Dr. Bray Links

Wednesday, November 30, 2016

Need Pricey Drugs From An Obamacare Plan? You’ll Shoulder More Of The Cost

Substantially more health plans on the federal insurance marketplaces require consumers next year to pay a hefty portion of the cost of the most expensive drugs, changes that analysts say are intended to deter persistently ill patients from choosing their policies.

The class of medicines known as specialty drugs often treat chronic illnesses such as multiple sclerosis, rheumatoid arthritis, HIV, hemophilia, some cancers and hepatitis C. Individual doses can be priced at more than $600. Many newer medicines cost $5,000 to $10,000 a month. That means patients with even a small cost-sharing requirement have to come up with thousands of dollars. For many patients there are no cheaper and equally effective alternatives.

In the four years that the healthcare.gov marketplaces have existed, plans requiring consumers to pay roughly a third or more of the cost of specialty drugs have expanded to 63 percent of all offerings from 37 percent, according to a Kaiser Health News analysis.

http://khn.org/news/need-pricey-drugs-from-an-obamacare-plan-youll-shoulder-more-of-the-cost/

Tuesday, November 29, 2016

Protein from Akkermansia muciniphila improves metabolism in obese and diabetic mice

Obesity and type 2 diabetes are associated with low-grade inflammation and specific changes in gut microbiota composition1, 2, 3, 4, 5, 6, 7. We previously demonstrated that administration of Akkermansia muciniphila to mice prevents the development of obesity and associated complications8. However, the underlying mechanisms of this protective effect remain unclear. Moreover, the sensitivity of A. muciniphila to oxygen and the presence of animal-derived compounds in its growth medium currently limit the development of translational approaches for human medicine9. We have addressed these issues here by showing that A. muciniphila retains its efficacy when grown on a synthetic medium compatible with human administration. Unexpectedly, we discovered that pasteurization of A. muciniphila enhanced its capacity to reduce fat mass development, insulin resistance and dyslipidemia in mice. These improvements were notably associated with a modulation of the host urinary metabolomics profile and intestinal energy absorption. We demonstrated that Amuc_1100, a specific protein isolated from the outer membrane of A. muciniphila, interacts with Toll-like receptor 2, is stable at temperatures used for pasteurization, improves the gut barrier and partly recapitulates the beneficial effects of the bacterium. Finally, we showed that administration of live or pasteurized A. muciniphila grown on the synthetic medium is safe in humans. These findings provide support for the use of different preparations of A. muciniphila as therapeutic options to target human obesity and associated disorders.

http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.4236.html

Measurement of intracellular vitamin C levels in human lymphocytes

Vitamin C plays an active role in many important metabolic processes, such as collagen formation and the prevention of bleeding. Although overt scurvy is now rare, there is evidence that subclinical vitamin C deficiency is still quite common. Serum and plasma vitamin C measurements do not correlate well with tissue levels while lymphocyte vitamin C levels provide the most accurate assessment of the true status of vitamin C stores and are not affected acutely by circadian rhythm or dietary changes. We report a specific and reproducible reverse phase high performance liquid chromatographic method (HPLC) for the quantification of vitamin C in lymphocytes.
METHODS:

Reverse phase HPLC with a UV detection system was used. National Committee for Clinical Laboratory Standards (NCCLS) guidelines were followed for evaluation. Sample stability testing for lymphocyte vitamin C was performed for a period of 24 h at room temperature and 4 degrees C. Lymphocyte vitamin C levels were measured in 51 children.
RESULTS:

Lymphocyte vitamin C measurement with HPLC revealed very good analytical sensitivity with a 1.42 microg/10(8) lymphocyte lower limit of detection on repeated testing. An external standard curve was used for quantification, which showed a linear range of 1.25-100 microg/10(8) lymphocyte with a correlation coefficient of 0.989. Precision studies showed an inter-assay repeatability coefficient of variance (CV) between 0.25-9.98% and a within-assay coefficient of variance between 1.2-12.49%. The inter-assay CV for a period of 20 days was less than 10% for concentrations equal to or less than 1.42 microg/10(8) lymphocytes and less than 5.5% for concentrations between 5-100 microg/10(8) lymphocytes. Vitamin C was most stable at 4 degrees C, with a 0.31% decrease after 3 h and 2.35% after 4 h. At room temperature, vitamin C loss was more significant, with losses of 8.44% and 15.6% at 3 and 4 h, respectively, at a concentration of 29.9 microg/10(8) lymphocytes.
CONCLUSIONS:

The proposed HPLC method offers a reliable and reproducible technique for the quantification of intracellular vitamin C. Lymphocyte samples can be rapidly prepared and represent a more homogeneous tissue sample source for intracellular vitamin C measurement as compared to serum. To ensure stability, lymphocyte lysates should be prepared and stored at or below -20 degrees C within 2 h of blood collection.

https://www.ncbi.nlm.nih.gov/pubmed/15820776

Poor diet to blame for return of scurvy, health officials say

The head of the department, Jenny Gunton, told ABC that a patient had a foot ulcer for seven months and she wanted to understand why.

"She was doing the right things, she had normal nerve function, normal blood vessels, but the wound just wouldn't heal, so I looked at things that might stop wounds healing like low vitamin C or low zinc," Gunton said.

The patient's vitamin C level was extremely low at a rate of 10, with 40 being normal, and prevented the wound from healing. Gunton checked other patients and discovered that scurvy was the cause.

Symptoms of the disease include joint pain, swollen gums, fatigue and shortness of breath.

Some of the individuals were eating vegetables, but overcooking them – therefore not receiving the nutritional benefits, according to Gunton.

Gunton's findings were published in the Diabetic Medicine journal.

Foods high in vitamin C include leafy greens, citrus fruits, tomatoes and kiwifruit.

https://www.rt.com/viral/368625-scurvy-comeback-australia-diet/

Trump Taps Seema Verma, Medicaid Expansion Architect, for CMS

President-elect Donald Trump today announced that Seema Verma, MPH, an architect of Medicaid expansion under the Affordable Care Act (ACA) in Indiana, is his choice to head the Centers for Medicare & Medicaid Services (CMS).

As part of Trump's team to repeal and replace the ACA and overhaul Medicaid, Verma is well versed on how to shift healthcare policy decisions from Washington, DC, to state capitals. If confirmed by the Senate, she presumably would answer to Rep. Tom Price, MD (R-Ga), Trump's nominee for secretary of the Department of Health and Human Services (HHS) and a staunch opponent of a large federal footprint in healthcare.

Verma is the founder and president of SVC, a healthcare policy consulting firm in Indianapolis. She's credited with designing the 9-year-old "consumer-directed" Medicaid program called Healthy Indiana Plan (HIP), which gives beneficiaries something similar to a health savings account — it's called a Personal Wellness and Responsibility (POWER) account — to apply toward a $2500 deductible. Verma also helped create HIP 2.0, which expanded Medicaid coverage as part of the ACA using federal dollars.

http://www.medscape.com/viewarticle/872516

Popular Heartburn Medication Linked to Increased Stroke

Proton pump inhibitors (PPIs) — used widely to reduce stomach acid and treat heartburn — have been linked to an increased risk for ischemic stroke in a new study.

The Danish nationwide observational study, presented at the recent American Heart Association's Scientific Sessions 2016, showed a dose-related increased risk for ischemic stroke with all four PPIs investigated, but no increased risk with histamine-2 (H2) blockers, which are used for similar indications.

The researchers, led by Thomas Sehested, MD, Danish Heart Foundation, Copenhagen, Denmark, note that their findings add to a growing body of evidence linking PPIs with cardiovascular disease.

He reported that preclinical studies have shown PPIs reduce the production of nitric oxide leading to endothelial dysfunction, and several observational clinical studies have linked their use to cardiovascular disease. "But to our knowledge, this is the first study to look at the effect of PPI drugs on ischemic stroke."

http://www.medscape.com/viewarticle/872483

Monday, November 28, 2016

Is Exercising Too Much Damaging Your Heart?



Myocardial fibrosis (MF) is a common phenomenon in the late stages of diverse cardiac diseases and is a predictive factor for sudden cardiac death. Myocardial fibrosis detected by magnetic resonance imaging has also been reported in athletes. Regular exercise improves cardiovascular health, but there may be a limit of benefit in the exercise dose-response relationship. Intense exercise training could induce pathologic cardiac remodeling, ultimately leading to MF, but the clinical implications of MF in athletes are unknown. For this comprehensive review, we performed a systematic search of the PubMed and MEDLINE databases up to June 2016. Key Medical Subject Headings terms and keywords pertaining to MF and exercise (training) were included. Articles were included if they represented primary MF data in athletes. We identified 65 athletes with MF from 19 case studies/series and 14 athletic population studies. Myocardial fibrosis in athletes was predominantly identified in the intraventricular septum and where the right ventricle joins the septum. Although the underlying mechanisms are unknown, we summarize the evidence for genetic predisposition, silent myocarditis, pulmonary artery pressure overload, and prolonged exercise-induced repetitive micro-injury as contributors to the development of MF in athletes. We also discuss the clinical implications and potential treatment strategies of MF in athletes.

https://www.ncbi.nlm.nih.gov/pubmed/27720455

Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy



OBJECTIVE:
To study the association between bilateral oophorectomy and the rate of accumulation of multimorbidity.

PATIENTS AND METHODS:
In this historical cohort study, the Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy before age 50 years between January 1, 1988, and December 31, 2007, in Olmsted County, Minnesota. Each woman was randomly matched to a referent woman born in the same year (±1 year) who had not undergone bilateral oophorectomy. We studied the rate of accumulation of 18 common chronic conditions over a median of approximately 14 years of follow-up.

RESULTS:
Although women who underwent bilateral oophorectomy already had a higher multimorbidity burden at the time of oophorectomy, they also experienced an increased risk of subsequent multimorbidity. After adjustments for 18 chronic conditions present at baseline, race/ethnicity, education, body mass index, smoking, age at baseline, and calendar year at baseline, women who underwent oophorectomy before age 46 years experienced an increased risk of depression, hyperlipidemia, cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, and osteoporosis. In addition, they experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio, 1.22; 95% CI, 1.14-1.31; P<.001). Several of these associations were reduced in women who received estrogen therapy.

CONCLUSION:
Bilateral oophorectomy is associated with a higher risk of multimorbidity, even after adjustment for conditions present at baseline and for several possible confounders. However, several of these associations were reduced in women who received estrogen therapy.

https://www.ncbi.nlm.nih.gov/pubmed/27693001

Physical Activity and Cognitive Function in Middle-Aged and Older Adults



OBJECTIVE:
To examine the associations of physical activity (PA) frequency (both moderate and vigorous intensity) and PA levels with cognitive function.

PATIENTS AND METHODS:
Data of individuals 50 years or older, from 20 European countries (along with Israel), were collected from 2004 to November 2013 in the biannual Survey of Health, Ageing and Retirement in Europe. A total of 104,909 participants were assessed for cognitive function at least once (mean follow-up length, 29.5±35.7 months). Baseline moderate- and vigorous-intensity PA were reported by participants as more than once a week, once a week, one to three times a month, or hardly ever or never. With regard to PA frequency, participants were categorized as inactive, low active, intermediate active, or high active. The main outcome measure is a cognitive composite score created by summing the z scores of 4-item temporal orientation, 10-word list for delayed recall, and verbal fluency.

RESULTS:
Adjusted, 2-level mixed-effect regressions found that compared with doing no PA, doing PA more than once a week, once a week, or one to three times a month was positively associated with the composite score (β coefficients varied from 0.52 to 0.75 for moderate-intensity PA and from 0.26 to 0.33 for vigorous-intensity PA). Similarly, compared with the inactive category, high-active, intermediate-active, and low-active categories had positive associations with the composite score (β varied from 0.77 to 1.10). Positive associations were also obtained between PA variables and the raw scores of cognitive tests.

CONCLUSION:
Physical activity has dose-response associations with cognitive function, with even low PA frequencies (few times per month) being positively associated with cognitive function during aging.

https://www.ncbi.nlm.nih.gov/pubmed/27720454

Importance of Diet in Gout



Gout is an inflammatory arthritis caused by deposition of monosodium urate crystals within synovial joints as a result of elevated serum uric acid (SUA) levels.  1  The classic symptoms described are recurrent “attacks” of severe pain, swelling, redness, and warmth in one or a few joints; in some cases it can become chronic and polyarticular. 2

In the United States the estimated prevalence of gout is 8 million individuals, which is an increase of approximately 1.2% over the last 20 years.  3 4 5  When comparing 2 incidence cohorts from 1977-1978 and 1995-1996 in Minnesota, the incidence of primary gout was shown to have increased from 42 to 62.3 per 100,000 ( P = .1) over the 20-year period.  6  Other studies have shown this trend to be worldwide. In New Zealand, where gout is especially common, the prevalence is estimated at 2.69% and rose as high as 25% in elderly men.  7

Because of new pharmacotheraputics targeting hyperuricemia, healthcare providers often start medical therapy sooner and give dietary counseling less emphasis.  8  With this approach comes the inherent risk of drug toxicity, interactions, and polypharmacy in patients who often have multiple comorbidities. However, if the approach to gout treatment included dietary therapy and lifestyle modification, it could lower uric acid levels as well as potentially mitigate the long-term consequences of the metabolic syndrome that often coexist with gout.  9 10

...

Although the current teaching is that health care professionals should concentrate on urate-lowering therapy, diet remains a very important part of gout management. More importantly than improving the arthritis associated with gout, diet gives the practitioner the opportunity to impact patients' risk for morbidity and mortality from consequences of metabolic syndrome.

Strong evidence supports weight loss through diet as a foundation of lifestyle changes needed in gout patients. Liberal intake of plant proteins, nuts, vegetables, legumes, whole grains, lower-sugar fruits, and plant oils is supported, and up to 2 servings daily of low-fat dairy products is recommended ( Figure 2 ). Although fish intake can increase serum urate, there may be greater overall cardiovascular benefit from the addition of moderate amounts of cold water, oily fish such as tuna, salmon, and trout, which are high in omega-3 fatty acids.  9  Eggs and poultry are lower-risk protein sources when used in moderation. One or less serving(s) of red meat or shellfish per week may be recommended. Avoidance of fructose-sweetened food, beer, liquor, and starchy carbohydrates is highly recommended. Wine in moderation is acceptable. Up to 6 cups of coffee daily has been shown beneficial but warn that new initiation of coffee may exacerbate gout flares.  9  Supplementation with vitamin C may be useful, but a dosing range and long-term safety recommendations have not been made. Cherry products may be beneficial, but better data are needed before making this a recommendation to patients. During an acute flare it is recommended to increase water intake to at least 8-16 cups per day and avoid alcohol or meat.




https://www.ncbi.nlm.nih.gov/pubmed/27452679

Saturday, November 26, 2016

Why Dietary Cholesterol Does Not Matter (for most people)

If you have high cholesterol, you can often lower it through simple lifestyle changes.

For example, losing extra weight may help reverse high cholesterol.

Several studies show that a modest weight loss of 5–10% can lower cholesterol and decrease the risk of heart disease in overweight individuals (27, 28, 29, 30, 31).

There are also many foods that can help lower cholesterol. These include avocados, legumes, nuts, soy foods, fruits and vegetables (32, 33, 34, 35).

Adding these foods to your diet can help lower cholesterol and reduce the risk of heart disease.

Being physically active is also important. Studies have shown that exercise has positive effects on cholesterol levels and heart health (36, 37, 38).

https://authoritynutrition.com/dietary-cholesterol-does-not-matter/

4 Reasons Why Some People Do Well as Vegans (While Others Fail)

So, why isn't such a widespread issue causing mass epidemics of vitamin A deficiency? Simple: in the Western world, carotenoids provide less than 30% of people's vitamin A intake, whereas animal foods provide over 70% (8). An omnivorous BCMO1 mutant can generally skate by on vitamin A from animal sources, blissfully unaware of the carotenoid battle waging within.

But for those who eschew animal products, the effects of a dysfunctional BCMO1 gene will be obvious — and eventually detrimental. When poor converters go vegan, they can eat carrots until they're orange in the face (literally!) without actually obtaining enough vitamin A for optimal health. Carotenoid levels simply rise (hypercarotenemia), while vitamin A status nosedives (hypovitaminosis A), leading to deficiency amidst seemingly adequate intake (3).

https://authoritynutrition.com/4-reasons-some-do-well-as-vegans/

Co-infection of Ticks: The Rule Rather Than the Exception.

INTRODUCTION:

Ticks are the most common arthropod vectors of both human and animal diseases in Europe, and the Ixodes ricinus tick species is able to transmit a large number of bacteria, viruses and parasites. Ticks may also be co-infected with several pathogens, with a subsequent high likelihood of co-transmission to humans or animals. However few data exist regarding co-infection prevalences, and these studies only focus on certain well-known pathogens. In addition to pathogens, ticks also carry symbionts that may play important roles in tick biology, and could interfere with pathogen maintenance and transmission. In this study we evaluated the prevalence of 38 pathogens and four symbionts and their co-infection levels as well as possible interactions between pathogens, or between pathogens and symbionts.
METHODOLOGY/PRINCIPAL FINDINGS:

A total of 267 Ixodes ricinus female specimens were collected in the French Ardennes and analyzed by high-throughput real-time PCR for the presence of 37 pathogens (bacteria and parasites), by rRT-PCR to detect the presence of Tick-Borne encephalitis virus (TBEV) and by nested PCR to detect four symbionts. Possible multipartite interactions between pathogens, or between pathogens and symbionts were statistically evaluated. Among the infected ticks, 45% were co-infected, and carried up to five different pathogens. When adding symbiont prevalences, all ticks were infected by at least one microorganism, and up to eight microorganisms were identified in the same tick. When considering possible interactions between pathogens, the results suggested a strong association between Borrelia garinii and B. afzelii, whereas there were no significant interactions between symbionts and pathogens.
CONCLUSION/SIGNIFICANCE:

Our study reveals high pathogen co-infection rates in ticks, raising questions about possible co-transmission of these agents to humans or animals, and their consequences to human and animal health. We also demonstrated high prevalence rates of symbionts co-existing with pathogens, opening new avenues of enquiry regarding their effects on pathogen transmission and vector competence.

https://www.ncbi.nlm.nih.gov/pubmed/26986203

Thursday, November 24, 2016

Quercetin and its Modified Form for Allergies and More | Dr. Michael Murray

Flavonoids are a group of plant pigments largely responsible for the colors of many fruits and flowers. Flavonoids are also responsible for the medicinal actions of foods, juices, herbs and bee pollen and are now known to be directly related to their flavonoid content.

As a class of compounds, flavonoids have been referred to as "nature's biologic response modifiers" because of their ability to modify the body's reaction to other compounds, such as allergens, viruses, and carcinogens, as evidenced by their anti-inflammatory, antiallergic, antiviral, and anticancer properties. In addition, flavonoids act as powerful antioxidants, providing remarkable protection against oxidative and free radical damage.

This brief review will focus on the use of quercetin and its more bioavailable modified form—enzymatically modified isoquercitrin (EMIQ).

http://doctormurray.com/quercetin-and-its-modified-form-for-allergies-and-more/

Tuesday, November 22, 2016

Akkermansia muciniphila mediates negative effects of IFNγ on glucose metabolism : Nature Communications

Cross-talk between the gut microbiota and the host immune system regulates host metabolism, and its dysregulation can cause metabolic disease. Here, we show that the gut microbe Akkermansia muciniphila can mediate negative effects of IFNγ on glucose tolerance. In IFNγ-deficient mice, A. muciniphila is significantly increased and restoration of IFNγ levels reduces A. muciniphila abundance. We further show that IFNγ-knockout mice whose microbiota does not contain A. muciniphila do not show improvement in glucose tolerance and adding back A. muciniphila promoted enhanced glucose tolerance. We go on to identify Irgm1 as an IFNγ-regulated gene in the mouse ileum that controls gut A. muciniphila levels. A. muciniphila is also linked to IFNγ-regulated gene expression in the intestine and glucose parameters in humans, suggesting that this trialogue between IFNγ, A. muciniphila and glucose tolerance might be an evolutionally conserved mechanism regulating metabolic health in mice and humans.

http://www.nature.com/articles/ncomms13329

Flu vaccine increases susceptibility to flu

In an even more unusual finding, people who were vaccinated 3 years in a row—in the 2012-13, 2013-14, and 2014-15 seasons—appeared to have a higher risk of being infected with the dominant flu strain in the latter season, according to the report, published last week in Clinical Infectious Diseases.

That surprising result echoed controversial findings reported by the Canadian flu surveillance network in the wake of the 2009 H1N1 flu pandemic. In studies published in 2010, researchers said they found that Canadians who had received a seasonal flu shot in the fall of 2008 were 1.4 to 2.5 times more likely to get an H1N1 infection requiring medical attention, compared with those who didn't get the seasonal shot.

http://www.cidrap.umn.edu/news-perspective/2016/04/study-prior-year-vaccination-cut-flu-vaccine-effects-2014-15

Spoil sprouts: How little greens can make you sick

Sprouts may sound cute, but the tiny greens have sickened more than 2,500 people and caused 186 hospitalizations and three deaths in the past two decades, a new report finds.

"Sprout contamination continues to pose a serious public health concern," the researchers from the Food and Drug Administration (FDA) wrote in their report. The arm of the FDA that wrote the new report focuses on investigating outbreaks and finding ways to prevent them. The findings on sprouts were presented on Oct. 28 at IDWeek 2016, a meeting in New Orleans of several organizations focused on infectious diseases. The report on sprouts has not been published in a peer-reviewed journal.

From 1996 to August 2016, 48 outbreaks of illness were associated with sprouts, the researchers found.

Alfalfa sprouts were the most common culprit during the study period, with 30 outbreaks. There were seven outbreaks linked to clover sprouts, six outbreaks linked to mung bean sprouts, two outbreaks linked to unspecified sprouts, two outbreaks linked to multiple sprout types and one outbreak linked to a food ingredient called sprouted chia powder, the FDA found.

Sprouts carried a number of different types of bacteria, the researchers found. Salmonella was implicated in the greatest number of outbreaks, at 35, followed by Escherichia coli (11 outbreaks) and Listeria monocytogenes (two outbreaks), according to the report.

Of the three sprout-related deaths during the study period, two were attributed to Salmonella and one to Listeria.

http://www.foxnews.com/health/2016/11/22/spoil-sprouts-how-little-greens-can-make-sick.html

Inflammation an Accurate Biomarker for Bipolar Disorder?

Levels of C-reactive protein (CRP), a known biomarker of inflammation, are elevated across all mood states in patients with bipolar disorder, with higher levels occurring during periods of mania, new research shows.

"In my opinion, CRP shows great promise as a biomarker, helping to define who would benefit most from treatments that target inflammation, which is one of the major goals of precision medicine ― defining who will, and will not, benefit from each treatment," senior author Brisa S. Fernandes, PhD, of the Deakin University School of Medicine, in Geelong, Victoria, Australia, told Medscape Medical News.

The study was published online November 9 in Lancet Psychiatry.

http://www.medscape.com/viewarticle/872258

Monday, November 21, 2016

Sleep Apnea Is A Craniofacial Problem

The entire basis for my sleep-breathing paradigm is that all modern humans have constricted facial structures, not due to a congenital or genetic problem, but due to our eating and lifestyle habits. Genetically, we're all programmed to have relatively wide jaws, with room for all your wisdom teeth. Now, that rarely ever happens. This is why obstructive sleep apnea can be described as a mild craniofacial condition that can significantly affect your upper breathing passageways.

Small Jaws, Small Airway

It seems that almost everyone these days will need braces to fix crooked teeth or narrow dental arches. Dental crowding by definition means that your upper and lower jaws are underdeveloped. This creates less total volume inside your mouth, leading to overcrowding of your tongue. Your tongue can then fall back easier when on your back, and when in deep sleep, due to muscle relaxation, you'll stop breathing more often at night.

Even your nose can be affected by this problem. Since your nasal sidewalls follow your upper molars, the side to side distance in your nose will be more narrow, and as the roof of your mouth (nasal floor) gets pushed up, it'll also cause your septum to buckle.

If you add additional inflammation and swelling in your nose (due to colds, allergies or nonallergic rhinitis), your nose will become stuffier faster, and even worse, your nostrils will cave in easier.

Having underdeveloped upper jaws prevents proper cheekbone fullness, giving your mid-face a sinked-in look. This type of facial appearance is so common these days that it's almost accepted as normal. I remember reading in the New York Times a few years back where they reported that women's preferences for male actors has changed from the classic square-faced, angular facial features, to softer, more feminine, rounded faces.

http://doctorstevenpark.com/sleep-apnea-is-a-craniofacial-problem

Marijuana and mental illness: Low dopamine levels may play a role

Long-term marijuana use has been linked to a number of mental health conditions, including schizophrenia, anxiety, and depression, but the mechanisms underlying this association have been unclear.

Given the increased legalization of marijuana for medicinal and recreational purposes, researchers are keen to learn more about how the drug affects the brain.

For this latest study, Prof. Howes and team conducted a review of numerous studies investigating how the primary psychoactive compound in marijuana - tetrahydrocannabinol (THC) - affects the brain.
THC exposure has long-term effects on the dopamine system

According to the researchers, there is now "substantial evidence" in animal and human studies that long-term exposure to THC leads to a decrease in levels of dopamine.

"The available evidence indicates that THC exposure produces complex, diverse and potentially long-term effects on the dopamine system," the authors explain. "These include increased nerve firing and dopamine release in response to acute THC, and dopaminergic blunting associated with long-term use."

The team believes this effect may explain why people who engage in long-term marijuana use are at increased risk for mental health problems.

http://www.medicalnewstoday.com/articles/314222.php

Does Intermittent Fasting Boost Your Metabolism?

In fact, a 2014 review found that intermittent fasting could help people lose an impressive 3–8% of their body weight in 3–24 weeks (9).

Moreover, a recent review concluded that in overweight and obese people, intermittent fasting may be a better approach to weight loss than very-low-calorie diets (10).

Interestingly, this approach to eating may also benefit your metabolism and metabolic health (1, 11, 12, 13).

There are a few different ways to try intermittent fasting. Some people follow the 5:2 diet, which involves fasting for two days a week. Others practice alternate-day fasting or the 16/8 method.

If you are interested in trying intermittent fasting, you can read more about it in this detailed guide for beginners.

https://authoritynutrition.com/intermittent-fasting-metabolism/

Sunday, November 20, 2016

Holosync

Holosync is a sophisticated form of audio technology that induces the brain wave patterns of deep meditation. Users experience all the benefits of a traditional meditation practice, but in an accelerated time-frame.

You will literally meditate like a Zen monk at the touch of a button.
The Benefits of Using Holosync Include:

» More happiness and flow in your life
» Heightened mental abilities, creativity and problem solving skills
» Dramatic reduction in stress and anxiety
» Improved sense of mental, emotional and physical well-being
» Super-charged confidence and motivation
» Optimal focus, concentration, memory and learning
» Better, more restful sleep
» Increased production of vital neurochemicals proven to slow aging and keep the body young
» Accelerated healing of unresolved mental and emotional blocks

How does Holosync produce these benefits for its users?

Holosync's ability to increase synchronous neuro-electrical activity between the two hemispheres of the brain, and it's ability to drive the nervous system to higher levels of functioning over time, naturally bring about some remarkable improvements in cognitive functioning.

Learning ability, creativity, problem-solving, focus and concentration, memory, and intuition are among the areas typically showing dramatic improvement.

https://www.centerpointe.com/holosync/

Thursday, November 17, 2016

Biomarker Research Advances in 'Chronic Fatigue Syndrome'

Jose Montoya, MD, professor of medicine at Stanford University, Palo Alto, California, presented findings from the largest such study to date, involving 192 patients with ME/CFS diagnosed by published criteria and 392 healthy but sedentary control patients. He found significant elevations in serum of patients compared with serum of control patients for 17 specific cytokines, 13 of them pro-inflammatory, that correlated with symptom severity among the patients (P values for linear trend ranged from 0.0062 to 0.0366).

The findings, Dr Montoya said, "likely substantiate many of the symptoms experienced by patients and the immune nature of the disease." And, he added, they also suggest that immune-modulating agents might be useful to treat some of the condition's inflammation-related symptoms.

Dr Komaroff commented, "Many of us for 20 to 30 years have held the hypothesis that symptoms of this illness likely are caused by increased cytokine levels in the brain due to chronic immune activation.... This is a very excellent demonstration of it. If those cytokines are the explanation for the symptoms, you would expect there to be a correlation between how high the cytokine was and how severe the symptom was, and that's what they found."

Another study, presented by Kenny L. DeMeirleir, MD, PhD, medical director of the Nevada Center for Biomedical Research in Reno, Nevada, involved 70 male and 70 female patients with ME/CFS and the same numbers of matched sedentary control participants. His team uncovered significant differences for four specific immune/inflammatory markers in venous blood samples (prostaglandin E2, interleukin 8, soluble CD14 [a surrogate marker for bacterial lipopolysaccharide], and CD57+ lymphocytes; P < .001 for each).

As a panel, the four markers correctly classified 89.5% of the males and 97.1% of the females with ME/CFS, as defined by published criteria.

http://www.medscape.com/viewarticle/871552

Microorganisms Causing Community-Acquired Acute Bronchitis: The Role of Bacterial Infection

Abstract
BACKGROUND:

Although acute bronchitis is quite common, there is relatively limited information regarding the microorganisms that are involved in this illness.
METHODS:

We performed a prospective study of acute bronchitis at 31 hospitals and clinics in Korea from July 2011 to June 2012. Sputum specimens were collected for polymerase chain reaction (PCR) and culture of microorganisms.
RESULTS:

Of the 811 enrolled patients, 291 had acceptable sputum specimens that were included for analysis of the etiologic distribution. With multiplex PCR testing, viruses were identified in 36.1% (105/291), most commonly rhinovirus (25.8%) and coronavirus (3.8%). Typical bacteria were isolated in 126/291 (43.3%) patients. Among these patients Haemophilus influenzae (n = 39) and Streptococcus pneumoniae (n = 30) were isolated most commonly; atypical bacteria were identified in 44 (15.1%) patients. Bacteria-only, virus-only, and mixed infections (bacteria plus virus) accounted for 36.7% (98/291), 17.2% (50/291), and 18.9% (55/291) of infections, respectively. In particular, 52.4% of patients with viral infection had a concurrent bacterial infection, and rhinovirus was the most common virus in mixed infections (40/55). Additionally, infections with typical bacteria were more common in patients with chronic lung disease (p = 0.029), and typical bacterial infections showed a trend towards a higher prevalence with older age (p = 0.001).
CONCLUSIONS:

Bacteria were associated with almost half of community-acquired acute bronchitis cases. Additional studies are required to further illuminate the role of bacteria and to identify patient groups most likely to benefit from antibiotic treatment.

https://www.ncbi.nlm.nih.gov/pubmed/27788254

Wednesday, November 16, 2016

Monsanto Is Scrambling To Bury This Breaking Story

This chemical is ending up in processed foods like Cheerios, Ritz Crackers, and Oreos and being consumed by humans across the world.

...

A FDA-registered food safety laboratory tested iconic American food for residues of the weed killer glyphosate (aka Monsanto's Roundup) and found ALARMING amounts.

Just to give you an idea of how outrageous these amounts are, independent research shows that probable harm to human health begins at really low levels of exposure – at only 0.1 ppb of glyphosate. Many foods were found to have over 1,000 times this amount! Well above what regulators throughout the world consider "safe".

http://foodbabe.com/2016/11/15/monsanto/

Feds approve YMCA diabetes program despite drug maker opposition

Federal regulators will move ahead with a national test of Medicare coverage for a YMCA diabetes prevention program over the objections of the pharmaceutical industry, which sells drugs including increasingly expensive insulin to treat disease.

The final rule, announced Wednesday by the Centers for Medicare and Medicaid Services, is designed to speed Medicare coverage of a program to combat a disease  that a quarter of people 65 and older have. National trade associations representing hospitals and doctors enthusiastically supported CMS' plan in comments filed with the agency.

The Pharmaceutical Research and Manufacturers of America (PhRMA) trade group, however, said in its comments that CMS is setting a "flawed precedent" and acting upon only "preliminary" evidence. A federal contractor studied the program for at least two years and the National Institutes of Health (NIH) and the Centers for Disease Control (CDC) analyzed it for about 20 years before that.

http://www.usatoday.com/story/news/politics/2016/11/02/feds-approve-ys-diabetes-program-despite-drugmaker-opposition/93125138/

Doctors finally admit too many patients are hooked on tranquilisers

There are 12 million prescriptions for 'benzos' — common brand names include Xanax and Restoril — every year.

The drugs, which also include diazepam (formerly marketed as valium and known as 'mother's little helper'), are used to treat severe anxiety and nervousness.

Janet Waterton does not look like a drug addict, but her doctors turned her into one. There are 12 million prescriptions for 'benzos', such as Xanax and Restoril, every year.

They work by depressing a part of the brain responsible for controlling consciousness and have a strong tranquillising and sedating effect.

And they are used as a muscle relaxant to treat pain, which is why Janet, a 62-year-old mother of two married to Edgar, 66, a retired mechanic, was prescribed them.

The problem is the brain soon becomes tolerant to the drug, so patients need higher doses to get the same effect. They are also addictive, so are meant to be prescribed for only two to four weeks.

But the withdrawal effects have been described as worse than coming off heroin and include muscle spasms, panic attacks, nightmares and insomnia.

And side-effects can include depression, insomnia, anxiety and depression.

This leaves patients caught in a trap: they can't come off the drugs, but staying on them leaves them feeling ghastly and often unable to function normally.

Janet spent 13 years on benzodiazepines and, she recalls, the experience was terrible. The drugs made her feel 'like a zombie' and she lost three stone, ending up at just seven stone. 'I looked like a bag of bones,' she says.

She spent most of those years 'rotting in bed — I just wanted to lie there with the curtains shut'.

http://www.dailymail.co.uk/health/article-3915114/Why-250-000-lives-ruined-mother-s-little-helpers-Doctors-finally-admit-patients-hooked-tranquilisers.html

How Many Carbs Should a Diabetic Eat per Day?

Very-Low-Carb, Ketogenic Diets

Very-low-carb diets typically induce mild to moderate ketosis, a state in which your body uses ketones and fat, rather than sugar, as its main energy sources.

Ketosis usually occurs at daily intakes of less than 50 grams of total carbs, or 30 grams of digestible carbs (total carbs minus fiber). This would be no more than 10% of calories on a 2,000-calorie diet.

Very-low-carb, ketogenic diets have been around for many years. Indeed, doctors prescribed them for people with diabetes before insulin was discovered in 1921 (5).

Several studies have shown that restricting carb intake to 20–50 grams of carbs per day can significantly reduce blood sugar levels, promote weight loss and improve heart health markers in people with diabetes (6, 7, 8, 9, 10, 11, 12, 13, 14, 15).

In addition, these improvements often occur very quickly.

For instance, in a study of obese people with diabetes, limiting carbs to 21 grams per day led to a spontaneous decrease in calorie intake, lower blood sugar levels and a 75% increase in insulin sensitivity in two weeks (14).

In a small, three-month study, people were randomized to consume a calorie-restricted, low-fat diet or a low-carb diet containing up to 50 grams of carbs per day.

The low-carb group had an average decrease in HbA1c of 0.6% and lost over twice as much weight as the low-fat group. Also, 44% of the low-carb group discontinued at least one diabetes medication, compared to 11% of the low-fat group (15).

In fact, in several studies, insulin and other diabetes medications have been reduced or discontinued due to improvements in blood sugar control (6, 8, 10, 11, 13, 15).

Diets containing 20–50 grams of carbs have also been shown to lower blood sugar levels and reduce the risk of disease in people with prediabetes (15, 16, 17).

In a small, 12-week study of obese, prediabetic men who followed a Mediterranean diet limited to 30 grams of carbs per day, fasting blood sugar dropped to 90 mg/dL (5 mmol/L), on average, which is well within the normal range (17).

In addition, the men lost an impressive 32 pounds (14.5 kg) and experienced significant reductions in triglycerides, cholesterol and blood pressure, among other beneficial health effects (17).

Importantly, these men no longer met the criteria for metabolic syndrome due to reductions in blood sugar, weight and other health markers.

Although concerns have been raised that higher protein intake on low-carb diets may lead to kidney problems, a recent 12-month study found that very low carb intake did not increase the risk of kidney disease (18).

https://authoritynutrition.com/diabetes-carbs-per-day/

Replacing Nurses With Assistants Tied to More Deaths

Substituting nursing assistants for professional nurses in acute care hospitals in Europe is linked to poorer quality of care and increased mortality, according to a report published online November 15 in BMJ Quality & Safety.

Studies based on US hospital populations show that increasing the proportion of less highly trained nursing personnel adversely affects patient care. Data from European hospitals have been sparse, however.

Therefore, Linda H. Aiken, PhD, from the University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, and colleagues analyzed the effect of increasing the proportion of less extensively trained nurses at 243 acute care hospitals in Belgium, England, Finland, Ireland, Spain, and Switzerland.

http://www.medscape.com/viewarticle/871958

Tuesday, November 15, 2016

Non-nutritive sweetener effects may contribute to insulin resistance in consumers with obesity

Sucralose, a no-calorie sweetener widely used in beverages, may adversely affect glucose metabolism in consumers with obesity, according to a presenter here.

"There seem to be differential effects of sucralose on glucose metabolism in normal-weight people and in people with obesity, so previous findings in lean subjects cannot be extrapolated to what will be the effects of sucralose in subjects with obesity (and vice versa)," Marta Yanina Pepino De Gruev, PhD, assistant professor in food science and human nutrition at the University of Illinois in Urbana, told Endocrine Today. "Clinicians may find surprising that sucralose is not metabolically inert, as generally thought, at least for people with obesity."

http://www.healio.com/endocrinology/obesity/news/online/%7Bd976c2ee-06ee-425f-b1eb-aa3b6cbc2891%7D/non-nutritive-sweetener-effects-may-contribute-to-insulin-resistance-in-consumers-with-obesity

New Study Shows PharmaGABA Promotes Muscle Growth! | Dr. Michael Murray

PharmaGABA is manufactured via a fermentation process that utilizes the probiotic Lactobacillus hilgardii. This natural form has been shown to produce effects not achieved by the synthetic form of GABA, which is produced from pyrrolidinone – an industrial solvent. PharmaGABA has been shown to produce relaxation as evidenced by:
• Increasing the alpha to beta brain wave ratio.
• Preserving salivary antibody production during stress.
• Reducing markers of stress including cortisol levels.
• Improve sleep quality as noted by an ability to decrease the time required to go to sleep, promote proper sleep rhythm, and increase the time spent in both deep sleep stages and REM sleep.
Once ingested, it is absorbed easily and binds to GABA receptors outside the brain that ultimately lead to activation of the parasympathetic nervous system. This arm of the autonomic nervous system is responsible for producing what is referred to as the "relaxation response," a physiological response that is in direct contrast to the stress or "fight or flight" response. This activation of the parasympathetic nervous system by PharmaGABA is measurable within 5 to 30 minutes after ingestion.

New Data:
There is evidence that PharmaGABA may increase growth hormone (GH) secretion in response to weight lifting exercise. Since GH is an important regulator of body composition including muscle protein synthesis, GABA may enhance the muscle building effects of protein ingestion after weight lifting exercise.

http://doctormurray.com/natural-form-of-gaba-receives-stronger-health-claims-in-japan-new-study-shows-pharmagaba-promotes-muscle-growth/

Sweet Relief for Migraines | Dr. Michael Murray

One new study compared ginger powder head-to-head with sumatriptan, the generic form of the migraine drug Imitrex. Ginger proved to be equally effective as the prescription medication, but it had a better safety profile than the drug. Minor side effects of Imitrex include nausea, dizziness, drowsiness, and muscle weakness. But it can also cause more serious side effects, including coronary artery spasms, heart attacks, stroke, abnormal heartbeats, and seizures.

A team of neurologists in Iran compared ginger and sumatriptan in 100 men and women who had suffered migraines for an average of seven years. Participants were randomly assigned to either the ginger (250 mg caplet of dried ginger powder) or the sumatriptan (50 mg) group, and neither the participants nor the observers knew which caplets the patient was taking until the study was completed. Patients were instructed to take a caplet as soon as a migraine started.

For each headache that occurred during that month, participants recorded the time the headache began, headache severity before taking the medication, and degree of pain relief at 30, 60, 90, and 120 minutes, as well as 24 hours later. Results showed that ginger was equally as effective as sumatriptan, achieving 90 percent relief within two hours of ingestion. While a very small percentage (4 percent) of the ginger group experienced minor digestive upset, 20 percent of patients taking sumatriptan reported dizziness, drowsiness, or heartburn.

Monday, November 14, 2016

Fat Summit 2 - Mark Hyman MD


The Fat Summit 2 is online and FREE from November 7-14, 2016

Join Dr. Mark Hyman, Dr. Carrie Diulus, and over 30 of the world’s top experts as they dispel the biggest MYTHS about fat, and reveal the latest research about how to eat, move and supplement your diet for improved health and longevity!

http://fatsummit.com/

https://vimeo.com/154898337

  •     Biohacking your biology and weight loss with healthy fats
  •     Truths about saturated fat, cholesterol, butter, sugar, carbs and more
  •     Review and discussion of the latest articles on fat and weight loss
  •     Digestion of fats through supplementation
  •     Effects of dietary fat on fertility
  •     Importance of community for making/sustaining healthy lifestyle choices
  •     How eating more fat complements/combats other dietary approaches
  •     Best practices for maintaining your weight and healthy eating habits

Good Food on a Tight Budget - EWG


BETTER FOOD, LOWER COST Stretching your dollars to get a month's worth of healthy, filling food is a challenge. EWG assessed nearly 1,200 foods and hand-picked the best 100 or so that pack in nutrients at a good price, with the fewest pesticides, contaminants and artificial ingredients. Enjoy!

http://www.ewg.org/goodfood/index.php

Top Foodshttp://www.ewg.org/goodfood/fruits.php

Guide: http://static.ewg.org/reports/2012/goodfood/pdf/goodfoodonatightbudget.pdf


Sunday, November 13, 2016

Unraveling the metabolic health benefits of fasting related to beliefs of religion: A narrative review - Nutrition

Periodical fasting, under a religious aspect, has been adopted by humans for centuries as a crucial pathway of induction of spiritual catharsis. Caloric restriction, with or without eviction of certain type of food, is a key component of most religious dietary patterns. Fasting varies significantly among different populations according to cultural habits and local climate condition. Religious fasting in terms of patterns (continuous vs. intermittent) and duration can vary from 1 to 200 days, thus their positive and negative impact on human health can be considerable.

Advantages of religious fasting on human health are claimed by many, but have been explored by a limited number of studies conducted in Buddhist, Christian or Muslim populations. These trials indicate that religious fasting has beneficial effects on body weight, glycaemia, cardiometabolic risk markers and oxidative stress parameters. Animals exposed to a mimicking fasting diet have demonstrated: weight loss, plasma levels of glucose, triglycerides and insulin growth factor-1, although their lean body mass remained stable. Diabetic mice on repeated intermittent fasting had less insulin resistance that mice fed ad libitum. The long term significance of such changes on global health remained to be explored.

This review summarizes the data available with regard to benefits of fasting followed for religious reasons on human health, body anthropometry and cardio-metabolic risk markers. It highlights current knowledge gap on available evidence and future research agenda. Future studies should explore every type of religious fasting, as well as their consequences in subpopulations such as children, pregnant women and elderly people, or patients with chronic metabolic diseases.

http://www.nutritionjrnl.com/article/S0899-9007(16)30226-X/fulltext

Lipid-modifying effects of nutraceuticals: An evidence-based approach - Nutrition

The present review provides an up-to-date summary of the findings on the lipid-lowering effects of the most important nutraceuticals and functional foods. Based on current knowledge, nutraceuticals might exert significant lipid-lowering, and their use has several advantages:

    •They have natural origins and are mainly extracted from natural products.
    •They are mostly safe and very well tolerated.
    •Their use is supported by the findings from randomized controlled trials and meta-analyses.
    •The lipid-lowering effect of most nutraceuticals is multimechanistic, which makes them potential candidates for improving the effects of current lipid-lowering drugs when used in combination.

A number of important questions remain to be addressed, including whether longer durations of therapy would result in a better response and the exact safety profile of nutraceuticals, especially at doses higher than those consumed in an average diet. Additionally, data regarding the effects of nutraceutical supplementation on the incidence of cardiovascular outcomes are lacking, and it is not clear whether additional lipid lowering by nutraceuticals can modify the residual cardiovascular risk that remains after statin therapy.

http://www.nutritionjrnl.com/article/S0899-9007(16)30068-5/fulltext

Prenylated chalcones and flavonoids for the prevention and treatment of cancer - Nutrition

Prenylated chalcones and flavonoids gained increasing attention not only in nutrition but also in cancer prevention because of their biological and molecular activities in humans, which have been extensively investigated in vitro or in preclinical studies. These naturally occurring compounds exhibit antioxidant effects, modulate metabolism of carcinogens by inhibition of distinct phase 1 metabolic enzymes and activation of phase 2 detoxifying enzymes, and display antiinflammatory properties. In particular, their potential to prevent proliferation of tumor cells is noteworthy. Some representatives of this subclass of secondary plant compounds exert pronounced anti–tumor-initiating capacities and directly inhibit growth of cancer cells, whereas their toxic effects on healthy tissues are remarkably low. These promising pharmacologic characteristics are countered by low ingestion, low bioavailability, and little knowledge of their metabolism. This review focuses on the great potential of these plant- and nutrient-derived compounds for cancer prevention and therapy. Provided here is a comprehensive summary of the current knowledge and inherent modes of action, focusing on the prenylated chalcones xanthohumol, desmethylxanthohumol, and xanthogalenol, as well as the prenylated flavonoids isoxanthohumol, 6-prenylnaringenin, 8-prenylnaringenin, 6-geranylnaringenin, 8-geranylnaringenin, and pomiferin

http://www.nutritionjrnl.com/article/S0899-9007(16)30035-1/fulltext

Side effects are OK for women's birth control — but not for men's?

A study launched in 2008, and published last week by The Journal of Clinical Endocrinology and Metabolism, tested hormonal birth control shots in men that proved to be almost 96% effective at preventing pregnancy. (By contrast, condoms are, in real life, about 82% effective, according to Planned Parenthood.)

But the study was cut short when participants reported side effects — including mood disorders, acne and changes in libido.

Sound familiar, ladies?

http://college.usatoday.com/2016/11/01/male-birth-control-side-effects-come-on/

Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease — NEJM

Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.

http://www.nejm.org/doi/full/10.1056/NEJMoa1605086

Saturday, November 12, 2016

Why are we ticklish?


"Why does tickling induce laughter?" they wrote in their study. "Why do body parts differ in ticklishness? Why can't we tickle ourselves?"

To find out, they tickled young male rats in a systematic way. First, they tickled the animals on the back, then flipped them over and tickled them on the stomach. That was followed by gentle touching on the back, then front. Next, the researchers tickled the rats on their tails. Finally, they played the hand-chasing game. Each part of the routine lasted for about 10 seconds, followed by a 15-second break.

The rats responded with ultrasonic vocalizations in the range of 50 kilohertz, a pitch with a "positive emotional valence," according to the study. That frequency is too high for humans to hear, so the researchers transposed the vocalizations to lower frequencies. (Notably, none of the tickles caused rats to make utterances in the 22-kHz range, which are considered "alarm calls," according to the study.)

In addition to the vocalizations, the rats also reacted to tickles with spontaneous Freudensprünge jumps. These jumps resemble bunny hops, with the front legs and back legs moving in tandem.
Freudensprünge

Scientists say they can tell that rats enjoy tickling because they respond with "Freudensprünge," unsolicited jumps of joy. The animals also look for the tickling hand after it disappears.

Using a suite of electrodes, the scientists found that tickling prompted a specific pattern of activity in the somatosensory cortex, the part of the rat brain that processes touch. "Remarkably," they wrote, the hand-chasing game activated the same part of the rats' brains.

Ishiyama and Brecht wondered whether tickled rats would "laugh" no matter what, or if they had to be in a receptive state of mind. (No less a scientist than Charles Darwin has proposed that "the mind must be in a pleasurable condition" for a tickle to work, the pair noted.)

So the researchers made the animals anxious by placing them on an elevated platform and subjecting them to bright light. Under these conditions, the rats' vocalizations were "significantly suppressed." Brain activity also was suppressed compared with the normal conditions, the researchers found.

Later, the scientists were able to make rats laugh without even touching them. Instead, they stimulated the part of the somatosensory cortex that was most active when the rats were tickled. That did the trick.

This finding prompted researchers to wonder whether the somatosensory cortex helps process emotions in addition to tactile sensations. More work will be needed to answer that question, they wrote.

In the meantime, the results suggest that tickling is more than a quirk of the nervous system. It may even serve a useful social purpose.

"Tickling might be a trick of the brain to make animals or humans, respectively, interact and play with each other," Brecht said.

http://www.latimes.com/science/sciencenow/la-sci-sn-tickling-rats-20161110-story.html

High-Risk Meds for Elderly Most Prescribed in South, CMS Says

 

Clinicians in the South are more prone to prescribe red-flagged, high-risk medications (HRMs) such as barbiturates and alpha blockers for elderly patients than their colleagues elsewhere, according to Medicare Part D data for 2014, released by the government last week.

The drugs considered high risk by the Centers for Medicare & Medicaid Services (CMS) are derived from a list maintained by the nonprofit Pharmacy Quality Alliance. This group, in turn, relies on recommendations from the American Geriatrics Society on drugs that persons 65 years of age and older should avoid because the risk for adverse events is high, and safer drugs may be available.

The list also includes vasodilators for dementia, long-duration sulfonylureas for type 2 diabetes, the antithrombotic ticlopidine (Ticlid, Roche), skeletal muscle relaxants, and first-generation antihistamines.

The national average for prescribing HRMs is 0.86 claims per elderly beneficiary, according to CMS. In a swathe of Southern states from Arkansas to North Carolina, the rate of HRM prescribing was 1.09 to 1.31 claims per beneficiary, or 27% to 52% higher than the national average. States with the lowest HRM prescribing rates were in the far West, the upper Midwest, and New England.

http://www.medscape.com/viewarticle/867954

Study Calls Into Question Sunscreen in Melanoma Prevention

Sunscreen has long been touted as a protective measure against melanoma and sunburns, but some recent evidence has suggested otherwise. Sunscreens do a good job of blocking ultraviolet (UV)B rays, which are known to cause melanoma, but many do not block UVA rays. Although UVA radiation was long thought to produce only tans, it has recently been linked to melanoma.

Dr Crane said she recommends the newer broad-spectrum sunscreens that block both UVA and UVB radiation, at the highest SPF available.

UVA exposure is more or less constant throughout the day. So although the sunburn danger wanes when the sun is low in the sky, risk for UVA exposure can remain.

This is "an excellent study, very well done, and longitudinal, which is good," said Susan Nohelty, PhD, professor of public health and epidemiology at Capella University in Interlaken, New York, who presented a separate study during the session.

"I have lighter skin, so I do use sunscreen, but you have to wonder if sunscreen does help," Dr Nohelty added.

She also said she wonders if the broad-spectrum sunscreens will prove to be more beneficial. "I think it would be fascinating to evaluate the different kinds of sunscreen," she said.

In addition to recommending such broad-spectrum sunscreens, Dr Crane champions hats and protective clothing. "Kids on the beach should be wearing those swim shirts; they shouldn't be running around with just trunks or a bikini," she said. Broad-spectrum sunscreen can then be used on areas that can't be covered.

http://www.medscape.com/viewarticle/871438

Cellulitis: Misdiagnoses Common and Costly

 

One third of patients admitted to the hospital for cellulitis were discharged with a different diagnosis, according to a new single-center retrospective analysis. The researchers estimate that misdiagnosis of other conditions as cellulitis results in 50,000 to 130,000 unnecessary hospitalizations and from $195 million to $515 million in avoidable health costs each year.

"Our study serves as a call to arms for improving the care of patients with suspected lower extremity cellulitis," Qing Yu Weng, MD, from the Department of Dermatology at Massachusetts General Hospital, Boston, and colleagues write. The study was published online November 2 in JAMA Dermatology.

"Dermatologists need to consult on these cases because cellulitis of the lower extremity has many mimics that can make diagnosis challenging, particularly for nondermatologists," Sotonye Imadojemu, MD, and Misha Rosenbach, MD, write in an accompanying editorial.

"Objective diagnostic modalities for cellulitis, such as blood and skin cultures (including needle aspiration and biopsies) are rarely revealing, and diagnosis is usually made by medical history and physical examination alone," Dr Weng and colleagues explain.

Misdiagnosing other conditions as cellulitis also leads to higher antibiotic use; in this study, 92.3% of patients who were misdiagnosed received unnecessary antibiotics.

The investigators examined the medical records of all adult patients who were admitted to the hospital from the emergency department with a diagnosis of lower extremity cellulitis between June 2010 and December 2012. They excluded patients with an abscess, trauma, surgery, or recent intravenous antibiotics. Of the 259 patients included in the study, 30.5% had their diagnosis changed before discharge or within the following month.

Of the misdiagnosed patients, 85% did not require hospitalization, and 92% received unnecessary antibiotics. The mean hospital stay for these patients was 4.3 days (standard deviation, 3.7 days). After patients without cellulitis were discharged, 32% had a complication such as drug eruption, diarrhea, or gastrointestinal distress related to their treatment.

http://www.medscape.com/viewarticle/871542

Friday, November 11, 2016

CLA (Conjugated Linoleic Acid): A Detailed Review


...

The main dietary sources of CLA are animal foods from ruminants, such as cows, goats and sheep.

The total amount of CLA in these foods varies greatly depending on what the animals ate (10).

For example, the CLA content is 300-500% higher in beef and dairy from grass-fed cows, compared to grain-fed cows (11).

Most people are already getting some CLA from their diet… the average intake in the U.S. is about 151 mg per day for women and 212 mg for men (12).

However… it’s important to keep in mind that the CLA you find in supplements is NOT derived from natural foods.

It is made by chemically altering safflower and sunflower oils, which are unhealthy vegetable oils. The linoleic acid in the oils is turned into conjugated linoleic acid via a chemical process (13).

The balance of the different forms is heavily distorted in supplements. Foods are mostly c9, t11, while the supplements are very high in t10, c12, which is never found in large amounts in nature (14, 15).

For this reason, CLA taken in supplement form does not have the same health effects as CLA gotten from foods.

...

Should You Take it?

Personally I don’t think losing a few pounds is worth the risk of increased liver fat and worsened metabolic health.

If you disagree and still want to take CLA supplements, then I recommend that you get regular blood tests to monitor liver function and other metabolic markers, to make sure that you’re not harming yourself.

Although CLA from beef and dairy is beneficial, taking “unnatural” types of CLA made from chemically altered vegetable oils seems to be a bad idea.

Having a six pack is great, but there are other better ways to lose fat that won’t give you fatty liver disease and diabetes in the process.

https://authoritynutrition.com/conjugated-linoleic-acid/

Heavy Metals, Cardiovascular Disease, and the Unexpected Benefits of Chelation Therapy



This review summarizes evidence from 2 lines of research previously thought to be unrelated: the unexpectedly positive results of TACT (Trial to Assess Chelation Therapy), and a body of epidemiological data showing that accumulation of biologically active metals, such as lead and cadmium, is an important risk factor for cardiovascular disease. Considering these 2 areas of work together may lead to the identification of new, modifiable risk factors for atherosclerotic cardiovascular disease. We examine the history of chelation up through the report of TACT. We then describe work connecting higher metal levels in the body with the future risk of cardiovascular disease. We conclude by presenting a brief overview of a newly planned National Institutes of Health trial, TACT2, in which we will attempt to replicate the findings of TACT and to establish that removal of toxic metal stores from the body is a plausible mechanistic explanation for the benefits of edetate disodium treatment.



J Am Coll Cardiol. 2016 May 24;67(20):2411-8. doi: 10.1016/j.jacc.2016.02.066.
https://www.ncbi.nlm.nih.gov/pubmed/27199065



Major Brands Accused of Turning Health Food into Junk Food



A new report, Culture Wars: How the Food Giants Turned Yogurt, a Health Food, into Junk Food,issued by The Cornucopia Institute, accuses Dannon, Yoplait, Chobani and other major marketers of misleading parents, who are looking for healthier foods for their families, into purchasing yogurts loaded with sugar and containing a myriad of questionably safe artificial sweeteners, colors and emulsifiers.

The group alleges that agribusiness, in their marketing approach, has capitalized on yogurt’s historic, well-deserved healthful reputation while simultaneously adulterating the product, sometimes illegally, to gain competitive advantage and popular appeal.

In addition to The Cornucopia Institute’s comprehensive report on the yogurt industry, they also released a related scorecard rating 114 brands and separating the truly healthy options from those that would be found on any dietitian’s shortlist of foods to avoid.

https://www.cornucopia.org/yogurt/

Good nutrition site discussing yogurt:

Another good nutrition site and how to make your own yogurt:

Coronary Calcium Scores Can Help Some Patients Avoid Statins: More Evidence



ESSEN, GERMANY — Obtaining coronary artery calcium (CAC) scores in addition to performing guideline-recommended procedures can improve stratification of patients as high or low risk for coronary events, whether on statin therapy or not, according to a new study involving a German primary-prevention cohort[1].

CAC scoring could help clinicians match risk-factor modification to atherosclerotic plaque burden and actual risk, and it could lead to avoiding therapy in low-risk patients with low 10-year event rates, researchers say.

"Especially in subjects with intermediate risk according to traditional risk factors and a recommendation for statin therapy according to current guidelines, CAC scoring may help to identify patients without coronary plaque burden who have a low future event rate, in whom lifelong statin therapy may not be needed," lead author Dr Amir A Mahabadi (University of Disburse-Essen, Essen, Germany) told heartwire from Medscape.

Mahabadi and colleagues conducted a study involving 3745 individuals in the Ruhr area who were recruited during 2000–2003 into the Heinz Nixdorf Recall study.

The results were published online September 21, 2016 in JACC: Cardiovascular Imaging.

The researchers used electron-beam computed tomography (CT) to obtain images from the right pulmonary artery to the apex. They defined CAC as a focus of at least 4 contiguous pixels with a CT density greater than 130 Hounsfield units. Physicians and patients were blinded to the baseline CAC score.

Their first goal was to quantify differences among participants for statin therapy when applying guideline recommendations of the American Heart Association/American College of Cardiology (AHA/ACC) vs European Society of Cardiology (ESC) guidelines. AHA/ACC guidelines have a wider indication for statin therapy than ESC guidelines.

Of the 3745 individuals (mean age 59.8, 53% female) all without lipid-lowering therapy or known cardiovascular disease, 1288 (34.4%) met criteria for statin therapy under ESC guidelines, while 2101 (56.1%) did so under AHA/ACC guidelines. Also, 897 (24%) met statin indication under AHA/ACC but not under ESC, while 84 (2.2%) met statin criteria under ESC only.

A total of 131 fatal or nonfatal MIs occurred during a mean follow-up of 10.4 years (event rate 3.5%), while 241 hard cardiovascular events occurred (event rate 6.43%). Sixty participants with coronary events did not fit statin indication under ESC, while only 19 events occurred among participants without statin indication under AHA/ACC.

The researchers found that participants with CAC scores of 400 or higher experienced a 10-fold higher event rate compared with participants with a CAC score of zero (event rate 12.6% vs 1.3%). Frequency of events was low (3.3% or lower) in participants whose CAC score fell below 100.

"Following AHA/ACC vs ESC guidelines for statin therapy leads to relevantly different recommendations regarding statin therapy in primary prevention," Mahabadi told heartwire. "However, according to both guidelines, frequency of zero or low CAC score in patients with statin recommendation is high, while this group has an overall low event rate. Our results show that if CAC score is applied to appropriate subgroups, this may lead to significant improvement of risk prediction, especially in addition to European recommendations."

Strong Evidence for Use

Dr Michael Blaha (Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD), who coauthored an accompanying editorial[2], told heartwire that with the current study, "We now have excellent evidence from four studies[1,3-5] showing that coronary artery calcium can further reclassify risk after the pooled cohort equations and that the primary advantage is identifying patients who are truly at low risk despite being statin eligible under the new ACC/AHA prevention guidelines.

"The overall evidence is definitely strong enough to use CAC as part of shared decision making with patients right now," he added. "While this study is just one small piece of the puzzle, the totality of the evidence is now clear.

"We hope the next set of guidelines provides a thorough literature review on CAC and provides a clear and thoughtful recommendation about its use. Right now, the guidelines don't exactly match the way clinicians are using CAC in practice. The guidelines need to catch up to the current state of CAC imaging and provide clear recommendations that will facilitate its coverage by major payers," Blaha concluded.

http://www.medscape.com/viewarticle/869250

Thursday, November 10, 2016

Leaked Podesta Emails Confirm Suspicions About Aspartame Dangers


Kennedy is a former head of the FDA and current editor-in-chief of Science Magazine. In his email correspondence with her, he shares his concerns about aspartame's potential toxicity:

    "The whole sweeteners issue has interested me since my early time at FDA … A little later, still during my time as Commissioner I was called on by Don Rumsfeld, who introduced himself as the CEO of Searle …
    [W]e told him that we would look carefully at the evidence and rely on our expert committee structure as usual.
    Aspartame continued to attract concerned critics, and we at FDA saw no resumption of Searle's effort to get it approved. I looked up one piece on that history, which I append below. Not a very nice story.
    'In 1985 Monsanto purchased G.D. Searle, the chemical company that held the patent to aspartame, the active ingredient in NutraSweet.
    Monsanto was apparently untroubled by aspartame's clouded past, including a 1980 FDA Board of Inquiry, comprised of three independent scientists, which confirmed that it 'might induce brain tumors.'
    The FDA had actually banned aspartame based on this finding, only to have Searle Chairman Donald Rumsfeld … vow to 'call in his markers,' to get it approved' … "

In her correspondence with Kennedy, Abrams also noted her own adverse reactions to NutraSweet, noting that:

    "… I think it is poison … Doctors will swear to me it is fine, and I will tell them, maybe I'm the only person in the world who reacts like this, but clearly it affects me, and then they'll tell me again, it is fine. They are so brainwashed by the propaganda, they refuse to believe anything contrary.
    I also have a friend who worked for the researchers at University of Chicago (which has a top rated neurology dept [sic]) and the doctors there said when they gave NutraSweet to lab mice, it literally blew holes in their brains."

Long-term Testosterone Beneficial in Hypogonadal Men

 

For hypogonadal men, long-term treatment with an injectable form of testosterone improves sexual and urinary function, and, in hyopogonadal men with type 2 diabetes, it also improves glycemic control, registry data out to 8 years indicate.

In addition, it leads to striking changes in body composition, including reductions in waist circumference, body mass index (BMI), and body weight, and increases in lean muscle mass.

"Testosterone is one of the most beneficial — and at the same time, the most underestimated and under-rated — treatment modalities for hypogonadal men," said Farid Saad, MD, honorary professor at Gulf Medical University in Ajman, United Arab Emirates, and therapeutic area head of global medical affairs andrology at Bayer AG in Berlin.

"It's just amazing what it does, and it certainly does not deserve the bad reputation it has," he told Medscape Medical News.

"We need to do our best to convince healthcare professionals and the authorities that testosterone is actually a very beneficial treatment that confers many health benefits on these men, including less cardiovascular disease and fewer cardiovascular events," he explained.

Dr Saad presented his team's findings at the Sexual Medicine Society of North America Fall 2016 Scientific Meeting in Scottsdale, Arizona.

http://www.medscape.com/viewarticle/871741

Dietary Factors Linked to Better -- or Worse -- Function in ALS

Among patients recently diagnosed with amyotrophic lateral sclerosis (ALS), those who consume foods high in antioxidant nutrients and carotenoids have better function than those with a poorer diet, according to a new study.

"Foods high in antioxidants and carotenes, which are really fruits and vegetables, as well as high-fiber grains, fish, and poultry, all seem to make the disease a bit less severe," said lead study author, Jeri W Nieves, PhD, associate professor of clinical epidemiology, Mailman School of Public Health, Columbia University, New York City, New York.

But contrary to other recent research, the ALS Multicenter Cohort Study of Oxidative Stress (ALSCOSMOS) showed that milk-derived foods appear to have a negative effect on ALS.

The analysis was published online October 24 in JAMA Neurology

http://www.medscape.com/viewarticle/871750

Tuesday, November 8, 2016

Mexico's soda tax will save 18,900 lives and more than $983 million over 10 years, study says



A new estimate of the health impact of soda taxes in Mexico sheds some light on what's at stake in ballot measures coming to a vote in three Bay Area cities and Boulder, Colo. next week. In cases of heart disease and diabetes averted, the model suggests that, in Mexico, those levies are on track to save close to a billion dollars and powerfully improve lives.

After a tandem run-up in consumption of sugar-sweetened beverages and obesity, Mexico has become one of the fattest countries on Earth. In 2014, it adopted a 10% excise tax on the sale of sugary drinks.

The beverage producers claimed that soda taxes would do little to reduce consumption. But market surveys show that Mexicans reduced their purchases of sugar-sweetened beverages by an average of 6% in 2014 per household.

And by December 2014, that drop in purchases was at 12%.

If Mexicans sustain this pattern of consuming fewer sweetened beverages, the model developed by researchers predicts that over 10  years, the 10% excise tax could prevent 189,300 new cases of Type 2  diabetes, 20,400 strokes and heart attacks, and 18,900 deaths among adults 35 to 94 years old.

From 2013 to 2022, the reductions in diabetes alone could yield savings in projected healthcare costs of $983 million dollars, the researchers concluded.

http://www.latimes.com/science/sciencenow/la-sci-sn-soda-tax-mexico-20161102-story.html

High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions


Background  The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials and genetic studies.

Objectives  This study sought to reappraise the association of HDL-C level with CV and non-CV mortality using a “big data” approach.

Methods  An observational cohort study was conducted using the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) dataset, which was created by linking together 17 different individual-level data sources. People were included if they were between 40 and 105 years old on January 1, 2008, living in Ontario, Canada, without previous CV conditions or severe comorbidities, and had an outpatient fasting cholesterol measurement in the year prior to the inception date. The primary outcome was cause-specific mortality.

Results  A total of 631,762 individuals were included. The mean age of our cohort was 57.2 years, 55.4% were women, and mean HDL-C level was 55.2 mg/dl. There were 17,952 deaths during a mean follow-up of 4.9 ± 0.4 years. The overall all-cause mortality rate was 8.1 per 1,000 person-years for men and 6.6 per 1,000 person-years for women. Individuals with lower HDL-C levels were more likely to have low incomes, unhealthy lifestyle, higher triglycerides levels, other cardiac risk factors, and medical comorbidities. Individuals with lower HDL-C levels were independently associated with higher risk of CV, cancer, and other mortality compared with individuals in the reference ranges of HDL-C levels. In addition, individuals with higher HDL levels (>70 mg/dl in men, >90 mg/dl in women) had increased hazard of non-CV mortality.

Conclusions  Complex associations exist between HDL-C levels and sociodemographic, lifestyle, comorbidity factors, and mortality. HDL-C level is unlikely to represent a CV-specific risk factor given similarities in its associations with non-CV outcomes.

https://content.onlinejacc.org/article.aspx?articleID=2572335

Monday, November 7, 2016

What Is Choline? An Essential Nutrient With Many Benefits

Choline is a recently discovered nutrient.

It was only acknowledged as a required nutrient by the Institute of Medicine in 1998.

Although your body makes some, you need to get choline from your diet to avoid a deficiency.

However, less than 10% of the US population seems to be getting enough of this nutrient (1).

Here is everything you need to know about choline, including what it is and why you need it.

https://authoritynutrition.com/what-is-choline/

Saturday, November 5, 2016

Pre-Election Special: The Next Four Years - Functional Forum

The Evolution of Medicine is excited to announce that we will be hosting our first Functional Forum in Florida. The event will take place on Monday, November 7th, which also happens to be the night before the U.S. Presidential election. This episode will focus on what our community, by working together, can do in the next four years. We'll be hosting at the beautiful Turnberry Isle in Aventura, FL, which is just north of Miami.

Our first keynote is celebrity nutritionist and founder of the Mindshare Summit, JJ Virgin. She'll be sharing insights related to not only her decade of experience in nutrigenomics, but also the mindset required to make the kind of "miracle" we are looking to create through the work of our community.

Joining, JJ Virgin as keynote speaker is Craig Tanio, MD, MBA. Dr. Tanio been working across the health care industry over the past 25 years in a variety of roles including driving primary care innovation in business and health policy and will be speaking on why the ability to reduce cost for chronic disease puts us in an incredible position to affect change and key ways to do that.

We will also be joined by Susan Luck, RN – one of the leaders in the nurse coaching movement. She'll be sharing a case study of environmental health issues in Florida, particularly, on the Zika virus which has received a huge amount of media attention in the past few months.

Adiel Tel-Oren MD rounds out the incredible line up for this Pre-Election Special Forum. He specializes in in digestion and skin health.

This episode will be held at the Turnberry Isle which has a unique partnership to create healthy communities with Rezilir Health, the company in which Susan Luck and Craig Tanio practice. It's a beautiful five star resort environment and we encourage practitioners from all over the country to join us for this very special event.

For those that are able to join us live and in person, we'll be featuring content for the Future of Functional in 5 before the live stream.  You can apply to present your 5 minutes here: functionalforum.com/FoF5

http://functionalforum.com/next-event/

Friday, November 4, 2016

First 13 cases of deadly fungal infection emerge in US

Thirteen cases of a sometimes deadly and often drug-resistant fungal infection, Candida auris, have been reported in the United States for the first time, health officials said Friday.

The infection, which often spreads in hospitals and other health care settings, can invade the ear canal, urine and bloodstream.

Four of the US patients diagnosed with the infection have died, although the precise causes remain unclear, the CDC said.

"We need to act now to better understand, contain and stop the spread of this drug-resistant fungus," the US Centers for Disease Control and Prevention (CDC) Director Tom Frieden said.

"This is an emerging threat and we need to protect vulnerable patients and others."

http://m.medicalxpress.com/news/2016-11-cases-deadly-fungal-infection-emerge.html