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Guest Simone

These are some health articles I found.I see new things in health care on the web all the time but I never know if I should post them.So I'm going to use this thread to post articles that coulde be informational to people with Cushing's.If it's added onto that means Ive found some new stuff.


Test predicts heart risk better


Feb. 27) -- Cholesterol, schmolesterol. The name of the heart disease game is now ApoB, researchers are telling doctors.


It's not that cholesterol isn't important. After all, more scientists have won Nobel Prizes from studying cholesterol than any other molecule. But science has marched on. Four huge clinical trials now show that there's a better single measure of heart-disease risk than cholesterol levels. It's called apolipoprotein or Apo for short.


Apolipoproteins are tiny fat particles floating in the blood. Having a lot of one kind of Apo -- apolipoprotein B or ApoB -- means high risk of clogged arteries and heart attack. A high ApoB count predicts heart disease even better than a high level of "bad" LDL cholesterol, argue Allan Sniderman, MD, and colleagues. This international group of experts also argues that the ratio of ApoB to ApoA1 (another kind of Apo) tells doctors more than the ratio of LDL cholesterol to "good" HDL cholesterol.


"The measurement of apolipoproteins should now be introduced broadly into clinical practice," Sniderman and colleagues write in the March 1 issue of The Lancet.


The experts based their opinion on several huge clinical trials.


The new test should be particularly helpful for patients taking cholesterol-lowering drugs. Many studies show that LDL cholesterol levels don't do a good job of predicting heart disease risk in these patients. For them, measuring ApoB and the ApoB/ApoA1 ratio may be better.


Good tests for Apo already exist. In fact, they are even easier than cholesterol tests. That's because a patient doesn't have to fast before giving a blood sample. So why aren't most doctors already using the tests?


"The importance of cholesterol is densely entrenched within the medical profession and lay public," Sniderman and colleagues note. "The pace of change will be determined, in part at least, by how resistant conventional belief is to emerging clinical evidence."


SOURCE: The Lancet, March 1, 2003.


? 2003 WebMD Inc. All rights reserved.

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Whole-Grain Diet Reduces Diabetes


(March 3) -- Whole grains in your diet can lessen diabetes risk, according to a new study from Finland. Trouble is, Americans still reach for white bread, rather than whole wheat, when they make a sandwich.


The study puts teeth to a theory many nutritionists have promoted -- that a high-fiber diet composed of whole grains, fruits, and vegetables keeps obesity at bay. Obesity and lack of exercise are the top risk factors for type 2 diabetes.


A diet high in whole grains -- specifically rye -- had greater impact on reducing risk of type 2 diabetes, reports lead author Jukka Montonen, who's with the National Public Health Institute in Helsinki. His study appears in the March issue of the American Journal of Clinical Nutrition.


In this study, vegetables and fruits did not show an effect on reducing the risk of diabetes, he adds.


A few studies have suggested a link between whole grains and reduced risk of type 2 diabetes, but there has been little concrete evidence until now, Montonen says.


He and colleagues conducted yearly interviews of over 4,000 Finnish men and women from 1966 and 1972, to obtain an idea of their daily diet. He then followed them for 10 years, to detect the incidence of type 2 diabetes. Those who ate the most fiber decreased their risk of getting the disease by more than a third.


"Dietary fiber is one nutrient that may provide protection against the disease. The beneficial effect of soluble fiber may be ... the slow absorption and digestion of carbohydrates that lead to a reduced demand for insulin," writes Montonen.


Diabetes develops when the body cannot produce enough insulin or does not respond to insulin properly. The disorder develops slowly over many years. This dysfunction in insulin production causes blood sugar levels to rise beyond what is safe for the body, and damage occurs in blood vessels and nerves.


"Americans understand that whole grains are healthier than refined grains, but the average person eats less than one serving of whole grains per day," writes preventive medicine expert Simin Liu, a Harvard researcher with the Brigham and Women's Hospital in Boston, in an accompanying editorial.


"The challenge for the food industry is to make whole-grain products more appealing than refined-grain products," Liu says.


For the rest of us, "the challenge is to develop habits to increase whole-grain intake such as substituting whole wheat bread for white bread when making a sandwich," Liu says. "Developing such a simple habit may have long-term health benefits."


SOURCE: American Journal of Clinical Nutrition, March 1, 2003.


? 2003 WebMD Inc. All rights reserved.

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Vitamin D prevents fractures


Feb. 27) -- Preventing broken bones as you age could be as easy as popping a vitamin D pill just three times a year.


It's especially important to prevent bone thinning and fractures in the elderly. In fact, breaking the hip can even cause death in many elderly people -- due to an increase in pneumonia or blood clots from being immobilized in bed.


Prior studies have shown that a combination of vitamin D and calcium can reduce fractures. But researchers in a new study wanted to see if vitamin D alone would have the same effect. The study is published in the March issue of the British Medical Journal.


Researchers studied more than 2,500 people 65 to 85 years old. Each took 100,000 IU of vitamin D -- a high dose compared with the normal dose of 400 IU -- or a placebo every four months.


People who took vitamin D were 22% less likely to have a fracture during the five-year study. They were also 33% less likely to have a fracture in areas of the body that are commonly affected by osteoporosis (hip, wrist, forearm, and vertebrae).


There were no side effects of vitamin D and the cost was nominal -- $1.59 a year. If future research confirms that vitamin D is effective at preventing fractures, even when taken only a few times a year -- this could be a welcome addition to staving off osteoporosis and the potentially serious health effects of this disease.


SOURCES: British Medical Journal, March 1, 2003.


? 2003 WebMD Inc. All rights reserved.

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Guest Simone

Gene Helps determine hurt


WASHINGTON (Feb. 20) - When it comes to pain, people can be wimps, stoics or somewhere in between. Now scientists have found one reason - a variation in a single gene that shows stoics really can tolerate more pain.


The discovery by University of Michigan neuroscientists emphasizes the need to customize pain treatment - and might even allow doctors to soon try predicting which patients will respond to a certain kind of medication.


People's perceptions of pain are tremendously variable. A crushing blow to one person can be trivial to another; likewise, pain medication that helps one patient may do nothing for the next.


The new research shows how much you suffer is due at least partly to a gene that helps regulate how many natural painkillers, called endorphins, your body produces.


The gene produces an enzyme called COMT that metabolizes the brain chemical dopamine, which acts as a signal messenger between brain cells.


Everyone has two copies of this gene, one inherited from each parent - but they can inherit forms that differ by one amino acid. The COMT gene that contains the amino acid methionine, or met, is less active than if it contained the amino acid valine, or val.


Dr. Jon-Kar Zubieta put 29 healthy young adults into brain-imaging PET scanners. He injected their jaw muscles with enough salt water to make them really ache, simulating a painful condition called temporomandiular joint syndrome, or TMJ. Zubieta measured how their brain cells reacted while the volunteer victims rated, every 15 seconds, how much they hurt during the 20-minute pain cycle.


People who had two copies of the val-COMT gene were stoics. They withstood significantly greater saline doses than other volunteers while rating the resulting pain as less bothersome, Zubieta reports in Friday's edition of the journal Science.


The PET scans verified that response: Painkilling endorphins were much more active in these people's brains.


In contrast, people with two copies of the met-COMT gene suffered the most pain from the smallest saline injections - and had far less natural painkiller action.


People who inherited both a met and val gene copy tolerated pain at levels between the two extremes.


A quarter of the U.S. population carries the "stoic'' gene variation while another quarter has the gene variant that makes them super-sensitive to pain, Zubieta estimates.


Why would a gene that regulates dopamine also affect painkilling endorphins? Too much dopamine in the brain reduces endorphin content, Zubieta explained. People with the double-val gene make a very potent COMT enzyme that clears out dopamine rapidly, triggering more endorphin production, while people with the double-met gene have the opposite reaction.


It's an important discovery, said neurobiologist Adron Harris of the University of Texas at Austin, who has long studied why men and women tolerate pain differently.


One reason: When standard pain medications fail, antidepressants that target dopamine sometimes relieve severe, chronic pain. But there has been no way to predict who might benefit. The new research suggests a simple gene test might soon solve that problem, Harris said.


"Certainly the need to individualize pain treatment ... is great, and is now done mostly by trial and error,'' he said. "This (research) is really getting to molecular medicine or genetic medicine, where you're using the genotype to predict which drug would be best for the person.''


Pain response clearly depends on more than a single gene, Zubieta cautioned. For example, in another study, he found women tolerate pain better during the time of the menstrual cycle when estrogen levels are highest.


And Zubieta's ultimate goal isn't just to predict pain tolerance, but to understand what combination of genetics and other factors make certain people more vulnerable to painful diseases, like the joint-afflicting fibromyalgia that tends to strike women.


02/20/03 15:24 EST


Copyright 2003 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press.  All active hyperlinks have been inserted by AOL.

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Longer drug use for depression


LONDON (Feb. 20) - Most patients treated for depression should remain on medication after their gloom has lifted, new research suggests.


Over the last decade, scientists have discovered that depression, which plagues millions, recurs repeatedly in four out of five patients. However, it is still mostly tackled as an episode, and drugs are usually prescribed for no more than two or three months.


A comprehensive review of 30 years of evidence, published this week in the Lancet medical journal, suggests that is the wrong approach. In the analysis, those who stayed on antidepressants were half as likely to have another bout of depression as those who stopped taking medication.


``Everybody thinks that when their symptoms are under control they can withdraw the treatment,'' said one researcher, Dr. David Kupfer. ``It looks like the people who need medication to get better, need it to stay better.''


The World Health Organization has identified depression as the disease with the fourth heaviest burden to society and predicts that it will become the second leading cause of disability worldwide by 2020 - after heart disease - unless strides are made in prevention, diagnosis and treatment.


More than 340 million people worldwide, 18 million in the United States alone, are estimated to have depression at any one time. Experts calculate that 13 percent of men and 21 percent of women get severe depression sometime during their lives.


The Lancet researchers combined the information from 31 studies conducted over the last 30 years on patients with recurrent bouts of depression. The patients had done well on short-term antidepressant therapy and then were randomly assigned either continued drug treatment or fake pills.


The studies involved a total of 4,410 patients. Most of the studies followed patients for a year, but some tracked them for three years. The studies examined a wide range of antidepressants.


Only 18 percent of those who stayed on their drugs relapsed during the study period, compared with 41 percent of those who discontinued their medication.


It did not seem to matter which antidepressant was used.


``This calls for a clear recognition that you need to think about this as a chronic recurrent disease, and it's the same way you would treat hypertension, diabetes or chronic asthma,'' said Kupfer, chair of psychiatry at the University of Pittsburgh Medical Center.


Although experts differ on whether depression turns recurrent after two episodes or three, they agree that long-term treatment is not necessarily appropriate after a single bout of depression.


``It doesn't apply to someone who's had some kind of crisis and has got depressed for the first time and it's all rather understandable,'' said Dr. Guy Goodwin, a professor of psychiatry at Oxford University in England, which led the Lancet analysis.


And not all depression requires drugs.


Mild to moderate depression can be treated by psychotherapy, experts say, but when the condition is severe - such as when there are suicidal thoughts - medication is needed.


About 70 percent of people with depression are treated by family doctors, who prescribe the vast majority of antidepressants.


``Nobody pays any attention to the family history, the genetics, the clinical features, the fact that this is the third episode. They don't treat this as a chronic disorder, they treat it as a situational disorder and that's because we spent several decades teaching that,'' said Dr. John Greden, a depression expert who was not connected with the research.


Greden - chair of psychiatry and director of the Depression Center at the University of Michigan in Ann Arbor - said primary care doctors are getting better at diagnosing and treating depression.


``But in most cases, primary care doctors don't know enough about it, are uncomfortable with it, don't have much time with each patient and don't know what to do when the patients complain of side effects,'' he said. ``So they tend to respond by going to lower doses, which don't work.''


So far, there is no reason to believe there are any long-term health risks to continued antidepressant therapy, scientists say.


But there is evidence that recurrent depression could be bad for the brain.


``When people get ill and stay depressed, you can actually measure changes on MRI scans of the brain. You can actually see shrinkage in certain areas,'' Goodwin said. ``People's memories are chronically impaired, and recovery seems to become very difficult when severe depression has lasted for a long time. We don't really know which is the chicken and which is the egg there, but the association is very clear.''


02/20/03 20:24 EST


Copyright 2003 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press.  All active hyperlinks have been inserted by AOL.

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Study links arthritis, heart attack


WASHINGTON (Feb. 18) - Women suffering from rheumatoid arthritis may face up to double the heart attack risks of women without the condition, according to a study released on Monday.


Researchers at the Brigham and Women's Hospital analyzed health conditions of more than 114,000 people in a 20-year study, including 527 arthritis sufferers.


Their findings, reported in "Circulation: Journal of the American Heart Association," point to a possible correlation between rates of arthritis and heart attack risks in women.


"Both physicians and patients should recognize rheumatoid arthritis as a marker for increased heart attack risk," said Daniel Solomon, a rheumatologist and epidemiologist at Brigham and Women's in Boston.


"Our study, the largest of its kind to date, illustrates the importance of considering more aggressive cardiac preventive measures in arthritic patients," he said.


About 2.1 million Americans have rheumatoid arthritis, an autoimmune disease characterized by joint inflammation. Heart disease is the leading cause of death among American women.


The Brigham and Women's study found women with rheumatoid arthritis had twice the risk of heart attack compared to those without it. Those who had the joint condition for at least 10 years faced triple the heart attack risks of non-sufferers.


The study cited no link between arthritis and stroke risk.


Solomon, also a Harvard Medical School instructor, said the findings suggested inflammation could be a common catalyst for the two conditions.


"We have long known that inflammation is a hallmark of rheumatoid arthritis and new research suggests that heart disease also has an important inflammatory component," he said.


"Given this possible shared pathway, future research will need to determine whether early treatment of arthritis with anti-inflammatory drugs may also reduce the future risk of heart attacks."


02/17/03 09:59 ET

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Many undiagnosed for depression


LITTLE ROCK, Ark. (Feb. 19) - Old-age symptoms can mask signs of depression, making it difficult to diagnose and treat about 2 million older adults nationwide who suffer from depression, doctors say.


Seniors do not present classic signs of depression during visits to their family practitioners, but instead complain of various aches and pains, which Dr. Bradley Diner says are likely related to depression.


"One of the biggest red flags is when they have symptoms with no obvious cause, when in fact, what they have is depression,'' said Diner, a psychiatrist who specializes in treating the elderly.


Because doctors and patients have been conditioned to expect certain ailments in seniors - weight loss, fatigue, poor concentration, forgetfulness - some doctors overlook the possibility of depression and some patients forego seeking help. Both sides simply regard the ailments as an inevitable side-effect of aging.


"People would think, 'If you're old and sick, you'd be depressed, too.' We don't buy that anymore,'' said Dr. Mark D. Miller, an associate professor of psychiatry at the University of Pittsburgh. "A lot of people are under the impression that depression is a weakness, it's not - it's not a character flaw to admit you have it.''


Miller, who authored the book "Living Longer Depression Free,'' said most people perceive depression as something they can "get over,'' but it is a debilitating illness.


"Once it gets a hold of you, it can be just as fatal as pneumonia,'' he said. "You can look physically normal, but it's not something you can snap yourself out of.''


The National Institute of Mental Health, a federal group established in 1946 to fund mental-illness research, found depression is a significant predictor of suicide in older adults who, the group said, are disproportionately more likely to take their own lives than other age groups.


Miller said 98 percent of all suicides at any age are due to depression, but it can be prevented.


"If you treat it adequately and treat it early, it's preventable,'' he said. "When depression is removed, attitude and the ability to cope changes.''


Diner is conducting a clinical trial to examine the effects of a new drug that he hopes will provide better treatment for older adults. His Little Rock clinic is one of 50 sites in the United States recruiting seniors 62 and older to participate in the experimental study.


One of his patients, a 68-year-old woman from Sheridan who has suffered from major depression for about four years, said she is finally starting to feel normal again. The woman, who spoke only on condition that her name be withheld, said doctors could not find a physical cause when she complained of extreme fatigue four years ago.


"I was just tired all the time and I felt like I had gotten to the point where I couldn't handle it on my own,'' she said. "I used to read, do crosswords and volunteer at church, but it got worse and worse and all I could do was get up, eat and go back to sleep.''


The woman, a native Arkansan married for 51 years, said her two children and five grandchildren wanted her to get well.


"I didn't see them too much,'' she said. "But my daughter didn't give up, she kept pursuing this.''


She has been on the new medication for about six months and is now active again.


Dr. Helen Lavertsky, a researcher in geriatric depression at the University of California at Los Angeles, said the elderly are not comfortable admitting they might be depressed.


"Elderly citizens see it as a stigma, something embarrassing,'' Lavertsky said. "Some older primary care physicians may also not feel comfortable asking their patients if they feel depressed - they (the doctors) just weren't trained that way.''


Dr. G. Richard Smith, chief of psychiatry at the University of Arkansas for Medical Sciences, helped develop a new questionnaire, called the Depression-Arkansas Scale, which can help primary care physicians better diagnose and treat patients. Some of the 11 questions on the form seek to determine whether the patient feels sad, lethargic, guilty, distracted or suicidal.


Smith said that for every 10 people suffering from depression, five receive treatment; of those five, only one receives appropriate care.


"There will never be enough psychiatrists in the U.S. to treat it,'' he said.


Although family practitioners can be found in all but three of Arkansas' 75 counties, only 29 counties have psychiatrists and more than 50 percent of them are based in the Little Rock area, the state's most populous.


Donna Brown, a fourth-year medical student majoring in psychiatry at the University of Arkansas for Medical Sciences, said the lack of access to psychiatrists may contribute to problems in diagnosing and treating the disease.


02/19/03 12:13 EST

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Guest Rose Marie

I should say so! I see information too and wonder if it is post-worthy. Now that you have opened this thread... the worry is no more!


Thanks Simone!


rm :P

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  • 1 month later...
Guest Simone

Looks like its off to the swimming pool. I was hoping I could get around it. Maybe Ill take up "racket sports" lol. Thanks for the support ladies.






Study: Only Vigorous Exercise Helps Heart



.c The Associated Press


LONDON (AP) - A half-hour brisk walk every day may make you feel better, but it is not enough to ward off premature death from heart trouble, new research suggests.


A study published this week in Heart, a British medical journal, found that only vigorous exercise - such as jogging, hiking, climbing stairs, racket sports and swimming - seems to help lower the risk of early death from heart disease. Other research has shown moderate exercise helps.


Official government recommendations in the United States and elsewhere say 30 minutes of moderate activity every day, such as brisk walking, is sufficient for heart health. A major World Health Organization consensus report published last month reached the same conclusion.


However, the latest study, conducted by scientists at Queen's University in Belfast, Northern Ireland, found that activities considered to provide mild exercise - such as walking, bowling and sailing - as well as pursuits of moderate intensity - such as golfing, dancing and brisk walking - did not lower the risk of early death among 2,000 British men followed for a decade.


``It's very compelling. It does kind of fly in the face of what we have been trying to tell people, and I think it will create a big stir,'' said Dr. Ron Sha, medical director of the Duke University Diet and Fitness Center in Durham, N.C.


Sha was not involved in the study.


Previous research has yielded conflicting results, dividing experts between a group that believes moderate exercise is enough and a smaller group convinced that vigorous exercise is needed before any heart benefit can occur.


``This is one report. It's important to have this information, but it's not sufficient for us to now scrap our recommendations, which rest on a huge amount of evidence,'' said Steven Blair, president of the Cooper Institute, a Dallas-based research organization that focuses on exercise.


Blair's own studies have concluded the heart benefits from moderate exercise.


The Belfast study involved 1,975 men who had no evidence of heart diseases and were between the ages of 49 and 64 when they entered the study. They each filled out an exercise questionnaire that estimated how many calories they burned each day through exercise in their spare time.


Types of exercise were classed as light, moderate or vigorous, according to how many calories the activity burned over a fixed period of time. About 30 percent of the men reported no vigorous exercise at all, and those who did exercise intensely did not do it very often.


After about 10 years, 252, or 13 percent, of the men had died, mostly from heart or blood vessel diseases.


One drawback of the study, the scientists acknowledged, is that the men only were questioned about their exercise habits one time at the start of the study, so there is no way to know whether the men changed their habits over the 10 years the study was conducted.


Only vigorous exercise was linked with a reduction in the risk of death from heart disease or any other cause within the 10 years of the study. The more heavy exercise the men did, the less their chances of dying during the study.


Those who did the most exercise were 40 percent less likely to die than those who did the least, the researchers found.


The results were adjusted for the exercise the men did at work, but that did not change its conclusions, the scientists said.


Studies that compare different intensities and patterns of exercise, but keep the number of calories burned equal, likely will provide stronger insight into the question of exactly what is required for heart health, Blair said.


He said the superiority of the vigorous exercise might simply come down to the fact that it burns more calories than moderate exercise.

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