For the average individual working in modern society, while also seeking optimal healthy longevity, the task of remaining attentive to health concerns can often be submerged by daily routines and concerns. This is particularly true of cholesterol levels since unhealthy levels are often not accompanied by any signs of ill health. ErinPharm recommends that you have multiple sources of information bringing your attention to important issues such as your lipid panel without you having to actively bring such issues to the forefront of your mind. One such source is the Mayo Clinic. Read this excellent review of triglycerides, HDL, LDL, apolipoproteins, C-reactive protein and homocysteine to appreciate the common sense of signing up for the Mayo Clinic newsletter.
From the Mayo Clinic
Kerry Fox of the Boston Globe recently pointed out that a second opinion is a wise decision particularly for patients with cancer. A study looking at initial recommendations given to breast cancer patients found that 52% had one or more changes made to those recommendations after visiting a tumor specialist. The report he quotes, published in the journal Cancer, suggests that sometimes the original doctor did not follow national treatment guidelines, and did not take into account newer techniques. The research also found that 29% of patients studied had pathologists interpret biopsy results differently than the original doctors, leading to a change in diagnosis. Although seeking a second opinion or seeking consultation with a team of specialists is a well known strategem it is often not taken by patients overwhelmed by illness. This article by Kerry Fox is important, worth paying attention to, and validates the reasons for seeking a second opinion.
From the Boston Globe
As alarm grows among medical experts about statistics revealing the increasing incidence of obesity among the young, news from The Journal of Pediatrics makes it clear that the potential risk of obesity leading to heart disease is evident in data collected from pre-teens. Surely this is a clarion call to all parents to immediately take action to prevent or reverse obesity in their children and protect them from future heart disease.
It has been evident to clinical investigators for some time that an elevated C-reactive protein level, a marker for inflammation, is a factor for subsequent heart failure. This detailed study, called the Rotterdam study, based on a cohort from a Rotterdam suburb, now places that evidence on a firm basis. The study, which included 6437 men and women without heart failure, aged 55 or over, resulted in the conclusion that C-reactive protein is strongly and independently associated with occurrence of heart failure in men. In women, the association is weaker and does not persist after accounting for established cardiovascular risk factors.
In a report from Dr. Brendan Everett of Brigham and Women's Hospital in Boston, evaluating 15,632 initially healthy middle-aged women over 10 years, it was found that elevated total cholesterol and a total-to-HDL level, and a low HDL level, were associated with future ischemic stroke risk. His team also found an association between C-reactive protein and ischemic stroke risk.
Dr. Everett told Reuters that C-reactive protein appeared to associate most closely with stroke risk at a lower level than is known for the association between elevated lipids and coronary heart disease and stroke risk.
As studies continue to evaluate the reasons why some individuals achieve exceptional age, a new study in people of Ashkenazi Jewish descent older than 95 years of age shows a variant of the cholesterol ester transfer protein (CETP), previously associated with increased HDL levels and LDL particle size and longer life, is also associated with less dementia and improved memory. Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine, studied a second cohort 20 years younger and found the same association.
In one of the longest ever follow-up studies reported, by Dr. John Sylvester of the Seattle Prostate Institute, it was found that radioactive "seed" implants in combination with external beam radiation in patients with prostate cancer gave outcomes comparable to the best results gained from surgery with 74% overall relapse-free survival rate 15 years after, and even higher survival rates among men with low to intermediate risk cancers.
In a remarkable advance in vaccine therapy, one which should be as widely known as quickly as possible, the first vaccine for human papillomavirus (HPV), approved by the FDA June 8, 2006, is a breakthrough in the prevention of cervical cancer with the expectation that universal vaccination of female children will result in a dramatic decline of cervical cancer in the decades ahead. It has been calculated that an overall lifetime reduction risk of 94% for the possibility of getting cervical cancer is a rational objective.
In a welcome development it has been reported that stem cells can be readily gathered and cultured from human amniotic fluid. Researchers reported in the January issue of Nature Biotechnology that these cells, neither embryonic nor adult, have characteristics of both and can differentiate into cells displaying specialized functions and show promise for a variety of therapeutic applications. They are easily available, so potentially a large supply of cells could be available for therapeutic applications.
In a troubling report published in the January issue of Stroke, results from the Framingham Heart Study indicate that individuals with symptoms of depression younger than 65 have quadruple the risk of ischemic stroke or transient ischemic attacks. This prospective study on 4,120 subjects between 29 and 100 years of age also noted that the risk was not seen in subjects older than 65. This conclusion needs a great deal more investigation.
Emory University in Atlanta has launched a new global health institute with backing from the Bill and Melinda Gates Foundation and Finland's National Public Health Institute. The university has budgeted $110 million for the new institute, crossing political and philosophical barriers to begin building a base for bringing facilities and trained medical staff to the developing countries. The World Health Organization (WHO) estimates 4 million more health workers are needed globally to combat AIDS alone with many more needed to battle tuberculosis and malaria.
An intriguing report from the Cleveland Clinic reported in the Journal of the American College of Cardiology assesses new analyses of two intravascular ultrasound (IVUS) studies looking at how to identify patients most likely to derive benefit from implementation of aggressive risk-factor modification strategies. This look at the differences between soft and vulnerable plaque in the coronary arteries compared to more calcified plaque seems intuitively to be very reasonable; that plaque with lower calcification is more likely to regress with lipid lowering while plaque with more calcification will not. The trials evaluated, REVERSAL and CAMELOT, are leading to better methods of stratifying patients to different medical therapies.
The continuing story of the impact of statins on humankind has now another curious, even paradoxical, turn with this report from researchers at Chapel Hill in North Carolina. Lead author of the study, Dr. Xuemei Huang, explained that risk factors for cardiovascular disease, such as smoking, have been related to a reduced incidence of Parkinson's disease, while incidence of heart attack and stroke is reduced in patients with Parkinson's disease. The paradox arises because the data indicates that casual inferences should be taken with caution, since low LDL levels seemed to be indicative of increased incidence of Parkinson's disease and yet the use of statins to lower LDL levels was related to a lower occurrence of Parkinson's disease. This does seem to relate to other recent findings that statins may be neuroprotective, as seen in studies of dementia, Alzheimer's disease, and multiple sclerosis.
At a time when we know that folate intake is not reaching FDA benchmarks in the American population, this report adds to the importance of folic acid in nutrition. In this observational study researchers at Columbia University Medical Center in New York have shown that a higher folate intake is associated with a decreased risk of Alzheimer's disease in subjects aged 65 and older in a cohort who had a high prevalence of vascular risk factors.
In a thought provoking analysis published in the January 13, 2007 issue of Lancet a group of researchers led by Dr. Scott Brouilette from the University of Leicester, UK, looked at the West of Scotland Primary Prevention Study (WOSCOPS) and found that as the length of telomeres in leukocytes shortened the risk of coronary heart disease increased and that the risk was substantially attenuated by pravastatin. Since statins have been shown to increase the production of a protein-telomere capping protein that prevents telomeres from shortening it is a potential hypothesis that statins bring about their benefit by this mechanism. This is very early research but it implies that statins could well have the ability to slow certain aging processes.
The race among pharmaceutical companies to be the first to bring to market a safe drug treatment to raise HDL-cholesterol levels is reviewed in this article. Both short-term and long-term treatments are targeted.
From Vascular Web
A startling article in New Scientist asserts that a simple cheap drug used to treat rare mitochondrial disorders, sodium dichloroacetate, killed human lung, breast and brain cancer cells cultured outside the body but not healthy cells. Tumors induced in rats with human cancer tissue also shrank drastically when they were fed sodium dichloroacetate in water. The researchers, at the University of Alberta, have a rationale for this effect and human clinical trials are planned. Dramatic though their rat studies be, this is time for scepticism and caution; such 'discoveries' have been made before but have not yielded breakthrough results after human trials. So there is hope, but let us not project our optimism into human trials that have not yet taken place.
From New Scientist