What is a stress test?

A stress test, also known as an exercise test or treadmill test, is used by doctors to determine how well a patient's heart works during physical activity. When the heart pumps harder during exercise, the stress test can reveal problems, such as poor blood supply through the coronary arteries - these problems might not be apparent at other times.

The stress test is also useful when the doctor is advising patients on the best type of physical activity for them.

A stress test typically involves walking on a treadmill or riding a stationary bicycle while the patient's breathing, blood pressure and heart rhythm are monitored.

According to the American Heart Association, "The (stress) test can show if there's a lack of blood supply through the arteries that go to the heart (coronary arteries)".

Some patients may not be able to do the exercise involved in a normal stress test, examples may include people with arthritis or certain disabilities in their limbs. There is another test - the pharmacological (chemical) stress test - in which the doctor gives the patient a medicine to make the heart work harder, as it might during exercise.

Why do a stress test

The doctor may recommend a stress test to determine whether the patient:

• has arrhythmia - irregular heartbeat or abnormal heart rhythm. When the electrical impulses that coordinate heart rhythm are faulty, the heart may beat irregularly.


• has symptoms that are heart-related, such as difficulty breathing or chest pain


• is suitable for an exercise program, and if so, how hard he/she should exercise


• is suitable for a cardiac rehabilitation program, and if so, how hard he/she should exercise


• is responding to heart treatment


• needs other tests to detect narrowed arteries, such as a coronary angiogram

A study carried out at the Cleveland Clinic found that a stress test can identify obstructive sleep apnea patients most at risk of death.

What happens during a treadmill stress test?

During a stress test the doctor aims to determine the patient's heart rate, blood pressure, breathing, and how tired he/she feels under different levels of physical activity.

During a stress test, the patient also undergoes an electrocardiogram (ECG or EKG) test. This is a simple test that records the heart's electrical activity - it helps the doctor understand how well the heart is working. An ECG shows how fast the heart is beating, it analyzes heart rhythm, and measures the strength and timing of electrical signals as they pass through each part of the heart.

For the ECG test, wires with electrodes are hooked up to the patient's chest, arms, shoulders and legs. Toward the end the patient may have to breathe into a mouthpiece.

All-new hybrid material offers potential for wearable electronic devices

Leveraging the amazing natural properties of the Morpho butterfly's wings, scientists have developed a nanobiocomposite material that shows promise for wearable electronic devices, highly sensitive light sensors and sustainable batteries. A report on the new hybrid material appears in the journal ACS Nano. Eijiro Miyako and colleagues explain that Morpho butterfly wings have natural properties that are beyond the capabilities of any current technology to reproduce artificially...

New type of gas hydrate desalination technique could make potable water from oil and gas production

In the midst of an intensifying global water crisis, scientists are reporting development of a more economical way to use one form of the "ice that burns" to turn very salty wastewater from fracking and other oil and gas production methods into water for drinking and irrigation. The study on the method, which removes more than 90 percent of the salt, appears in the journal ACS Sustainable Chemistry & Engineering. Yongkoo Seol and Jong-Ho Cha explain that salty wastewater is a byproduct of oil and gas production, including hydraulic fracturing, or fracking...

Management of rheumatoid arthritis just as good with specialist nurses as with doctors

Patients attending clinical nurse specialist clinics do not get inferior treatment to that offered by consultant rheumatologists, the results of a major new clinical trial have revealed. The results of the multi-centre trial at the University of Leeds, funded by Arthritis Research UK, showed that there may be some clinical benefit to people with rheumatoid arthritis, whose condition is managed in clinics run by rheumatology clinical nurse specialists, especially with respect to their disease activity, pain control, physical function and general satisfaction with their care...

A glass of wine a day may keep depression away

We have all heard that drinking a glass of red wine in moderation may be good for our health. But now, researchers have found that drinking wine may also reduce the risk of depression, according to a study published in the journal BMC Medicine.

Researchers from Spain analyzed 2,683 men and 2,822 women over a 7-year period from the PREDIMED Trial - a study that conducts research around nutrition and cardiovascular risk.

All participants were between 55 and 80 years of age, with no history of depression or alcohol-related problems when the study began.

They were required to complete a validated 137-item food frequency questionnaire annually in order to assess their alcohol intake, and their mental health and lifestyle was analyzed throughout the study period.

Two to seven glasses a week 'may reduce depression'

The findings of the study revealed that those who drank moderate amounts of alcohol (5 to 15 g a day) were less likely to suffer from depression.

Major cause of age-related memory loss discovered

Scientists say they have discovered a protein deficiency in the brain that is a major cause of age-related memory loss, according to a study published online in the journal Science Translational Medicine.

The researchers, from Columbia University Medical Center (CUMC), say this discovery offers the "strongest causal evidence" that age-related memory loss and Alzheimer's disease are individual recognizable conditions.

The study, conducted on postmortem human brain cells and in mice, revealed that the hippocampus in the brain - a region that plays an important part in memory, lacks a protein called RbAp48 in those who experience age-related memory loss.

The finding suggests that a deficiency of this protein is a cause of memory loss, but more importantly, the researchers say this form of memory loss is reversible.

They began conducting this current study in order to seek direct evidence that Alzheimer's disease is a completely separate condition from age-related memory loss.

Previous research has suggested that Alzheimer's disease hinders a person's memory by affecting the entorhinal cortex (EC) in the brain. The EC is a region that provides important pathways to the hippocampus.

According to the study authors, it was thought that age-related memory loss was an early sign of Alzheimer's, but they add that recent evidence suggests age-related memory loss is a separate process that affects the dentate gyrus (DG). This is a subregion in the hippocampus that has direct input from the EC.

Jet lag recovery sped up in mice

New research led by the University of Oxford in the UK suggests it may be possible to speed up recovery from jet lag by targeting a mechanism that prevents the body clock adjusting quickly to changes in patterns of light and dark.

Working on mice, they found a protein called SIK1 acts as a buffer or brake to limit the effect of light on the body clock. When they blocked the activity of the protein, the mice adjusted faster to changes in their light/dark cycle.

One of the team leaders, Dr. Stuart Peirson from Oxford's Nuffield Laboratory of Ophthalmology, says they found a mechanism that "actively prevents the body clock from re-adjusting," and explains it makes sense to have such a system because it keeps the body clock stable:

"The clock needs to be sure that it is getting a reliable signal, and if the signal occurs at the same time over several days it probably has biological relevance. But it is this same buffering mechanism that slows down our ability to adjust to a new time zone and causes jet lag."

The study, which was funded by the Wellcome Trust and F. Hoffmann La Roche, was published online in the journal Cell on August 29th.

Body clock synchronizes rhythm of life

Nearly all living things have an internal body clock that syncs their biology to a 24-hour cycle, ensuring functions like sleeping and eating are correctly tuned to daily patterns of light and dark.

Geriatric Safe Medicines Summit, 6-17 September 2013, London

Call for specialists involved in clinical trials in older people SMi Group reports (August 29, 2013): Call for geriatric specialists: Big Pharma Companies will meet in London to discuss challenges and opportunities for performing clinical trials in older people There are only�3 weeks left until leading industry experts will gather in London at Geriatric Safe Medicines Summit (16-17 September) to discuss major challenges faced when performing clinical trials in older people. Through a novel range of case studies, attendees will discover new market gaps, market strategies and much more...

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Announcing the All-New HIX Reloaded - Brochure Now Available We know. Health insurance marketplaces offer numerous opportunities for all of the stakeholders, but the sense of uncertainty and lack of concrete information may also be a thorn in your side. As of now, you are preparing for HIX deadlines that are constantly changing, strategizing for marketplaces that haven't launched, and trying to move forward without clear regulatory guidance. Your job may seem unmanageable and your business goals unattainable. The good news is we just may have the solution to your problems...

What exactly is metabolically healthy obesity?

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Nyack Hospital experimental study finds racial differences in optimal dosing of antibiotic used for critically ill patients

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Childhood arthritis: what remission really looks like

A molecular signature depicting remission from juvenile arthritis is described in the open access journal Arthritis Research & Therapy. The findings boost our understanding of the molecular processes involved in the disease, and could be used to help develop strategies to enhance remission. Juvenile idiopathic arthritis (JIA) is an chronic inflammatory disease of unknown cause that affects around 1 in 1000 children. Remission can be achieved with the anti-rheumatic drug methotrexate and/or drugs that target immune and inflammatory processes; so-called TNF alpha blockers...

Researchers uncover a major cause of age-related memory loss

A team of Columbia University Medical Center (CUMC) researchers, led by Nobel laureate Eric R. Kandel, MD, has found that deficiency of a protein called RbAp48 in the hippocampus is a significant contributor to age-related memory loss and that this form of memory loss is reversible. The study, conducted in postmortem human brain cells and in mice, also offers the strongest causal evidence that age-related memory loss and Alzheimer's disease are distinct conditions. The findings were published in the online edition of Science Translational Medicine...

Women urged to maintain periodontal health during pregnancy

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Sleep apnea sufferers may benefit from new surgical tool

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The height-IQ connection

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Promising therapeutic target for hard-to-treat brain tumor

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What is a breast biopsy?

A breast biopsy is the surgical removal of a small sample of breast tissue or cells to be tested for breast cancer. The doctor may recommend a biopsy if the patient has an abnormal mammogram or a lump in the breast.

Why have a breast biopsy?

A breast biopsy can be recommended for one of several reasons.

• The nipple changes - perhaps there is a bloody discharge, dimpling, scaling or crusting of the skin.


• A mammogram, ultrasound or MRI scan reveal an area in the breast that requires further investigation.


• A lump is felt in the breast, either by the patient or the doctor. There may be some thickening in the breast.

There are several methods for a breast biopsy.

Fine needle aspiration biopsy

In a FNAB (fine needle aspiration biopsy) the surgeon, pathologist or radiologist uses a very fine needle and a syringe to withdraw (aspirate) a sample of fluid from a breast cyst. It can also be used to remove clusters of cells from a solid lump. FNA is a percutaneous (through the skin) procedure.

If the doctor can feel the lump or suspicious area, the surgeon guides the needle to its target just by touch. If it cannot be felt, ultrasound may be used to see where the needle is going on the screen - this is known as an ultrasound-guided biopsy.

Stereotactic needle biopsy - the exact location of the mass is mapped using mammograms taken from two angles. That data is fed into a computer. Also known as "image-guided stereotactic breast biopsy".

The needle used in FNAB is very thin, thinner than one used for taking blood tests. According to the American Cancer Society, sometimes the patient may not even need a local anesthetic.

If clear fluid is aspirated, the mass is probably not malignant (cancerous) and the patient has a benign cyst. Cloudy or bloody fluid usually means it is either cancer or a benign cyst. If small pieces of tissue are withdrawn, the pathologist will look at the tissue and/or fluid under a microscope to determine whether it is cancer.

As the needle is so thin, the procedure might miss nearby cancerous cells. If the diagnosis is not clear, the doctor may recommend a further biopsy or a different procedure.

Video - image-guided stereotactic breast biopsy

This video below, from SouthSound Radiology, tells you what to expect from a image-guided stereotactic breast biopsy.

Core needle biopsy

With CNB (core needle biopsy), the surgeon removes solid, small samples of tissue. A hollow "core" needle is used, similar to the one in FNAB, but this one is slightly larger.

The surgeon is usually guided by ultrasound or x-rays. If a lump is palpable - can be felt with one's hand - the needle may be guided while palpating the mass.

The hollow needle withdraws cores (small cylinders) of tissue from the mass. The needle goes in several times, possibly up to six times, to remove several cores of tissue.

Although CNB is a longer procedure than FNAB, it is less likely to miss cancer cells, so the result is more reliable.

After CNB the patient may experience some bruising, but no scars.

Video - core needle biopsy

BUPA explains the procedure during a core needle breast biopsy.

Vacuum assisted biopsy

A small cut, less than ¼ inch long is made and a hollow probe is inserted through the incision and guided to the abnormal mass using MRI, ultrasound or x-rays. The probe has a hole in its side, into which tissue is "sucked" using a vacuum technique.

The surgeon can rotate the probe and collect several samples through one single incision.

No stitches are required and scarring is usually minimal.

Open (surgical) biopsy

The breast is cut and the whole (excisional biopsy) or part (incisional biopsy) of the lump is taken out and examined under a microscope. The incision is between 3 to 5 centimeters (1 to 2 inches) long

This procedure is more commonly done in the hospital's outpatient department than in the doctor's office. The patient may either receive a local or general anesthetic - in either case, the patient feels no pain.

Wire localization - if the surgeon cannot find the lump by touch, a thin, hollow needle is inserted into the breast while x-rays guide it to the mass. Then a very thin wire with a hook at the end is threaded into the hollow of the needle and attaches itself to the lump. The needle is removed, but the wire stays so that the surgeon can be guided to the target area.

With a surgical biopsy, the patient will need sutures and there will be a scar. If much tissue is removed, the patient may notice a difference in the shape of her breast afterwards.

It is common in all biopsies for the area to swell and bleed, making the mass seem bigger afterwards. This is normal - usually the bruising and bleeding will go away rapidly.

What are biopsy markers?

This is a clip or marker to mark the biopsy site. After the tissue samples have been removed, the surgeon may place a tiny clip or marker, a surgical grade medical device that is visible on mammograms.

The marker helps the doctor locate the exact site of the suspicious area in future mammograms to determine whether there are any changes.

Researchers from the Technical University of Munich in Germany explained in the Journal of Molecular Diagnostics why multiple tumor zones should be analyzed for proper biopsy diagnosis.

Preparing for your biopsy

You will be asked to sign a consent form which shows that you have given permission for the procedure to go ahead. Read it carefully and ask questions about anything that concerns you.

The John's Hopkins Hospital tells patients not use deodorant, powder, lotion, cream, or perfume on their arms or breasts on the day of the biopsy.

Before the procedure, it is important to let the doctor know if you..:

• are allergic to anything


• have taken aspirin during the previous week


• are taking anticoagulants (blood-thinning drugs), such as heparin or warfarin


• have a history of bleeding disorders


• cannot lie face down for long periods


• are taking any prescription drugs, over-the-counter medications, herbs, or supplements


• have a cardiac pacemaker or any electronic device implanted within your body. The doctor may plan to use MRI during the procedure.


• are pregnant

The Agency for HealthCare Research & Quality (AHRQ) recommends that you ask the medical team "Who will give me the results?" and "When will I get the results?".

The Mayo Clinic recommends patients wear a bra. After the procedure the medical team may place a cold pack against the biopsy site, which the bra can hold in place.

If you are to have general anesthesia, you may be required to fast (no food or drink) for up to 12 hours before the procedure.

After your biopsy

Patients who received general anesthesia are taken to the recovery room for observation after the procedure. As soon as their blood pressure, heart rate and breathing are stable, and they are mentally alert, they will be discharged.

If you are to receive general anesthesia or sedatives, arrange for somebody to drive you home afterwards.

Patients who received local anesthesia will be discharged as soon as they have completed the recovery period.

If there are stitches, keep the area clean and dry. If there are no stitches, remove the dressing or bandage according to the medical team's instructions.

The biopsy area will probably be sore and tender for some days. Your doctor will have recommended which painkillers to take. Avoid aspirin as it thins the blood and increases the risk of bleeding. Many women find that wearing a supportive bra helps.

Avoid any strenuous physical activity, according to your doctor's instructions.

Let your doctor know immediately if you have any signs and symptoms of infection, such as fever/chills, redness, bleeding, swelling, or pain around the biopsy site.

Written by Christian Nordqvist

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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What is the hemoglobin A1c test

Wireless fitness monitor 'can help heart surgery recovery'

A simple wireless "off-the-shelf" fitness monitor could help the recovery of patients who have had heart surgery, according to a study to be published in The Annals of Thoracic Surgery.

Researchers from the Mayo Clinic in Rochester, MN, analyzed a number of patients over the age of 50 who had undergone elective heart surgery. This included coronary artery bypass grafting, valve repair replacement or both.

All patients lived at home, were ambulatory before surgery, and were expected to be in hospital for 5-7 days after the procedures.

All patients were divided into groups:

• Length of hospital stay (short, intermediate or long)


• Discharge location (home, home with health care support or skilled nursing facility).

Monitors flagged 'significant differences' in mobility

On day one of recovery, when patients were discharged from the intensive care unit, wireless fitness monitors were attached to the ankle of each individual.

Parkinson's severity linked to brain inflammation

A new study found markers of inflammation in the cerebrospinal fluid that protects the brain and spine from injury, linking these markers to symptoms like fatigue, depression and anxiety in patients with Parkinson's disease. Researchers say the findings may lead to new ways of treating the complex riddle of Parkinson's.

Lena Brundin, now an associate professor at the College of Human Medicine at Michigan State University, carried out the research as part of a team from Lund University in Sweden, Skåne University Hospital in Sweden and the Mayo Clinic College of Medicine in Jacksonville, Florida.

The team measured a number of inflammatory markers in fluid samples of patients with Parkinson's and in a control group without the disease.

Prof. Brundin told the press this week:

"The degree of neuroinflammation was significantly associated with more severe depression, fatigue, and cognitive impairment even after controlling for factors such as age, gender and disease duration."

A report on the study is available to read online in Brain, Behavior, and Immunity.

Parkinson's disease not limited to motor symptoms

There is currently no cure for Parkinson's disease, a chronic, progressive neurological disorder that results from loss of brain cells that produce dopamine, a chemical that helps brain cells communicate and control movement.

According to the Parkinson's Action Network, there are around 1 million Americans with Parkinson's disease, which the Centers for Disease Control and Prevention (CDC) place as the 14th leading cause of death in the US.

The primary symptoms of Parkinson's are trembling in hands, arms, legs, jaw and face, plus stiffness of limbs and trunk, coupled with slowness of movement, impaired balance, and other symptoms such as problems chewing, swallowing and speaking. As symptoms progress, patients experience difficulty walking, talking and carrying out simple tasks.

But in addition to these motor symptoms, patients with Parkinson's disease also experience depression, fatigue and cognitive impairment.

Brain inflammation link to Parkinson's not new

The idea that brain inflammation is somehow involved in Parkinson's disease is not new, and previous studies have already linked it to non-motor symptoms like depression, fatigue and cognitive impairment.

Previous research also suggests that inflammation in the brain could drive cell death, and drugs that target this process could offer new treatments to slow progression of the disease. For instance, a study published as far back as 2007 suggested that brain cell death in parkinsons may be reduced by blocking enzyme activity.

However, Prof. Brundin explains that many of these previous studies looking at inflammatory markers in the cerebrospinal fluid of Parkinson's patients have involved only small numbers of patients, often without comparing them to healthy controls.

The study investigated over 120 patients and controls

For their investigation, the team enrolled 87 Parkinson's patients between 2008 and 2012, together with 37 healthy controls.

All participants had routine blood tests and underwent physical exams.

The team tested for the following markers of inflammation: C-reactive protein (CRP), interleukin-6, tumor necrosis factor-alpha, eotaxin, interferon gamma-induced protein-10, monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein 1-beta.

The results showed that increased levels of inflammatory markers were significantly associated with more severe symptoms of depression, anxiety, fatigue, and cognition in the entire group of Parkinson's patients.

Also, after controlling for possible influencers such as duration of Parkinson's disease, age, gender, dementia and other factors, the team found high CRP levels were significantly tied to more severe symptoms of depression and fatigue, and high MCP-1 levels were significantly associated with more severe symptoms of depression.

Prof. Brundin says they hope new treatment options will emerge from studies like this that increase understanding of Parkinson's through finding links between inflammatory markers and non-motor symptoms.

Written by Catharine Paddock PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Mental and substance use disorders 'leading cause of non-fatal illness'

Researchers say that combined, mental and substance use disorders were the leading cause of non-fatal illness worldwide in 2010, according to a study published in the The Lancet.

The study, conducted by researchers from Australia and the US, analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010).

The researchers looked at 20 mental and substance use disorders included in GBD 2010, then systematically reviewed the patterns, causes and effects of the disorders. They analyzed prevalence of the disorders by age, sex, country, region and year.

In order to calculate the years lived with disability (YLD), the researchers used community and internet-based surveys. Premature mortality was calculated as years of life lost (YLL) from cause of death estimates from 1980 to 2010 for 20 age groups, both sexes and 187 countries.

Disability-adjusted life years (DALYs) were calculated from the sum of years lived with disability and years of life lost.

Higher global death burden than HIV

Results of the analysis showed that mental and substance use disorders were the fifth leading cause of death and disease worldwide.

However, when looking at how mental and substance use disorders affected non-fatal illness only, it was found to be the leading cause, contributing to 22.8% of all disease burden.

The authors say that this difference in non-fatal illness compared with the cause of death and disease is supported by the fact that mental and substance use disorders caused a low death rate in 2010 at 232,000, relative to the overall illness they caused.

The study authors say:

"Mental and substance use disorders were the leading global cause of all non-fatal burden of disease (YLDs).

In 2010 they accounted for 175.3 million YLDs, or 22·9% of all non-fatal burden. Depressive disorders contributed most of the non-fatal burden of mental and substance use disorders followed up by anxiety disorders, drug use disorders, and schizophrenia."

Additionally, the results showed that mental and substance use disorders were responsible for higher global death and illness than HIV/AIDS, tuberculosis, diabetes, and transport injuries.

The analysis also revealed that girls and women over the age of 14 showed a higher risk of death and disease from mental disorders compared with boys and men. But men showed a higher risk of death and disease from drug and alcohol dependence over all age groups.

Number of deaths 'potentially higher'

Although the majority of the deaths recorded were a result of substance use disorders alone, the researchers note that there is a high level of premature mortality in those who suffer from mental disorders. However, within GBD 2010, the study authors say deaths are "coded" to physical cause of death.

GBD protocol states that death by suicide is to be coded under "injuries," even though, the researchers note, the majority of suicide deaths are due to mental disorders.

Also, death from illicit drugs are frequently coded as "accidental poisonings." The study authors warn that although they tried to account for these different codings, the number of deaths caused by illicit drug use could be even higher.

'Resources needed' to deliver interventions

Some individual disorders analyzed showed significant variations over countries, with eating disorders showing the largest difference. The proportion of death and disease from eating disorders was 40 times higher in Australasia, compared with sub-Saharan Africa.

The burden of death and disease from mental and substance disorders were only statistically lower in China, North Korea, Japan and Nigeria, compared with the global average.

Professor Harvey Whiteford of the Queensland Centre for Medical Health Research at the University of Queensland, Australia, says this research shows that although cost-effective interventions are available for most disorders, adequate financial and human resources are needed to deliver these interventions worldwide, particularly in developing countries.

"Despite the personal and economic costs, treatment rates for people with mental and substance use disorders are low, and even in developed countries, treatment is typically provided many years after the disorder begins," adds Prof. Whiteford.

"In all countries, stigma about mental and substance use disorders constrain the use of available resources as do inefficiencies in the distribution of funding and interventions."

"If the burden of mental and substance use disorders is to be reduced, mental health policy and services research will need to identify more effective ways to provide sustainable mental health services, especially in resource constrained environments."

Written by Honor Whiteman

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Excessive screen time affecting children's wellbeing - UK report

A sedentary lifestyle with too much time spent sitting in front of screens - such as watching TV, playing video games and surfing the Internet - is harming children's wellbeing and increasing their anxiety, according to a new briefing paper from Public Health England (PHE).

In the paper, titled "How healthy behaviour supports children's wellbeing," the PHE, a new executive agency of the UK's Department of Health, says too much screen time is having a negative effect on children by reducing self-worth, self-esteem and levels of self-reported happiness.

Children who spend too long sitting in front of a screen can also experience more emotional distress, anxiety and depression, they add.

Professor Kevin Fenton, Director of Health and Wellbeing at PHE, told the press:

"There are many complex factors that affect a child's wellbeing such as the wider environment they live in and their social, financial and family circumstances, but there are also some very simple things we can all do every day with our children to help improve their health and wellbeing."

PHE says more than 7 in 10 youngsters in the UK fail to meet the minimum recommended level of 60 minutes of daily physical activity, and just over 2 in 10 do more than the recommended minimum, placing the UK in tenth position out of 29 Organisation for Economic Co-operation and Development (OECD) countries.

PHE briefing draws on new research

The PHE briefing paper draws on new research, including evidence from academic studies and a new report from NatCen Social Research produced for the Department of Health, titled "Predicting wellbeing."

The NatCen report re-analyzed data from a number of large studies, such as the Millennium Cohort Study (MCS), Understanding Society (USoc), and the Health Survey for England (HSE), and tested a wide range of factors - spanning most aspects of life - as potential predictors of subjective wellbeing.

It found, among other things, that:

• Levels of wellbeing vary across the life course, tending to fall a little in the mid-teenage years, then again at midlife, and finally among the oldest old.


• Excessive computer gaming becomes more common as children grow into young people, and is associated with lower levels of wellbeing.


• Those children who, on a school day, spent 4 hours or more on computer gaming tended to have lower wellbeing than peers who spent less time doing this.


• The highest wellbeing was reported by children who spent less than an hour a day playing computer games.


• Home dynamics also matters, especially "things such as feeling supported and sharing meals together as a family."

NHS Smart Restart campaign suggests 5 simple things

The PHE briefing paper's release coincides with a new NHS Change4Life campaign geared toward helping families use the back-to-school period as an opportunity to encourage youngsters to reduce screen time and adopt healthier habits.

Called "Smart Restart," the campaign lists 5 simple things families can do in the first 6 weeks of the new academic year. These are:

1. Stretch your legs - walk to school, or ride a bike or scooter, instead of a bus or car


2. 10-minute moves - build up to 60 active minutes a day or more with fun, short, physical activities


3. Screen-time switch - swap 30 minutes a day of TV, computer or tablet time for something physically active


4. Beat the treats - swap unhealthy treats for healthier alternatives


5. Super lunches - prepare quick, healthy, tasty lunches that keep children going through the school day.

Families can sign up on the Smart-Restart section of theChange4Life website to get ideas and tools to help them set goals and adopt the healthier habits.

The PHE briefing explains how children who spend more time being physically active tend to concentrate better in class and enjoy better relationships with their schoolfriends.

Children with a less sedentary lifestyle also have lower levels of worry, anxiety and depression.

As in Smart-Restart, the PHE paper makes the point that even small simple changes can shift a lifestyle from sedentary to active.

Lil Caprani, Director of Communications, Policy and Campaigns at The Children's Society, says this message also came through in the survey they did for their Good Childhood Report, where they asked children about their wellbeing.

They found a strong link between being active and being happy, and while quite sporty things like cycling, swimming or playing football all had a clear relationship, as one might expect, simple things like just going for walks were also linked with higher wellbeing.

Written by Catharine Paddock PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Zealous imaging is fuelling unnecessary and harmful treatment of low risk thyroid cancers, warn experts

New imaging techniques are fuelling an epidemic in diagnosis and treatment of thyroid cancers that are unlikely to ever progress to cause symptoms or death, warn experts on bmj.com. New technologies such as ultrasound, CT and MRI scanning can detect thyroid nodules as small as 2mm - many of these small nodules are papillary thyroid cancers. In the US, cases have tripled in the past 30 years - from 3.6 per 100,000 in 1973 to 11.6 per 100,000 in 2009 - making it one of the fastest growing diagnoses. Yet the death rate from papillary thyroid cancer has remained stable...

New report shows improvement for patients with IBD following biological therapy

Over half of patients saw an improvement after being treated with biological therapies for inflammatory bowel disease (IBD). Data from the first national report of biological therapies shows that 62% of adult patients and 73% of paediatric patients saw the severity of their disease decrease after 12 weeks of treatment with biological therapy. IBD affects approximately 240,000 people in the UK[1] and patients with Ulcerative Colitis (UC) and Crohn's Disease (CD) will often require surgery during their lifetime...

First analysis of global drug dependence reveals opioids responsible for the greatest burden of death and illness

The first ever analysis of the global and regional prevalence of dependence upon the four major categories of illicit drugs - amphetamine, cannabis, cocaine, and opioids (such as heroin) - has revealed that opioid dependence causes the greatest health burden (overall death and illness) of all the illicit drugs. The results come from new analysis of the Global Burden of Disease Study 2010, and are published in The Lancet. For all of the drugs studied, over two thirds of dependent individuals were male (64% each for cannabis and amphetamines, and 70% each for opioids and cocaine)...

Interesting and useful musings are associated with a happy mood

Mind wandering can be a sign of mental wellbeing, provided that your off-task musings are interesting and useful even if not related to the task at hand, finds a new study in Frontiers in Psychology. The negative effects of mind wandering on performance and mood have recently received much attention, for example in the much-publicized study A wandering mind is an unhappy mind (Science 2010, 330:932). But Michael S...

Kidney stone removal breakthrough combines robotic surgery with new cooling technique

A first-ever technique using ice slush and minimally invasive robotic surgery to remove a particularly large type of kidney stone has been reported by urologists at Henry Ford Hospital. Dubbed RANL, for robotic anatrophic nephrolithotomy, the technique was devised to remove staghorn calculi - large kidney stones with sharp, craggy branches - that can cause disease and sometimes death if left untreated...

Best practice standards for coordinator-based fracture liaison services

Implementation of effective coordinator-based FLS services worldwide can reduce treatment gap by ensuring that fracture patients are identified and treated to reduce future fracture risk An influential report published in the journal 'Osteoporosis International', recommends 13 best practice standards in the implementation of coordinator-based fracture liaison services (FLS)...

Cannabis and the adolescent brain: Perception as a 'safe drug' is scientifically inaccurate

The nature of the teenage brain makes users of cannabis amongst this population particularly at risk of developing addictive behaviors and suffering other long-term negative effects, according to researchers at the University of Montreal and New York's Icahn School of Medicine at Mount Sinai. "Of the illicit drugs, cannabis is most used by teenagers since it is perceived by many to be of little harm. This perception has led to a growing number of states approving its legalization and increased accessibility...

Novel treatment for stroke and possibly other neurological diseases

In the latest in a series of experiments testing the use of stem cells to treat neurological disease, researchers at Henry Ford Hospital have shown for the first time that microscopic material in the cells offers a "robust" treatment for crippling stroke. "In this study we pioneered a totally new treatment for stroke, and possibly for all neurological disease," says Michael Chopp, Ph.D., scientific director of the Henry Ford Neuroscience Institute. The new study is published online in the current issue of Journal of Cerebral Blood Flow and Metabolism...

Gynecologic surgery patients benefit from enhanced recovery pathway

Patients who had complex gynecologic surgery managed by an enhanced recovery pathway (ERP) resulted in decreased narcotic use, earlier discharge, stable readmission rates, excellent patient satisfaction and cost savings, according to a Mayo Clinic study. The findings are published in the journal Obstetrics & Gynecology. A team of gynecologic oncologists, urogynecologists and anesthesiologists developed an enhanced recovery pathway for patients undergoing gynecologic surgery to recover more quickly...

What is neutropenia? What causes neutropenia?

Neutropenia is a blood condition, a granulocyte disorder, that characterized by a deficiency of neutrophils, a type of white blood cell that defends the body against bacterial and fungal infections.

Granulocytes are a category of white blood cells. They are made in bone marrow. They contain microscopic granules with proteins (enzymes) that digest invading bacteria, viruses, fungi and parasites and play a key role in our immune system response.

There are three types of granulocytes:

• Neutrophils


• Eosinophils


• Basophils

Neutropenia refers to a deficiency of neutrophils only, while agranulocytosis is when the bone marrow fails to make enough granulocytes in general (the three types). The two terms are often mistakenly used interchangeably.

Neutrophils surround invading bacteria or fungi and ingest them. Between 50% and 70% of our circulating white blood cells consist of neutrophils.

Patients with neutropenia are more likely to suffer complications from bacterial infections, which can sometimes develop into life-threatening neutropenic sepsis.

Types of neutropenia

There are several types of neutropenia. Some people are born with the disorder, others get it after taking certain prescription drugs, some after becoming ill, and in others patients the cause it not known.

Below are some basic types of neutropenia: (Source: Neutropenia Support, Australia)

• Congenital neutropenia - the patient is born with it. This type is very rare. The most severe form is known as Kostmann's syndrome.


• 
  


• Cyclic neutropenia - also very rare. Patients have low neutrophil levels every three weeks - the low level persists for 3 to 6 days each time. Consequently, they are more susceptible to becoming ill from infections in cycles of between three to four weeks, hence the name.


• 
  


• Idiopathic neutropenia - usually occurs as a result of being ill. Doctors often use this term if the patient is getting very sick all the time, but nobody is able to associate the symptoms to other diseases.


• 
  


• Autoimmune neutropenia - more commonly found in babies and young children. The body's immune system destroys the neutrophil cells. Fortunately, in many cases the child's symptoms improve with time.


• 
  


• Drug-induced neutropenia - occurs when the patient is taking a medication that may lower the white blood cell count.

'Majority' of stroke patients might have undiagnosed attention disorders

The majority of stroke patients may have attention disorders, most of which are not diagnosed, according to a study published in the journal Neurology.

Researchers from Imperial College London in the UK analyzed 110 patients who were being treated for stroke at London's Charing Cross Hospital, alongside 62 participants who had not suffered from stroke.

Five of the stroke patients had already been diagnosed with an attention disorder called "neglect" - a deficit of attention and awareness in one side of the body.

All of the participants were required to take part in an attention network test (ANT) so that the researchers could measure the patients' alertness, orientation and executive control. The tests involved "computer game" style measurements.

During the tests, the participants' performance in the brain was measured with MRI scans using a "voxel-lesion mapping approach."

'Over half of stroke patients have attention problems'

The results of the tests revealed that over 50% of the stroke patients had attention disorders that had not been diagnosed.

Dr. Paul Bentley of the department of medicine at Imperial College London says:

"We found that more than half of stroke patients have some form of attention problem, and these may be missed by routine bedside examinations."

The researchers say that the type of attention disorder was dependent on what part of the brain the patient had suffered the stroke. For example, patients who had strokes that affected:

• Front of the brain - experienced difficulty filtering out distraction


• Back of the brain - had difficulty following instructions


• Center of the brain - showed a reduction in alertness.

Doctors could predict type of attention disorder

The study authors say that the methods in this study could easily be used to predict what type of attention disorder a stroke patient might have.

The brain scans could be used to see which area of the brain had been affected by the stroke, the researchers add, while the attention network tests could be used to confirm the diagnosis.

Dr. Bentley told Medical News Today:

"Computer games similar to the one used here have been developed which can act as 'brain training' aids, and which can be tailor-made to each patient so as to rehabilitate them specifically for the deficit they show.

These findings therefore suggest a new strategy by which stroke treatments can be personalized depending on information gained from patients' brain scans."

Dr. Bentley adds that the researchers are also currently in the process of developing a "brain training" style application for the iPad. He adds:

"[It] will allow for a large proportion of stroke patients to be both assessed for attention deficit, and by playing it repeatedly, to boost any attention deficits they may have."

The researchers note that the 3 types of attention disorders discovered in this study could also lead to tailored drug therapies for stroke patients.

Scientists discover drug that could combat migraines

Researchers have discovered a new compound that could potentially treat migraines by blocking light sensors in the eyes, according to a study published in the journal Nature Chemical Biology.

Researchers from the Salk Institute for Biological Studies have found that a series of compounds called opsinamides can block a receptor in the eye called melanopsin - a receptor found in neurons connecting the eyes and the brain.

The researchers discovered 10 years ago that melanopsin is responsible for sensing light on its own, away from normal vision. Continued research found that this receptor is responsible for maintaining sleep cycles and various other sensitivity functions in those with healthy vision.

The receptor was also found to be responsible for constricting the pupil within the eye when it is exposed to bright light, triggering the light-sensitivity that is commonly linked to migraines.

The receptor also picks up on light-sensitivity as we sleep, explaining why sleep patterns can be disrupted if exposed to artificial light during the night.

From this discovery, the researchers believed that if they could find a way to block melanopsin, treatments could be created to prevent and treat migraines.

However, there are other receptors that are closely related to melanopsin - rhodopsin and cone opsins - which are responsible for processing visual information to the brain. Therefore, the researchers needed to create a drug that blocked melanopsin but did not interfere with the other receptors.

Opsinamides successful in mice study

For their latest study, the researchers analyzed hundreds of chemicals from the Lundbeck library to see whether each chemical would block melanopsin, and they measured the calcium levels when the receptors were exposed to light.

Salt intake controlled by brain, not diet

Reducing salt consumption has been recommended to help manage cardiovascular disease and high blood pressure, based on the idea that our sodium intake exceeds the needs of our body. But a study led by scientists at UC-Davis lends credence to a recent finding that sodium intake is controlled by networks in the brain, not by the salt we consume.

The current US sodium guidelines for healthy individuals are no more than 2,300 mg per day, while for those at risk of heart disease, the recommended level is no more than 1,500 mg per day.

But a study led by David McCarron and published in the American Journal of Hypertension found that humans have a specific range of sodium intake each day, which lies between 2,600 and 4,800 mg. This range, say the authors, has stayed constant during 50 years and across 45 countries.

David McCarron says:

"Our data clearly demonstrate that humans' sodium (salt) intake is regulated within a relatively narrow 'normal' range that is defined by the body's physiology and biological need rather than by the food supply."

He adds that the future health policies and guidelines for sodium intake in the US should "be developed based on that biologically determined range."

CE Mark approval for Seralite® announced, the world's first point-of-care diagnostic device for multiple myeloma

Serascience Limited, a specialist cancer diagnostics company established by a joint venture between Abingdon Health and the University of Birmingham, announces the receipt of European CE Mark approval for the commercial sale of Seralite®, its proprietary point-of-care diagnostic device for multiple myeloma. The approval allows the Company to market the world's first point-of-care diagnostic device in multiple myeloma in the 30 countries that comprise the European Union (EU) and the European Free Trade Association (EFTA)...

Target Meeting's 3rd World Cardiovascular Online Conference, September 16-18, 2013

A Free Virtual Cardiovascular Conference at Targetmeeting.com featuring 55 live presentations from academic and industry experts around the world. The 12 sessions, which will be spread over three days will discuss Cardiovascular Disease Epidemiology, Cardiovascular Clinical, Preventive Cardiovascular Medicine, Vascular Diseases, Cardiovascular Research, Heart Diseases, and many more. Attendees can earn the free Certificates of Attendance. Computer and internet connection are required. Do not need any special equipment or software...

Doctors Without Borders starts emergency rabies intervention in Democratic Republic of Congo

The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) has started a rabies intervention in the east of the Democratic Republic of Congo after an alarming number of people were bitten by rabid dogs. With ten deaths already reported, the emergency intervention aims to prevent any further fatalities from this neglected disease...

Allied granted CE mark for lead regenerative product CardioCel®

Allied Healthcare Group have announced that CardioCel® has received CE mark approval, allowing the company to launch and market the product in Europe. The CE mark for CardioCel® allows for the repair and reconstruction of heart defects including treating congenital heart disease and repairing heart valves in both children and adults...

Peptides: Not proven for use in sport

Australia's leading hormone scientists has warned that widespread assumption of the efficacy of peptides in enhancing sporting performance could lead to increased, unregulated use amongst young sportspeople. At their annual meeting in Sydney, council members of The Endocrine Society of Australia (ESA) raised concern that recent high profile cases of alleged use of banned substances in sport has created the assumption that these substances are proven to boost performance, when in fact there is little to no scientific evidence proving their effectiveness...

Return to play after concussion: Consensus reports summarized

Concussions are a common sports injury that can have long-term neurological consequences if not properly diagnosed and treated. Several new or updated guidelines for managing sports concussions were released earlier this year, and their key areas of consensus, including recommendations for return to play, are presented in an article in Journal of Neurotrauma, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available on the Journal of Neurotrauma website. Therese A. West, DNP and Donald W...

College football players gain strength and size during 4 years' training, but not speed or power

From freshman through senior year, college football players achieve significant increases in strength and size, reports a study in the September issue of The Journal of Strength and Conditioning Research, official research journal of the National Strength and Conditioning Association (NSCA). The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. But even with modern training regimens, these athletes show limited changes in speed and power, according to the study by Bert H. Jacobson, EdD, FACSM, and colleagues of Oklahoma State University, Stillwater...

Scientists exonerate a process thought to play a role in causing Parkinson's disease

Clues left at the scene of the crime don't always point to the guilty party, as EPFL researchers investigating Parkinson's disease have discovered. It is generally accepted that the disease is aggravated when a specific protein is transformed by an enzyme. The EPFL neuroscientists were able to show that, on the contrary, this transformation tends to protect against the progression of the disease. This surprising conclusion could radically change therapeutic approaches that are currently being developed by pharmaceutical companies...

Discovery of 105 additional genetic errors that cause cystic fibrosis

Of the over 1,900 errors already reported in the gene responsible for cystic fibrosis (CF), it is unclear how many of them actually contribute to the inherited disease. Now a team of researchers reports significant headway in figuring out which mutations are benign and which are deleterious. In so doing, they have increased the number of known CF-causing mutations from 22 to 127, accounting for 95 percent of the variations found in patients with CF...

Drug dosage of valproate for epilepsy linked to specific birth defects

In a world first, new Australian medical research has given pregnant women with epilepsy new hope of reducing their chance of having a baby with physical birth defects. According to research published in the September 2013 issue of Neurology®, the medical journal of the American Academy of Neurology, epilepsy experts at The Royal Melbourne Hospital have discovered a link between high doses of common epilepsy drug valproate and the increased risk of having a baby with spina bifida or hypospadias...

Compounds already exist to potentially treat both inherited and non-inherited cases of Parkinson's disease

Researchers at Johns Hopkins and elsewhere have brought new clarity to the picture of what goes awry in the brain during Parkinson's disease and identified a compound that eases the disease's symptoms in mice. Their discoveries, described in a paper published online in Nature Neuroscience, also overturn established ideas about the role of a protein considered key to the disease's progress...

Men and women with a dementia diagnosis are more likely to receive a diagnosis of urinary or fecal incontinence than those without dementia

Patients with a diagnosis of dementia have approximately three times the rate of diagnosis of urinary incontinence, and more than four times the rate of fecal incontinence, compared with those without a diagnosis of dementia, according to a study in this week's issue of PLOS Medicine by Robert Grant (Kingston University and St. George's, University of London) and colleagues. Furthermore, patients with dementia and incontinence were more likely to receive incontinence medications and indwelling catheters than those with incontinence but without dementia, the authors state...

How earning power affects sleep quality

Occupation and pay has an effect on our quality of sleep, according to The Great British Bedtime Report from the UK's Sleep Council.

The research for the report was conducted using an online poll in January of this year. More than 5,000 UK adults completed the survey, which asked them questions about their bedtime habits, occupation and household income.

According to the report, couples who have a household income of less than around $54,400 (£35,000) a year are less likely to sleep together.

The survey showed that of those who earn below the $54,400 threshold, 77% of couples say they sleep together every night, compared with 82% of those earning over $54,400 per annum.

Jessica Alexander of The Sleep Council, adds:

"The most startling statistics were how household income, or lack of it, is clearly taking its toll on relationships [...] Among those earning less than £25k [around $39,000], 12% said they never sleep with their spouse or partner. Among those not working at all the figure is 13%."

Alexander goes on to say: "[It appears around $54,400] would be a clear dividing line in terms of the number of couples who share the same bed, and once you get to the over the £55,000 [$85,000] income bracket, the percentage of couples sleeping together rises further to up to 86%." The Sleep Council is a consumer education body funded by the trade association for British bed manufacturers.

High coffee intake may help against prostate cancer

Consuming four or more cups of coffee a day could reduce the risk of prostate cancer recurrence and disease progression, according to a study published in the journal Cancer Causes and Control.

Researchers from the Fred Hutchinson Cancer Research Center in Seattle analyzed 1,001 prostate cancer survivors from a population-based study, aged between 35 and 74 years of age. All survivors had been diagnosed with the disease between 2002 and 2005.

The participants were asked to complete a food frequency questionnaire two years before their prostate cancer diagnosis, and were required to give information regarding their diet and beverage consumption.

The participants were also interviewed about their:

• Demographic and lifestyle information


• Family history of cancer


• Medication use


• Prostate cancer screening history.

The researchers ran a follow-up analysis five years after the participants' first diagnosis to find out whether the prostate cancer had recurred and/or progressed. Of the original 1,001 participants, 630 then answered questions about their coffee intake and were included in the final results.

What causes schizophrenia? Gene discoveries offer clues

Scientists have discovered 13 new locations in our genetic code that could help explain the cause of schizophrenia.

The researchers conducted an analysis over 59,000 people, publishing their findings in Nature Genetics. The study included 5,001 schizophrenia patients alongside 6,243 controls. This analysis was followed by a type of review that combines studies, a meta-analysis of studies into genome-wide associations.

They also replicated single nucleotide polymorphisms (SNPs) within 168 genomic regions of independent brain samples. SNPs are the most common type of genetic variation found within the human genome.

The study was done through a collaboration of researchers from the University of North Carolina School of Medicine, the Karolinska Institutet in Sweden, the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, and the Mt. Sinai School of Medicine in New York.

The results of the analysis identified 22 genome locations, with 13 new locations that they believe are involved in the development of schizophrenia.

You take care of Mom, but who will take care of you?

The pool of family and friends to care for Baby Boomers as they age into their 80s will be less than half as deep as it is today, according to a new report from AARP. The report predicts the ratio of potential family caregivers to elders needing care will plummet from today's seven caregivers for each person over age 80 to fewer than three caregivers per elderly person in 2050...

How TB evolves to get the better of humans

New analysis of tuberculosis (TB) genomes gathered from around the world has revealed secrets of the pathogen's brilliance in adapting itself to prey on human poverty.

By any measure, TB is highly successful in its basic success criteria of survival and replication. The authors give estimates that TB infects one-third of the world's population. It has also firmly resisted all attempts at countermeasures.

Now, thanks to close analysis of dozens of TB genomes, a team of scientists led by Professor Caitlin Pepperell of UW-Madison's department of medical biology and immunology has been able to assemble a more detailed picture of how the TB bacterium uses ruthless natural selection to adapt and perfect itself.

In their paper published in the Pathogens section of the Public Library of Science (PLoS), the team describe a bacterium that has evolved and synchronized with human population growth and development, optimizing itself to exploit particularly crowded and impoverished human settlements.

Placing winning bets

"It's as though the bacterium places bets on human behavior," says Prof. Pepperell, formerly of Stanford University:

"It always bets that humans will go to war, send people to refugee camps, and gather in miserable places. Historically, that's been a winning bet on the bacterium's part."

The study, whose senior author is Marcus Feldman of Stanford, focused on the role of natural selection, looking at patterns of genetic diversity among 63 TB and related pathogenic mycobacterial genomes gathered from around the globe.

Their analysis reveals the degree to which the evolution of TB genome variations indicates a "purifying" selection process and close matching with patterns of human populations' geographic spread and phylogeny.

The study also suggests that tuberculosis bacteria "instantaneously" expanded at least 25-fold in the 1680s, near the peak of European exploration and colonization of Africa, the Americas, Asia and Oceania, and at a time when world population had begun to show exponential growth.

"The timing is coincident with expansion, urbanization and colonial migrations of global human populations," Prof. Pepperell explains. "These findings suggest that much of the current TB pandemic has its origins in historical events of the last three centuries."

Natural selection

TB can only survive and spread within humans - not in the wider environment. It particularly thrives in the crowded conditions of prisons, refugee camps and slums, and TB populations tend to be dominated by the bacteria "lucky" enough to land in those environments.

The study shows a highly constrained bacterial genome, with most deleterious mutations quickly discarded. The team said this was especially true for genes essential for causing disease, protein translation and the trafficking and metabolism of inorganic ions, which help control the interaction between the TB pathogen and its human host.

The bacterium's "defense" genes, on the other hand, showed a high degree of tolerance for beneficial mutations, which may play a role in evolution of drug resistance and evasion of the human immune system.

Prof. Pepperell notes:

"Evolutionary theory predicts that Mycobacterium tuberculosis populations should be vulnerable to extinction. Yet it is obviously highly prevalent. It must have some incredibly clever strategies and tricks to hang on."

Finding control strategies

As a result, the explosive spread of TB parallels the growth of human populations and takes every advantage of a world in which most people live in crowded and impoverished conditions.

Prof. Pepperell says the study should help other researchers home in on genes that may be good candidates for targeting with new drugs, and aid disease control strategies that accommodate or even co-opt the bacterium's evolution mechanisms to help speed its extinction.

Written by: Nick Valentine

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Stuttering preschoolers fare as well, if not better

New research from Australia suggests that stuttering is more common among preschoolers than first thought and refutes the idea that it is associated with developmental problems. If anything, the study, which followed 1600 children from birth to age 4, found the opposite: stuttering was tied to better language and non-verbal skills, and showed no discernible link with mental or emotional drawbacks.

The findings also support the idea that for many cases of preschool stuttering, "watch and wait" may be better than giving speech therapy straight away.

A paper on the research, led by Murdoch Childrens Research Institute, Victoria, was published online in the journal Pediatrics on Monday.

Stuttering affects 1% of people

Nobody knows precisely what causes stuttering, which the National Stuttering Association (NSA) in the US defines as a communication disorder involving "disruptions or disfluencies" in a person's speech.

Although the majority of affected children outgrow stuttering, it persists in about 1% of adults across all languages and cultures. The American Institute for Stuttering (AIS) suggests the condition affects nearly 4 million people in the US and 60 million worldwide.

The condition is not caused by emotional problems and is not a nervous disorder, but people who stutter often also have tension in their speech muscles, which can be compounded by shyness, anxiety and fear of speaking.

There are as many patterns of stuttering as people, and while some only have mild stuttering patterns, others can struggle with very severe forms. Curiously, many people who stutter can sing normally.

"Watch and wait" may be best for preschool stuttering

A survey the NSA conducted in 2009 found that speech therapy helps the majority of people who stutter, however, this new study suggests that for very young children, intervening too promptly after onset of stuttering may not be the best course of action.

Lead author Professor Sheena Reilly, who is also of the University of Melbourne Department of Paediatrics at the Royal Children's Hospital in Melbourne, says their findings show that neither language ability, nor social and emotional development of young children who stutter is harmed by adopting a "watch and wait" approach, explaining that:

"Current best practice recommends waiting for 12 months before commencing treatment, unless the child is distressed, there is parental concern, or the child becomes reluctant to communicate. It may be that for many children treatment could be deferred slightly further."

Proportion of preschoolers who stutter may be higher than previously thought

For their study, the researchers set out to document "the natural history" of stuttering up to the age of four.

The data they analyzed came from the Early Language in Victoria Study, which kept records on 1619 children and their mothers from when the children were eight months to four years old.

The analysis showed that 11% of the children were stuttering by their fourth birthday. This is higher than previously reported figures: for instance the AIS says it occurs among 5-8% of children, usually between the ages of two and six.

Stuttering linked to above average language skills

But based on the data gathered from the parents, children who stuttered were no less socially or emotionally developed compared to non-stuttering peers. Plus, their scores on measures of vocabulary and other language skills were above the average.

Prof Reilly says while treatment is effective, it is intensive and expensive. To watch and wait would help target otherwise very scarce resources to the smaller number of youngsters who do not recover, and who do experience developmental problems.

There is also added security in the knowledge that delaying treatment for 12 months or a little longer does not reduce the effectiveness of treatment, she adds.

Surprisingly, the researchers also found that rates of recovery in the first 12 months after onset was low, it was only 6.3%. Recovery rates were higher in boys than girls, and in those children who did not repeat whole words at onset. Boys were also more likely to develop stuttering.

The low rates of recovery meant the researchers weren't able to find out what factors predict which kids will recover. Prof Reilly says they will be working on this next.

Written by Catharine Paddock PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Stress fuels cancer spread by triggering master gene

A new study from the US published in the Journal of Clinical Investigation finds that activation of a master gene called ATF3 that is important for helping cells adapt to stress may be involved in helping breast, and possibly other cancers spread to other parts of the body (metastasis).

With the vast majority of all cancer suffering and death associated with metastasis, researchers are keen to learn more about what causes it. The American Cancer Society says metastasis is the single most significant challenge to management of cancer.

Stress could be unifying theme in cancer spread

Previous studies have shown that stress is a risk factor for cancer, and for example, that psychological stress is linked to breast cancer aggressiveness.

And researchers already know that ATF3 is activated when all types of cells experience stressful conditions that threaten their ability to maintain a constant internal environment (homeostasis).

Under normal circumstances, triggering ATF3 protects the body from harm by causing normal cells to commit suicide if there is a risk they have become permanently damaged by the stressful conditions (eg lack of oxygen or irradiation).

When cancer cells first arise, the immune system recognizes them as foreign agents and enlists immune cells to attack them. In the early stages of cancer development this works. But then things go wrong: one reason is cancer cells start to send signals to immune cells that cause them to misbehave in a way that helps the tumor grow.

In the new study, researchers at Ohio State University show that cancer cells are able to switch on ATF3 in immune cells that have been summoned to tumor sites. The result is ATF3 then causes the immune cells to malfunction and allow cancer cells to escape from the tumor and spread to other parts of the body.

Senior author Tsonwin Hai, a professor of molecular and cellular biochemistry at Ohio, says:

"If your body does not help cancer cells, they cannot spread as far. So really, the rest of the cells in the body help cancer cells to move, to set up shop at distant sites. And one of the unifying themes here is stress."

Study suggests cancer cells target AFT3 in myeloid cells

In previous work, Prof Hai and her team found expression of ATF3 was linked to poorer outcomes in 300 breast cancer patients.

When they examined tumor samples from those patients they were stunned to find expression of ATF3 in certain immune cells was tied to poorer outcomes whereas ATF3 in cancer cells showed no such link.

In the new study, the researchers investigated those clinical results further by conducting two experiments in mice.

They first injected breast cancer cells in normal mice and in mice that could not express ATF3 in any cells.

The breast cancer in normal mice spread to the lungs much faster and more extensively than it did in the mice lacking ATF3.

In the second experiment, the team repeated what they did in the first experiment, except that instead of mice that could not express ATF3 in any cells, they used mice that had been genetically engineered to lack ATF3 only in a group of immune system cells called myeloid cells.

The results of the second experiment were similar to those of the first experiment, leading Prof Hai and her team to write:

"In conclusion, we identified ATF3 as a regulator in myeloid cells that enhances breast cancer metastasis and has predictive value for clinical outcomes."

Stress gene could be target for drugs to fight metastasis

If further studies confirm these findings, the team believe the stress gene could one day be a target for drugs that fight cancer spread.

In the meantime, Prof Hai says, they help us better understand how tumor cells hijack the body's own resources to promote cancer survival and spread.

There are lots of ways to switch on ATF3 in cells, as well as the signals sent by cancer cells, a high-fat diet, radiation, chemotherapy, UV damage and even chronic behavioral stress, are others.

The team now plans to investigate further how these and other stressors affect immune cells through switching on ATF3, changing them from attacking cancer cells to helping cancer cells.

Written by Catharine Paddock PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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Assessing pediatric readmission and revisit rates and hospital performance

Readmission rates of adult patients to the same hospital within 30 days are an area of national focus and a potential indicator of clinical failure and unnecessary expenditures. However, a new UC San Francisco (UCSF) study shows that hospital readmissions rates for children are not necessarily meaningful measures of the quality of their care...

Fabricated illness in children: Healthcare professionals need to be vigilant

While it's rare for a parent to fabricate an illness in their child, a McMaster University researcher says physicians and other health professionals need to be on the alert for this form of child abuse. Dr. Harriet MacMillan, a pediatrician and child psychiatrist of the Michael G. DeGroote School of Medicine, said caregiver-fabricated illness in a child often goes unrecognized. "It is probably more common than we realize," said MacMillan, who conducts family violence research, including trials of interventions aimed at preventing child maltreatment and intimate partner violence...

Counseling youth against tobacco use has potential to interrupt the trajectory from experimentation to regular use

The United States Preventive Services Task Force (USPSTF) recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use in school-aged children and adolescents. This recommendation statement is being jointly published in the peer-reviewed medical journals Annals of Internal Medicine and Pediatrics. This recommendation is an update. In 2003, the Task Force found insufficient evidence to recommend for or against primary care relevant interventions for youth tobacco prevention...

How SARS virus hijacks host cells

UC Irvine infectious disease researchers have uncovered components of the SARS coronavirus - which triggered a major outbreak of severe acute respiratory syndrome in 2002-03 - that allow it to take over host cells in order to replicate. This insight is critical for a full understanding of any outbreaks caused by such viruses and may prove beneficial in the development of therapies not only for human coronavirus infections but for other pathogenic illnesses as well. Study results appear online in the July/August issue of mBio...

A happier retirement ensured by better management of free time

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Red meat may raise Alzheimer's risk

Eating too much red meat, which raises brain levels of iron, may heighten the risk of developing Alzheimer's disease, researchers from the Semel Institute for Neuroscience and Human Behavior at UCLA reported in the Journal of Alzheimer's Disease .

As background information, the authors explained that iron can accelerate the damaging reactions of free radicals. Over time, iron builds up in brain gray matter regions and appears to contribute to the risk of developing Alzheimer's disease and other age-related illnesses.

Alzheimer's disease has been an exceptionally challenging enemy to defeat. Its number 1 risk factor is aging - something none of us can prevent.

Most scientists and specialists agree that Alzheimer's is caused by one of two proteins:

• Tau


• Beta-amyloid

As we get older, these two proteins either disrupt signaling between neurons or kill them off.

Team leader, Dr. George Bartzokis and colleagues believe there is a third likely cause of Alzheimer's - iron accumulation.

Professor Bartzokis and team compared the hippocampus and the thalamus using sophisticated brain-imaging high- and low-field strength MRI instruments. The hippocampus is a brain region that is damaged early on in Alzheimer's, while the thalamus is only affected during the late stages.

In early stage Alzheimer's, iron has built up in the hippocampus but not the thalamus

The MRI scans showed that iron builds up over time in the hippocampus but not the thalamus. They also saw an association between iron accumulation levels in the hippocampus and tissue damage in that area.

Most scientists concentrate on the accumulation of beta-amyloid or tau that cause the hallmark plaques associated with Alzheimer's, Bartzokis explained.

For a long time, Bartzokis had been saying that the breakdown starts off much further "upstream".

Communication between neurons is disrupted when myelin, a fatty tissue that coats nerve fibers, is destroyed, promoting the accumulation of plaques. These amyloid plaques then destroy more myelin - a self-perpetuating cascade of destruction. The more the signaling is disrupted, the more the nerve cells die, and the classic signs of Alzheimer's appear.

Myelin is produced by oligodendrocytes. Oligodendrocytes are a type of brain cell. Bartzokis explained that oligodendrocytes, along with myelin, have the highest iron levels of any brain cells.

"Circumstantial evidence has long supported the possibility that brain iron levels might be a risk factor for age-related diseases like Alzheimer's," says Bartzokis.

Too much iron promotes oxidative damage

Iron is vital for cell function. However, too much of it encourages oxidative damage, something to which the brain is particularly susceptible.

Bartzokis and team set out to determine whether high tissue iron might cause the tissue breakdown associated with Alzheimer's. They focused on the hippocampus, an area of the brain that is involved in the formation of memories. They compared the hippocampus to the thalamus, which is relatively unaffected until the very late stages of the disease.

Their MRI technique was able to measure how much brain iron there was in a protein that stores iron - ferritin. The study included 31 Alzheimer's patients and 68 healthy individuals of the same age (controls).

Measuring iron in the brain is not easy if the patient has Alzheimer's, because the amount of water in the brain increases as the disease progresses. The more water there is in the brain, the harder it is to detect iron, Bartzokis explained.

Bartzokis said "It is difficult to measure iron in tissue when the tissue is already damaged. But the MRI technology we used in this study allowed us to determine that the increase in iron is occurring together with the tissue damage. We found that the amount of iron is increased in the hippocampus and is associated with tissue damage in patients with Alzheimer's but not in the healthy older individuals - or in the thalamus. So the results suggest that iron accumulation may indeed contribute to the cause of Alzheimer's disease."

The team added that the build up of iron in the brain could be the result of some modifying environmental factors, including how much red meat the person consumes, or their intake of iron dietary supplements. Another factor that can raise iron levels in the brain is having a hysterectomy before the menopause.

In an abstract in the journal, the authors concluded:

"The data shows that in AD, Hipp damage occurs in conjunction with ferritin iron accumulation. Prospective studies are needed to evaluate how increasing iron levels may influence the trajectory of tissue damage and cognitive and pathologic manifestations of AD."

Iron imbalance linked to Creutzfeldt-Jakob disease, Alzheimer's and Parkinson's

Researchers from Case Western Reserve University, Cleveland, reported in the Journal of Alzheimer's Disease (March 2013 issue) that an iron imbalance caused by prion proteins collecting in the brain is probably the cause of cell death in CJD (Creutzfeldt-Jakob disease).

The authors added that certain proteins found in the brains of patients with Alzheimer's and Parkinson's also regulate iron. They suggest that "neurotoxicity by the form of iron, called redox-active iron, may be a trait of neurodegenerative conditions in all three diseases."

Study leader, Neena Singh, said "There are many skeptics who think iron is a bystander or end-product of neuronal death and has no role to play in neurodegenerative conditions. We're not saying that iron imbalance is the only cause, but failure to maintain stable levels of iron in the brain appears to contribute significantly to neuronal death."

Written by Christian Nordqvist

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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