry eye symptoms, often associated with computer work, they add.

The study team tested the tears from both eyes of 96 Japanese office workers, about two-thirds of them men, and measured how much of the total protein content of the tears was MUC5AC.

Workers employed in jobs involving computer screens filled out questionnaires about their working hours and symptoms of any eye problems.

Seven percent of men and 14 percent of women were diagnosed with ‘dry eye disease,’ meaning they reported symptoms of eye problems like irritation, burning or blurred vision and had poor quality or quantity of tear film, according to the tests.

Overall, participants looked at screens for work for just over eight hours a day and had an average of about 6.8 nanograms of MUC5AC per milligram of protein in each eye.

However, people who worked with computer screens for more than seven hours per day had an average of 5.9 ng/mg of MUC5AC, compared to 9.6 ng/mg for people who spent fewer than five hours daily with screens.

Similarly, people with definite dry eye disease had an average of 3.5 ng/mg of MUC5AC compared to 8.2 ng/mg for people without the disease.

“Mucin is one of the most important components of the tear film,” said Dr. Yuichi Hori, who was not a part of the new study. “Mucins (like MUC5AC) function to hold water on the ocular surface of the epithelia that synthesize them, hence, they are major players in maintenance of the tear film on the ocular surface,” Hori told Reuters Health by email.

He is chair of the department of Ophthalmology at Toho University Omori Medical Center in Tokyo.

Concentration of the protein was also lower for people with symptoms of eye strain than for people without symptoms, according to the results published in JAMA Ophthalmology.

People with dry eyes at work tend to be less productive and are more likely to be depressed, according to previous studies, Uchino said.

Office workers who are worried about dry eye can make some simple changes to decrease their risk, Uchino said.

“The exposed ocular surface area can be decreased by placing the terminal at a lower height, with the screen tilted upward,” Uchino said.

Doctors also recommend using a humidifier at the office and avoiding being in the direct path of the wind from an air conditioner, he said.

“We advise the office workers suffering from ocular fatigue and dry eye symptoms that they should blink more frequently in an intended manner during (screen use), and that they should use artificial tears,” Hori said.

“And they should ask an eye care doctor if their symptoms still remain.”

Eye examinations can easily be incorporated into your annual preventative physical program.

Source: Huffington Post

Adding 3-D mammography to conventional digital mammography substantially improved detection of invasive breast cancers and reduced the number of women called back for reexamination, according to the first large study of the new technology, released Tuesday.

Doctors in 13 academic and community health settings discovered 41 percent more of the most lethal cancers when women had both traditional digital mammograms and the 3-D screening known as “tomosynthesis.” The technology, approved by the Food and Drug Administration in 2011, provides images that appear as slices of the breast, removing the effect of overlapping breast tissue that can obscure views of tumors.

Sarah Friedewald, co-medical director of the Caldwell Breast Center at Advocate Lutheran General Hospital in Park Ridge, Ill., who led the study, unequivocally endorsed the value of 3-D mammography over conventional imaging. “In my opinion,” she said of any woman about to be screened for breast cancer, “she should have the 3-D mammogram.”

The paper, published online in the Journal of the American Medical Association, reviewed 454,850 examinations from 13 sites across the country — 281,187 conducted with digital mammography and 173,663 that provided the traditional mammogram and tomosynthesis. The improved technology found 41 percent more invasive cancers (4.1 per thousand women screened versus 2.9 per thousand) and more cancers overall.

The addition of tomosynthesis also reduced the need to recall women for further testing, which decreases patients’ anxiety and holds down health-care costs. There was no difference in discovery of ductal carcinoma in situ, a condition that is the subject of heated debate concerning overdiagnosis and overtreatment of some breast cancers.

The 3-D screening subjects women to more radiation than traditional mammography, but the amount is still well within limits set by the FDA, Friedewald said. But it costs more, is not available everywhere and is not always covered by insurance, she said.

The new research did not examine how the patients screened actually fared — an area that Friedewald said needs more study.

Breast cancer kills 40,000 women annually, according to the American Cancer Society, although screening mammography has been important in reducing the mortality rate. But in recent years, women have been subjected to a confusing outpouring of information and research on who should be screened for breast cancer, when and how often.

In recent years, influential medical boards in the United States, Canada and Switzerland have revised their recommendations on screening mammography as debate continued over false-positive findings and over-diagnosis.

In an editorial that accompanied the 3-D mammography study Tuesday, two physicians who were not involved in the research suggested that the results will renew debate, this time over whether tomosynthesis should replace digital mammography. They called for more research.

The Presidential Healthcare Center offers 3D mammography at the co-located Sibley Breast Center.

Source: Washington Post

Stress has long been thought to trigger heart attacks, but the mechanism is unknown. Now, researchers think that bacteria could play a role. A study published today in suggests that stress hormones can break up mats of bacteria growing on the fatty plaques in arteries, releasing the plaques and causing strokes or heart attacks.

Researchers have suspected for years that bacteria infect the plaques of hardened arteries. The plaques form a surface on which bacteria can attach and grow in masses called biofilms, held together in a scaffold. To test this, a team led by bacteriologist David Davies of Binghamton University in New York analyzed arteries from 15 patients with cardiovascular disease. Using fluorescent tags that mark bacterial DNA, they discovered at least 10 species of bacteria clustered tightly around the plaques, including the biofilm-forming Pseudomonas aeruginosa.

If these biofilms are tightly attached to plaques, they may have an effect on cardiovascular disease, Davies says. Plaques in blood vessels are normally stable, but if they break up and enter the bloodstream, they can trigger blood clots that lead to heart attacks or strokes.

To test this idea, the researchers grew P. aeruginosa in artificial arteries made of silicone tubing and waited for the bacteria to form biofilms. They then flooded the tubes with the stress hormone noradrenaline, which caused the biofilms to break up.

The authors say that stress hormones in the blood trigger the body’s cells to release iron into the bloodstream. The iron causes bacteria such as P. aeruginosa to produce enzymes that sever the polymer bonds that hold the bacteria together in the biofilm matrix and attach the bacteria to the plaque. The plaque is broken up as collateral damage, Davies says. Although he says that much more research in animals and humans is needed, the work “introduces a completely unexpected potential culprit” in the mystery of how plaques trigger heart attacks, he adds.

“It’s quite an intriguing hypothesis,” says microbiologist Primrose Freestone of the University of Leicester, UK. But she adds that the amount of noradrenaline that the authors used in the experiment is much higher than would be present in a human body.

Still, Freestone says, it is possible that noradrenaline levels are somewhat higher at the site of the plaque. And she says that the project could serve as a “springboard” for researchers to think more about the role of bacteria in cardiovascular disease.

Emil Kozarov, a microbiologist at Columbia University in New York, agrees that the idea is interesting. But he says that he would like to see whether noradrenaline breaks up plaques in mice injected with the biofilm bacteria, and whether noradrenaline disperses biofilms formed by other bacterial species.

Davies says that he plans to model the process in mice. He and his team are also planning to determine whether the arteries of healthy people contain biofilm-forming bacteria.

Source: Scientific American

You may want to stand up to read this.

A new study suggests that people who spend the bulk of their day sitting — whether behind the wheel, in front of the TV or working at a computer — appear to have an increased risk for certain kinds of cancers.

Previous studies have tied too much time spent sedentary to a variety of health problems, including heart disease, blood clots, a large waistline, higher blood sugar and insulin, generally poor physical functioning, and even early death.

For the new study, researchers zeroed in on 43 studies that specifically looked at the link between sitting and nearly 70,000 cases of cancer.

After combining the results from individual studies — a statistical tool that helps to reveal trends in research — there was good news and bad news.

The good news? Being sedentary did not appear to be linked to every kind of cancer. Scientists found no relationship between sitting and breast, ovarian, testicular or prostate cancers, or cancers of the stomach, esophagus and kidneys, or non-Hodgkin lymphoma.

The bad news was that there did seem to be a consistent relationship between hours spent sitting and an increased risk for colon and endometrial cancers.

People who spent the most time sitting during the day had a 24 percent increased risk of getting colon cancer compared to those who logged the least number of hours in a chair, according to the study.

When the researchers looked just at time spent watching TV, the risk jumped even more. Those who clocked the most hours glued to the tube had a 54 percent increased risk of colon cancer compared to those who watched the least.

That may be because viewers tend to consume unhealthy snacks and drinks while watching TV, said study author Daniela Schmid, an epidemiologist at the University of Regensburg in Germany.

For endometrial — or uterine — cancer, the risks were even higher. There was a 32 percent increased risk for women who spent the most time seated compared to those who sat the least, and a 66 percent increased risk for those who watched the most TV, the study authors said.

Moreover, every two-hour increase in sitting time was linked to an 8 percent increased risk of colon cancer and a 10 percent increased risk of endometrial cancer.

The risks remained even for “active couch potatoes” — folks who squeeze in some time at the gym but still spend most of their day off their feet. This suggests that regular exercise can’t offset the risks of too much sitting, the study authors said.

The findings, published June 16 in the Journal of the National Cancer Institute, make sense to Dr. Graham Colditz. He’s the associate director for prevention and control at Washington University’s Siteman Cancer Center in St. Louis.

“High blood sugar and high insulin is a clear sort of pathway to colon cancer, and we know from intervention studies that walking lowers insulin and getting up after meals lowers blood sugar compared to sitting,” said Colditz, who was not involved in the research.

As for endometrial cancer, “Obesity is a phenomenally strong cause. In fact, it is the main modifiable risk factor for endometrial cancer,” he said.

“So for me, the likely scenario there is that the sitting, the weight gain and obesity really go together and exacerbate the risk of endometrial cancer,” he added.

Because the studies included in the review only looked at broad relationships, they can’t prove that sitting, by itself, causes cancer. But the findings appeared to be remarkably consistent across studies, so Colditz thinks they should be taken seriously.

The study authors agree.

Continue reading below…

“Cutting down on TV viewing and sedentary time is just as important as becoming more active,” said Schmid. “For those whose jobs require them to sit at a desk most of the day, we recommend breaking up the time spent sitting by incorporating short bouts of light activity into the daily routine,” she added.

Source: Web MD

No one really expects to go to the doctor for shoulder pain and end up with a cancer diagnosis. Well, maybe those of us who are hypochondriacs would, but my husband certainly didn’t. Yet that’s exactly what happened to him.

John Anderson, my husband of 15 years, died in September 2012 after a five-month battle with colon cancer. He left behind our two children, now nearly 7 and 11, and my stepdaughter, a 33-year-old from his first marriage.

John was 59, and, no, he didn’t have a colonoscopy — until it was too late.

Sometimes it’s the first question that people ask when they learn our news: “Did he ever get a colonoscopy?” or, even worse, “Didn’t he get a colonoscopy?”

Why, despite knowing the facts about colorectal cancer screening, didn’t he? That question will plague me for the rest of my life. And it tortured John from the moment he was diagnosed until the day he died.

Colon cancer is one of the cancer success stories. There are various screening methods that can identify colon or rectal changes that may lead to cancer. Tests such as sigmoidoscopy and colonoscopy can find premalignant polyps. These polyps can be removed during the procedure. These tests can also find cancer in its earliest stage, when it’s most treatable.

But unfortunately, our family wasn’t part of this success story.

According to experts, those considered at average risk for colorectal cancer should begin regular screening at age 50. When John turned 50, I reminded him to get an annual physical and a colonoscopy. He got his physical but no colonoscopy. We had the same conversation maybe half a dozen times over the years. He had physicals. Each time he’d come home with a fecal occult blood test kit and a colonoscopy prescription. But he never followed through with either.

To encourage him, I would invoke our family (“Do it for the kids; they need you”), my own screening habits (“How would you feel if I didn’t get my annual mammogram?”), the data (he was a behavioral scientist, after all), the Katie Couric effect (a celebrity whom he liked and respected) and his risk factors (age, weight, diet). In the end, was my nagging just noise?

One month shy of his 59th birthday, John finally got that colonoscopy. It was after shoulder pain, initially diagnosed as a rotator cuff injury, led to side pain, which led to a sonogram, which revealed tumors on his liver. Apparently his enlarged liver or a liver tumor was pressing on his diaphragm, which was causing referred shoulder pain. Who would have thought?

John’s diagnosis: stage 4 colon cancer with inoperable liver tumors. Cancer that had started in his colon and spread to his liver. Unless John’s cancer responded to treatment, there wasn’t much hope.

At some point during his treatment — when we still had hope that the chemotherapy might work — I asked John: “Why didn’t you get a colonoscopy?” This was one of many emotional “what if” conversations that he and I had, typically late at night, when the house was quiet. Sometimes initiated by him, sometimes initiated by me, these topics were raw and gut-wrenching. Scary but difficult to ignore.

And I knew that particular question was like salt in a wound. There would be no answer that would ever heal a thing or make a difference. But still, I had to ask him. “Why didn’t you get a colonoscopy?”

He didn’t have a definitive answer. None of it really made sense, he admitted. And our hearts broke with the reality that no answer could matter, that there was no excuse. It was too late.

During the painful discussion when John’s oncologist had to tell us that nothing more could be done, John calmly said, “I should have gotten that colonoscopy.” His oncologist — very compassionately and honestly — said not to go there.

But John and I couldn’t help it: We knew the truth. Colorectal cancer screening saves lives. And it might have saved John’s.

Article via Washington Post

Former President George H.W. Bush celebrated his 90th birthday on Thursday by making a tandem parachute jump near his summer home in coastal Maine, fulfilling a goal he made five years ago after a similar jump even though he can no longer use his legs.

The nation’s 41st president jumped from a helicopter at about 6,000 feet while harnessed to retired Sgt. 1st Class Mike Elliott, a former member of the Golden Knights, the Army’s parachute team. Elliott guided Bush to a safe landing on his 85th birthday.

“That’s what he wanted for his 90th birthday and that’s what he got,” Elliott said. “It’s a very good feeling to be involved and be able to turn back time.”

The helicopter picked up Bush outside his Kennebunkport home. His family transported him from his wheelchair to the chopper, singing “Happy Birthday” before it took off.

Bush floated to the ground under a red, white and blue parachute and landed on the lawn of St. Ann’s Episcopal Church, where several hundred friends and family had gathered. Elliott said Bush’s foot got tangled up underneath him during the landing, causing him to tumble forward onto the ground. A spokesman later said the former president was feeling “fine.”

“He had a big smile for the crowd. You could tell he was exhilarated,” said Diana Untermeyer, a family friend from Houston. “He’s an amazing man. This is just another sign of that. I think that like most of America, our family loves him to pieces. It was just a real thrill to do this again.”

Bush was greeted with a kiss from his wife, Barbara, and a hug from his son, former President George W. Bush. The family left without talking to reporters.

Outside the grounds, several hundred people gathered on the rocky shore to get a glimpse of the jump.

“He has a lot of courage. We need more like him,” said David Morris, 79, of Melrose, Massachusetts.

Said Carol Schierl, 75, of Green Bay, Wisconsin: “I think it’s wonderful. I hope I can jump out of a plane at 90.”

The jump was kept secret until Thursday morning–partly to give Bush the option of bagging it because of less-than-ideal weather, including a low ceiling of clouds.

“It’s vintage George Bush,” spokesman Jim McGrath said. “It’s that passion for life. It’s wanting to set a goal, wanting to achieve it. I’m sure part of it is sending a message to others that even in your retirement years you can still find challenges.”

Bush had to overcome the objections of his doctor, Barbara and the rest of the family before making the latest jump, Elliott said. Eventually, he won them over.

“He’s smiling like a kid in kindergarten,” Elliott said following the jump.

Bush’s jump was indicative of a trend among people of advanced age, said Lenard Kaye, director of the Maine Center on Aging at the University of Maine. More and more seniors are participating in extreme physical activities deep into their golden years, a trend that will pick up steam as more baby boomers retire, he said.

Such “extreme acts of adventure” are becoming a part of many seniors’ lives but they need to be mindful that their bones are more fragile than when they were younger, he said.

The first time Bush jumped from an airplane was when his plane was shot down in World War II over the Pacific. He marked his 75th, 80th and 85th birthdays by skydiving. Thursday was his eighth jump.

Other birthday festivities included a private dinner with more than 200 relatives and friends, including some from his White House days: press secretary Marlin Fitzwater, White House counsel Boyden Gray and political director Ron Kaufman, McGrath said. His children, including George W. Bush and former Florida Gov. Jeb Bush, will be there, McGrath said.

Kennebunkport is a special place for the president. As a boy, he visited the family home at Walker’s Point every summer, except during World War II. The retreat was later dubbed his “summer White House.”

Article via Washington Post

Chikungunya infections in Caribbean countries spiked last week, led by quickly growing numbers mainly in the Latin parts of the region, according to the latest update from the Pan American Health Organization (PAHO).

Also two new countries—Barbados and Chile—are investigating their first suspected or confirmed imported cases, according to media and infectious disease reporting system sources.

The outbreak of the mosquito-borne disease has now reached 107,424 suspected or confirmed cases, which is 41,204 higher than the 66,220 cases reported the previous week, PAHO said in a May 30 update. It reported 1 more death from the disease, edging the total to 14.

PAHO’s numbers are higher than reported in today’s communicable disease threat update from the European Centre for Disease Prevention and Control (ECDC), especially for the Dominican Republic. PAHO said the country has had a massive jump, from 8,058 suspected cases on May 23 to 38,639 on May 30. In contrast, the ECDC lists 8,017 suspected cases in the Dominican Republic.

PAHO said suspected chikungunya cases in Haiti rose from 3,460 the week before to 6,312 last week. The ECDC, which does not list suspected cases for Haiti, reports 632 confirmed cases in the country. Its numbers for both countries did not change from the previous week’s report.

Haiti’s health ministry said infections in the country have reached 15,000, according to a report yesterday from Haiti Libre.

The ECDC in its update said the number of new cases last week grew in a handful of countries, including Dominica, where infections rose from 1,578 suspected cases to 1,817; Saint Vincent and the Grenadines, where suspected and confirmed cases climbed from 27 to 167; and St. Kitts and Nevis, where confirmed cases rose from 1 to 21.

The ECDC reports only 63,889 confirmed, probable, or suspected cases for the region.

Suspected cases in Barbados

Elsewhere, Barbados’ health ministry is investigating seven suspected cases, including two in people who had just returned from Dominica, according to a May 31 report from the Caribbean Media Corporation (CMC).

Samples from the patients were sent to the Caribbean Public Health Agency for testing on May 29, according to the report.

Chile reports first imported case

In Chile, health officials have confirmed the country’s first case, in a 49-year-old woman who had visited the Dominican Republic between Apr 29 and May 6, according to a ProMED Mail post today submitted by Cecilia Perret, MD, a pediatrician and infectious disease specialist in Santiago, Chile. ProMED Mail is the online reporting system of the International Society for Infectious Diseases.

Perret said on May 9 the patient came down with a low-grade fever and intense pain in her wrists, interphalangeal joints, ankles, and knees. The woman also had a rash on her limbs that lasted 2 days.

Perret said the first sample taken on day 2 of the patient’s illness was negative for chikungunya and dengue, but an indirect immunofluorescence assay on day 6 was positive.

Members of Amish communities in Ohio traveled to the Philippines for heartfelt reasons: They were there on service projects to help less fortunate people. Unfortunately, they came home with unwelcome hitchhikers: measles viruses.

Those travelers hadn’t been vaccinated against this highly contagious disease, the Centers for Disease Control and Prevention said Thursday. As a result, they have triggered an outbreak of more than 130 cases, primarily among their unvaccinated friends and relatives in Amish communities.

Those travelers hadn’t been vaccinated against this highly contagious disease, the Centers for Disease Control and Prevention said Thursday. As a result, they have triggered an outbreak of more than 130 cases, primarily among their unvaccinated friends and relatives in Amish communities.

The cases reported to date are in 18 states. The CDC says 41 people have been hospitalized, but nobody has died so far.

There is a safe and effective measles vaccine (known as MMR), CDC officials note. But most cases these days are among people who have philosophical or religious objections to vaccination.

This outbreak has changed some hearts and minds, though. Melanie Amato at the Ohio Department of Health told Shots that more than 8,000 Amish people have lined up to be vaccinated for measles to help stem outbreaks in six Ohio counties.

Measles strikes more than 20 million people around the world each year. The Philippines is in the midst of an epidemic that has so far sickened 32,000 people, the CDC says. That’s one major source of the current outbreaks in the United States, though the virus has been imported by travelers to more than a dozen different countries. So far all of the cases in the U.S. have been connected to foreign travel.

People traveling overseas should make sure they have been vaccinated against measles, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the CDC, said at a press conference. If you’re not sure whether you have gotten the recommended two shots, go ahead and get them, she says.

Source: NPR

When the kidney does not properly eliminate salts and minerals, those waste products can grow into the small, agonizing pellets known as kidney stones. Roughly one in 11 Americans develops them—a rate that has doubled over the past two decades as a result, in part, of our obesity epidemic. About the size of a grape seed, this stone passed through the ureter of its owner naturally.

The false-colored scanning electron microscope image (magnified 50×) depicts the stone in grisly detail, with smooth calcium oxalate monohydrate crystals overgrown with jagged dehydrate crystals. Not all kidney stones escape easily: some grow so large that they block urinary flow and require medical intervention.

The most common way to get rid of them is shock wave lithotripsy, a noninvasive technique in which high-frequency shock waves directed at the stone generate enough pressure to shatter it into tiny, sandlike fragments. This spring a team of urologists, engineers and mathematicians at Duke University improved on the technique. The researchers cut a small groove in the lens that focuses the shock waves and found that the simple adjustment optimizes wave shape so that the procedure is more accurate and minimizes damage to surrounding body tissues. It is a relatively cheap, straightforward innovation that may soon help treat millions of kidney stone patients worldwide.

Source: Scientific American