Sleep Patterns May Offer Clues to Alzheimer’s

HealthDay Reporter

WEDNESDAY, Jan. 9, 2019 (HealthDay News) — Poor sleep is common among Alzheimer’s patients, and researchers say they’re beginning to understand why.

Scientists studied 119 people aged 60 and older. Eighty percent had no thinking or memory problems, while the rest had only mild problems.

The researchers found that participants with less slow-wave sleep — deep sleep that’s needed to preserve memories and to wake up feeling refreshed — had higher levels of the brain protein tau.

Elevated tau levels are a possible sign of Alzheimer’s disease and have been linked to brain damage and mental decline, the scientists said.

The findings suggest that poor sleep among older adults could be a warning sign of declining brain health, according to the researchers at Washington University School of Medicine in St. Louis.

“We saw this inverse relationship between decreased slow-wave sleep and more tau protein in people who were either cognitively normal or very mildly impaired, meaning that reduced slow-wave activity may be a marker for the transition between normal and impaired,” said first author Dr. Brendan Lucey. He’s an assistant professor of neurology and director of the Washington University Sleep Medicine Center.

“Measuring how people sleep may be a noninvasive way to screen for Alzheimer’s disease before or just as people begin to develop problems with memory and thinking,” Lucey said in a university news release.

He noted that the people with increased tau levels “were actually sleeping more at night and napping more in the day, but they weren’t getting as good quality sleep.”

Lucey doesn’t expect sleep monitoring to replace brain scans or cerebrospinal fluid analysis for identifying early signs of Alzheimer’s disease. “But it could supplement them,” he said. The study only found an association between sleep quality and tau levels.

“It’s something that could be easily followed over time, and if someone’s sleep habits start changing, that could be a sign for doctors to take a closer look at what might be going on in their brains,” Lucey said.

About 5.7 million Americans have Alzheimer’s disease. Brain changes associated with the disease can begin up to two decades before symptoms such as memory loss and confusion appear.

The study findings were published Jan. 9 in the journal Science Translational Medicine.

Diabetes: Can we teach the body to heal itself?

In diabetes, the pancreas is unable to produce enough insulin, the hormone that is key to regulating levels of blood sugar. New research now asks if we can teach pancreatic cells to address this problem on their own.

The pancreas contains three different types of cells, each of which produces different hormones that contribute to the regulation of blood sugar levels, one way or another.

These cells are alpha-cells that produce glucagon to boost blood sugar, beta-cells that produce insulin to lower levels of glucagon, and delta-cells that produce somatostatin, a hormone that regulates alpha- and beta-cell activity.

In both type 1 and type 2 diabetes, research has linked the lack of insulin with problems in pancreatic beta-cells.

However, a new study by researchers from the University of Bergen in Norway suggests that, with just a small “push,” we may be able to train the body to start producing adequate levels of insulin once more, on its own.

More specifically, the investigators explain, some alpha-cells could turn into beta-cells and release insulin.

“We are possibly facing the start of a totally new form of treatment for diabetes, where the body can produce its own insulin, with some start-up help,” says study co-author Luiza Ghila from the Raeder Research Lab in the Department of Clinical Science at the University of Bergen.

The researchers explain their findings in detail in a study paper in the journal Nature Cell Biology.

Higher risk of blood clots associated with some HRT tablets

Thursday, 10 January 2019

Some hormone replacement therapy (HRT) tablets appear to be associated with a higher risk of rare but serious venous thromboembolism (VTE), suggests a large study* published today in The BMJ.

However, the study found no increased risk of VTE for HRT skin patches, gels or creams, although the vast majority of women choosing HRT are prescribed oral preparations.

Different treatments of HRT used to relieve menopausal symptoms are available depending on the symptoms, such as tablets containing oestrogen only or a combination of oestrogen and progestogen, as well as ‘transdermal’ treatments, such as patches, gels and creams.

Previous trials have shown increased risks of blood clots in menopausal women using HRT, but there is a lack of information on risks associated with different types of HRT.

Therefore, Yana Vinogradova, a member of an epidemiological team at the University of Nottingham led by Julia Hippisley-Cox, set out to assess the association between VTE risk and all available types of HRT in the UK between 1998 and 2017.

The research team used two UK primary care databases (QResearch and CPRD) and compared HRT prescription records of 80,396 women aged 40-79 years who developed blood clots (cases) with those of over 391,494 women who did not (controls).

Other relevant factors, such as lifestyle, family history of blood clots, and underlying conditions linked to blood clots were taken into account.

Analysis showed that most HRT tablets were found to be associated with increased VTE risk (nine extra cases per 10,000 women per year) compared with no HRT.

Tablets containing equine oestrogen, including single and combined preparations, were consistently associated with higher risks than tablets containing synthetic oestrogen.

In addition, higher doses of oestrogen were also associated with higher VTE risk, but there was no increased VTE risk found for skin patches, gels and creams.

This was an observational study so it could not establish cause and the researchers acknowledged some limitations that may have influenced the results.

Nevertheless, they said: “This study has provided a more detailed picture of the VTE risks for different HRT preparations and can help clinicians and women make treatment choices.”

They suggested clinicians should give greater consideration to transdermal HRT, particularly for women already at an increased VTE risk and in line with recent guidelines.

Royal College of General Practitioners chair Professor Helen Stokes-Lampard said the study was interesting but stressed that it showed association and not causation.

“The menopause is a transition stage for every woman and can cause difficulties for many – and for some specific symptoms, such as hot flushes and night sweats, HRT is the only medical treatment that has good evidence of benefit,” she said.

“While this study is certainly interesting and important, as the authors themselves acknowledge, the findings do not prove that tablets cause more DVTs [Deep vein thrombosis] than patches, just that there is an association. As such, it is essential that more research is conducted in this area and taken into account as new clinical guidelines are updated and developed.

“It’s important that patients don’t panic or stop taking HRT as a result of reading about this study, but instead discuss their concerns at their next routine GP appointment, or seek advice from a reputable website like NHS Choices.”

Flu Cases on Upswing as New Medicine Arrives

Jan. 7, 2019 — As predictable as post-holiday bills and weight loss resolutions, flu activity is on the rise in the U.S., the CDC reports.
Slideshow
Slideshow: Foods for the Flu

For the week ending Dec. 29, 2018, 19 states and New York City reported high flu activity, compared to 9 states and New York City the previous week. More than 1,000 lab-confirmed cases of influenza-related hospitalizations have been reported, and as of Dec. 29, 13 children have died of flu this season.

Experts hesitate to predict how bad a flu season will be, but they say several points are worth noting about year’s flu season:

A new drug to treat flu, Xofluza, is now available to pharmacies nationwide. It joins Tamiflu, the most commonly prescribed treatment.
It’s not too late to get a flu shot.
While symptoms can make you miserable, preventing complications is most important.

New Drug on the Block

Xofluza (baloxavir marboxil) was approved by the FDA in late October and treats flu symptoms, says Andrew Villani, a spokesperson for Genentech, which distributes the prescription medicine. However, when WebMD checked six pharmacies last week, just one had it in stock, although all offered to order it.

Xofluza is a single dose oral medication, and like other medicines for flu, needs to be taken quickly after symptoms start. The ideal window, doctors say, is to start it within 48 hours after symptoms begin.

Xofluza is approved for people 12 years old and older, based on results of a study that pitted the drug against a placebo. The study found the median time to symptoms improving was 54 hours on the drug and 80 hours on placebo, Villani says. “Xofluza helps you recover from the symptoms of the flu in just over 2 days,” he says.

Xofluza Availability

In a telephone spot check of major drug chains in Los Angeles, Chicago, New York City, Minneapolis, Atlanta, and Kankakee, Il., only the Minneapolis drug store had it in stock.

Staff at the other stores said they could order it, giving various timelines about how long it would take to get it in.
Old Standbys

Tamiflu has been on the market since 1999. In 2016, a generic version was approved. It comes in pill or liquid form and can be taken by people 14 days old and older.

It is typically taken twice daily for 5 days. (It can also be prescribed to prevent flu; that regimen is once a day for 7 days.) Besides Tamiflu and Xofluza, the FDA has approved zanamivir (Relenza) to treat flu in people 7 years old and older. A powder that is inhaled, it is usually taken twice daily for 5 days.

Another drug, peramivir (Rapivab), is given in a vein by a health care professional. The FDA approved it for people 2 years old and older. The one-time dose usually takes less than 30 minutes to administer.

More on Tamiflu, Xofluza

Advocates of Xofluza mention the convenience of the single dose vs. 5 days’ worth of Tamiflu doses. While the drugs require different doses and work differently, they have the same result, according to William Schaffner, MD, medical director of the National Foundation for Infectious Diseases. Both interfere with the flu virus’ ability to reproduce and multiply, he says.
Facts About the Flu Vaccine

No studies have looked at head-to-head comparisons of Xofluza and Tamiflu, says Villani of Genentech, which also markets Tamiflu.

The CDC does not recommend Xofluza for pregnant women or breastfeeding mothers, and it’s also not recommended for flu prevention or patients in the hospital.

Patients don’t seem to know about the newer drug, says Lisa Dabby, MD, an emergency medicine doctor at the UCLA Medical Center in Santa Monica, CA. “Not one person has asked me to prescribe it,” she says of Xofluza. “People know Tamiflu and they ask for it.”

If someone did request the new drug, she would consider prescribing it, she says, but first would want to be sure local pharmacies are stocking it to save patients frustration in finding it. And she reminds them: “These antivirals are not the be-all, end-alls.” They shorten how long symptoms last, but they don’t make them disappear instantly, she reminds patients.

As for side effects, patients on these antivirals most often complain of diarrhea and nausea, she says. Others report headache and common cold symptoms.

In kids, Tamiflu has been linked with some psychiatric side effects, such as irritability and occasional seizures. Those reports have caused some pediatricians to hesitate to prescribe it, Schaffner says. But those symptoms go away once the drug is stopped.
Tamiflu, Xofluza Costs

On a wholesale level, the cost of Xofluza is about $150 and of Tamiflu about $152, Villani says.

Insurance coverage and copays for these two drugs vary. But those who have commercial insurance that covers Xofluza can use a coupon available on the drug’s website and ”may pay as little as $30,” he says. Those without insurance may reduce their costs for it by about $60, with a net cost of about $90, he says.

The generic version of Tamiflu is sold online, without insurance, for about $50.

More Stats on the Flu Season

Usually, flu activity peaks from December through February, the CDC says, and February has been the most common peak month in the past 36 years.

This year, the circulating viruses are predominantly influenza A (H1N1)pdm09 and H3N2, with influenza B viruses also circulating, the CDC says.

The H1N1 viruses have been most prevalent in the United States, but the influenza A (H3) has been most common in the southeastern U.S., the CDC says.

And some good news: Most of the circulating viruses analyzed are similar to the viruses in this season’s vaccine.

Focusing on Complications, Risks

While patients with the flu are eager to feel better and get back to work or family responsibilities, doctors are focused on more than that, Schaffner says. “The main thing we want to do is prevent the serious complications of influenza.”

These include pneumonia, inflammation of the heart, and organ failure. Those at high risk of flu complications include anyone 65 and older, children younger than 5, pregnant women and women who have delivered a baby within the past 2 weeks, Native Americans, Alaska Natives, and nursing home or long-term care home residents. In addition, anyone with health conditions such as asthma, sickle cell disease, lung or heart disease, diabetes, kidney or liver problems, the very obese (BMI of 40 or more), immune system issues such as HIV, or cancer is at high risk of getting complications.

When his patients come back for a follow-up visit after getting through the flu, griping about time off work or flu misery in general, Schaffner says he often tells them: “I’m glad you are [still] here to complain.”

Things You Should Never Do to Your Skin

The Derm: Heidi Waldorf, M.D., Director of Laser And Cosmetic Dermatology, Mt. Sinai Hospital, New York City

It was Jerry Seinfeld who gave dermatologists the “Pimple Popper M.D.” moniker. The truth is, Mr. Seinfeld, we express, drain, and extract, but, we never, ever pop. The difference lies in the details of semantics and technique. Squeezing a blemish (often with bacteria-laden fingertips), creates a lot of inflammation in the skin, sometimes leaving behind scars and discoloration. If a zit is too big to bear, try to see your dermatologist for an injection of cortisone, or put on a bit of benzoyl peroxide to bring that baby down. Chronic breakouts should be managed with medical regimen tailored specifically to your type of skin and acne.

Pickers, Waldorf and I urge you, find your zen zone. Do not take that anxiety out on the skin (more on this later).

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Could You Be Eating These Foods Wrong?

Yes, eating healthy means choosing the right foods, but that’s only part of it. For example, the skin of many fruits and veggies (or just under it) is where a lot of the vitamins and minerals are, so when you peel it off, you’re missing out. Find out what you can do to get the most nutritional value out of what you put in your mouth.

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The Low-Impact Cardio Workout You Need for Lazy Days

Let’s be real for a hot second: Some days, when you start getting ready for the gym, your body (and mind) just isn’t in the mood. It’s those days — when burpees feel 10,000 times harder than they did yesterday — that you need a more chill workout. There’s nothing wrong with doing something low impact. In fact, experts say that it’s crucial to break up those balls-to-the-walls days with more low-key routines to give your body time to recover while still being active. (That said, you can still get your brain in the game. Here’s how.)

That’s where this workout from Ellen Barrett comes in. It’s a cardio-based, fat-burning walking workout, so you can do it pretty much anywhere. And it’s only 20 minutes, so you can even squeeze it in on that lunch break.

Read More…

Scientists design ‘smart’ wound healing technique

New research, published in the journal Advanced Materials, paves the way for “a new generation of materials that actively work with tissues to drive [wound] healing.”

As more and more surgical procedures are performed in the United States, the number of surgical site infections is also on the rise.

Chronic wounds that do not heal — such as those that occur in diabetes — often host a wide range of bacteria in the form of a biofilm.

Such biofilm bacteria are often very resilient to treatment, and antimicrobial resistance only increases the possibility that these wounds become infected.

According to recent estimates, chronic wounds affect approximately 5.7 million people in the U.S. Some chronic wounds can result in amputations, as is the case with diabetic ulcers.

On a global level, researchers approximate that every 30 seconds a chronic, nonhealing diabetic ulcer causes an amputation.

In this context, there is a dire need for innovative, effective wound healing methods. New research shows promise in this regard, as scientists have devised a molecule that helps harness the body’s natural healing powers.

The molecules are called traction force-activated payloads (TrAPs). They are growth factors that help materials such as collagen interact with the body’s tissues more naturally.

Ben Almquist, Ph.D., a lecturer in the department of engineering at Imperial College London in the United Kingdom, led the new research.

TrAP technology and wound healing

Materials such as collagen are often used in wound healing. For instance, collagen sponges can treat burn injuries, and collagen implants can help bones regenerate.

But how does collagen interact with tissue? In so-called scaffold implants, cells move through the collagen structure, pulling the scaffold along with them. This triggers healing proteins, such as growth factors, that help the tissue regenerate.

In the new study, Almquist and the team engineered TrAP molecules to recreate this natural process. The scientists “folded” DNA strands into aptamers, which are three-dimensional shapes that bind to proteins.

Then, they designed a “handle” for cells to grip. They attached cells to one end of the handle and a collagen scaffold to the other end.

Lab tests revealed that the cells dragged the TrAPs along as they moved through the collagen implants. In turn, this activated growth proteins that triggered the healing process within the tissue.

The scientists explain that this technique recreates healing processes that exist throughout the natural world. “Using cell movement to activate healing is found in creatures ranging from sea sponges to humans,” says Almquist.

“Our approach mimics them and actively works with the different varieties of cells that arrive in our damaged tissue over time to promote healing,” he adds.

A ‘new generation’ of healing materials

The research also revealed that tweaking the cellular handle changes the type of cells that can attach and hold on to the TrAPs.

In turn, this enables TrAPs to release personalized regenerative proteins based on the cells that have attached to the handle.

This adaptability to different types of cells means that the technique can be applied to various types of wounds — ranging from bone fractures to scar tissue injuries caused by heart attacks and from nerve damage to diabetic ulcers.

Finally, aptamers are already approved as drugs for human clinical use, which could mean that the TrAP technique may become widely available sooner rather than later.

“The TrAP technology provides a flexible method to create materials that actively communicate with the wound and provide key instructions when and where they are needed,” explains Almquist.

“This sort of intelligent, dynamic healing is useful during every phase of the healing process, has the potential to increase the body’s chance to recover, and has far-reaching uses on many different types of wounds,” he adds.

The researcher concludes, “[t]his technology has the potential to serve as a conductor of wound repair, orchestrating different cells over time to work together to heal damaged tissues.”

Pediatric leukemia ‘super drug’ could be developed in the coming years

Northwestern Medicine scientists have discovered two successful therapies that slowed the progression of pediatric leukemia in mice, according to three studies published over the last two years in the journal Cell, and the final paper published Dec. 20 in Genes & Development.

When a key protein responsible for leukemia, MLL, is stabilized, it slows the progression of the leukemia, the most recent study found. The next step will be to combine the treatments from the past two years of research into a pediatric leukemia “super drug” to test on humans in a clinical trial.

The survival rate is only 30 percent for children diagnosed with MLL-translocation leukemia, a cancer that affects the blood and bone marrow. Patients with leukemia have a very low percentage of red blood cells, making them anemic, and have approximately 80 times more white blood cells than people without cancer.

“These white blood cells infiltrate many of the tissues and organs of the affected individuals and is a major cause of death in leukemia patients,” said senior author Ali Shilatifard, the Robert Francis Furchgott Professor of Biochemistry and Molecular Genetics and Pediatrics, the chairman of biochemistry and molecular genetics and the director of Northwestern’s Simpson Querrey Center for Epigenetics. “This is a monster cancer that we’ve been dealing with for many years in children.”

There are several types of leukemia. This research focused on the two most common found in infants through teenagers: acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL).

For the past 25 years, Shilatifard’s laboratory has been studying the molecular function of MLL within its complex known as COMPASS (Complex Proteins Associated with Set1). Most recently, it was demonstrated that COMPASS components are one of the most frequently identified mutations in cancer. The next step of this work will be to bring the drug to a clinical trial setting, which Shilatifard said he hopes will happen in the next three to five years.

“I’ve been working on this translocation for more than two decades, and we’re finally at the point where in five to 10 years, we can get a drug in kids that can be effective,” Shilatifard said. “If we can bring that survival rate up to 85 percent, that’s a major accomplishment.”

Earlier work from Shilatifard’s laboratory published in Cell in 2018 identified compounds that could slow cancer growth by interrupting a gene transcription process known as “Super Elongation Complex” (SEC). It was the first compound in its class to do this.

This MLL stabilization process discovered in the most recent paper could potentially work in cancers with solid tumors, such as breast or prostate cancer, said first author Zibo Zhao, a postdoctoral research fellow in Shilatifard’s lab.

“This opens up a new therapeutic approach not only for leukemia, which is so important for the many children who are diagnosed with this terrible cancer, but also for other types of cancers that plague the population,” Zhao said.

“The publication of these four papers and the possibility of a future human clinical trial could not have happened if it weren’t for the cross-disciplinary collaboration at Northwestern,” Shilatifard said.

Iron-Rich Foods

Spinach may not give you superhuman strength to fight off villains like Popeye’s nemesis Bluto, but this leafy green and other foods containing iron can help you fight a different type of enemy — iron-deficiency anemia.

Iron-deficiency anemia, the most common form of anemia, is a decrease in the number of red blood cells caused by too little iron. Without sufficient iron, your body can’t produce enough hemoglobin, a substance in red blood cells that makes it possible for them to carry oxygen to the body’s tissues. As a result, you may feel weak, tired, and irritable.

About 20% of women, 50% of pregnant women, and 3% of men do not have enough iron in their body. The solution, in many cases, is to consume more foods high in iron.

How Your Body Uses Iron in Food

When you eat food with iron, iron is absorbed into your body mainly through the upper part of your small intestine.

There are two forms of dietary iron: heme and nonheme. Heme iron is derived from hemoglobin. It is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry (meat, poultry, and seafood contain both heme and non-heme iron). Your body absorbs the most iron from heme sources. Most nonheme iron is from plant sources.

Iron-Rich Foods

Very good sources of heme iron, with 3.5 milligrams or more per serving, include:
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  • 3 ounces of beef or chicken liver
  • 3 ounces of clams or mussels
  • 3 ounces of oysters

Good sources of heme iron, with 2.1 milligrams or more per serving, include:

  • 3 ounces of cooked beef
  • 3 ounces of canned sardines, canned in oil

Other sources of heme iron, with 0.6 milligrams or more per serving, include:

  • 3 ounces of chicken
  • 3 ounces of cooked turkey
  • 3 ounces of ham
  • 3 ounces of veal

Other sources of heme iron, with 0.3 milligrams or more per serving, include:

  • 3 ounces of halibut, haddock, perch, salmon, or tuna

Iron in plant foods such as lentils, beans, and spinach is nonheme iron. This is the form of iron added to iron-enriched and iron-fortified foods. Our bodies are less efficient at absorbing nonheme iron, but most dietary iron is nonheme iron.

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