Drug Shows Promise Against Arthritis Common in People with Psoriasis

 

WEDNESDAY June 11, 2014, 2014 -- A new drug called Brodalumab appears to be effective in treating patients suffering from psoriatic arthritis, a study says.

Patients who responded to brodalumab had a significant improvement in their skin and reduction in the swelling of the fingers and toes, a condition called dactylitis that is common in psoriatic arthritis, according to the study's lead researcher, Dr. Philip Mease, a rheumatologist at Swedish Medical Center in Seattle.

"We have a medication with a different mechanism of action than currently available drugs, increasing our chances to control this disease, which can be disabling and significantly affects patients' function and quality of life," said Mease.

"We know that many patients will lose response to some medications or develop adverse effects, so there is a need for medicines that work differently," he said. "We have a chance to bring patients back closer toward their normal state of being."

The study was funded by Amgen, the maker of brodalumab. Results of the study were published June 12 in the New England Journal of Medicine. The study's findings were also scheduled to be presented on Thursday at the European Congress of Rheumatology's annual meeting in Paris.

Psoriatic arthritis is a type of arthritic inflammation that affects as many as 30 percent of people who have psoriasis, according to background information in the study.

Psoriasis causes scaly red and white patches on the skin, according to the American College of Rheumatology (ACR). In psoriatic arthritis, the immune system attacks the joints as well, causing inflammation. Persistent inflammation from psoriatic arthritis can lead to joint damage, according to the ACR.

Like psoriasis, psoriatic arthritis symptoms come and go, vary from person to person, and even change locations over time.

Psoriatic arthritis may affect one joint or several. For example, it may affect one or both knees. Affected fingers and toes can become swollen. Fingernails and toenails also may be affected.

Mease noted that psoriatic arthritis has a genetic component that makes it distinct from other types of arthritis.

"There are also certain genes that are present in people who develop the arthritis that are not present in people with psoriasis. So there seems to be a heavy genetic component for determining who gets psoriasis and goes on to get psoriatic arthritis," he said.

Current treatment for psoriatic arthritis depends on how much pain the patient has. Treatment usually starts with painkillers such as ibuprofen (Motrin or Advil) or naproxen (Aleve).

Mease noted that many patients are also given methotrexate (Trexall), which treats both arthritis and psoriasis. Other drugs, known as biologic therapy, that are also used to treat both conditions include adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi) and infliximab (Remicade).

Current drugs such as methotrexate target a substance called tumor necrosis factor-alpha, which is produced in response to inflammation. But these drugs tend to be less effective over time, Mease said.

Brodalumab works differently. It acts against interleukin-17 receptor A, a substance found in higher levels in people with psoriatic arthritis, according to the study.

For the current phase 2 trial of brodalumab, Mease and colleagues randomly assigned 168 patients with psoriatic arthritis to a low (140 milligrams) or high dose (280 milligrams) of brodalumab, or a placebo.

The average age of the study participant was 52 years. Two-thirds of the study volunteers were women and 94 percent were white (which included Hispanics and Latinos). The average amount of time they'd had psoriatic arthritis was nine years, according to the study.

After 12 weeks, patients taking either dose of brodalumab had a greater response to treatment than those receiving placebo (37 percent and 39 percent versus 18 percent).

Moreover, 14 percent of those taking brodalumab had a 50 percent improvement in symptoms based on the American College of Rheumatology response criteria, compared with 4 percent who received the placebo, the researchers found.

Improvements were seen in both patients who had previous biologic therapy, as well as those who had not had biologic therapy in the past, the researchers noted.

After 24 weeks of treatment, 51 percent of patients taking the lower dose of brodalumab and 64 percent taking the higher dose responded to the drug. In addition, 44 percent of the patients who switched from placebo to brodalumab responded to treatment.

These responses were maintained through a year, the researchers said.

At week 12, serious side effects occurred in 3 percent of patients in the brodalumab groups and in 2 percent of those in the placebo group, they add. These included stomach pain and a skin infection called cellulitis. "This is consistent with what had been seen with other so-called biologic medications," Mease said.

Dr. Robert Kirsner is a professor and vice chairman of the department of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine. "The results of this, albeit small study are extremely encouraging for patients who suffer from these conditions and for the physicians who treat them," Kirsner, who was not part of the study, said.

A phase 3 trial -- the last step before potential U.S. Food and Drug Administration approval -- is under way, testing brodalumab as a treatment for psoriasis. According to Mease, Amgen hopes to have the drug approved for psoriasis first, and then as a treatment for psoriatic arthritis.

Take Heartburn Medicines Before Breakfast for Best Effect

 

WEDNESDAY June 11, 2014, 2014 -- Many people with heartburn aren't taking their acid-reducing medicine at the right time, which makes the drugs less effective and wastes money, according to new research.

Only about one-third of those buying these medications -- such as Nexium, Prevacid and Prilosec -- over-the-counter used them properly compared to just under half of those who were prescribed the drugs by their primary care doctor. Those who were given a prescription by a gastroenterologist were most likely to use the drugs as they're supposed to be used, with seven out of 10 taking the drugs properly, according to the study.

These drugs are activated once in the body, said the study's senior author, Dr. M. Michael Wolfe, a gastroenterologist and chair of the department of medicine at MetroHealth System. "In order to activate the medicine, you must eat. For that reason, you take it before breakfast. If you don't take the drug correctly, you don't do as well," Wolfe said.

Despite labels advising users to take the drugs before breakfast, people aren't following those directions, he said. Those who aren't taking the medicines properly "are wasting money, they're not feeling well and they aren't getting symptom relief," Wolfe added.

The study was published in the June issue of The American Journal of Gastroenterology.

Heartburn is a painful, burning feeling just below the breastbone, experienced at least once a month by about 44 percent of U.S. adults. About 7 percent have heartburn daily. Frequent heartburn may indicate a condition called gastroesophageal reflux disease, or GERD. Food and acid from the stomach backs up, or refluxes, into the esophagus. Reflux can damage the esophagus and cause serious issues over time.

Direct costs related to GERD, including acid-reducing medicines, top $10 billion each year in the United States, according to background information in the study.

The medications looked at in this study are a class of drugs known as proton pump inhibitors. They work by reducing the amount of stomach acid produced, according to the U.S. National Library of Medicine. Unlike antacids, such as Tums or Rolaids, proton pump inhibitors don't provide immediate relief of heartburn symptoms. It takes about 7 days of continuous use for the drugs to reach their maximum acid-suppressing potential, the study noted.

Wolfe and his colleagues surveyed 610 patients who used heartburn medicine for their GERD. Of that group, 190 got a prescription heartburn medicine from a gastroenterologist and 223 received a prescription from their primary care doctor. The other 197 bought over-the-counter heartburn medicines.

Those prescribed the medicines by their gastroenterologist did best, Wolfe noted, with 71 percent taking the medicines correctly. Only 47 percent of those who got prescriptions from their primary care doctors took them correctly. And just 39 percent of those who bought them over-the-counter used them right, the investigators found.

In a previous study, only one-third of primary care doctors told patients to take the medicines before meals, but nearly all gastroenterologists did, according to the report.

In his study, Wolfe found, the severity and frequency of symptoms were better in those who were prescribed the drug by a gastroenterologist compared to a primary care doctor.

"If you have frequent heartburn, you have a disease, GERD," Wolfe said. "And you really should see a physician and not treat yourself," he explained.

Dr. John Lipham is director of the Digestive Health Center at Keck Medicine of the University of Southern California. Lipham reviewed the findings but was not involved in the study.

"It's something we have known since these medications came out, that they work best if you take them 30 minutes or so before a meal," said Lipham.

However, he pointed out that the new study puts some data behind what experts knew from experience.

Lipham said the new study is the first, to his knowledge, to show a difference in taking the medicine correctly depending on who prescribed it.

Wolfe and Lipham both find that patients often think of the proton pump inhibitors in the same way as antacids, meant to be taken when heartburn strikes.

"But these [proton pump inhibitor] medicines don't work that way," Lipham said. "They need to be stimulated by acid and need to build up in your system. You have to take them at the correct time each day and you also need to take them every day to get the maximum effectiveness of the medications."

As to why doctors aren't all telling their patients how to use these drugs, Wolfe speculated that primary care doctors may be too busy and don't have the time to read all of the drug literature.

The bottom line is "it boils down to education," said Wolfe. Physicians and consumers need to take the time to learn about the drugs.

Ideally, Wolfe said, you should take the medicine in the morning, then ''eat something that causes your stomach to make acid, such as protein, an egg, a piece of cheese, yogurt." For those who hate breakfast, he advises drinking a glass of milk or at least a cup of coffee.

More information

To learn more about heartburn, visit the U.S. National Library of Medicine.

Posted: June 2014

Mylan Launches Generic Actonel Tablets, 150 mg

 

PITTSBURGH, June 11, 2014 /PRNewswire/ -- Mylan Inc. (Nasdaq: MYL) today announced that it has launched Risedronate Sodium Tablets USP, 150 mg, the generic version of Warner Chilcott's Actonel® Tablets. Mylan received final approval from the U.S. Food and Drug Administration (FDA) for its Abbreviated New Drug Application (ANDA) for this product, which is indicated for the treatment and prevention of osteoporosis in postmenopausal women.

Risedronate Sodium Tablets USP, 150 mg, had U.S. sales of approximately $171.6 million for the 12 months ending March 31, 2014, according to IMS Health.

Currently, Mylan has 303 ANDAs pending FDA approval representing $105.3 billion in annual brand sales, according to IMS Health. Forty-one of these pending ANDAs are potential first-to-file opportunities, representing $25.4 billion in annual brand sales, for the 12 months ending Dec. 31, 2013, according to IMS Health.

Mylan is a global pharmaceutical company committed to setting new standards in health care. Working together around the world to provide 7 billion people access to high quality medicine, we innovate to satisfy unmet needs; make reliability and service excellence a habit; do what's right, not what's easy; and impact the future through passionate global leadership. We offer a growing portfolio of more than 1,300 generic pharmaceuticals and several brand medications. In addition, we offer a wide range of antiretroviral therapies, upon which approximately 40% of HIV/AIDS patients in developing countries depend. We also operate one of the largest active pharmaceutical ingredient manufacturers and currently market products in approximately 140 countries and territories. Our workforce of more than 20,000 people is dedicated to improving the customer experience and increasing pharmaceutical access to consumers around the world. But don't take our word for it. See for yourself. See inside. mylan.com

SOURCE Mylan Inc.

Posted: June 2014

Guidelines address long-term needs of prostate cancer survivors

 

The guidelines are designed to promote optimal health and quality of life for the posttreatment prostate cancer survivor by facilitating the delivery of comprehensive posttreatment care by primary care clinicians. They are based on recommendations set forth by an expert panel convened as part of the work of the National Cancer Survivorship Resource Center, a collaboration between the American Cancer Society and The George Washington University Cancer Institute, funded by a 5-year cooperative agreement from the Centers for Disease Control and Prevention (CDC).

Prostate cancer survivors represent more than four in ten male cancer survivors and one in five of all cancer survivors in the United States. While guidelines exist for treatment and surveillance for recurrent disease, availability of guidelines for long-term posttreatment care is limited. The American Cancer Society Prostate Cancer Survivorship Care guidelines were developed using a combined approach of evidence synthesis and expert consensus. They address health promotion, surveillance for recurrence and screening for second primary cancers, and the assessment and management of physical and psychosocial long-term and late effects resulting from prostate cancer and its treatment. A key challenge to the development of the guidelines was the limited availability of published evidence informing the clinical management of prostate cancer survivors after treatment.

Among the recommendations:

• Since information needs evolve as patients transition from treatment through various stages of survivorship, survivor and caregiver information needs should be assessed regularly, with information and support services provided or referred to as necessary.
• Primary care clinicians should provide regular evaluations of survivors to determine appropriate levels of participation in health promotion and lifestyle modification programs.
• Primary care clinicians should conduct routine assessments of body mass index among survivors across the prostate cancer survivorship continuum, with recommendations for limiting consumption of high-calorie foods and beverages for survivors who are overweight or obese.
• Primary care clinicians should educate survivors regarding the association between physical activity and lower overall and prostate cancer-specific mortality and improved quality of life.
• Since smoking after treatment of prostate cancer increases the risk of cancer recurrence and second cancers, primary care clinicians should assess for tobacco use and offer or refer survivors to cessation counseling and resources.
• While existing evidence is not definitive with regard to frequency of monitoring for recurrence using PSA testing, a leading clinical practice guideline, The NCCN guidelines for prostate cancer treatment recommend measuring serum PSA levels every 6 to 12 months for the first 5 years after definitive treatment, and then to recheck annually.
• Clinicians should be aware of a small increased risk of second primary cancers after radiation therapy compared with men receiving surgery. While evidence does not support increased frequency or intensity of screening, adherence to routine ACS screening guidelines for the early detection of any new cancers is recommended.
• Survivors should be assessed for physical (e.g.: urinary, sexual, bowel) and psychosocial effects of prostate cancer and its treatment; the focus of assessment should be tailored to the type of cancer treatment received and current disease state to trigger appropriate self-management and clinical management strategies for support and therapy.
• Estimates indicate that as many as 30% of patients with prostate cancer experience clinically relevant general distress, 25% have increased anxiety, and nearly 10% experience major depressive disorder. These guidelines affirm early identification, treatment, and ongoing assessment for psychological distress as important aspects of prostate cancer survivorship care.

"We are hopeful that the hard work that went into the development of these much-needed guidelines will pay off in improved care for the approximately 240,000 men diagnosed with prostate cancer every year," said Rebecca Cowens-Alvarado, MPH, principal investigator for the National Cancer Survivorship Resource Center, director of Cancer Control Mission Strategy at the American Cancer Society and co-author of the report. "The adoption of these guidelines will be a critical step forward to improve the delivery of prostate cancer survivorship care."

Malaria: Blood cells behaving badly

 

June 10, 2014

American Institute of Physics (AIP)

New insight into how malaria parasites perturb flow, turning infected cells into sticky capillary cloggers, may lead to new and better treatments. All the billions of flat, biconcave disks in our body known as red blood cells (or erythrocytes) make three basic, tumbling-treadmill-type motions when they wend their way through the body's bloodstream ferrying oxygen from our lungs to our brains and other tissues. That is, unless they are infected with malaria parasites, in which case their motions are completely different.

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New insight into how malaria parasites perturb flow, turning infected cells into sticky capillary cloggers, may lead to new and better treatments.

A team of researchers at the National University of Singapore (NUS) has discovered this striking difference by comparing the flow dynamics of healthy vs. malaria-infected red blood cells. Reported this week in the Journal of Applied Physics, from AIP Publishing, their work may provide insights into developing better-targeted drug treatments for malaria in the future.

"By gaining a better understanding of why and how erythrocytes undergo changes in geometry and physical properties, we hope to elucidate such changes as possible targets for possible effective treatment of malaria," said Nhan Phan-Thien, a professor in the Department of Mechanical Engineering at the National University of Singapore.

Malaria, a life-threatening disease caused by Plasmodium parasites, afflicts hundreds of millions of people each year and is responsible for more than half a million deaths -- mostly children living in Sub-Saharan Africa. Transmitted through the saliva of a female Anopheles mosquito, the parasites have a complicated, multi-stage life cycle part of which is spent inside the red blood cells of their human host.

Once the mosquito takes a blood meal and infects a person, malaria parasites invade red blood cells, making the cells stiffer and stickier. These cells also morph from a bi-concave shape to a more spherical form during the late "schizont stage" of malaria, which occurs 36 to 48 hours after onset of the infection. When red blood cells become stiff and deformed, they can become stuck in narrow capillaries and cause anemia, because fewer blood cells can flow to deliver oxygen to the different organs in the body, including the brain.

In the new paper, the NUS team reports how they used a particle-based method called "dissipative particle dynamics" to zero in on the three typical modes of motion of a cell or capsule in shear flow -- tank-treading, tumbling, or trembling -- and uncover the behavior of healthy and malaria-infected erythrocytes.

"Tank-treading mode is a steady state, in which a cell remains stationary while its membrane rotates around the internal fluid continuously," Phan-Thien explained. "Tumbling mode is an unsteady state in which the cell flips or tumbles periodically in its original shape as a rigid body. And the trembling mode is a transitional state between the two other modes, and is characterized by a shape variation and an angular oscillation."

The team discovered that, when experiencing the same shear rate, if a healthy erythrocyte undergoes a tumbling motion, the malaria-infected cell instead exhibits only a tumbling motion.

What advantage can malaria parasites gain by affecting the tumbling motion of erythrocytes? "Tumbling may allow the red blood cell to make better contact with the blood vessel wall and provide an opportunity to adhere to it," said Phan-Thien. The advantage to the parasite in making the red blood cell stick could be that it stalls the cells and keeps them from circulating and be cleared by the spleen or the immune system.

The researchers also found that at rates where a healthy erythrocyte undergoes a trembling motion, a malaria-infected cell can't exhibit the tank-treading motion. "And if a healthy erythrocyte undergoes a tank-treading motion, the malaria-infected one will exhibit any one of the three dynamic motions," noted Phan-Thien.

Mammography has led to fewer late-stage breast cancers

 

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In the last 30 years, since mammography was introduced, late-stage breast cancer incidence has decreased by 37 percent, a new study from the University of Michigan Comprehensive Cancer Center finds.

The analysis takes into account an observed underlying trend of increased breast cancer incidence present since the 1940s, a sort of inflation rate for breast cancer.

Researchers looked at early-stage and late-stage breast cancer diagnoses between 1977-1979, before mammography became popular, and compared it to diagnoses between 2007-2009. Based on trends observed in the pre-mammography period of the 1940s to the 1970s as well as continued trends over time, the researchers took into account a central estimated increase in breast cancer incidence of 1.3 percent per year. This is called an annual percentage change, or APC.

Think of the APC like the inflation rate: $1 from 1977 does not go as far in 2007. Just as the cost of money rises, the number of breast cancer diagnoses is increasing, independently of efforts to detect it earlier.

In the current paper, published in Cancer, the researchers looked at the late 1970s data and projected incidence of early-stage and late-stage breast cancer in 2007-2009 based on the APC. They then compared the projected rates to actual rates.

Late-stage breast cancer incidence decreased 37 percent from the projected rate, and early-stage breast cancer incidence correspondingly increased 48 percent from 1977-1979 to 2007-2009. They also conducted similar analyses with other APC values, ranging from 0.5 percent to 2 percent. All estimates showed a substantial decrease in late-stage disease.

"When you factor in this temporal trend, our analysis shows that there has been a shift from late-stage to early-stage breast cancer over the last 30 years. This is what you would expect with a successful screening program. Not only are we detecting more early-stage cancer, but we are decreasing the number of late-stage cases that tend to be more challenging to treat and more deadly," says senior study author Mark Helvie, M.D., professor of radiology and director of breast imaging at the U-M Comprehensive Cancer Center.

There are many reasons why breast cancer incidence is increasing over time, including reproductive, dietary and environmental factors. Prior estimates showed a 1 percent to 3 percent annual increase in the United States and Europe before mammography screening began. In countries in Africa, Asia and Eastern Europe with no routine screening mammography, breast cancer rates are increasing as much as 3 percent to 5 percent per year.

Importantly, the current study also found that since mammography was introduced, there has been an overall 9 percent decrease in invasive breast cancer, when factoring in a 1.3 percent annual percentage increase. This has been offset by an increase in ductal carcinoma in situ, so-called stage 0 breast cancer, which is not invasive.

"While we have seen an increase in overall breast cancer incidence over the last 30 years, the drop in late-stage diagnoses is a positive benefit of mammography and our heightened awareness of early detection. The decrease in late-stage disease, together with improved treatments, contributes to the decreased mortality from breast cancer in the United States in the last 20 years," Helvie says.

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Story Source:

The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.

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Journal Reference:

1. Mark A. Helvie, Joanne T. Chang, R. Edward Hendrick, Mousumi Banerjee. Reduction in late-stage breast cancer incidence in the mammography era: Implications for overdiagnosis of invasive cancer. Cancer, 2014; DOI: 10.1002/cncr.28784

New biometric watches use light to non-invasively monitor glucose, dehydration, pulse

 

In a pair of papers published in The Optical Society's (OSA) open-access journal Biomedical Optics Express, groups of researchers from the Netherlands and Israel describe two new wearable devices that use changing patterns of scattered light to monitor biometrics: one tracks glucose concentration and dehydration levels, and the other monitors pulse.

The glucose sensor is the first wearable device that can measure glucose concentration directly but noninvasively, the authors say.

And while other wearable devices have been made to monitor pulse, the authors claim their new design would be less sensitive to errors when the wearer is in motion, for example while walking or playing sports

Both of the watches described in the two papers make use of the so-called "speckle" effect, the grainy interference patterns that are produced on images when laser light reflects from an uneven surface or scatters from an opaque material. When the material that is scattering the light is moving -- say, in the case of blood flowing through the circulatory system -- "the speckle pattern changes with changes in the flow," explained biomedical engineer Mahsa Nemati, a graduate student in the Optics Research Group at the Delft University of Technology in the Netherlands and the lead author of the Biomedical Optics Express paper on monitoring pulse. Those light variations are a valuable source of information, she says.

The 'Holy Grail' of Diagnostics

In the first paper, bioengineer Zeev Zalevsky of Israel's Bar-Ilan University and his colleagues describe a new wearable biometric system that uses the speckle effect to directly monitor the glucose concentration in the bloodstream, as well as the wearer's relative hydration level.

"Glucose is the holy grail of the world of biomedical diagnostics, and dehydration is a very useful parameter in the field of wellness, which is one of our main commercial aims," Zalevsky said.

The watch-like device consists of a laser to generate a wavefront of light that illuminates a patch of skin on the wrist near an artery, and a camera that measures changes over time in the light that is backscattered off the skin. Unlike other chemicals present in the blood, glucose exhibits a so-called Faraday effect. This means that in the presence of an external magnetic field (generated by a magnet attached to the device) the glucose molecule alters the polarization of the wavefront and thus influences the resulting speckle patterns. Analyzing these changing patterns provides a direct measurement of the glucose concentration. Because one of the main signs of mild to moderate dehydration is muscle weakness, which will alter the strength of the signals, the same device can also be used to indicate the relative dehydration level of the user as it changes over time.

Zalevsky and his colleagues are now working to reduce the margin of error in the device's readings. "Around 96 percent of our in vivo measurements were within a range of 15 percent deviation from the readout of a medical reference glucometer device," Zalevsky noted. "The main factor for errors now is the stability of our device on the wrist of the user. We are currently investing efforts in deriving proper calibration and motion cancellation procedures that will allow us to reduce this sensitivity."

Zalevsky says this is the first step toward non-invasive, continuous in vivo measurement of glucose that is based on sensing an effect that is directly related to glucose concentration. The team expects a commercial version of the device to reach the market within two to three years.

Pulse Tracker

In the second Biomedical Optics Express paper, Nemati and her colleagues at Delft and at Phillips Research developed a method that could be used to monitor pulse non-invasively with a sensor that isn't thrown off by the wearer's movement.

Using simulated heart beats generated in milk and measurements performed on the finger of a volunteer, they found that speckle changes can be used to accurately measure flow pulsations -- that is, the heart rate -- even when the light source used to create the speckle pattern is also moving, as would be the case with a wearable biometric sensor. The researchers found that just a couple of pixels from the image were sufficient to extract the pulse rate.

"This paper shows for the first time that a speckle pattern generated from a flowing liquid can give us the pulsation properties of the flow in spite of motion-induced artifacts," Nemati said. "Sophisticated optics is not necessary to implement this, so the costs for devices can be kept low. Another advantage is that the devices can be non-contact or far from the sample," she added.

The team is currently working with companies to integrate their motion-friendly pulse-monitoring technique into existing sensors, for potential use clinically as well as in sports, Nemati said.

Smokers, passive smokers more likely to suffer hearing loss, study shows

 

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Giving up or reducing smoking and avoiding passive exposure to tobacco smoke may reduce your risk of hearing loss, new research shows.

Smokers and passive smokers more likely to suffer hearing loss, study shows

Current smokers have a 15.1% higher odds of hearing loss than non-smokers The University of Manchester study, funded by Action on Hearing Loss, Medical Research Council and the National Institute for Health Research, found.

Passive smoking also increased the likelihood of hearing loss by 28%.

But ex-smokers had a slightly reduced risk of going deaf -- which may be because once they quit they adopt a more healthy life style overall.

The study is published in the Journal of the Association for Research in Otolaryngology today.

Researchers looked at 164,770 UK adults aged 40 to 69 years of age who took hearing tests between 2007 and 2010 when they joined UK Biobank, a national project to improve health.

Dr Piers Dawes, from the Centre for Human Communication and Deafness at The University of Manchester who led the research, said: "Given around 20% of the UK population smoke and up to 60% in some countries, smoking may represent a significant cause of hearing loss worldwide.

"We found the more packets you smoke per week and the longer you smoke, the greater the risk you will damage your hearing."

The link between smoking and hearing loss is still unclear but many smokers also often had heart disease.

Dr Dawes added: "We are not sure if toxins in tobacco smoke affect hearing directly, or whether smoking-related cardiovascular disease causes microvascular changes that impact on hearing, or both."

The increased risk among passive smokers -- higher than that for smokers -- could be because smokers were compared to both complete non-smokers and passive non-smokers but passive smokers were only compared to non-smokers.

This means the association with smoking and hearing loss maybe under estimated, the researchers say.

Dr Ralph Holme, Head of Biomedical Research at Action on Hearing Loss, said "Hearing loss affects 10 million people in the UK and with an aging population is set to become a major public health issue.

"Hearing loss is often viewed as an inevitable consequence of aging, but as the research published today shows, this may not always be the case. Giving up smoking and protecting your ears from loud noise are two practical steps people can take today to prevent hearing loss later in life."

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Story Source:

The above story is based on materials provided by Manchester University. Note: Materials may be edited for content and length.

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Journal Reference:

1. Piers Dawes, Karen J. Cruickshanks, David R. Moore, Mark Edmondson-Jones, Abby McCormack, Heather Fortnum, Kevin J. Munro. Cigarette Smoking, Passive Smoking, Alcohol Consumption, and Hearing Loss. Journal of the Association for Research in Otolaryngology, 2014; DOI: 10.1007/s10162-014-0461-0

Hepatitis B screening now recommended for high risk individuals

 

June 5, 2014

Loyola University Health System

A simple blood test can detect if a person is one of the two billion people worldwide infected with hepatitis B. And now experts recommend that all teens and adults who are high risk for hepatitis B get screened for the infection. “Many people with hepatitis B do not show any symptoms so they are not diagnosed which means they keep transmitting the disease to others,” says a board certified hepatologist.

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A simple blood test can detect if a person is one of the two billion people worldwide infected with hepatitis B. And now the U.S. Preventive Services Task Force recommends that all teens and adults who are high risk for hepatitis B get screened for the infection.

"Many people with hepatitis B do not show any symptoms so they are not diagnosed which means they keep transmitting the disease to others," says Steve Scaglione, MD, board certified hepatologist at Loyola University Health System. Hepatologists are specialists in treating liver disease. "Increased screening means the disease is diagnosed earlier, treated earlier and better controlled."

Hepatitis B is an infectious disease that is passed from person to person through blood and bodily fluids. There are two varieties of the disease: acute hepatitis B causes illness for a short term before recovery. Chronic hepatitis B is ongoing and can cause life-threatening liver damage.

"Advancements in treatment for hepatitis B are bring made but prevention and early diagnosis are still the best route for public health," says Scaglione, who regularly treats hepatitis B patients at Loyola.

According to the Hepatitis B Foundation, up to 100,000 people in the United States get the virus each year, and 10 million to 30 million people in the world are infected.

Treatment for hepatitis B ranges from antiviral medication to stop the virus from multiplying to liver transplantation in cases of extreme illness. Hepatitis B can be transmitted if you:

• Have sex with an infected person without using a condom.

• Share needles (used for injecting drugs) with an infected person.

• Get a tattoo or piercing with tools that weren't sterilized.

• Share personal items like razors or toothbrushes with an infected person

Individuals considered to be high risk for hepatitis B and who are recommended to be screened include:

• Adolescents and adults not vaccinated for Hepatitis B at birth.

• People born in countries with a high rate of hepatitis B infection. These include Africa, Southeast Asia, Pacific Islands, China, the Middle Eastern, Eastern Europe and the northern countries of South America such as Colombia, Venezuela and Ecuador.

• People whose parents were born in countries with a high rate of infection.

• People with HIV.

• People who inject drugs.

• Men who have sex with men.

• People who live with or have sex with someone with hepatitis B.

• Patients with weakened immune systems or who are receiving kidney dialysis.

A mother infected with hepatitis B can transmit the disease to her baby. Medication can be given to the child to prevent the infection from spreading.

Symptoms of hepatitis B include:

• Feeling very tired.

• Mild fever.

• Headache.

• Not wanting to eat.

• Feeling sick to your stomach or vomiting.

• Belly pain.

• Diarrhea or constipation.

• Muscle aches and joint pain.

• Skin rash.

• Yellowish eyes and skin (jaundice). Jaundice usually appears only after other symptoms have started to go away.

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Story Source:

The above story is based on materials provided by Loyola University Health System. Note: Materials may be edited for content and length.

Soccer for untrained 70-year-old men yields amazing results

 

June 6, 2014

University of Copenhagen

Untrained elderly men get markedly fitter and healthier as a result of playing soccer. After only four months of twice-weekly one-hour training sessions, the men achieved marked improvements in maximum oxygen uptake, muscle function and bone mineralization. The study revealed that inactive elderly men improved their maximum oxygen uptake by 15% and their performance during interval exercise by as much as 50% by playing soccer for 1 hour two times per week over 4 months.

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It is never too late to start playing football. Soccer boosts physical capacity and heart health, and minimizes the risk of falls and fractures in elderly men, who have never soccer before or have not played for decades.

Research carried out by the Copenhagen Centre for Team Sport and Health in Denmark shows that untrained elderly men get markedly fitter and healthier as a result of playing soccer. After only 4 months of twice-weekly 1-hour training sessions, the men achieved marked improvements in maximum oxygen uptake, muscle function and bone mineralization.

Three scientific articles will be published in the Scandinavian Journal of Medicine & Science in Sports describing the fitness and health effects of soccer training for 63‒75-year-old untrained men.

The Copenhagen researchers, led by Professor Peter Krustrup of the Copenhagen Centre for Team Sport and Health, University of Copenhagen, have a compelling case. Soccer is a fun, social and effective form of high-intensity interval training that is open to all.

Untrained elderly men can also play

"Our previous studies have shown that 70-year-old men with lifelong participation in soccer possess a postural balance and rapid muscle force that is comparable to that of 30-year-old untrained men," says Krustrup. "This time we have gone one step further by evaluating the intensity of soccer training as well as the health and fitness effects of soccer for untrained elderly men with little experience of soccer."

"The study revealed that inactive elderly men improved their maximum oxygen uptake by 15% and their performance during interval exercise by as much as 50% by playing soccer for 1 hour two times per week over 4 months. Moreover, muscle function was improved by 30% and bone mineralization in the femoral neck increased by 2%," says Krustrup.

"The results provide strong evidence that soccer is an intense, versatile and effective form of training, including for untrained elderly men. It is definitely never too late to start playing soccer. Soccer boosts physical capacity and heart health, and minimizes the risk of falls and fractures in elderly, men who have never played soccer before or have not played for decades," says Krustrup.

Sky-high intensity

"The players had heart rates that were sky high and corresponded to the values obtained during elite soccer games," says Associate Professor Eva Wulff Helge of the Department of Nutrition, Exercise and Sports, University of Copenhagen.

"GPS measurements and video analyses also showed that there are many fast runs, stops, turns, dribbles, passes and shots, providing strong stimuli for muscle and bone adaptations. The fast runs, intense actions and unorthodox movements may well be the cause of a large increase in bone mineralization in the femur bone and femoral neck after only 4 months and of the further 3% improvement from 4 to 12 months of training," says Helge.

An active everyday life and better health

"Our study shows that intense training such as soccer can change the lives of elderly men," says Krustrup.

"The remarkable improvements in aerobic fitness and muscle strength make it easier for the players to live an active life and overcome the physical challenges of everyday life such as climbing stairs, shopping, cycling and gardening. This benefits not only the players themselves, but also their families and friends," says Krustrup.

The scientific study

The researchers at the Copenhagen Centre for Team Sport and Health have conducted numerous randomized controlled training studies involving soccer and other team sports.

In the present study, a total of 27 untrained men aged 63 to 75 were recruited, tested and randomized into a soccer group, a strength training group and an inactive control group. The two training groups exercised for 1 hour twice a week for a year. A comprehensive testing battery was used at baseline, after 4 months and after 12 months. The research team, comprising 20 researchers from the Copenhagen Centre for Team Sport and Health, the University of Southern Denmark, Gentofte University Hospital and the National Research Centre for the Working Environment, was led by Professor Peter Krustrup, who has studied fitness and health effects for more than 10 years and published 55 articles in the area over the last 5 years.

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Story Source:

The above story is based on materials provided by University of Copenhagen. Note: Materials may be edited for content and length.

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Journal References:

1. T. R. Andersen, J. F. Schmidt, M. Thomassen, T. Hornstrup, U. Frandsen, M. B. Randers, P. R. Hansen, P. Krustrup, J. Bangsbo. A preliminary study: Effects of football training on glucose control, body composition, and performance in men with type 2 diabetes. Scandinavian Journal of Medicine & Science in Sports, 2014; DOI: 10.1111/sms.12259
2. T. R. Andersen, J. F. Schmidt, J. J. Nielsen, M. B. Randers, E. Sundstrup, M. D. Jakobsen, L. L. Andersen, C. Suetta, P. Aagaard, J. Bangsbo, P. Krustrup. Effect of football or strength training on functional ability and physical performance in untrained old men. Scandinavian Journal of Medicine & Science in Sports, 2014; DOI: 10.1111/sms.12245
3. E. W. Helge, T. R. Andersen, J. F. Schmidt, N. R. Jørgensen, T. Hornstrup, P. Krustrup, J. Bangsbo. Recreational football improves bone mineral density and bone turnover marker profile in elderly men. Scandinavian Journal of Medicine & Science in Sports, 2014; DOI: 10.1111/sms.12239