viernes 3 de febrero de 2012

Study Finds Link Between Heart Failure, Brain Changes: MedlinePlus

Study Finds Link Between Heart Failure, Brain Changes

Memory, planning problems could make it harder to keep up with heart treatments, researchers say

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121451.html
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By Robert Preidt

Wednesday, February 1, 2012

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WEDNESDAY, Feb. 1 (HealthDay News) -- Heart failure is associated with a loss of gray matter in the brain and a decline in mental processes, according to a new study.

These changes can make it more difficult for heart failure patients to remember and perform health care instructions such as taking the correct medications at the right times, the Australian researchers said.

They conducted memory and other mental performance tests on 35 heart failure patients, 56 patients with ischemic heart disease (which sometimes but not always accompanies heart failure), and 64 healthy people.
MRI exams were used to assess gray matter volume in different parts of the brain.

In heart failure, the heart muscle is unable to pump enough oxygen-rich blood to the body, while ischemic heart disease affects the supply of blood to the heart.

Heart failure patients had worse immediate and long-term memory and reaction speeds than healthy people. The brain scans showed that heart failure was associated with losses of gray matter in areas believed to be important for memory, reasoning and planning.

The study appears online Feb. 1 in the European Heart Journal.

"What we found in this study is that both ischemic heart disease and heart failure are associated with a loss of cells in certain brain regions that are important for the modulation of emotions and mental activity -- such a loss is more pronounced in people with heart failure, but can also be seen in people with ischemic heart disease without heart failure," Osvaldo Almeida, director of research at the Western Australia Centre for Health and Ageing in Perth, said in a journal news release.

People with both kinds of heart conditions "show subtle deficits in cognitive abilities" compared to healthy people, Almeida said. However, the researchers could not determine whether people with heart failure performed worse than those with ischemic heart disease.

Almeida said the findings "are consistent with the possibility that patients with heart failure may have trouble following complex management strategies, and, therefore, treatment messages should be simple and clear. Health professionals and patients need to be aware that problems caused by heart disease are not limited to the heart."

SOURCE: European Heart Journal, news release, Jan. 31, 2012

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More Health News on:: Heart Failure; Memory

Study Finds Link Between Heart Failure, Brain Changes: MedlinePlus

Stenting, Surgery Appear Comparable for Opening Neck Artery: MedlinePlus

Stenting, Surgery Appear Comparable for Opening Neck Artery

Re-blockage rates similar for both procedures, study finds

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121452.html
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By Randy Dotinga

Wednesday, February 1, 2012

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WEDNESDAY, Feb. 1 (HealthDay News) -- To open a clogged neck artery, a surgeon has two options: either insert a metal stent to keep blood flowing or perform surgery. A new study finds that both approaches will likely keep the arteries clear for at least two years and help prevent stroke.

"Unlike bare metal stents placed in coronary [heart] arteries, where re-blockage occurs about 20 percent of the time, we found the re-blockage rates in the carotid artery were quite small," said study lead author Dr. Brajesh K. Lal, associate professor of vascular surgery at the University of Maryland School of Medicine in Baltimore, in a statement provided by the American Stroke Association.

"Patients and physicians can be reassured that both procedures are durable and that re-blockage rates are equivalent, so they can use different criteria to determine which procedure is right for a patient," he added.
The study was funded by the U.S. National Institute of Neurological Disorders and Stroke, and by stent maker Abbott Vascular Solutions.

Clogs in the carotid arteries -- the two large blood vessels in the neck -- cause about 10 percent of strokes.
The study looked at about 2,200 patients with a partially blocked neck artery. About half the patients received a stents in the artery, which is a minimally invasive procedure, and about half underwent an artery-opening surgery.

Over two years, the researchers found that the arteries narrowed again in close to 6 percent of both groups of patients. The arteries became entirely blocked less than 1 percent of the time in both groups.

Patients whose arteries narrowed again faced a four-fold increase in their risk of stroke.

The research into these patients will continue so physicians can see what happens over a 10-year period.

Dr. Brahmajee K. Nallamothu, an associate professor of internal medicine at the University of Michigan Health System, who's familiar with the findings, said the research is valuable.

"First, it supports the durability of carotid stenting over time, and provides additional evidence for this minimally invasive treatment option," he said. "Second, it suggests a link between the recurrence of blockages and future strokes. This is an interesting observation, which has potential implications for how we manage patients who develop recurrent narrowing in their carotid artery."

Nallamothu said patients should almost always get to decide which strategy they prefer. Carotid stenting is a bit more expensive than surgery, he noted, and "side effects are the big issue. Carotid stenting appears to lower the risks of heart attacks relative to (surgery) around the time of the procedure, while the reverse is true in regards to the risk of stroke," he added.

The study was scheduled for release Wednesday at the American Stroke Association conference in New Orleans.

Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

SOURCES: Brahmajee K. Nallamothu, M.D., associate professor of internal medicine, University of Michigan Health System, Ann Arbor; American Stroke Association, International Stroke Conference 2012, New Orleans, Feb. 1, 2012

HealthDay

More Health News on:: Carotid Artery Disease; Stroke

Stenting, Surgery Appear Comparable for Opening Neck Artery: MedlinePlus

Adult Children of Stroke Sufferers May Show Signs of Brain Aging, Too: MedlinePlus

Adult Children of Stroke Sufferers May Show Signs of Brain Aging, Too

Offspring may experience physical, mental changes that can precede stroke

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121450.html

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By Robert Preidt

Wednesday, February 1, 2012

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Stroke

WEDNESDAY, Feb. 1 (HealthDay News) -- Many adults whose parents suffered a stroke before age 65 experience vascular changes and brain aging in middle age that may precede a stroke, a new study finds.

It included nearly 1,300 participants with an average age of 61 who underwent MRI brain scans to assess their brain health, including total brain volume, the volume of white matter lesions and other signs of aging or damage to brain tissue.

The participants also underwent tests to assess various mental abilities, including verbal memory, abstract reasoning, verbal learning and visuospatial memory, which is the ability to recall objects presented visually.

The study was to be presented Wednesday at the American Stroke Association meeting in New Orleans.

Nearly 10 percent of the participants had one or both parents who suffered a stroke before age 65. Strokes occur when blood flow to the brain ceases.

The scans showed these offspring had a higher volume of white matter lesions, equivalent to a difference of nearly three years in brain age, researchers said in an association news release.

A follow-up of about six years found they were also the most likely to perform poorly on tests of visuospatial memory and were more likely to have a worsening of executive functioning, which controls attention and the ability to plan.

However, having a parent who suffered a stroke before age 65 did not affect a person's total brain volume or verbal memory, abstract reasoning and verbal learning.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

SOURCE: American Stroke Association, news release, Feb. 1, 2012

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Adult Children of Stroke Sufferers May Show Signs of Brain Aging, Too: MedlinePlus

Alzheimer's-Linked Brain Plaques May Affect Memory in Healthy People: MedlinePlus

Alzheimer's-Linked Brain Plaques May Affect Memory in Healthy People

Research could lead to better understanding of the origins of Alzheimer's

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121459.html
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Wednesday, February 1, 2012

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Alzheimer's Disease

WEDNESDAY, Feb. 1 (HealthDay News) -- A new study suggests that a brain-clotting plaque linked to Alzheimer's disease may cause cognitive decline even in healthy people, potentially setting the stage for the development of the devastating illness later in life.

The findings don't point to any new treatment for Alzheimer's disease, which is incurable, and the detected decline in brain function is so small that affected people probably wouldn't notice anything in their daily lives.

Still, "I think they certainly are at higher risk of Alzheimer's," said study co-author Denise Park, A cognitive neuroscientist at the Center for Vital Longevity at the University of Texas at Dallas. She added that the test that turned up signs of the brain plaque could eventually help doctors figure out if someone's at risk for the disease long before they reach old age.

"Just because we don't have a treatment for Alzheimer's doesn't mean we'll never have one. What if we can develop this field enough that we can say things about your brain in your 40s and tell people, 'Here's a pill that you can take to slow [cognitive deterioration] down so it will never go to Alzheimer's?'" she said.

The plaque at issue is known as beta amyloid. It's a kind of protein that collects in the brains of people with Alzheimer's disease along with stringy "tangles" that appear in neurons. Research suggests that the plaques and neurons kill off brain cells, leading to declines in mental function.

The researchers wanted to study beta amyloid levels in people without Alzheimer's disease. They did PET scans on 137 people aged 30 to 89, and gave them several cognitive tests that measured things like memory and how fast their brains worked.

Those with higher levels of the brain gunk performed worse on cognitive tests measuring brain-processing speed, working memory and reasoning.

However, the differences in brain function may not mean much to the individuals. "In everyday life, I don't think you'd notice it," Park said

The study appears in the Feb. 1 online issue of Neurology.

What does the study suggest about the brain plaque? "One idea is that it's a first step in a cascade of events that ultimately leads to Alzheimer's disease," Park said. "Another possibility is that although the amyloid is there, maybe it won't increase or harm the individual for 20 or more years, that it doesn't progress as rapidly as many people think it does."

Dr. Brad Dickerson, an associate professor of neurology at Harvard Medical School, said the study is important because it adds to previous research that links higher levels of beta amyloid to cognitive problems.

"It will be interesting to follow these individuals over time in order to see whether these differences between people have any implications for risk for future cognitive decline," he said. "It would also be interesting to investigate other types of measures of brain structure and function in these individuals."

SOURCES: Denise Park, Ph.D., professor and cognitive neuroscientist, University of Texas at Dallas; Brad Dickerson, M.D., associate professor, neurology, Harvard Medical School, Boston; Feb. 1, 2012, Neurology

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Alzheimer's-Linked Brain Plaques May Affect Memory in Healthy People: MedlinePlus

Seed therapy for prostate cancer may zap fertility: MedlinePlus

Seed therapy for prostate cancer may zap fertility

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121485.html

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Wednesday, February 1, 2012

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By Amy Norton
NEW YORK (Reuters Health) - Radioactive "seeds" that are sometimes used to treat early prostate cancer may do widespread damage to the DNA in a man's sperm, a small study finds.

The damage, researchers say, would seem to be enough to make a man infertile. And they should be aware of that going into treatment.

Known as brachytherapy, the treatment involves implanting radiation-emitting pellets into the prostate gland to kill off cancer cells.

Studies have found that brachytherapy is less likely to cause erectile dysfunction than either traditional external radiation or surgical removal of the prostate gland -- two other treatment options for prostate cancer.

The prostate gland produces fluid for semen, so surgically removing it leads to infertility. But not as much has been known about the effects of brachytherapy, according to Dr. Neil Fleshner, the senior researcher on the new study.

Studies have suggested that men who undergo brachytherapy often become infertile. But there are case reports of patients who have gone on to be fathers -- planned or not.

Many men now have prostate cancer diagnosed at an earlier stage -- and at an earlier age -- through screening with prostate-specific antigen (PSA) blood tests.

"More and more prostate cancers are being diagnosed in younger men, and there are more and more older men who still want to have children," said Fleshner, who heads urology at the University Health Network in Toronto, Canada.

So it's important to give men a clearer picture of what to expect after brachytherapy, Fleshner told Reuters Health.

To help do that, he and his colleagues studied semen samples from five men who'd undergone brachytherapy at least one year earlier, all of whom were younger than 55.

They compared the samples with published data on healthy, fertile men and with information on more than 7,600 infertile men who were part of a large database.

Overall, 46 percent of sperm from the brachytherapy patients had DNA "fragmentation" -- genetic damage that, in great enough proportion, would render a man infertile.

By comparison, 13 percent of sperm from fertile men and 20 percent from infertile men had such damage.

All five brachytherapy patients had an abnormally high amount of genetically damaged sperm -- "indicating likely infertility in all," Fleshner's team reports in the Journal of Urology.

Men who are having their prostates surgically removed and still want to have children can opt to bank their sperm ahead of treatment.

Similarly, Fleshner said, "if a man is going for brachytherapy, then sperm-banking may be a good idea."
But in weighing treatment options, any man has to discuss the benefits and risks of each with his doctor, according to Fleshner.

In general, any prostate cancer therapy can have lasting side effects, like urinary incontinence and erectile dysfunction.

And because brachytherapy is used for early-stage prostate cancer, some men who are candidates for it may also be able to delay having any treatment at all.

That's because prostate cancer is often slow-growing and may never advance to the point of threatening a man's life. So many men with early-stage tumors can opt for "active surveillance" -- which means monitoring the prostate cancer over time to see if it's progressing.

One study found that more than 120,000 American men diagnosed with prostate cancer every year are ideal candidates for active surveillance.

In reality, though, the majority of those men end up having surgery, radiation or other treatment instead.

SOURCE: http://bit.ly/wxNaA6 Journal of Urology, online January 19, 2012.
(Note: This story corrects an earlier version to remove an extra character in SOURCE line immediately above.)

Reuters Health

More Health News on:: Male Infertility; Prostate Cancer

Seed therapy for prostate cancer may zap fertility: MedlinePlus

Science Shows How Massage Eases Sore Muscles: MedlinePlus

Science Shows How Massage Eases Sore Muscles

Getting one post-workout can spur cellular processes that cut inflammation and pain

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121461.html
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By Robert Preidt

Wednesday, February 1, 2012

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WEDNESDAY, Feb. 1 (HealthDay News) -- Having a massage after strenuous exercise not only feels good, it reduces inflammation in muscles at the cellular level, researchers have found.

Massage also appears to promote the growth of new mitochondria in skeletal muscle. Mitochondria are cells' energy-producing "powerhouses," explained the researchers at the Buck Institute for Research on Aging and McMaster University in Hamilton, Ontario.

For the study, the investigators conducted genetic analyses of muscle biopsies from the quadriceps of 11 men after they exercised to exhaustion on stationary bicycles. After the workout, one of each participant's legs was massaged. Biopsies from both legs were taken before exercise, immediately after 10 minutes of massage, and 2.5 hours after the end of the workout.

The researchers found that massage reduced the activity of inflammation-inducing proteins called cytokines in muscle cells and promoted the growth of new mitochondria, according to the study published in the Feb. 1 online edition of the journal Science Translational Medicine.

Many people find that having a massage after exercise reduces muscle pain. This pain reduction may involve the same mechanisms as those targeted by common anti-inflammatory drugs, explained Simon Melov, a Buck Institute faculty member.

"There's general agreement that massage feels good; now we have a scientific basis for the experience," Melov said in an institute news release.

The findings provide validation for massage, which is growing in popularity, said lead author Dr. Mark Tarnopolsky, of the pediatrics and medicine department at McMaster.

"The potential benefits of massage could be useful to a broad spectrum of individuals including the elderly, those suffering from musculoskeletal injuries, and patients with chronic inflammatory disease," Tarnopolsky said. "This study provides evidence that manipulative therapies, such as massage, may be justifiable in medical practice."

SOURCE: Buck Institute for Research on Aging, news release, Feb. 1, 2012

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Science Shows How Massage Eases Sore Muscles: MedlinePlus

The very old may feel helpless, but not depressed: MedlinePlus

The very old may feel helpless, but not depressed

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121480.html
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Wednesday, February 1, 2012

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By Andrew M. Seaman
NEW YORK (Reuters Health) - People over 100 years old may say they feel "helpless" and "worthless" because they can't do the things they used to, but that doesn't mean they're not in good spirits suggests a new study.

The researchers say their findings indicate that people around 100 years old may see life differently than people 20 or 40 years their junior and traditional tests for depression may not be effective in the extremely old.

"We're saying look at more of the components that make up depression," said Peter Martin, a gerontology researcher at Iowa State University and one of the study's authors. "Some may be more relevant to centenarians than others."

Martin and his fellow researchers examined existing information collected from 323 people living in Georgia between 1988 and 1997 who were over 60, 80 or 100 years old. Of these, 139 participants were over 100 years old, 93 were in their 80s and 91 were in their 60s.

Each of the study's participants answered a survey known as the Geriatric Depression Scale, which asks 30 yes-or-no questions about whether the person was depressed in the past week. The more yeses, the more likely they're depressed.

Overall, the100-year-olds scored higher for depression than the people in their 80s or 60s according to the survey's summary score of all 30 questions.

The centenarians answered "yes" to about 13 questions on the survey while people in their 80s answered "yes" to about 12 and people in their 60s said "yes" to about 11 questions.

All of the 100-year-olds, however, said they were in "good spirits."

Indeed, when the researchers looked at subsets of questions, they found the participants in their 60s and 80s said yes more often to statements like, "I feel downhearted," "I am not satisfied with life," "I am afraid of something bad," and "I do not enjoy getting up in the morning."

"If you look (just) at the summary score you might come to the wrong conclusion," Martin told Reuters Health.

Even though the survey was developed for geriatric subjects, he says, some of the questions may yield misleading answers when it comes to the oldest old.

Some of the "yes" answers on the scale could be chalked up to the 100-year-olds' advanced age -- especially those relating to being less active, being unable to start new projects or saying they had lost interest or energy.

Other than physical impairments and limitations, Martin said, there are differences in other symptoms when you compare younger people to those who are over 100 years old.

"You know a centenarian is probably going to tell you, 'I'm not going to live much longer,'" said Martin. But he added, while that statement may sound disturbing coming from a younger person, it's reality for someone over 100 years old.

Instead, Martin said, a 100-year-old saying they feel sad or "blue" may be a better sign of depression.

"Depression varies in both its appearance and experience across the lifespan," said Dr. Charles F. Reynolds III, the endowed professor in geriatric psychiatry at the University of Pittsburg Medical Center.

Reynolds, who was not involved with the new study, told Reuters Health that in diagnosing depression, it's typical to combine the use of self reporting, like a survey, with an interview of the person, their family or someone involved with their care.

The researchers write in the Journal of the American Geriatrics Society that the study is limited because it focused on people still living in a community. So the results may not be applicable to someone living in a nursing home or other institution.

Martin told Reuters Health that treatment for depression in a very old person can include medication, but he said it could be as simple as allowing the person to contribute or be more engaged.

"Their life is not over yet. It's the last chapter of the book, but sometimes the last chapter of the book has the most interesting stuff in it," said Martin.

SOURCE: http://bit.ly/AfLdBd Journal of the American Geriatrics Society, online January 27, 2012.

Reuters Health