Depression Ups Heart Failure Death Risk

Depression significantly increases the risk of major health problems and even death in elderly people with chronic heart failure.

"This trial demonstrates the critical importance of mental health monitoring for successful management of heart failure in this population," study co-author Dr. Aldo Maggioni, of the ANMCO Research Center in Florence, said in a prepared statement.

His team studied almost 19,000 patients over the age of 60 with heart failure. Of these, more than 2,400 were receiving drug treatment for depression before their diagnosis of heart failure. The patients being treated for depression tended to be older, female, and more likely to have a history of peripheral vascular disease and stroke than those without depression.

The heart failure patients with depression were much more likely to die or suffer problems such as stroke, transient ischemic attack (TIA), or mild stroke), heart attack, and to require re-hospitalization, the researchers reported.

"Effective methods to monitor and treat depression in nursing homes should be implemented to improve the quality of life for patients with heart failure," Maggioni said.

Source:www.medical-health-care-information.com

Diet & Nutrition Tips

The intention behind this article is to coerce you into sparing more than a passing thought about your Diet and Nutrition. Is the thought of changing your diet or spending money on real food overwhelming? How much mass have you gained in the last few months? When's the last time you ate fruit or vegetables? How much water are you consuming on a daily basis? If the answers to these questions don’t paint a pretty picture about your fitness, then it is a sure sign that you’ve been lulled into apathy by the so-called conveniences of junk food, fast food and processed food.

Naturally, this brings us to discuss diet and nutrition, though there's really nothing new under the sun when it comes to this topic. Since, having a healthy diet is sometimes easier said than done. It is tempting to eat less healthy foods because they might be easier to get or prepare, or they satisfy a craving. Between family and work or school, you are probably balancing a hundred things at once. Taking time to buy the ingredients for and cooking a healthy meal sometimes falls last on your list. Perhaps, what is important or what we lack, is directing our energies towards implementation. A little learning and planning can help in attaining a healthy diet and you might even relish it!

So let’s vow to make the following diet with nutritious value to boot a part of our daily meals!
Fruits: Eat a variety of fruits – whether fresh, frozen, canned or dried – rather than fruit juice for most of your fruit choices. For a 2,000 calorie diet, you will need 2 cups of fruit each day (for example, 1 small banana, 1 large orange, and some dried apricots or peaches).

Vegetable: Eat more dark green veggies, such as broccoli, and other dark leafy greens; orange veggies, such as carrots, sweetpotatoes, pumpkin, peas (split and lentils) and beans such as pinto beans, kidney beans, black beans.

Your daily doze of Calcium: 1 glass of milk equivalent amount of yogurt and/or low-fat cheese (1 1/2 ounces of cheese equals one cup of milk) – every day. For kids aged 2 to 8, its 2 cups of milk. If you don't or can't consume milk, choose lactose-free milk products and/or calcium-fortified foods and beverages.

Grains: Eat whole-grain cereals, breads, crackers, or rice, every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. See to it that grains such as wheat, rice, oats, or corn are somehow part of your diet.

Proteins: Vary your protein choices with more fish, beans, peas, nuts and seeds. Go easy on meats and poultry-bake it, broil it, or grill it.

Never knew that nutritious food could be so colourful and delightful? We suggest treat yourself to one, and savor the experience!!

Source: www.medical-health-care-information.com

Insomnia drug can improve brain function

zolpidem, a drug normally used to treat insomnia, temporarily improved brain function in a patient suffering from akinetic mutism, a condition in which the person is alert but cannot speak or move. The patient was able to communicate, walk, and eat without assistance after receiving the drug for a bout of insomnia. The study was published in the March 2007 issue of Annals of Neurology, the official journal of the American Neurological Association.

Led by Christine Brefel-Courbon, M.D., of the University Hospital in Toulouse, France, researchers conducted a study of a 48 year-old woman who developed akinetic mutism due to oxygen deprivation to her brain following an attempted suicide by hanging. The patient was totally dependent, unable to speak or walk, and was using a feeding tube for nourishment, although she was able to understand single words. Two years after the suicide attempt, she was given zolpidem for a bout of insomnia; 20 minutes later, she was able to communicate to her family, eat by herself, and move. These effects lasted for up to three hours. After systematically withdrawing all of her medications one by one, it was concluded that the positive effect was due to zolpidem. "This phenomenon was so reproducible that caregivers used to give her up to three tablets each day without sleepiness as 'side effect,'" the authors state.

The researchers systematically assessed the effect of zolpidem on motor and cognitive function and explored its effect on brain activity using positron emission tomography (PET) scans. They administered motor tests such as finger tapping and walking, and language tests such as spontaneous speech, word repetition, and object naming. They also conducted brain imaging studies to assess brain metabolism and cognitive activation using PET scans. All of these were conducted with both zolpidem and a placebo in a randomized, double-blind study.

The results showed that after receiving zolpidem, the patient was able to stand up and walk, repeat words and sentences, read words, and name objects, although she was not able to speak spontaneously. Administration of the drug increased brain metabolism, and PET scans also showed improvement in cerebral areas involved in motivational processing.

Although previous studies have shown the positive effect of zolpidem on catatonic conditions, the authors state, "To our knowledge, this is the first study assessing the impact of zolpidem of post-anoxic brain injury using the modern methodological standards of clinical pharmacology." The authors demonstrated increased brain activity in the frontal cortex, which is associated with higher cognitive performances, with zolpidem. They suggest that the mechanism may be due to an activation of neural circuits in the brain that control movement and verbal expression, but that the lesions that occurred due to oxygen deprivation may have been too severe to allow spontaneous speech. They conclude that single patient trials can be a logical approach to identifying potentially beneficial drugs, especially in the case of rare or orphan diseases.

Source: www.epsdrugstore.com

Women benefit less from clot-busting stroke drug

Women who suffer strokes are much less likely than men to benefit from treatment with the powerful clot-dissolving drug known as tissue plasminogen activator (tPA), new research suggests.

The biggest such study yet conducted found that while more women survived their stroke after receiving tPA, male patients were more than three times as likely to retain good physical function as measured by a test three months after tPA treatment.

"The most intriguing possibility is that there might be an intrinsic biological difference in the way in which women respond to tPA vs. how men respond to tPA," said Dr. Gary Abrams, an associate professor of neurology at the University of California, San Francisco, and a spokesman for the American Academy of Neurology.

Abrams was not involved in the study, which is published in the March 13 issue of Neurology.
Federal rules mandate that tPA can be used only if treatment starts in the first three hours after a stroke. The drug helps limit brain damage by dissolving clots that block blood flow through arteries.

The trial included almost 1,400 stroke patients, 333 of whom (24 percent) were treated with tPA within three hours.

The study found that 47.5 percent of men getting tPA had good function three months later on a standard measure called the Barthel Index, compared to 30.3 percent of women. On another measure, the Rankin Score, 32.2 percent of men and 23.4 percent of women did well.

"In general, women have worse outcomes than men after a stroke," noted lead researcher Dr. Mitchell S. V. Elkind, an associate professor of neurology at Columbia University, in New York City. "There are potential biological reasons why women may not respond as well as men to tPA. Hormonal factors such as the effects of hormones on blood clots may be the reason."

But Elkind added that, "at this point in time, it is premature to treat women differently [than men] after a stroke. We recommend that women as well as men get to a hospital as quickly as possible and be treated as aggressively, including tPA."

There have been indications that postmenopausal women have higher levels than men of a substance that inhibits tPA activity, Abrams said. "A lot more work would have to be done to prove it, but it is an intriguing thought. But there is conflicting evidence and reasons to believe there are caveats in taking this too far."

The results should also be interpreted cautiously, noted Dr. Edgar J. Kenton III, chair of the American Academy of Neurology's practice committee. "This is the only large trial of the response to tPA in women," he said. "We need more trials proving the point one way or another."

"I don't want this study interpreted to say that women should not get tPA," Kenton stressed. "There are small studies suggesting that with ultra-early treatment -- within one hour -- they do better than men. We need more women in more trials to look at these factors."

Kenton also noted the unusually high percentage of patients in the study who received tPA therapy within the three-hour post-stroke limit recommended by experts.

"Twenty-four percent got tPA within three hours," Kenton noted. "The national average is 5 or 6 percent." The measures used in this trial to get tPA delivered to patients early can and should be applied to everyday practice, he said.

Source: www.epsdrugstore.com

Statin drugs and risk of advanced prostate cancer

Statins are commonly prescribed agents to lower cholesterol and the associated risks of vascular events. Statins are also known to have proapoptotic and antimetastatic effects in cancer. In fact, some studies inversely associate statin use with breast and colorectal cancers, but others to include epidemiologic ones have not supported this observation. Dr. Platz and colleagues evaluated over 30,000 men in a longitudinal health study with regard to statin use and risk of prostate cancer (CaP) and reported their findings in the December 20, 2006 issue of the Journal of the National Cancer Institute.

Study participants were enrolled in the Health Professionals Follow-up Study, an ongoing prospective cohort study of diet and other risk factors for heart disease, cancer and other conditions. It began in 1986 and questionnaires were completed biennially with an overall questionnaire response rate of 94%. Data regarding statin use began in 1990 and was thus the time of initiating study analysis. Medical records were obtained for men diagnosed with CaP. Stage T1a disease was excluded and participants were categorized as organ confined or advanced; regionally invasive, metastatic or fatal. Disease was also categorized as lower grade or higher grade. While 91% of all cholesterol drugs taken were statins, data on brand, type or dose was not acquired.

Between 1990 and 1994, 4.4% and 9.3%, respectively, of the men in the study reported using statins. This increased to 24% by the year 2000. Current use of statins was not associated with either total CaP or organ-confined disease after age adjustment or multivariable adjustment. Compared with nonuse of statins, current use was inversely associated with risk of advanced disease after adjusting for age and other CaP risk factors. The age-standardized incidence rate of advanced CaP for current statin users and nonusers was 38 and 89 per 100,000 person-years, respectively. This inverse association was even stronger for risk of metastatic and fatal CaP. Current use of statins was not associated with risk of either higher grade disease or lower grade disease. However, among ever-users of statins for 5 or more years, the relative risk of higher grade disease was lower than the relative risk of lower grade disease.

This epidemiologic study reports that men who currently used statin drugs had half the risk of advanced CaP and less than half the risk of metastatic or fatal CaP compared to men who did not currently use statins. The authors state that despite their data, it is premature to advocate the use of statins for chemoprevention of advanced CaP.

Source: www.epsdrugstore.com

FDA strengthens information on anemia drug safety

Earlier today the US Food and Drug Administration (FDA) issued new safety information and labelling for three drugs used to treat anemia.

The drugs affected, known as erythropoiesis-stimulating agents or ESAs, are darbepoetin alfa (brand name Aranesp) and two epoetin alfa brands (Epogen and Procrit). All three brands are made by Amgen Inc of Thousand Oaks, California. Procrit is also marketed and distributed by Ortho Biotech LP, a subsidiary of Johnson & Johnson.

ESAs are genetically engineered versions of the human protein erythropoietin that increases red blood cells (hemoglobin) and is made in the kidneys.

The new product labelling covers updated warnings, boxed warnings and changes to dosing instructions.Doctors and patients are urged to weigh the risks of taking ESAs versus the risk of transfusion. The boxed warning advises doctors to keep an eye on red blood cell count and to adjust the ESA dose so the patient takes the minimum amount needed to avoid a blood transfusion.

Director of the FDA's Center for Drug Evaluation and Research, Dr Steven Galson, said that the FDA "is in the process of re-evaluating the safety of Aranesp, Epogen, and Procrit on the basis of the results of recent clinical studies."These studies showed that patients with chronic kidney failure who take higher than the recommended dose of ESAs carry an increase risk of death, strokes, heart attacks and blood clots.

Also, patients with cancer who were not receiving chemotherapy and took recommended doses of ESAs carried an increase risk of death, while patients who took ESAs at the recommended dose after orthopedic surgery carried an increased risk of blood clots.

Dr Galson added that the new information reflects the findings of these studies and applies to all ESAs which have the same method of increasing hemoglobin. He also announced there would be another meeting in May when the Oncologic Drugs Advisory Committee (ODAC) will look at the evidence and they may suggest further changes to the labels.

The safety labelling for these drugs has been revised three times since 1997 to reflect new safety concerns.All three drugs are approved by the FDA to treat patients whose anemia is caused by chronic kidney failure or chemotherapy treatment for cancer.

In addition, Epogen and Procrit are approved for patients who are about to have major surgery to minimise need for blood transfusions and for HIV patients who have anemia due to zidovudine therapy.

However, no ESAs have been approved to treat the symptoms of anemia, including fatigue, in cancer, surgical and HIV patients.

Anemia, the most common blood disorder, is a deficiency in red blood cells or the oxygen-carrying hemoglobin within them. Reduced ability of the blood to transport essential oxygen to cells is called hypoxia which has varying degrees of severity.

Anemia is usually caused by one of three things: excessive loss of blood, excessive destruction of blood cells, or deficiency in red blood cell production. Iron deficiency is another way that menstruating women can get anemia since it reduces production of red blood cells.

Source: www.epsdrugstore.com

What is Anxiety

Anxiety is the response of the body during fear. Anxiety is a disorder results from the fear response becoming out of proportion to the actual risk. Anxiety disorders involve excessive levels of negative emotions, such as fear, worry, nervousness, and tension, and the anxious feelings occur involuntarily despite your best attempts to avoid them or stave them off.

The body responds to anxiety stimulus both physically and mentally. Anxiety can lead to over-stimulation of the sympathetic nervous system. It manifests by the physical symptoms such as a racing heartbeat, sweating and trembling, and psychological symptoms such as restlessness, insomnia and difficulty in concentrating.Anxiety is often seen as a triggering of the fight-or-flight reaction, causing excess adrenaline to be produced by the adrenal glands, which in turn produce other hormones (catecholamines) that affect various parts of the body, such as heartbeat and respiration.

Causes of Anxiety Disorder:-
The cause of anxiety disorder has been studied for decades. There are various reasons for feeling the way that you do. Modern studies indicate that as a result of past, present or perceived circumstances that occurred to an individual, a chemical imbalance may have occurred in the brain. The emotions we feel are based on the release and reuptake of neurotransmitters in the brain. This is how cells within the brain communicate. Feelings off anxiety are triggered by an imbalance of specific 'neurochemicals' in the brain.

What is the cause of the chemical imbalance?
Some theories suggest that chemical imbalances are a normal part of life. Everyone feels stressed or anxious at times, even depressed. This is a normal response by our body to events occurring around us. It is important to note that the physical or mental feelings we experience and exhibit are being caused by the release of chemicals and hormones in our brains. Most modern methods for treating chemical imbalances come in the form of prescription medications. Drugs like Paxil, Prozac and Effexor are believed to have a direct effect on key neurotransmitters.

Types of Anxiety Disorders:-
There are many forms of anxiety, below is a list of a few different types. You may want to note which ones you are experiencing before you see a doctor to aid in diagnosing which type of anxiety you may have.
Panic Disorder
Obsessive Compulsive Disorder
Post Traumatic Stress Disorder
Social Anxiety Disorder
Specific Phobias
Generalized Anxiety Disorder
Symptoms of Generalized Anxiety Disorder :-
Here we provide you a list of anxiety physical symptoms that is a guide only, may be the sufferer experiences slightly different symptoms so it is meant as a guide only. But If you identify with 4 or more of the symptoms on this list, then there are chances that you are suffering from anxiety disorder.
Panic attacks
Dizziness
Breathlessness
Head aches
Chest pains
Stomach problems
Tingling sensations
Weak legs
Disturbing thoughts
Visual disturbances
Tinnitus
Lump in throat
Butterflies in stomach
Palpitations
Heart racing
Nausea
Sore eyes
Shaking or trembling
The symptoms of anxiety can affect you in many ways, but, please rest assured that none of these physical symptoms can harm you in any way whatsoever, they are simply the sensations created by an anxious and tense body.

Source: www.medical-health-care-information.com

FDA warns migraine medicine makers

The government had warned the world's largest maker of generic drugs and 19 other companies that they are illegally selling migraine medicines without federal approval.The Food and Drug Administration said the 20 warning letters were part of an effort to halt the marketing of unapproved and potentially dangerous drugs. The goal is to get the unapproved drugs off the market, agency officials said. The manufacturers could seek agency approval for the products.

The prescription migraine treatments contain a drug called ergotamine tartrate. Ergotamine is derived from a rye fungus called ergot, from which a separate drug, the illegal hallucinogen LSD, also can be synthesized. Ergotamine is a vasoconstricting drug, meaning it narrows the blood vessels when taken.

The letters — dated Monday but not publicly disclosed until Thursday — went to companies that include a U.S. subsidiary of Israel's Teva Pharmaceutical Industries Ltd., the world's largest generics manufacturer. Other recipients included Iceland's Actavis and Sandoz Inc., a pioneer in the marketing of ergotamine tartrate that is now part of Switzerland's Novartis AG. Messages left with all three companies were not immediately returned Thursday.

The FDA said the companies have 60 days to stop making the drugs and 180 days to stop distributing them. Otherwise, the companies are subject to seizure or injunction, the FDA said.

"Because these drugs don't have approval, we don't know how they were formulated or manufactured. We don't know if they are safe or effective," Deborah Autor, director of the office of compliance within the FDA's Center for Drug Evaluation and Research, told reporters.

The FDA said the labels of the drugs failed to warn consumers of dangerous interactions if taken with other medications, including some HIV drugs, antibiotics and anti-fungal agents.There are five ergotamine tartrate drugs on the market that have FDA approval, including one made by Sandoz. The labels of those approved medications carry "black-box" warnings, the most severe the government can require, about the risk of drug interactions.

The FDA stepped up last year its efforts to get drugs without agency approval off the market. Under guidelines issued in June, the FDA said those unapproved drugs most likely to pose a risk to public health would be the highest priority for enforcement action.

Source: www.epsdrugstore.com

Stress and the Developing Brain

It is well known that the early months and years of life are critical for brain development. But the question remains: just how do early influences act on the brain to promote or challenge the developmental process? Research has suggested that many both positive and negative experiences, chronic stressors, and various other environmental factors may affect a young child's developing brain. And now, studies involving animals are revealing in greater detail how this may occur.

One important line of research has focused on brain systems that control stress hormones—cortisol Cortisol and other stress hormones play an important role in emergencies: they help our bodies make energy available to enable effective responses, temporarily suppress the immune response, and sharpen attention. However, a number of studies conducted in people with depression indicate that excess cortisol released over a long time span may have many negative consequences for health.Excess cortisol may cause shrinking of the hippocampus, a brain structure required for the formation of certain types of memory.

In experiments with animals, scientists have shown that a well-defined period of early postnatal development may be an important determinant of the capacity to handle stress throughout life. In one set of studies, rat pups were removed each day from their mothers for a period as brief as 15 minutes and then returned. The natural maternal response of intensively licking and grooming the returned pup was shown to alter the brain chemistry of the pup in a positive way, making the animal less reactive to stressful stimuli. While these pups are able to mount an appropriate stress response in the face of threat, their response does not become excessive or inappropriate. Rat mothers who spontaneously lick and groom their pups with the same intensity even without human handling of the pups also produce pups that have a similarly stable reaction, including an appropriate stress hormone response.

Striking differences were seen in rat pups removed from their mothers for periods of 3 hours a day, a model of neglect compared to pups that were not separated. After 3 hours, the mother rats tended to ignore the pups, at least initially, upon their return. In sharp contrast to those pups that were greeted attentively by their mothers after a short absence, the "neglected" pups were shown to have a more profound and excessive stress response in subsequent tests. This response appeared to last into adulthood.

The implications of these animal studies are worrisome. However, research is in progress to determine the extent to which the hypersensitive or dysregulated stress response of "neglected" rat pups can be reversed if, for example, foster mothers are provided who will groom the pups more intensely, or if the animals are raised in an "enriched" environment following their separation. An enriched setting may include, for example, a diverse and varied diet, a running wheel, mazes, and changes of toys.

Animal investigators are well aware of another kind of long-term change, again rooted in the first days of life. Laboratory rats are often raised in shoebox cages with few sources of stimulation. Scientists have compared these animals to rats raised in an enriched environment and found that the "privileged" rats consistently have a thicker cerebral cortex and denser networks of nerve cells than the "deprived" rats.

Another study recently reported that infant monkeys raised by mothers who experienced unpredictable conditions in obtaining food showed markedly high levels of cortiocotropin releasing factor (CRF) in their cerebrospinal fluid and, as adults, abnormally low levels of cerebrospinal fluid cortisol. This is a pattern often seen in humans with post-traumatic stress disorder and depression. The distressed monkey mothers, uncertain about finding food, behaved inconsistently and sometimes neglectfully toward their offspring. The affected young monkeys were abnormally anxious when confronted with separations or new environments. They were also less social and more subordinate as adult animals.

It is far too early to draw firm conclusions from these animal studies about the extent to which early life experience produces a long-lived or permanent set point for stress responses, or influences the development of the cerebral cortex in humans. However, animal models that show the interactive effect of stress and brain development deserve serious consideration and continued study.

Source: www.medical-health-care-information.com