Παρασκευή 20 Ιανουαρίου 2012

Digital Exercise Beneficial For Cognitive Function Of Older Adults

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Main Category: Sports Medicine / Fitness
Also Included In: Seniors / Aging;  Neurology / Neuroscience
Article Date: 18 Jan 2012 - 10:00 PST

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A new study, published in the American Journal of Preventive Medicine's February issue, reveals that virtual reality-enhanced exercise called "exergames," which combine physical exercise with computer-simulated environments and interactive videogame features, can achieve a greater cognitive benefit for older adults than traditional exercise alone.

The two-year study wanted to explore how interactive digital gaming can improve the health behaviors and outcomes for people aged 50 years and older.

Leading researcher Cay Anderson-Hanley, PhD, from the Healthy Aging and Neuropsychology Lab and Department of Psychology at the Union College in Schenectady, NY explained: "We found that for older adults, virtual-reality enhanced interactive exercise, or 'cybercycling' two to three times per week for 3 months, yielded greater cognitive benefit, and perhaps added protection against mild cognitive impairment (MCI), than a similar dose of traditional exercise."

Studies have proven that exercise is likely to prevent or delay dementia and improve cognitive functioning in normal aging, yet only 14% of adults between the ages of 65 to 74 years old, and only 7% of over 75 year-olds report to do regular exercise. Exergames are likely to increase exercise by diverting the attention from aversive aspects towards motivating features like competition and three-dimensional scenery, which lead to greater frequency and intensity as well as improved health outcomes.

Researchers recruited 101 participants aged from 58 to 99 years, from independent living facilities with indoor access, to an exercise bike for the Cybercycle Study. From all participants, 79 completed initial evaluations and training. They rode identical recumbent stationary bikes but the experimental bike had a virtual reality display on which cybercycle participants could experience 3-D tours and race against a "ghost rider," a fictional character based on their last best ride. Overall, 63 participants completed the study with an average of three rides weekly. The researchers performed a cognitive assessment to assess executive functions like attention, planning, working memory and problem solving at enrollment, after 1 month (pre-intervention) and after 3 months (post-intervention). They examined blood plasma to measure if a change in brain-derived neurotrophic growth factor (BDNF) suggested possible neuroplasticity, a mechanism of change that potentially connects exercise with cognition.

The researchers discovered that those who rode the cybercycle displayed substantially better executive function, compared with those who rode a traditional stationary bike. They also found that cybercyclists experienced a 23% reduction in progression to MCI compared with traditional exercisers. Co-principal project researcher Paul Arciero, PhD, professor of health and exercise sciences at Skidmore College, declared: "No difference in exercise frequency, intensity, or duration was found between the two groups, indicating that factors other than effort and fitness were responsible for the cognitive benefit."

Dr. Anderson-Hanley remarked: "Navigating a 3D landscape, anticipating turns, and competing with others require additional focus, expanded divided attention, and enhanced decision making. These activities depend in part on executive function, which was significantly affected."

The findings also revealed a substantially larger increase of BDNF in cybercyclists compared with traditional riders, which indicates that interactive/combined mental and physical exercise could potentially lead to cognitive benefits by way of biomarkers associated with to neurotrophic effects.

Dr. Anderson-Hanley states: "Further research will be needed to tease apart the contributions of a variety of factors in the cybercycling condition. Consistency across conditions for goal setting and competition suggests virtual reality imagery and interactive decision-making might be potent factors of the cybercycle." The final interviews with the participants provided the researchers with anecdotal evidence of the value of these unique exergames with participants commenting that they enjoyed the visual stimulation and the challenge of 'beating' fictional characters.

Dr. Anderson-Hanley concludes: "The implication of our study is that older adults who choose exergaming with interactive physical and cognitive exercise over traditional exercise may garner added cognitive benefit, and perhaps prevent decline, all for the same exercise effort."

Written by: Petra Rattue

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our sports medicine / fitness section for the latest news on this subject. "Exergaming and Older Adult Cognition: A Cluster Randomized Clinical Trial," C. Anderson-Hanley, P.J. Arciero, A.M. Brickman, J.P. Nimon, N. Okuma, S.C. Westen, M.E. Merz, B.D. Pence, J.A. Woods, A.F. Kramer, and E.A. Zimmerman doi:10.1016/j.amepre.2011.10.016. American Journal of Preventive Medicine, Volume 42, Issue 2 (February 2012). Please use one of the following formats to cite this article in your essay, paper or report:

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18 Jan. 2012. APA

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Stopping Prostate Cancer Growth - Breakthrough

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Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology
Article Date: 18 Jan 2012 - 14:00 PST

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A study by investigators at the Methodist Research Institute at Indiana University confirms that an all-natural, doctor-designed formula is effective in suppressing prostate cancer tumors. The study conducted on mice, used a human prostate cancer xenograft model.

Results from the live animal study were presented by lead researcher, Dr. Daniel Sliva at the 16th World Congress on Advances in Oncology in Rhodes, Greece and at the 14th International Symposium on Molecular Medicine.

The formula showed to be considerably effective in suppressing the proliferation and metastasis of human hormone refractory (androgen independent) prostate cancer cells. Furthermore, the formula was confirmed to be non-toxic and poses no risk of adverse effects.

Dr. Sliva, explains: "Dietary supplements are used as an alternative or adjuvant therapies. However, rigorous scientific verification of their biological activity in vitro and in vivo is necessary for the acceptance of dietary supplements in conventional cancer treatment and prevention."

The study is significant, as it is exceptionally hard to treat hormone refractory prostate cancer (androgen independent). Hormone refractory prostate cancer is the most aggressive, advanced form of the disease and usually leads to metastasis and progression of the cancer.

The ingredients of the formula, which contains botanical extracts, antioxidants, botanically enhanced medical mushrooms, and phytonutrients were chosen by the researchers based on scientific research showing their abilities to fight prostate abnormalities and provide extensive prostate support.

The researchers grafted human prostate cancer cells (tissues) onto mice using a xenograft model - where organs or tissue from an individual of one species is grafted or transplanted onto an organism of another species, genus, or family. The team found that oral administration of this natural formula produced a statistically significant suppression of tumor growth.

Study results also demonstrated that the formula worked to suppress several genes involved in cancer metastasis and proliferation. Two of the suppressed genes are associated to the metastatic potential. The genes can highlight the ability of this preparation to suppress the primary tumor growth as well as the metastatic process, a vital benefit in fighting this aggressive cancer.

Prior investigations studying this formula have been conducted at research laboratories at Columbia University, NY, NY, the Cancer Research Laboratory, Methodist Research Institute, and Indiana University health, Indianapolis, IN, using cell culture studies and gene expression analysis. These previous studies demonstrated considerable results in the formula's ability to suppress proliferation and prostate cancer growth.

The current study is a breakthrough in the investigation of this natural formula, as it used an xenograft model on mice to test for toxicity and demonstrated to inhibit tumor growth within a living mammal.

Dr. Sliva explained: "In summary, this dietary supplement is a natural compound for the possible therapy of human hormone refractory (independent) prostate cancer."

Current research on this formal continues to demonstrate positive results, and further investigations are to be conducted in the future.

Written By Grace Rattue
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Mental Health - Experts Urge For Special UN Session

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Main Category: Mental Health
Article Date: 18 Jan 2012 - 10:00 PST

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A team of international health experts has made a call for the United Nations to hold a United Nations General Assembly Special Session (UNGASS) to focus worldwide attention on neurological and mental disorders as well as substance use disorders as a central development issue, which need commitment to improve access to care, promote human rights, and reinforce evidence on effective prevention and treatment methods.

In an article of this week's issue of PLoS Medicine, the health experts, led by Vikram Patel from the London School of Hygiene and Tropical Medicine in the UK and Judith Bass from the Johns Hopkins School of Public Health in the USA declare:

"The time has come for recognition at the highest levels of global development, namely the UN General Assembly, of the urgent need for a global strategy to address the global burden of MNS disorders."

Mental, neurological, and substance use disorders, in short MNS disorders, a fairly recent acronym invented by the World Health Organization, refer to the entire range of brain and mind disorders and are leading contributors to the global burden of disease. These disorders make a profound impact on individuals' and communities' social and economic wellbeing, but most of those affected by MNS disorders around the world have no access to evidence-based interventions, with many experiencing discrimination and abuses of their human rights.

The experts highlight three extensive areas of action that need urgent investment. One of them is to improve access to evidence-based sets of care to treat MNS disorders, whilst the second one is to realize the human rights commitment that are preserved in the Convention on the Rights of Persons with Disabilities to ensure that those suffering from MNS disorders live a dignified life and the last one is to broaden the knowledge about MNS disorders.

The experts argue: "Securing the commitment of a majority of governments for a UNGASS will require a concerted effort from the diverse group of stakeholders concerned with MNS disorders. The fact that MNS disorders affect people in all countries should offer considerable incentive for investments by both public and private sectors in this initiative."

They also encourage support for the development of a ''People's Charter for Mental Health'', which aims to detect the most urgent needs and convert them into practical actionable steps for countries to implement, and explain: "This charter will be developed in consultation with the organizations from 96 countries who have signed up to the ''Great Push'' initiative so far, representing over one million people including consumers, family members, advocates, researchers, professional organizations, and policy makers."

The experts conclude stating: "Together, this grand coalition of local, national, and global actors will converge their energies towards the implementation of a UNGASS to achieve the ultimate goal of reducing the global burden of MNS disorders."

Written by: Petra Rattue

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our mental health section for the latest news on this subject. "A United Nations General Assembly Special Session for Mental, Neurological, and Substance Use Disorders: The Time Has Come" Bass JK, Bornemann TH, Burkey M, Chehil S, Chen L, et al. (2012), PLoS Med 9(1): e1001159. doi:10.1371/journal.pmed.1001159 Please use one of the following formats to cite this article in your essay, paper or report:

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Drug Helps Maintain Platelet Inhibition And Anti-Clotting Levels Prior To Cardiac Surgery

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Main Category: Blood / Hematology
Article Date: 18 Jan 2012 - 15:00 PST

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According to a study in the January 18 issue of JAMA, patients who stop using an antiplatelet agent, such as clopidogrel, before undergoing cardiac surgery to reduce their risk of bleeding and received intravenously the platelet inhibitor cangrelor, achieved a higher rate of maintenance of platelet inhibition than those who were given placebo.

The researchers explained:

"Thienopyridines (antiplatelet agents) are among the most widely prescribed medications, but their use can be complicated by the unanticipated need for surgery. Despite increased risk of thrombosis, guidelines recommend discontinuing thienopyridines 5 to 7 days prior to surgery to minimize bleeding."

However, stopping antiplatelet treatment before operations, such as coronary artery bypass grafting (CABG) too early has been linked to higher ischemic complications. Strategies of platelet inhibition need to be defined in order to safely "bridge" patients to their surgery, with minimum risk of bleeding complications or ischemic events, according to the researchers. Cangrelor is characterized by fast, effective, predictable, and reversible platelet inhibition with fast offset of effect, desirable pharmacodynamic properties for these types of patients.

Dominick J. Angiolillo, M.D., Ph.D., of the University of Florida, Jacksonville and his team conducted a randomized, multicenter trial that included 210 individuals with acute coronary syndrome (ACS), or patients treated with a coronary stent and receiving an antiplatelet agent prior to CABG surgery, in order to analyze if cangrelor is an effective and safe medication for connecting individuals receiving antiplatelet agents to CABG surgery.

Patients discontinued antiplatelet agent use 5 to 7 days prior to surgery and were given either cangrelor or placebo for at least 48 hours, which was stopped 1 to 6 hours prior to surgery. For patients who received cangrelor the median time of infusion was 2.8 days, compared to 3.4 days for those who received placebo. The primary safety end point was excessive CABG surgery-related bleeding, while the main measure of effectiveness was platelet reactivity of less than 240 P2Y12 Reaction Units (PRUs), which was evaluated each day.

The authors found that the percentage of participants with platelet reactivity of less than 240 RPU throughout the entire infusion of the investigation drug was considerably lower in the placebo group (19.0% [16 of 84]) than the cangrelor group (98.8% [83 of 84]).

The investigators say: "The percentage of overall samples displaying platelet reactivity less than 240 PRU, patients with all samples with baseline PRU value, total patient samples that maintained higher than 60 percent platelet inhibition during study drug infusion were all greater with cangrelor than with placebo."

In total, 22 participants experienced study-defined excessive CABG surgery-related bleeding. The researchers found that excessive CABG surgery-related bleeding was not considerably different among patients who received cangrelor (11.8% [12 of 102]) or those who received placebo (10.4% [10 of 96]). For both groups, pre-CABG-surgery major-bleeding events were rare; minor bleeding events were more prevalent among participants in the cangrelor group.

The investigators conclude:

"In this trial, cangrelor achieved and maintained target levels of platelet inhibition known to be associated with a low risk of thrombotic events compared with placebo, without a significant excess in bleeding complications. Our data support the hypothesis that intravenous cangrelor is a feasible management strategy in patients waiting for cardiac surgery who require prolonged platelet P2Y12 inhibition after thienopyridine discontinuation."

Written By Grace Rattue
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Grace Rattue. "Drug Helps Maintain Platelet Inhibition And Anti-Clotting Levels Prior To Cardiac Surgery." Medical News Today. MediLexicon, Intl., 18 Jan. 2012. Web.
18 Jan. 2012. APA

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Tamiflu's Effectiveness Remains Uncertain - Roche Still Not Releasing Vital Trial Data

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Main Category: Flu / Cold / SARS
Also Included In: Swine Flu;  Respiratory / Asthma
Article Date: 18 Jan 2012 - 10:00 PST

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Two years ago, pharmaceutical giant, Roche, promised the BMJ to release key Tamiflu trial data for an independent investigation. However, Roche refuses to provide full access to all its data. According to a new report by the Cochrane Collaboration, Roche's refusal to provide access leaves critical concerns about how the drug works unresolved.

A BMJ investigation, published at the same time as the report, also voices serious concerns regarding drug data access, the drug approval process and the use of ghostwriters in drug trials.

Because Tamiflu has become a common influenza treatment in the UK, with the World Health Organization also adding the drug onto their list of Essential Medicines, Roche continues to declare that it is supported by influential health agencies.

When Cochrane researchers decided to investigate into Roche's claim that Tamiflu prevented complications and reduced the number of people in need of hospitalization, they found their investigation to be jeopardized by Roche's refusal to provide all of its trial data for analysis. They managed to obtain some clinical study reports from the European Medicines Agency (EMA), but discovered that these were inconsistent with published reports and potentially under-reported the drug's side effects. The BMJ questioned Roche earlier, with Roche admitting that some of its published papers had been written by ghostwriters.

The BMJ study shows how various regulators applied different approaches to the data that was submitted to them, which lead to conflicting messages in terms of the drug's effectiveness, for example, even though Cochrane obtained a proportion of Tamiflu's clinical study reports of the trials from the EMA, it admits not asking for the remainder from the manufacturer despite being legally entitled to do so. Since then, the EMA has informed the BMJ of its plans to start publishing reports for all drugs submitted for approval within the next few years.

Dr Fiona Godlee, BMJ Editor-in-Chief declared: "We hope very much that the EMA will indeed take this important step in making the full study reports available. But we are still a long way away from having a full trial history for all drugs in clinical use. Public safety and the proper use of public money demands that we should stop at nothing less than this."

In the meantime, the US Food and Drug Administration (FDA), decided not to review the largest ever trial of Tamiflu during its drug approval process, even though it reviewed the Tamiflu trial program in probably more detail than anyone outside of Roche. The FDA declares that, "Tamiflu has not been shown to prevent such complications [serious bacterial infections]." In contrast, the US Centers for Disease Control and Prevention (CDC) carries on quoting key published trials of Tamiflu that declare the drug has a lower risk of influenza complications, even after Roche's confession of using ghostwriters for some of these trials.

Dr Godlee warns: "The discrepancies between the conclusions reached by different regulators around the world highlights the absurd situation we find ourselves in. In a globalized world, regulators should cooperate and pool their limited resources. Otherwise we will continue to waste money and risk people's health on drugs that don't work."

The investigation has also brought questions about Tamiflu's clinical effects into light. The Cochrane researchers state that after a thorough assessment of trial data Tamiflu seems to affect the production of antibodies, a statement that Roche refutes. The team highlights the importance given that influenza vaccination relies on antibody response to be effective, however when the BMJ questioned Roche, they refused to explain how the drug operates. The Cochrane researchers therefore comment that "until more is known about the mode of action of neuraminidase inhibitors, health professionals, patients and other decision makers need to reflect on the findings of this review before making any decision about the use of the drug."

Cochrane also disputes claims of Tamiflu's ability to prevent influenza from spreading, as it has not been proven in trials, however this is one of the main reasons why governments worldwide have spent billions of dollars to stockpile Tamiflu in case of a pandemic.

Roche claims that they have provided the Cochrane team with sufficient information to carry out their investigation, yet according to the Cochrane team this is untrue.

Dr Peter Doshi from Johns Hopkins University School of Medicine declares: "In the BMJ in December 2009, Roche promised full study reports to any legitimate investigators. They have not provided a single full study report to Cochrane, despite our repeated requests."

Written by: Petra Rattue


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Petra Rattue. "Tamiflu's Effectiveness Remains Uncertain - Roche Still Not Releasing Vital Trial Data." Medical News Today. MediLexicon, Intl., 18 Jan. 2012. Web.
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FDA Approves Voraxaze To Treat Patients With Chemotherapy Toxicity

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Main Category: Cancer / Oncology
Article Date: 17 Jan 2012 - 17:00 PST
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Voraxaze is an enzyme that rapidly breaks down the chemotherapy drug methotrexate to a byproduct that the body can more easily eliminate. Voraxaze is given intravenously.
Methotrexate was developed in the 1950s as a chemotherapy and is used either alone or in combination with other drugs. It is effective for the treatment of a number of cancers including: breast, head and neck, leukemia, lymphoma, lung, osteosarcoma, bladder, and trophoblastic neoplasms. It is also used for autoimmune diseases such as rheumatoid arthritis, psoriasis, psoriatic arthritis, lupus and Crohn's disease, as well as for treating ectopic pregnancy and for inducing medical abortions.
Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in the FDA's Center for Drug Evaluation and Research said :
"Prolonged exposure to high levels of methotrexate can result in kidney and liver damage, severe mouth sores, damage to the lining of the intestine, skin rashes, and death due to low blood counts ... Voraxaze is an important new treatment option for cancer patients aimed at preventing these toxicities associated with sustained high levels of methotrexate."
22 patients were added to a single clinical trial aiming to evaluate the effectiveness of Voraxaze. All the patients received Voraxaze treatment and the study considered treatment a success if the methotrexate level fell below a critical level within 15 minutes and stayed below the critical level for eight days. Ten of the 22 patients achieved this standard. Although not all patients experienced the highest results, Voraxaze eliminated 95 percent of the methotrexate in all patients. A separate trial of 290 patients analyzed problems of clearing the drug from the bloodsteam
Patients did complain of some side effects including : low blood pressure (hypotension), headache, nausea, vomiting, flushing, and abnormal sensation (paraesthesia) which were experienced by around one percent of test subjects.
Written by Rupert Shepherd
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Πέμπτη 19 Ιανουαρίου 2012

Vitamin D Doesn't Help Chronic Obstructive Pulmonary Disease

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Academic Journal
Main Category: COPD
Article Date: 18 Jan 2012 - 9:00 PST

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Chronic Obstructive Pulmonary Disease (COPD) is characterized by diseases such as Bronchitis and Emphysema, where breathing becomes more difficult as the airways are inflamed, blocked with mucus and ultimately permanently damaged. The problem is usually caused by cigarette smoking, although exposure to industrial chemicals, pollutants or smoke inhalation may also be involved.

It was thought that vitamin D might be effective in helping to ease the condition, because most patients with COPD have vitamin D deficiency, but new research published in Annals of Internal Medicine suggests otherwise.

The study was carried out by scientists at The University Hospitals Leuven, Leuven, Belgium and funded by Applied Biomedical Research Program, Agency for Innovation by Science and Technology. Wim Janssens, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues gave test subjects monthly doses of 100,000 IU or more than 3,200 IU per day, where the standard recommended dose is only 600 IU daily to 800 IU daily for lactating women and the elderly. However no marked change or improvement was seen in the patients' symptoms.

In total, 182 patients were part of the trial and all had moderate to severe COPD and recent history of exacerbations. The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, quality of life, and death.

Patients' vitamin D level was measured by blood test throughout the trial, and patients were given either 100,000UI of vitamin D per month for a year, or a placebo. The researchers then recorded whether patients had exacerbations of COPD during the study.

Although patients receiving the supplements of vitamin D showed increased levels in their blood, the number of exacerbations over the course of the year was no different to those on the placebo. Researchers did note that a small group of patients that started the trial with extremely low vitamin D levels may have showed some improvement, but results were inconclusive.

They recommended a further research to investigate whether patients with very low vitamin D levels may benefit from supplements, but so far it appears in general that most patients won't benefit greatly, if at all, and certainly Vitamin D supplements are not an effective way to prevent exacerbation of COPD.

Dr. Wim Janssens, from the respiratory division at University Hospital Gasthuisberg in Leuven, the lead investigator said :

"There are studies showing that patients with vitamin D deficiency are more susceptible to different inflammatory, infectious and autoimmune diseases, and most likely COPD ... [however] ... Vitamin D restoration to normal levels in COPD patients does not reduce the number of exacerbations, does not reduce the infections and inflammation."

Written by Rupert Shepherd
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