Tuesday, April 22, 2014
Study found abnormal rhythms when blood sugar dipped at night in people with type 2 disease
Low Blood Sugar & Heartbeat in People With Diabetes
Study found abnormal rhythms when blood sugar dipped at night in people with type 2 disease
WebMD News from HealthDay
By Serena Gordon
April 22, 2014
Low blood sugar levels -- known as hypoglycemia -- in people with diabetes may cause potentially dangerous changes in heart rate, according to a small new study.
This study's findings may help explain why a large-scale study found that very tight control of blood sugar levels in people with type 2 diabetes led to higher-than-expected death rates. It may also help explain why some otherwise healthy people with type 1 diabetes die during their sleep -- sometimes called "dead-in-bed syndrome" -- without an apparent cause, researchers say.
"We found that hypoglycemia was fairly common and that nocturnal episodes in particular were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept," said Dr. Simon Heller, senior study author and a professor of clinical diabetes and honorary consultant physician at the University of Sheffield, in England.
"These periods of hypoglycemia were associated with a high risk of marked slow heart rates [bradycardia] accompanied by [abnormal] beats. We have therefore identified a mechanism which might contribute to increased mortality in individuals with type 2 diabetes and high cardiovascular risk during intensive insulin therapy," Heller said.
Low blood sugar levels are not uncommon in people with diabetes, a disease that can produce dangerously high blood sugar levels. That's because the very treatments that can help prevent high blood sugar levels -- and the serious complications that accompany long-term high blood sugar levels -- can cause blood sugar levels to drop too low.
Although some oral diabetes medications can cause low blood sugar levels, the most common treatment to drop blood sugar levels too low is insulin. Insulin is a naturally occurring hormone that helps usher sugar into cells to be used as fuel.
"Your body needs fuel to survive and run properly," said Dr. Simon Fisher, an associate professor of medicine, cell biology and physiology at Washington University in St. Louis. "During hypoglycemia, the body is low on energy. When hypoglycemia is more severe, the brain [which runs on sugar] can get confused and stop functioning. If the blood sugar gets low enough, hypoglycemia can be fatal."
Fisher is also a co-author of an editorial accompanying the study in the May issue of Diabetes.
Low blood sugar is a well-recognized problem for people with type 1 diabetes, who must take multiple daily injections of insulin because their bodies no longer produce the hormone, according to study author Heller. But, low blood sugar generally isn't considered to be as significant a problem in type 2 diabetes, noted Heller, who added that the researchers were somewhat surprised to see that people with type 2 diabetes had low blood sugar levels about 10 percent of the time.
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Friday, April 11, 2014
Lab clue to caffeine benefit on Alzheimer's
Lab clue to caffeine benefit on Alzheimer's
Yahoo News
April 10, 2014
French and German researchers on Wednesday said they had found evidence in the lab to back theories that drinking caffeine has a preventive effect on Alzheimer's disease.
In mice, regular doses of caffeine inhibited the growth of tau, a protein that clogs brain cells in Alzheimer's patients, they said. The discovery was made among mice that had been genetically modified to produce tau. They were given a tiny dose of caffeine -- 0.3 grammes per litre (0.005 ounces per pint) -- in their drinking water over 10 months. This is roughly equivalent to two cups of coffee per day for human beings. The mice were compared with an identical group of "tau" rodents which did not get the caffeine dose. "Mice that were given caffeine were less affected in terms of memory and tau buildup but also in terms of inflammation of the brain tissue," said David Blum of France's National Institute of Health and Medical Research (Inserm). Previous research has found that older people are less likely to suffer cognitive decline if they take regular, moderate amounts of caffeine. Experiments have also found that caffeine slows memory loss in mice bred to develop so-called amyloid plaques -- another compound buildup in the brain that is associated with Alzheimer's. The study appears in the US journal Neurobiology of Aging.
Yahoo News
April 10, 2014
French and German researchers on Wednesday said they had found evidence in the lab to back theories that drinking caffeine has a preventive effect on Alzheimer's disease.
In mice, regular doses of caffeine inhibited the growth of tau, a protein that clogs brain cells in Alzheimer's patients, they said. The discovery was made among mice that had been genetically modified to produce tau. They were given a tiny dose of caffeine -- 0.3 grammes per litre (0.005 ounces per pint) -- in their drinking water over 10 months. This is roughly equivalent to two cups of coffee per day for human beings. The mice were compared with an identical group of "tau" rodents which did not get the caffeine dose. "Mice that were given caffeine were less affected in terms of memory and tau buildup but also in terms of inflammation of the brain tissue," said David Blum of France's National Institute of Health and Medical Research (Inserm). Previous research has found that older people are less likely to suffer cognitive decline if they take regular, moderate amounts of caffeine. Experiments have also found that caffeine slows memory loss in mice bred to develop so-called amyloid plaques -- another compound buildup in the brain that is associated with Alzheimer's. The study appears in the US journal Neurobiology of Aging.
Sunday, April 6, 2014
Study: Vegetarians Less Healthy, Lower Quality Of Life Than Meat-Eaters
Study: Vegetarians Less Healthy, Lower Quality Of Life Than Meat-Eaters
Vegetarians have a lower BMI and drink alcohol sparingly, but vegetarian diets are tied to generally poorer health, poorer quality of life and a higher need for health care than their meat-eating counterparts.
CBS Atlanta
April 1, 2014
ATLANTA (CBS ATLANTA) – Vegetarians may have a lower BMI and drink alcohol sparingly, but vegetarian diets are tied to generally poorer health, poorer quality of life and a higher need for health care than their meat-eating counterparts.
A new study from the Medical University of Graz in Austria finds that vegetarians are more physically active, drink less alcohol and smoke less tobacco than those who consume meat in their diets. Vegetarians also have a higher socioeconomic status and a lower body mass index. But the vegetarian diet — characterized by a low consumption of saturated fats and cholesterol that includes increased intake of fruits, vegetables and whole-grain products — carries elevated risks of cancer, allergies and mental health disorders.
Vegetarians were twice as likely to have allergies, a 50 percent increase in heart attacks and a 50 percent increase in incidences of cancer.
The cross-sectional study from Austrian Health Interview Survey data and published in PLos One examined participants dietary habits, demographic characteristics and general lifestyle differences.
The most significant dietary habit difference between meat-eaters and vegetarians concerned their BMI and alcohol consumption – with both being higher for those who consume meat.
Many past studies have instead put an emphasis on the health risks associated with red meat and carnivorous diets, but this study points the other dietary direction. However, the researchers do caution that continuing studies will be needed to substantiate some of the rather broad dietary distinctions, associations presented in this current research. Overall, vegetarians were found to be in a poorer state of health compared to other dietary groups. Vegetarians reported higher levels of impairment from disorders, chronic diseases, and “suffer significantly more often from anxiety/depression.” Subjects who consumed lower amounts of animal fat were also linked to poor health care practices, such as avoidance of vaccinations and a lack of preventive care. Chronic problems associated with vegetarians and people eating carnivorous diets rich in fruits and vegetables were linked to more frequent visits to doctors, which the study authors suggest requires public health programs to reduce the health risk due to their nutritional factors. The researchers conclude: “Our study has shown that Austrian adults who consume a vegetarian diet are less healthy (in terms of cancer, allergies, and mental health disorders), have a lower quality of life, and also require more medical treatment.” “Therefore, a continued strong public health program for Austria is required in order to reduce the health risk due to nutritional factors.” The Centers for Disease Control and Prevention notes that healthy diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases for all dietary groups. A 2009 study from the CDC found that about 1 in 200 young Americans, or 367,000 US children, are vegetarians. – Benjamin Fearnow
Vegetarians have a lower BMI and drink alcohol sparingly, but vegetarian diets are tied to generally poorer health, poorer quality of life and a higher need for health care than their meat-eating counterparts.
CBS Atlanta
April 1, 2014
ATLANTA (CBS ATLANTA) – Vegetarians may have a lower BMI and drink alcohol sparingly, but vegetarian diets are tied to generally poorer health, poorer quality of life and a higher need for health care than their meat-eating counterparts.
A new study from the Medical University of Graz in Austria finds that vegetarians are more physically active, drink less alcohol and smoke less tobacco than those who consume meat in their diets. Vegetarians also have a higher socioeconomic status and a lower body mass index. But the vegetarian diet — characterized by a low consumption of saturated fats and cholesterol that includes increased intake of fruits, vegetables and whole-grain products — carries elevated risks of cancer, allergies and mental health disorders.
Vegetarians were twice as likely to have allergies, a 50 percent increase in heart attacks and a 50 percent increase in incidences of cancer.
The cross-sectional study from Austrian Health Interview Survey data and published in PLos One examined participants dietary habits, demographic characteristics and general lifestyle differences.
The most significant dietary habit difference between meat-eaters and vegetarians concerned their BMI and alcohol consumption – with both being higher for those who consume meat.
Many past studies have instead put an emphasis on the health risks associated with red meat and carnivorous diets, but this study points the other dietary direction. However, the researchers do caution that continuing studies will be needed to substantiate some of the rather broad dietary distinctions, associations presented in this current research. Overall, vegetarians were found to be in a poorer state of health compared to other dietary groups. Vegetarians reported higher levels of impairment from disorders, chronic diseases, and “suffer significantly more often from anxiety/depression.” Subjects who consumed lower amounts of animal fat were also linked to poor health care practices, such as avoidance of vaccinations and a lack of preventive care. Chronic problems associated with vegetarians and people eating carnivorous diets rich in fruits and vegetables were linked to more frequent visits to doctors, which the study authors suggest requires public health programs to reduce the health risk due to their nutritional factors. The researchers conclude: “Our study has shown that Austrian adults who consume a vegetarian diet are less healthy (in terms of cancer, allergies, and mental health disorders), have a lower quality of life, and also require more medical treatment.” “Therefore, a continued strong public health program for Austria is required in order to reduce the health risk due to nutritional factors.” The Centers for Disease Control and Prevention notes that healthy diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases for all dietary groups. A 2009 study from the CDC found that about 1 in 200 young Americans, or 367,000 US children, are vegetarians. – Benjamin Fearnow
Wednesday, April 2, 2014
Low Vitamin D Levels Linked to Disease in Two Big Studies
Correction: April 5, 2014
An earlier version of this article incorrectly listed kale as a source of vitamin D. It is not.
Low Vitamin D Levels Linked to Disease in Two Big Studies
By ANAHAD O'CONNOR
April 1, 2014
NYT
New research has found that lower vitamin D levels were associated with illness, but didn't show whether they were a cause. Lawrence Lool/European Pressphoto AgencyNew research has found that lower vitamin D levels were associated with illness, but didn’t show whether they were a cause. People with low vitamin D levels are more likely to die from cancer and heart disease and to suffer from other illnesses, scientists reported in two large studies published on Tuesday. The new research suggests strongly that blood levels of vitamin D are a good barometer of overall health. But it does not resolve the question of whether low levels are a cause of disease or simply an indicator of behaviors that contribute to poor health, like a sedentary lifestyle, smoking and a diet heavy in processed and unhealthful foods. Nicknamed the sunshine nutrient, vitamin D is produced in the body when the skin is exposed to sunlight. It can be obtained from a small assortment of foods, including fish, eggs, fortified dairy products and organ meats, and vegetables like mushrooms and kale. And blood levels of it can be lowered by smoking, obesity and inflammation. Vitamin D helps the body absorb calcium and is an important part of the immune system. Receptors for the vitamin and related enzymes are found throughout cells and tissues of the body, suggesting it may be vital to many physiological functions, said Dr. Oscar H. Franco, a professor of preventive medicine at Erasmus Medical Center in the Netherlands and an author of one of the new studies, which appeared in the journal BMJ. “It has effects at the genetic level, and it affects cardiovascular health and bone health,” he said. “There are different hypotheses for the factors that vitamin D regulates, from genes to inflammation. That’s the reason vitamin D seems so promising.” The two studies were meta-analyses that included data on more than a million people. They included observational findings on the relationship between disease and blood levels of vitamin D. The researchers also reviewed evidence from randomized controlled trials — the gold standard in scientific research — that assessed whether taking vitamin D daily was beneficial. Dr. Franco and his co-authors — a team of scientists at Harvard, Oxford and other universities — found persuasive evidence that vitamin D protects against major diseases. Adults with lower levels of the vitamin in their systems had a 35 percent increased risk of death from heart disease, 14 percent greater likelihood of death from cancer, and a greater mortality risk overall. When the researchers looked at supplement use, they found no benefit to taking vitamin D2. But middle-aged and older adults who took another form, vitamin D3 — which is the type found in fish and dairy products and produced in response to sunlight — had an 11 percent reduction in mortality from all causes, compared to adults who did not. In the United States and Europe, it is estimated that more than two-thirds of the population is deficient in vitamin D. In their paper, Dr. Franco and his colleagues calculated that roughly 13 percent of all deaths in the United States, and 9 percent in Europe, could be attributed to low vitamin D levels. “We are talking about a large part of the population being affected by this,” he said. “Vitamin D could be a good route to prevent mortality from cardiovascular disease and other causes of mortality.” In the second study, also published in BMJ, a team of researchers at Stanford and several universities in Europe presented a more nuanced view of vitamin D. They concluded there was “suggestive evidence” that high vitamin D levels protect against diabetes, stroke, hypertension and a host of other illnesses. But they also said there was no “highly convincing” evidence that vitamin D pills affected any of the outcomes they examined. “Based on what we found, we cannot recommend widespread supplementation,” said Evropi Theodoratou, an author of the study and research fellow at the Center for Population Health Sciences at the University of Edinburgh. The second study also looked at bone health. While Vitamin D had long been believed to help prevent osteoporosis fractures from falls, clinical trials in recent years have challenged the idea. The study also found no evidence to support that assumption. “Vitamin D might not be as essential as previously thought in maintaining bone mineral density,” Dr. Theodoratou and her colleagues wrote. Dr. Theodoratou was not alone in suggesting people hold off on taking vitamin D supplements for now. Even though Dr. Franco found them to be beneficial, he said that more research was needed to show what levels are best. Instead of taking pills, people could improve their vitamin D levels with an adequate diet and 30 minutes of sunlight twice a week, he said. “The most important factors in obtaining vitamin D are going out and doing some exercise and following a healthy diet,” he added...
An earlier version of this article incorrectly listed kale as a source of vitamin D. It is not.
Low Vitamin D Levels Linked to Disease in Two Big Studies
By ANAHAD O'CONNOR
April 1, 2014
NYT
New research has found that lower vitamin D levels were associated with illness, but didn't show whether they were a cause. Lawrence Lool/European Pressphoto AgencyNew research has found that lower vitamin D levels were associated with illness, but didn’t show whether they were a cause. People with low vitamin D levels are more likely to die from cancer and heart disease and to suffer from other illnesses, scientists reported in two large studies published on Tuesday. The new research suggests strongly that blood levels of vitamin D are a good barometer of overall health. But it does not resolve the question of whether low levels are a cause of disease or simply an indicator of behaviors that contribute to poor health, like a sedentary lifestyle, smoking and a diet heavy in processed and unhealthful foods. Nicknamed the sunshine nutrient, vitamin D is produced in the body when the skin is exposed to sunlight. It can be obtained from a small assortment of foods, including fish, eggs, fortified dairy products and organ meats, and vegetables like mushrooms and kale. And blood levels of it can be lowered by smoking, obesity and inflammation. Vitamin D helps the body absorb calcium and is an important part of the immune system. Receptors for the vitamin and related enzymes are found throughout cells and tissues of the body, suggesting it may be vital to many physiological functions, said Dr. Oscar H. Franco, a professor of preventive medicine at Erasmus Medical Center in the Netherlands and an author of one of the new studies, which appeared in the journal BMJ. “It has effects at the genetic level, and it affects cardiovascular health and bone health,” he said. “There are different hypotheses for the factors that vitamin D regulates, from genes to inflammation. That’s the reason vitamin D seems so promising.” The two studies were meta-analyses that included data on more than a million people. They included observational findings on the relationship between disease and blood levels of vitamin D. The researchers also reviewed evidence from randomized controlled trials — the gold standard in scientific research — that assessed whether taking vitamin D daily was beneficial. Dr. Franco and his co-authors — a team of scientists at Harvard, Oxford and other universities — found persuasive evidence that vitamin D protects against major diseases. Adults with lower levels of the vitamin in their systems had a 35 percent increased risk of death from heart disease, 14 percent greater likelihood of death from cancer, and a greater mortality risk overall. When the researchers looked at supplement use, they found no benefit to taking vitamin D2. But middle-aged and older adults who took another form, vitamin D3 — which is the type found in fish and dairy products and produced in response to sunlight — had an 11 percent reduction in mortality from all causes, compared to adults who did not. In the United States and Europe, it is estimated that more than two-thirds of the population is deficient in vitamin D. In their paper, Dr. Franco and his colleagues calculated that roughly 13 percent of all deaths in the United States, and 9 percent in Europe, could be attributed to low vitamin D levels. “We are talking about a large part of the population being affected by this,” he said. “Vitamin D could be a good route to prevent mortality from cardiovascular disease and other causes of mortality.” In the second study, also published in BMJ, a team of researchers at Stanford and several universities in Europe presented a more nuanced view of vitamin D. They concluded there was “suggestive evidence” that high vitamin D levels protect against diabetes, stroke, hypertension and a host of other illnesses. But they also said there was no “highly convincing” evidence that vitamin D pills affected any of the outcomes they examined. “Based on what we found, we cannot recommend widespread supplementation,” said Evropi Theodoratou, an author of the study and research fellow at the Center for Population Health Sciences at the University of Edinburgh. The second study also looked at bone health. While Vitamin D had long been believed to help prevent osteoporosis fractures from falls, clinical trials in recent years have challenged the idea. The study also found no evidence to support that assumption. “Vitamin D might not be as essential as previously thought in maintaining bone mineral density,” Dr. Theodoratou and her colleagues wrote. Dr. Theodoratou was not alone in suggesting people hold off on taking vitamin D supplements for now. Even though Dr. Franco found them to be beneficial, he said that more research was needed to show what levels are best. Instead of taking pills, people could improve their vitamin D levels with an adequate diet and 30 minutes of sunlight twice a week, he said. “The most important factors in obtaining vitamin D are going out and doing some exercise and following a healthy diet,” he added...
Sunday, February 23, 2014
Antidepressant Paxil May Promote Breast Cancer
Antidepressant Paxil May Promote Breast Cancer
Newsmax
19 Feb 2014
A troubling new study has found the popular antidepressant paroxetine — better known by its commercial name, Paxil — may promote the development and growth of breast tumors in women.
The finding, by researchers from the City of Hope in Duarte, resulted from a new way the scientists developed to identify drugs and chemicals that can disrupt the balance of sex hormones in human beings and influence the development and progress of breast cancer, the Los Angeles Times reports.
A trial screening of 446 drugs in wide circulation flagged Paxil as having a weak estrogenic effect that could promote breast cancer.
The researchers noted as many as a quarter of breast cancer patients suffer from depression, which is typically treated with antidepressants known as SSRIs (selective serotonin reuptake inhibitors), including Paxil, which has been on the market since 1992.
Almost a quarter of American women in their 40s and 50s are taking an antidepressant, mostly SSRIs. Last year, the Food and Drug Administration approved a low dose of paroxetine — repackaged under the commercial name Brisdelle — as a nonhormonal treatment for hot flashes and other menopausal symptoms.
About 70 percent of breast cancers in women are fueled, at least in part, by estrogen.
The novel screening method developed at City of Hope is described in a forthcoming issue of the journal Toxicological Sciences. It also identified two antifungal medications — biconazole and oxyconazole — as having an anti-estrogenic effect similar to that of medications prescribed to prevent breast cancer and its recurrences in women.
In addition, the researchers identified bisphenol A — a compound used in the manufacture of plastics and epoxy resins — as an estrogen promoter capable of raising breast cancer risk.
The finding that paroxetine has estrogenic effects "has implications for patients with estrogen-sensitive breast cancer who are on other medications," said Shihuan Chen, professor and chairman of City of Hope's department of cancer biology and lead author of the study.
Newsmax
19 Feb 2014
A troubling new study has found the popular antidepressant paroxetine — better known by its commercial name, Paxil — may promote the development and growth of breast tumors in women.
The finding, by researchers from the City of Hope in Duarte, resulted from a new way the scientists developed to identify drugs and chemicals that can disrupt the balance of sex hormones in human beings and influence the development and progress of breast cancer, the Los Angeles Times reports.
A trial screening of 446 drugs in wide circulation flagged Paxil as having a weak estrogenic effect that could promote breast cancer.
The researchers noted as many as a quarter of breast cancer patients suffer from depression, which is typically treated with antidepressants known as SSRIs (selective serotonin reuptake inhibitors), including Paxil, which has been on the market since 1992.
Almost a quarter of American women in their 40s and 50s are taking an antidepressant, mostly SSRIs. Last year, the Food and Drug Administration approved a low dose of paroxetine — repackaged under the commercial name Brisdelle — as a nonhormonal treatment for hot flashes and other menopausal symptoms.
About 70 percent of breast cancers in women are fueled, at least in part, by estrogen.
The novel screening method developed at City of Hope is described in a forthcoming issue of the journal Toxicological Sciences. It also identified two antifungal medications — biconazole and oxyconazole — as having an anti-estrogenic effect similar to that of medications prescribed to prevent breast cancer and its recurrences in women.
In addition, the researchers identified bisphenol A — a compound used in the manufacture of plastics and epoxy resins — as an estrogen promoter capable of raising breast cancer risk.
The finding that paroxetine has estrogenic effects "has implications for patients with estrogen-sensitive breast cancer who are on other medications," said Shihuan Chen, professor and chairman of City of Hope's department of cancer biology and lead author of the study.
Sunday, January 19, 2014
Evidence shows cognitive rest aids concussion recovery
Evidence shows cognitive rest aids concussion recovery
Michelle Healy
USA TODAY
January 6, 2014
After a concussion, children and teens who engaged in the highest levels of cognitive activity took the longest to fully recover from symptoms, a study finds.
Story Highlights
Increased cognitive activity is associated with longer concussion recovery
Data supporting the benefit of brain rest following a concussion has been limited
Academic accommodations for students recovering from concussions should be allowed
Letting a young person rest his or her brain after a concussion — limiting reading, online activities, even homework — can result in quicker recovery, a new study says.
Although reducing cognitive activity to rest the brain is commonly recommended for concussion treatment, there has been limited research to back up that advice. But the new study in January's Pediatrics, published online today, lends support to the idea.
Story: Report calls for action on concussions among kids
In the study of 335 children and young adults, ages 8 to 23, those reporting the greatest levels of cognitive activity (including homework, playing video games, doing crossword puzzles, text messaging and online activities) after a concussion took the longest to fully recover from their symptoms — approximately 100 days on average, compared to approximately 20 to 50 days for patients reporting lesser levels of activity.
Cognitive activities were defined as "activities that require you to think harder than usual" and study participants were grouped according to the average amount of cognitive activity — from complete cognitive rest to a full schedule — that they reported doing between each visit to a concussion clinic.
In addition to showing that cognitive rest works, the findings also show "there's no need to take cognitive rest to the extreme," such as putting patients in a dark room and eliminating all cognitive activity, as advocated by some. "Those who were doing milder levels of cognitive activity recovered at about the same rate as those who were doing minimal levels," says study co-author William Meehan, director of research for the Brain Injury Center at Boston Children's Hospital and director of the Micheli Center for Sports Injury Prevention.
The findings bolster recommendations in favor of academic accommodations that allow cognitive rest for students recovering from concussions, says Meehan.
Even though there are guidelines by the American Academy of Pediatrics, the American College of Sports Medicine, the American Academy of Neurology and others, "the implementation of cognitive rest has been variable and even controversial" in part because of the lack of empirical evidence, he says.
According to statistics from the University of Pittsburgh Medical Center Sports Medicine Concussion Program, between 1.7 and 3 million sports- and recreation-related concussions occur every year. Five of 10 concussions go unreported or undetected. One in 10 high school athletes who play contact sports will suffer a concussion this year.
"Most of us involved in concussion management have been telling folks for years to do some degree of cognitive rest up front, (although) we didn't have great evidence behind that" recommendation, says Greg Canty, director of the Center for Sports Medicine at Children's Mercy Hospitals and Clinics in Kansas City, Mo. This research "starts to build a better body of evidence," says Canty, who was not involved in the study.
It also "adds some recognition that it's not just physical rest that may allow that brain to heal, but that some degree of cognitive rest is also likely beneficial."
Michelle Healy
USA TODAY
January 6, 2014
After a concussion, children and teens who engaged in the highest levels of cognitive activity took the longest to fully recover from symptoms, a study finds.
Story Highlights
Increased cognitive activity is associated with longer concussion recovery
Data supporting the benefit of brain rest following a concussion has been limited
Academic accommodations for students recovering from concussions should be allowed
Letting a young person rest his or her brain after a concussion — limiting reading, online activities, even homework — can result in quicker recovery, a new study says.
Although reducing cognitive activity to rest the brain is commonly recommended for concussion treatment, there has been limited research to back up that advice. But the new study in January's Pediatrics, published online today, lends support to the idea.
Story: Report calls for action on concussions among kids
In the study of 335 children and young adults, ages 8 to 23, those reporting the greatest levels of cognitive activity (including homework, playing video games, doing crossword puzzles, text messaging and online activities) after a concussion took the longest to fully recover from their symptoms — approximately 100 days on average, compared to approximately 20 to 50 days for patients reporting lesser levels of activity.
Cognitive activities were defined as "activities that require you to think harder than usual" and study participants were grouped according to the average amount of cognitive activity — from complete cognitive rest to a full schedule — that they reported doing between each visit to a concussion clinic.
In addition to showing that cognitive rest works, the findings also show "there's no need to take cognitive rest to the extreme," such as putting patients in a dark room and eliminating all cognitive activity, as advocated by some. "Those who were doing milder levels of cognitive activity recovered at about the same rate as those who were doing minimal levels," says study co-author William Meehan, director of research for the Brain Injury Center at Boston Children's Hospital and director of the Micheli Center for Sports Injury Prevention.
The findings bolster recommendations in favor of academic accommodations that allow cognitive rest for students recovering from concussions, says Meehan.
Even though there are guidelines by the American Academy of Pediatrics, the American College of Sports Medicine, the American Academy of Neurology and others, "the implementation of cognitive rest has been variable and even controversial" in part because of the lack of empirical evidence, he says.
According to statistics from the University of Pittsburgh Medical Center Sports Medicine Concussion Program, between 1.7 and 3 million sports- and recreation-related concussions occur every year. Five of 10 concussions go unreported or undetected. One in 10 high school athletes who play contact sports will suffer a concussion this year.
"Most of us involved in concussion management have been telling folks for years to do some degree of cognitive rest up front, (although) we didn't have great evidence behind that" recommendation, says Greg Canty, director of the Center for Sports Medicine at Children's Mercy Hospitals and Clinics in Kansas City, Mo. This research "starts to build a better body of evidence," says Canty, who was not involved in the study.
It also "adds some recognition that it's not just physical rest that may allow that brain to heal, but that some degree of cognitive rest is also likely beneficial."
Statins may provide a slight benefit in the prevention of AD and all-type dementia
Pharmacoepidemiol Drug Saf. 2013 Apr;22(4):345-58. doi: 10.1002/pds.3381. Epub 2012 Dec 6.
Statins in the prevention of dementia and Alzheimer's disease: a meta-analysis of observational studies and an assessment of confounding.
NCBI
Wong WB, Lin VW, Boudreau D, Devine EB.
Studies demonstrate the potential for statins to prevent dementia and Alzheimer's disease (AD), but the evidence is inconclusive.
OBJECTIVE:
Conduct a meta-analysis to estimate any benefit of statins in preventing dementia and examine the potential effect of study design and confounding on the benefit of statins in dementia. A secondary goal is to explore factors that may elucidate the mechanisms by which statins exert their potentially beneficial effect.
METHODS:
Performed systematic literature review to identify relevant publications. Relative risk (RR) estimates were pooled using both fixed and random effect models. Studies were stratified by study design and potential confounding factors.
v RESULTS:
The pooled results for all-type dementia suggest that use of statins is associated with a lower RR of dementia when compared to non-statin users (random effects model: RR 0.82 (95%CI [0.69, 0.97]). The pooled results for AD also suggested a lower RR with statin user compared to non-statin users in random effects models (RR: 0.70, 95% CI [0.60, 0.83]). Study design and methods used to address biases may influence the results.
CONCLUSION:
These pooled results suggest that statins may provide a slight benefit in the prevention of AD and all-type dementia. This benefit observed in both disease states should be interpreted with caution as observational studies are subject to bias, and it is possible that the slight benefit observed may disappear when these biases are addressed in a well-designed randomized controlled trial.
Statins in the prevention of dementia and Alzheimer's disease: a meta-analysis of observational studies and an assessment of confounding.
NCBI
Wong WB, Lin VW, Boudreau D, Devine EB.
Studies demonstrate the potential for statins to prevent dementia and Alzheimer's disease (AD), but the evidence is inconclusive.
OBJECTIVE:
Conduct a meta-analysis to estimate any benefit of statins in preventing dementia and examine the potential effect of study design and confounding on the benefit of statins in dementia. A secondary goal is to explore factors that may elucidate the mechanisms by which statins exert their potentially beneficial effect.
METHODS:
Performed systematic literature review to identify relevant publications. Relative risk (RR) estimates were pooled using both fixed and random effect models. Studies were stratified by study design and potential confounding factors.
v RESULTS:
The pooled results for all-type dementia suggest that use of statins is associated with a lower RR of dementia when compared to non-statin users (random effects model: RR 0.82 (95%CI [0.69, 0.97]). The pooled results for AD also suggested a lower RR with statin user compared to non-statin users in random effects models (RR: 0.70, 95% CI [0.60, 0.83]). Study design and methods used to address biases may influence the results.
CONCLUSION:
These pooled results suggest that statins may provide a slight benefit in the prevention of AD and all-type dementia. This benefit observed in both disease states should be interpreted with caution as observational studies are subject to bias, and it is possible that the slight benefit observed may disappear when these biases are addressed in a well-designed randomized controlled trial.
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