This is default featured slide 1 title
This is default featured slide 2 title
This is default featured slide 3 title
This is default featured slide 4 title
This is default featured slide 5 title
 

Monthly Archives: January 2017

Walking Helps Heart and Brain

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in theProceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.

The study was supported by the National Institute on Aging, the Pittsburgh Claude D. Pepper Older Americans Independence Center, and the University of Pittsburgh Alzheimer’s Disease Research Center. The authors said they had no conflicts.

Painkiller Use Common Among NFL Players

Retired National Football League players who abused opioid painkillers while active were most likely to use and abuse the same drugs after leaving the sport, the results of a telephone survey and analysis found.

The survey found more than half of the retired NFL players interviewed used opioidpainkillers during their career. Of those, 71 percent reported misusing the drugs while playing, and 15 percent said they still abuse the prescription medication, Dr. Linda B. Cottler, of Washington University School of Medicine, and colleagues reported online in Drug and Alcohol Dependence.

The former broadcaster and NY Giants great, Frank Gifford, said, “pro football is like nuclear warfare. There are no winners, only survivors.”

The findings from Cottler’s survey support Gifford’s assessment.

An analysis of survey data showed the rate of opioid misuse while the retired players were active in the NFL was roughly three times greater than the lifetime rate of nonmedical use of opioids in the general population of approximately the same age.

Misuse in the past 30 days in retired players was seven percent, versus less than two percent in adults 26 and older in the general population. Looking only at men in the general population, the abuse rate is about two and half percent.

The final sample included 644 former players listed in the 2009 Retired NFL Football Players Association Directory who had retired from 1979 to 2006 and had at least one phone number listed.

They completed a phone interview that discussed general demographic data, health status, pain, impairment, alcohol use, prescription opioid use, and illicit drug use. Prescription opioid use was measured for while a player was active as well as over the past 30 days. Participants were categorized into users and nonusers. Users were subcategorized as having used the drugs as prescribed, or having misused them.

Misuse was defined as taking more of the drug than prescribed, using it in a way other than prescribed, using it after a prescription ended, using it for a different reason, or using it without a prescription.

When compared against players prescribed opioids while in the NFL and with those who were non-users during their NFL careers, 17 percent of those who misused while playing used as prescribed in the past 30 days, 15 percent misused in the past 30 days, and 68 percent reported no use.

In a multivariate analysis, moderate to severe pain, undiagnosed concussions, and drinking 20 or more alcoholic drinks a week were the strongest predictors of misuse. Undiagnosed concussions were reported by 81 percent of misusers.

“This association might have been due to the fact that those who choose not to report concussions are the same players who choose not to reveal their pain to a physician, thus managing their pain on their own,” the researchers wrote. “They may believe that if they report a concussion, they will be pulled from active play.”

The researchers noted the study may have been limited by lack of detailed pain information from while a player was active, a small sample size, a more inclusive definition of misuse that included abuse of opioids a player was prescribed, and a sample that included potentially more-healthy-than-average retired footballers — the researchers noted interviews with former players not in the Retired Players Association uncovered “multiple examples of serious and heavy opioid abuse.”

They added that future research could measure number of alcoholic drinks and level of pain while active in the NFL against opioid use and abuse.

The study received funding from ESPN and the National Institute on Drug Abuse.

Head Injuries Carry Long Term Death Risk

The risk of death after head injury remained significantly increased for as long as 13 years, irrespective of the severity of the injury, results of a case-control study showed.

Overall, patients with a history of head injury had more than a twofold greater risk of death than did two control groups of individuals without head injury.

Among young adults, the risk disparity ballooned to more than a fivefold difference, Scottish investigators reported online in the Journal of Neurology, Neurosurgery and Psychiatry.

“More than 40% of young people and adults admitted to hospital in Glasgow after a head injury were dead 13 years later,” Dr. Thomas M. McMillan, of the University of Glasgow, and coauthors wrote in the discussion of their findings. “This stark finding is not explained by age, gender, or deprivation characteristics.”

“As might be expected following an injury, the highest rate of death occurred in the first year after head injury,” they continued. “However, risk of death remained high for at least a further 12 years when, for example, death was 2.8 times more likely after head injury than for community controls.”

Previous studies of mortality after head injury have focused primarily on early death, either during hospitalization or in the first year after the injury. Whether the excess mortality risk persists over time has remained unclear, the authors noted.

Few studies have compared mortality after head injury with expected mortality in the community. To provide that missing context, McMillan and coauthors conducted a case-control study involving 757 patients who incurred head injuries of varying severity from February 1995 to February 1996 and were admitted to a Glasgow-area hospital.

For comparison, the investigators assembled two control groups, both matched with the cases for age, sex, and socioeconomic status and one matched for duration of hospitalization after injury not involving the head.

One control group was comprised of persons hospitalized for other injured and other comparison group included healthy non-hospitalized adults.

The cases comprised 602 men and 155 women who had a mean age of 43, and almost 70 percent were in the lowest socioeconomic quintile.

At the end of follow-up, 305 of the head-injured patients had died, compared with 215 of the hospitalized control group, and 135 of healthy, non-hospitalized adults.

Mortality after one year remained significantly higher in the head-injury group—34 percent versus 24 percent among the hospitalized comparison group and 16 percent for the healthy non-hospitalized adults.

Overall, the head-injury group had a death rate of 30.99/1,000/ year versus 13.72/1,000/year in the community controls and 21.85/1,000/year in the hospitalized-other injury control group.

The disparity was greater among younger adults (15 to 54), who had a rate of 17.36/1,000/year versus 2.21/1,000/year in the community controls. Older adults in the head injury group had a death rate of 61.47/1,000/year compared with 39.45/1,000/year in the community controls.

“Demographic factors do not explain the risk of death late after head injury, and there is a need to further consider factors that might lead to health vulnerability after head injury and in this way explain the range of causes of death,” the authors wrote in conclusion. “The elevated risk of mortality after mild head injury and in younger adults makes further study in this area a priority.”

Imported Jewelry Can Pose Danger

A 1-year-old boy living in New York City had a rapid increase in blood lead levels, and the likely source of the exposure was traced to a Cambodian amulet made from knotted string and metallic beads, according to researchers from the NYC Department of Health and Mental Hygiene and the CDC.

Testing revealed that the beads contained 45 percent lead, the researchers reported in Jan. 28 issue of Morbidity and Mortality Weekly Report.

The boy had worn the amulet — “something to protect him,” his father said — since he was 3 months old, and had been seen putting it in his mouth.

“Healthcare providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations,” the authors wrote.

Healthcare professionals should ask parents — particularly from Southeast Asian families — about the use of amulets, they added, noting that educational efforts about the risk of lead poisoning from jewelry are needed for immigrant families.

An accompanying editorial note pointed out that the CDC recommends blood lead testing for internationally adopted and refugee children and that the New York City health department recommends testing all children with recent travel to foreign countries.

Although the most common source of lead exposure in young children is paint, other sources have been increasingly identified.

That is particularly true in immigrant communities because of the use of lead-containing products from their country of origin, such as spices, food, candy, cosmetics, health remedies, ceramics or pottery, and jewelry.

For the case of the 1-year-old boy, routine lead testing showed an elevated blood lead level of 10 micrograms/dL.

According to the National Institutes of Health lead concentrations in blood should be less than 10 micrograms/dL in children and less than 20 micrograms/dL in adults.

Because he lived in a household with a cousin who had had lead poisoning, he had also been tested at 6 months. His blood lead level was just 1 microgram/dL then.

A risk assessor from the Environmental Protection Agency visited the home to look for potential sources of the lead exposure. The boy’s father denied using any imported products, and the assessor failed to find any potential sources of exposure.

Three months later, the boy’s blood level doubled to 20 micrograms/dL.

The boy’s father again denied that the child wore jewelry or charms, but eventually admitted that the child had worn an amulet acquired at a Cambodian market since he was 3 months old.

A second home inspection identified one area of paint with an elevated lead level, as well as imported spices and rice. Testing revealed that the food products did not have elevated lead content.

Within eight days of the amulet being removed from the home, the boy’s blood lead level decreased to 14 micrograms/dL.

About five weeks later — after the lead paint was reported to be removed — the boy’s blood lead level was 10 micrograms/dL, and five months after the amulet was removed, the level was down to 5 micrograms/dL.

“Although other factors might have contributed to the child’s overall lead burden,” the researchers wrote, “the most likely source identified was the amulet, based on its high lead content, statements that the child had been observed mouthing it, and the rapid decrease in the child’s blood lead level after its removal.”