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Jun 29
Heavy snorers 'face double the risk' of rheumatoid arthritis
Snoring heavily almost doubles the risk of developing rheumatoid arthritis, a new study shows.

Researchers found patients diagnosed with the snoring-related condition sleep apnoea were nearly twice as likely to suffer the joint-damaging disease.

The discovery, which comes from research carried out in Taiwan, is something of a surprise as rheumatoid arthritis - which affects around 350,000 people in the UK - is thought to be triggered when something goes wrong with the immune system.

The same study found a similar increase in the risk of other so-called autoimmune disorders, where the body's defences start to attack healthy tissues.

Scientists said they believe the explanation lies in the fact that chronic sleep apnoea can lead to inflammation in blood vessels throughout the body, which may act as a catalyst for arthritis.

Although previous studies have suggested sleep apnoea may raise the risk of heart attacks, the latest investigation is the first to show a link with arthritis.

An estimated three million people in Britain suffer with sleep apnoea, though many more may remain undiagnosed.

As sleep begins, the muscles in the airway relax. For most people this does not pose a problem but in sleep apnoea, it leads to a complete collapse which shuts off breathing for at least ten seconds.

It also disrupts breathing and triggers the sound of snoring as air vibrates against the soft tissue that stands in its way.

Once the brain realises breathing has stopped it sends out a signal for the airway muscles to contract again.

This opens the airway and the sufferer normally wakes with a jolt. In mild sleep apnoea, this can happen about once every ten minutes. If it's severe, it means sleep can be disturbed every couple of minutes.

Very few people remember waking up at all because they fall asleep again within seconds.

Yet the cumulative effect is that they feel exhausted during the day, putting them at increased risk of accidents. Being overweight is one of the major risk factors.

In the latest study, by experts at the Taipei Medical University, 1,411 sleep apnoea patients were compared to a 7,000-strong group of healthy adults.

Over a five-year period, researchers monitored how many in each group went on to develop rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematous - all conditions where the immune system goes haywire and causes swollen, painful joints and flu-like symptoms.

The results, published in the journal Sleep Medicine, showed the snoring-affected group were 91 per cent more likely to develop one of the three conditions.

However, the researchers stressed that the absolute risk of falling ill was still small. Out of the snoring patients, only 2.91 percent experienced arthritis-related problems.

In a report on their findings the researchers said: 'Our study is the first to investigate the association between sleep apnoea and the development of autoimmune diseases.

'We think this may have gone unnoticed in clinical settings because these cases are relatively rare and may not be reported.

'But the potential link between these two conditions should not be overlooked. Among the diseases we studied, rheumatoid arthritis had the highest risk of developing in sleep apnoea patients.'

As well as inflamed and swollen joints, arthritis sufferers also experience flu-like symptoms. In very severe cases, they can end up crippled and unable to live a full life.

But diagnosing the condition can be difficult as the early signs can be as innocuous as a slight stiffness in hand joints, often early in the morning.

Jun 29
'Ageing not linked to drop in testosterone levels'
Ageing, surprisingly, may have little to do with a gradual drop in testosterone levels, but is more likely to result from a man's behavioural and health changes, says a new study.

"It is critical that doctors understand that declining testosterone levels are not a natural part of aging and that they are most likely due to health-related behaviours or health status itself," said study co-author Gary Wittert, professor of medicine at the University of Adelaide, Australia.

"Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed at either clinic visit," Wittert said.

"While stopping smoking may be a cause of a slight decrease in testosterone, the benefit of quitting smoking is huge," added Wittert. This hormone is important for many bodily functions, including maintaining a healthy body composition, fertility and sex drive.

Few population-based studies have tracked changes in testosterone levels among the same men over time, as their study did, Wittert said, according to an Aadelaide statement.

Wittert and his co-authors analysed testosterone measurements in more than 1,500 men recorded at two clinic visits five years apart. All blood testosterone samples underwent testing at the same time for each time point, said Wittert.

Researchers included 1,382 men in the data analysis, aged between 35 and 80 years, averaging 54 years, after screening out those who were taking medicines or had medical conditions known to affect hormones.

On average, testosterone levels did not decline significantly over five years; rather, they decreased less than one percent each year, the authors reported. However, when the investigators analysed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study.

Unmarried men in the study had greater testosterone reductions than did married men. Wittert attributed this finding to past research showing that married men tend to be healthier and happier than unmarried men. "Also, regular sexual activity tends to increase testosterone," he explained.

Jun 27
Daily Exercise May Cut Breast Cancer Risk
Staying highly active may protect against breast cancer whether it's walking, running, or anything in between, researchers found.

Women who got around 2 hours of exercise a day most days of the week were about 30% less likely to develop breast cancer whether pre- or post-menopausal in a population-based study by Lauren E. McCullough, MSPH, of the University of North Carolina in Chapel Hill, and colleagues.

High-intensity exercise didn't appear any better than low-intensity activity, the group reported online in Cancer.

"Given that three-quarters of the U.S. population participates in some physical activity, it is conceivably one of the most important lifestyle risk factors associated with the incidence of breast cancer," they wrote.

The study included 1,504 women with cancer and 1,555 without it in the population-based Long Island Breast Cancer Study Project.

Simply getting some physical activity outside of work didn't appear to have much impact on breast cancer risk, with an odds ratio of 0.94 (95% CI 0.79 to 1.12).

Reproductive status did seem to matter. Exercise during the reproductive years -- between the birth of a first child until menopause -- or after menopause had the biggest influence.

Even then, less than average activity levels (9 or 10 hours) were not significantly protective in either group.

Only the third quartile in both showed statistically significant benefits in terms of reduced breast cancer risk.

Women who got 10 to 19 hours of exercise a week during their reproductive years showed an odds ratio of 0.67 for breast cancer compared with inactive women (95% CI 0.48 to 0.94).

Women in their childbearing years who got more than 19 hours of activity a week showed a reduced odds ratio of 0.86 as well but with a wide, nonsignificant CI.

With regard to activity levels after menopause, women in the quartile that got 9 to 17 hours a week of physical activity had an odds ratio of 0.70 for breast cancer (95% CI 0.52 to 0.95). Those who got more than 17 hours again tended to have reduced risk but not significantly so (OR 0.84, 95% CI 0.63 to 1.13).

The lack of a linear dose-response "could be interpreted as weak evidence of an association" but a J- or U-shaped curve is also possible, McCullough's group noted.

Sustained activity can generate cellular and DNA damage and depress immune function, they pointed out.

Results were similar for in situ and invasive cancer and across hormone receptor status.

Every weight category showed lower breast cancer risk with more activity versus none.

Substantial weight gain after menopause appeared to eliminate the benefits of exercise for breast cancer risk, though still apparently better than a big gain without staying active (OR 1.02 versus 1.28).

"Collectively, these results suggest that women can still reduce their breast cancer risk later in life by maintaining their weight and engaging in moderate amounts of activity," the researchers wrote.

The group noted that exercise's benefits likely come from cutting down on insulin resistance and inflammation by keeping energy balance and obesity under control.

They cautioned that the study cohort was richer and better educated than typical in the U.S. and included few women who didn't have children, which may have an impact on generalizability.

Jun 27
The Internet Knows You're Depressed, but Can It Help You?
Depressive people tend to use the Internet differently than mentally healthy types, but it's not clear whether their pattern of use helps or exacerbates their mood.

How do depressed people behave online? According to a new study of college students with depressive symptoms - recently described by its authors in the New York Times - they compulsively check email, watch many videos, spend a lot of time playing games and chatting, and frequently switch back and forth between applications.

With permission, the authors tracked the Internet use patterns of 216 undergrads at the Missouri University of Science and Technology for a month. They measured their levels of depression at the start of the study.

About 30% had some depressive symptoms like low mood, loss of concentration and excessive feelings of anxiety. This doesn't mean that a third of college students were clinically depressed; rather, they had at least some of the symptoms associated with the disorder. The finding is in line with data from surveys showing that 10% to 40% of college students have depressive symptoms at one time or another.

The research cannot determine, however, whether depression causes this differing pattern of use, or vice versa - or more importantly, whether this Internet behavior worsens, alleviates or has no effect on mood problems.

A depressed person might use gaming and video watching to avoid coping with emotional pain, or gaming could actually be a healthy escape that helps lift mood. Similarly, excess chatting and emailing might be a sign that someone is reaching out for helpful support, or it could signal desperation and anxiety related to socializing.

Rapid application switching seems likely to reflect the impairment in concentration that characterizes some kinds of depression, as the authors suggest, but it might alternatively be an adaptive way to get things done when focus is in short supply. Because the researchers avoided investigating the content of applications, emails and chats due to privacy concerns, it's impossible to tell.

Jun 25
Smoking fathers pass on damaged DNA to their children raising the risk of cancer
Fathers who smoke pass on damaged DNA to their children raising the risk of cancer, research shows.

A study found that smoking harms the father's DNA, and these damaged genes can be inherited by his children.

This raises the risk of youngsters developing childhood cancers, particularly leukaemia, warn researchers at the University of Bradford.
Because a fertile sperm cell takes three months to fully develop, fathers should kick the habit 12 weeks before conceiving to avoid the risk, Dr Diana Anderson said.
She added: 'Smoking by fathers at the time around conception can lead to genetic changes in their children. These changes may raise the risk of developing cancer.'
Meanwhile scientists at the University of Glasgow have also found that men who drink lots of tea are far more likely to develop prostate cancer.

They found that those who drank seven or more cups a day had a 50 per cent higher risk of contracting the disease than men who had three or fewer.

The warning comes after researchers tracked the health of more than 6,000 men for four decades.

Their findings run counter to previous research, which had suggested that tea-drinking lowers the risk of cancer, as well as heart disease, diabetes and Parkinson's disease.

Jun 25
Built in dengue virus killer found in humans
Scientists may have hit gold in their fight against dengue. They have located a human antibody that can neutralise and kill its virus within two hours.

Significantly, they have also identified a way to reproduce this antibody in large quantities, potentially opening the door to a cure for dengue infected patients.

The symptoms of dengue are sudden-onset fever, headache (located behind the eyes), muscle and joint pains, and a rash. The alternative name for dengue, `break-bone fever,` which comes from the associated muscle and joint pains.

This discovery was made by a combined team from the National University of Singapore (NUS) Yong Loo Lin School of Medicine, Duke-NUS Graduate Medical School and the Defence Medical & Environmental Research Institute, all based in Singapore.

By studying a group of cell lines from recovered dengue-infected patients over two years, the team identified the antibody, could attach itself strongly to a specific part of the dengue virus and inhibit it from attacking other cells.
The antibody eventually destroys the virus and at a much faster speed compared to existing anti-dengue compounds. It has been proven to increase the survival in a mouse model infected with the dengue virus, according to a NUS statement.

The World Health Organization estimates there may be 50-100 million dengue infections worldwide every year. With no approved vaccines or specific treatment available, dengue continues to be a public health concern.

This newly discovered antibody specifically treats DENV1, one of the four dengue serotypes, which accounts for up to 50 percent of the dengue cases in Southeast Asian countries.

The research team tested this new antibody with DENV1 types from these countries - with equally promising results, said Paul Macary, associate professor of microbiology at NUS Yong Loo Lin School, who as the principal investigator, led the research team.

"This represents the best candidate therapy that currently exists for dengue and thus is likely to be the first step in treating dengue infected patients who currently have no specific medicine or antibiotic to take and may take days to fully recover," concludes Macary.

Jun 22
Cardiovascular Mortality Rates Higher Among Elderly Who Live Alone
It is estimated that one in seven American adults live alone. An international study of stable outpatients who were either at risk of or suffered from arterial vascular disease, such as coronary disease or peripheral vascular disease has now discovered that individuals who live alone have a higher risk of mortality and cardiovascular mortality. The study, published Online First in JAMA's Archives of Internal Medicine reveals that social isolation may be linked to poor health outcomes.

According to the study's background information, epidemiological evidence indicates that social isolation could have various implications, such as influencing health behavior and effecting access to health care. It can also potentially change neurohormonal-mediated emotional stress, which can either be linked to or lead to the development of cardiovascular risk.

Jacob A. Udell, M.D., M.P.H., from Brigham and Women's Hospital at the Harvard Medical School in Boston and his team decided to assess whether living alone was linked to a higher risk of mortality and cardiovascular (CV) disease. They evaluated data obtained from the global REduction of Atherothrombosis for Continued Health (REACH) Registry and found that 8,594 people or 19% lived alone from a total of 44,573 REACH participants.

Their results revealed a four-year mortality rate of 14.1% in those living alone, compared with 11.1% in those who lived with others. The risk of cardiovascular disease was 8.6% for those living alone, compared to 6.8% for those who did not.

In terms of age, people between the ages from 45 to 65 years who lived alone were linked to a higher death risk (7.7%) than those who lived with others (5.7%), whilst participants between the ages of 66 to 80 years had a 13.2% higher risk, compared to a 12.3% risk respectively. The results also demonstrate that those above the age of 80 who lived alone had a lower increased risk of mortality, i.e. 24.6%, compared with those who lived with someone else (28.4%).

The researchers state:

"In conclusion, living alone was independently associated with an increased risk of mortality and CV death in an international cohort of stable middle-aged outpatients with or at risk of atherothrombosis. Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of CV disease, and this observation warrants confirmation in further studies."

Jun 22
Suicide second leading cause of death among young Indians
Suicide has become the second leading cause of death of young people in India, which has one of the highest suicide rates in the world, according to a study published in Lancet.

"Suicide kills nearly as many Indian men aged 15-29 as transportation accidents and nearly as many young women as complications from pregnancy and childbirth," said the study's lead author Vikram Patel, of London School of Hygiene & Tropical Medicine.

Transport accidents are the leading cause of deaths in men (about 14 per cent) in India while maternal disorders are the main cause of deaths among women (about 16 per cent), the study said.

After that suicide is the second leading cause of death of young people in India - 13 per cent in men and 14 per cent in women.

With decline in maternal death rates, suicide could soon become the leading cause of death among young women, he said, noting further that public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India.

"In India, suicide is the cause of about twice as many deaths as is HIV/AIDS, and about the same number as maternal causes of death in young women," the article states.

The research is based on the Registrar General of India's first national survey of the causes of death, conducted in 2001-03, and the researchers applied the age-specific and sex -specific proportion of suicide deaths in the 2001 03 survey to the 2010 UN estimates of absolute numbers of deaths (and age-specific risks) for all causes in India.

The Registrar General of India's survey found that about 3 per cent of deaths in India of people aged over 15 are due to suicide.

Using projections by the United Nations of total deaths, the study authors estimated that about 187,000 suicides occurred in 2010. Of those men who died by suicide, 40 per cent were between the ages of 15 and 29. Of the women, 56 per cent were in that age bracket.

Jun 21
Why some urinary tract infections recur persistently after treatment
Scientists including one of an Indian origin have found new clues to why some urinary tract infections recur persistently after multiple rounds of treatment.

Their research, conducted in mice, suggested that the bacteria that cause urinary tract infections take advantage of a cellular waste disposal system that normally helps fight invaders.

In a counterintuitive finding, the researchers at Washington University School of Medicine in St. Louis learned that when the disposal system was disabled, the mice cleared urinary tract infections much more quickly and thoroughly.

"This could be the beginning of a paradigm shift in how we think about the relationship between this waste disposal system, known as autophagy, and disease-causing organisms," said senior author Indira Mysorekar, PhD, assistant professor of obstetrics and gynaecology and of pathology and immunology.

"There may be other persistent pathogens that have found ways to exploit autophagy, and that information will be very useful for identifying new treatments," she explained.

Urinary tract infections are very common, particularly in women.. Scientists believe 80 percent to 90 percent of these infections are caused by the bacterium Escherichia coli (E. coli).

Data from the new study and earlier results have led Mysorekar and her colleagues to speculate that E. coli that cause recurrent urinary tract infections may hide in garbage-bin-like compartments within the cells that line the urinary tract.

These compartments, found in nearly all cells, are called autophagosomes. They sweep up debris within the cell, including harmful bacteria and worn-out cell parts. Then, they merge with other compartments in the cell that are filled with enzymes that break down the contents of autophagosomes.

"We think, but can't yet prove, that the bacteria have found a way to block this final step. This would transform the autophagosome from a death trap into a safe haven where the bacteria can wait, hidden from the immune system, for their next chance to start an infection," Myosrekar said.

In the new research, Mysorekar teamed with colleagues at the School of Medicine who had developed mice in which both copies of an important autophagy gene, Atg16L1, were impaired. Co-author Herbert W. Virgin, MD, PhD, Edward Mallinckrodt Professor and head of the Department of Pathology and Immunology, and others created the mice to study Crohn's disease, a chronic bowel inflammation associated with mutations in Atg16L1.

Co-lead authors Caihong Wang, DVM, PhD, a staff scientist, and Jane Symington, an MD/PhD student in the Mysorekar group, infected the mice with E. coli. The researchers found that bacteria levels in the urinary tracts of the modified mice decreased much more rapidly after infection than they did in normal mice. Cells lining the urinary tract in mice with the mutated gene also had significantly fewer dormant reservoirs of E. coli than in normal mice.

The scientists identified structural changes in urinary tract cells of the mice with Atg16L1 mutations that may help explain their unexpected results. These changes may have made it much more difficult for the bacteria to find and break into autophagosomes, Mysorekar says.

The altered gene also was associated with changes in the immune system. In the modified mice, E. coli infections in the urinary tract led cells to produce more inflammatory immune factors and prompted additional bacteria-fighting immune cells to come to the site of the infection.

"The immune system appears to be primed to attack at the slightest provocation in the mice with mutations. This may be why mutations in Atg16L1 are also connected with Crohn's disease, which involves immune cells erroneously attacking beneficial microorganisms in the gut," Mysorekar stated.

Mutations in Atg16L1 are quite common, according to Virgin, although not everyone who has a mutated form of the gene will get Crohn's disease.

"These new results may help explain why the mutations have persisted for so long in the general population. They don't just put the carrier at risk of Crohn's disease, they also may have a protective effect that helps fight infections," he said.

Mysorekar plans to investigate how E. coli takes advantage of a fully functioning autophagy system in mice with urinary tract infections.

The results will be published in the early online edition of The Proceedings of the National Academy of the Sciences.

Jun 21
Eating too much salt may trigger high BP
People who eat a high-salt diet are more likely to develop hypertension, or high blood pressure, a new research has warned.

Researchers say eating a high-salt diet for several years may damage blood vessels - increasing risk of developing high blood pressure.

This research hints at the presence of a "sodium amplification loop" in which eating too much salt for a long time damages blood vessels, leading to a greater chance of developing high blood pressure if the high-salt diet is continued.

Researchers didn't assess the cause-and-effect relationship between salt intake and high blood pressure. But the study's results "add to the considerable evidence that a diet heavy on salt is closely linked to high blood pressure," said John Forman, M.D., lead author of the study and a nephrologist at Brigham and Women's Hospital and Harvard Medical School in Boston, Mass.

"In addition, this study reinforces guidelines backed by the American Heart Association and other professional organizations that recommend reducing salt consumption to minimize the risk of developing high blood pressure," Forman said.

One gram of sodium is equal to 2.5 grams of table salt (sodium chloride).

Researchers conducted an observational study (PREVEND) in which they tracked the sodium intake of 5,556 men and women from the general population of Groningen, Netherlands. Sodium intake was assessed by collecting multiple 24-hour urine samples, which is considered the optimal method to measure sodium intake.

Researchers analyzed the association between sodium consumption and blood levels of uric acid and albumin in the urine - both markers of blood vessel damage - in participants not taking high blood pressure medicine.

During a median follow-up of 6.4 years, 878 new hypertension diagnoses were made.

Higher sodium intake was associated with increasing levels of uric acid and albumin over time. The higher the levels of these markers, the greater the risk of developing hypertension if dietary salt intake was high, researchers found.

Compared with participants eating the least amount of sodium (about 2,200 milligrams a day), those eating the most (about 6,200 mg/d) were 21 percent more likely to develop high blood pressure. However, those who had high uric acid levels and ate the most salt were 32% more likely to develop high blood pressure while those with high urine albumin levels and highest salt intake were 86% more likely to develop high blood pressure

A high-salt diet is believed to be responsible for 20% to 40% of all cases of high blood pressure in the United States. Because the study involved only European Caucasians, the results should be replicated in Hispanics, African-Americans and others in the United States; however, other researchers have found a link between a high-salt diet and high blood pressure in these other populations, Forman said.

The finding was reported in the American Heart Association journal Circulation.

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