31 Jul

Medical News Today: Green tea compound may reduce the harms of a Western diet

a cup of green tea
A compound in green tea could help to reduce the health implications of a Western diet, say researchers.
Green tea is one of the most commonly consumed beverages across the globe, largely due to its associated health benefits. New research offers yet another reason to drink this popular beverage, after finding that it could help to combat the negative health implications of a Western diet.

Researchers found that a compound in green tea called epigallocatechin gallate (EGCG) reduced the development of insulin resistance, obesity, and memory impairments in mice fed a high-fat, high-fructose diet.

Study co-author Xuebo Liu, Ph.D., of the College of Food Science and Engineering at Northwest A&F University in China, and colleagues recently reported their findings in The FASEB Journal.

The Western diet is generally defined as a diet rich in red and processed meats, high in saturated fats, refined sugars, and refined carbohydrates, and low in fruits, vegetables, whole grains, seafood, and poultry.

Unsurprisingly, following such a diet has been linked to weight gain and obesity, as well as the development of type 2 diabetes. What is more, studies have indicated that a Western diet may raise the risk of cognitive impairment.

The new study, however, suggests that the green tea compound EGCG could help to protect against the harms of a Western diet.


Testing EGCG in mice

Dr. Liu and team came to their findings by studying three groups of 3-month-old male mice.

For a total of 16 weeks, each group followed a different diet. One group of mice was fed a high-fat, high-fructose diet (HFFD), one group was fed an HFFD alongside 2 grams of EGCG in every liter of drinking water, while the remaining group was fed a standard diet (the controls).

At the end of the 16-week study period, as expected, the mice fed the HFFD had gained more weight than the control group. However, the weight gain was much less severe for mice whose HFFD was supplemented with EGCG.

Additionally, the team found that the mice fed HFFD plus EGCG were less likely to experience insulin resistance in response to an HFFD, as determined by the upregulation of specific brain pathways that control insulin signaling.

The memory of the mice was assessed with the Morris water maze test, a navigation task wherein researchers monitor rodents’ ability to find an escape platform.

Compared with mice fed the HFFD, the researchers found that mice fed an HFFD plus EGCG were repeatedly much faster at finding the escape platform, and they also took a shorter path to locate it.


‘Compelling evidence’

The team then removed the platform from the maze to test the rodents’ memory in a probe trial, which measures how long a rodent spends in the “target quadrant,” or the area of the maze where the platform used to be. A longer time spent in the target quadrant indicates better memory.

The researchers found that mice fed the HFFD plus EGCG spent longer in the target quadrant than the mice fed the HFFD alone.

The HFFD plus EGCG mice also had more platform crossings – that is, a greater number of crossings over the target location – indicating that these rodents had a better idea of where the escape platform was located previously.

While human trials are needed to confirm these findings, the researchers believe that EGCG not only has the ability to reduce the development of insulin resistance and weight gain in response to a Western diet, but it could also protect the brain.

To our knowledge, this study is the first to provide compelling evidence that the nutritional compound EGCG has the potential to ameliorate HFFD-triggered learning and memory loss.”

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Source: medicalnewstoday

31 Jul

Medical News Today: Popular Netflix show may increase suicidal tendencies

sad teenager watching TV
A new study suggests that the Netflix drama ’13 Reasons Why’ may increase suicidal thoughts among teenagers.
Could a popular show increase teenagers’ suicidal tendencies? New research has investigated, and the results are alarming.

Suicide is a serious public health concern. According to the latest data from the Centers for Disease Control and Prevention (CDC), suicide ranks as the 10th leading cause of death in the United States, across all age groups.

However, suicide becomes the third leading cause of death when zooming in on young people aged between 10 and 14. Furthermore, among those aged between 10 and 24 years, suicide rises to the second spot in the top causes of death.

Experts have expressed concern over the impressionability and susceptibility of young people to suicide. The phenomenon of “suicide contagion” is more pervasive among teenagers and adolescents, and exposure to certain media programs might increase the risk of copying suicidal behavior in this age group.

In particular, a new, popular Netflix drama that centers around a teenager who commits suicide has sparked controversy and worry over the psychological well-being of teenagers.

Now, a team of researchers led by John W. Ayers, an associate research professor at San Diego State University Graduate School of Public Health in California, set out to investigate the impact of this show – called “13 Reasons Why” – on suicide-related Internet searches.

The findings were published in JAMA Internal Medicine.


Examining Internet searches

Specifically, the study examined Google search trends in the days following the show’s release. Prof. Ayers and team looked at searches for the word “suicide,” excluding occurrences of the word “suicide” together with the word “squad,” so as to avoid searches for the popular film “Suicide Squad.”

Additionally, they monitored related search terms, avoiding unrelated or vague phrases that included the word suicide, such as “suicide slide” or “suicide bridge.” The researchers also examined specific suicide-related search queries, such as “how to commit suicide” and “how to kill yourself.”

Prof. Ayers and colleagues looked at the volume of Internet searches between March 31, 2017 and April 18, 2017. The end date of the period was chosen in order to avoid the date of April 19, 2017, which was when the American football player Aaron Hernandez committed suicide.

The researchers compared Internet search volumes after the show aired with what the search volumes would have been if the show had not been released. These volumes were estimated based on daily trends over 3 months, which were fed into an algorithm called “autoregressive integrated moving average,” designed by Hyndman and Khandakar.

“This strategy allows us to isolate any effect ’13 Reasons Why’ had on how the public engaged with and thought of suicide,” says study co-author Benjamin Althouse, a research scientist at the Institute for Disease Modeling in Bellevue, WA.


Suicide searches up by 19 percent

Overall, the study revealed a bump in all suicide-related searches after the show’s premiere.

Specifically, all of the suicide-related queries were up by 19 percent, compared with what would have been expected if the show had not aired.

The search for phrases that indicate users’ interest in suicide prevention strategies partially accounted for this increase. Namely, searches for phrases such as “suicide hotline” went up by 12 percent, and those for “suicide prevention” increased by 23 percent.

However, queries such as “how to commit suicide,” “commit suicide,” and “how to kill yourself” also increased considerably, by 26 percent, 18 percent, and 9 percent, respectively.

“In relative terms, it’s hard to appreciate the magnitude of [the release of ’13 Reasons Why’],” says study co-author Mark Dredze, a professor of computer science at Johns Hopkins University in Baltimore, MD.

“In fact, there were between 900,000 and 1,500,000 more suicide-related searches than expected during the 19 days following the series’ release.”

While it’s heartening that the series’ release concurred with increased awareness of suicide and suicide prevention […] our results back up the worst fears of the show’s critics: the show may have inspired many to act on their suicidal thoughts by seeking out information on how to commit suicide.”

Prof. John W. Ayers

The researchers cannot determine whether or not the searches triggered actual suicide attempts.

However, the scientists point to previous studies that have indicated a correlation between suicide search trends and actual suicides, as well as studies showing that the more suicides are covered by the media, the more people try to commit suicide.

Finally, the researchers point to the World Health Organization’s (WHO) guidelines for suicide prevention – specifically those aimed at the media – and urge the show’s creators, as well as Netflix, to abide by these principles.

“It is critical that media makers follow these guidelines. For instance, these guidelines discourage content that dwells on the suicide or suicide act. ’13 Reasons Why’ dedicated 13 hours to a suicide victim, even showing the suicide in gruesome detail,” says co-author Jon-Patrick Allem, a research scientist at the University of Southern California in Los Angeles.

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Source: medicalnewstoday

31 Jul

Medical News Today: Alcohol improves memory of previous learning

red wine being poured
Is it possible that drinking alcohol can actually improve information recall?
A new study finds that drinking alcohol can improve recall of learning that occurs before a drinking session, and that this effect is stronger with greater alcohol consumption.

The reason for the finding is not fully understood, say researchers from the University of Exeter in the United Kingdom, who report it in the journal Scientific Reports.

It has been suggested, they note, that alcohol stops the brain being able to take on new information, freeing up resources to more firmly bed down earlier learning.

“The theory is that the hippocampus – the brain area really important in memory – switches to ‘consolidating’ memories, transferring from short- into longer-term memory,” explains senior study author Celia Morgan, a professor of psychopharmacology at the University of Exeter.

However, she and her team wish people to realize that that their findings point to a “limited effect” that should be weighed up against the well-known negative consequences on memory and mental and physical health that result from excessive alcohol consumption.


First study in ‘naturalistic setting’

In their study paper, the team explains that there is a lot of documented evidence on the effects of alcohol on memory performance. This shows, for example, that people under the influence of alcohol are less able to form new memories.

And, paradoxically, there is also evidence that alcohol can improve memory when the information is learned before intoxication takes place.

Thus, while the new study is not the first to observe this effect, it is the first to demonstrate it in a “naturalistic setting,” outside the laboratory. The setting for the study was the participants’ own homes.

The authors also note that, “Since alcohol is the most popular recreational drug worldwide, with an estimated 38.3 percent of the global population currently using it, investigating the naturalistic effects of alcohol is important in assessing the harms and potential benefits of this ubiquitous substance.”

For their investigation, Prof. Morgan and colleagues recruited 88 social drinkers (31 men and 57 women), aged between 18 and 53, and they randomly assigned them to one of two groups: the alcohol group and the sober group.

All participants undertook a word-learning task in a quiet room at home in the early evening. This was followed by a first test of recall.

Those in the alcohol group were then invited to drink as much alcohol as they wished, and those in the sober group were asked to drink only nonalcoholic drinks.


Improved recall of pre-drinking learning

The next morning, the participants undertook a second test to recall the words that they had learned the evening before. This test took place around 18 hours after the learning task.

The results showed that the performance in the second recall test (that is, following the drinking session) was better than in the first recall test (before the drinking session) for the alcohol group only.

Our research not only showed that those who drank alcohol did better when repeating the word-learning task, but that this effect was stronger among those who drank more.”

Prof. Celia Morgan

The researchers suggest that the reason that greater consumption of alcohol might improve recall of pre-drinking learning might be that alcohol creates a state in the brain that “better facilitates cellular and systems consolidation as dose increases.”

They also note that there could be an interaction between the effect of sleep and the effect of alcohol, as the second recall test was done the following morning, after a night’s sleep.

The team suggests that future studies should attempt to “empirically rule out alternative neurobiological explanations for retrograde facilitation by controlling for sleep.”


Memory no better after intoxicated learning

The participants also underwent a second experiment, in which the learning task took place under the influence of alcohol.

They completed the learning phase of the second experiment, which involved looking at images on a screen and then undergoing a first test of recall, shortly after the drinking session, before they went to bed.

The second test of recall for this post-drinking memory task also took place the next morning, shortly after the word-learning recall test.

The results showed no significant improvement in recall between the two tests for the alcohol group.

Prof. Morgan and team conclude that their findings “support the notion that alcohol can facilitate memory for previously learned information.”

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31 Jul

Medical News Today: Cryoglobulinemia: Causes, symptoms, and treatment

older persons hands with hot drink
Cryoglobulinemia may only appear in cold weather.
Cryoglobulinemia is a disease caused by an abundance of a protein called cryoglobulin in the blood.

Cryoglobulins are proteins found in the blood stream that clump together in colder temperatures. These clusters cause blood plasma to become very thick, which can block normal blood flow to tissue and organs.

Cryoglobulinemia is most common in adults over the age of 50. Some people experience continuous symptoms while others go through periods of flares. As cold temperatures play a role in cryoglobulinemia, people may experience flares during colder months and fewer symptoms in the summer.


What causes cryoglobulinemia?

Cryoglobulinemia causes clumps of abnormal proteins in the blood stream that can block blood flow. The blockages can, in turn, cause tissue, joint, nerve, and organ damage.

The causes of cryoglobulinemia vary from person to person. Some of the most common causes include:

  • having an abundance of cryoglobulin in the blood
  • certain blood cell cancers
  • having a connective tissue disease
  • having an infection, most often hepatitis C


Symptoms

numb fingers
Symptoms of cryoglobulinemia may include numbness and joint pain.

A person with cryoglobulinemia may or may not experience any symptoms.

Some people may have low numbers of cryoglobulin in their blood and experience no symptoms. Others discover they have a large number of cryoglobulins in the blood after having blood tests for an unrelated condition.

For others, symptoms may include:

  • joint pain
  • fatigue
  • numbness
  • weakness
  • rash with red spots or purple bruises

Less common symptoms include:

  • kidney damage
  • enlarged spleen or liver
  • swelling, particularly around ankles and legs
  • discoloration of the hands in the cold
  • weight loss
  • skin ulcers and gangrene
  • numbness or tingling
  • high blood pressure

Just as symptoms will vary among individuals, so will the number of flares a person experiences throughout the year.


Diagnosis

To diagnosis cryoglobulinemia, a doctor will run a specific blood test that checks for cryoglobulins. From the blood test, a doctor will be able to determine:

  • if there are cryoglobulins in the blood
  • what type of cryoglobulins are in the blood

There are four main types of cryoglobulinemia:

  • Type 1 is referred to as simple cryoglobulinemia and is the result of a single protein in the blood.
  • Types 2 and 3 are considered mixed cryoglobulinemia, meaning they contain other proteins including rheumatoid factor (RF). RF is a protein produced by the immune system that attacks healthy tissues in the body. RF is often linked to autoimmune diseases, and hepatitis C. Types 2 and 3 cryoglobulinemia make up the majority of cases of cryoglobulinemia.
  • Essential cryoglobulinemia has no association with a disease or underlying condition. The presence of type 2 and 3 cryoglobulinemia and their association with hepatitis C lead some researchers to believe there may not be such thing as essential cryoglobulinemia.
  • Secondary cryoglobulinemia indicates a connection between the disease and other underlying conditions.

Determining the type of cryoglobulins present will help a doctor determine how best to treat the disease. The type may also help the doctor identify what underlying condition or disease is causing the cryoglobulinemia.


Treatment

pharmacist looking for prescription
A doctor may prescribe corticosteroids or other immunosuppressors to treat cryoglobulinemia.

A doctor will treat cryoglobulinemia based on the type, the severity of the damage, the parts of the body affected, and the underlying disease or condition present.

A doctor will probably discuss the options with a person prior to starting treatment.

In mild cases without symptoms, a doctor may not treat the condition at all. Instead, they may advise people to avoid cold weather or simply monitor them and recommend that they return for a further assesment if they develop any new symptoms.

In more moderate to severe cases, a number of treatment options are available. These include:

  • Corticosteroids or other immunosuppressors, which help stop the immune system from attacking healthy cells.
  • Plasmapheresis, which filters out the clumps of cryoglobulins and helps prevent blocked arteries and organ damage.
  • Newer biologic medications, such as rituximab (Rituxan), which is an artificial antibody that can prevent the protein forming clumps.

In cases of secondary cryoglobulinemia, treatment involves correcting the underlying condition. When the underlying cause is treated, the symptoms of cryoglobulinemia should improve as well.

If a doctor determines that the cryoglobulinemia is caused by hepatitis C, the treatment will center on antiviral medication and the person will likely be referred to a liver specialist. Pegylated interferon alfa and a combination of sofosbuvir and ribavirin have shown success in treating cryoglobulinemia and its complications associated with hepatitis C.


Outlook

The outlook for people with cryoglobulinemia varies depending on the severity of their symptoms, the extent of any damage done, and what underlying causes might be present. For the mildest cases, no treatment may be necessary.

In more moderate to severe cases, treatment can help keep flares to a minimum and reduce the overall severity of the symptoms. Left untreated, more severe cases can lead to permanent damage to organs, nerves, and tissues.

It is also important to be aware of the potential side effects of some treatments, such as antiviral medications. People can discuss possible side effects with their doctor.

Hepatitis C, blood cancers, and other underlying causes of cryoglobulinemia will require specific treatment and prognosis will vary from person to person.

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Source: medicalnewstoday

31 Jul

Medical News Today: Hypersomnolence: Symptoms, diagnosis, and treatment

Hypersomnolence.
Hypersomnolence is when someone is excessively sleepy, regardless of how much sleep they get.
Hypersomnolence is a condition where a person experiences significant episodes of sleepiness, even after having 7 hours or more of quality sleep.

Other terms used to describe hypersomnolence include excessive daytime sleepiness, excessive daytime somnolence, and hypersomnia.


What is hypersomnolence?

Many people find themselves sleep-deprived or excessively tired at various times in their lives. On the other hand, a person with hypersomnolence can feel the need to sleep even after they have slept well for the recommended number of hours.

Hypersomnolence can be problematic because it affects a person’s abilities at work and school. It can also affect their safety while driving and can be an indicator of an underlying medical disorder.

The symptoms of hypersomnolence usually begin when people are 17 to 24 years old. According to an article in the journal Psychosomatics, the average age of onset is 21.8 years.

Left untreated, hypersomnolence can impact a person’s quality of life.


Symptoms

Struggling to wake up.
Symptoms of hypersomnolence include struggling to wake up, falling asleep at random times, and constantly feeling tired.

In people with hypersomnolence, excessive sleepiness is not due to another underlying medical disorder or medication.

The primary symptom of hypersomnolence is excessive sleepiness, even though a person is getting 7 hours of sleep a night. Other symptoms include:

  • falling asleep several times during the day
  • taking naps to combat the sleepiness but not waking up refreshed
  • sleeping more than 9 hours but not feeling rested
  • having difficulty waking up from sleep
  • feeling confused or combative while trying to wake up

Excessive sleeping may cause problems at work, school, or for other daily activities.

Hypersomnolence has three categories: acute, subacute, and persistent.

  • acute hypersomnolence, lasting 1 month or less
  • subacute hypersomnolence, lasting 1 to 3 months
  • persistent hypersomnolence, lasting more than 3 months

Hypersomnolence is similar to another sleep disorder known as narcolepsy in that people experience episodes of sleepiness during the day.

However, people with narcolepsy often describe episodes of sleepiness as sudden sleep “attacks.” In contrast, hypersomnolence episodes tend to come on gradually.


Causes

Researchers are still working to identify what interactions in the brain cause hypersomnolance. It is possible that people have an increase in brain chemicals that are known to cause sleepiness. This increase can act much like a sleeping pill.

Although researchers have not yet identified the specific substance or molecule that may be involved in hypersomnolence, they believe it interacts with a substance called y-aminobutyric acid (GABA), which is responsible for promoting sleep in the brain. Sedative medications used in surgery work on the same GABA substance to keep a person asleep during surgery.

Risk factors for a person developing hypersomnolence include:

While these are known risk factors and potential contributors to the condition, some people may have hypersomnolence for no known reason.

Hypersomnolence without a known cause is called idiopathic hypersomnolence, which affects an estimated 0.01 to 0.02 percent of the population.


Diagnosis

Hypersomnolence is one of several disorders described in the “sleep-wake disorders” category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Other conditions in this category include nightmare disorder, restless legs syndrome, and breathing-related sleep disorders.

Doctors often diagnose hypersomnolence by first ruling out other possible causes of the excessive sleepiness.

A doctor will ask questions about a person’s symptoms, which may include:

  • When did you first notice them?
  • Does anything make them worse? Does anything make them better?
  • What other medical conditions are you currently being treated for?
  • What are your sleeping patterns?
  • What is your sleep environment like?

A doctor will also review any medication a person might be taking to help identify if this could be causing the daytime drowsiness.

A doctor may also recommend a sleep study. This involves an overnight stay in a “sleep lab” where a person is hooked up to various monitors, including a pulse oximeter, an electrocardiogram, and a brain wave monitor. This equipment helps the doctor decide if a person’s daytime sleepiness could be due to a sleep disorder, such as obstructive sleep apnea.

If there are no signs of an underlying disorder or medical cause, a doctor may diagnose a person with hypersomnolence.


Treatment

Sleep routine.
Establishing a bedtime routine, and limiting distractions before going to sleep, can help to treat hypersomnolence.

Stimulants are most commonly prescribed to treat hypersomnolence. Examples of these medications include:

  • amphetamine
  • methylphenidate
  • modafinil

Additional drugs used to treat hypersomnolence include clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors (MAOIs).

In addition to medications, a doctor may recommend making changes to a person’s “sleep hygiene” to help them get a good night’s sleep.

Examples of these changes include:

  • Avoiding stimulant substances before bedtime, such as caffeine and nicotine.
  • Drinking alcohol only in moderation. Although alcohol can make a person feel drowsy, drinking it in excess can result in poorer sleep quality.
  • Avoiding foods that cause heartburn or impact digestion. Examples include foods made with high-fat creams, fried foods, spicy meals, citrus fruits, and carbonated drinks.
  • Using visual lighting cues to differentiate between day and night. This can include being exposed to plenty of outdoor light during the day, and making a room darker before going to sleep.
  • Establishing a bedtime routine that a person finds relaxing and helps to signal to their body that it is time for bed. Examples include taking a shower or reading a book.
  • Changing a sleep environment to make it more comfortable. This includes cooling a room to between 60°F-67°F, avoiding light from artificial sources, including cell phones and computers, and sleeping on a comfortable mattress.

Outlook

With lifestyle changes and medications, doctors consider hypersomnolence to be a very treatable sleep disorder.

A person may also benefit from counseling and cognitive-behavioral therapies to change their sleep habits and learn how to reduce stress when possible.

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Source: medicalnewstoday

31 Jul

Medical News Today: Cognitive decline could be reduced with a Mediterranean-style diet

an older woman eating a salad
Researchers say that greater adherence to a Mediterranean-style diet in later life may help to reduce cognitive decline.
A wealth of studies have suggested that a healthful diet may help to protect the brain against the effects of aging. New research adds fuel to the fire, after finding that following a Mediterranean-style diet in later life could help to stave off cognitive decline.

Researchers found that older adults who had diets similar to the Mediterranean diet or the Mediterranean-DASH diet Intervention for Neurodegeneration Delay (MIND) – which is a diet that incorporates features of the Mediterranean diet – scored significantly better on cognitive tests than those who followed less healthful diets.

Study co-author Dr. Kristine Yaffe, of the University of California, San Francisco, and colleagues recently reported their findings in the Journal of the American Geriatrics Society.

Low in junk foods and dairy products and high in fruits, vegetables, whole grains, and olive oil, the Mediterranean diet is considered one of the most healthful diets to follow.

Not only have studies linked the Mediterranean diet to better heart health and reduced cancer risk, but research has also shown the diet to have cognitive benefits.

Another diet associated with better cognitive function is the appropriately named MIND diet. This eating plan consists of 10 foods that are considered beneficial for the brain, many of which are included in the Mediterranean diet, such as vegetables, whole grains, and olive oil.

For the new study, Dr. Yaffe and colleagues set out to gain a better understanding of the link between Mediterranean-style diets and cognitive function, noting that “variation between studies makes it difficult to draw firm conclusions.”


‘Important public health implications’

To reach their findings, the researchers analyzed the data of 5,907 older adults who were a part of the Health and Retirement Study.

All adults completed food frequency questionnaires. The researchers used information from these questionnaires to determine how closely subjects followed a Mediterranean or MIND diet.

Participants also underwent cognitive assessments, which included tests of working memory, episodic memory, and attention.

The team found that adults who had higher adherence to the Mediterranean diet were 35 percent less likely to have poor test scores, compared with adults who followed less healthful diets.

Even older adults with moderate adherence to the Mediterranean diet were 15 percent less likely to have poor test scores, the researchers report.

Similar results were found for subjects with moderate or high adherence to the MIND diet.

Additionally, the study revealed that the incidence of cognitive impairment was lower among older adults with greater adherence to the Mediterranean or MIND diets.

According to Dr. Yaffe and colleagues, these findings indicate that a Mediterranean-style diet could protect against cognitive decline among older adults, which may “have important public health implications for preservation of cognition during aging.”

“Given the limited evidence base and lack of clear dietary recommendations for cognitive health, further prospective population-based studies and clinical trials are required to elucidate the role of dietary patterns in cognitive aging and brain health,” conclude the researchers.

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31 Jul

Medical News Today: Gold injections: Can they treat rheumatoid arthritis?

gold injection
Gold injections are usually injected into the buttocks.
Gold treatments were one of the earliest treatments for rheumatoid arthritis going back at least 75 years.

There is no cure for rheumatoid arthritis (RA). Medications can slow down the disease, while complementary therapies can help people cope with the joint pain and stiffness, chronic fatigue, and other symptoms, such as low-grade fevers and dry skin and eyes.

While gold injections were once praised for their high rates of remission, their use has declined. This is due to potentially severe side effects and the development of stronger and better-tolerated RA medicines.


What are gold injections?

Gold injections are made from a compound called sodium aurothiomalate, which contains gold. Sodium aurothiomalate belongs to a class of drugs called disease-modifying antirheumatic drugs, or DMARDs.

DMARDs are known for their inflammation-blocking qualities. If inflammation in the body is not blocked, it can cause the joints and tissues to wear down to the point of disability in just a few years.

Like other DMARDs, gold injections reduce the immune system’s response. As a result, they should be used with care.

As these medications suppress the immune system to stop inflammation, they also increase the risk of infection. It is therefore important for people to take care to avoid infections, get treated quickly for symptoms of a possible infection, and discuss the use of any live vaccines with their doctors.

Examples of live vaccines include:

  • the nasal spray flu vaccine
  • vaccine injections for varicella (chickenpox)
  • the MMR vaccine (measles, mumps, and rubella)


Treating RA with gold

rheumatoid arthritis hands
Gold injections may decrease the inflammation of rheumatoid arthritis.

Gold injections have long been used to treat RA and other inflammatory joint diseases. They have previously been proven successful for many people with RA.

These injections are not pain relievers, but they decrease pain because they decrease inflammation. They may also help in managing morning joint stiffness and swelling associated with RA.

Gold treatment was once the norm for treating moderate to severe RA. Its use goes back to the 1920s when gold compounds were treatments for tuberculosis.

Researchers once thought that RA and tuberculosis were related. Eventually, that theory was debunked, and the idea that gold could treat RA and provide significant symptom relief was confirmed.

The anti-inflammatory properties of gold compounds are unknown. However, there has been enough evidence to confirm that gold can inhibit behavior of substances responsible for production of antibodies and the release of inflammatory cytokines.

Due to the number and severity of side effects that they cause, gold treatments are now rarely used to treat RA and other inflammatory conditions. Doctors are prescribing other DMARDs instead, including methotrexate, which is considered safer.

Previous research has shown gold injections to be just as effective as methotrexate, according to a historical report of RA treatments in the medical journal, JSM Arthritis. Although rarely prescribed, gold therapy remains the most effective treatment for some people.


How are gold treatments administered?

Gold injections are injected into a muscle, usually the buttock, by a medical professional. Individuals need to lie down during injection and wait at least 10 minutes before sitting up or standing to avoid lightheadedness.

Dosage depends on the person’s medical condition, the severity of symptoms, and their response to treatment. Injections are given once a week until there is improvement. After that, they are given twice a month or less. If RA symptoms return or worsen, then an individual will go back to having the injections weekly.

Gold injection treatment must be used regularly for the best results. It can take up to 3 months before people see significant results. People should inform their doctors if symptoms do not get better or worsen after this time.


Side effects and risks

Just like other DMARDs, gold injections may cause side effects, including:

stressed senior
Side effects of gold injections may include lightheadedness, nausea, and dizziness.
  • dizziness
  • nausea and vomiting
  • flushing and sweating
  • lightheadedness
  • increased joint pain at the start of treatment
  • kidney disease

People should inform their doctors of any serious side effects, including any of the following:

  • eye pain
  • mood or mental state changes, such as confusion or hallucinations
  • fainting
  • difficulty breathing
  • stomach pain
  • skin rash or another allergic reaction
  • lower leg edema


Current RA treatments

The drug methotrexate has been used since the 1940s as a cancer treatment. Following a 1985 report in the New England Journal of Medicine, doctors began using it to treat RA.

This research showed that methotrexate was effective for treating RA symptoms, including pain and swelling. It was not long before it replaced gold as the standard treatment for RA and inflammatory arthritis.

Methotrexate may be one of the safest RA drugs, but it can still cause side effects. These include raised levels of liver enzymes, which may cause long-term liver problems, oral ulcers, and gut symptoms. Taking folic acid on a daily basis can help reduce these side effects, however.

Some people, especially pregnant women, should not take methotrexate. People should always discuss use of the drug with a doctor to weigh up the risks and benefits.

If methotrexate does not provide adequate symptom relief on its own, doctors may prescribe it in combination with other medications. Options include other DMARDs, such as sulfasalazine doxycycline and hydroxychloroquine.

For people who do not respond to DMARDs, either alone or in combination with other medications, doctors may consider biologic drugs. Biologics hinder over-reactive immune system responses, which are the main culprits for heightened inflammatory responses.

Biologics include TNF inhibitors, such as adalimumab, that block TNF, a protein that encourages inflammation.


The future of gold treatment

Even though the use of gold compounds to treat RA has declined due to the introduction of newer DMARDs and biologic therapies, some researchers are looking to reintroduce it.

Researchers who have studied the anti-inflammatory qualities of metallic gold have reported in the Journal of Inflammation about the unique effect that gold compounds have on inflammation. Their research could potentially lead to new therapies involving the use of metallic gold implants to treat RA and other inflammatory diseases.

Reviewing the use of old therapies is not a new concept. Newer studies on gold compounds are looking at more cost-effective ways to better manage the inflammatory process with acceptable side effects.

Researchers also want to take advantage of gold treatments for their antibacterial and antiviral properties. Moreover, the future use of gold therapy in treating cancer may be promising.

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Source: medicalnewstoday

31 Jul

Medical News Today: Water intoxication – when you drink too much water

Eight bottles of water

All the cells and organs in your body need water to function properly.

Because of this, you need to constantly replace water lost through sweat, urine and breath.

Not drinking enough water can cause symptoms such as fatigue, dizziness and muscle cramps.

Conversely, drinking way too much water can also cause a serious condition called water intoxication.

What is water intoxication?

Also known as water poisoning, water intoxication is the disruption of brain function due to drinking too much water (1).

Drinking a lot of water increases the amount of water in your blood.

This water can dilute the electrolytes in your blood, especially sodium. When sodium levels fall below 135 mmol/L, it is called hyponatremia.

Sodium helps balance fluids between the inside and outside of cells.

When sodium levels drop due to excess water consumption, fluids shifts from the outside to the inside of cells, causing them to swell (2).

When this happens to brain cells, it can produce dangerous and potentially life-threatening effects.

Bottom line: Water intoxication results from drinking too much water. The excess water dilutes blood sodium levels and causes fluids to move inside cells, which then swell.


Drinking too much water can be dangerous

Water intoxication results from the swelling of cells.

When brain cells swell, pressure inside the skull increases. This pressure causes the first symptoms of water intoxication, which include:

Five bottles of water

Severe cases can produce more serious symptoms, such as:

  • Increased blood pressure.
  • Confusion.
  • Double vision.
  • Drowsiness.
  • Difficulty breathing.
  • Muscle weakness and cramping.
  • Inability to identify sensory information.

Excess fluid accumulation in the brain is called cerebral edema, which can affect the brain stem and cause central nervous system dysfunction.

In severe cases, water intoxication can cause seizures, brain damage, coma and even death (1).

Bottom line: Drinking too much water increases pressure inside the skull. This can cause various symptoms and even be fatal in severe cases.

Water intoxication has caused death

It’s very difficult to consume too much water by accident, yet there have been reported cases of deaths due to this condition.

Many water intoxication cases have been reported in soldiers (3, 4).

One report concerned 17 soldiers who developed hyponatremia as a result of excess water intake. Their blood sodium levels ranged from 115 to 130 mmol/L, but the normal range is 135-145 mmol/L (4).

Another report described how three soldiers died due to hyponatremia and cerebral edema. These deaths were associated with drinking 2.5-5.6 gallons (10-20 liters) of water in just a few hours (5).

The symptoms of hyponatremia can be misinterpreted as those of dehydration. One soldier, who was misdiagnosed as suffering from dehydration and heat stroke, died from water intoxication as the result of repeated oral hydration (3).

Water intoxication also occurs during sports, especially endurance sports. Over-hydration is common in these activities as a means to avoid dehydration.

For this reason, hyponatremia often occurs during major sporting events (6, 7).

At the 2002 Boston Marathon, 13% of participants had hyponatremia symptoms. 0.06% showed critical hyponatremia, with sodium levels less than 120 mmol/L (8).

Unfortunately, some instances of water intoxication at these sports events have resulted in deaths.

One case involved a runner after a marathon. Tests revealed that his sodium levels were less than 130 mmol/L. He developed hydrocephalus and brain stem herniation, which caused his death (9).

Excessive water drinking can also occur in psychiatric patients, especially schizophrenics (10, 11, 12).

One study of 27 schizophrenics that had died young showed that five of them died due to self-induced water intoxication (13).

Bottom line: Water intoxication is most common among soldiers, endurance sports athletes and schizophrenia patients. Several hyponatremia cases and deaths have been reported in these populations.


How much water is too much?

Over-hydration and water intoxication happens when you drink more water than your kidneys can get rid of via urine.

Water pouring into a glass

But the amount of water isn’t the only factor. How long you take to drink the water also counts.

You have a greater risk of developing water intoxication if you drink a lot of water in a short period of time. The risk is less if you drink the same amount over a much longer period of time.

Symptoms of hyponatremia can occur from as little as 0.8-1 gallons (3-4 liters) of water in a short amount of time (14).

Your kidneys can eliminate about 5.3-7.4 gallons (20-28 liters) of water a day, but they can’t get rid of more than 27-33 ounces (0.8-1.0 liters) per hour (14, 15).

Therefore, in order to avoid hyponatremia symptoms, you should not drink more than 27-33 ounces (0.8-1.0 liters) of water per hour, on average (14).

Many reported cases of water intoxication result from drinking large amounts of water in a short period of time.

For example, one report describes soldiers who developed symptoms after consuming half a gallon of water (1.8 liters or more) per hour (4).

Another report shows the development of hyponatremia with water intake of 2.5-5.6 gallons, or 10-20 liters, in just a few hours (5).

A case of water intoxication and prolonged hyponatremia also occurred in a healthy, 22-year-old male prisoner after he drank 1.5 gallons (6 liters) of water in 3 hours (1).

Finally, a 9-year old girl who drank almost a gallon (a total of 3.6 liters) of water in 1-2 hours developed water intoxication (14).

Bottom line: The kidneys are capable of excreting up to 7 gallons (28 liters) of fluid per day. However, they cannot excrete more than 1 liter per hour. Therefore, drinking more than this is not a good idea.


How much water do you actually need?

There is no specific number for how much water you actually need to drink a day. It differs for each individual.

To determine how much you need, consider your body weight, physical activity level and climate.

The Institute of Medicine (IOM) suggests the adequate water intake per day for men is 125 ounces (3.7 liters), while for women it is 91 ounces (2.7 liters).

However, these recommendations include water from beverages and foods (16).

Some people still follow the 8 x 8 rule, which recommends drinking eight 8-ounce glasses of water per day. However, this rule is mostly arbitrary and not based on research (17, 18).

A good rule of thumb is to listen to your body and drink when you feel thirsty. This should be enough to maintain good hydration levels.

However, relying on thirst alone may not work for everyone. Athletes, older adults and pregnant women may need to drink some extra water each day.

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Source: medicalnewstoday

30 Jul

Medical News Today: Swank diet: Does it help with multiple sclerosis?

Swank diet.
The Swank diet intends to ease the symptoms of MS through nutritional management.
The Swank diet developed in the 1950s as a treatment for people with multiple sclerosis. Proponents of the diet claim it can reduce the frequency of flares and lessen the severity of symptoms related to the disease.

In this article, we look at the history of the Swank diet, what it consists of, and the impact that diet might have on multiple sclerosis (MS).


History of the Swank diet

Sandwhich.
The Swank diet focuses on limiting the amount of fat consumed, and focusing on wholegrain, vegetables,
and lean meats.

Dr. Roy Swank began studying people with MS in Canada in the 1940s. He then traveled to Europe for further research and conducted a survey in Norway.

Based on the study results, he found that the prevalence of MS was higher in the mountains and lower in coastal fishing towns.

Dr. Swank then examined dietary differences between people living in the mountains and along the coast. He found that the people in the mountains consumed more meat, eggs, and dairy than those living near the coast, who, in turn, ate more fish.

Based on these findings, Dr. Swank worked with Aagot Grimsgard, a dietitian, to develop the low-fat diet now known as the Swank diet.

A main feature of the Swank diet is that it limits fat, especially saturated fat. People who follow the diet are encouraged to consume lean fish, non-fat dairy products, fruits, vegetables, and whole grains. Dr. Swank published a book on the diet in 1987.


What does the Swank diet consist of?

The main points of the Swank diet are described below:

Fats

  • no more than 15 grams (g) of saturated fat per day
  • no less than 20 g of unsaturated fat per day
  • no more than 50 g of total fat per day

Plant oils, such as olive oil, canola oil, soybean oil, peanut oil, and flax oil are allowed on the Swank diet because they contain mostly unsaturated fat.

Coconut and palm oils are not recommended due to their high saturated fat content. Similarly, butter, lard, margarine, shortening, and hydrogenated oils are not allowed due to their high saturated or trans fat content.

Nuts, nut butter, and seeds are recommended as snacks, but they must be counted in the daily fat total.

Fruits and vegetables

All fruits and vegetables are allowed on the Swank diet, and the amounts are not restricted. People following the diet are encouraged to consume at least 2 servings each of fruits and vegetables per day.

Fruits that naturally contain fat, such as avocados and olives, must be counted towards the daily fat total.

Meats and poultry

Red meat and pork are banned during the first year of a person following the Swank diet. After that, they may eat 3 ounces of red meat once per week.

Skinless white chicken and turkey meat are allowed on the Swank diet. Dark meat poultry and processed poultry products are not recommended.

Fish

White fish and shellfish are allowed on the Swank diet. Portion sizes are not limited, except for shellfish in people with high cholesterol.

Fatty fish, such as salmon and tuna, must be included in the daily fat total.

Dairy and eggs

The Swank diet recommends 2 servings per day of non-fat or low-fat dairy products.

Servings of some dairy products, such as non-fat milk, non-fat cottage cheese, and fat-free cheese, are not restricted.

Due to the saturated fat content of egg yolks, Swank diet followers are limited to one whole egg no more than three times per week.

Grain products

The Swank diet recommends people consume 4 servings of grain products per day. Breads, low-fat cereals, rice, pasta, and certain crackers are allowed. Wholegrain products are favored.

Baked goods that contain a fat source that should be avoided, such as butter or lard, are not recommended.

Caffeine and alcohol

Caffeinated beverages are limited to 3 cups per day while on the Swank diet. It also allows 1 serving per day of wine or liquor.

Supplements

Specific vitamin and mineral supplements are recommended for those following the Swank diet. The suggested supplements include cod liver oil, a multivitamin with minerals, vitamin C, and vitamin E.


Evidence for use in managing MS

Dr. Swank published multiple articles advocating the benefits of a low-fat diet for people with MS. He followed some of those from his original diet study for many years.

In 1990, he published a 34-year follow-up study on 144 people with MS. He reported that those who ate less than 20 g of saturated fat per day had less disease progression and were less likely to die than those who ate more saturated fat.

It is important to note that Dr. Swank’s research is criticized for not having a control group to make comparisons with, and for lacking strict inclusion criteria. His study also had a high drop-out rate.

To expand on Dr. Swank’s work, a study published in 2016 looked at how people with MS were affected by following the McDougall Program for 1 year. The McDougall Program is very low-fat, similarly to the Swank diet, but it also excludes meat, fish, eggs, dairy, and vegetable oils.

Study participants in the diet group did not see improvements in their brain scans or fewer symptom flares than those in the control group. They did, however, report improved energy levels, and they had positive changes in their BMIs.

Interestingly, cholesterol and insulin levels were lower in the diet group after 6 months, but not when the study ended.


Swank diet concerns

The Swank diet is very restrictive and may be difficult for many people to follow over a long period.

One study found that people who adhered to the Swank diet did not get enough of the vitamins C, A, E, or folate.

People on a very low-fat diet, such as the Swank diet, may also experience drier skin and hair and have lower energy levels than other people.


Can a specific diet or foods help with MS?

Paleolithic foods.
Currently, research is ongoing into what kinds of diets provide the most benefits for people with MS.

Nutrition is a form of complementary and alternative medicine commonly used by people with MS. A small survey completed in 2014 found that almost 30 percent of people with MS followed a special diet, as part of their treatment.

Currently, according to the National Multiple Sclerosis Society, there is not enough evidence to recommend one diet as best for people with MS.

Terry Wahls, a doctor, author, published researcher and a clinical professor of medicine with progressive MS herself, has developed the Wahls protocol. This emphasizes a Paleolithic style diet and excludes grains and gluten.

Research is expanding on a Paleolithic diet approach, but a 2017 study shows its promise as part of a complementary approach to MS management.

A 2009 study revealed that people who had MS had elevated levels of gluten antibodies compared to controls and recommended consideration of a gluten-free diet.

A 2012 meta-review also found a genetic correlation between celiac disease and other autoimmune disorders and MS.

Despite the conflicting opinions about the role of grains and gluten, people with MS are encouraged to consume a healthful diet. Such a diet limits added sugar and processed foods and emphasizes fruits, vegetables, lean proteins, and healthful fats.

How might specialized nutrition help with symptoms?

Certain nutrients have been studied to see if they might help with MS symptoms.

MS and salt

The effect of dietary salt intake on MS has been studied in animals and humans.

In mice, dietary salt has been linked to increased inflammation of the nervous system and decreased immune system function. In people with MS, higher dietary salt intake has been linked to more brain scarring and more frequent symptom flares.

Further studies are needed before salt intake can definitively be linked to MS symptom severity.

MS and fish oil

Some researchers believe that fish oil can help treat MS. However, a 2012 study found no difference in multiple outcome measures between people with MS who took fish oil and those given a placebo.

A 2016 study found omega-3s originating from fish reduced MS diagnosis risk over a 12-month period. Other research suggests omega-3s may be more protective for men than women.

MS and vitamin D

A small study showed that vitamin D might cut the occurrence of MS attacks. Study participants who took a vitamin D supplement also had fewer nervous system scars visible on imaging.

Other, more extensive research published in 2017 revealed that high-dose vitamin D reduced a specific antibody level in relapsing-remitting MS.

Dietary dos and don’ts for multiple sclerosis

Some researchers report that high cholesterol, high blood pressure, heart disease, diabetes, and obesity may increase the rate of MS progression and severity. Therefore, it may be important for people with MS to follow an eating plan that helps them maintain a healthy weight.

Eating balanced meals regularly throughout the day can help people with MS keep their energy levels up. Keeping healthful food on hand that is also easy to prepare can be important, for those battling fatigue.

People with MS may experience bladder problems, but staying hydrated is important. Adequate fluid and fiber can help manage constipation, while foods to fight inflammation are also key.

One area of intense study involves gut bacteria, the gut-brain axis, and autoimmune and neurological diseases, such as MS. The bacterium Clostridium perfringens was found to be elevated in those with MS, while an imbalance of the Bacillus species and others were observed in a 2017 review.


Outlook

Nutrition continues to be a hot topic in the research on MS treatment. Many specialist diets continue to be studied for their potential benefits.

People with MS looking to optimize their nutrition should seek the advice of a registered dietitian. A specialist of this kind can look at someone’s medical history and lifestyle to help them find the best plan, strategy, or goals to use.

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Source: medicalnewstoday

30 Jul

Medical News Today: Superior vena cava syndrome: Symptoms, treatment, and outlook

heart diagram
The superior vena cava is a large vein of the heart.
The superior vena cava is the vein that carries used blood from the upper body to the heart for reoxygenation.

Superior vena cava syndrome is often a secondary problem caused by a cancerous tumor or a blood clot that restricts blood flow through this particular vein.

It used to be considered a medical emergency. However, doctors no longer believe this to be the case.

Even so, those experiencing symptoms of superior vena cava syndrome should be evaluated promptly by a doctor.


What is superior vena cava syndrome?

The superior vena cava is the larger of the two veins that transport deoxygenated blood back to the heart.

The superior vena cava carries used blood from the head and upper body to the right atrium (upper chamber) of the heart. This vein is in the middle of the chest and is surrounded by lymph nodes.

Superior vena cava syndrome is the name given to the symptoms that occur when the blood flow through the superior vena cava is blocked or compressed.

These symptoms include breathing problems, lightheadedness, and swelling in the upper body.


Causes

Superior vena cava syndrome most often occurs as a complication of another medical issue, such a tumor or a swollen lymph node obstructing the flow of blood through the vein.

Common causes of superior vena cava syndrome include:

Less common causes of superior vena cava syndrome include:

  • metastatic breast cancer
  • colon cancer
  • esophageal cancer
  • thyroid cancer
  • Hodgkin lymphoma
  • blood clots from an intravenous catheter or pacemaker
  • severe chest infections, such as tuberculosis
  • some immune system diseases, such as Behcet’s disease


Symptoms

man coughing
Symptoms of superior vena cava syndrome may include hoarseness, chest pain, and coughing.

If the obstruction causing superior vena cava syndrome is not causing a total blockage, a person may not experience any symptoms.

More often, a person with a partial blockage will experience mild symptoms that they may overlook.

If the blockage is complete or worsens quickly, a person is likely to experience more extreme symptoms.

Symptoms may include a combination of the following:

  • coughing
  • difficulty breathing or swallowing
  • hoarseness
  • chest pain
  • coughing up blood
  • swollen veins in the neck or chest
  • arm swelling
  • facial swelling
  • stridor or wheezing
  • nausea
  • lightheadedness
  • red skin on the chest or neck

Superior vena cava syndrome in children

Although rare, superior vena cava syndrome in children is always a medical emergency.

A child’s windpipe is smaller and less rigid than an adult’s, making it more prone to swelling quickly and causing breathing problems. Symptoms are often similar to those in adults and tend to be due to lymphoma (cancer of the lymphatic system).

Symptoms in pregnancy

Pregnant women in their late second and third trimester may experience a condition similar to superior vena cava syndrome. Symptoms occur when the inferior vena cava (the smaller of the two veins that transport deoxygenated blood back to the heart) gets compressed by pressure from the fetus and the enlarged uterus.

A pregnant woman may experience lightheadedness and low blood pressure when lying directly on her back. Lying on the left side often resolves these symptoms.


Diagnosis

If a doctor suspects a person has superior vena cava syndrome, they will first do a physical exam. The exam may show enlarged veins in the upper body.

If the physical exam suggests superior vena cava syndrome, a doctor will likely order several additional tests, including:

two surgeons looking at a lung x ray
Additional tests, such as a chest X-ray, may be ordered by a doctor.
  • a chest X-ray to check for tumors in the lungs or an enlargement in the chest
  • a CT scan to show blockages
  • venography, which is an X-ray of the veins after an injection of a special dye that makes the veins visible
  • an ultrasound to look for blood clots in the upper extremities

If a tumor is found to be responsible for the blockage, a doctor may order a biopsy to determine what type of tumor is causing the problem. Knowing whether the tumor is cancerous or benign is essential for receiving proper treatment.


Treatment

In most cases of superior vena cava syndrome, treatment aims to reduce symptoms and shrink any tumor causing the obstruction. In mild cases, watchful waiting may be the only treatment recommended.

Many people with superior vena cava syndrome see vast improvements in their symptoms by keeping their head elevated and using supplemental oxygen. Some doctors may also try to reduce swelling with prescribed steroids.

Most treatment of superior vena cava syndrome focuses on addressing the underlying cause of the syndrome.

Since the majority of cases occur due to cancer, appropriate treatment is key. Treatment will depend on the type of cancer involved and may include a combination of chemotherapy and radiation.

In cases where superior vena cava syndrome is caused by a blood clot, blood thinners may be prescribed. A stent may also be used to open up the vein. In rare cases, bypass surgery may be performed.


Outlook

In most cases, symptoms of superior vena cava syndrome are greatly improved within 1 month of treatment. However, because cancer causes the majority of cases, the general outlook depends heavily on the type and stage of cancer present.

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Source: medicalnewstoday