Earlier Mortality with Restless Legs Syndrome.


Results from a Health Professionals Follow-up Study analysis support an association.

To examine the controversial notion that restless legs syndrome (RLS) is associated with increased mortality, researchers tracked mortality among 18,425 participants in the Health Professionals Follow-up Study (HPFS) who answered a standardized questionnaire about the potential presence of RLS. Patients with diabetes, arthritis, or renal failure were excluded. The investigators documented deaths comprehensively using vital statistics, the National Death Index, family reports, and the postal system.

A total of 2765 deaths occurred between 2002 and 2010. After adjustment for age, RLS was associated with a significant increase in mortality (hazard ratio [HR], 1.39). The association was mildly weakened after adjustment for factors such as body-mass index, lifestyle, other chronic diseases, amount of sleep, and other sleep-related disorders (adjusted HR, 1.30). After excluding other chronic diseases associated with RLS (e.g., Parkinson disease), the association remained significant (adjusted HR, 1.92). Age, weight, short sleep duration, smoking, poor exercise, and a less healthy diet did not affect the association. The study did not include blood testing for iron deficiency.

Comment: Restless legs syndrome affects an estimated 5% to 10% of the population. Because of the association between RLS and chronic conditions such as renal disease, disentangling the mortality risk of RLS has been challenging. Strengths of the current study include accounting for all potential comorbidities such as diabetes, cardiovascular disease, and kidney disease, and establishment of the RLS diagnosis through the use of standardized questions. Not only was there an increased mortality with RLS in general, but this increased mortality occurred more commonly when there was concomitant respiratory dysfunction, endocrine disease, nutritional issues, or presence of metabolic disease or an immunologic disorder. Although observational studies do not prove causality, clinicians should be aware of the increased mortality risk in any patient presenting with RLS-type symptoms. This study was limited by the lack of information on use of dopaminergic medication, which is the best treatment for RLS. Neurologists and primary care doctors should to work together when treating RLS patients. Treating primary RLS symptoms and addressing sleep, blood pressure, cardiovascular, and other comorbidities could be helpful. However, we do not yet understand how to modify the increased mortality risk in patients with RLS.

Source: Journal Watch Neurology

 

FDA Investigating Two Deaths Linked to Schizophrenia Drug.


The FDA is investigating the deaths of two patients following injection of the long-acting antipsychotic olanzapine pamoate (Zyprexa Relprevv). The deaths occurred 3 to 4 days after injection, well beyond the 3-hour monitoring period that the drug requires.

Postmortem blood tests revealed very high levels of olanzapine. The drug’s label includes a warning about post-injection delirium sedation syndrome, the FDA notes. This occurs when the drug enters the bloodstream too quickly, leading to sedation and possibly coma, as well as delirium. High doses can also lead to cardiopulmonary arrest and arrhythmias, according to the agency.

The FDA is reminding providers who prescribe olanzapine pamoate to follow its Risk Evaluation and Mitigation Strategy, which includes injection at a certified facility, at least 3 hours of monitoring following injection, and accompaniment to one’s home afterward.

Source: FDA 

Does Death Exist? New Theory Says ‘No’.


Many of us fear death. We believe in death because we have been told we will die. We associate ourselves with the body, and we know that bodies die. But a new scientific theory suggests that death is not the terminal event we think.

does_death_exist

One well-known aspect of quantum physics is that certain observations cannot be predicted absolutely. Instead, there is a range of possible observations each with a different probability. One mainstream explanation, the “many-worlds” interpretation, states that each of these possible observations corresponds to a different universe (the ‘multiverse’). A new scientific theory – called biocentrism– refines these ideas. There are an infinite number of universes, and everything that could possibly happen occurs in some universe. Death does not exist in any real sense in these scenarios. All possible universes exist simultaneously, regardless of what happens in any of them. Although individual bodies are destined to self-destruct, the alive feeling – the ‘Who am I?’- is just a 20-watt fountain of energy operating in the brain. But this energy doesn’t go away at death. One of the surest axioms of science is that energy never dies; it can neither be created nor destroyed. But does this energy transcend from one world to the other?

Consider an experiment that was recently published in the journalScience showing that scientists could retroactively change something that had happened in the past. Particles had to decide how to behave when they hit a beam splitter. Later on, the experimenter could turn a second switch on or off. It turns out that what the observer decided at that point, determined what the particle did in the past. Regardless of the choice you, the observer, make, it is you who will experience the outcomes that will result. The linkages between these various histories and universes transcend our ordinary classical ideas of space and time. Think of the 20-watts of energy as simply holo-projecting either this or that result onto a screen. Whether you turn the second beam splitter on or off, it’s still the same battery or agent responsible for the projection.

According to Biocentrism, space and time are not the hard objects we think. Wave your hand through the air – if you take everything away, what’s left? Nothing. The same thing applies for time. You can’t see anything through the bone that surrounds your brain. Everything you see and experience right now is a whirl of information occurring in your mind. Space and time are simply the tools for putting everything together.

Death does not exist in a timeless, spaceless world. In the end, even Einstein admitted, “Now Besso” (an old friend) “has departed from this strange world a little ahead of me. That means nothing. People like us…know that the distinction between past, present, and future is only a stubbornly persistent illusion.” Immortality doesn’t mean a perpetual existence in time without end, but rather resides outside of time altogether.

This was clear with the death of my sister Christine. After viewing her body at the hospital, I went out to speak with family members. Christine’s husband – Ed – started to sob uncontrollably. For a few moments I felt like I was transcending the provincialism of time. I thought about the 20-watts of energy, and about experiments that show a single particle can pass through two holes at the same time. I could not dismiss the conclusion: Christine was both alive and dead, outside of time.

Christine had had a hard life. She had finally found a man that she loved very much. My younger sister couldn’t make it to her wedding because she had a card game that had been scheduled for several weeks. My mother also couldn’t make the wedding due to an important engagement she had at the Elks Club. The wedding was one of the most important days in Christine’s life. Since no one else from our side of the family showed, Christine asked me to walk her down the aisle to give her away.

Soon after the wedding, Christine and Ed were driving to the dream house they had just bought when their car hit a patch of black ice. She was thrown from the car and landed in a banking of snow.

“Ed,” she said “I can’t feel my leg.”

She never knew that her liver had been ripped in half and blood was rushing into her peritoneum.

After the death of his son, Emerson wrote “Our life is not so much threatened as our perception. I grieve that grief can teach me nothing, nor carry me one step into real nature.”

Whether it’s flipping the switch for the Science experiment, or turning the driving wheel ever so slightly this way or that way on black-ice, it’s the 20-watts of energy that will experience the result. In some cases the car will swerve off the road, but in other cases the car will continue on its way to my sister’s dream house.

Christine had recently lost 100 pounds, and Ed had bought her a surprise pair of diamond earrings. It’s going to be hard to wait, but I know Christine is going to look fabulous in them the next time I see her.

Source: BBC

 

NASA Scientist Reveals How You Can Improve Your Health by Moving Correctly.


Story at-a-glance

  • Sitting for extended periods of time is an independent risk factor for poor health and premature death.
  • An analysis of 18 studies found that people who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least
  • Research by a former NASA scientist shows your body needs perpetual motion to function optimally. The good news is that there are virtually unlimited opportunities for movement throughout the day, from doing housework or gardening, to cooking and even just standing up every 10 to 15 minutes
  • To compensate for long hours spent sitting down at work, you could incorporate Foundation Training exercises; powerful simple structural movements that help strengthen and realign your body posture
  • Grounding, by walking barefoot outside, is another grossly neglected foundational practice for optimal health that you can easily correct

Most people, including me, spend a large portion of each day in a seated position. It’s hard to avoid these days, as computer work predominates, and most also spend many precious hours each week commuting to and from work.

Interestingly, a growing body of evidence suggests that sitting in and of itself is an independent risk factor for poor health and premature death—even if you exercise regularly.

An increasingly sedentary lifestyle has led to a steady increase in a number of health problems, including:

While these disorders were historically associated with advancing age, they now affect increasing numbers of people well before middle-age. Even children are falling victim.

In the video above, Dr. Joan Vernikos,1 former director of NASA’s Life Sciences Division and author of Sitting Kills, Moving Heals, presents a scientific explanation for why sitting has such a dramatic impact on your health, and what you can do about it.

In another words, she was one of the primary doctors assigned to keep the astronauts from deteriorating in space, and what she found has profound implications for each and every one of us.

You might think, like I did, that if you had a phenomenal exercise program that you wouldn’t have to worry about prolonged sitting. But nothing could be further from the truth.

In order to figure out why regular exercise does not appear to compensate for the negative effects of prolonged sitting, some of her research focused on finding out what type of movement is withdrawn by sitting.

The Gravity of the Situation…

What she discovered was nothing short of astounding. “Standing was more effective than walking,” she says. And, it wasn’t how long you were standing, but how many times you stood up that made the difference. In conclusion, she discovered that it is the change in posture that is the most powerful, in terms of having a beneficial impact on your health.

In a nutshell, your body needs perpetual motion to function optimally. As Dr. Vernikos states, the good news is that there are virtually unlimited opportunities for movement throughout the day.

“The key to lifelong health is more than just traditional gym exercise once a day, three to five times a week,” she says. “The answer is to rediscover a lifestyle of constant, natural low-intensity non-exercise movement that uses the gravity vector throughout the day.”

Some of the examples she lists include housecleaning, stirring a pot of pasta sauce, rolling dough, gardening, hanging clothes to dry, dancing… the list is endless, because it covers the entire spectrum of movements you engage in during daily life. Interestingly, recent research23 has also found that those who engage in community gardening projects have considerably lower body mass index (BMI) than non-gardeners. Overall, female community gardeners were 46 percent less likely to be overweight or obese than the average woman in their neighborhood, and men who gardened were 62 percent less likely to be overweight or obese than their non-gardening neighbors.

The problem is that our modern society and our reliance on technology has reduced or eliminated many of these opportunities for low-intensity movement and replaced it with sitting. Instead of walking across the street to talk to your best friend, you send them a text while slumped on the couch. Some people even text other family members inside the same house instead of getting up and walking into the next room! All of this sloth-like inactivity adds up.

The answer then, as Dr. Vernikos states, is to reintroduce these opportunities for movement. Part of the mechanism that makes non-strenuous, posture-shifting movement so effective is that it engages what she refers to as the gravity vector. The less you move, the less you use gravity, and gravity, it turns out, is your lifeline

’ve previously written about the health benefits of Acceleration Training, or Whole Body Vibration Training, in which you perform exercises on a vibrating platform such as the Power Plate. Acceleration Training works by increasing the force of gravity on your body—which is at the heart of issue, according to Dr. Vernikos.

To a lesser degree, a mini trampoline will also increase the G forces on your body and provide similar, yet less extreme, benefits. A mini trampoline or rebounder subjects your body to gravitational pulls ranging from zero at the top of each bounce to 2 to 3 times the force of gravity at the bottom, depending on how high you jump. Some of the benefits rebounding offers include circulating oxygen and nutrients to tissues and organs, and promoting increased muscle strength.

Mounting Evidence Indicts Sitting as Independent Risk Factor for Poor Health

In recent years, researchers have taken a serious look at the effects of inactivity, and have repeatedly found that not moving or engaging in very limited-range movements for extended periods of time has a profoundly negative impact on health and longevity. For example, one study, published last year in the British Journal of Sports Medicine,4 concluded that adults who spend an average of six hours a day in front of the TV will reduce their life expectancy by just under 5 years, compared to someone who does not watch TV.

Again, it’s a matter of allowing technology to severely limit your opportunity for regular movement. If you weren’t watching TV, what would you do? Unless you’re sitting down reading, chances are you’d be doing something that requires you to move your body.

Another recent analysis5 of 18 studies (which in total included nearly 800,000 people), found that those who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least. And, while prolonged sitting was linked to an overall greater mortality risk from any cause, the strongest link was to death due to diabetes. According to lead researcher Thomas Yates, MD:6

“Even for people who are otherwise active, sitting for long stretches seems to be an independent risk factor for conditions like diabetes, cardiovascular disease, and kidney disease.”

A 2009 study7 highlighted much of the recent evidence linking sitting with biomarkers of poor metabolic health, showing how total sitting time correlates with an increased risk of type 2 diabetes, heart disease and other prevalent chronic health problems—even if you exercise regularly. According to the authors:

“Even if people meet the current recommendation of 30 minutes of physical activity on most days each week, there may be significant adverse metabolic and health effects from prolonged sitting — the activity that dominates most people’s remaining ‘non-exercise’ waking hours.”

In other words, even if you’re fairly physically active, riding your bike to work or hitting the gym four or five days a week — you may still succumb to the effects of too much sitting if the majority of your day is spent behind a desk or on the couch.

Counteracting the Ill Effects of Sitting, Using Foundation Training

While sitting down is not the only thing that can cause trouble (adopting any particular posture for long periods of time can slow down your circulatory system), sitting is one of the most pervasive postures in modern civilizations. So how can you increase your activity levels if you have a fulltime “desk job,” as so many of us do these days?

One of the things I do to compensate for the time I spend sitting each day is to regularly do Foundation exercises developed by a brilliant chiropractor, Eric Goodman. These exercises also address the root cause of most low back pain, which is related to weakness and imbalance among your posterior chain of muscles. It is easily argued that these imbalances are primarily related to sitting. I recently interviewed Dr. Goodman about his techniques, so to learn more, you can check out that interview.

Below are two video demonstrations: “The Founder,” which helps reinforce proper movement while strengthening the entire back of your body, and “Adductor Assisted Back Extension,” which will teach you how to properly extend your spine.

Besides “disengaging from the gravity vector,” when you sit, your head and shoulders drop forward, and your hip flexors and abdomen shorten. This misalignment is a major cause of chronic pains. Every exercise included in Foundation Training lengthens the front of your body, which is over-tightened, and strengthens the back of your body, which will help you stand tall and move with strength and flexibility. I do these exercises daily and it is a great tool to build a stronger and more stable low back. As explained by Dr. Goodman:

“The place to start is learning how to hinge effectively. Learn how your hamstrings, lower back, and glutes are designed to work and stretch together. Once that part is in place, you can then advance to all the exercises that build upon that foundation, that build upon The Founder exercise.”

Source: mercola.com

Focused PSA Screening Strategy, Based on Empirical Data.


Three lifetime prostate-specific antigen tests (age: mid 40s, early 50s, and 60) are sufficient for at least half of men.

 

Swedish investigators have reported that 60-year-old men with blood prostate-specific antigen (PSA) levels 1 µg/L have 0.2% risk for prostate cancer within 25 years (JW Gen Med Oct 7 2010). In this study, the same investigators determined the associations between PSA levels at various ages and subsequent risk for metastatic prostate cancer and prostate cancer–related death.

From 1974 to 1984, 21,000 men (age, 52) provided baseline blood samples; 4900 provided additional samples 6 years later. During a median follow-up of 27 years, prostate cancer was diagnosed in 1369 men: Metastatic disease occurred in 241 men, and 163 prostate cancer–related deaths were recorded. Outcomes were as follows:

  • 15-year risk for metastatic prostate cancer was 0.6% for men in the highest PSA decile at age 40 (1.3 µg/L), 1.6% for men in the highest PSA deciles at ages 45 to 49 (1.6 µg/L), and 5.2% for men in the highest deciles at ages 51 to 55 (2.4 µg/L)
  • For men with PSA levels below the median at ages 45 to 49 (0.68 µg/L) and 51 to 55 (0.85 µg/L), 15-year risks for metastatic prostate cancer were only 0.1% and 0.3%, respectively
  • 44% of prostate cancer–related deaths within 30 years occurred in men in the highest PSA deciles at ages 45 to 49 (1.6 µg/L) and 51 to 55 (2.4 µg/L)

Comment: Based on these results, the authors recommend that screening not begin until age 45 and that men with PSA levels 1.0 µg/L undergo one repeat screening in their 50s and one at age 60 (those with PSA levels 1.0 µg/L at age 60 should not undergo further screening). They also suggest that men with PSA levels >1.0 µg/L at any age undergo more frequent screening and that men in the highest PSA deciles at ages 45 to 55 receive “particular focus,” because they contribute close to half of all deaths from prostate cancer before age 75. Although this strategy could be more efficient than the annual screening often conducted in the U.S., whether screening in this manner would prevent prostate cancer–related mortality is unclear.

 

Source:Journal Watch General Medicine

 

Early and long-term excess mortality in 227 patients with intracranial dural arteriovenous fistulas.


Abstract

OBJECT

The aim of this study was to assess the early and long-term excess mortality in patients with intracranial dural arteriovenous fistula (DAVF) compared with a matched general Finnish population in an unselected, population-based series.

METHODS

The authors identified 227 patients with DAVFs admitted to 2 of the 5 Departments of Neurosurgery in FinlandHelsinki and Kuopio University Hospitals—between 1944 and 2006. All patients were followed until death or the end of 2009. Long-term excess mortality was estimated using the relative survival ratio compared with the general Finnish population matched by age, sex, and calendar year.

RESULTS

The median follow-up period was 10 years (range 0–44 years). Two-thirds (67%) of the DAVFs were located in the region of transverse and sigmoid sinuses. Cortical venous drainage (CVD) was present in 28% of the DAVFs (18% transverse and sigmoid sinus, 42% others). Of the 61 deaths counted, 11 (18%) were during the first 12 months and were mainly caused by treatment complications (5 of 11, 45%). The 1-year survivors presenting with hemorrhage experienced excess mortality until 7 years from admission. However, DAVFs with CVD were associated with significant, continuous excess mortality. There were more cerebrovascular and cardiovascular deaths in this group of patients than expected in the general Finnish population. Location other than transverse and sigmoid sinuses was also associated with excess mortality.

CONCLUSIONS

In the patients with DAVF there was excess mortality during the first 12 months, mainly due to treatment complications. Thereafter, their overall long-term survival became similar to that of the matched general population. However, DAVFs with CVD and those located in regions other than transverse and sigmoid sinuses were associated with marked long-term excess mortality after the first 12 months.

Source: JNS

 

Eating oily fish ‘can extend life’.


fish

Eating oily fish rich in omega-3 fatty acids can add years to your life, a study has shown.

Higher blood levels of omega-3 reduce the chances of dying from heart disease by more than a third, according to the research.

They cut the overall risk of dying by as much as 27 per cent.

Scientists found that people with the largest amounts of the fatty acids in their blood lived on average 2.2 years longer than those with lower levels.

“Although eating fish has long been considered part of a healthy diet, few studies have assessed blood omega-3 levels and total deaths in older adults,” said lead researcher Dr Dariush Mozaffarian, from the Harvard School of Public Health in the US.

“Our findings support the importance of adequate blood omega-3 levels for cardiovascular health, and suggest that later in life these benefits could actually extend the years of remaining life.”

The scientists analysed 16 years of data from around 2,700 US adults aged 65 and older taking part in the Cardiovascular Health Study (CHS).

Participants gave blood samples and were questioned about their health, medical history and lifestyle.

Three key omega-3 fatty acids, both separately and together, were associated with a significantly reduced risk of death.

One, docosahexaenoic acid ( DHA) , was linked to a 40% lower risk of death due to coronary heart disease. This was especially true for deaths caused by heart rhythm disturbances.

Another omega-3 compound, docosapentaenoic acid (DPA) was strongly associated with a lower risk of death from stroke.

The third type of omega-3, eicosapentaenoic acid (EPA) was linked to a reduced risk of non-fatal heart attack.

Overall, participants with the highest levels of all three types of fatty acid had a 27 per cent lower risk of death from all causes.

The findings appear in the online edition of the journal Annals of Internal Medicine.

Oily fish, such as mackerel, tuna and sardines, is the most important source of omega-3. The fatty acids can also be found in flaxseed, walnuts and rapeseed oil.

Source: .independent.co.uk

Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study.


depressedman

Objective To determine the risk of people with mental disorders being victims of homicide.

Design National cohort study.

Setting Sweden.

Participants Entire adult population (n=7 253 516).

Main outcome measures Homicidal death during eight years of follow-up (2001-08); hazard ratios for the association between mental disorders and homicidal death, with adjustment for sociodemographic confounders; potential modifying effect of comorbid substance use.

Results 615 homicidal deaths occurred in 54.4 million person years of follow-up. Mortality rates due to homicide (per 100 000 person years) were 2.8 among people with mental disorders compared with 1.1 in the general population. After adjustment for sociodemographic confounders, any mental disorder was associated with a 4.9-fold (95% confidence interval 4.0 to 6.0) risk of homicidal death, relative to people without mental disorders. Strong associations were found irrespective of age, sex, or other sociodemographic characteristics. Although the risk of homicidal death was highest among people with substance use disorders (approximately ninefold), the risk was also increased among those with personality disorders (3.2-fold), depression (2.6-fold), anxiety disorders (2.2-fold), or schizophrenia (1.8-fold) and did not seem to be explained by comorbid substance use. Sociodemographic risk factors included male sex, being unmarried, and low socioeconomic status.

Conclusions In this large cohort study, people with mental disorders, including those with substance use disorders, personality disorders, depression, anxiety disorders, or schizophrenia, had greatly increased risks of homicidal death. Interventions to reduce violent death among people with mental disorders should tackle victimisation and homicidal death in addition to suicide and accidents, which share common risk factors.

Source:BMJ

 

 

Norovirus Infection Causes Substantial Problems in Elders.


Hospitalization rates and mortality rose during outbreaks in nursing homes.

Gastroenteritis outbreaks, 86% of which are caused by norovirus, are common in nursing homes. Norovirus infection is thought to be associated with substantial morbidity and mortality in nursing home residents, but the exact risk is undefined.

In this retrospective cohort study, researchers used linked databases of infection outbreaks and Medicare nursing homes to assess the incidences of hospitalizations and deaths during norovirus outbreaks in 308 nursing homes in Oregon, Wisconsin, and Pennsylvania. Four hundred seven outbreaks were reported during 2009 and 2010, with a median of 26 cases per outbreak. In analyses adjusted for seasonal differences, risk for hospitalization was 9% higher and risk for death was 11% higher during outbreaks than at other times.

Comment: These results put some hard numbers to the trends that are observed clinically: Risks for hospitalization and death rise during norovirus outbreaks in nursing homes. The authors estimate that about 100 excess hospitalizations and 45 excess deaths occurred in these homes during the study period, which translates to 500 to 600 excess deaths in nursing home residents nationwide during 2 years. Norovirus vaccine development (now under way) and more aggressive infection control strategies are warranted.

Source: Journal Watch General Medicine

 

 

 

Outbreak of Illness and Death Among Children in Cambodia.


The outbreak appears to have been caused by enterovirus 71.

In early July 2012, an outbreak of severe illness with high mortality was reported by the Ministry of Health in Cambodia. According to a WHO report dated July 13, 78 cases in 14 provinces had been identified since April, mostly in children aged ❤ years.

Investigation focused on the 61 children who met the case definition, of whom 54 had died. Illness manifestations included respiratory symptoms, fever, and generalized neurological abnormalities; children who died usually did so within 24 hours after hospital admission. Samples from 31 patients were tested for a variety of pathogens by Institut Pasteur du Cambodge, and “most” tested positive for enterovirus 71 (EV-71); a few also tested positive for dengue virus or Streptococcus suis. On July 15, 2012, authorities announced that no additional cases had been noted in Cambodia. Investigators believed that the use of steroids, which can suppress the immune system, worsened the illness in many of the patients.

Comment: EV 71 — a member of the picornavirus family — was first isolated in the late 1960s. It has been associated with outbreaks worldwide, most recently in Asia. Infection with EV 71, like that with other enteroviruses, ranges from asymptomatic to lethal and can manifest as rashes, diarrhea, respiratory symptoms, meningitis, hand-foot-mouth disease (HFMD), or myocarditis. Less commonly, it has been associated with acute flaccid paralysis, encephalitis, Guillain-Barré syndrome, and pulmonary edema and hemorrhage.

HFMD is most often caused by coxsackievirus A16 (another enterovirus) but is also caused by EV 71. According to the WHO, HFMD usually begins with fever, poor appetite, malaise, and sore throat. One or 2 days after fever onset, painful sores develop on the tongue, gums, and inside of the cheeks, beginning as small red blistering spots and then often becoming ulcers. A nonitchy skin rash develops over 1 or 2 days, with flat or raised red spots that may blister. Usually located on the palms of the hands and soles of the feet, the rash can also appear on the buttocks or genitals. Generally, HFMD is spread from person to person by direct contact with nose or throat discharges, saliva, fluid from blisters, or stool of infected persons. Transmissibility is greatest during the first week of the illness but can last for several weeks. No vaccine or antiviral agent has proven effective in preventing or treating EV 71 infection.

Source: Journal Watch Infectious Diseases