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Nov 19
Afternoon caffeine associated with significant sleep disruptions, study shows
You may want to reconsider that late afternoon trip to Starbucks.

A new study from the Journal of Clinical Sleep Medicine shows that consuming caffeine even six hours before bedtime can still cause significant sleep disruptions.

In a study conducted at Wayne State University in Detroit, Mich., researchers studied the way that caffeine exposure affected the sleep habits of 12 healthy sleepers.

Participants were given three pills a day and instructed to take one pill six hours before bedtime, one pill three hours before bedtime and one pill right before they went to sleep. Each day, only one of the pills contained 400 mg of caffeine, which is equivalent to the amount of caffeine found in two to three cups of coffee.

Researchers then measured participants' sleep using both subjective analyses and in-home sleep monitors that tracked their brain activity.

Surprisingly, the researchers discovered that caffeine consumption appeared to cause significant sleep disruptions, regardless of when it was consumed during the day.

"We expected to see a time-sleep effect. We expected to see it at all time points, but we thought it would be more pronounced the closer to bedtime," study author Thomas Roth, founder of the Sleep Disorders and Research Center at the Henry Ford Hospital in Detroit, told FoxNews.com. "(But) it was pretty comparable at all time points."

In fact, consuming caffeine six hours before bedtime was associated with a one-hour reduction in total sleep time, the researchers reported.

"One hour of loss sleep - that's huge." Roth said. "The average sleeping pill you take will increase sleep for 30 minutes. This decreases sleep for about an hour. If you did this on a chronic basis, you'd become pretty sleep deprived."

Though researchers didn't examine why caffeine has such a pronounced effect on sleep, Roth suspects it has something to do with the way caffeine effects adenosine - a neurotransmitter that builds up in the brain during waking hours and decreases with sleep.

"Adenosine is what builds up in your brain to increase sleep pressure and (caffeine) may be negating that," Roth said.

Overall, Roth said that chronic sleep deprivation can cause a number of ill health effects, including cognitive impairment during the day and negative mood.

Though heavy caffeine drinkers may be more immune to the stimulant's effects, people who drink a moderate amount of coffee should avoid it later in the day.

Nov 19
Childhood cancer survivors face heart risks soon after treatment
Children who survive cancer treatment face increased heart health risk and should take measures soon after life-saving therapy to reduce the risk of serious problems later in life, according to research presented at a major medical meeting.

The five-year survival rate from childhood cancer has soared from 58 percent in 1975 to 1977, to 83 percent in the period from 2003 to 2009.

While earlier research had shown that childhood cancer survivors face heart disease and other potentially serious health problems decades after treatment, a new study found that chemotherapy takes a toll on artery health while survivors are still children, leaving them vulnerable to premature atherosclerosis and heart disease.

"We may need to start the clock earlier monitoring these children," said Donald Dengel, lead author of the study presented on Sunday at the American Heart Association scientific meeting in Dallas.

"Healthcare providers who are managing chemotherapy-treated childhood cancer survivors need to monitor cardiovascular risk factors immediately following completion of their patients' cancer therapy," said Dengel, a professor at the University of Minnesota.

Researchers used measures of the brachial and carotid arteries to test artery stiffness, thickness and function of 319 Americans ages 9 to 18 who had survived leukemia or other cancers, and compared the findings to 208 siblings not diagnosed with cancer.

Signs of premature heart disease, demonstrated by a decline in artery function, was more prevalent among those children and teenagers who had survived cancer, researchers found.

Childhood leukemia survivors had a 9 percent decrease in arterial health after completing chemotherapy compared with the non-cancer group.

"Given the increased risk, children who survive cancer should make lifestyle changes to lower their cardiovascular risk," Dengel said.

Such changes would include a heart-healthy diet and regular exercise.

However, more studies would be needed to assess whether blood vessel health can be improved by lifestyle changes in these survivors as has been shown in studies of childhood obesity. It may be that damage caused by chemotherapy cannot be reversed, Dengel said.

"I really don't think it's the cancer per se, it's the treatment" that is causing the problems, Dengel added.

A pilot study has begun in which childhood cancer survivors will be given cholesterol lowering statins after puberty to see if that can reduce the risk of future heart problems.

"It may serve them better to be more aggressive," Dengel said.

The study did have limitations, researchers noted.

Because of differences in cancer treatments, they were unable to attribute changes in arterial health to any particular chemotherapy.

In addition, most of the children in the study were white, so the findings were not necessarily applicable to other racial or ethnic groups.

Children in the study, which was funded by the National Institutes of Health and other research groups, had survived at least five years since their initial cancer diagnosis, researchers said.

They said it was the first such study to look at heart health of childhood cancer survivors while they were still children.

Nov 18
Malaria may be evolving around natural defence
Scientists have discovered recent genetic mutations in a malaria parasite and have found a duplication of a gene known to enable the parasite to infect red blood cells and two possible additional components to a more complex red cell invasion mechanism.

To learn the functions of the mutations, and whether the parasite is evolving around a natural defence, Peter A. Zimmerman, professor of international health, biology and genetics at the Case Western Reserve School of Medicine, and David Serre, a scientific staff member of the Genomic Medicine Institute at Lerner and assistant professor of genomics at Case Western Reserve, have received a 3.5 million dollars grant from the National Institute of Allergy and Infectious Disease at the National Institutes of Health. They will begin their field study in early 2014.

Researchers have long thought that P. vivax infects a person one way: a protein on the parasite, called the Duffy binding protein, latches onto a Duffy receptor on the surface of the person's red blood cell and works itself through the membrane.

P. vivax does not grow well in the laboratory, so to try to understand how the parasite lives and operates; the researchers gathered samples from malaria patients and focused on its genome.

They found a duplication of the Duffy binding protein in half of 189 P. vivax infection samples taken in Madagascar. Other researchers' prior efforts to sequence the P. vivax genome missed the duplication but all indications are it's a recent change, Serre said.

The researchers suspect the mutation is spreading from Madagascar through travellers. They found the duplication in less than 10 percent of samples from Cambodia and Sudan.

"Binding proteins and receptors are locks and keys," Zimmerman said. "If the parasite has one key and there's one lock, you may be able to block that. But if it has more keys and there are more locks, there are multiple ways in."

The researchers say the duplication may be a cause of the growing infections among Duffy negative people, but it's too early to tell.

The study is scheduled to be published in the journal PLoS Neglected Tropical Disease.

Nov 18
India is world's coronary, diabetic capital, says expert
India has earned the dubious distinction of becoming the world's capital of coronary heart disease and diabetes, says a wellness expert.

Conducting a fitness workshop for journalists at Mumbai Press Club here, leading wellness expert Namita Jain said that several studies exposed the health hazards faced by stress-ridden Indian society.

She was speaking on the occasion of 'World Diabetes Day' observed recently.

According to the World Congress of Cardiology, it is estimated that by 2020, heart diseases will be the cause of over 40 per cent deaths in India as compared to 24 per cent in 1990.

"World Health Organisation (WHO) estimates that nearly 200 million people all over the world suffer from diabetes and this number is likely to double in the coming years. In India, there are nearly 50 million diabetics," Jain said.

The enormity can be gauged from a recent report that states many heart patients are below the age of 30. In a study of 350 heart attack patients conducted by a team of doctors, around 9.5 per cent of cases were below 40 years of age and 3 per cent below 30, she said.

According to the November 2009 issue of Harvard Men's Health Watch, as many as 10 per cent of all heart attacks in men occur before the age of 45.

Smoking was invariably a common factor in almost all the young patients. Apart from Smoking, sedentary lifestyle, obesity, stress, high-blood pressure, high cholesterol levels, diabetes, increasing age, family history are some other factors that increase chances of heart ailments.

Jain also touched upon a common problem experienced by many people - indigestion and acidity. This is due to bad eating and dietary habits, especially when we copy the West in their eating patterns, whereas we in India have the most complete and wholesome meal - like Thali.

"Digest what you eat, eat slowly, chew well, drink water, and watch what you eat will help in somewhat alienating the problem. Your diet should consist of cereals, fruits / vegetables, proteins and fats", she added.

Nov 16
CDC importing meningitis vaccine to fight Princeton outbreak
Federal health officials have agreed to import a meningitis vaccine approved in Europe and Australia but not the U.S. as officials at Princeton University consider measures to stop the spread of the disease on the Ivy League campus.

The Food and Drug Administration this week approved importing Bexsero for possible use on Princeton's campus, said Barbara Reynolds, a spokeswoman for the Centers for Disease Control and Prevention. Princeton officials confirmed the school's seventh case of meningitis in 2013 this week and a spokesman said trustees will discuss the issue this weekend.

No vaccine for use against the type B meningococcal bacteria which caused the cases at Princeton is available in the U.S., Reynolds said, adding that the decision to receive the vaccine would be optional if Princeton and CDC officials agree to offer it to students.

Bacterial meningitis can cause swelling of the membranes covering the brain and spinal cord. The disease is fairly rare in the United States. Those who get it develop symptoms quickly and can die in a couple of days. Survivors can suffer mental disabilities, hearing loss and paralysis.

The bacteria are spread by coughing, sneezing and kissing, and most cases occur in previously healthy children and young adults. The disease can easily spread in crowded conditions, like dorm rooms. All students living in dorms are required by state law to have a licensed meningitis vaccine, but it does not protect against type B.

The school is telling students to wash their hands, cover their coughs and not to share items such as drinking glasses and eating utensils.

Nov 16
Baby illnesses tied to parents nixing vitamin K shots
Health officials are reporting four Tennessee cases of a rare infant illness that have been linked to parents refusing a routine shot for newborns.

The four Nashville-area infants suffered brain or stomach bleeding earlier this year. Their parents had declined vitamin K shots, which have routinely been given to newborns since 1961. The shots improve blood clotting and prevent internal bleeding. All four children were treated with vitamin K and survived.

On Thursday, the Centers for Disease Control and Prevention said the illnesses were the first tied to parents opting out of the shots; reports of vitamin K deficiency are rare. The CDC said the parents cited a belief that the shots weren't necessary or cause leukemia. Officials say neither is true.

Nov 15
Next gen malaria vaccines set to be available by 2030
The world should be aiming to get vaccines, which cut malaria cases by 75 percent, and are capable of eliminating malaria, licensed by 2030, according to the updated 2013 Malaria Vaccine Technology Roadmap.

This new target comes in addition to the original 2006 Roadmap's goal of having a licensed vaccine against Plasmodium falciparum malaria, the most deadly form of the disease, for children under 5 years of age in sub-Saharan Africa by 2015.

Dr Robert D. Newman, Director of the World Health Organization's (WHO) Global Malaria Programme, said that despite all the recent progress countries have made, and despite important innovations in diagnostics, drugs and vector control, the global burden of malaria remains unacceptably high.

Final results from Phase III trials of the most advanced vaccine candidate, RTS,S/AS01, will be available by 2015.

Depending on the final trial results, and depending on the outcome of the regulatory review by the European Medicines Agency, a WHO recommendation for use and subsequent prequalification of this first vaccine could occur in late 2015.

Dr Jean-Marie Okwo Bele , Director of WHO's Department of Immunization, Vaccines and Biologicals, said that the new vaccines should show at least 75 percent efficacy against clinical malaria, be suitable for use in in all malaria-endemic areas, and be licensed by 2030.

She said that the roadmap also sets a target for malaria vaccines that reduce transmission of the parasite.

Nov 15
Doctors are told to get serious about obesity
Next time you go for a checkup, don't be surprised if your doctor gets on your case about your weight.

The medical profession has issued new guidelines for fighting the nation's obesity epidemic, and they urge physicians to be a lot more aggressive about helping patients drop those extra pounds.

Doctors should calculate your body mass index, a weight-to-height ratio. And if you need to lose weight, they should come up with a plan and send you for counseling.

"We recognize that telling patients to lose weight is not enough," said Dr. Donna Ryan, co-chair of the guidelines committee.

The good news? By next year, most insurance companies are expected to cover counseling and other obesity treatments, following in the steps of the Medicare program, which began paying for one-on-one help last year.

More than a third of U.S. adults are obese, and that's been the case since the middle of the last decade. Officials define someone with a BMI of 30 or higher as obese. A 5-foot-9 person would be obese at 203 pounds.

Doctors are well aware that excess weight can trigger diabetes and lead to heart disease and other health problems. Yet surveys have shown that only about a third of obese patients recall their doctor talking to them about their BMI or counseling them about weight loss.

The guidelines were released this week by a group of medical organizations that include the American Heart Association, the American College of Cardiology and the Obesity Society.

They come amid a spate of important developments in the fight against obesity.

Last year, the Food and Drug Administration approved two more obesity-fighting drugs. And this year, the AMA labeled obesity a disease, a measure intended to get doctors to pay more attention to the problem and prod more insurers to pay for treatments.

Yet many people have been on their own when it comes to slimming down, left to sift through the myriad diets and exercise schemes that are promoted for weight loss. And most doctors have little training in how to help their obese patients, other than telling them it's a problem and they need to do something about it.

"I feel for these guys," said Dr. Tim Church, a researcher at Louisiana State University's Pennington Biomedical Research Center. "They have patients who come in and ask them about the latest fad diet. They're not trained in this stuff and they're not comfortable" recommending particular diets or weight-loss plans.

The guidelines advise doctors to:

- At least once year, calculate patients' BMI, measure their waists and tell them if they are overweight or obese.

- Develop a weight-loss plan that includes exercise and moderate calorie-cutting.

- Consider recommending weight-loss surgery for patients with a BMI of 40 or for those with a BMI of 35 who also have two other risk factors for heart disease such as diabetes or high blood pressure.

- Refer overweight and obese patients who are headed for heart problems to weight-loss programs. Specifically, discuss enrolling them in at least 14 face-to-face counseling sessions over six months with a registered dietitian, psychologist or other professional with training in weight management.

Web or phone-based counseling sessions are considered a less effective option.

Diane LeBlanc said the new guidelines are overdue.

More than year ago, the Baton Rouge, La., woman sat down with her longtime family doctor to talk about her weight and get a referral for some kind of help. She had tried dieting without success for more than a decade, had high blood pressure and was about to hit a dress size of 20.

She said the doctor smiled and told her: "There's a lot of programs out there. But really, you just have to eat less."

"It just devastated me," LeBlanc recalled. "He was saying, `It's all in your mind.' I was thinking, `If I could do that, don't you think I would have done it by now?'"

She changed doctors and has lost 40 pounds from her 5-foot-4 frame since May after getting into an intensive Pennington weight-loss program that includes counseling sessions.

Doctors "need to get the message," "LeBlanc said. "Just telling someone you need to push the plate away is not going to work for everyone."

Nov 14
Diabetes can cause osteoporosis
Researchers including two Indian-origin scientists have confirmed that osteoporosis could be caused by type 2 diabetes.

Senior author Sundeep Khosla, MD, Mayo Clinic endocrinologist, said that this is the first demonstration - using direct measurement of bone strength in the body - of compromised bone material in patients with type 2 diabetes.

He said that clearly, the skeleton needs to be recognized as another important target of diabetes complications.

The Mayo researchers validated that assumption in a clinical study of 60 postmenopausal women, 30 of whom had type 2 diabetes. Using a new tool (OsteoProbe), the researchers performed micro indentation testing of the tibia (actually causing a microscopic crack) to measure bone material strength.

Compared to the control group of women, aged 50 to 80, the group with type 2 diabetes had significantly lower bone material strength.

There was no difference between the microarchitecture of the bone or bone density between the two groups.

The study showed that diabetic women with lower bone material strength had also experienced higher levels of hyperglycemia over the previous 10 years, suggesting potential detrimental effects of poor glucose control on bone quality.

The resounding message: Conventional measurements underestimated the risk of fracture among patients with type 2 diabetes and loss of bone material strength, or bone quality, is a clear, downstream consequence of the disease.

Co-author Shreyasee Amin, M.D, said that the new technology may help in studying other conditions where fractures occur at higher than expected bone density.

The study has been published in the Journal of Bone and Mineral Research.

Nov 14
E-cigarettes may save 'millions of lives,' scientists say
The merits of e-cigarettes were thrashed out at a one-day gathering of scientists, experts, policymakers and industry figures at the Royal Society in London.

The use of electronic cigarettes - pen-sized battery-powered devices that simulate smoking by heating and vaporising a liquid solution containing nicotine - has grown rapidly. Sales have doubled annually for the last four years and there are an estimated seven million users across Europe.

"Cigarettes are killing 5.4 million people per year in the world," said Robert West, the director of tobacco studies at Cancer Research UK.

He said switching to e-cigarettes could save millions of lives, but the debate was about "whether that goal can be realized and how best to do it".

Dr. Jacques Le Houezec, a French consultant in public health and tobacco dependence, told delegates that while e-cigarettes contained some harmful substances, the levels of toxicants were nine to 450 times lower than in cigarette smoke.

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