Patients admitted to intensive heart care with chest pains have a better chance of surviving if they have high blood pressure. This is shown in a study by scientists at Linköping University in Sweden published in the world’s largest medical journal JAMA.

High blood pressure is usually associated with poor prognoses in heart disease. But that means blood pressure monitored at rest. The new findings show that it is important to factor in the situation in which the blood pressure is measured.

The study, by researchers Ulf Stenestrand, Fredrik Nyström, Magnus Wijkman, and Mats Fredriksson of Linköping University, comprised 119,151 patients admitted to intensive heart care for acute chest pain between 1997 and 2007. The data was retrieved from RIKS-HIA, a register that covers all Swedish intensive heart care units.

The blood pressure first measured upon admission was related to the risk of the patient dying during the care period or within a year. It turned out that the higher the upper, systolic, pressure was, the lower was the risk of dying. Among patients who had more than 162 mm Hg, the fatality risk was 22 percent lower than for those in the interval 128-144. The latter in turn ran a 40-percent lower risk of dying than those whose systolic blood pressure was under 128 mm Hg.

“The really big news in the study is that the risk continued to decline at even higher levels, all the way up to 200 mm Hg, after which the reduction in risk leveled off,” says Fredrik Nyström, professor of internal medicine.

The differences between the various groups were even clearer when the researchers examined the patients’ risk of dying only from cardiovascular disease. The improved prognosis was also valid for high-risk groups, such as diabetics, smokers, and obese patients.

It was previously known that low blood pressure can be associated with poor prognoses for certain types of heart disease, but in those cases the low blood pressure was caused by heart failure.

A new, large-scale study of more than 10,000 adults found that more than one in every 200 asymptomatic people screened with CT colonography, or virtual colonoscopy, had clinically unsuspected malignant cancer and more than half of the cancers were located outside the colon. The findings were published in the April issue of the journal Radiology.

“We are finding that virtual colonoscopy screening actually identifies more unsuspected cancers outside of the colon than within it,” said lead author Perry J. Pickhardt, M.D., professor of radiology and chief of GI Imaging, at the University of Wisconsin School of Medicine & Public Health. “As with asymptomatic colorectal cancers identified by virtual colonoscopy screening, these cancers are often detected at an early, curable stage.”

Colorectal cancer remains the second leading cause of cancer death in the U.S., and the National Cancer Institute estimated that there would be 146,970 new cases diagnosed in 2009 and 49,920 deaths. The disease is largely preventable through screening for colon polyps, which are benign growths that may develop into cancer if not removed. The American Cancer Society recommends that people at average risk for colorectal cancer begin regular colorectal cancer screening at age 50, but current compliance with this recommendation is below 50 percent. Many people resist screening because of the discomfort and inconvenience caused by the conventional optical colonoscopy test.

Virtual colonoscopy is less invasive than optical colonoscopy and produces precise and detailed “fly-through” images of the entire colon’s interior without having to insert a scope. With virtual colonoscopy screening, there is essentially no risk of bleeding or of perforating the colon. There is no need for intravenous sedation, and the procedure is less costly than conventional optical colonoscopy. It also is more convenient, typically taking 10 minutes or less.

Virtual colonoscopy also allows for limited assessment of structures outside the colon (extracolonic), including the abdomen, pelvis and portions of the lungs. Additional diagnostic tests for unsuspected extracolonic findings are performed in about 6 percent of cases, nearly half of which ultimately prove to be clinically relevant.

“Optical colonoscopy cannot provide for any assessment beyond the colon itself, whereas virtual colonoscopy can detect a wide array of unsuspected extracolonic diseases, most notably cancers and aortic aneurysms,” Dr. Pickhardt said.

For the study, Dr. Pickhardt and colleagues set out to determine the detection rate and clinical outcome of unsuspected malignancies detected with virtual colonoscopy in an asymptomatic screening population. The researchers retrospectively reviewed the medical records of 10,286 adults (5,388 men and 4,898 women) with a mean age of 59.8 years who were evaluated at either the University of Wisconsin or National Naval Medical Center. All of the adults had undergone colorectal cancer screening with virtual colonoscopy at the two centers between April 2004 and March 2008. The mean time for follow-up was 30.2 months.

Unsuspected cancer was confirmed in 58 patients, including 33 women and 25 men. Invasive colorectal cancer was found in 22 patients, and extracolonic cancer was found in 36 patients. Cancers in 31 patients (53.4 percent) were stage 1 or localized cancers.

“To our knowledge, none of the patients who presented with stage 1, stage 2 or localized disease at diagnosis has progressed to a higher stage,” Dr. Pickhardt said. “The fact that so many of the cancers in our study were localized or detected at an early stage appears to have positively affected survival.”

Extracolonic malignancies, which outnumbered cases of invasive colorectal cancer, included renal cell carcinoma, lung cancer and non-Hodgkin lymphoma, among others.

“Although extracolonic evaluation at screening CT colonography does carry some disadvantages, such as patient anxiety, inconvenience, or the potential for benign biopsy, our results suggest that early detection of asymptomatic extracolonic cancer represents an additional benefit of screening CT colonography that is not available with optical colonoscopy,” Dr. Pickhardt said.

“Virtual colonoscopy is an accurate, safe and convenient screening test that could potentially be a life-saving examination,” he added.

“A good night’s sleep” has long been the intention of millions of people suffering from sleep disorders around the world. However, this objective is scarcely met with ease. The reality of this scenario is that many will not seek the professional help to address the serious sleep disorders that plague them, resulting in numerous health consequences. The World Association of Sleep Medicine (WASM) will be holding the third annual World Sleep Day on Friday, March 19, 2010. The event is organized by the World Sleep Day Committee and is regarded as a platform for medical professionals to deliver the message of the importance of healthy sleep to the public.

Sleep is a function in which all vertebrates and some invertebrates participate, however the physiological purpose of sleep has yet to be discovered. While sleep is necessary to be alert to optimally navigate daily tasks, research shows sleep may also be a factor in growth, regeneration, and memory. With an estimated one third of adults suffering from clinically recognizable insomnia and approximately 80 additional sleep-related disorders, there is significant concern for the health consequences that occur with the lack of quality sleep. Studies suggest that a lack of sleep is detrimental to health in ways such as the development of high blood pressure, obesity, diabetes and other chronic ailments in those who consume less than 6 hours nightly.

The 10 Commandments of Sleep Hygiene listed below make common sense recommendations that are rarely complied with fully.

1. Fix a bedtime and an awakening time.

2. If you are in the habit of taking siestas do not exceed 45 minutes of daytime sleep.

3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke.

4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.

5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.

6. Exercise regularly, but not right before bed.

7. Use comfortable bedding.

8. Find a comfortable temperature setting for sleeping and keep the room well ventilated.

9. Block out all distracting noise and eliminate as much light as possible.

10. Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room.

Violation of these commandments causes poor quality of nocturnal sleep, short duration of sleep, fragmentation of sleep and serious sleep deprivation. These infringements may lead to poor alertness, lack of attention, reduced concentration, decreased work and academic productivity, and even motor vehicle accidents. Physical health problems come next.

It is due to the widespread effects of sleep disorders and increasing number of sufferers worldwide, that World Sleep Day dedicates its efforts in 2010 to educate the world on important sleep topics. The day’s events will take place online, featuring the organization of local groups promoting sleep health, presentation of educational materials, an award presentation to the best creation and exhibition of historic videos.

Extreme obesity is affecting more children at younger ages, with 12 percent of black teenage girls, 11.2 percent of Hispanic teenage boys, 7.3 percent of boys and 5.5 percent of girls now classified as extremely obese, according to a Kaiser Permanente study of 710,949 children and teens that appears online in the Journal of Pediatrics.

This is the first study to provide a snapshot of the prevalence of extreme obesity in a contemporary cohort of children ages 2 – 19 years from a large racially and ethnically diverse population using the recent 2009 U.S. Centers for Disease Control and Prevention extreme obesity definition. Previous research was based on recent National Health and Nutrition Examination Survey (NHANES) data and included information on obesity but not extreme obesity.

“Children who are extremely obese may continue to be extremely obese as adults, and all the health problems associated with obesity are in these children’s futures. Without major lifestyle changes, these kids face a 10 to 20 years shorter life span and will develop health problems in their twenties that we typically see in 40 – 60 year olds,” said study lead author Corinna Koebnick, PhD, a research scientist at the Kaiser Permanente Southern California’s Department of Research and Evaluation in Pasadena, Calif. “For example, children who are extremely obese are at higher risk for heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few.”

Researchers used measured height and weight in electronic health records to conduct a cross-sectional study of 710,949 children ages 2 – 19 years in the Kaiser Permanente Southern California integrated health plan in 2007 and 2008. Children in the study had an average of 2.6 medical visits per year where height and weight were measured.

The study found that 7.3 percent of boys and 5.5 percent of girls were extremely obese, translating into more than 45,000 extremely obese children in this cohort. The percentage of extreme obesity peaked at 10 years in boys and at 12 years in girls. The heaviest children were black teenage girls and Hispanic boys. The percentage of extreme obesity was lowest in Asian-Pacific Islanders and non-Hispanic white children.

According to the recent CDC recommendations, extreme obesity is defined as more than 1.2 times the 95th percentile, or a body mass index (BMI) of more than 35 kilograms/meter squared. Obesity is defined as more than the 95th percentile or a BMI of more than 30 kg/m(2). Overweight is defined as more than the 85th percentile or a BMI of more than 25 kg/m(2). The BMI is a reliable indicator of body fatness and calculated based on height and weight. For children, BMI percentiles are the most commonly used indicator to assess the size and growth patterns of individual children. The percentile indicates the relative position of the child’s BMI number among children of the same sex and age.

“Our focus and concern is all about health and not about appearance. Children who are morbidly obese can do anything they want — they can be judges, lawyers, doctors — but the one thing they cannot be is healthy,” said study co-author Amy Porter, MD, a Kaiser Permanente Baldwin Park pediatrician who leads the Pediatric Weight Management Initiative for Kaiser Permanente’s Southern California Region.

“The most important advice to parents of extremely obese children is that this has to be addressed as a family issue. There is rarely one extremely obese kid in a house where everyone else is extremely healthy. It’s important that everyone in the family is invested in achieving a healthier lifestyle,” Porter said.

“This publication is only the beginning. Now we are trying to quantify the health risks and long-term effects associated with extreme obesity, determine which groups are affected most, and develop strategies for population care management to reduce these health risks. Children’s health is important and we have a long way to go,” Koebnick said.
Day Spa Denver – Highlands Ranch Dentist – Whey Protein

R-rated movies portray violence and other behaviors deemed inappropriate for children under 17 year of age. A new study finds one more reason why parents should not let their kids watch those movies: adolescents who watch R-rated movies are more likely to try alcohol at a young age.

Published in the March issue of Prevention Science, a scientific journal of the Society for Prevention Research, the study of 6,255 children examined the relationship between watching R-rated movies and the probability of alcohol use across different levels of “sensation seeking,” which is a tendency to seek out risky experiences. The study was funded by the National Institute on Alcohol Abuse and Alcoholism and conducted by James D. Sargent, MD, a pediatrician at Dartmouth Medical School. The children were surveyed every 8 months for a period of two years from 2003 through 2005.

“The study found that watching R-rated movies affected the level of sensation seeking among adolescents. It showed that R-rated movies not only contain scenes of alcohol use that prompt adolescents to drink, they also jack up the sensation seeking tendency, which makes adolescents more prone to engage in all sorts of risky behaviors” Sargent said.

“There is another take home point in the findings. When it comes to the direct effect on alcohol use, the influence of R-rated movies depends on sensation seeking level. High sensation seekers are already at high risk for use of alcohol, and watching a lot of R-rated movies raises their risk only a little. But for low sensation seekers, R-rated movies make a big difference. In fact, exposure to R-rated movies can make a low sensation seeking adolescent drink like a high sensation seeking adolescent.” Sargent explained.

The Dartmouth pediatrician said that one possible explanation is high sensation seeking adolescents tend to get their experiences out on the street. They hang around other high sensation seekers, who are also engaging in risky behaviors, so there is less room for movies to make a difference in their risk for alcohol use.

R-rated movies and alcohol

“The message to parents is clear. Take the movie ratings literally. Under 17 should not be permitted to see R-rated movies,” Sargent said.

The study was based on telephone surveys of 6,522 adolescents aged 10-14 years. Parental consent and adolescent consent was obtained prior to interviewing each respondent. To protect confidentiality, adolescents indicated their answers to sensitive questions by pressing numbers on the telephone, rather than speaking aloud. The study sample mirrored the U.S. adolescent population with respect to age, sex, household income and census region, but with a slightly higher percentage of Hispanics and a slightly lower percentage of Blacks.

Sensation seeking was based on how individual subjects identified with statements like: “I like to do scary things, I like to do dangerous things, I often think there is nothing to do, and I like to listen to loud music.” Adolescents were also asked if they had ever tried alcohol that their parents were not aware of. This excluded adolescents who initiated drinking with sips of alcohol provided by parents. R-rated movie watching was measured by asking respondents if they had watched a random selection of movie titles drawn from box office hits during 2003 that had grossed at least $15 million. The movie titles included movies that had G (general audience), P/G (parental guidance) and R (restricted) ratings.

M. D. Anderson Cancer Center are encouraging men and women to learn more about colon polyps and how they affect a person’s risks for cancer.

“Finding out you have colon polyps doesn’t have to be frightening,” said Gottumukkala S. Raju, M.D., professor in the Department of Gastroenterology, Hepatology and Nutrition at M. D. Anderson. “Most colon polyps are not cancer. Yet, certain kinds of polyps may make you more likely to develop colon cancer.”

The colon is part of the large intestine. A colon polyp is a growth on the inside lining of the colon. A doctor looks for polyps during a colonoscopy.

Learn your polyp type

Polyps come in different shapes and sizes. Some are:

– Raised on stems like mushrooms

– Found on the surface of the colon, like a mushroom without a stalk

– Found flat on the surface of the colon, like a pancake

When a doctor removes a polyp during a colonoscopy, he or she sends it to a pathologist for examination under a microscope. The pathologist determines if the polyp is a:

– Hyperplastic polyp, which is not cancer

– Adenomatous polyp, which is not cancer but can become cancer if it’s not removed

– Malignant polyp, which is cancer

“It’s important for you to know all about the polyps your doctor found during your last colonoscopy,” Raju said.

Daylight Savings Time can be hazardous for your health.

On average, people go to work or school on the first Monday of Daylight Savings after sleeping 40 fewer minutes than normal. And recent studies have found there’s a higher risk of heart attacks, traffic accidents and workplace injuries on the first Monday of Daylight Savings.

“Many people already are chronically sleep-deprived, and Daylight Savings Time can make them even more tired for a few days,” said Dr. Nidhi Undevia, medical director of the Sleep Program at Loyola University Health System.

Undevia offers these tips for getting enough sleep after moving the clock forward an hour:

– In the days before the time change, go to bed and wake up 10 or 15 minutes earlier each day.

– Don’t nap on the Saturday before the time change.

– To help reset your internal body clock, expose yourself to sunlight in the morning as early as you can.

Loyola offers a comprehensive and multidisciplinary program to help identify and treat sleep disorders. The sleep laboratory and sleep clinic diagnose and treat a full range of sleep disorders, including insomnia, sleep walking, obstructive sleep apnea, narcolepsy, circadian rhythm disorders, restless legs syndrome and periodic limb movement disorders.

The thousands of bacteria, fungi and other microbes that live in our gut are essential contributors to our good health. They break down toxins, manufacture some vitamins and essential amino acids, and form a barrier against invaders. A study published in Nature shows that, at 3.3 million, microbial genes in our gut outnumber previous estimates for the whole of the human body. Scientists at the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany, working within the European project MetaHIT and in collaboration with colleagues at the Beijing Genomics Institute at Shenzhen, China, established a reference gene set for the human gut microbiome a catalogue of the microbe genes present in the human gut. Their work proves that high-throughput techniques can be used to sequence environmental samples, and brings us closer to an understanding of how to maintain the microbial balance that keeps us healthy.

“Knowing which combination of genes is necessary for the right balance of microbes to thrive within our gut may allow us to use stool samples, which are non-invasive, as a measure of health,” says Peer Bork, whose group at EMBL took part in the analysis. “One day, we may even be able to treat certain health problems simply by eating a yoghurt with the right bacteria in it.”

This catalogue of the microbial genes harboured by the human gut will also be useful as a reference for future studies aiming to investigate the connections between bacterial genetic make-up and particular diseases or aspects of people’s lifestyles, such as diet.

To gain a comprehensive picture of the microbial genes present in the human gut, Bork and colleagues turned to the emerging field of metagenomics, in which researchers take samples from the environment they wish to study and sequence all the genetic material contained therein. They were the first to employ a high-throughput method called Illumina sequencing to metagenomics, dispelling previous doubts over the feasibility of using this method for such studies.

From a bacterium’s point of view, the human gut is not the best place to set up home, with low pH and little oxygen or light. Thus, bacteria have had to evolve means of surviving in this challenging environment, which this study now begins to unveil. The scientists identified the genes that each individual bacterium needs to survive in the human gut, as well as those that have to be present for the community to thrive, but not necessarily in all individuals, since if one species produces a necessary compound, others may not have to. This could explain another of the scientists’ findings, namely that the gut microbiomes of individual humans are more similar than previously thought: there appears to be a common set of genes which are present in different humans, probably because they ensure that crucial functions are carried out. In the future, the scientists would like to investigate whether the same or different species of bacteria contribute those genes in different humans.

Many people feel insecure when they drive in tunnels. However, their anxiety can be reduced.

“Driving in tunnels is actually twice as safe as driving in the open air, when all factors are taken into account,” says SINTEF scientist Gunnar Jensen.

However, a rough estimate suggests that as many as 10 – 20 percent of the population feel uncomfortable or very uncomfortable driving in tunnels. Older people in particular tend to feel insecure.

In a previous study carried out by SINTEF, as many as 40 percent of the older age-group said that they felt extremely insecure driving in tunnels. They spoke of walls and road lanes that seemed to shrink, and of a feeling of being completely exhausted when they eventually reached the end of the tunnel.

Gunnar Jenssen believes that this may be due to the fact that elderly people tend to have poorer vision than younger people. This means that lighting conditions in tunnels play a decisive role in determining how people experience tunnels, he believes.

Design can reduce discomfort

On this background, SINTEF transport researchers have been studying the use of various ranges of colour, lighting and patterns, as well as the use of cavern spaces in tunnels. The group’s driving simulator has been and still is a very aid in testing out lighting designs.

“The cavern in the tunnel is one measure that is high on our list. The trumpet-like widenings of the caverns’ entrances and exits are a way of breaking up the impact of long tunnels. The 24.5 km-long Lærdal Tunnel has three well-lit caverns designed according to proposals submitted by the Kadabra Produktdesign company, researchers and the artists Arild Juul and Brit Dyrnes.

Norwegian breathing spaces in Chinese tunnel

In 2007, the lighting design from Trondheim was exported to China, and Gunnar Jenssen was project manager for “Safety and Lighting Design” when that country inaugurated the world’s longest twin-tube tunnel, the Qinling Zhongnan Mountain Tunnel, in which the monotony is broken by huge caverns excavated at intervals of three to seven kilometres.

“The tunnel is 18×2 kilometres long, and to begin with it was a dry, monotonous tunnel, which was then developed in collaboration with Norwegian artists and designers into an oasis with palm-trees and clouds on the roof ,” says Jenssen.

Lighting for safety

The main point is to obtain a good distribution of light, in conjunction with the use of artistic lighting, which turns out to give drivers a feeling of space and of greater security. Modern lighting systems, with two rows of lamps, light sources that illuminate the opposite direction and driving lane, are beginning to be quite common in new Chinese tunnels, and they have also been installed in the tunnel that forms part of the Øresund Link between Denmark and Sweden.

A daily dose of vitamin D may just be what Chicagoans need to get through the long winter, according to researchers at Loyola University Chicago Marcella Niehoff School of Nursing (MNSON). This nutrient lifts mood during cold weather months when days are short and more time is spent indoors.

“Vitamin D deficiency continues to be a problem despite the nutrient’s widely reported health benefits,” said Sue Penckofer, PhD, RN, professor, MNSON. “Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D.”

Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of certain health concerns. The preferred range in the body is 30 – 60 ng/mL of 25(OH) vitamin D.

Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes.

“There is evidence to suggest that vitamin D supplementation may decrease insulin resistance,” said Dr. Penckofer. “If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women.”

Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time.

“Vitamin D has widespread benefits for our health and certain chronic diseases in particular,” Dr. Penckofer said. “Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression.”