Exercise training increases size of hippocampus and improves memory Aerobic exercise may help improve memory in older people

 

A year of modest aerobic exercise reversed normal brain shrinkage by one to two years in older adults and improved their memory function, according to a study published in the Proceedings of the National Academy of Sciences. As people age, the hippocampus, the brain's memory center, loses 1% to 2% of its volume annually, affecting memory and possibly increasing the risk for dementia. A growing body of evidence has pointed to aerobic exercise as a low-cost hedge against neurocognitive decline. In this study, magnetic resonance imaging was used to measure the effects of aerobic exercise on the hippocampus in 120 Americans in their late 50s to early 80s. Half the group walked three times a week for 40 minutes, aiming for their target heart rate, while the other half did yoga and toning exercises. The hippocampus in walkers increased by 2% after a year and shrank by 1.4% in controls. Both groups showed significant improvements on spatial memory tests conducted before and after the study. This could be due to taking the test repeated times, the researchers said. In the walking group, however, changes in hippocampus volume were directly related to improved memory performance, they said.

Caveat: The study found that exercise had a selective effect on the brain, influencing the volume of the anterior hippocampus but not the posterior. Researchers suspect aerobic exercise might have the most effect on regions of the brain that show the largest decline in late adulthood, such as the anterior hippocampus.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Enterovirus infection and type I diabetes mellitus: systematic review and meta-analysis of observational molecular studies

 

Type I diabetes: A virus that causes a host of ailments ranging from mild respiratory illnesses to meningitis and polio was found to be associated with the development of type I diabetes, especially in children under 5, according to a meta-analysis in the British Medical Journal. The global incidence of type I diabetes has been steadily increasing, particularly the juvenile form of the disease. Previous studies have associated enterovirus infections with type I diabetes and pre-diabetes autoimmunity but the findings weren't conclusive. In this study, Australian researchers analyzed 24 studies and two abstracts published from 1965 to 2010 that involved a combined total of 4,448 subjects who had undergone molecular testing for enteroviruses. They found type I diabetics were almost 10 times as likely to have had a recent enterovirus infection as non-diabetics and to experience persistent enterovirus infections. Children with recent enterovirus infections had three times higher risk for pre-diabetes. Researchers recommended further studies of the environmental, geographical and genetic factors believed to play a role in the development of type 1 diabetes.

Caveat: Other factors that weren't measured may have influenced the risk of developing diabetes, such as cow's milk, vitamin D and weight gain in infancy, researchers said. Also, there was uneven reporting among the various studies of the methodology used to detect enteroviruses.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Jewish Ethnicity and Pancreatic Cancer Mortality in a Large United States Cohort Pancreatic Cancer:

American Jews may be genetically predisposed to developing pancreatic cancer, according to a study in Cancer Epidemiology, Biomarkers and Prevention. Jewish ethnicity and pancreatic cancer have been examined in four previous studies dating to the 1950s, three of which reported higher mortality among Jews than non-Jews. This study is the first to consider the known risk factors for pancreatic cancer—smoking, obesity and diabetes—and the birthplace of Jews and their parents. Data were analyzed from an American Cancer Society study that followed 1,014,625 men and women from 1982 to 2006. Of the 6,727 deaths from pancreatic cancer during this period, 480 were among Jewish participants. Deaths were 43% higher among Jews than non-Jews and didn't vary significantly by age, family history or immigration background. Genetic factors and non-O blood type may contribute to the higher mortality, the study suggests. About 65% of U.S. Jews have non-O blood compared with 55% of white non-Jews. Understanding the reasons why Jews are at greater risk for pancreatic cancer may provide clues to its cause and lead to screening techniques, researchers said.

Caveat: The study lacked information on Ashkenazi or Sephardic Jewish origin. As the U.S. Jewish population is predominantly Ashkenazi, the results may not generalize to Sephardic Jews, researchers said. Information on the number of Jewish converts involved in the study wasn't available.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Drug Deals with Medical Insurance Carriers Tie Prices to How Well Patients Do.

So What’s in it for us?

Pressed by insurance companies, some drug makers are beginning to adjust what they charge for their drugs, based on how well the medicines improve patients’ health, reports A. Pollack. “Think of it as product guarantees by the drug industry.”


Traditionally, discounts and rebates that drug companies offer insurers have been based on how much drug is used, not how well patients do. But the emerging, outcomes-based contracts would — in theory — better align the incentives of insurers, drug companies and the employers that provide health coverage toward improving people’s health. Johnson & Johnson set what is considered the prototype deal in 2007 with Britain’s national health system, which had tentatively decided not to pay for the cancer drug Velcade. To avert that decision, the company offered essentially a money-back guarantee. If Velcade did not shrink a patient’s tumors after a trial treatment, the company would reimburse the health system for the cost of that patient’s drug.


In a current deal Merck will agree to peg what the insurer Cigna pays for the diabetes drugs Januvia and Janumet to how well Type 2 diabetes patients are able to control their blood sugar. Also the two companies that jointly sell the osteoporosis drug Actonel agreed to reimburse the insurer Health Alliance for the costs of treating fractures suffered by patients taking that medicine. “We’re standing behind our product,” said Dan Hecht, general manager of the North American pharmaceutical business of Procter & Gamble, which sells Actonel with Sanofi-Aventis. “We’re willing to put our money where our mouth is.” Under the Actonel deal, if a patient insured by Health Alliance suffers a nonspinal fracture despite faithfully taking Actonel, the drug makers will help pay for the medical care — spending $30,000 for a hip fracture, for instance, and $6,000 for a wrist fracture.


This clearly lowers the cost of the drug to Health Alliance, a small insurer in Illinois and Iowa. But Procter & Gamble and Sanofi-Aventis might benefit as well. The deal could reduce the pressure on the insurance company to move patients off Actonel, which costs about $100 a month, to less-expensive generic versions of Fosamax. And the insurer has kept Actonel in a tier of its drug list that requires a smaller co-payment than for a competing brand-name drug, Boniva.


Some experts hail such arrangements as a welcome step toward health care that rewards good outcomes for patients. “We’re going to see a growth in outcomes guarantees for pharmaceuticals, and it’s very healthy,” said Robert Seidman, a consultant who was formerly the chief pharmacy officer for WellPoint, an insurance company.


Such contracts started to take hold a few years ago in countries with national health systems, in which the government could effectively block a drug from being used if it was too costly. In the United States, where insurance companies do not have national monopolies — and where Medicare, by law, is precluded from negotiating drug prices — insurers have less leverage with drug makers. Even so, they can give favorable treatment to certain drugs, by reducing the required co-payments, for example.

The deal between Cigna and Merck is more complex.


Rather than getting paid more for good results, Merck will actually give Cigna bigger discounts on Januvia and Janumet. Some discounts will be granted if more people diligently take the drugs as prescribed. This helps both Cigna, because people who take their pills are likely to have fewer complications from the disease, and Merck, because it sells more pills. The assumption is that Cigna will push for patient-compliance programs that urge people to take their medicine at the right times and in the proper doses.


Moreover, in an unusual move, Merck will offer even greater discounts to Cigna on Januvia and Janumet if patients’ blood sugar is better controlled — regardless of whether the improvement comes through Merck’s drugs or other medications. In effect, though, Merck is betting not only that its drugs prove superior but that Cigna’s incentives to reap the benefits of the deeper Januvia and Janumet discounts will prompt the insurer to try to keep patients on those drugs. Januvia, approved in 2006, costs about $150 a month. Janumet, approved a year later, is a combination of Januvia and metformin, a widely used generic drug.


As part of the agreement, too, Merck will get better placement for Januvia and Janumet on Cigna’s formulary, meaning a lower co-payment for patients than for some other branded drugs. The deal was made with the pharmacy benefit management division of Cigna, which manages prescriptions for 7.1 million people.


So what’s in it for us patients?

If this does not translate to our pocketbooks there will be problems.

We’ll wait and see if and how much this will save we patients.

 Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

TOO MANY X-RAYS ARE HARMFUL

CT scans is associated with significant radiation exposure in some patients; the risks should be considered carefully when imaging for chronic disease and when screening asymptomatic individuals .It is estimated that 1.5-2.0% of US population cancers may be caused by CT radiation exposure. A retrospective, cohort study at a tertiary academic medical center identified 31,462 patients undergoing diagnostic CT during 2007; and 190,712 CTs over 22 years. Estimated lifetime attributable risk (LAR) for cancer was calculated. In this cohort, baseline cancer rates predicted 13,214 cancers and 6,292 fatal cancers; 98 additional cancers (62 fatal) were predicted from CT.

REFERENCE: “Recurrent CT, Cumulative Radiation Exposure and Associated Radiation-Induced Cancer Risks from CT of Adults” by Sodickson A et al. Radiology 2009;251:175-184 Colonoscopy Prevents 15,000 Cancer Cases

 Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Use Genetic Tests To Help Make Prescription Decisions

Medco Health Solutions Inc. "is encouraging doctors to use genetic tests to determine whether drugs will work for particular patients -- saving money and reducing harm caused when prescriptions are wrong." Medco and CVS Caremark Corp. also have increased their investments in providers of genetic testing services. Bloomberg notes that the FDA requires genetic testing for six drugs, "recommends testing before prescribing for more than two dozen medicines, and mentions diagnostic tests in the labels...of more than 150 others."

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Whole-genome sequencing may soon become clinically useful.

Two newly published papers may reignite the once-"disappointing" search for the "genetic roots of major killers like heart disease, diabetes, and Alzheimer's." In the seven or so years "since first full genetic code of a human was sequenced for some $500 million, less than a dozen genomes had been decoded, all of healthy people." Now, researchers at Baylor College and the Institute for Systems Biology were able to demonstrate that it is "possible to sequence the entire genome of a patient at reasonable cost and with sufficient accuracy to be of practical use to medical researchers."

        

What makes the technology even more impressive, she said, is that these were whole genomes of people that provided 'very interesting stories about rare diseases.'" 

        University of Utah researchers, "used gene sequencing technology to take a closer look at a "four-member family. After completing and comparing the genomes, investigators were able to tell that the "two parents passed recessive genes to their two children, each of whom had a condition called Miller Syndrome that may cause cleft palates, misshapen ears, and short stature." According to the paper in Science, the children also had "a lung disorder called primary ciliary dyskinesia that can lead to pneumonia, bronchitis and other respiratory infections." 

        Indeed, "experts have long known that Miller syndrome is genetic."But they had never been able to pinpoint the gene." Having the entire family's genomes in their hands, however, "helped shrink the genetic haystack from thousands of genes to four likely targets," and investigators were also able to calculate the odds of inheriting the variants.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com