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Monthly Archives: October 2016

Chemical Found in Blood Holds

Even within the normal range, higher bilirubin levels appear to be associated with reduced risks of lung cancer, chronic obstructive pulmonary disease (COPD), and death, a longitudinal, prospective analysis of a large database showed.

For every 0.1-mg/dL increase in bilirubin level, the rate of lung cancer dropped by 8 percent in men and 11 percent in women, according to Laura Horsfall, MSc, of University College London, and colleagues.

In addition, the same incremental increase in bilirubin was associated with a 6 percent decline in the rate of COPD and a 3 percent decline in mortality for both sexes, the researchers reported in the Feb. 16 issue of the Journal of the American Medical Association.

“Based on our findings, bilirubin levels within the normal range appear to capture information about patients that may reflect a combination of environmental and genetically determined susceptibility to respiratory diseases,” they wrote.

Most people are familiar with bilirubin because of its role in jaundice — the yellowing of the skin that is sometimes seen in newborns but is also associated with liver disease.

Bilirubin is actually a byproduct of the turn over of red blood cells — the cells that carry oxygen throughout the body. Healthy individuals constantly replace old red blood cells with new ones. As the old cells are broken down they produce bilirubin, a chemical characterized by a distinctive yellow color.

The spleen and the liver taking in bilirubin and use it to break down or metabolize other substances into bile, which is used to aid digestion.

Although the study cannot establish causality for any of the relationships, there is some experimental evidence that bilirubin has benefits for respiratory health because of its cytoprotective properties, including antioxidant, anti-inflammatory, and antiproliferative effects, according to the researchers.

They noted that a better understanding of the possible mechanisms linking bilirubin levels to lung cancer, COPD, and death may lead to potential therapies that target the activity of UGT1A1, a liver enzyme responsible for converting insoluble bilirubin to an excretable form.

Horsfall and her colleagues examined data from the Health Improvement Network, a U.K. primary care research database.

Their analysis included 504,206 patients ages 20 and older from 371 practices. All of the patients had recorded serum bilirubin levels but no evidence of hepatobiliary or hemolytic disease.

Median bilirubin levels were 0.64 mg/dL in men and 0.53 mg/dL in women.

Through a median follow-up of eight years, there were 1,341 incident cases of lung cancer, 5,863 incident cases of COPD, and 23,103 all-cause deaths. The corresponding rates per 10,000 person-years were 2.5, 11.9, and 42.5.

For men, the rate of lung cancer per 10,000 person-years dropped from 5.0 in the lowest decile of bilirubin levels to 3.0 in the fifth decile. Similar declines were seen for COPD (19.5 to 14.4) and death (51.3 to 38.1).

The findings were similar for all outcomes in women, and the declines in both sexes remained significant after adjustment for age, body mass index, systolic blood pressure, smoking, alcohol intake, and a measure of social deprivation.

The authors acknowledged some limitations of the study, including possible residual confounding by unmeasured environmental exposures or race/ethnicity and the inability to establish causality for the observed relationships.

Walking Can Helps Brain And Heart

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in theProceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.

The study was supported by the National Institute on Aging, the Pittsburgh Claude D. Pepper Older Americans Independence Center, and the University of Pittsburgh Alzheimer’s Disease Research Center. The authors said they had no conflicts.

How Seat Belts Save Lives ?

It’s been proven time and again, on back roads and superhighways: A seat belt can save a life in a car accident. According to the National Highway Traffic Safety Administration (NHTSA), more than 15,000 lives are saved each year in the United States because drivers and their passengers were wearing seat belts when they were in accidents.

Seat Belt Safety: 5-Way Protection

“Seat belts prevent occupants of the vehicle from serious injury in five ways,” says Angela Osterhuber, director of the Pennsylvania Traffic Injury Prevention Project in Media, Pa. A seat belt:

  • Keeps the occupants of the vehicle inside. “It’s clearly a myth that people are better off being thrown clear from the crash,” Osterhuber says. “People thrown from a vehicle are four times more likely to be killed than those who remain inside.”
  • Restrains the strongest parts of the body. “Restraints are designed to contact your body at its strongest parts. For an older child and adult, these parts are the hips and shoulders, which is where the seat belt should be strapped,” Osterhuber says.
  • Spreads out any force from the collision. “Lap-and-shoulder belts spread the force of the crash over a wide area of the body. By putting less stress on any one area, they can help you avoid serious injury,” Osterhuber says. A shoulder strap also helps keep your head and upper body away from the dashboard, steering wheel, and other hard interior parts of the automobile should you stop suddenly or be hit by another vehicle.
  • Helps the body to slow down. “What is it that causes injury? A quick change in speed,” Osterhuber says. “Seat belts help extend the time it takes for you to slow down in a crash.”
  • Protects your brain and spinal cord. A seat belt is designed to protect these two critical areas. “Head injuries may be hard to see immediately, but they can be deadly,” Osterhuber says. Likewise, spinal cord injuries can have serious consequences.

Seat Belt Safety: Buckle Up Correctly

Adjusting your seat belt properly is a must: Getting the right fit is as important as wearing it. The strap that goes across your lap should fit snugly over your hips and upper thigh area. “If the belt rides up on the stomach, it could cause serious injuries in a crash,” Osterhuber says.

Shoulder belts should rest securely across your chest and shoulders between your breasts. Don’t ever let the strap fall across your neck or face and never place the strap under your arms or behind your back. “Any one of these positions can cause serious injury,” Osterhuber says.

Seat Belt Safety: Rules for Infants and Children

Children are not small adults — they need specialized protection in a moving vehicle. “Their skeletal structure is different,” Osterhuber says. Age, height, and weight determine the safest way for a child to travel.

According to the American Academy of Pediatrics, here’s how to select the right option for your child:

  • Rear-facing child safety seat. Children under age 1 and those who weigh less than 20 pounds should sit in rear-facing, child safety seats approved by the National Highway Traffic Safety Administration (NHTSA). The seats should be placed in the backseat of the car.
  • Forward-facing child safety seat. Children older than 1 who weigh more than 20 pounds should ride in forward-facing child safety seats. The seat should be placed in the rear of the vehicle until the child reaches the upper weight or height limit of the particular seat. Typically, a child will outgrow a safety seat around age 4 and once she reaches about 40 pounds.
  • Booster seat. Children age 4 and older who weigh more than 40 pounds should ride in booster seats. A child can safely progress to a seat belt when the belt fits properly across the upper thighs and chest. “This is usually at age 8 or when they are at least 4 feet 9 inches tall,” Osterhuber says.
  • Seat belt. When children outgrow their booster seats, they can use seat belts, but they still should sit in the back of the vehicle. “Really, all children should be riding in the backseat of the car until they are at least 13 years old,” Osterhuber says.

7 Ways to Fit In Exercise

The benefits of regular exercise are unrivaled: Physical activity can help you lose weight and prevent a host of ailments, including heart disease, diabetes, and osteoporosis. Being fit also can help you stay mentally sharp.

While most people know they should exercise, you may not know where to start or how to fit it into a busy schedule. The American College of Sports Medicine (ACSM) and the American Heart Association (AHA) recommend that healthy adults get at least 150 minutes of moderate-intensity aerobic activity spread out over five days a week, or 20 minutes of vigorous-intensity aerobic activity on each of three days a week.

“This is something we recommend to all Americans,” says Gerald Fletcher, MD, a cardiologist at the Mayo Clinic in Jacksonville, Fla., and a spokesman for the AHA.

An ideal fitness routine also includes resistance or weight training to improve muscle strength and endurance. The ACSM and the AHA recommend that most adults engage in resistance training at least twice a week.

Finding Fitness: 7 Ways to Get in Exercise

Sometimes the problem isn’t motivation — it’s simply finding the time. But scheduling exercise isn’t as difficult as you might think. Here are 10 ways to get you moving more often:

  1. Be less efficient. People typically try to think of ways to make daily tasks easier. But if we make them harder, we can get more exercise, says Sabrena Merrill, MS, of Lawrence, Kan., a certified personal trainer, group fitness instructor, and spokeswoman for the American Council on Exercise (ACE). “Bring in the groceries from your car one bag at a time so you have to make several trips,” Merrill says. “Put the laundry away a few items at a time, rather than carrying it up in a basket.”
  2. Shun labor-saving devices. Wash the car by hand rather than taking it to the car wash. “It takes about an hour and a half to do a good job, and in the meantime you’ve gotten great exercise,” Merrill says. Use a push mower rather than a riding mower to groom your lawn.
  3. Going somewhere? Take the long way. Walking up or down a few flights of stairs each day can be good for your heart. Avoid elevators and escalators whenever possible. If you ride the bus or subway to work, get off a stop before your office and walk the extra distance. When you go to the mall or the grocery store, park furthest from the entrance, not as close to it as you can, and you’ll get a few extra minutes of walking — one of the best exercises there is, Dr. Fletcher says. “Walking is great because anyone can do it and you don’t need any special equipment other than a properly fitting pair of sneakers.”
  4. Be a morning person. Studies show that people who exercise in the morning are more likely to stick with it. As Merrill explains, “Are you going to feel like exercising at the end of a hard day? Probably not. If you do your workout in the morning, you’re not only more likely to do it, but you’ll also set a positive tone for the day.”
  5. Ink the deal. Whether morning, afternoon, or evening, pick the time that is most convenient for you to exercise and write it down in your daily planner. Keep your exercise routine as you would keep any appointment.
  6. Watch your step. Investing in a good pedometer can help you stay motivated. “If you have a pedometer attached to your waist and you can see how many steps you’ve taken, you’ll see it doesn’t take long to walk 5,000 steps and you will be inspired,” Merrill says. And building up to 10,000 steps a day won’t seem like such a daunting a task.
  7. Hire the right help. While weight training is important, if you don’t know what you’re doing, you run the risk of injuring yourself or not being effective, Merrill says. It’s best to get instructions from a personal trainer at the gym. You also can buy a weight-training DVD and follow along in your living room.