Get Your Flu Shot, Or We All Pay The Price!

Unvaccinated Adults are a Costly Economic Burden Ever Year in the U.S.

LabelsNewswise, October 31, 2016 -- Many of us have seen the signs at work, gotten the emails from our health care insurer, or heard the ads on the radio telling us that it is flu season, and thus time to get an annual flu shot.

Many Americans will comply with this yearly health edict, but many will challenge medical wisdom and opt to face their impending exposure to an onslaught of sneezes, coughs and sniffles without the shield of vaccination. In fact, the CDC estimates that only 42% of adults ages 18 and older received the flu vaccine for the 2015-2016 flu season.

This results in many adults getting sick, causing lost days from work, health care expenses, and even death for those highly susceptible, such as the elderly.

Vaccines are available for prevention of many illnesses, and most Americans get a thorough course of vaccinations as children.

There are also vaccines that the CDC recommends for adults, such as those for influenza (flu), HPV, hepatitis A and B, and meningococcal disease. As we age, our susceptibility to certain illnesses increases, so the CDC urges older adults to get immunized against pneumonia, shingles, and influenza, which are particularly dangerous to the elderly.

Younger adults in late teens to early twenties are strongly urged to get vaccinated against human papilloma virus (HPV), which is sexually transmitted and so common that most American adults will contract a strain of it at some point in their lives.

College-aged adults are also urged to get the meningococcal vaccine, which protects against a potentially deadly infection that causes swelling of the protective coverings surrounding the brain. Many universities require this vaccine for incoming students prior to allowing them to register or move in to on-campus housing.

Despite the proven efficacy and minimal risks associated with vaccines, many American adults continue to forgo getting vaccinations, usually due to doubt of effectiveness, concerns of the safety of the vaccines, or just a lack of consistent follow-up on their personal health care needs.

The result is costly health and economic losses, both to themselves and to the general public.

A recent studyrevealed that illnesses attributable to vaccine-preventable diseases in the U.S. caused a $9 billion economic burden in 2015. Ninety-five percent of these costs ($8.3 billion) were health care expenses, with the remaining 5% ($700 million) representing productivity losses, such as lost income during treatment.

The majority of these costs, approximately $5.8 billion, was attributed to influenza illnesses alone, even though flu shots are readily available at low or no cost to both the insured and uninsured in the U.S.

Many employers offer shots free of charge to employees during flu season, and many health care providers and pharmacies make the vaccine available at convenient times by holding special flu shot clinics in evenings and weekends and at community-based locations during flu season.

In addition to the personal health toll vaccine-preventable illnesses can make on the individual, unvaccinated adults put others at greater risk of illness through exposure to the diseases.

Children, the immune-compromised, or others who have health conditions that preclude them from receiving certain vaccinations are put at unnecessary risk of exposure to illness by the unvaccinated who become sick.

 In a place such as Washington, DC, where there is close contact with many people in crowded public venues or through the use of public transportation, these risks of exposure and disease spread are amplified and further illustrates the need for all those who can to get properly vaccinated.

Vaccines are available to adults for the following 14 illnesses: HPV, Herpes zoster (shingles), varicella (chicken pox), pneumococcal disease (pneumonia), meningococcal disease (meningitis), influenza (flu), Measles, Mumps, and Rubella, Tetanus, Diphtheria, Pertussis (whooping cough), and hepatitis A and B.

To find a location where flu shots are available, use this link. Many locations also offer vaccinations for the other 13 diseases for low cost, and health insurance will cover most or all of these shots as well.

You can also test your Flu I.Q. by taking this CDC quiz.

The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure.

The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives. 

Experimental Drug Shows Promise In Treating Alzheimer’s Disease

Newswise, October 31, 2016--An experimental drug shows promise in treating Alzheimer’s disease by preventing inflammation and removing abnormal protein clumps in the brain that are associated with the disease, suggests a study in mice presented at the ANESTHESIOLOGY® 2016 annual meeting.

A key characteristic of Alzheimer’s disease is the development of abnormal protein clumps called amyloid plaques and tangled bundles of fibers in the brain. These changes cause inflammation in the brain and damage to the neurons.

This progressive damage leads to memory loss, confusion and dementia. The new drug, known as NTRX-07, appears to decrease this inflammation in the brain, while preserving neurons and regenerative cells in the brain.

“This drug may reduce inflammation in the brain, which is linked to Alzheimer’s disease,” said lead researcher Mohamed Naguib, M.D., a physician anesthesiologist in the Department of General Anesthesiology at the Cleveland Clinic and professor of anesthesiology at the Cleveland Clinic Lerner College of Medicine.

“NTRX-07 uses a different mechanism than many other Alzheimer’s drugs currently available, as it targets the cause of the disease, not just the symptoms.”

The authors discovered NTRX -07’s memory-restoring abilities while studying the drug’s potential to treat a complex, chronic pain condition called neuropathic pain.

“Patients who have neuropathic pain have chronic neuroinflammation,” said Dr. Naguib. “This is a compound that blunts that inflammation.”

Researchers tested NTRX -07 on mice bred to have similar brain neurodegenerative issues as seen in Alzheimer’s. They found that inflammation produced in response to the disease caused changes in the brain’s microglia cells – immune cells that typically remove dangerous amyloid plaques (protein clumps) in the brain.

As the amyloid plaques accumulated in the mice, the microglia (immune cells) were unable to remove them, leading to inflammation and damage to nerve cells, which caused decreased cognitive ability.

Microglia cells have receptors on the surface called CB2 receptors, which when activated can produce an anti-inflammatory response. NTRX -07 targets CB2 receptors, which leads to decreased inflammation and prevents damage to the brain tissue.

The new drug improved removal of abnormal amyloid plaques and improved memory performance and other cognitive skills.

The drug also increased levels of a protein called SOX2, which has been shown to help new brain cells develop and protect the brain in people with Alzheimer’s disease.

The study found in mice treated with NTRX-07, the levels of SOX2 were restored to normal levels. In contrast, mice treated with a placebo showed decreased levels of SOX2, active inflammation in the brain, poor removal of amyloid plaques, and poor memory performance.

Joseph F. Foss, M.D., director, of clinical research for general anesthesiology at Cleveland Clinic, and Dr. Naguib are co-founders of NeuroTherapiaTM, a spin-off company created by Cleveland Clinic Innovations to develop NTRX -07. NeuroTherapiaTM recently received a $1.7 million investment from the Alzheimer’s Drug Discovery Foundation to advance NTRX-07 toward human clinical trials.

The company also has received $700,000 from the Alzheimer’s Association to support the proposed Phase I human studies. They anticipate initiating the human clinical studies in 2017.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® 2016 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES16.

November is Diabetes Awareness Month

Mount Sinai Experts Weigh In on Self-Management, Treatment Options,

Reversing the Disease and the Newest Advances in Diabetes Research

Newswise, New York, October 31, 2016–Diabetes is the seventh leading cause of death in the United States. Today, 29.1 million people in the United States have been diagnosed with diabetes, according to the U.S. Centers for Disease Control and Prevention (CDC). 

November is Diabetes Awareness Month and Mount Sinai Health System experts are sharing tips on self-management, treatment options, reversing the disease, and the newest advances in diabetes research.

Mount Sinai Experts

• Jeanine Albu, MD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease), Icahn School of Medicine at Mount Sinai
• Carol Levy, MD, Clinical Director, Mount Sinai Diabetes Center, The Mount Sinai Hospital
• Maria Rodriguez, RD, Certified Diabetes Educator, The Diabetes Alliance, Mount Sinai Health System
• Ronald Tamler, MD, PhD, Medical Director, Clinical Diabetes Institute, Icahn School of Medicine at Mount Sinai
• Jerome Tolbert, MD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease), Icahn School of Medicine at Mount Sinai
• Andrew Stewart, MD, PhD, Director, Mount Sinai Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai

Mount Sinai Artificial Pancreas (AP) Research Program:

Dr. Carol Levy and her team of researchers at the Icahn School of Medicine at Mount Sinai are studying the safety and efficacy of AP systems to improve the blood glucose control and reduce the burden of disease for people with type 1 diabetes.

Symptoms of Diabetes:
• Frequent urination and blurry vision
• Unusual thirst and sensations of hunger and fatigue
• Unintended weight loss
• Recurrent infections, like skin, gum, or bladder infections

Tips for Diabetes Prevention:
• Make smarter food choices
• Increase physical activity
• Maintain a healthy weight
• Reduce salt and sugar intake

Risk Factors for Prediabetes:
• Elevated blood glucose levels
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle and obesity and a history of cardiovascular disease

About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.

Queen Latifah And UCLA Cardiologist Discuss Why Heart Failure Is A Family Affair

Queen Latifah and UCLA's Dr. Karol Watson joined together on World Heart Day to educate the public on living with heart failure. Latifah's mother suffers from the condition.

 Newswise, October 31, 2016 — More than 6 million Americans live with heart failure. Including Queen Latifah’s mother.

That’s why the award-winning actress, singer, songwriter and producer recently joined UCLA cardiologist Dr. Karol Watson and the American Heart Association on World Heart Day for a Facebook Live event held at UCLA.

The goal? Raise awareness of the AHA’s “Rise Above Heart Failure” campaign and talk about how patients and caregivers can help manage the disease.

Heart failure is a condition in which the heart can’t pump efficiently to get enough blood to the organs. Symptoms include difficulty breathing, fatigue and swelling of the feet, ankles and legs.

“Once we got over the shock of my mom’s diagnosis, we started to learn that there are a lot of things we could do,” said Latifah, whose mother, Rita Owens, was in her early 50’s when she was diagnosed with heart failure ten years ago.

“We learned about medications she could take and how we could make simple lifestyle changes. We became educated and changed our entire family’s lifestyle and her heart began to improve.”

Watson, a professor of medicine/cardiology at the David Geffen School of Medicine at UCLA, noted that heart failure doesn’t affect just one person, it affects the whole family.

“But the good thing is that there are so many proactive steps that patients can take, like managing salt, diet and activity. Having family rally around the patient to support them is important,” said Watson, who is also co-director of the UCLA Program in Preventive Cardiology, and director of the UCLA Barbra Streisand Women’s Heart Health Program.

Whether it’s a family member or yourself, here are some key things about managing heart failure that Latifah and Watson discussed:

Notice a change? Get it checked out by your doctor.

People don’t always notice the signs of heart failure or they may mistake them as signs of other conditions or simply old age.

“A lot of people mistake the signs of heart failure as just getting older; I know my mom did,” Latifah said.

“But if you have symptoms like feeling short of breath when you bend down to put on your shoes, or have trouble sleeping at night without a bunch of pillows – don’t think ‘old age’. Think ‘heart failure’ and be sure to talk to your doctor.”

Watson added that if you see a definite change in your activity or if you’re not able to do the things you used to do, then definitely get it checked out.

“We are all at-risk for heart failure,” said Watson. “No one is untouched by this disease and we have to consider ourselves potentially at risk.”

Low-salt diet is important.

One of the biggest contributors to hear failure is too much salt in the diet, and it’s one of the first things a doctor will advise patients to cut back on.

“Too much salt makes us retain water and makes our heart have to work harder to try and get rid of it,” explained Watson.

For most heart failure patients, salt intake should be limited to one teaspoon, or no more than 1,500 milligrams, daily.

Latifah said she and her family had learned to use less salt.

“We find the flavor is in the food. Once you start to adjust, if you start putting salt on your food, everything will taste salty to you,” she said.

Watson noted the UCLA preventative cardiology program has a motto that encompasses the essential components to healthy heart and lifestyle: Move frequently, eat thoughtfully, connect deeply.

“We should all be physically active, including those with heart failure. We should strive to think about what we eat—we won’t always be perfect, but we can try to eat the right things and limit the bad,” said Watson, “And, it’s so important to maintain strong social connections with family and friends.”

Latifah summed it up by saying, “Our heart is our life and we need this thing to beat so we can live.”

Watch the video of the Facebook Live event with Latifah and Dr. Watson.

AHA’s Rise Above Heart Failure is nationally supported by Novartis Pharmaceuticals Corp. Latifah and her mother have joined the initiative to spread the word about heart failure and help others understand the symptoms and how to manage it.

Visit www.heart.ucla.edu for more information on UCLA Health’s heart services.

Alzheimer's Drug Discovery Foundation Launches Expanded Brain Health And Dementia Prevention Website

Site Features Science-Based Ratings of Options to Improve Brain Health, Help Consumers Make Informed Choices

Newswise, October 31, 2016— The Alzheimer’s Drug Discovery Foundation (ADDF) announced today the relaunch of CognitiveVitality.org, its brain health and dementia prevention website. The streamlined, easy-to-navigate site separates fact from fiction and empowers people to make smarter choices for their brain health.

“Americans are spending millions of dollars every year on supplements, drugs, and brain training games in the hope of staving off cognitive decline and dementia,” said Penny Dacks, PhD, director of Aging and Alzheimer's Prevention at the ADDF.

“Despite this massive investment, people are still unsure about what works and what doesn’t, and even about what is and isn’t safe. We developed CognitiveVitality.org to give consumers trustworthy information based on scientific evidence.”

At CognitiveVitality.org, neuroscientists from the ADDF review all of the available research and provide clear, unbiased ratings on the potential benefit, supporting evidence, and safety of options to improve brain health and potentially prevent dementia.

These options include food and drinks, drugs, and vitamins and supplements. Ratings may be viewed individually, or in a streamlined grid that allows users to compare options. New ratings are included, and previous ratings have been updated to include the latest scientific evidence.

“Science suggests there are steps people can take to lower their odds of getting dementia while other approaches are very unlikely to help. We want people to have the latest evidence on what they can do,” said Dr. Dacks.

Prior to posting, each rating is reviewed by two members of the independent Cognitive Vitality Clinical Advisory Board, which consists of nationally recognized leaders in epidemiology, neurology, geriatrics and gerontology, and related fields.

New Ratings of Supplements Provided

The relaunched site includes new ratings of the active ingredients in widely used supplements, including nicotinamide riboside and apoaequorin, which make brain health claims. Vitamins B6, B12, and folic acid—which are promoted for brain health—are also rated.

“These ratings should be especially helpful to consumers, as nutritional supplements are not required to prove their efficacy or safety in the manner required of pharmaceuticals,” said Howard Fillit, MD, the ADDF’s Founding Executive Director and Chief Science Officer.

Cognitive Vitality Blog Featured
CognitiveVitality.org features a blog with in-depth articles on potential risks, lifestyle factors, and emerging science that may affect the brain. The relaunched site includes new posts on lifestyle choices and risks that may affect brain health, including hypertension, smoking, and anesthesia, organized into user-friendly categories to help people find exactly what they want.

About Cognitive Vitality
CognitiveVitality.org is an initiative of the Aging and Alzheimer’s Prevention program at the ADDF, which is directed by Dr. Penny Dacks. It was initially launched in 2014. In addition to ratings and the blog, CognitiveVitality.org includes a description of the types of evidence used to develop the ratings, and a list of relevant scientific publications.

About the Alzheimer’s Drug Discovery Foundation
Founded in 1998 by Leonard A. and Ronald S. Lauder, the Alzheimer’s Drug Discovery Foundation (ADDF) is dedicated to rapidly accelerating the discovery of drugs to prevent, treat and cure Alzheimer’s disease.

The ADDF is the only public charity solely focused on funding the development of drugs for Alzheimer’s, employing a venture philanthropy model to support research in academia and the biotech industry. Through the generosity of its donors, the ADDF has awarded over $90 million to fund more than 500 Alzheimer’s drug discovery programs and clinical trials in 18 countries.

 To learn more, please visit: http://www.alzdiscovery.org/.

Natural Compound Reduces Signs Of Aging In Healthy Mice

Safety of NMN being tested in small clinical trial in Japan

Newswise, October 31, 2016 — Much of human health hinges on how well the body manufactures and uses energy. For reasons that remain unclear, cells’ ability to produce energy declines with age, prompting scientists to suspect that the steady loss of efficiency in the body’s energy supply chain is a key driver of the aging process.

Now, scientists at Washington University School of Medicine in St. Louis have shown that supplementing healthy mice with a natural compound called NMN can compensate for this loss of energy production, reducing typical signs of aging such as gradual weight gain, loss of insulin sensitivity and declines in physical activity.

The study is published Oct. 27 in the journal Cell Metabolism

.

“We have shown a way to slow the physiologic decline that we see in aging mice,” said Shin-ichiro Imai, MD, PhD, a professor of developmental biology and of medicine.

“This means older mice have metabolism and energy levels resembling that of younger mice. Since human cells rely on this same energy production process, we are hopeful this will translate into a method to help people remain healthier as they age.”

Imai is working with researchers conducting a clinical trial to test the safety of NMN in healthy people. The phase 1 trial began earlier this year at Keio University School of Medicine in Tokyo.

With age, the body loses its capacity to make a key element of energy production called NAD (nicotinamide adenine dinucleotide). Past work by Imai and co-senior author Jun Yoshino, MD, PhD, an assistant professor of medicine, has shown that NAD levels decrease in multiple tissues as mice age.

Past research also has shown that NAD is not effective when given directly to mice so the researchers sought an indirect method to boost its levels. To do so, they only had to look one step earlier in the NAD supply chain to a compound called NMN (nicotinamide mononucleotide).

NMN can be given safely to mice and is found naturally in a number of foods, including broccoli, cabbage, cucumber, edamame and avocado.

The new study shows that when NMN is dissolved in drinking water and given to mice, it appears in the bloodstream in less than three minutes. Importantly, the researchers also found that NMN in the blood is quickly converted to NAD in multiple tissues.

“We wanted to make sure that when we give NMN through drinking water, it actually goes into the blood circulation and into tissues,” Imai said. “Our data show that NMN absorption happens very rapidly.”

To determine the long-term effects of giving NMN, Imai, Yoshino and their colleagues studied three groups of healthy male mice fed regular mouse chow diets.

Starting at five months of age, one group received a high dose of NMN-supplemented drinking water, another group received a low dose of the NMN drinking water, and a third group served as a control, receiving no NMN.

The researchers compared multiple aspects of physiology between the groups, first at 5 months of age and then every three months, until the mice reached 17 months of age. Typical laboratory mice live about two years.

The researchers found a variety of beneficial effects of NMN supplementation, including in skeletal muscle, liver function, bone density, eye function, insulin sensitivity, immune function, body weight and physical activity levels. But these benefits were seen exclusively in older mice.

“When we give NMN to the young mice, they do not become healthier young mice,” Yoshino said.

“NMN supplementation has no effect in the young mice because they are still making plenty of their own NMN. We suspect that the increase in inflammation that happens with aging reduces the body’s ability to make NMN and, by extension, NAD.”

In skeletal muscle, the investigators — including the study’s first author, Kathryn Mills, the research supervisor in Imai’s lab — found that NMN administration helps energy metabolism by improving the function of mitochondria, which operate as cellular power plants.

They also found that mice given NMN gained less weight with aging even as they consumed more food, likely because their boosted metabolism generated more energy for physical activity.

The researchers also found better function of the mouse retina with NMN supplementation, as well as increased tear production, which is often lost with aging. They also found improved insulin sensitivity in the older mice receiving NMN, and this difference remained significant even when they corrected for differences in body weight.

In a paper published earlier this year in Cell Reports, Yoshino and his colleagues revealed more details of how NAD works in influencing glucose metabolism and the body’s fat tissue.

In that study, the mice had a defect in the ability to manufacture NAD only in the body’s fat tissue. The rest of their tissues and organs were normal.

“Even though NAD synthesis was stopped only in the fat tissue, we saw metabolic dysfunction throughout the body, including the skeletal muscle, the heart muscle, the liver and in measures of the blood lipids,” Yoshino said.

“When we gave NMN to these mice, these dysfunctions were reversed. That means NAD in adipose tissue is a critical regulator of whole body metabolism.”

Added Imai, “This is important because Jun showed that if you mess up NAD synthesis only in fat tissue, you see insulin resistance everywhere. Adipose tissue must be doing something remarkable to control whole body insulin sensitivity.”

During the long-term NMN study in healthy mice, Imai also said they monitored the animals for any potential increase in cancer development as a result of NMN administration.

“Some tumor cells are known to have a higher capability to synthesize NAD, so we were concerned that giving NMN might increase cancer incidence,” Imai said. “But we have not seen any differences in cancer rates between the groups.”

The phase 1 trial in Japan is using NMN manufactured by Oriental Yeast Co., which also provided the NMN used in these mouse studies. Outside of this clinical trial, high-grade NMN for human consumption is not commercially available. But there’s always broccoli.

New Hope For Recovery Of Hand Movement For Stroke Patients

Newswise, October 26, 2016 — Stroke patients are starting a trial of a new electronic device to recover movement and control of their hand.

Neuroscientists at Newcastle University have developed the device, the size of a mobile phone, which delivers a series of small electrical shocks followed by an audible click to strengthen brain and spinal connections.

The experts believe this could revolutionise treatment for patients, providing a wearable solution to the effects of stroke.

Following successful work in primates and healthy human subjects, the Newcastle University team are now working with colleagues at the prestigious Institute of Neurosciences, Kolkata, India, to start the clinical trial. Involving 150 stroke patients, the aim of the study is to see whether it leads to improved hand and arm control.

Stuart Baker, Professor of Movement Neuroscience at Newcastle University who has led the work said: "We were astonished to find that a small electric shock and the sound of a click had the potential to change the brain's connections. However, our previous research in primates changed our thinking about how we could activate these pathways, leading to our study

in humans."

Recovering hand control

Publishing  in the Journal of Neuroscience, the team report on the development of the miniaturised device and its success in healthy patients at strengthening connections in the reticulospinal tract, one of the signal pathways between the brain and spinal cord.

This is important for patients as when people have a stroke they often lose the major pathway found in all mammals connecting the brain to spinal cord. The team's previous work in primates showed that after a stroke they can adapt and use a different, more primitive pathway, the reticulospinal tract, to recover.

However, their recovery tends to be imbalanced with more connections made to flexors, the muscles that close the hand, than extensors, those that open the hand.

This imbalance is also seen in stroke patients as typically, even after a period of recuperation, they find that they still have weakness of the extensor muscles preventing them opening their fist which leads to the distinctive curled hand.

Partial paralysis of the arms, typically on just one side, is common after stroke, and can affect someone's ability to wash, dress or feed themselves.

 Only about 15% of stroke patients spontaneously recover the use of their hand and arm, with many people left facing the rest of their lives with a severe level of disability.

Senior author of the paper, Professor Baker added: "We have developed a miniaturised device which delivers an audible click followed by a weak electric shock to the arm muscle to strengthen the brain's connections. This means the stroke patients in the trial are wearing an earpiece and a pad on the arm, each linked by wires to the device so that the click and shock can be continually delivered to them.

"We think that if they wear this for 4 hours a day we will be able to see a permanent improvement in their extensor muscle connections which will help them gain control on their hand."

Improving connections

The techniques to strengthen brain connections using paired stimuli are well documented, but until now this has needed bulky equipment, with a mains electric supply.

The research published today is a proof of concept in human subjects and comes directly out of the team's work on primates. In the paper they report how they pair a click in a headphone with an electric shock to a muscle to induce the changes in connections either strengthening or weakening reflexes depending on the sequence selected.

They demonstrated that wearing the portable electronic device for seven hours strengthened the signal pathway in more than half of the subjects (15 out of 25).

Professor Stuart Baker added: "We would never have thought of using audible clicks unless we had the recordings from primates to show us that this might work.

Furthermore, it is our earlier work in primates which shows that the connections we are changing are definitely involved in stroke recovery."

The work has been funded through a Milstein Award from the Medical Research Council and the Wellcome Trust.

The clinical trial is just starting at the Institute of Neurosciences, Kolkata, India. The country has a higher rate of stroke than Western countries which can affect people at a younger age meaning there is a large number of patients. The Institute has strong collaborative links with Newcastle University enabling a carefully controlled clinical trial with results expected at the end of this year.

More American Men With Early-Stage Prostate Cancer Could Opt Out Of Immediate Treatment

Newswise, October 26, 2016 — A new report on Swedish men with non-aggressive prostate cancer suggests that a lot more American men could safely choose to monitor their disease instead of seeking immediate radiation treatment or surgery.

Published in the Journal of the American Medical Association (JAMA) Oncology online Oct. 20, the report shows that well over half of 32,518 men in Sweden diagnosed with prostate cancers least likely to spread chose monitoring during a recent, five-year period over immediate treatment.

Led by researchers at NYU Langone Medical Center and its Perlmutter Cancer Center, an international team concluded that men are likely to choose monitoring once presented with the choice.

Called active surveillance, the monitoring option relies on regular blood tests, physical exams, and the periodic biopsy, or sampling, of prostate tissue to screen for any signs of a tumor’s growth before therapy is considered.

The move to active surveillance, say the study authors, averts the risk of sexual dysfunction, as well as bowel and bladder problems that frequently accompany traditional therapies.

“The main conclusion here is that if the majority of men in Sweden have adopted this management strategy for very low- to low-risk prostate cancer, then more American men might choose this option if it were presented to them,” says lead study investigator and urologist Stacy Loeb, MD, MSc.

Among the study’s key findings was that from 2009 to 2014 the number of Swedish men with very low-risk cancer choosing active surveillance increased from 57 percent to 91 percent, and men with low-risk cancer choosing this option rose from 40 percent to 74 percent.

Meanwhile, the authors report, the number of men in both groups who chose to simply wait, do no further testing, and postpone therapy unless symptoms develop — a passive practice called watchful waiting — dropped by more than half.

For the study, researchers analyzed data from Sweden’s National Prostate Cancer Register, one of the few such national databases in the world (and for which nothing comparable exists in North America).

Loeb, an assistant professor in the urology and population health departments at NYU Langone, and a member of Perlmutter, says that while increasing numbers of American men diagnosed with early-stage disease are choosing active surveillance, they still account for less than half of those for whom it is an option.

“Our findings should encourage physicians and cancer care professionals in the United States to offer such close supervision and monitoring to their patients with low-risk disease,” says Loeb.

More American men opting for active surveillance, she adds, “could go a long way toward reducing the harms of screening by minimizing overtreatment of non-aggressive prostate cancer.”

Loeb says recent studies have suggested that some men with early-stage disease who opted for treatment later regretted it because of lingering problems, such as incontinence and impotence.

A large study also recently showed no difference in death rates a decade after diagnosis between those who chose active surveillance and those who chose immediate treatment, Loeb says.

Meanwhile, there is a greater risk of side effects among men undergoing therapy. She cautions, however, that this pattern has not been confirmed for the Swedish men in the current study.

The U.S. National Cancer Institute estimates that 26,000 American men will die from the disease in 2016, with 181,000 getting diagnosed, most in its earliest stages.

Funding support for the study, which took two years to complete, was provided by grants from the Swedish Research Council (825-2012-5047) and the Swedish Cancer Society (130428). Additional funding support was provided by the Laura and Isaac Perlmutter Cancer Center and the Louis Feil Charitable Lead Trust.

Besides Loeb, another NYU Langone investigator involved in the study was Caitlin Curnyn, MPH. Other study investigators were Yasin Folkvaljon, MSc, at the Regional Cancer Center at Uppsala University in Uppsala, Sweden; David Robinson, MD, PhD, at Ryhov County Hospital in Jonkoping, Sweden, and Umea University in Umea, Sweden; Ola Bratt, MD, PhD, at Addenbrooke’s Hospital in Cambridge, England, and Lund University in Lund, Sweden; and principal investigator Pär Stattin, MD, PhD, at both Uppsala University and Umea University.

Electronic Records Help Link Genes To Age-Related Hearing Loss

 UCSF-Kaiser collaboration studied more than 6,000 cases of hearing impairment

Newswise, October 26, 2016 — A study of patient electronic medical records and genome sequences from adults with age-related hearing impairment by researchers at UC San Francisco and Kaiser Permanente Northern California, identified two genetic variations linked to the hearing disorder.

The research—led by Thomas Hoffmann, PhD, a professor of epidemiology and biostatistics and member of the Institute for Human Genetics at UCSF—was published October 20, 2016 in PLOS Genetics.

“This is one of the first studies that has found and replicated genes linked with age-related hearing impairment,” Hoffmann says.

“And it provides some of the best evidence to date that age-related hearing loss may share a common biological basis with other forms of hearing impairment.”

Age-related hearing impairment (ARHI) is a common condition, affecting one quarter of individuals aged 65, and half of individuals aged 80 and older.

While hearing aids and other technologies offer treatments, scientists hope that a better understanding of the underlying genetics of the disorder may one day yield a cure.

To find genetic variations linked to ARHI, the scientists conducted a genome-wide association study using 6,527 age-related hearing impairment cases and 45,882 controls among white participants in the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, a collaboration between UCSF and the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH).

“Our collaboration with Kaiser is incredibly powerful,” Hoffmann said. “They have a very long history of electronic health records on all of their patients in the system, so as a researcher you have this rich set of information that you can look at to understand the factors that drive health and disease.”

The researchers discovered two genome variants that contribute to the disorder: a novel variation near the ISG20 gene, and a second variant within TRIOBP, a gene previously associated with another type of hearing loss.

To verify their findings, the scientists replicated the experiment in Latino, East Asian, and African American cohorts within GERA and in an independent cohort of individuals from the UK Biobank.

They also looked at genes known to play a role in hearing loss and identified two additional genetic variations linked to ARHI.

This study provides novel insights into the genetic factors involved in ARHI. In particular, the discovery of the two additional variations in known hearing loss genes suggests that these may be regions of the genome to focus on in future studies of ARHI.

The findings also highlight the utility of large cohorts with matched genomic data and electronic health records for revealing the underlying genetic basis of ARHI and other disorders.

“This has been a long process,” Hoffmann says of the project to collect genomic data and link it with GERA health records.

“It’s really nice to see at the end that all the collaborative work that we’ve done is producing interesting results that help advance the field.”

Additional authors on the paper include Bronya J. Keats, PhD, of Louisiana State University Health Sciences Center; Noriko Yoshikawa, MD, of Kaiser Permanente Medical Center, Oakland; Catherine Schaefer, PhD, of Kaiser Permanente Northern California Division of Research, Oakland; Neil Risch, PhD, who is Lamond Family Foundation Distinguished Professor in Human Genetics, professor of epidemiology and biostatistics, and director of the Institute for Human Genetics at UCSF and an adjunct investigator at the Kaiser Permanente Northern California Division of Research; and Lawrence R. Lustig, MD, of Columbia University Medical Center.

Funders of the research include the National Institute of Deafness and Other Communication Disorders (grant K01 DC013300), the National Institute on Aging, National Institute of Mental Health, the National Institutes of Health Common Fund (RC2 AG036607), the Robert Wood Johnson Foundation, the Wayne and Gladys Valley Foundation, the Ellison Medical Foundation, and Kaiser Permanente National and Regional Community Benefit Programs. The authors have declared no competing financial interests.

About UCSF: UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland – and other partner and affiliated hospitals and healthcare providers throughout the Bay Area. Please visit www.ucsf.edu/news and follow @ucsf.

About the Kaiser Permanente Division of Research: The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 550-plus staff is working on more than 350 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us @KPDOR. 

Sixty Percent Of Americans With Diabetes Skip Annual Sight-Saving Exams

American Academy of Ophthalmology reiterates the importance of dilated eye exams in preventing vision loss...This is especially timely as the Academy is reiterating the importance of eye exams during the month of November, which is observed as Diabetic Eye Disease Awareness Month.

 

Newswise, October 26, 2016– People with diabetes are at increased risk of developing serious eye diseases, yet most do not have sight-saving annual eye exams, according to a large study presented at AAO 2016, the 120th annual meeting of the American Academy of Ophthalmology.

This is especially timely as the Academy is reiterating the importance of eye exams during the month of November, which is observed as Diabetic Eye Disease Awareness Month.

Researchers at Wills Eye Hospital in Philadelphia have found that more than half of patients with the disease skip these exams. They also discovered that patients who smoke as well as those with less severe diabetes and no eye problems were most likely to neglect having these checks.

The researchers collaborated with the Centers for Disease Control and Prevention to review the charts of close to 2,000 patients age 40 or older with type 1 and type 2 diabetes to see how many had regular eye exams. Their findings over a four-year period revealed that:

• Fifty-eight percent of patients did not have regular follow-up eye exams
• Smokers were 20 percent less likely to have exams
• Those with less-severe disease and no eye problems were least likely to follow recommendations
• Those who had diabetic retinopathy were 30 percent more likely to have follow-up exams

One in 10 Americans have diabetes, putting them at heightened risk for visual impairment due to the eye disease diabetic retinopathy.

The disease also can lead to other blinding ocular complications if not treated in time. Fortunately, having a dilated eye exam yearly or more often can prevent 95 percent of diabetes-related vision loss.

Eye exams are critical as they can reveal hidden signs of disease, enabling timely treatment. This is why the Academy recommends people with diabetes have them annually or more often as recommended by their ophthalmologist, a physician who specializes in medical and surgical eye care.

“Vision loss is tragic, especially when it is preventable,” said Ann P. Murchison, M.D., M.P.H., lead author of the study and director of the eye emergency department at Wills Eye Hospital. “That’s why we want to raise awareness and ensure people with diabetes understand the importance of regular eye exams.”

The Academy has released a new animated public service announcement to help educate people about the importance of regular exams and common eye diseases including diabetic retinopathy. It encourages the public to watch and share it with their friends and family.

“People with diabetes need to know that they shouldn't wait until they experience problems to get these exams,” Rahul N. Khurana, M.D, clinical spokesperson for the Academy. “Getting your eyes checked by an ophthalmologist can reveal the signs of disease that patients aren’t aware of.”

American seniors 65 and older may be eligible to get a medical eye exam at no cost through Eye Care America, a public service program of the Academy. For more information about diabetic eye disease, visit the Academy’s EyeSmart website.

Nonadherence to Eye Care in People with Diabetes was presented at AAO 2016, the 120th annual meeting of the American Academy of Ophthalmology.

The event was held in conjunction with the Asia-Pacific Academy of Ophthalmology Oct. 14-18 at McCormick Place, Chicago. Known as the place "Where all of Ophthalmology Meets™,” the Academy’s annual meeting is the world’s largest conference for eye physicians and surgeons. For more information, see AAO 2016 highlights.

About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.

Exercise May Help Ward Off Memory Decline

Newswise, October 24, 2016– Exercise may be associated with a small benefit for elderly people who already have memory and thinking problems, according to new research published in the October 19, 2016, online issue of Neurology®, a medical journal of the American Academy of Neurology.

The research involved people with vascular cognitive impairment, which is the second most common cause of dementia after Alzheimer’s disease. In vascular cognitive impairment, problems with memory and thinking skills result from damage to large and small blood vessels in the brain.

“Studies have shown that exercise can help reduce the risk of developing memory problems, but few studies have looked at whether it can help people who already have these problems get better or keep from getting worse,” said study author Teresa Liu-Ambrose, PT, PhD, of the University of British Columbia in Vancouver, Canada.

The study involved 70 people with an average age of about 74 who had mild vascular cognitive impairment.

Half of the participants took part in one-hour exercise classes three times a week for six months. The other half received information each month about vascular cognitive impairment and a healthy diet, but no information on physical activity.

All of the participants were tested before the study started, at the end of the study and again six months later on their overall thinking skills, executive function skills such as planning and organizing and how well they could complete their daily activities.

Those who exercised had a small improvement on the test of overall thinking skills compared to those who did not exercise. The scores of those who exercised improved by 1.7 points compared to those who did not exercise.

“This result, while modest, was similar to that seen in previous studies testing the use of drugs for people with vascular cognitive impairment,” Liu-Ambrose said.

 “However, the difference was less than what is considered to be a the minimal clinically important difference of three points.”

Six months after the participants stopped the exercise program, their scores were no different than those who did not exercise. Also, there was no difference between the two groups at any point on the tests of executive function skills or daily activities.

Those who exercised also improved compared to the other group in their blood pressure and on a test of how far they could walk in six minutes, which measured overall cardiovascular capacity.

These findings are also important to note given that high blood pressure is a risk factor for developing vascular cognitive impairment.

Liu-Ambrose said more studies are needed to determine whether exercise can improve thinking abilities in people with mild vascular cognitive impairment.

Because the study sample size was based on detecting a difference on the overall thinking skills test, large samples might be needed to detect differences in specific thinking abilities, such as planning, and everyday skills, such as managing one’s finances.

The study was supported by the Canadian Stroke Network and the Heart and Stroke Foundation of Canada.

To learn more about brain health, visit www.aan.com/patients.

The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 30,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, LinkedIn and YouTube.