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WEBLOG DO FRAGA - - WEBLOG DO FRAGADaily News in Health and Aging Sunday, January 07, 2018 How Alzheimer's disease spre... WEBLOG DO FRAGA - - WEBLOG DO FRAGADaily News in Health and Aging Sunday, January 07, 2018 How Alzheimer's disease spreads throughout the brain – new studyHarmful tau protein spreads through networks.Alzheimer's disease is a devastating brain illness that affects an estimated 47m people worldwide. It is the most common cause of dementia in the Western world. Despite this, there are currently no treatments that are effective in curing Alzheimer's disease or preventing its relentless progression. Alzheimer's disease is caused by the build-up of two abnormal proteins, beta-amyloid and tau. Tau is particularly important because it causes neurons and their connections to die, preventing brain regions from communicating with each other normally. In the majority of cases, tau pathology first appears in the memory centres of the brain, known as the entorhinal cortex and hippocampal formation. This has been shown to occur many years before patients have any symptoms of disease. Over time, tau begins to appear in increasing quantities throughout the brain. This causes the characteristic progression of symptoms in Alzheimer's diseases, where initial memory loss is followed by more widespread changes in thinking and behaviour that lead to a loss of independence. How this occurs has been controversial. Transneuronal spread In our study, published in Brain, we provide the first evidence from humans that tau spreads between connected neurons. This is an important step, because stopping this spread at an early stage might prevent or freeze the symptoms of Alzheimer's disease. This idea, called "transneuronal spread", has been proposed before and is supported by studies in mice. If abnormal tau is injected into a healthy mouse brain, it quickly spreads and causes the mice to manifest dementia symptoms. However, it had not previously been shown that this same process occurs in humans. The evidence from mouse studies was controversial, as the amount of tau injected was relatively high, and disease progression occurred much more rapidly than it does in humans. In our study, we combined two advanced brain imaging techniques. The first, positron emission tomography (PET), allows us to scan the brain for the presence of specific molecules. With this, we were able to directly observe the abnormal tau in living patients, to see exactly how much of it was present in each part of the brain. The second, functional magnetic resonance imaging (fMRI), measures blood flow in the brain in real time. This allowed us to observe the activity produced by brain regions communicating with each other. For the first time, by scanning the same people with both methods, we were able to directly relate the connections of the brain to the distribution of abnormal tau in living humans with Alzheimer's disease. Artist’s impression of tau spreading between connected neurons.We used a mathematical technique called "graph analysis" to analyse brain connectivity. This technique involved splitting the brain up into 598 regions of equal size. We then treated the connectivity between regions like a social network, assessing factors such as the number of contacts a brain region had, how many "friendship" groups it took part in, and how many of a brain region's contacts were also contacts of each other. In a flu epidemic, people with a large number of social contacts are most likely to become infected and then to pass the infection on to others. Similarly, the transneuronal spread hypothesis predicts that strongly connected brain regions will accrue most tau. This is what we observed. This relationship was present within each brain network individually, as well as across the whole brain. We were also able to exclude potential alternative explanations for the appearance of tau throughout the brain. It had previously been suggested that tau might appear at brain regions that were vulnerable because of high metabolic demand or a lack of support from their neighbours. While it is possible that these factors are important in neuronal death, our observations were not consistent with them being the primary drivers of the initial accumulation of abnormal tau. In addition, by looking at patients with a range of disease severity, from mild cognitive impairment through to established Alzheimer's disease, we were able to disentangle the causes of tau accumulation from its consequences. We showed that increasing amounts of tau in Alzheimer's disease caused the brain to become less connected overall, and the connections that remained became increasingly random. Long-range connections Finally, we contrasted the findings in Alzheimer's disease to a rarer condition called progressive supranuclear palsy (PSP), which affects approximately three in every 100,000 people. This condition is also caused by tau, but it remains confined to the base of the brain. We demonstrated that in PSP the evidence did not support transneuronal spread. This might be because of the different structure of abnormal tau pathology in the two diseases. In Alzheimer's disease, tau is present in "paired helical filaments", while in PSP it is in "straight filaments". We showed that as PSP progresses, direct long-range connections are preferentially damaged, meaning that information had to take a more indirect route across the brain. This might explain why, when asked a question, patients with PSP usually respond slowly but correctly. Overall, evidence of transneuronal spread in humans with Alzheimer's disease provides proof of concept for exciting new treatment strategies to lock up tau pathology before it can cause significant damage. This article was originally published on The Conversation. Read the original article. Provided by The ConversationNo comments: Labels:Alzheimer disease Thursday, January 04, 2018 Do you take calcium and vitamin D to protect your bones? A new study says it doesn't help If taking more vitamin and mineral supplements is part of your plan for a healthier new year, a new study may prompt you to reconsider. Researchers who scoured the medical literature for evidence that calcium and vitamin D pills could help prevent bone fractures came up empty. 04 JAN 2018--Their analysis focused on adults older than age 50 who lived on their own (that is, not in a nursing home or other type of residential care facility). Fractures are a serious health concern for this population—previous studies have found that about 40 percent of women in this age group will wind up with at least one "major osteoporotic fracture" at some point in their lives, and that among adults who break a hip, 20 percent died within a year of their injury. The researchers, led by Dr. Jia-Guo Zhao of Tianjin Hospital in northeastern China, combed through clinical trials, systematic reviews and other reports published in the last decade, since late 2006. They identified 51,145 people who were included in studies assessing the role of calcium and/or vitamin D in preventing bone fractures. Their findings appear in Tuesday's edition of the Journal of the American Medical Association. Among the 14 trials that pitted calcium supplements against either a placebo or no treatment, there was no statistically significant relationship between use of the mineral (in pill form) and the risk of suffering a hip fracture. Nor was there any clear link between calcium supplements and fractures involving the spine or other bones. Even when the researchers accounted for each study participant's gender, past history of bone fractures, the amount of calcium they consumed in their diets and the dose of the calcium pills they took (if they did), there was still no sign that supplements were helpful. An additional 17 trials examined the role of vitamin D, which helps the body absorb calcium. Once again, they found no statistically significant link between supplement use and hip fracture risk. Ditto for fractures in the spine and elsewhere. Upon drilling down to certain subgroups, they found that for people who started out with at least 20 nanograms of vitamin D per milliliter of blood, adding more vitamin D through supplements was associated with a greater risk of hip fractures. The same was true for people who took high doses of vitamin D supplements just once a year. Finally, there were 13 trials involving people who took a combined calcium-vitamin D supplement. As before, there was no statistically significant link between supplement use and the risk for any kind of fracture or combination of fractures. That held up even when accounting for gender, past fractures, supplement dose, dietary calcium or baseline blood levels of vitamin D. The researchers noted that thousands of people in this final group were participants in the Women's Health Initiative, a long-term study sponsored by the National Heart, Lung and Blood Institute in the U.S. Earlier reports based on data gathered by the Women's Health Initiative found that calcium and vitamin D supplements were associated with a lower risk of fractures, but only for women who took hormone therapy after menopause. To get a clearer picture of the direct link (if any) between supplements and fracture risk, Zhao and his colleagues opted not to include data from women on hormone therapy. It's still possible that calcium and vitamin D supplements are useful for people who live in nursing homes or other residential facilities, the study authors wrote. Such people are more likely to have osteoporosis, due to a combination of poor diet, less sun exposure (which the body needs to synthesize vitamin D) and other factors. But for older adults who live on their own, they wrote, the results are clear: "These findings do not support the routine use of these supplements." More information: Jia-Guo Zhao et al. Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults, JAMA (2017). DOI: 10.1001/jama.2017.19344No comments: Labels:Calcium,d vitamin Saturday, December 30, 2017 New medical advances marking the end of a long reign for 'diet wizards' French fries and chocolate milkshakes affect people differently. Some are tempted by them, and others are not.For many years, the long-term success rates for those who attempt to lose excess body weight have hovered around 5-10 percent. In what other disease condition would we accept these numbers and continue on with the same approach? How does this situation sustain itself? 30 dec 2017--It goes on because the diet industry has generated marketing fodder that obscures scientific evidence, much as the Wizard of Oz hid the truth from Dorothy and her pals. There is a gap between what is true and what sells (remember the chocolate diet?). And, what sells more often dominates the message for consumers, much as the wizard's sound and light production succeeded in misleading the truth-seekers in the Emerald City. As a result, the public is often directed to attractive, short-cut weight loss options created for the purposes of making money, while scientists and doctors document facts that are steamrolled into the shadows. We are living in a special time, though – the era of metabolic surgeries and bariatric procedures. As a result of these weight loss procedures, doctors have a much better understanding of the biological underpinnings responsible for the failure to lose weight. These discoveries will upend the current paradigms around weight loss, as soon as we figure out how to pull back the curtain. As a dual board-certified, interventional obesity medicine specialist, I have witnessed the experience of successful weight loss over and over again – clinically, as part of interventional trials and in my personal life. The road to sustained transformation is not the same in 2018 as it was in 2008, 1998 or 1970. The medical community has identified the barriers to successful weight loss, and we can now address them. The body fights back For many years, the diet and fitness industry has supplied folks with an unlimited number of different weight loss programs – seemingly a new solution every month. Most of these programs, on paper, should indeed lead to weight loss. At the same time, the incidence of obesity continues to rise at alarming rates. Why? Because people cannot do the programs. First, overweight and obese patients do not have the calorie-burning capacity to exercise their way to sustainable weight loss. What's more, the same amount of exercise for an overweight patient is much harder than for those who do not have excess body weight. An obese patient simply cannot exercise enough to lose weight by burning calories. Second, the body will not let us restrict calories to such a degree that long-term weight loss is realized. The body fights back with survival-based biological responses. When a person limits calories, the body slows baseline metabolism to offset the calorie restriction, because it interprets this situation as a threat to survival. If there is less to eat, we'd better conserve our fat and energy stores so we don't die. At the same time, also in the name of survival, the body sends out surges of hunger hormones that induce food-seeking behavior – creating a real, measurable resistance to this perceived threat of starvation. Third, the microbiota in our guts are different, such that "a calorie is a calorie" no longer holds true. Different gut microbiota pull different amounts of calories from the same food in different people. So, when our overweight or obese colleague claims that she is sure she could eat the same amount of food as her lean counterpart, and still gain weight – we should believe her. Strength conditioning builds muscle mass, which can help increase capacity. Credit: Rudd Center for Food Policy and Obesity, CC BY-SALots of shame, little understanding Importantly, the lean population does not feel the same overwhelming urge to eat and quit exercising as obese patients do when exposed to the same weight loss programs, because they start at a different point. Over time, this situation has led to stigmatizing and prejudicial fat-shaming, based on lack of knowledge. Those who fat-shame most often have never felt the biological backlash present in overweight and obese folks, and so conclude that those who are unable to follow their programs fail because of some inherent weakness or difference, a classic setup for discrimination. The truth is, the people failing these weight loss attempts fail because they face a formidable entry barrier related to their disadvantaged starting point. The only way an overweight or obese person can be successful with regard to sustainable weight loss, is to directly address the biological entry barrier which has turned so many back. Removing the barrier There are three ways to minimize the barrier. The objective is to attenuate the body's response to new calorie restriction and/or exercise, and thereby even up the starting points. First, surgeries and interventional procedures work for many obese patients. They help by minimizing the biological barrier that would otherwise obstruct patients who try to lose weight. These procedures alter the hormone levels and metabolism changes that make up the entry barrier. They lead to weight loss by directly addressing and changing the biological response responsible for historical failures. This is critical because it allows us to dispense with the antiquated "mind over matter" approach. These are not "willpower implantation" surgeries, they are metabolic surgeries. Second, medications play a role. The FDA has approved five new drugs that target the body's hormonal resistance. These medications work by directly attenuating the body's survival response. Also, stopping medications often works to minimize the weight loss barrier. Common medications like antihistamines and antidepressants are often significant contributors to weight gain. Obesity medicine physicians can best advise you on which medications or combinations are contributing to weight gain, or inability to lose weight. Third, increasing exercise capacity, or the maximum amount of exercise a person can sustain, works. Specifically, it changes the body so that the survival response is lessened. A person can increase capacity by attending to recovery, the time in between exercise bouts. Recovery interventions, such as food supplements and sleep, lead to increasing capacity and decreasing resistance from the body by reorganizing the biological signaling mechanisms – a process known as retrograde neuroplasticity. Lee Kaplan, director of the Harvard Medical School's Massachusetts Weight Center, captured this last point during a recent lecture by saying, "We need to stop thinking about the Twinkie diet and start thinking about physiology. Exercise alters food preferences toward healthy foods … and healthy muscle trains the fat to burn more calories." The bottom line is, obese and overweight patients are exceedingly unlikely to be successful with weight loss attempts that utilize mainstream diet and exercise products. These products are generated with the intent to sell, and the marketing efforts behind them are comparable to the well-known distractions generated by the Wizard of Oz. The reality is, the body fights against calorie restriction and new exercise. This resistance from the body can be lessened using medical procedures, by new medications or by increasing one's exercise capacity to a critical point. Remember, do not start or stop medications on your own. Consult with your doctor first. This article was originally published on The Conversation. Read the original article. Provided by The ConversationNo comments: Labels:weight loss Thursday, December 28, 2017 Feeling sad? Here's how to beat the holiday bluesThe holiday blues might be a common phenomenon, but there's plenty you can do to protect your mental health this time of year. Even in a tumultuous year like 2017. "With its combination of natural and human disasters, this year was especially traumatic for many people," said Dr. Richard Catanzaro, chief of psychiatry at Northern Westchester Hospital in Mount Kisco, N.Y. 28 dec 2017--In addition, "social media can make it seem like everyone you know is having the best time of their lives, while what you're really seeing is everyone's 'greatest hits,' " he said in a hospital news release. "This adds to the pressure many people feel to have a good time during the holidays. If they are not enjoying themselves, they may feel out of step with everyone else," Catanzaro said. Along with causing and intensifying depression and anxiety, the holiday season can trigger sadness about relatives and friends who are no longer alive, feelings of exhaustion and stress about money, he noted. What to do? Catanzaro suggests taking preventive steps. If you do feel depressed, don't isolate yourself, Catanzaro said. If you're already seeing a therapist, be sure to continue over the holidays—and if you're not seeing a therapist, consider seeking help. Also, if you know or suspect you have a condition called Seasonal Affective Disorder (SAD)—a form of depression that occurs in the winter months due to less daylight—there are effective treatments such as light therapy, psychotherapy and medications. More information: The National Alliance on Mental Illness has more on beating the holiday blues.No comments: Labels:holiday blues Wednesday, December 27, 2017 Cancer screening burdens elderly patientsElena Altemus is 89 and has dementia. She often forgets her children's names, and sometimes can't recall whether she lives in Maryland or Italy. Yet Altemus, who entered a nursing home in November, was screened for breast cancer this summer. "If the screening is not too invasive, why not?" said her daughter, Dorothy Altemus. "I want her to have the best quality of life possible." 27 dec 2017--But a growing number of geriatricians, cancer specialists and health-system analysts say there are many reasons. Such testing in the nation's oldest patients is highly unlikely to detect lethal disease, hugely expensive and more likely to harm than help since any follow-up testing and treatment is often invasive. And yet such screening is widespread in the United States, the result of medical culture, aggressive awareness campaigns and financial incentives to doctors. By looking for cancer in people who are unlikely to benefit, "we find something that wasn't going to hurt the patient, and then we hurt the patient," said Dr. Sei Lee, an associate professor of geriatrics at the University of California-San Francisco. Nearly 1 in 5 women with severe cognitive impairment—including older patients like Elena Altemus—are still get regular mammograms, according to the American Journal of Public Health—even though they're not recommended for people with a limited life expectancy. And 55 percent of older men with a high risk of death over the next decade still get PSA tests for prostate cancer, according to a 2014 study in JAMA Internal Medicine. Among people in their 70s and 80s, cancer screenings often detect slow-growing tumors that are unlikely to cause problems in patients' lifetimes. Such patients often die of something else long before their cancers would ever have become a threat, said Dr. Deborah Korenstein, chief of general internal medicine at New York's Memorial Sloan Kettering Cancer Center. Prostate cancers, in particular, are often harmless. Patients with dementia, for example, rarely live longer than a few years. "It generally takes about 10 years to see benefit from cancer screening, at least in terms of a mortality benefit," Korenstein said. Enthusiasm for cancer screenings runs high among patients and doctors, both of whom tend to overestimate the benefits but underappreciate the risks, medical research shows. In some cases, women are being screened for tumors in organs they no longer have. In a study of women over 30, nearly two-thirds who had undergone a hysterectomy got at least one cervical cancer screening, including one-third who had been screened in the past year, according to a 2014 study in JAMA Internal Medicine. Even some patients with terminal cancer continue to be screened for other malignancies. Nine percent of women with advanced cancer—including tumors of the lung, colon or pancreas—received mammograms and 6 percent received cervical cancer screening, according to a 2010 study of Medicare recipients over age 65. Among men on Medicare with incurable cancer, 15 percent were screened for prostate cancer. Although screenings can extend and improve lives for healthy, younger adults, they tend to inflict more harm than good in people who are old and frail, Korenstein said. Testing can lead to anxiety, invasive follow-up procedures and harsh treatments. "In patients well into their 80s, with other chronic conditions, it's highly unlikely that they will receive any benefit from screening, and more likely that the harms will outweigh the benefits," said Dr. Cary Gross, a professor at the Yale School of Medicine. By screening patients near the end of life, doctors often detect tumors that don't need to be found and treated. Researchers estimate that up to two-thirds of prostate cancers are overdiagnosed, as are a third of breast tumors. "Overdiagnosis is serious," Gross said. "It's a tremendous harm that screening has imposed. . It's something we're only beginning to reckon with." A variety of medical specialties—from the American College of Surgeons to the Society of General Internal Medicine—have advised doctors against screening patients with limited time to live. For example, the American Cancer Society recommends prostate and breast cancer screenings only in patients expected to live 10 years or more. In November, a coalition of patient advocates, employers and others included prostate screenings in men over age 75 in its list of the top five "low-value" medical procedures. Dr. A. Mark Fendrick, co-director of the coalition, referred to the five procedures as "no-brainers," arguing that health plans should consider refusing to pay for them. Prostate cancer screening in men over 75 cost Medicare at least $145 million a year, according to a 2014 study in the journal Cancer. Mammograms in this age group cost the federal health plan for seniors more than $410 million a year, according to a 2013 study in JAMA Internal Medicine. And while cancer screenings generally aren't expensive—a mammogram averages about $100—they can begin a series of follow-up tests and treatments that add to the total cost of care. Most spending on unnecessary medical care stems not from rare, big-ticket items, such as heart surgeries, but cheaper services that are performed much too often, according to an October study in Health Affairs. Many older patients expect to continue getting screened, said Dr. Mara Schonberg, an associate professor at Harvard Medical School and Boston's Beth Israel Deaconess Medical Center. "It's jarring for someone who's been told every year to get screened and then at age 75 you tell them to stop," she said.No comments: Labels:Cancer Screening Tuesday, December 26, 2017 Experts say these two things are the secret to living a longer lifeCosta Rica’s Nicoya Peninsula is home to the second-largest community of centenarians in the world. "Blue zones" are areas of the world where people live considerably longer lives. On these territories we can find octogenarians, nonagenarians and many centenarians, and even some supercentenarians (people who have reached the age of 110). These regions were named "blue zones" after the Belgian demographer Michel Poulain and the Italian doctor Gianni Pes discovered a population with such features in the region of Barbaglia (Sardinia, Italy), and they marked out the area with blue ink 26 dec 2017--A demographic study carried out at the beginning of this century showed that one out of 196 people who were born between 1880 and 1990 reached the age of 100 years old. Later on, the American researcher Dan Buettner embarked on a project aimed at identifying other areas with high longevity rates. He found four additional regions. These were also named "blue zones": Okinawa (Japan), Icaria (Greece), Loma Linda (California) and Nicoya Peninsula (Costa Rica). In all these territories there is a high proportion of long-lived people, and each area is characterised by specific features which relate to that condition. In the region of Barbaglia, located in the Sardinian mountain area, there is the world's largest concentration of centenarians. Okinawa Island is inhabited by the oldest women on Earth. Icaria – an island which is located in the Aegean Sea – has the long-lived population with the lowest senile dementia levels. Loma Linda is home to a community of Seventh-day Adventists whose life expectancy is 10 years over the average lifespan in the United States. And in Nicoya we can find the second-largest community of centenarians in the world. What is the secret behind this great longevity; the mystery of the blue zones, where so many centenarians live? A team composed of several specialists (doctors, anthropologists, demographers, nutritionists, epidemiologists) – and led by Dan Buettner himself – travelled many times to the different blue zones. They identified the following nine general longevity factors, which are related to diet and lifestyle: intense and regular physical activity in the performance of daily duties. The concept of a sedentary lifestyle is unknown to the people living in these regionshaving an "ikigai" – a Japanese word (Okinawa) which is used to define our own "reasons for being" or, more precisely, the reasons why we wake up every morningreduction of stress, a factor which is closely linked to almost all ageing-related diseases. Stress reduction means interrupting the normal pace of our daily lives in order to allow time for other activities which are part of normal social habits. For example, taking a nap in Mediterranean societies, praying in the case of Adventists, the tea ceremony of women in Okinawa, and so on."Hara hachi bu" – a Confucian teaching that means we should not continue to eat until we are full, but only until 80% of our eating capacityprioritising a diet that is rich in plant-based products. Meat, fish and dairy products may be consumed, but in lower amountsa moderate consumption of alcoholic beverages, which confirms the belief that moderate drinkers live longer lives than nondrinkersengaging in social groups that promote healthy habitsengaging in religious communities with common religious practicesbuilding and maintaining solid relationships between family members: parents, siblings, grandparents and others.To sum up, the above nine longevity factors could be synthesised in just two. Firstly, maintaining a healthy lifestyle – which implies regular intensity exercise, including routines to "break" from daily stress, and including mainly plant-based products in our diets, eating without filling up and not drinking excessively. Secondly, integrating in groups that promote and support those "good practices": family, religious communities, social groups, and so on – all of which must have their own "ikigai", that is, their own "reason to live". There is a personal "ikigai", but there is also a collective "ikigai" that sets the goals for each community as well as the challenges to overcome in order to achieve them. Living this way means living better and longer. Longevity may be determined by genetics, but it is also something that can be trained, as can be seen in the example of the inhabitants of the blue zones. Rafael Puyol, Director of the Observatory of Demography and Generational Diversity, IE Business School This article was originally published on The Conversation. Read the original article. Provided by The ConversationNo comments: Labels:blue zones,centenarians,longevity Sunday, December 24, 2017 What psychiatrists have to say about holiday bluesHoliday parties, fun though they may be, can also bring conflict. This time of the year brings a lot of changes to the usual day-to-day life of hundreds of millions of people: The weather is colder, trees are naked, snowy days become plentiful and friendly critters are less visible around the neighborhood. Especially in the Western Hemisphere, this time of the year is also linked to a lot of joyous celebrations and traditions. Most children and many adults have been excited for this time of the year to come for months, and they love the aura of celebrations, with their gatherings, gifts, cookies, emails and cards. 24 dec 2017--Alas, there are also millions who have to deal with darker emotions as the world literally darkens around them. The holiday blues – that feeling of being in a lower or more anxious mood amid the significant change in our environment and the multitude of stressors that the holidays can bring – is a phenomenon that is yet to be researched thoroughly. However, as academic psychiatrists and neuroscience researchers, we have seen how several factors contribute to this experience. Why feel blue in the red and green season? There are many reasons to feel stressed or even downright overwhelmed during this time of year, in addition to the expectations set around us. Memories of holidays past, either fond or sad, can create a sense of loss this time of year. We may find ourselves missing people who are no longer with us, and carrying on the same traditions without them can be a strong reminder of their absence. The sense of burden or obligation, both socially or financially, can be significant. We can get caught up in the commercial aspects of gift giving, wanting to find that perfect item for family and friends. Many set their sights on special gifts, and we often can feel stretched thin trying to find a balance between making our loved ones happy and keeping our bank accounts from being in the black. It's also a time for gathering with those close to us, which can stir up many emotions, both good and bad. Some may find themselves away from or without close connections and end up isolated and withdrawn, further disconnected from others. On the other hand, many people find themselves feeling overwhelmed by the combination of potlucks and Secret Santas stacking up through multiple invitations, be it at school, work, or from friends and family – leaving us with the difficult position of not wanting to disappoint others, while not getting totally depleted by all the constant socializing. Great expectations People often feel disappointed when reality does not meet expectations. The larger the mismatch, the worse the negative feelings. One of us (Arash) often finds himself telling his patients: Childhood fairy tales can set an unrealistic bar in our minds about life. I wish we were told more real stories, taking the bad with the good, as we would get hurt less when faced with difficult realities of life, and learn how to especially appreciate our good fortunes. These days viewers are showered with Christmas and New Year's Eve movies, almost all of which sound and feel like fairy tales. People get married, get rich, fall in love or reconnect with their loved ones. Even unhappy events within "A Christmas Carol" conclude with a happy ending. These all, besides exposure to only happy moments and beautiful gifts (courtesy of Santa), dazzling Christmas decorations, and picturesque family scenes on social media, often set an unrealistic expectation for how this time of the year "should" feel. Reality is different, though, and at its best is not always as colorful. There may be disagreements about hows, wheres, whats and whos of the celebration, and not all family members, friends and relatives get along well at parties. And as we feel lonelier, we may find ourselves spending more time immersed in TV and social media, leading to more exposure to unrealistic views of the holidays and feeling all the worse about our situation. When is blue a red flag? While many experience the more transient "holiday blues" this time of year, it is important not to miss more serious conditions like seasonal mood changes, which in its most severe case leads to clinical depression, including Seasonal Affective Disorder. SAD consists of episodes of depression or a worsening of existing depression during the late fall and early winter. The person may feel depressed and hopeless, or they may find it difficult to focus, sleep, or be motivated – they can even feel suicidal. As our emotions can color our thoughts and memories, a depressed person may remember more negative memories, have a more negative perception and interpretation of the events, and feel upset about the holidays. In such cases, the sadness is "coincident" with the holidays and not caused solely by its circumstances. It is important to seek professional help with SAD, as we have effective treatments available, such as medications and light therapy. What to do to minimize the blues? While the holiday blues are most often temporary, it's important to identify when things have crossed over into clinical depression, which is more severe and longer lasting. It also impairs daily functioning. For these symptoms it is often helpful and necessary to seek professional help. This can consist of counseling or use of medications, or both, to help treat symptoms. This article was originally published on The Conversation. Read the original article. Provided by The ConversationNo comments: Labels:holiday blues Saturday, December 23, 2017 Laser shoes prevent 'freezing' in Parkinson patientsFigure1: laser shoes.Freezing of gait, an absence of forward progression of the feet despite the intention to walk, is a debilitating symptom of Parkinson's disease. Laser shoes that project a line on the floor to the rhythm of the footsteps help trigger the person to walk. The shoes benefit the wearer significantly, according to research by the University of Twente and Radboud university medical center, which will be published on December 20 in Neurology, the scientific journal of the American Academy of Neurology. 23 dec 2017--Walking problems are common and very disabling in Parkinson's disease. In particular, freezing of gait is a severe symptom which generally develops in more advanced stages. It can last seconds to minutes and is generally triggered by the stress of an unfamiliar environment or when medication wears off. Because the foot remains glued to the floor but the upper body continues moving forward, it can cause the person to lose her balance and fall. Lines on the floor Parkinson patient experience a unique phenomenon. By consciously looking at objects on the floor, such as the lines from a zebra crossing ('visual cues'), and stepping over them, they are able to overcome their blockages during walking. This activates other circuits in the brain, hereby releasing the blockages and allowing the person to continue walking. This is why patients often make use of floor tiles at home. With the laser shoes, these useful cues can be continuously applied in everyday life, to walk better and safer. The principle behind the laser shoes is simple: upon foot contact, the left shoe projects a line on the floor in front of the right foot. The patient steps over or towards the line, which activates the laser on the right shoe, and so on (see videos below the text). Beneficial effect The present research study shows a beneficial effect in a large group of patients. The number of 'freezing' episodes was reduced by 46% with the use of the shoes. The duration of these episodes was also divided by two. Both effects were strongest in patients while they had not taken their medication yet. This is typically when patients experience the most problems with walking. But an improvement was also seen after the patients had been taking their medication. "Our tests were administered in a controlled lab setting with and without medication," says researcher Murielle Ferraye. " Further research in their everyday environment is necessary. We plan on testing this using laser shoes that in the meantime came on the market." Activating the laser Of the nineteen patients who tested the shoes, the majority would be happy to use them. The patients did not seem to mind that the laser was activated for each single step. "Ideally, the laser should only be activated once the blockage is detected, but we're not quite there yet," says Ferraye. "Freezing is a very complex phenomenon." Murielle Ferraye, who developed the laser shoes, conducted her study at the Donders Institute at Radboud university medical center and the MIRA Institute for Biomedical Technology and Technological Medicine at the University of Twente. Provided by Radboud UniversityNo comments: Labels:Parkinson disease Thursday, December 21, 2017 USPSTF reviews use of ECG for preventing A-fib, CVD eventsThe U.S. Preventive Services Task Force (USPSTF) has found that the current evidence is inadequate to assess the benefits and harms of screening with electrocardiogram (ECG) for atrial fibrillation (AF) in older adults; and for low-risk adults, screening with resting or exercise ECG is not recommended for preventing cardiovascular disease (CVD) events. These findings form the basis of two draft recommendation statements published online Dec. 19 by the USPSTF. 21 dec 2017--Researchers from the USPSTF reviewed the evidence on screening for and the treatment of nonvalvular AF among adults aged 65 years and older. The evidence was inadequate to assess whether screening with ECG identified older adults with previously undiagnosed AF more effectively than usual care. The Task Force found adequate evidence that screening is associated with small-to-moderate harms. Based on these findings, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of AF screening with ECG (I statement). USPSTF researchers also examined the evidence on screening asymptomatic adults for CVD risk using resting or exercise ECG. The evidence was inadequate to examine whether incremental information offered by resting or exercise ECG can reduce CVD events. However, the Task Force found adequate evidence that screening can lead to small or moderate harms. Based on these findings, the USPSTF concludes that the potential harms of screening are equivalent to or exceed the potential benefits among asymptomatic adults at low risk for CVD events (D recommendation). The two draft recommendation statements have been posted for public comment. Comments can be submitted through Jan. 22, 2018. More information: Evidence Review - A-FIB Draft Recommendation Statement - A-FIB Comment on Recommendation Statement - A-FIB Evidence Review - CVD Draft Recommendation Statement - CVD Comment on Recommendation Statement - CVDNo comments: Labels:Atrial Fibrillation Tuesday, December 19, 2017 Factors affecting the health of older sexual and gender minorities A special issue of LGBT Health includes the latest research, clinical practice innovations, and policy aimed at addressing disparities and enhancing healthcare for older LGBT populations. A collection of informative and insightful articles that contribute to the understanding of factors that affect the health of older gay, lesbian, bisexual, and transgender Americans is published in LGBT Health. Guest Editors Judith B. Bradford, PhD and Sean R. Cahill, PhD coordinated this special issue of LGBT Health. Included is an article entitled "Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013-2014," in which Christina Dragon, MSPH, Centers for Medicare & Medicaid Services (Baltimore, MD) and coauthors from NORC at the University of Chicago (Bethesda, MD), KPMG (McLean, VA), and The Fenway Institute (Boston, MA) explored differences between older sexual minorities and heterosexuals across multiple health indicators. The researchers found better outcomes or health-related behaviors among sexual minorities for some of the indicators, but sexual minorities were more than twice as likely to report binge drinking compared with their heterosexual peers. Stuart Michaels, PhD, NORC at the University of Chicago, IL and colleagues from NORC and the Centers for Medicare & Medicaid Services coauthored the article entitled "Improving Measures of Sexual and Gender Identity in English and Spanish to Identify LGBT Older Adults in Surveys." They demonstrated that efforts to identify LGBT older adults may be hindered by language-related obstacles among non-LGBT Spanish speakers who might have difficulty understanding terms used to designate sexual identities. In the article "Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data," a team of authors from the Centers for Medicare & Medicaid Services and NORC at the University of Chicago (Bethesda, MD), led by Christina Dragon, MSPH, report on differences in the chronic conditions burden between transgender and cisgender Medicare beneficiaries. Overall, transgender beneficiaries were found to have a greater burden of chronic conditions, and higher rates of asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders compared with cisgender beneficiaries. Transgender Medicare beneficiaries also had higher observed rates of potentially disabling mental health and neurological/chronic pain conditions. "This special issue of LGBT Health highlights innovations in research, practice, and policy to improve healthcare and services for LGBT older adults. The articles in the issue contribute to our understanding of health disparities and resiliencies in these populations, and suggest ways to improve care and integrate support services to ensure healthy aging," says Guest Editor Sean Cahill, The Fenway Institute. "The timing of this special issue is important, as the federal government is rolling back sexual orientation and gender identity nondiscrimination regulations and data collection. The special issue is dedicated to Judy Bradford, a leader in LGBT aging and LGBT health research, and to her vision of LGBT health and equality." Provided by Mary Ann Liebert, IncNo comments: Labels:lgbt Older PostsHomeSubscribe to:Posts (Atom)GOOGLE TRANSLATESELECIONE UM IDIOMA NA CAIXA ACIMA PARA TRADUÇÃO!RUBENS DE FRAGA JÚNIOR CRM 9639 PRWELCOME TO FRAGA'S WEBLOG!THIS SITE PROVIDE UPDATE IN HEALTH AND AGING.CONTACT ME IN THIS E-MAILGERIPAR@HOTMAIL.COM This site complies with the HONcode standard for trustworthy health information: verify here. Search only trustworthy HONcode health websites: Total PageviewsFollow by EmailBlog ArchiveHONcode Web 2.0 rules as followingPrinciple 1 - Authorityall commenters are by default considered as nonmedical professionals.commenters must behave at all times with respectand honesty.Principle 3 - Confidentialityposts in weblog do fraga are visible toeveryone andcommenters don't be able to modify or erase theirposts.Principle 4 - Attributioncommenters could give references (links for ex.)to the health/medical information they provide.What we mean by personal experience is anything the person has undergone himself/herself.Principle 5 - Justifiabilityplatform users must post informationwhich are true and correct to their knowledge.Principle 8 - Honesty in advertising & editorial policy advertisement from the commenters (links, banners,content, etc.) is not permitted on the blog.The information contained above is intended for general reference purposes only.It is not a substitute for professional medical advice or a medical exam. Always seek the advice of your physician or other qualified health professional before starting any new treatment. Medical information changes rapidly, some information may be out of date. The information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor.This blog don't have any advertisement. "The Web site owners undertake to honour or exceed the legal requirements of medical/health information privacy that apply in Brazil and will not share any of the visitors information." Ver mais

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