July 31, 20087:29 am
posted by Aric Thorpe, MHR

Marriage May Protect Against Dementia

The mental stimulation that marriage provides may be enough to cause a certain amount of resistance to Alzheimer’s disease and other cognitive impairments according to a prospective population-based study. Krister Hakansson of Vaxjo University, Sweden, recently reported at the International Conference on Alzheimer’s Disease that individuals who from midlife on live alone have almost three times more likelihood of developing some level of cognitive impairment. There were greater similar risks of Alzheimer’s disease (OR 2.83, P<0.05) and mild cognitive impairment (OR 3.17, P<0.001). According to Hakansson, "This study points to the beneficial effects of a married life… consistent with the general hypothesis of social stimulation as a protective factor against dementia." The following is an excerpt of an article from Medpage Today that reviews the study's findings:

It has been suggested that remaining socially active may protect against the development of dementia, and Hakansson reasoned that a partner relationship would form the most intense form of social interaction because of the necessity of dealing with another’s needs or perspectives, enhanced communication, and joint problem-solving.

So he and colleagues turned to the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, which randomly selected middle-age participants from the general population of Finland. Baseline measurements were taken from 1972 to 1987.

In 1998, after a mean follow-up of 21 years, 1,432 of the participants ages 65 to 79 were evaluated for signs of cognitive impairment. At baseline, 1,147 were married or cohabitating, 111 were single, 63 were separated or divorced, and 111 were widowed.

Click here to read the rest of this story from Medpage Today

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July 30, 200812:03 pm
posted by Aric Thorpe, MHR

Mismanagement of prescription medications at home

A recent study suggests that the usual concentration on hospital medication errors may be overlooking a much more serious problem. From Jan. 1, 1983 to Dec. 31, 2004 the amount of deaths caused by mismanagement of prescription medications at home increased six-fold. “The decades-long shift in the location of medication consumption from clinical to domestic settings is linked to a dramatic increase in fatal medication errors,” they said. This “six-fold” figure, however, is nothing compared to deaths due to mixing legal medications with street drugs, reported David Phillips, Ph.D., and colleagues at the University of California San Diego in the July 28 issue of the Archives of Internal Medicine. The following is an excerpt of an article from Medpage Today that reviews the findings:

Ledger, who starred as the Joker in the just-released Batman movie, died in his New York apartment in January, with the cause given as a combination of pain killers, sleeping pills, and anti-anxiety medications. There was no evidence of street drugs or alcohol.

Such polypharmacy may be one of the reasons fatal drug errors in the home have risen, the researchers said, while the lack of direct supervision by a clinician and the increasing number of drugs sold over the counter are others.

To quantify the issue, the researchers classified fatal medication errors, as recorded on the death certificates, into four groups:

* Type one deaths occurred in the patient’s home and involved medications and street drugs and/or alcohol.
* Type two deaths occurred in the patient’s home without street drugs or alcohol.
* Both types three and four deaths did not take place in the patient’s home, with the difference being the presence or absence of alcohol and/or street drugs.

Click here to read the rest of this article from Medpage Today

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July 29, 200811:13 am
posted by Aric Thorpe, MHR

More than 1,000 people have died from nonpharmaceutical fentanyl

According to the CDC more than 1,000 people have died over the past two years from a street-drug version of the painkiller fentanyl. Camden, N.J., was the first city to report deaths from nonpharmaceutical fentanyl; however, Detroit, Chicago, and Philadelphia were soon to follow. According to a piece in the July 25 issue of Morbidity and Mortality Weekly Report, a single gram of pure fentanyl can produce around 7,000 doses of street fentanyl, which are considered to be 30 to 50 times more potent than heroin. Adding to the complexity of the problem, instructions on how to prepare the street drug are readily available on the internet. The following is an excerpt of an article from Medpage Today that discusses the issue:

A single gram of pure fentanyl can be cut into about 7,000 doses of street fentanyl and instructions or recipes for the process are available on the Internet, the CDC said.

Illicitly manufactured nonpharmaceutical fentanyl (NPF) is a synthetic opioid 30 to 50 times more potent than heroin. Testing of drug samples containing fentanyl can distinguish between pharmaceutical and illicitly manufactured NPF. However, testing of biologic samples (e.g., serum) cannot distinguish between pharmaceutical fentanyl and NPF.

A month after Camden reported the spike in deaths, the CDC implemented an ad hoc case-finding and surveillance system in six states — Delaware, Illinois, Michigan, Missouri, New Jersey, and Pennsylvania.

That effort, which is now managed by the Drug Enforcement Administration, identified 1,013 nonpharmaceutical fentanyl deaths from April 4, 2005 through March 28, 2007.

“Law enforcement agencies (e.g., DEA and local and state police) responded by identifying and arresting sellers … seizing nonpharmaceutical fentanyl, and closing … production facilities, including one in Toluca, Mexico, in May 2006,” the CDC wrote.

Moreover, in April 2007, the DEA began regulating access to N-phenethyl-4-piperidone, a chemical used in the manufacture of street fentanyl.

Click here to read the rest of this article from Medpage Today

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July 28, 20087:44 am
posted by Aric Thorpe, MHR

Peers at the heart of teen weight concerns

According to findings recently published online in the Journal of Youth and Adolescence, peer group identification among teenagers greatly determines how a girl perceives the need to control her figure. According to the study, authored by Dr. Eleanor Mackey of Children’s National Medical Center in Washington D.C., and colleague Dr. Annette La Greca of the University of Miami, peer groups are an avenue through which teenage girls perceive what others feel is normal body weight. The authors of the study surveyed 236 girls between the ages of 13 and 18; the survey measured one’s own concern about body weight, which peer group one identifies with, and perceptions of peer’s weight concerns. Girls who did not identify with any group were most likely to be incorporating slimming strategies. Non-conformists, who the study labeled as “Alternatives,” were also likely to be concerned about their weight and to be incorporating strategies for weight loss. Least concerned about weight were girls that identified themselves as being athletic, or “Jocks.”

Understanding avenues through which teenagers conceptualize what a normal body image is could help to create intervention and prevention strategies and programs in schools as well as primary care settings. The following is an excerpt of an article from Medical New Today that reviews the study:

Dangerous weight control practices such as excessive dieting and bulimic tendencies often begin in adolescence and can have serious long-term health implications. Although it is clear that peers can have a major effect on adolescent girls’ weight control strategies, exactly how peers exert their influence is to date not well understood. The researchers aimed to clarify how identifying with a particular peer group influences whether or not girls worry about their weight and how they decide to control it.

The authors tested 236 girls aged between 13 to 18 years old, who completed surveys looking at which peer groups they most identified with, their own concerns about body weight, their perception of their peers’ weight concerns and their own weight control behaviors. The researchers found that there is a complex relationship between peer group affiliation and girls’ weight control behavior. In particular, which group girls identified with was often related to how they controlled their weight.

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July 24, 200811:47 am
posted by Aric Thorpe, MHR

Exercise may be able to slow Alzheimer brain atrophy

A recent study has found that exercise may be able to slow Alzheimer brain atrophy. According to the study, which was published in the July 15 issue of Neurology, Individuals with early-stage Alzheimer’s disease and high oxygen consumption levels during a treadmill test showed less atrophy in the brain than those that were less fit and had early-stage Alzheimer’s. Researchers commenting stated, “…to our knowledge this is the first study to demonstrate a direct relationship between cardiorespiratory fitness and measures of whole brain atrophy in Alzheimer’s disease.” The following is an excerpt of an article from Medpage Today that reviews the findings:

In 57 patients with dementia, peak oxygen consumption was associated with whole brain volume (beta=0.35, P=0.02) and with white matter volume (beta=0.35, P=0.04), as determined by MRI imaging, after controlling for patients’ age.

The relationship between fitness and brain volume remained significant after accounting for other covariates, including sex, dementia severity, reported level of physical activity, and physical frailty.

However, results of 15 standard tests of cognitive performance were not significantly associated with peak oxygen consumption after controlling for age.

In an interview, Dr. Burns said the study may have been underpowered to find a significant effect on cognitive performance. “The correlations were in the right direction for the most part,” he said.

In a control group of 64 people who did not have dementia, there was no relationship between cardiorespiratory fitness and brain volume or cognitive performance after controlling for age.

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July 23, 20085:00 pm
posted by Aric Thorpe, MHR

Are bullies at a greater risk for suicidal thoughts?

A recent review of findings from a variety of studies focusing on bullying found that not only victims of bullying are at risk for suicidal thoughts but also the bullies themselves. The review, which was conducted by a group of researchers at Yale School of Medicine and published in the International Journal of Adolescent Medicine and Health, analyzed research on bullying from 13 different countries including the US, Canada, some European countries, Japan, South Africa and South Korea. According to the findings, a child bully may be at two to nine times higher risk for suicide. Commenting, Dr. Young-Shin Kim, lead author and assistant professor at Yale School of Medicine’s Child Study Center, said, “While there is no definitive evidence that bullying makes kids more likely to kill themselves, now that we see there’s a likely association, we can act on it and try to prevent it.” The following is an excerpt of an article from the New York Times that reviews the findings:

Bullying tormentors also are at risk. Compared to other kids, a child who bullies may be at two to nine times higher risk for suicide, according to the study. Girl bullies appear to be at highest risk. Some researchers have also found a “dose-response” relationship, showing that those who bully more frequently are at highest risk for suicide.

While the studies showed an association with bullying and suicide, it wasn’t clear whether the behavior actually increases risk for suicide or whether kids already at risk for suicide are more likely to become bullies or their victims. The researchers noted that most of the studies failed to take into account the influence of factors like gender, psychiatric problems and a history of suicide attempts.

According to international studies, bullying is common and affects anywhere from 9 percent to 54 percent of children.

Click here to read the entire article from the New York Times

Click here for information on behavioral health treatment

Pastoral Action Point: As we all know, Jesus taught us that the great commandment is to love the Lord our God with all of our heart, mind and strength and to love our neighbor as ourself. Studies such as this one really highlight the consequences associated with being unkind to others and should fortify the reasoning behind the great commandment to love.

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July 22, 20084:41 pm
posted by Aric Thorpe, MHR

Sudden Death May Follow on Anniversary of Parent’s Demise

Findings from an intriguing study found a relationship between the anniversary of one’s parent’s death and one’s own sudden death. The study, reported at an American College of Cardiology meeting, revealed that 13 out of 102 sudden deaths occurred on the anniversary of one’s parent’s demise. Out of the 13 (12.7%) 10 of the sudden deaths (77%) occurred in males. Sudden death was not associated with family members other than parents. Interestingly, 4 of the patients who experienced sudden death on the anniversary of their parent’s death died at the same age as their parent. The following is an excerpt of an article from Medpage Today that reviews the study:

He said that patients and physicians need to be aware that psychological factors can trigger sudden death.

Physicians, he said, should ask patients about the deaths of close family members and should take action to prevent sudden death, including psychological therapy, stress reduction, behavior modification, management of cardiovascular risk factors, and treatment with medications like beta-blockers or aspirin.

Recently, psychological and chronobiological factors — including the anniversary effect — have been identified as triggers for sudden death or lethal arrhythmia, he said. So he and colleagues examined the life circumstances surrounding the 102 sudden deaths in patients ages 37 to 79.

More than two-thirds (68%) of the cases had underlying coronary artery disease.

Seven patients died on the anniversary of their father’s death, five on the anniversary of their mother’s death, and one on the anniversary of the deaths of both parents.

Click here to read the rest of this article from Medpage Today

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July 21, 20081:03 pm
posted by Aric Thorpe, MHR

Brain Activity Shows Susceptibility to Obsessive-Compulsive Disorder

A recent study pinpointed a region of the brain affected in those with obsessive compulsive disorder (OCD). According to the study published in the July 18 issue of Science, an area of the brain associated with unlearning behavior and allowing for flexibility in behavior, the lateral orbitofrontal cortex, was under active in the brain’s of participants who were diagnosed with OCD or in unaffected relatives. The researchers believe that MRI scans measuring activity in the lateral orbitofrontal cortex could be useful for future research; however, they will most likely not be used for common screening of OCD as other detection tools are highly successful. The following is an excerpt of an article from Medpage Today that discusses the study:

Patients with obsessive-compulsive disorder and their unaffected relatives showed less activity in the lateral orbitofrontal cortex on functional MRI compared with controls, reported Samuel R. Chamberlain, Ph.D., of the University of Cambridge, and colleagues in the July 18 issue of Science.

These findings from a small, case-control study suggest that this and related brain regions have an impact not only on day-to-day flexibility — which involves the ability to suppress intrusive thoughts and repetitive rituals — but also development of these pathologic compulsions, the researchers said.

Reduced function in brain areas related to unlearning may be a marker for vulnerability to obsessive-compulsive disorder “that exists in people at increased genetic risk, even in the absence of chronic treatment or symptom confounders,” they wrote.
This kind of marker would likely be limited to research use for now since imaging is not needed for diagnosis or treatment decisions, commented Kenneth M. Heilman, M.D., of the University of Florida in Gainesville, Fla., who was not involved in the study.
The disorder often runs in families, with first-degree relatives of patients at up to an eight-fold risk of developing symptoms themselves.
But because little progress has been made in finding responsible genes, researchers have been looking for brain-based markers as objective, measurable traits.

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Click here for more information on OCD

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July 18, 200811:30 am
posted by Aric Thorpe, MHR

Impaired Vision Plus Poor Health Possible Suicide Risk

According to a study published in the July issue of the Archives of Ophthalmology poor vision along with related indirect effects of poor health may be linked to an increase in risk of suicide. The study, conducted by Byron L. Lam, M.D., of the Bascom Palmer Eye Institute at the University of Miami, revealed that those with poor vision and indirect effects such as poor health had a risk of suicide that was 18% greater than those that do not suffer from these conditions. In addition to increased risk of suicide, researchers relayed that the psychosocial and health consequences of having impaired vision are many; social seclusion, increased risk of motor accidents, depression, falls, factures, cognitive impairment, and difficulty with activities of daily living are just a few mentioned in the study. Additionally, those with impaired vision have been associated with an overall increase in mortality risk, researchers said. The following is an excerpt of an article from Medpage Today that reviews findings from the study:

Dr. Lam’s team reviewed data from National Health Interview Surveys (1986-1996) including data on 137,479 noninstitutionalized adults.

Participants reported demographic information along with details of visual impairment and other health conditions. Verified deaths of participants up to 2002 were reported through the National Death Index. Structural equation modeling was used to determine the relationship between reported visual impairment and suicide.

During a mean 11 years of follow-up, there were 200 suicides.

After controlling for survey design, age, sex, race, marital status,
number of non-ocular health conditions, and self-rated health, the direct effect of visual impairment on death from suicide was elevated but not significant (hazard ratio 1.50, 95% confidence interval 0.90 to 2.49).

However, the approximate indirect effect of visual impairment on suicide via poorer self-rated health was a significant 5% (HR 1.05, 95% CI 1.02 to 1.08).

For the number of non-ocular health conditions, the rate was a significant 12% (HR 1.12, 95% CI 1.01 to 1.24).

Click here to read the rest of this article from Medpage Today

Click here for information on depression

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11:06 am
posted by Aric Thorpe, MHR

According to a study published in the July issue of the Archives of Ophthalmology poor vision along with related indirect effects of poor health may be linked to an increase in risk of suicide. The study, conducted by Byron L. Lam, M.D., of the Bascom Palmer Eye Institute at the University of Miami, revealed that those with poor vision and indirect effects such as poor health had a risk of suicide that was 18% greater than those that do not suffer from these conditions. In addition to increased risk of suicide, researchers relayed that the psychosocial and health consequences of having impaired vision are many; social seclusion, increased risk of motor accidents, depression, falls, factures, cognitive impairment, and difficulty with activities of daily living are just a few mentioned in the study. Additionally, those with impaired vision have been associated with an overall increase in mortality risk, researchers said. The following is an excerpt of an article from Medpage Today that reviews findings from the study:

Dr. Lam’s team reviewed data from National Health Interview Surveys (1986-1996) including data on 137,479 noninstitutionalized adults.

Participants reported demographic information along with details of visual impairment and other health conditions. Verified deaths of participants up to 2002 were reported through the National Death Index. Structural equation modeling was used to determine the relationship between reported visual impairment and suicide.

During a mean 11 years of follow-up, there were 200 suicides.

After controlling for survey design, age, sex, race, marital status,

number of non-ocular health conditions, and self-rated health, the direct effect of visual impairment on death from suicide was elevated but not significant (hazard ratio 1.50, 95% confidence interval 0.90 to 2.49).

However, the approximate indirect effect of visual impairment on suicide via poorer self-rated health was a significant 5% (HR 1.05, 95% CI 1.02 to 1.08).

For the number of non-ocular health conditions, the rate was a significant 12% (HR 1.12, 95% CI 1.01 to 1.24).

Click here to read the rest of this article from Medpage Today

Click here for information on depression

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