Heberden’s Nodes in Fingers Tied to Knee Osteoarthritis

TUESDAY, Jan. 22, 2019 — The presence of Heberden’s nodes (HNs) in finger joints may also indicate structural damage associated with knee osteoarthritis, according to a study published online Jan. 9 in Arthritis & Rheumatology.

Arya Haj-Mirzaian, M.D., M.P.H., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated 575 participants for HNs and knee osteoarthritis with magnetic resonance imaging at baseline and 24 months.

The researchers identified 395 patients with HNs and 188 without HNs. Compared with patients without HNs, patients with HNs had more periarticular bone area expansion in the knee joint over 24 months (adjusted odds ratio [aOR], 1.39; 95 percent confidence interval [CI], 1.06 to 1.83), especially in the medial femur (aOR, 1.49; 95 percent CI, 1.05 to 2.13), lateral femur (aOR, 2.51; 95 percent CI, 1.58 to 3.97), femoral notch (aOR, 1.37; 95 percent CI, 1.02 to 1.84), and lateral trochlea (aOR, 1.44; 95 percent CI, 1.08 to 1.90). However, compared with patients without HNs, there was a trend toward less osteophyte worsening in the whole knee joint among patients with HNs (aOR, 0.63; 95 percent CI, 0.40 to 1.02), particularly in the femoral region (aOR, 0.54; 95 percent CI, 0.31 to 0.95).

“These exploratory results have motivated us to initiate more focused investigations to further characterize the nodal osteoarthritis phenotype and tailor specific treatments for patients in future trials,” a coauthor said in a statement.

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Posted: January 2019

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Here’s why you should eat more almonds

When one plans to stay fit and healthy, deciding upon the meal plan becomes important so that one can follow through with the diet.

While one may be following a healthy meal routine, intermittent snacking too becomes important in the long run.

Highly nutritious and rich in healthy fats, antioxidants, vitamins and minerals, almonds can be a healthy option for some intermittent snacking.

Speaking about snacking in-between meals and almonds, nutritionist Ritika Samaddar says, “A handful of almonds may have satiating properties that promote a feeling of fullness, which may keep hunger at bay in between meals. They are also an excellent source of vital nutrients like vitamin E, calcium, good fat, dietary fibres and plant protein.”

To maintain dietary resolutions, planning what to eat, before venturing out, is also important.

When venturing out of the house, one has to ensure that they do not compromise on meal plans. Whether at home, work or on the go, a handful (30 grams/23 almonds ) of almonds are a convenient snack that can be eaten anywhere, any time of the day and through the year. Nutritionist Madhuri Ruia says, “Always keep some almonds handy in a tiffin box so you’ll always have your perfect daily portion. Pair them with fruits or include them in other snacks. This way you will always have something healthy with you while on the go.”

Avoiding overindulgence in high-calorie food when at a get together is important to maintain the diet. “Coming together as a family is what adds to festive celebrations and gatherings. I make it a point to bring everyone in my family together to celebrate important festivities. It helps us all connect and relive and enjoy memories. And as we get together, we usually snack on our favourite masala almonds. It’s a tradition that has been carrying on for a long time, “ shares Dr. Madhu Chopra, actor Priyanka Chopra’s mother.

“If you are throwing a party, a good snack will be tossing almonds in your favourite herb. My favourite for this season is jaggery coated almonds. They make for a healthy option and are a huge favourite with the guests too,” chef Manish Mehrotra further adds.

Here are five reasons why one should snack on almonds:

– Almonds have a lot of nutrients. Experts say that a handful of almonds supply 161 calories and 2.5 grams of digestible carbohydrates. They are high in healthy monosaturated fats, fibre, protein and various important nutrients.

– Almonds have antioxidants. This can protect cells from oxidative damage, a major contributor to aging and disease. A clinical trial with 60 male smokers found that 84 grams of almonds per day reduce oxidative stress biomarkers by 23 – 34 per cent over a four-week period.

– Almonds are high in Vitamin E. Several studies have linked higher vitamin E intake with lower rates of heart disease, cancer and Alzheimer’s disease.

– Almonds can help control blood sugar. Their high magnesium content offer major improvements for metabolic syndrome and type 2 diabetes.

– Almonds may lower cholesterol levels. Some studies have shown almonds to effectively lower LDL lipoproteins in the blood. Eating almonds can lead to mild reductions in LDL cholesterol in the body, reducing the risk of heart disease.

Almonds are a simple and tasty nut that contain many nutrients that contribute to heart-health, such as mono-saturated (good) fat, vitamin E, dietary fibre, calcium and phyto-chemicals. They are also rich in antioxidants, manganese, riboflavin, and copper. Research has shown that regular consumption of these nutrient-rich nuts not only help you manage weight but also contribute towards heart health.

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First Published: Jan 23, 2019 10:20 IST

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Liver regeneration is an important issue for almost all people

Table of contents

  • The liver needs a Regeneration
  • Toxins can’t hide from the liver
  • When the liver is overloaded
  • Signs of liver damage
  • You help your liver to regenerate
  • So take a load off your liver
  • So help your liver in the Regeneration
    • Base Excess Food:
    • Green Smoothies:
    • Well &amp chew; small meals:
    • High-Quality Nutritional Supplement:
    • Drink plenty of water:
    • Herbs for the liver
    • Capsaicin from Chilis
    • Bitter substances
    • Antioxidants
    • Probiotics

    The liver needs a Regeneration

    The liver is one of the most important organs of our body, when it comes to the healthy maintenance of the entire organism.

    Measures for liver regeneration are, therefore, in regular intervals, very useful – which is obvious especially when you look at all of the tasks and areas of responsibility of the liver:

    The liver is the connection point of almost all areas of the body. Anything and everything that gets in the body, happens also the liver and this ultimately decides what is good for the body and that which is detrimental.

    So all of the food components, for example, according to their metabolism by the intestine in the liver. There you will be processed in accordance with the individual needs of the body, and is then, if necessary, to the relevant bodies and forwarded.

    Not immediately required nutrients and vital substances can save the liver up to a certain amount, to have for later times, inventories.

    The liver also produces the digestive necessary bile juice, with the giving of the gallbladder.

    Since the liver is also a detoxification organ No. 1, it builds toxins and ensures that this can’t be a burden on the organism.

    Toxins can’t hide from the liver

    The nutrients also contained in the toxins from entering the liver.

    Furthermore, those toxins are absorbed through the lungs and through the skin, via the blood straight to the liver.

    This has excellent defense mechanisms against harmful substances. You can do it with the help of special enzymes harmless and through the intestine or the kidney for elimination, and round-the-clock and day-to-day. The removal of the toxic substances are strong cell poisons, which can damage the liver cells themselves immensely. But even here, the uniqueness of this institution is again clear, for the repair of your cells, the liver does in person. It produces the required complex fats, called phospholipids – in a sufficient extent.

    The detoxification of incoming toxins can, however, take place, exactly how the cell repair, then in full, if the poison load is limited and when the liver is completely healthy and efficient.

    When the liver is overloaded

    The number of toxins every day by the liver cells filtered from the blood, has been increasing since decades.

    In addition to the body’s own toxins, enjoyment, constitute poisons, such as alcohol, nicotine and drugs as well as medicines of any kind are a tremendous burden on the liver.

    Add to intestinal problems such as bloating, gas, which generate highly toxic gases, pesticides in food, fungal toxins such as aflatoxins, environmental pollutants, heavy metals in drinking water, mercury in teeth, and much more. When the liver is no longer able to cope with the ongoing onslaught of various poisons, the non-filtered toxins straight back into the bloodstream and can do this way in all areas of the body great damage.

    Another Problem is that the liver is able to adequate amounts of phospholipids for the repair of its defective cells, which represents a significant impairment of their efficiency.

    At some point you can no longer meet their varied vital duties in an appropriate manner.

    Signs of liver damage

    In the interior of the liver has no nerve fibres run, therefore, the liver can’t Express their Overload in the Form of pain.

    The pain of the liver for a long time, silent. Only later it comes to a Push in the right upper abdomen.

    This fact makes it difficult, of course, liver damage and to take appropriate counter-measures.

    The result of a weakened liver, a weakened, tired and low-energy person who suffers from digestive problems and/or chronic itching is in the first place.

    Other signs, which may indicate, however, massive liver congestion, are the following:

    – high-red – so-called strawberry tongue – frequent nosebleeds – excessive sweating – dark urine – small red, pinhead-sized dots that appear at various Points of the body at irregular intervals and back – yellow disappear yellowing of the skin yellowish discoloration of the white eyeball – swelling between the eyebrows – Fever and discomfort on hot summer days – loss of appetite – impaired concentration

    Of course, not all of these symptoms need to have to do always and exclusively with a liver damage. However, it is very unlikely that in case of complaints of this type, the liver is involved. For safety’s sake, you can go to, of course, in the case of the described symptoms, a Doctor, and this clarification ask.

    But at least now it is time to let the liver those support it needs for Regeneration.

    Very good news is that can recover the liver even if it is already damaged.

    You help your liver to regenerate

    The liver is a pronounced regeneration of viable Organ. Even if half of the liver would be severely damaged, it could regenerate itself completely – of course only then, if the damaging factors are avoided in future.

    The sooner you are ready to relieve your liver aware of and to support you in setting up your cells in a natural way, the faster your entire body from the effects of your liver will benefit friendly measures.

    So take a load off your liver

    • Organic food: when you buy your food, that you with pesticides that are charged. Food from controlled organic cultivation is the best choice.
    • Fruit and vegetables thoroughly clean: Conventionally grown fruit and vegetables should be thoroughly cleaned. If you want to manufacture your own cleaning products, so you can find the instructions at the end of this text.
    • Ready meals to avoid: do not Buy traditional ready meals, because they contain many synthetic additives also substandard in fat and sugar additives. These ingredients can be consumed in larger quantities, the Regeneration of the liver also affect. If you want to occasionally rely on ready-made meals, select products from the Bio-trade.Â
    • Zero alcohol: Avoid alcohol consistently. Even small amounts affect your liver, especially if this is in the regeneration phase.
    • Pure water: Filter your tap water with a powerful water filter. Or you use to cook with carbon dioxide free mineral water.
    • Bio-cleaning agents: Use only organic cleaners, as the chemical fumes of traditional products over the breathing in the body. More contained in the chemical substances be absorbed through the skin.
    • Natural cosmetics: Buy it for the same reason, for the cleaning and care of your skin and hair consistent products from the natural products trade.

    The implementation of the above measures will not only reduce the burden on your liver, noticeably. You will feel significantly more comfortable, more free and more powerful.

    While the above points ensure that your liver is in the future preserved in the best possible way in front of the toxins that can provide you with the subsequent measures your liver with everything you need for a successful Regeneration:

    So help your liver in the Regeneration

    Base Excess Food:

    Eat a healthy diet and pay special attention to an adequate intake of fresh, nutrient-rich foods (fruits, vegetables, salads, sprouts, etc.).

    Green Smoothies:

    To prepare a daily green Smoothie (herbs or green leafy vegetables with fruit mixed in). Especially the high chlorophyll content of the herbs and green vegetables, as well as the effective antioxidant potential of the vital substances to support the liver for detoxification and Regeneration. Delicious Smoothie recipe ideas you can find on many Websites.

    Well &amp chew; small meals:

    Do not eat large quantities at once, but you get used to smaller portions, so that the liver is not overwhelmed. You chew on in addition to thoroughly. This improves your digestion and therefore the health of the liver.

    High-Quality Nutritional Supplement:

    Optimize your diet with a supplementary supply of Vital substances through high quality supplements. The Chlorella algae, for example, has – in addition to their nutrients and vital substances offer a certain degree of binding capacity for heavy metals. This property makes them specially for the Regeneration of the liver to an ideal component.

    Drink plenty of water:

    You can drink a day about 1.5 liters (or 30 ml per kilogram of body weight) of non-carbonated water in good quality, so that a part of the toxic substances can also be excreted via the kidneys.

    Herbs for the liver

    Herbs such as milk Thistle, artichoke and dandelion have always been known for their liver protective properties.

    The dandelion can be integrated daily in the meals (Smoothies, salads, soups, etc.).

    The milk Thistle should be chosen, however, better in the Form of high-dose preparations.

    The artichoke is offering in the Form of fresh plant pressed juice, which is several times a day tablespoon.

    Special herbal mixtures are also tailored explicitly to support the liver in its detoxifying activity, be effective. In this way, the liver is relieved and strengthened at the same time.

    Products of this type are as a dietary Supplement for liver strengthening and / or liver regeneration.

    Capsaicin from Chilis

    Capsaicin is pepper, the spicy-tasting substance from the chili. In Tests has proven to be Capsaicin as a great liver protector that could protect the liver from damage by liver toxic substances.

    Even in the case of liver fibrosis (progressive scarring of liver tissue, which can Cirrhosis and cancer) could Capsaicin help, and fibrosis, although not fix, but its progression to prevent, so that it does not have to come to cancer.

    Capsaicin can be taken via capsules.

    Bitter substances

    Bitter substances are those secondary plant substances, the liver is particularly pleased. They provide a healthy flow of Bile, regulate the acid-base balance and to activate the functions of the liver. Bitter substances are elixirs, in the Form of herbal bitter (such as bitter star), Bitter (e.g., Bittrio herbal elixir-alcoholic), bitter plant powders (e.g., lion’s tooth powder), or bitter plant extracts (e.g., dandelion root extract) taken.


    Also the intake of antioxidants (e.g., glutathione, Astaxanthin, OPC, etc.) is an important contribution to the protection of the liver. All of the liver onerous toxins generate a large number of free radicals, which can be made by taking additional amounts of antioxidants are harmless. This measure allows the liver cells to also a faster recovery.


    There is a close link between the intestinal health and the performance capacity of the liver. In the meantime, scientists found that taking can help of probiotics, even during the removal of a fatty liver.

    Probiotics can be taken solo. You can, however, come in the context of a colon cleansing program. Because The healthier and cleaner the colon, the less toxins enter the liver, and the better the liver. How to perform a colon cleansing, you can find here: How does a colon cleansing

    You now know a whole lot about the exceptional organ of the liver. You can find further information here: The holistic liver cleansing

    Sure, you have already dealt with this earlier with the well-being of your liver, if you would have been informed of this important Organ is sufficient.

    But now nothing stands in their activity in terms of liver support in the way 🙂

    For their contribution to liver regeneration, your body will reward you in any case up to a high age with the best of health.

    Your training to become a holistic nutritionist

    Healthy eating is your passion? You will love the base excess, natural diet? Would you like to understand the connections between our food and our health from a holistic point of view? You want nothing more than all your Knowledge about health and nutrition to your profession?

    The Academy of Naturopathy is people like you in 12 to 18 months to technical consultant for holistic health. If you want to know more about the course at the Academy of naturopathy, then you will learn all the Details as well as feedback from current and former participants.

Jicama: Health benefits, nutrition, and diet tips

Originally from Mexico, the jicama is sometimes also known as a Mexican turnip or yam bean.

Although the root is safe to eat, the rest of the plant, including the beans, are toxic.

In this article, we discuss some of the potential health benefits of eating jicama. We also cover its nutritional content, safety, and how to use this vegetable.

Healthful source of dietary fiber

Jicama is a good source of fiber. A 1-cup or 130-gram (g) serving of raw jicama contain 6.4 g of dietary fiber.

According to the United States Food and Drug Administration (FDA), most Americans do not get enough fiber. The recommended daily intake of dietary fiber is 25 g a day for females and 38 g for males. For those over 50 years of age, the daily intake recommendations are 21 g for females and 30 g for males.

Dietary fiber can prevent or treat constipation. It can also help stabilize a person’s blood sugar, which may help treat or prevent diabetes. High-fiber diets also promote regular bowel movements and reduce the risk of heart disease, according to the FDA.

Furthermore, getting more fiber in the diet may contribute to people living longer.

A 2016 study followed 1,609 adults, aged 49 years or older, for 10 years. The researchers found that participants who consumed the most fiber had a greater likelihood of aging successfully.

Among the nutritional factors the study assessed, fiber intake was the most significant predictor of health and longevity. This epidemiological data suggests that increasing fiber-rich foods in the diet may decrease disease during the aging process.


Probiotics are bacteria and yeast that are beneficial to human health.

Living in every person’s gut is a large community of bacteria. Consuming foods or supplements that contain probiotics can help restore the natural balance of this community. Studies link probiotics with a range of health benefits, including improved gut health and a lower risk of certain infections.

Prebiotics are a type of fiber that the body cannot digest. Prebiotics support the growth of probiotics by providing them with food. Jicama is rich in inulin, a type of prebiotic fiber.

Jicama is low in calories and sugar, very low in fat and protein, and high in fiber. A single 100 g serving of raw jicama contains:

  • 38 calories
  • 8.82 g of carbohydrates
  • 1.80 g of sugar
  • 0.09 g of fat
  • 0.72 g of protein
  • 4.90 g of fiber
  • 150 mg of potassium
  • 12 mg of calcium
  • 20.20 mg of vitamin C


For people interested in trying jicama, it is essential to know that only the root vegetable is safe to eat. The rest of the plant, including the beans and flowers, contain rotenone.

Rotenone is a natural insecticide that is toxic to humans, especially in large doses. Research suggests that consuming rotenone may raise a person’s risk of developing Parkinson’s.

A person should also remove the brown skin before eating jicama. Anyone who develops an allergic reaction or digestive symptoms after consuming jicama should avoid it in the future.

How to use

Eaten raw, jicama tastes similar to an uncooked potato but slightly juicier and sweeter.

A person can use jicama to add flavor and texture to a variety of dishes. Try adding it to a Mexican fruit salad or thinly slicing it to give some crunch to a vegetable salad.

Some other, easy ways to prepare jicama include:

  • thinly slicing the jicama, sprinkling it with sea salt and lime juice, and serving on top of avocado
  • sautéing it and tossing with other vegetables, such as broccoli and carrots
  • using it as a substitute for water chestnuts in a stir-fry


Jicama is a starchy root vegetable that people describe as tasting like a sweeter and juicer version of potato. It is low in calories, sugars, and fats, but rich in fiber and contains several essential vitamins and minerals.

Jicama may be a good choice for people with diabetes or those on a low-sugar diet. The root vegetable is safe to eat cooked or raw and can add texture to a wide variety of meals. However, the rest of the plant, including the flowers and beans, is toxic.

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A psychologist tells, how to stick to your New Year resolutions

What you can learn from a psychologist to stick to your New Year resolutions.

Psychologists work closely with their clients to set and achieve goals all year round, so naturally, they know a thing or two about making good habits stick. Here, we tap into their professional knowledge for nailing those New Year’s resolutions.

Set specific goals.

Keep it real

Don’t overload yourself with a mountain of must-dos, says Brisbane-based coaching psychologist Patrea O’Donoghue. “Often people set too many New Year’s resolutions, and it becomes far too hard to prioritise. It’s more effective to start with one to three. List a lot, then single out the ones you really want to nail. Tick them off, and then later you can move to the others.”

And be sure the time’s really right, adds Melbourne clinical psychologist Dr Jo Mitchell. “The best New Year’s resolutions are not made on New Year’s Eve or Day. They are thought about beforehand and a plan put in place. New Year just becomes the starting line for a commitment to behaviour change.”

Know your why

Dig deep to identify resolutions that truly resonate, advises Dr Mitchell. “Behaviour change is more successful when you connect it to your values. We need to understand why this behaviour is important to us. What does it say about who we are and what we stand for? For example, do you exercise to stay fit and healthy for your family, or as a way of connecting with friends? If it's not a meaningful goal then it just doesn’t stick.”

She adds: “An effective resolution is usually one that makes sense in the broader context of your life – it connects with your values, lifestyle and resources to put it in place.”

Be super-specific

Psychologists agree that when it comes to goal setting, the devil’s in the detail. “If you set a vague goal, it won’t work,’ says Patrea O’Donoghue. “The brain doesn't operate on those fuzzy instructions.”

Says Dr Mitchell: “What is the behaviour you want to change? How often do you plan to do it, when and where? For example: I am going to meditate five days a week for 10 minutes, on the tram to work, with my headphones on and listening to the Headspace app.”

Clearly planned and visualised goal setting works best because it programmes our non-conscious brain to adopt habits, says O’Donoghue. “The non-conscious part governs so much of what we do, those automatic habits like cleaning your teeth in the morning. It’s the part of your brain that’s working without you being aware of it; for example, when you forget a name and then it pops into your head later, once you've stopped trying to remember it.”

She recommends US psychologist Gabriele Oettingen’s WOOP (Wish, Outcome, Obstacle, Plan) strategy, which involves imagining how it will look and feel to overcome obstacles and achieve your goal.

Make it positive

Patrea O’Donoghue advises using the ‘towards motivation’ to stick to your goals. “Rather than focus on what you don’t want to do, or what you want to get rid of, frame it positively,” she says. “Instead of saying you want to lose weight, you could say you want to aim to weigh 56 kilos. Instead of wanting to give up smoking, decide you want to be a fresh air breather, or to be able to run upstairs.”

Focusing on what you want to move towards rather than what you want to move away from or lose, she says, taps into that non-conscious sweet spot in your brain that drives habit forming. “How we frame our goals can tap into an endless source of drive and willpower,” she says.

Repeat… and repeat

“The more you repeat the behaviour, the easier it becomes,” says Dr Mitchell. “You’ll start to miss it if you have to skip a day. With time, your brain is going to have a hard time letting go of it. You will know you have been successful when you don’t have to think twice about the behaviour – it is simply a habit.”

And remember, says O’ Donoghue, that new habits don't stick overnight. “There isn’t one standard length of time to embed a new habit, but research has shown the average is 66 days,” she says. “And often it’s a lot longer than that, especially if you’re trying to change a lifetime habit. Goals happen because of small steps done repeatedly.”

Be curious

Says Dr Mitchell: “If things seem to be getting in the way, instead of beating yourself up about it, be curious about what’s happening.

Perhaps, when you look closer, there’s emotional stuff coming up and blocking you.”

Be prepared to learn as you go, she says. “Adjust your plan if needed. Perhaps the tram to work is too crowded to meditate, so try the tram home, when you usually get a seat. Maybe four days is more realistic than five days?”

Be your own cheer squad

“Forming new habits is hard, so be kind to yourself as you get started,” says Dr Mitchell. “Praise your effort and if one strategy fails, have some self-compassion, reset and try again. If you have to skip a day or a workout it’s no biggie, just commit to the next opportunity. Don't beat yourself up about it – it might be the wrong time for you, so let it go.”

She recommends “a healthy dose of realism – change is hard, be prepared for setbacks and celebrate the successes.”

Want to find out more about what makes us tick? Discover how a postgraduate degree in psychology through Swinburne Online can open the door to our minds. Swinburne Online offers flexible postgraduate degrees delivered by industry professionals in a dynamic online learning environment. We’re here to help you reach your goals.

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Burger King Just Released a New Shake That Beats Any McFlurry

It may be cold (ahem, freezing) outside, but that doesn’t deter me from trying a brand-new ice cream shake. Burger King has just added a Vanilla Shake with M&M’s Chocolate Candies to its menu, and it looks like a McDonald’s McFlurry on another level.

The shake is made with vanilla soft-serve, M&M’s chocolate candies and vanilla syrup and is topped with whipped cream. BUT, this shake is only around for a limited time, so get it while you can.

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when you really just want to pour a bag of M&M’S in your mouth, but want soft serve, too. we got you. introducing the M&M’S shake.

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The M&M’s shake joins a lineup of other tasty ones available at BK, including an Oreo Shake, Oreo Chocolate Shake, Hershey’s Chocolate Shake, Vanilla Shake, and Strawberry Shake. But—dare I say—this one looks like the best one yet.

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Heart disease risk begins in the womb

Heart disease is the greatest killer in the world today, and it is widely accepted that our genes interact with traditional lifestyle risk factors, such as smoking, obesity and/or a sedentary life to promote an increased risk of cardiovascular disease. However, a new study in sheep, publishing January 22 in the open-access journal PLOS Biology, by a team from Cambridge University, finds that offspring whose mothers had a complicated pregnancy may be at greater risk of heart disease in later life, suggesting that our cards may be marked even before we are born.

In addition to the effects of adult lifestyle, there is already evidence that the gene-environment interaction before birth may be just as, if not more, important in “programming” future heart health and heart disease. For instance, human studies in siblings show that children born to a mother who was obese during pregnancy are at greater risk of heart disease than siblings born to the same mother after bariatric surgery to reduce maternal obesity. Such studies have provided strong evidence in humans that the environment experienced during critical periods of development can directly influence long-term cardiovascular health and heart disease risk.

The new research funded by The British Heart Foundation and the Biotechnology and Biological Sciences Research Council UK shows that adult offspring from pregnancies complicated by chronic hypoxia have increased indicators of cardiovascular disease, such as high blood pressure and stiffer blood vessels. Chronic hypoxia or lower-than-normal oxygen levels in the developing baby within the womb is one of the most common outcomes of complicated pregnancy in humans. It occurs as a result of problems within the placenta, as can occur in preeclampsia, gestational diabetes or maternal smoking.

The Cambridge study, led by Professor Dino Giussani, used pregnant sheep to show that maternal treatment with the antioxidant vitamin C during a complicated pregnancy could protect the adult offspring from developing hypertension and heart disease. The work therefore not only provides evidence that a prenatal influence on later heart disease in the offspring is indeed possible, but also shows the potential to protect against it by “bringing preventative medicine back into the womb,” as Dr. Kirsty Brain, first author of the study, puts it.

It turns out that vitamin C is a comparatively weak antioxidant, and while the Cambridge study provides a proof-of-principle, future work will focus on identifying alternative antioxidant therapies that could prove more effective in human clinical practice.

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Bleeding risks may offset aspirin’s benefit vs heart disease

Should healthy people take aspirin to ward off heart disease?

The notion has been controversial, and the medical advice mixed.

But a review of scientific data on the topic Tuesday showed that any benefits are slight, and are counterbalanced by a matching rise in bleeding risks.

Aspirin is a blood thinner and can help prevent clots that may lead to heart attack or stroke. But aspirin also boosts the risk of hemorrhage in the brain, stomach and intestines.

“When considering the totality of evidence, cardiovascular benefits associated with aspirin were modest and equally balanced by major bleeding events,” said the report in the Journal of the American Medical Association.

The meta-analysis examined 10 prior studies involving a total of more than 164,000 people with an average age of 62.

Comparing aspirin users to those who don’t take aspirin, researchers found “significant reductions” in strokes, heart attacks and deaths from cardiovascular disease among those who took aspirin.

Aspirin use was also linked to an increased risk of “major bleeding events compared with no aspirin,” it said.

Statistically, the benefits were close to the risks.

If 10,000 people without heart disease took no aspirin for a year, 61 of them would have a heart attack or stroke, explained Kevin McConway, emeritus professor of applied statistics at The Open University.

If 10,000 similar people took aspirin for a year, 57 of them would have a heart attack or stroke.

“Only four fewer in 10,000, but that still has some importance given how common such diseases are and how serious cardiovascular disease is,” said McConway, who was not involved in the study.

Heart disease is the top killer of people worldwide, taking 17.9 million lives around the planet each year, for one-third of all deaths, says the World Health Organization.

Downside: bleeding

“The downside is the increase in major bleeding events, including bleeding inside the skull and brain or major bleeds in the stomach or gut,” added McConway.

In a non-aspirin-taking pool of 10,000 people, 16 would have such an event in a year, compared to 23 among aspirin-takers.

In other words, about seven more major bleeds annually, which McConway described as a “substantial increase,” even though the annual risk of a hemorrhage “is still not high.”

According to Jeremy Pearson, associate medical director of the British Heart Foundation, the meta-analysis “valuably updates our knowledge, but does not change the current perspective.

“It confirms that the average risk of harm exceeds benefit, so that guidelines should not be changed.”

Aspirin is not recommended in Britain for prevention of heart disease.

But in the United States, the US Preventive Services Task Force recommends “initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer in adults aged 50 to 59 years who have a 10 percent or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years.”

Cancer benefits ‘neutral’

The study also delved into aspirin’s preventive benefits when it comes to cancer, and found “no overall association between aspirin use and incident cancer or cancer mortality.”

The review pointed out one study that had found a 15 percent reduction in cancer death associated with aspirin use after five years of follow-up.

However, the same findings were not replicated in a second trial, which followed almost 500 patients for seven years.

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Messages for Increasing Parental Confidence in HPV Vaccine ID’d

TUESDAY, Jan. 22, 2019 — Providing information on the benefits of vaccination, including cancer prevention, and avoiding expressing urgency to vaccinate can increase parent confidence in human papillomavirus (HPV) vaccination, according to a study published online Jan. 22 in Pediatrics.

Parth D. Shah, Pharm.D., Ph.D., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues surveyed a national sample of 1,196 U.S. parents of children aged 9 to 17 years in 2017 to 2018. The researchers recorded brief videos of a pediatrician providing messages that addressed seven HPV vaccination topics that often elicit questions or concerns. Parents were randomly assigned to one of the messages and viewed four videos on that topic.

The researchers found that when parents were exposed to messages addressing lack of knowledge about HPV vaccine, messages that included information about cancer prevention, messages that required a higher reading level, and messages that were longer, they felt more confident about HPV vaccination. When exposed to messages in which urgency was expressed, parents had less confidence in HPV vaccines.

“Providers may take these messages as a starting point and elaborate as needed. In our study, messages elicited higher confidence when they were longer and required a higher reading grade level,” the authors write. “We aimed for shorter messages that providers could remember. However, parents seeking information may prefer longer answers (i.e., those that translate to a longer discussion).”

One author disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text

Posted: January 2019

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Daily aspirin does more harm than good for ‘worried well’

Taking an aspirin each day does more HARM than good for healthy middle-aged adults because it raises their risk of major internal bleeding

  • Aspirin, a blood thinner, is regularly given to healthy people in middle age
  • But a study says the harms of major internal bleeding outweigh the benefits
  • King’s College London scientists reviewed 13 trials of 160,000 participants 

Healthy people who take a daily aspirin to prevent heart attacks in later life may be doing more harm than good, research suggests.

Aspirin – which is a blood thinner – has for decades been given to people diagnosed with heart disease to stop heart attacks and strokes.

But many healthy people in middle age also take the pills as an ‘insurance policy’ against heart problems.

A major new study, which includes data from more than 160,000 people, concludes the risk of major internal bleeding significantly outweighs the benefit of aspirin among those with no history of heart disease.

Aspirin, which is a blood thinner, is regularly given to healthy people in middle age, to lower the risk of heart problems

The review, led by experts at King’s College London, reinforces growing evidence that aspirin should no longer be used for ‘primary prevention’ – the term for treatment of patients who have no symptoms of heart problems.

The researchers found among healthy people, use of aspirin saw risk of heart attack or a stroke drop 11 per cent.

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But the risk of bleeding went up 43 per cent.

This means that 265 people would have to take aspirin for five years to prevent a single heart attack or stroke – but one in 210 would have a major bleed.

Study leader Dr Sean Zheng, academic clinical fellow in cardiology at King’s College London, said: ‘This study demonstrates that there is insufficient evidence to recommend routine aspirin use in the prevention of heart attacks, strokes and cardiovascular deaths in people without cardiovascular disease.’ 


Taking just a quarter of an aspirin tablet a day could slash the risk of bowel cancer by a fifth, a major study concluded in March 2016.

Harvard scientists found middle-aged people who regularly took the painkillers were less likely to be diagnosed with cancer of any kind.

They found the cheap pills, which cost less than 2p per tablet, are particularly effective at warding off cancers of the digestive system.

The most dramatic impact was seen for bowel cancer, with people who took aspirin every day for six years seeing their risk drop by 19 per cent.

The experts, who tracked 136,000 people for 32 years, predicted that regular aspirin use in the US could prevent 30,000 tumours a year.

The team found the picture was more complicated for patients diabetes, who are at higher risk of heart disease and who are often prescribed aspirin.

Among these patients the risk of a heart attack or stroke also dropped 11 per cent – and the risk of bleeding went up 30 per cent.

Dr Zheng said: ‘There has been more uncertainty surrounding what should be done in patients who are at higher risk of cardiovascular disease and in patients with diabetes.

‘This study shows that while cardiovascular events may be reduced in these patients, these benefits are matched by an increased risk of major bleeding events.

‘Aspirin use requires discussion between the patient and their physician, with the knowledge that any small potential cardiovascular benefits are weighed up against the real risk of severe bleeding.’

In the past low-dose aspirin, which is very cheap, was frequently prescribed for even healthy people in middle age to reduce heart disease.

Guidelines issued by several professional health bodies between 2005 and 2008 solidified this position, recommending routine use of aspirin for people aged 50 and older with type 2 diabetes or high blood pressure.

A decade ago a series of major studies started to reveal the risk of major bleeding, and guidelines were changed to remove the formal recommendation, but many doctors still prescribe the drugs.

Experts are also concerned many the ‘worried well’ who take the tablets without being aware of side-effects that can include internal bleeding.

Professor Jeremy Pearson associate medical director at the British Heart Foundation said: ‘Current guidelines do not recommend aspirin for people who don’t already have heart and circulatory diseases.

‘This is because, while aspirin reduces these people’s risk of heart attacks and strokes, any benefit is outweighed by an increased risk of bleeding.

‘If you have a heart attack, your doctor will usually prescribe a daily aspirin to try and prevent a second attack. In this case, the reduced risk of a second life-threatening heart attack substantially outweighs the risk of side effects, such as bleeding.

‘The risk of bleeding from aspirin is likely to differ between groups of people. Further research may well uncover subsets of people where benefits do outweigh risks, paving the way for personalised treatments.’

Professor Jane Armitage of the University of Oxford, said: ‘The conclusion [in this paper] reinforces the message from those trials that, for healthy people, the small benefits of aspirin in preventing strokes and heart attacks are counter balanced by increases in the risk of serious bleeding.’

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