Category "Health"

Cardiovascular screenings are a cost-effective way to identify middle-aged athletes who may risk heart attacks or strokes by participating in high-intensity sports, a new study suggests.

“I would suggest that all middle-aged athletes should be screened at least once, particularly men over 40 and women over 50,” said the study’s lead author, Dr. Andrea Menafoglio, a cardiologist at Ospedale San Giovanni in Bellinzona, Switzerland.

While the benefits of regular exercise are well known, vigorous physical exertion can be life-threatening for older athletes who may not realize that they have an underlying heart condition. Guidelines in Europe and the U.S. urge cardiovascular risk evaluations for middle-aged athletes, but researchers say the recommendations aren’t universally followed because widespread implementation hasn’t proved effective or affordable.

To see if widespread screening could detect hidden symptoms and risks for heart disease at a reasonable price, Menafoglio and colleagues at three hospitals in Switzerland evaluated 785 athletes between the ages of 35 and 65.

Each of the athletes reported spending at least two hours a week participating in high-intensity sports such as running, cycling, triathlon, football, swimming, tennis, climbing, or cross-country skiing.

The initial evaluation included a personal and family history, a physical exam, and a resting electrocardiogram, or ECG. For each participant, the researchers also estimated the risk of death from cardiovascular disease within the next 10 years based on gender, age, cholesterol level, blood pressure, and smoking habits.

Overall, the cost of screening averaged $199 per athlete (about 160 euros), because most athletes didn’t need any testing beyond the initial evaluation.

About one in seven athletes needed additional screening. Extra tests found some cases of previously unimagined diabetes, hypertension, high cholesterol, and mild heart valve disease.

Overall, the screenings caught previously undetected cardiovascular abnormalities in about 3 percent of participants and a high cardiovascular risk profile in about 4 percent.

Just three athletes had abnormalities that made it too dangerous for them to continue their exercise routines.

Source: Reuters Health

“The Presidential Healthcare Center can design a personalized exercise prescription for you.”

Almost a century after the discovery that sleep helps us remember things, scientists are beginning to understand why.

During sleep, the brain produces chemicals that are important to memory and relives events we want to remember, scientists reported this week at the Society for Neuroscience meeting in Washington D.C.

“One of the most profound effects of a night of sleep is the improvement in our ability to remember things,” says Ravi Allada, a sleep researcher at Northwestern University. Yet this connection hasn’t been well-understood, he says.

That’s changing, thanks to recent research from scientists including Jennifer Choi Tudor from the University of Pennsylvania. At the meeting, Tudor presented a study involving a brain chemical (known as 4EBP2) that is produced during sleep and is thought to play a role in remembering new information.

Previous experiments have shown that sleep-deprived mice have memory problems and lower levels of this chemical. So the team tried injecting the chemical into the brains of mice, then deprived them of sleep. “With the injection, their memory is normal,” Tudor says.

Sleep is also a time when old memories can be modified and new memories can be formed, says Karim Benchenane from the National Center for Scientific Research in Paris. Benchenane was part of a team that studied the brains of rats while the rats were awake, as well as during sleep.

When the animals were awake and traveling around their cages, the scientists identified brain cells that became active only when the rats were in a specific location. During sleep, these same cells became active in the same order, indicating that the rats were reliving their travels and presumably strengthening their memories of places they’d been.

Source: NPR

Exposure to secondhand smoke and roadway traffic may be tied to increased body mass index in children and adolescents, a new study suggests.

Researchers studied 3,318 children in 12 Southern California communities beginning at an average age of 10, and then followed them through age 18. They used parental questionnaires to establish exposure to smoking, and data on traffic volume and levels of nitrogen dioxide, ozone and particulates to track pollution.

The study, in Environmental Health Perspectives, controlled for many other factors: sex, initial B.M.I., asthma, physical activity, insurance status, parental education and income, acres of parks and open space nearby, percentage of people living in poverty in each community.

But even after accounting for these issues and more, they found that compared with children exposed to no secondhand smoke or near-roadway air pollution, B.M.I. was 0.80 higher in children exposed to pollution alone, 0.85 higher in those exposed to secondhand smoke alone, and 2.15 higher in those exposed to both.

A normal B.M.I. for adults is 18.5 to 24.9. Higher than 25 is considered overweight, and above 30 obese.

“It would be interesting to know more about the mechanism,” said the lead author, Dr. Rob McConnell, a professor of preventive medicine at the University of Southern California. “But the finding challenges the view that obesity is due solely to increased caloric intake and reduced physical activity. That’s not the whole story.”

Source: New York Times

The winter season is chock full of delicious dishes and treats, but no one likes the extra calories and added pounds that can come with the seasonal food. Use these smart tips on substitutions and choices to enjoy your favorite winter beverages and foods.

Eggnog

• Mix it up. Fill your glass with half- to three-quarter-parts of low-fat or skim milk and one part eggnog. You’ll still get the flavor without all the calories.
• Act like a kid. Take out the alcohol. This simple step will reduce the caloric content.
• Cut the fluff. Pass on that big dollop of whipped cream to avoid the extra sugar and saturated fat.

Hot Chocolate

• Skip the heavy stuff. If you order hot chocolate at a restaurant or coffee shop, ask that it be made with low-fat or skim milk, and without the whipped cream.
• Do some research. To make instant hot chocolate at home, look for product packets marked “low-fat/fat-free” or “low-sugar/sugar-free.” Be sure to add the mix to low-fat milk, skim milk or hot water.
• Go easy on the toppings. Use five to eight mini-marshmallows instead of large ones. If using whipped cream, look for low-fat versions and stick to less than one tablespoon. If you have hot chocolate regularly, try to limit the toppings to “once in a while treats” since they can pack a lot of calories and added sugars.

Apple Cider

• Read the labels. When buying cider at the store, check its added sugar content. Many products contain added sugars, which can increase your calorie intake and cause weight gain. Choose low-sugar and sugar-free options.
• Do it yourself. When making cider at home, use low-sugar apple juice and a variety of spices (like cinnamon sticks, cloves, nutmeg and whole cranberries). You’ll keep the flavor while cutting calories.

Cocktails and Other Alcoholic Beverages

• Enjoy cocktails. Serve non-alcoholic versions of your favorite cocktails to lower the calories. Be sure to check the nutrition label, because sometimes products that are alcohol-free have more added sugar.
• Break it up. To reduce the amount of calorie-laden drinks you consume during a holiday gathering, drink a glass of water or sparkling water between each beverage. This will help fill your stomach, leaving less room to overindulge.

Sodium

• Limit your sodium. Did you know that many of your favorite holiday dishes may be packed with sodium? Breads and rolls, poultry, and canned soups are three common foods that can add sodium to your diet. When shopping for ingredients to prepare your holiday meal, compare the labels to find lower sodium varieties.
• Savor the flavor. Use herbs and spices, like rosemary and cloves, to flavor dishes instead of salt or butter.
• Go fresh. Choose fresh fruits and vegetables to use in your dishes. If using canned products, rinse with water in a colander before cooking and serving.

Turkey

• Outsmart the bird. Reach for the lighter pieces of meat; they have fewer calories and less fat than the darker ones. Another way to cut calories is to take off the skin.
• Keep portions in check. A serving size of meat is 3 oz., about the size of a deck of cards. So, be conscious of how much you put on your plate, and pass on that second helping. If you’re also having another meat, like ham or lamb, take smaller portions of each.
• Watch out for the gravy train. Turkey usually comes with gravy, which can add excess fat, calories and sodium. Limit gravy to a tablespoon, and keep it off other items, like the dressing.

Dressing

• Call it what it is. Dressing is intended to be a complement to your meal, not an entrée. To keep calories and excess fat in check, aim for ¼ cup (or about half a scoop with a serving spoon).
• Judge it by its cover. If the dressing is filled with fatty meats like sausage and pork, looks greasy or buttery, and is made with white bread or sweet rolls, it may be best to pass. Better options would be dressings that have whole grain or cornbread, lean meat (or no meat), nuts (like almonds or walnuts), and lots of veggies and fruits.

Desserts

• Treat yourself right. The best way to enjoy an occasional sweet without losing control is by sampling a selection or two, rather than having full servings. For example, have one bite of pie, half a cookie or one small square of fudge. Find a friend or family member who will stick to the sampling rule with you.

Source: American Heart Association

The sixth annual World Pneumonia Day was observed this week to raise awareness about pneumonia’s toll and to promote interventions to protect against, treat, and prevent the disease globally. The United States has made great strides in protecting children from the serious, and sometimes deadly, effects of pneumonia through recent vaccination efforts. Tennessee, for example, is experiencing historically low rates of pneumonia hospitalizations in children aged <2 years since pneumococcal conjugate vaccines were introduced in 2000. Data suggest that this progress also is being seen across the country. In spite of this success, however, pneumonia still kills approximately 50,000 people in the United States each year, 85% of whom are adults aged ≥65 years. In response, this year CDC recommended pneumococcal conjugate vaccine for adults aged ≥65 years.

Globally, pneumonia kills nearly 1 million children aged <5 years each year. In addition to bacterial pathogens, many viruses such as respiratory syncytial virus, influenza, and measles also are major causes of pneumonia globally. Many deaths and illnesses from pneumonia can be prevented with the use of 1) pneumococcal, Haemophilus influenzae type b (Hib), influenza, and measles vaccines; 2) appropriate antimicrobial therapy; and 3) supportive health care, among other strategies.

Communities around the world face a range of respiratory disease threats, including reemerging or newly identified pathogens. In late summer, infection with the uncommon enterovirus EV-D68 led to the hospitalization of hundreds of children in multiple states. In and around the Arabian Peninsula, a recently recognized coronavirus (Middle East respiratory syndrome coronavirus) has been fatal in about one third of reported cases. Vaccines are not available to provide protection against these or many of the other pathogens that commonly cause pneumonia, including respiratory syncytial virus, human metapneumovirus, and Mycoplasma pneumoniae, highlighting the importance of research into vaccine development as well as effective treatment and diagnostics for viral and bacterial pneumonia. Additional information regarding World Pneumonia Day is available at https://worldpneumoniaday.org.

Source: CDC
The Presidential Healthcare Center offers Prevnar-13 as a special order vaccination.

The US Food and Drug Administration (FDA) is warning consumers that fraudulent treatments for Ebola virus disease are being marketed online.

Although some experimental therapies and vaccines are in early phases of development, no products for treating Ebola infection have been approved by the FDA.  So far, only limited data are available about the safety and effectiveness of the products being tested, and only small supplies are available, according to the agency.  Experimental therapies were used to treat 2 US health care workers who were moved to Atlanta after they became infected by Ebola virus while caring for patients in West Africa, where there is an ongoing outbreak.

The US Center for Disease Control and Prevention says there is little threat of Ebola spreading in the United States.  But some online marketers have seized on global concern about the illness to sell fraudulent products, according to the FDA.  It is illegal for companies to market unapproved products claiming to cure or prevent disease.  The FDA is asking the public to report suspect claims about Ebola-related products (https://1.usa.gov/1mS3T3P).

(JAMA)
Read more here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you travel.

A new, large-scale study has identified six new genetic variants associated with habitual coffee drinking. The genome-wide meta-analysis, led by Harvard School of Public Health and Brigham and Women’s Hospital researchers, helps explain why a given amount of coffee or caffeine has different effects on different people and provides a genetic basis for future research exploring the links between coffee and health.

“Coffee and caffeine have been linked to beneficial and adverse health effects. Our findings may allow us to identify subgroups of people most likely to benefit from increasing or decreasing coffee consumption for optimal health,” said Marilyn Cornelis, research associate in the Department of Nutrition at Harvard School of Public Health and lead author of the study.

Genetics have long been suspected of contributing to individual differences in response to coffee and caffeine. However, pinpointing the specific genetic variants has been challenging.

The researchers, part of the Coffee and Caffeine Genetics Consortium, conducted a genome-wide meta-analysis of more than 120,000 regular coffee drinkers of European and African American ancestry. They identified two variants that mapped to genes involved in caffeine metabolism, POR and ABCG2 (two others, AHR and CYP1A2 had been identified previously). Two variants were identified near genes BDNF and SLC6A4 that potentially influence the rewarding effects of caffeine. Two others—near GCKR and MLXIPL, genes involved in glucose and lipid metabolism—had not previously been linked to the metabolism or neurological effects of coffee.

The findings suggest that people naturally modulate their coffee intake to experience the optimal effects exerted by caffeine and that the strongest genetic factors linked to increased coffee intake likely work by directly increasing caffeine metabolism.

“The new candidate genes are not the ones we have focused on in the past, so this is an important step forward in coffee research,” said Cornelis.

“Like previous genetic analyses of smoking and alcohol consumption, this research serves as an example of how genetics can influence some types of habitual behavior,” said Daniel Chasman, associate professor at Brigham and Women’s Hospital and the study’s senior author.

Source: (Harvard School of Public Health)

A growing hazard in the summer backyard can be found in the wire bristle brushes commonly used to clean barbecue grills, a researcher reported here.

A 55-year-old woman came to the emergency department with acute onset pain in the left side of her abdomen. She reported having eaten at a family barbecue the night before, and had a history of cesarean sections and abdominal adhesions, according to Pranith Perera, MD, of Brown University in Providence, R.I.

Her abdomen was distended, and laboratory tests revealed leukocytosis. On a CT examination of the abdomen and pelvis, a 7-mm density was identified in the lower left quadrant with possible perforation of the wall of the jejunum.

Spiral enteroscopy detected a foreign object located about 90 cm from the pylorus. This was removed with forceps and turned out to be a wire brush bristle.

“We’ve had six or seven cases of this just within the last 18 months, all within 24 hours of the patient eating grilled food,” Perera told MedPage Today during a poster session at the annual meeting of the American College of Gastroenterology.

“These bristles are very small and thin, and can stick to the grill. Patients may not even feel it, and there have been cases of neck and tonsil perforation, abscesses, and intestinal perforations requiring rapid surgical intervention,” he said.

“There has been a lot of blame in terms of cheaper products, and how they’re manufactured,” he added.

The Consumer Product Safety Commission is currently collecting data to see if there are specific brands and designs of brushes that are particularly hazardous, if the type of grill matters, such as those made of uncoated or porcelain-coated cast iron, and if there’s an association with particular types of food.

The CDC now recommends that alternative methods of cleaning barbecue grills be employed, or at least that very careful inspection of the grill be done after cleaning to ensure that no bristles adhere to the surface.

If this type of ingestion and potential abdominal injury is suspected, abdominal/pelvic CT scan should be done without oral contrast, which could obscure the bristle, according to Perera.

This patient’s abdominal pain resolved after the foreign body was removed, and there was no evidence of abscess or peritoneal air. She was discharged on oral antibiotics.

“Physician awareness of this potential injury is critical to facilitate timely diagnosis and treatment. Awareness of this potential injury by the general population, manufacturers, and retailers can reduce exposures and decrease the likelihood of occurrence,” CDC has stated.

Source: Medpagetoday

Dr. Elting appeared on News Channel 8 this past Wednesday, October 22^nd, with Bruce Depuyt to discuss Ebola virus. Depuyt asked Dr. Elting, an infectious disease specialist, for insight into the virus; particularly focusing on ways the virus can be contracted, and how we may be at an increased risk when using air travel. 

From the broadcast:

Up first – Answering your questions about Ebola.  The news of late has been good.  The people who came into contact with those who cared for patient Thomas Duncan are said to be symptom-free.  And the potential cases of Ebola that we’ve seen on the news, those have turned out to be false alarms.  Nonetheless, we know there is anxiety about the Ebola virus – how it is spread, how it is treated, and whether it’s likely we’ll see more cases in the days, weeks, months ahead.

Joining us now is Dr. Jeffrey Elting.  He’s former head of infectious disease control and response for the DC Hospital Association.  He is now the Medical Director at the Presidential Healthcare Center in the National Capitol region. 

“The public health sector has stepped up its game” Dr. Elting said.  “It is important to keep everything in perspective by taking into account that someone dies every 34 seconds of a heart attack.  We have 30,000 people killed in motor vehicle accidents each year, and we have influenza that kills millions of people.  Comparatively, we’ve had 1 person unexpectedly come to the US with Ebola who unfortunately died from the virus, but aside from some initial missteps, the rest of the cases have been managed quite well and people are recovering.” “Ebola is a special case and more deadly than others,” he said.  “That’s why we have decontamination units, isolation rooms, stockpiles of medication, protective suits and face masks.”

Dr. Elting also spoke about how the Ebola virus is transmitted.  “The transmission
method for Ebola is generally from contaminated fluid from infected patients.  It’s not transmitted by respiratory droplets like the flu or a cold.”

He also addressed the symptoms experienced after contracting Ebola.  “The initial symptoms are going to be somewhat flu-like.  You’re going to have a fever, headache, muscle aches, irritation of the throat, and then it will progress.  Ebola is a hemorrhagic virus, therefore, it can cause bleeding into the eyes, lungs and intestinal system.  Distinguishing patients with Ebola may become more challenging as the flu season approaches.”

View the entire interview here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you go.

If you’re going to overindulge and gain weight, at least try to make sure the extra calories come from unsaturated fats, a new study suggests.

When lean people pack on even a few extra pounds, heart disease risk factors in the bloodstream change – some for the better if the excess food contains unsaturated fats, versus saturated fats, researchers found.

Even a moderate weight gain of about three pounds for lean, young people clearly increased markers of heart disease risk factors like insulin resistance as well as signs of impaired vascular function, said senior author Dr. Ulf Riserus of the Unit for Clinical Nutrition and Metabolism at Uppsala Science Park in Sweden.

But unsaturated fats in the diet improved cholesterol levels despite the extra calories and weight gain, which is surprising, Riserus told Reuters Health by email.

For seven weeks, two groups of healthy, relatively lean adults ages 20 to 38 were told to keep to their habitual exercise level and daily diets, adding three to four muffins to their diets each day.

The researchers provided the 240-calorie muffins, with half their energy from fats. One group of 19 adults received muffins made with sunflower oil, polyunsaturated fatty acids (PUFA), while the other group of 20 people ate muffins made with palm oil, a saturated fat. The muffins were otherwise identical.

After seven weeks, each group had gained between two and three percent of their body weight, about 3.5 pounds (1.5 kilos) each, and waist girth increased by about one percent, but blood pressure did not change significantly.

This level of weight gain in the short term is probably not dangerous at all, Riserus said, but if weight accumulates over time, especially abdominal fat, there can be health consequences.

Based on blood tests, the sunflower oil group had lower cholesterol and lipid levels at the end of the study than they had at the beginning of the study. For the palm oil group, cholesterol went up, according to the results in the Journal of the American Heart Association.

Both groups showed signs of increased insulin resistance, a diminished ability to process blood sugar that can be a warning sign for diabetes onset.

Riserus and his team had previously found that the type of fat in the diet determined how much of the excess calories were stored as abdominal fat and liver fat, he said.

“If the high-caloric diet was based on unsaturated fats rather than saturated fats, very little fat was stored as liver and abdominal fat, whereas the opposite was true for the diet high in saturated fats,” he said.

Saturated and unsaturated fats have different molecular effects on the liver, he said. Unsaturated fats signal the liver to take up cholesterol from the blood, he said.

“We believe our results are very relevant considering that a large part of most populations are in caloric excess and gradually gain weight over time,” Riserus said. “Although weight gain should be avoided, the results basically tell us that we may benefit from having enough unsaturated fats in our diets, irrespectively of how many calories we eat.”

The results support the American Heart Association recommendation to replace some saturated fats in the diet, like fatty beef, butter and cheese, with unsaturated fats like vegetable oils and nuts, he said.

“I do not think people usually plan for weight gain, but, as we know, it just happens quite commonly,” said Ursula Schwab, an associate professor of nutrition therapy at the University of Eastern Finland in Kuopio.

“So, by following the guidelines regarding dietary fat, unintentional weight gain can be less harmful than in cases when the recommendations on the quality of dietary fat is not followed,” Schwab told Reuters Health by email. She was not involved in the new study.

All dietary polyunsaturated fats are beneficial, she said, but that is not necessarily the case for supplements.

In addition to sunflower oil, rapeseed oil and canola oil are good sources of polyunsaturated fats, Riserus said.

Source: Reuters