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Jul 23
Improved Recovery In Patients Who Exercised Prior To Stroke
A person who has exercised regularly prior to the onset of a stroke appears to recover more quickly, say researchers from Mayo Clinic in Florida, who led a national study.

In the July 2009 issue of the Journal of Neurology, Neurosurgery & Psychiatry, the researchers reported that stroke patients who had previously exercised regularly before a stroke occurred were significantly more likely to have milder impairments and, thus, were better able to care for themselves, compared to patients who rarely exercised.

"It appears that exercise is very beneficial to people at risk of developing a stroke," says Mayo Clinic neurologist James Meschia, M.D., the study's lead investigator. "Many studies have shown that exercise can reduce the risk of developing a stroke in the first place, and this study suggests that if an active person does have a stroke, outcomes can be improved."

Dr. Meschia cautions, however, that a larger study is needed to validate these findings, because this study depended on recall from 673 people who had a stroke. A new study could also help clarify whether moderate or vigorous exercise is necessary to improve outcomes, he says.

"It makes complete sense that a person who exercised before a stroke would recover quicker," Dr. Meschia says. "A brain that generally has good blood and oxygen flow from aerobic exercise will be in a better position to compensate for neurological deficits caused by a stroke."

The findings are potentially important, he adds, because stroke is a common cause of illness, disability, and death among those over age 65 worldwide. In the United States, stroke results in more than 780,000 deaths each year, making it the third leading cause of mortality, and it causes more serious long-term disability than any other disease, according to the National Institutes of Health.

Patients enrolled in the study were treated for acute ischemic stroke - the most common kind of stroke, which results in the death of brain cells due to blockage of blood flow to a part of the brain.

Researchers reviewed a questionnaire patients had completed that asked about exercise before the stroke, and they also looked at measurements of stroke outcome taken after the stroke and then three months later.

Of the 673 patients enrolled, 50.5 percent reported that prior to their stroke, they exercised less than once a week, 28.5 percent exercised one to three times a week, and 21 percent reported aerobic physical activity four times a week or more.

After accounting for different patient variables, such as age, gender, race, body weight and medical history, the researchers found that exercise did not affect the size or severity of a stroke, but did modulate outcomes. Specifically, patients scored better in tests that assessed their ability to perform daily activities involved in living on their own, and determine whether a patient had regained normal functioning.

"We infer that patients who are active may recover more quickly immediately after a stroke, with trends that point to better outcomes at three-month follow-up," says Dr. Meschia.

Researchers could not determine from the data the "dose effect" of the exercise - how much is needed per week for better functioning.

Jul 23
Help For Persons With Aphasia - Computerized Writing Aids
It is possible to improve writing skills for those with aphasia with the aid of computerised writing aids. This is the conclusion of a doctoral thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Aphasia affects the ability to understand and use spoken language, and the ability to read and write. Persons with aphasia were trained in the use of computerised writing aids in the study on which speech and language pathologist Ingrid Behrns' doctoral thesis is based. The subjects were aided by a computer-based spell-checker and a program for word prediction, similar to that used when writing SMS messages on mobile telephones.

The thesis shows that writing ability improved in several ways with the aid of these programs.

"A fairly high reading and writing ability is necessary in order to benefit from the most common spell-checkers. So we used two writing aids that have been specially developed for persons with dyslexia, instead. These programs were also useful for persons who have writing problems arising from aphasia", says Ingrid Behrns.

The programs are easy to use and cheap to purchase, and may be beneficial for many people who have aphasia. The greatest benefit for those who were members of the group receiving writing training was that it became easier to make corrections in what they had written. They also wrote longer sentences with fewer spelling errors.

"But is important to remember that time must be invested in learning how to use the computer programs. It was particularly encouraging to find that it is possible to improve writing ability even though several years have passed since the participants developed aphasia", says Ingrid Behrns.

Previous research into writing ability and aphasia has focussed on the spelling of single words, but the work presented in the thesis investigated not only the completed text but also revisions that were made when writing a story. This makes it possible to see the aspects of the writing process for which the writer has had to use most energy. The thesis also shows that persons with aphasia can write stories with high coherence and a good overall structure, despite their language difficulties. The results also show that it is sometimes easier for persons with aphasia to express themselves in writing rather than in spoken language.

"The good results from the writing training are very encouraging since the ability to express oneself in writing opens many possibilities for communication using the Internet", says Ingrid Behrns.

APHASIA: Aphasia is a collective term for language difficulties that can arise after a stroke, for example, or from head injuries such as may be suffered in a traffic accident. Older persons are affected more often than younger, but aphasia can affect persons of any age. A person with aphasia has difficulty understanding, speaking, reading and writing, while their intellectual abilities are not impaired in any way. Approximately 12,000 Swedes are affected by aphasia each year.

Jul 23
Ovary Removal May Increase Lung Cancer Risk - New Study Published In The International Journal Of Ca
Women who have premature menopause because of medical interventions are at an increased risk of developing lung cancer, according to a new study published in the International Journal of Cancer. The startling link was made by epidemiologists from the Université de Montréal, the Research Centre of the Centre Hospitalier de l'Université de Montréal and the INRS-Institut Armand-Frappier.

"We found that women who experienced non-natural menopause are at almost twice the risk of developing lung cancer compared to women who experienced natural menopause," says Anita Koushik, a researcher at the Université de Montréal's Department of Social and Preventive Medicine and a scientist at the Research Centre of the Centre Hospitalier de l'Université de Montréal. "This increased risk of lung cancer was particularly observed among women who had non-natural menopause by having had both their ovaries surgically removed."

The scientists studied 422 women with lung cancer and 577 control subjects at 18 hospitals across Montreal, Quebec, Canada. They assessed socio-demographic characteristics, residential history, occupational exposures, medical and smoking history, and (among women) menstruation and pregnancy histories.

"A major strength of this study was the detailed smoking information which we obtained from all study participants; this is important because of the role of smoking in lung cancer and because smokers generally have lower estrogen levels than non-smokers," says Dr. Koushik. "Although smoking is the dominant cause of lung cancer, we know other factors can play an important role in enhancing the impact of tobacco carcinogens; this research suggests that in women hormonal factors may play such a role."

Women were considered menopausal if their menstrual periods had stopped naturally, surgically (by hysterectomy with bilateral surgical ovary removal) or because of radiation or chemotherapy. Women who had at least one remaining ovary and who still had their menstrual periods at the time of diagnosis/interview were classified as premenopausal. Among participants with natural menopause, the median age for attaining menopause was 50 years old; among those with non-natural menopause, it was at 43 years.

"Non-natural menopause, particularly surgical menopause, may represent an increased risk with younger age at menopause given that surgery is usually done before natural menopause occurs. It's possible that vulnerability to lung cancer is caused by early and sudden decrease in estrogen levels or potentially long-term use of hormone replacement therapy and further research is needed to explore these hypotheses," says Jack Siemiatycki a professor at the Université de Montréal's Department of Social and Preventive Medicine and a scientist at the Research Centre of the Centre Hospitalier de l'Université de Montréal.

Jul 23
Physical Activity In Children Improves Their Sleeping Patterns
A research published ahead of print in the Archives of Disease in Childhood reports that every hour of the day children are inactive adds three minutes to the time it takes them to fall asleep.

The study indicates that children who fall asleep faster also sleep for longer. Although, it appears one is not the direct consequence of the other.

Research shows that approximately 16 percent of parents of school aged children report that their child finds it difficult to get to sleep.

There is a connection between poor sleeping patterns in children and inferior school performance. It is also linked to an increased risk of overweight and obesity.

Using an activity monitor (called an actigraph) worn for 24 hours, the authors evaluated the daytime activity and sleep patterns of a representative sample of 591 seven year olds.

They obtained full information on sleep patterns for 519 of the children. They took an average of 26 minutes to fall asleep. This is known as sleep latency, ranging from 13 to 42 minutes (interquartile range).

The parents reported that around one in ten of the children regularly found it difficult to fall asleep quickly. These children took around 15.5 minutes longer to get to sleep.

The children, who were physically active during the day, fell asleep more rapidly than their more sedentary peers. The more vigorous activity they did, the faster they fell asleep.

In addition, every hour of the day spent in sedentary activity increased sleep latency by three minutes.

Shorter sleep latency was also associated to longer duration of sleep. It fell by more than 11 minutes for each additional hour of sleep.

The authors comment these findings will validate what many parents already believe: that tiring out a child with plenty of physical activity will increase the likelihood that she or he will sleep well.

They write in conclusion: "This study emphasizes the importance of physical activity for children, not only for fitness, cardiovascular health and weight control, but also for sleep."

Jul 21
Starve A Fever, Feed A Cold, Don't Be Stressed
Whether it's getting a cold during exam time or feeling run-down after a big meeting, we've all experienced feeling sick following a particularly stressful time at work or school. Is this merely coincidence, or is it possible that stress can actually make us sick? In a new report in Perspectives on Psychological Science, a journal of the Association for Psychological Science, psychologist Janice K. Kiecolt-Glaser from the Ohio State University College of Medicine reviews research investigating how stress can wreak havoc on our bodies and provides some suggestions to further our understanding of this connection.

The field of psychoneuroimmunology (PNI) investigates how stress and negative emotions (such as depression and anxiety) affect our health. Over the past 30 years, researchers in this field have uncovered a number of ways that stress adversely affects our health, and specifically, how stress can damage our immune system. Numerous studies have shown that stressed individuals show weaker immune responses to vaccines, and as Kiecolt-Glaser observes, "The evidence that stress and distress impair vaccine responses has obvious public health relevance because infectious diseases can be so deadly." Stress and depression have been shown to increase the risk of getting infections and also result in delayed wound healing.

Inflammation is the body's way of removing harmful stimuli and also starts the process of healing, via release of a variety of chemicals known as proinflammatory cytokines (e.g., interleukin-6). However, too much inflammation can be damaging and has been implicated in the development of many age-related diseases, including Alzheimer's Disease, Parkinson's disease, arthritis, and Type II diabetes. Negative emotions and psychological stressors increase the production of proinflammatory cytokines. A recent study revealed that men and women who serve as caregivers to spouses with dementia (and thus are under constant stress) have a four times larger annual rate of increase in serum interleukin-6 levels compared to individuals without caregiving responsibilities.

What's more, the changes in interleukin-6 levels among former caregivers did not differ from current caregivers, even following the death of the impaired spouse, indicating that chronic stress may cause the immune system to age quickly. Kiecolt-Glaser notes, "These stress-related changes in inflammation provide evidence of one mechanism through which stressors may accelerate risk of a host of age-related diseases."

Kiecolt-Glaser argues that our environment should be taken into account when studying the link between stress and our health. For instance, diet may modify interactions between psychological and immunological responses: Omega-3 fatty acids (found in fish and walnuts) can reduce production of some proinflammtory chemicals and increasing levels of omega-3 fatty acids may result in positive effects on mood and the immune system. Environmental toxins (such as pesticides and air pollutants) can have extremely negative effects on the immune system and these effects may be intensified in stressed individuals, increasing their risk for developing allergies, asthma, and viral infections.

Kiecolt-Glaser suggests that to most effectively tackle the questions raised by recent PNI research, cross-discipline training needs to be emphasized for students. Psychology students who gain a strong foundation in areas such as biology and physiology will be able to enter into powerful collaborations with scientists conducting immunology research. Kiecolt-Glaser concludes that the questions answered by these collaborations will advance PNI as well as psychology in general.

Jul 21
International Study Links 3 Genes To Melanoma
A consortium of European and Australian scientists doing a genome-wide association study found three gene variants were strongly linked to melanoma risk: two of them had previously been linked to pigmentation, freckling and sun sensitivity, and one was a new discovery. The findings may explain why people with the most moles on their skin have the highest risk of melanoma, the most dangerous form of skin cancer.

The study was led by Professors Julia Newton Bishop and Tim Bishop of the Melanoma Genetics Consortium (GenoMEL) at the University of Leeds and is published in the 5 July online issue of Nature Genetics.

For the study, they examined the genetic make up of more than 10,000 people, which meant looking at over 300,000 variants or "snips" (SNPs, single nuclotide polymorphisms) comparing those of people with melanoma to those who did not have the disease. They found a number of clear, genetic patterns.

Every year about 48,000 people worldwide die of melanoma, a disease responsible for most deaths from skin cancer. Many scientists suggest that the increase in melanomas in recent decades is partly due to the emergency of package holidays where people who don't get a lot of sun most of the year suddenly expose themselves to a lot of it for one or two weeks. They say intermittent, rather than daily exposure to the sun over longer periods puts people at higher risk of melanoma.

Also, it has already been shown that people who burn easily, have fair skin and red hair are most at risk of melanoma. The researchers found that the people in this study who had been diagnosed with melanoma were also more likely to be carrying genes that gave them red hair and freckles.

He and his colleagues found clear links between some genes on chromosomes 9 and 22 and increased risk of melanoma, but, as he explained:

"These genes were not associated with skin colour."

In fact, what they found, when they teamed up with colleagues at King's College London and in Brisbane, Australia, who had been counting moles on twins, was that:

"These genes actually influenced the number of moles a person has," said Bishop. However, we still don't know much about how sunshine and genetics come together to cause cancer in some people, he added, explaining that:

"If you take the people who have the greatest exposure to sunlight -- those who work outside for example -- and compare them to those with the least exposure, their risks of getting skin cancer are actually quite similar. Statistically, the differences are quite negligible."

"The research goes further and identifies the actual genes associated with this increased risk."

Jul 21
Endoscopic Surgery As Effective As Open Surgery For Nasal Cancer
Researchers from Boston University School of Medicine (BUSM) have shown that endoscopic surgery is a valid treatment option for treating esthesioneuroblastoma (cancer of the nasal cavity), in addition to traditional open surgery and nonsurgical treatments. These findings appear in the July issue of Laryngoscope.

Esthesioneuroblastoma is a very rare cancer that develops in the upper part of the nasal cavity and thought to derive from neural tissue associated with the sense of smell. While this tumor generally grows slowly, in some cases it progresses rapidly and aggressively. The faster growing tumors are capable of widespread metastasis.

According to the BUSM researchers, the complex nature of this tumor has led to much debate regarding the optimal treatment modality. Several previous studies have analyzed survival rates of various treatments, the majority of which have shown that the most effective strategy is a combination of surgery and radiotherapy with or without chemotherapy. However, the evolution of surgical techniques has created another surgical option in the form of endoscopic surgery.

This study examined recent literature regarding outcomes of esthesioneuroblastoma treatment between 1992 and 2008 and found overall, surgery yielded more disease-free outcomes and better survival rates than nonsurgical treatment modalities. Endoscopic surgery produced better survival rates than open surgery. In addition, there was no significant difference between follow-up times in the endoscopic and open surgery groups.

"Although this meta-analysis suggests that the efficacy of endoscopic and endoscopic- assisted surgery is comparable to open surgery for less invasive tumors, further prospective studies are required to establish more definite conclusions, especially for larger tumors," added Devaiah. "It helps validate this revolutionary method of surgery that we perform here at BMC, one of the few centers in the world that can offer patients endoscopic skull base surgery for these and other skull base tumors."

Jul 21
Popular Dietary Supplement May Help Prevent, Treat Cataracts - New Evidence
Researchers are reporting evidence from tissue culture experiments that the popular dietary supplement carnosine may help to prevent and treat cataracts, a clouding of the lens of the eye that is a leading cause of vision loss worldwide. The study is scheduled for the July 28 edition of ACS' Biochemistry, a weekly journal.

In the new study, Enrico Rizzarelli and colleagues note that the only effective treatment for cataracts is surgical replacement of the lens, the clear disc-like structure inside the eye that focuses light on the nerve tissue in the back of the eye. Cataracts develop when the main structural protein in the lens, alpha-crystallin, forms abnormal clumps. The clumps make the lens cloudy and impair vision. Previous studies hinted that carnosine may help block the formation of these clumps.

The scientists exposed tissue cultures of healthy rat lenses to either guanidine - a substance known to form cataracts - or a combination of guanidine and carnosine. The guanidine lenses became completely cloudy, while the guanidine/carnosine lenses developed 50 to 60 percent less cloudiness. Carnosine also restored most of the clarity to clouded lenses. The results demonstrate the potential of using carnosine for preventing and treating cataracts, the scientists say.

Jul 21
Teeth And Gums Also Benefit From The Healing Power Of Aloe Vera
The aloe vera plant has a long history of healing power. Its ability to heal burns and cuts and soothe pain has been documented as far back as the 10th century. Legend has it that Cleopatra used aloe vera to keep her skin soft. The modern use of aloe vera was first recognized the 1930s to heal radiation burns. Since then, it has been a common ingredient in ointments that heal sunburn, minor cuts, skin irritation, and many other ailments. Recently, aloe vera has gained some popularity as an active ingredient in tooth gel. Similar to its use on skin, the aloe vera in tooth gels is used to cleanse and soothe teeth and gums, and is as effective as toothpaste to fight cavities, according to the May/June 2009 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

Aloe vera tooth gel is intended to perform the same function as toothpaste, which is to eliminate pathogenic oral microflora - disease-causing bacteria -in the mouth. The ability of aloe vera tooth gel to successfully perform that function has been a point of contention for some dental professionals. However, research presented in General Dentistry may alleviate that concern. The study compared the germ-fighting ability of an aloe vera tooth gel to two commercially popular toothpastes and revealed that the aloe vera tooth gel was just as effective, and in some cases more effective, than the commercial brands at controlling cavity-causing organisms.

Aloe latex contains anthraquinones, which are chemical compounds that are used in healing and arresting pain because they are anti-inflammatory in nature. But, because aloe vera tooth gel tends to be less harsh on teeth, as it does not contain the abrasive elements typically found in commercial toothpaste, it is a great alternative for people with sensitive teeth or gums. But buyers must beware. Not all aloe vera tooth gel contains the proper form of aloe vera. Products must contain the stabilized gel that is located in the center of the aloe vera plant in order to be effective. Products must also adhere to certain manufacturing standards. Dilip George, MDS, co-author of the study, explains that aloe "must not be treated with excessive heat or filtered during the manufacturing process, as this destroys or reduces the effects of certain essential compounds, such as enzymes and polysaccharides." Dr. George suggests that consumers consult non-profit associations such as the International Aloe Science Council to see what products have received the organization's seal of quality.

Although there are more than 300 species of the plant, only a few have been used for medicinal purposes. "Thankfully, consumers with sensitive teeth or gums have a number of choices when it comes to their oral health, and aloe vera is one of them," says AGD spokesperson Eric Shapria, MS, DDS, MAGD, MA. "If they are interested in a more alternative approach to oral hygiene, they should speak with their dentist to ensure that it meets the standards of organized dentistry, too."

Jul 18
Circumcising Men With HIV Did Not Protect Women, Trial Stopped Early
Early results of a trial in Uganda showed that circumcising men with HIV did not protect their female partners, and as circumcision does not benefit men who already have HIV the trial was stopped early to avoid further risk to the female participants.

The study is published in The Lancet and was conducted by lead and corresponding author Professor Maria Wawer of the Department of Population, Family and Reproductive Health at Johns Hopkins University, Bloomberg School of Public Health in Baltimore, Maryland, USA, and colleagues.

The researchers conducted the unblinded, randomized controlled trial, which took place in Rakai District, Uganda, because observation studies have concluded that there is a link between male circumcision and reduced risk of HIV infection in female sexual partners.

For the trial the researchers enrolled 922 uncircumcised HIV-infected men who were aged between 15 and 49. The men showed no symptoms and their CD4 cell count was at 350 cells per microlitre or more.

CD4 cells are helper white blood cells that lead attack against infection. After being infected with HIV for a long time a, person's CD4 count goes down, showing that the immune system is starting to struggle in its fight against a whole range of other infections.

The men were randomly assigned to receive circumcision either immediately (474 intervention subjects), or 24 months later (448 controls).

The researchers also enrolled the female partners who tested negative for HIV at the start of the study and then tested them again after 6, 12 and 24 months.

Only 92 couples in the intervention group and 67 couples in the control group were included in the analysis, which showed that:

* 17 (18 per cent) of women in the intervention group acquired HIV during follow up.

* 8 per cent of women in the control group acquired HIV during follow up.

* The cumulative probabilty of a woman being infected at 12 months was 21.7 per cent in the intervention group and 13.4 per cent in the control group.

Explaining the higher rate of infection in the intervention group, the researchers suggested it could be because the couples resumed sexual relations before the circumcision wound had fully healed.

The trial ended early "because of futility" wrote the researchers, who concluded that:

"Circumcision of HIV-infected men did not reduce HIV transmission to female partners over 24 months; longer-term effects could not be assessed. Condom use after male circumcision is essential for HIV prevention."

The researchers said all men should still be continue to be offered circumcision on an equal basis and not offering it to men with HIV might stigmatize them.

They also wrote that the study suggests:

"Strict adherence to sexual abstinence during wound healing, and continuous condom use thereafter must be strongly promoted when HIV-infected men receive circumcision."

They recommended that male babies and young boys be circumcised as a soon as possible, while respecting the need for consent by parents and the children themselves.

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