The serious side effects associated with fluoroquinolone antibacterial drugs.

 “The FDA issues advisory regarding treatment with fluoroquinolone antibacterial drugs. The tendon side effects include tendon ruptures. I was not aware of the central nervous system side effects. I posted a list of the brand names below for your information. The best known antibiotic in this class is Cipro.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

The U.S. Food and Drug Administration (FDA) is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. An agency safety review has shown that, when used systematically, fluoroquinolones are associated with disabling and potentially permanent serious side effects that can occur together. Side effects can involve the tendons, muscles, joints, nerves, and central nervous system. As a result, FDA is requiring the drug labels and medication guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information. The agency states that healthcare professionals should stop systemic fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course.

First-generation[edit]

Second-generation[edit]

The second-generation class is sometimes subdivided into “Class 1” and “Class 2”.[78]

Third-generation[edit]

Unlike the first- and second-generations, the third-generation is active against streptococci.[78]

Fourth-generation[edit]

Fourth-generation fluoroquinolones act at DNA gyrase and topoisomerase IV.[82] This dual action slows development of resistance.

In development[edit]

 

 

Take care of your teeth to reduce your risk of stroke.

“Here is another reason to put in the effort for the best gum health possible. Orthopedic surgeons tell patients that dental infections are a leading cause of infections in the blood stream getting into a total joint implant causing it to fail. Here is a report about an increased risk of stroke.

I love the Panasonic water irrigator. http://www.amazon.com/Panasonic-Dental-Flosser-Pressure-Settings/dp/B0027LSEPS/ref=sr_1_1_a_it/189-9774289-5118830?ie=UTF8&qid=1461892248&sr=8-1&keywords=panasonic+water+irrigator . It cleans my teeth and gums  better than a water pik, the more common irrigator.

Try this trick to motivate yourself. I timed how long it took me to use the irrigator thoroughly inside and outside of the teeth. It takes 2.5 minutes, 150 seconds. I always find the 150 seconds to keep my teeth healthy. “ Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

 

March 22, 2016 Cleveland Clinic Wellness Newsletter
Take care of your pearly whites! It may reduce your risk of stroke.
Raise your hand if you received a reminder card from your dentist and tossed it in the recycling bin. Now use that hand to grab the phone and call for an appointment! New research underscores the links between your oral health and your overall health, and calls attention to the importance of seeing your dental professional every six months. Multiple studies indicate a link between periodontal disease and heart disease — and, on the “good news” front, treating periodontal disease has been shown to lower your risk of heart attack. Now a new study sheds light on how the presence of Streptococcus mutans, a cavity-causing bacteria, may increase your risk of hemorrhagic stroke. Professional cleanings can reduce not only bacteria but also harmful inflammation, which may also contribute to heart disease. Brush and floss daily, and see your dental pro twice a year for cleaning and evaluation. If you find yourself slacking, remind yourself that, when it comes your health, everything is connected, so that good health anywhere in the body improves the likelihood of good health everywhere.

 

Traumatic Brain Injury associated with sleep problems long after the injury

“I included this article as an example of the public media journalists having no common sense and discretion when there is a minor first study suggesting something. The media prints it as fact though they say “suggestion.” Above are comments from Newsweek, L.A. Times, CBS and NPR.
Below is the abstract of the research. These headlines and their implications are a farce. Only 31 participants had a detailed sleep assessment. That has no statistical significance. My opinion is these minor works publish before anything is proven hoping to get enough financial support to do a real work of medical research.

Beware of public media headlines about medicine. They know better than make such a strong assertion. My opinion is not based on research; I am open to other interpretations” Bill Chesnut, MD.

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

Traumatic Brain Injury associated with sleep problems long after the injury
Newsweek (4/27, Firger) reports that research suggests individuals “who suffer” a traumatic brain injury (TBI) “may experience sleep problems a year and a half after the injury.” The study, published in Neurology, also found that “these patients often aren’t aware that it’s a problem.”

The Los Angeles Times (4/27, Healy) reports that “on average, 1½ years after their brain injury, subjects slept 8.1 hours per night vs. 7.1 hours for healthy controls.” The study indicated that “even with that extra hour, they were more tired during their wakeful hours, as measured by how quickly they fell asleep.”

On its website, CBS News (4/27, Welch) reports, however, that participants with TBI “didn’t report feeling any sleepier than those without head injuries when asked how tired they were during the day.”

According to the NPR (4/27, Hamilton) “Shots” blog, these findings “suggest there could be a quiet epidemic of sleep disorders among people with” TBIs.

Sleep–wake disorders persist 18 months after traumatic brain injury but remain underrecognized              Neurology 10.1212

Objective: This study is a prospective, controlled clinical and electrophysiologic trial examining the chronic course of posttraumatic sleep–wake disturbances (SWD).

Methods: We screened 140 patients with acute, first-ever traumatic brain injury of any severity and included 60 patients for prospective follow-up examinations. Patients with prior brain trauma, other neurologic or systemic disease, drug abuse, or psychiatric comorbidities were excluded. Eighteen months after trauma, we performed detailed sleep assessment in 31 participants. As a control group, we enrolled healthy individuals without prior brain trauma matched for age, sex, and sleep satiation.

Results: In the chronic state after traumatic brain injury, sleep need per 24 hours was persistently increased in trauma patients (8.1 ± 0.5 hours) as compared to healthy controls (7.1 ± 0.7 hours). The prevalence of chronic objective excessive daytime sleepiness was 67% in patients with brain trauma compared to 19% in controls. Patients significantly underestimated excessive daytime sleepiness and sleep need, emphasizing the unreliability of self-assessments on SWD in trauma patients.

Conclusions: This study provides prospective, controlled, and objective evidence for chronic persistence of posttraumatic SWD, which remain underestimated by patients. These results have clinical and medicolegal implications given that SWD can exacerbate other outcomes of traumatic brain injury, impair quality of life, and are associated with public safety hazards.

 

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

 

“Good information for you to have when dealing with someone who hit their head and has lots of varied complaints afterwards. Being sensitive to the sensations of your body is unhealthy and associated with my conditions. Recent research using electric shocks to produce pain show changes in nerve behavior. Other evidence implication hyper-somatization with fibromyalgia.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

Released: 20-Apr-2016 7:05 PM EDT
Source Newsroom: American Academy of Neurology (AAN)

Newswise — MINNEAPOLIS – Athletes who have medical complaints, like aches and pains, that have no known physical cause may take longer to recover after a concussion, according to a study published in the April 20, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Called psychosomatic symptoms, such complaints are often described as psychological distress expressed as physical illness.

“The goal of this study was to determine how physical complaints before and after concussion play a role in recovery,” said study author Lindsay D. Nelson, PhD, assistant professor of Neurosurgery and Neurology at the Medical College of Wisconsin in Milwaukee. “We found the greatest predictor of recovery after a concussion was the severity of early post-concussion symptoms. But somatic complaints before injury also play an important role, either by possibly enhancing how a person experiences the injury or affecting their reporting of post-concussive symptoms.”

For the study, 2,055 high school and college athletes were evaluated before the start of the season for balance, thinking and memory skills and psychological problems such as depression, anxiety and psychosomatic problems such as feeling faint or dizzy, nausea or upset stomach or pains in chest or heart. For the psychosomatic problems, the athletes rated how often they had been bothered by these symptoms during the last week. About 50 percent of the participants had at least one of 6 symptoms, and the other 50 percent had no symptoms.

During the season, 127 athletes suffered a concussion. Those athletes were then reassessed within the first 24 hours of injury and then again at 8, 15 and 45 days after the injury.

Of the concussed athletes, 61 percent played football, 24 percent played soccer, 6 percent played lacrosse, 3 percent were wrestlers, 3 percent played hockey, 2 percent played rugby and 1 percent played field hockey. Of the group, 80 percent was male.

On average, concussion symptoms lasted five days, with 64 percent of concussed athletes saying their symptoms were gone after one week and the vast majority, 95 percent, saying they no longer had symptoms after one month.

After concussion, those athletes who had reported pre-injury psychosomatic symptoms had longer recovery times, recovering at a slower rate than those who had no psychosomatic symptoms. For people with symptoms, about 80 percent had recovered within about 20 days of the concussion. For those with no symptoms, about 80 percent had recovered within about 10 days.

Those who had more severe physical symptoms after their concussions, like headache and balance issues, recovered at a slower rate than those with less severe symptoms.

“That these athletes were relatively healthy physically and psychologically highlights the relevance of psychosomatic symptoms and the role they play in recovery even in healthy people,” said Nelson. “Our hope is our study will lead to further research, because identifying those at risk for prolonged recovery is critical to developing early interventions that improve outcomes for people who suffer concussions.”

The study was funded by the U.S. Army Medical Research and Materiel Command, the Clinical and Translational Science Institute, and the National Institutes of Health National Center for Advancing Translational Sciences.

Learn more about concussion at www.aan.com/concussion, where you can access the AAN’s Sports Concussion Guideline, QuickCheck app, and other resources.
The American Academy of Neurology, an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Psychother Psychosom Med Psychol. 2011 Feb;61(2):82-6. doi: 10.1055/s-0030-1270518. Epub 2011 Feb 18.

[Article in German]

Franke GH1, Ankerhold A, Haase M, Jäger S, Tögel C, Ulrich C, Frommer J.

Abstract

The BSI-18, an abridged version of the Brief Symptom Inventory of Derogatis, contains the 3 six items scales Somatization, Depression, Anxiety, and the Global Score (GSI). In a sample of N=638 psychotherapeutic patients, reliability and validity were proven. Reliability of the 3 scales was good: Somatization α=0.79, Depression α=0.84, Anxiety α=0.84, and GSI α=0.91. The postulated three-factor structure was proven sufficiently using confirmatory and explorative factor analyses. The questionnaire separated different patients groups. Judgments of the therapists corresponded well with the self-rating behavior of the patients. In conclusion, the psychometric evaluation of the BSI-18 resulted in persuasive evidence for its reliability and validity. The loss of information, as a result of item reduction, is acceptable analyzing large samples; in cases of individual analyses, the SCL-90-R is advised.

 

Specific genes associated with marijuana addiction

“A genetic factor in cannabis dependence severity is important for the public to know. Look into the paragraph of Design, Setting, and Participants to appreciate the quality of this research. A 90% association of this genetic factor with another psychiatric condition or addiction is stunning.

The first paragraph is an announcement in the popular media. I looked up the original article and publish that article’s abstract below the horizontal line.”  Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Researchers identify specific genes associated with marijuana addiction

TIME (3/30, Szalavitz) reports that “specific genes associated with marijuana addiction have been identified – and some of them are also linked to increased risk for depression and schizophrenia.” Researchers arrived at this conclusion after studying “the genes of nearly 15,000 people from three different groups.” The study’s findings may “help explain why 90% of people with marijuana addictions also suffer from another psychiatric condition or addiction.” The study was published online in JAMA Psychiatry.

 

Below is the abstract of that original research publication March 30, 2016.

Online First >

Original Investigation | March 30, 2016

Genome-wide Association Study of Cannabis Dependence Severity, Novel Risk Variants, and Shared Genetic Risks ONLINE FIRST

Richard Sherva, PhD1; Qian Wang, MS2; Henry Kranzler, MD3,4; Hongyu Zhao, PhD2,5,6,7; Ryan Koesterer, MS1; Aryeh Herman, PsyD8; Lindsay A. Farrer, PhD1,9,10,11,12; Joel Gelernter, MD7,8,13,14

JAMA Psychiatry. Published online March 30, 2016. doi:10.1001/jamapsychiatry.2016.0036

ABSTRACT

ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS |ARTICLE INFORMATION | REFERENCES

Importance  Cannabis dependence (CAD) is a serious problem worldwide and is of growing importance in the United States because cannabis is increasingly available legally. Although genetic factors contribute substantially to CAD risk, at present no well-established specific genetic risk factors for CAD have been elucidated.

Objective  To report findings for DSM-IV CAD criteria from association analyses performed in large cohorts of African American and European American participants from 3 studies of substance use disorder genetics.

Design, Setting, and Participants  This genome-wide association study for DSM-IV CAD criterion count was performed in 3 independent substance dependence cohorts (the Yale-Penn Study, Study of Addiction: Genetics and Environment [SAGE], and International Consortium on the Genetics of Heroin Dependence [ICGHD]). A referral sample and volunteers recruited in the community and from substance abuse treatment centers included 6000 African American and 8754 European American participants, including some from small families. Participants from the Yale-Penn Study were recruited from 2000 to 2013. Data were collected for the SAGE trial from 1990 to 2007 and for the ICGHD from 2004 to 2009. Data were analyzed from January 2, 2013, to November 9, 2015.

Main Outcomes and Measures  Criterion count for DSM-IV CAD.

Results  Among the 14 754 participants, 7879 were male, 6875 were female, and the mean (SD) age was 39.2 (10.2) years. Three independent regions with genome-wide significant single-nucleotide polymorphism associations were identified, considering the largest possible sample. These included rs143244591 (β = 0.54,P = 4.32 × 10−10 for the meta-analysis) in novel antisense transcript RP11-206M11.7;rs146091982 (β = 0.54,P = 1.33 × 10−9 for the meta-analysis) in the solute carrier family 35 member G1 gene (SLC35G1); andrs77378271 (β = 0.29, P = 2.13 × 10−8 for the meta-analysis) in the CUB and Sushi multiple domains 1 gene (CSMD1). Also noted was evidence of genome-level pleiotropy between CAD and major depressive disorder and for an association with single-nucleotide polymorphisms in genes associated with schizophrenia risk. Several of the genes identified have functions related to neuronal calcium homeostasis or central nervous system development.

Conclusions and Relevance  These results are the first, to our knowledge, to identify specific CAD risk alleles and potential genetic factors contributing to the comorbidity of CAD with major depression and schizophrenia.

 

Heavy marijuana use in late adolescence may put men at higher risk for death

“More long term effects of regular marijuana use continue to arrive. The plant bud is an anxiolytic drug. There are better and safer drugs for anxiety, including a daily workout.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Heavy marijuana use in late adolescence may put men at higher risk for death by age 60, study finds

The CBS News (4/22, Marcus) website reported, “Heavy marijuana use in the late teen years puts men at a higher risk for death by age 60,” the findings of a study published online in the American Journal of Psychiatry suggest.

HealthDay (4/22, Preidt) reported that men “who were heavy marijuana users in their late teens were 40 percent more likely to die by age 60 than those who never used the drug, the investigators found.”

AMA News _ April 25, 2016.

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

 

“Good information for you to have when dealing with someone who hit their head and has lots of varied complaints afterwards. Being sensitive to the sensations of your body is unhealthy and associated with my conditions. Recent research using electric shocks to produce pain show changes in nerve behavior. Other evidence implication hyper-somatization with fibromyalgia.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Number of Medical Complaints Before Concussion May Help Predict Recovery Time       Released: 20-Apr-2016 7:05 PM EDT
American Academy of Neurology (AAN)

 

Number of Medical Complaints Before Concussion May Help Predict Recovery Time               Newswise — MINNEAPOLIS – Athletes who have medical complaints, like aches and pains, that have no known physical cause may take longer to recover after a concussion, according to a study published in the April 20, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Called psychosomatic symptoms, such complaints are often described as psychological distress expressed as physical illness.

“The goal of this study was to determine how physical complaints before and after concussion play a role in recovery,” said study author Lindsay D. Nelson, PhD, assistant professor of Neurosurgery and Neurology at the Medical College of Wisconsin in Milwaukee. “We found the greatest predictor of recovery after a concussion was the severity of early post-concussion symptoms. But somatic complaints before injury also play an important role, either by possibly enhancing how a person experiences the injury or affecting their reporting of post-concussive symptoms.”

For the study, 2,055 high school and college athletes were evaluated before the start of the season for balance, thinking and memory skills and psychological problems such as depression, anxiety and psychosomatic problems such as feeling faint or dizzy, nausea or upset stomach or pains in chest or heart. For the psychosomatic problems, the athletes rated how often they had been bothered by these symptoms during the last week. About 50 percent of the participants had at least one of 6 symptoms, and the other 50 percent had no symptoms.

During the season, 127 athletes suffered a concussion. Those athletes were then reassessed within the first 24 hours of injury and then again at 8, 15 and 45 days after the injury.

Of the concussed athletes, 61 percent played football, 24 percent played soccer, 6 percent played lacrosse, 3 percent were wrestlers, 3 percent played hockey, 2 percent played rugby and 1 percent played field hockey. Of the group, 80 percent was male.

On average, concussion symptoms lasted five days, with 64 percent of concussed athletes saying their symptoms were gone after one week and the vast majority, 95 percent, saying they no longer had symptoms after one month.

After concussion, those athletes who had reported pre-injury psychosomatic symptoms had longer recovery times, recovering at a slower rate than those who had no psychosomatic symptoms. For people with symptoms, about 80 percent had recovered within about 20 days of the concussion. For those with no symptoms, about 80 percent had recovered within about 10 days.

Those who had more severe physical symptoms after their concussions, like headache and balance issues, recovered at a slower rate than those with less severe symptoms.

“That these athletes were relatively healthy physically and psychologically highlights the relevance of psychosomatic symptoms and the role they play in recovery even in healthy people,” said Nelson. “Our hope is our study will lead to further research, because identifying those at risk for prolonged recovery is critical to developing early interventions that improve outcomes for people who suffer concussions.”

The study was funded by the U.S. Army Medical Research and Materiel Command, the Clinical and Translational Science Institute, and the National Institutes of Health National Center for Advancing Translational Sciences.

Learn more about concussion at www.aan.com/concussion, where you can access the AAN’s Sports Concussion Guideline, QuickCheck app, and other resources.
The American Academy of Neurology, an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

 

 

 

Psychother Psychosom Med Psychol. 2011 Feb;61(2):82-6. doi: 10.1055/s-0030-1270518. Epub 2011 Feb 18.

[The usefulness of the Brief Symptom Inventory 18 (BSI-18) in psychotherapeutic patients].

[Article in German]

Franke GH1Ankerhold AHaase MJäger STögel CUlrich CFrommer J.

Author information

Abstract

The BSI-18, an abridged version of the Brief Symptom Inventory of Derogatis, contains the 3 six items scales Somatization, Depression, Anxiety, and the Global Score (GSI). In a sample of N=638 psychotherapeutic patients, reliability and validity were proven. Reliability of the 3 scales was good: Somatization α=0.79, Depression α=0.84, Anxiety α=0.84, and GSI α=0.91. The postulated three-factor structure was proven sufficiently using confirmatory and explorative factor analyses. The questionnaire separated different patients groups. Judgments of the therapists corresponded well with the self-rating behavior of the patients. In conclusion, the psychometric evaluation of the BSI-18 resulted in persuasive evidence for its reliability and validity. The loss of information, as a result of item reduction, is acceptable analyzing large samples; in cases of individual analyses, the SCL-90-R is advised.

 

Anticholinergic medications may be linked to increased dementia risk

“Avoiding anticholinergic medications over the counter is a smart choice with this information. The list of common anticholinergic drugs is listed here in Wikipedia. https://en.wikipedia.org/wiki/Anticholinergic . It surprised me.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Anticholinergic medications may be linked to increased dementia risk

ABC World News Tonight (4/18, story 10, 0:20, Muir) reported that “certain medications may increase the risk of dementia,” a new study warns. Medicines, “including tablets for cold and flu, allergies and heartburn,” appear to be linked to “memory problems.”

According to CNN (4/18, Tinker), the study “offers the most definite proof yet of what scientists have known for at least a decade: that anticholinergic” medications are associated with “cognitive impairment and an increased risk of dementia.” Such medicines “are sold over the counter and by prescription as sleep aids and for chronic diseases including hypertension, cardiovascular disease and chronic obstructive pulmonary disease.”

TIME (4/18, Oaklander) points out that researchers “analyzed already existing data from 451 people around ages 70-75 who had normal brains,” then “examined the results of memory tests, MRI brain scans and other neuroimaging data – all while paying particular attention to people who said they took anticholinergic” medications. Seniors “who regularly took at least one anticholinergic drug showed poorer cognition, lower brain volumes and less glucose metabolism in the whole brain and the temporal lobe” than seniors who did not. The study was published online in JAMA Neurology.

 

Anti-smoking medications may not increase risk of mental health disorders

“This finding of no connection between Wellbutrin and its cousin Chantix and new mental health issues makes sense. Wellbutrin has been used a long time with fewer side effects than originally expected. It is available as a generic a lower costs. If you know a smoker, pass the good word along.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Anti-smoking medications may not increase risk of mental health disorders

The AP (4/23, Johnson) reported, “Seven years after US regulators slapped their strictest warning on two popular smoking-cessation medicines citing risks of suicidal behavior, a large international study found no such risk.”

According to HealthDay (4/23, Preidt), a new, FDA-requested, 8,000-participant study published online April 22 in The Lancet suggests anti-smoking medications Chantix (varenicline) and Wellbutrin (bupropion) “don’t appear to raise the risk of serious mental health disorders such as depression, anxiety and suicidal thoughts.” An accompanying editorial observed the study shows “neuropsychiatric adverse events occurring during smoking cessation are independent of the medication used.”

AMA news _4.25.16

 

Change your brain pathways for the better pathways. Be Better.

“The advances in functional MRI and SPECT scans of the brain are leading to better correlations between personality, mood and mental disorders with anatomic sections fo the brain. The SPECT scan shows hypoperfusion and hyperperfusion of areas of the brain. Depression, bipolar disorder and similar dysfunctions are associated with hypoperfusion is brain areas. The Cleveland Clinic advice has more science behind it now than ten years ago. The proof is in the pudding. Try it and you will see that your brain assumptions and reflex reactions change.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

April 26, 2016 Cleveland Clinic Wellness Newsletter  http://www.clevelandclinicwellness.com/

Harness the power of positive thinking…for your health!

Pollyanna gets a bad rap. What if it turns out that her relentless optimism wasn’t naiveté, but wisdom? Considering that negative thinking contributes to chronic stress and a host of health problems, Polly may have known exactly what she was doing. Advances in neuropsychology have shown that returning to the same thought over and over creates a real neural pathway in the brain, just like taking the same path through a field day after day creates a visible trail. Once the “thought pathway” is there, you’re more likely to follow it. Take these three steps to set yourself up for good health by increasing positive thinking and interrupting negative thinking before it gets entrenched. Happy trails!

Get perspective. If you notice that you’re having a negative thought, step outside yourself (figuratively!) and take stock. This probably isn’t the worst day ever, and everyone is not, in fact, out to get you. Your brain is just in a mental rut. Really. It’s that simple.

Sit and be still. A regular meditation practice can help steer you away from negative thought pathways and lead to lasting, beneficial changes in your brain. Sitting quietly, paying attention to your breath, and noticing your thoughts and emotions without judging them (all hallmarks of meditation) will help you to cultivate a more positive frame of mind.

Revel in the good stuff. Reinforce positive pathways by basking in enjoyable experiences, like the scent of fresh lilacs, a laughing fit with your best friend, or the natural high you feel after a bike ride. Keep a “joy journal” or a “gratitude register” to record the high points. And if people start calling you Polly, take it as a compliment!

Bright light therapy may benefit depression

“I include this article for emphasis that this type of treatment is not used enough. Also the Cleveland Clinic describes the details of the type to use and for how long.” Bill Chesnut, MD

 Let there be light! Bright light therapy may benefit depression — and not just the seasonal variety. Cleveland Clinic Wellness newsletter February 24, 2016
There’s a relationship, it seems, between outer light and inner light. Step outside on a sunny day, and you can practically feel your mood meter rising a few points. And while depression doesn’t lift so easily, it may respond to light. Light therapy with specialized lamps is standard treatment for seasonal depression (a.k.a. seasonal affective disorder). A new study shows that it may help chronic, year-round depression, too, possibly by affecting the mood-regulating hormone serotonin. In one study, combining light therapy with antidepressant medication was shown to be more effective than either treatment alone. If you have depression, talk with your mental health professional about adding light therapy to your treatment plan. ADVISORY: If you have been diagnosed with bipolar depression, you must be sure to check with your doctor before you use a light box. You’ll want to look for a light box that offers 10,000 lux and then schedule a time to sit nearby for about 30 minutes a day, ideally at sunrise. Be sure you’re getting regular exercise, which has also been shown to ease depression. The more mood boosters, the merrier…literally!

The Health Benefits of Friendship

“This article was first published in 2010. The Cleveland Clinic Wellness newsletter published in again this month. This is more than listing health benefits; it discusses how to make friends. Be deliberate and see out relationships.” Bill Chesnut, MD

 The Health Benefits of Friendship     By Victoria Moran            Cleveland Clinic Wellness newsletter_Published 6/29/2010

No doubt you’ve heard the good-health prescription: Eat a colorful, natural diet; exercise regularly; manage your stress with relaxation, recreation and meditation; get enough sleep; and have the proper checkups and screenings for your age and history. Recently, a host of research has added another, perhaps surprising, to-do to that list: Make friends, and keep those friendships in good repair.

”Researchers have found that having even one close friend that you confide in can extend your life by as much as 10 years,” says sociologist and relationship coach Jan Yager, PhD, author of Friendshifts.“Numerous studies also show that recovery from a major health challenge, such as a heart attack or cancer, is enhanced because of friendship.”

The Friendship Advantage

A landmark UCLA study in 2000 showed that, for women, having a circle of friends actually provides an alternative to the traditional fight-or-flight response to stress. The researchers called this response “tend-and-befriend” and showed that when women gather with other women (and with children), they release more oxytocin, the mother-love hormone associated with breast-feeding, which has a marked calming effect.

But women aren’t alone in attaining measurable health benefits from friendship. The Australian Longitudinal Study of Aging looked at nearly 1,500 seniors — women and men — for a full decade. Among their findings was that having good friends is more likely to increase longevity than even close relationships with adult children and other family members. The study subjects with the largest number of close friends outlived those with the fewest by 22 percent. Even major life changes such as the death of a spouse could not erode the “friendship advantage.” What makes these findings exciting — and practically applicable — is that while anyone’s number of family members is limited, we can expand our network of friends for as long as we live.

Friends may also add to the quality of those extra years by helping us maintain brain function. A Harvard School of Public Health study that looked at older adults across the country provides evidence that social integration — through marriage, volunteer work or frequent contact with children and neighbors — delays memory loss in elderly Americans.

While it’s clear that having friends is a healthy habit, the verdict is still out on the precise reasons why this is so. The Australian researchers speculate that, in addition to the emotional support friends provide one another during difficult times, positive peer pressure may also play a role — encouraging the adaptation of healthy lifestyle practices, such as joining a gym or a smoking cessation program together — as well as the stress-reduction benefits that derive from feeling connected to other people.

Friends in Health

Stress management is, in fact, one of the great gifts of friendship. One 2009 study found that clients with the fewest friendship connections were those most likely to be dealing with depression, anxiety and heart disease. Stress is known to encourage a host of maladies, from the common cold to the arterial inflammation that contributes to cardiovascular disease.

That might explain the results of a two-year study that looked at 500 women with suspected coronary artery disease. Those with a strong support system were not only more likely to be alive after two years, but their rates of hypertension and diabetes were lower, and they were less likely to have an excess of abdominal fat.

The Friend-Weight Dilemma

It is in the area of excess fat, however, that a single dark cloud may lurk in the bright sky of friendship and health. A study reported in 2007 in the New England Journal of Medicine suggests that there could be a connection between the rise of obesity and our social interactions. In other words, obesity may “spread” through a network of friends as members of that network become more tolerant of obesity and the behaviors that lead to it.

Reflecting on this study, Michelle P. Gallant, MS, RD, of Harvard University Health Services, says, “Because we want to fit in with our peers, we might go along with their way of eating. If we’re out with people having appetizers, drinks and desserts, the brain is stimulated by that, and it can trigger us to eat more than we’re really hungry for.”

Curiously, it’s our same-gender friends that appear to be the culprits here. The New England Journal report suggests that we’re influenced more by those who “resemble us.” Even spouses, who presumably share a kitchen and routinely dine together, may not affect each other’s weight gain as much as mutual friends do.

These same friends can also exert another kind of unhelpful peer pressure, especially among young women, when they overemphasize and idealize thinness. “I see the damage friends can cause each other about body image,” says Gallant. “Too much ‘diet talk’ can cause women to be preoccupied with body size in a negative way.”

The secret seems to be choosing well-balanced, health-conscious friends and engaging together in health-promoting activities. Good habits, as well as bad, may be “contagious” when we’re in the company of people we care about and whose company we genuinely enjoy. A University of Pennsylvania study reported in the Archives of Internal Medicine looked at 344 African-American women and men, and found that exercising with a family member or friend led to more weight loss than going solo, but only if the buddy-cisers enrolled together. Being assigned an exercise partner who wasn’t a “real friend” had a negligible effect.

Making Friends 101

As positive friendships vie with dark, leafy greens as the good-health superstars, how do we get more of them, especially if we’re not the life-of-the-party type? Some ideas:

Make the first move: According to Dr. Yager, showing an interest in another person is the first step on the road to friendship.

Branch out: “Since having shared interests is an obvious way to begin a relationship that might become a friendship, get active in sports or cultural activities where you’ll meet people. If someone seems interesting, suggest getting a cup of coffee before or after the next session.”

Be interested: Once a nascent friendship is underway, be genuinely interested in learning about this person. Keep things light and allow for humor. Although strong friendships can develop in support groups and other places where people go for help, more often the person who’ll be there for you when things get rough entered your life through shared good times.

Show your appreciation: Finally, cherish the friends you already have. It’s no easy matter to stay in touch these days, especially if you’ve lived in seven cities, had a dozen jobs and your face-to-face friends are in competition with a hundred Facebook friends you may not have seen since childhood (if you’ve ever met at all). While it can be fun to “know” a lot of people, acquaintances aren’t the same as friends. Stay close to the tried-and-true by getting together in person when you can, sharing a phone call every so often and making e-mail contact or even sending a real note — on paper with a stamp! Handwritten notes were always special, but now that they’re so rare, they’re worth their weight in friendship gold.

Finally, be there for the people you care about when they could use a friend. Most of us will never save a life by running into a burning building or jumping into a churning sea, but science now tells us that we just might extend someone’s life simply by being a part of it.

 

Knitting and other crafting activities have also been linked with a reduced risk of cognitive impairment.

“This is true science. Using your mind to concentrate on a pleasurable task reduced the risk of cognitive impairment. You feel better, have less stress and less stress mean better health.” Bill Chesnut, MD

Crafters, take note: To help keep your brain sharp, hang up your “just gone knitting” sign.Cleveland Clinic Wellness newsletter_February 25, 2016

Knit one, pearl two, brain power, we love you! Sudoku and other paper puzzles aren’t the only activities that can help keep your neurons firing as you age. Knitting and other crafting activities have also been linked with a reduced risk of cognitive impairment. The calming, meditative effects of knitting have been shown to reduce stress, but there may be additional benefits as well. Knitting and other creative crafting activities also require the use of multiple parts of the brain, which may help keep you sharp. And don’t think it’s ever too late to learn or re-learn. Pshaw! Until relatively recently, conventional medical “wisdom” held that we couldn’t generate new brain cells, but we now know better. Research has shown that our nervous systems have endless “neuroplasticity,” meaning that they continue to form new connections and patterns throughout our entire lives. Find a knitting class or a friend who’s willing to teach you. If you’re an old hand at knitting or crocheting, challenge yourself with new patterns and skills. And with every click of your needles, imagine your brain cells doing a little happy dance.

Outsmart Alzheimer’s_grow a Brain Forest to

“This article in 2010 is worth reading again. Think of growing a brain forest.” Bill Chesnut, MD

 Grow a Brain Forest to Outsmart Alzheimer’s

By Dana Sullivan  Cleveland Clinic Wellness newsletter_Published 6/29/2010

We’ll just get the bad news out of the way first: “There is no way to prevent Alzheimer’s disease,” says Nancy Udelson, the executive director of the Alzheimer’s Association’s Cleveland Area Chapter. Before you toss in the towel (and stop reading), here’s the good news: There is plenty of evidence that if you stay active, eat a healthy diet with plenty of antioxidants and “good” fats and exercise regularly, you won’t develop the symptoms. “We do autopsies on brains that definitely have Alzheimer’s, but the person never manifested the symptoms,” explains Paul Nussbaum, PhD, a clinical neuropsychologist and the chairman of the Alzheimer’s Prevention Advisory Council for the Alzheimer’s Foundation of America. By way of explanation, he compares a healthy, active brain to a thickly forested jungle. If your brain resembles the Amazon, should Alzheimer’s cut down a few of the “trees” — aka brain cells — the symptoms may go unnoticed. On the other hand, if poor lifestyle habits have led your brain to look like a desert island, with a palm tree here and there, losing a single tree is going to make a bigdifference.

“It’s possible to build up brain reserves in childhood and early adulthood so that later in life you have that ‘rain forest’ of a brain,” adds Mark Mapstone, PhD, of the University of Rochester Medical Center, who is a spokeman for the Alzheimer’s Foundation of America. If you’re well past either life stage, there’s still a good way to build up reserves: Go back to school. The more education a person has, and the more mentally challenging his or her work, the lower the risk of developing the symptoms of Alzheimer’s, Dr. Mapstone states.

Among the other ways you can add new trees to your brain forest to keep it lush and vibrant:

Get Your Game On

Scrabble, crossword puzzles, card games and chess are all brain builders. You’ve got to hold information in your mind to solve problems that arise during such games, and   intellectually stimulating activities such as these spur the brain to produce new neurons and connections between brain cells. In fact, a recent study of adults 75 or older found that those who played cards and board games, did crossword puzzles and read also lowered their risk of dementia. Play with other people and you cut your risk even more: Researchers in Sweden found that older adults who participated in social activities reduced their risk of dementia by nearly half.

Just Sit There

“Americans have a hard time sitting quietly,” says Dr. Nussbaum. We fill every moment — too many moments, actually — with passive activities such as watching television and playing video games. He says that taking 30 minutes a day to just sit (with the TV off!) and think, pray or meditate ultimately helps boosts brain power. People who meditate strengthen the left prefrontal cortex of the brain, the part that is responsible for memory.

Home in on a Hobby

Learn French, Spanish, Russian or even sign language, pick up knitting, master the classical guitar or write your memoirs (you don’t even have to let anyone read them).  The benefit comes from “engaging in something novel,” says Dr. Nussbaum. If you don’t want to give up the hobbies that you love, and that you’re already good at, just look for ways to make your favorite pastimes more challenging. If you repeat the same activity, you’re operating on autopilot and not building new pathways (or planting new trees, to use Dr. Nussbaum’s brain forest metaphor) in your brain. Here, some ideas to spur your creativity:

  • Is knitting a favorite activity? Try to learn a new stitch every once in a while, and don’t just knit the same scarf for every person on your Christmas list. Challenge yourself with a sweater!
  • Like to build birdhouses? Sketch out different designs.
  • Crazy for quilting? Experiment with a variety of patterns.
  • Love jigsaw puzzles? Try doing an occasional puzzle facedown, which forces you to fit the pieces together using just the shapes.

 

Carotid Endarterectomy and Stenting Equally Durable

“Stroke is a devastating injury. This article discusses carotid artery arthrosclerosis. We don’t think of that as often as hardening of the coronary arteries. The carotid arteries are just under the skin in our necks, easy to open, remove the plaque and close again. Stenting has equally good results in this study of 1600 subjects. When you think of stroke, remember to think of your carotid arteries.” Bill Chesnut, MD

 

Carotid Endarterectomy and Stenting Equally Durable, Safe Over Long Term for Preventing Stroke

February 22, 2016

By Alex Morrisson

LOS ANGELES — February 22, 2016 — Carotid endarterectomy and carotid stenting have equal durability and safety in preventing stroke among both symptomatic and asymptomatic patients with greater than a 70% stenosis of their neck arteries, according to results of the landmark Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) presented at the 2016 International Stroke Conference (ISC).

The final 10-year analysis of CREST included 1,607 patients who had been followed up every 6 months for a median of 7.2 years at 117 centres in the United States. Those who underwent carotid stenting procedures experienced 42 ipsilateral strokes (6.9%), compared with patients treated by carotid endarterectomy, who experienced 41 strokes (5.6%), indicating virtually no differences (P = .96) between the methods.

The composite endpoint of stroke, heart attack, or death was virtually the same — about 10% in each group at 10 years, stated lead author Thomas G. Brott, MD, Mayo Clinic, Jacksonville, Florida, speaking at a late-breaker presentation here on February 18. The event curves overlapped for the entire 10-year period, Dr. Brott added.

“The results showed that stenting and surgery were safe, and that patients from both groups had very few strokes during the extended follow-up period,” stated Dr. Brott. “Equal benefit was found for older and younger individuals, men and women, for patients who had previously had a stroke, and for those who had not. The 10-year comparisons of re-narrowing of the carotid artery were very low for both stenting and surgery — about 0.7% per year.”

Approximately 12.2% of the patients who underwent stenting experienced restenosis or the need for revascularisation, compared with 9.6% of the patients who underwent endarterectomy and experienced restenosis or required revascularisation.

Previous interim results from CREST demonstrated that, with an average follow-up of 2.5 years, the overall safety and efficacy of the 2 procedures were largely the same. “Now we have data over a longer period of time that shows the durability of both procedures,” noted Dr. Brott. “With life expectancy increasing in the elderly, these long-term results provide doctors and patients with much-needed information on safety and effectiveness to help guide the choice of treatment options.”

Results were simultaneously published online in the New England Journal of Medicine.

 

Study shows decades-long decline in dementia rates

“This first of the two included studies shows a decades-long decline in dementia ratesEncouraging news about dementia trends in 5,200 participants. I like the AMA Wire newsletter because they include a link to the research they quote. Without a subscription or paying a fee you get the abstract of the original research by following that link.” Bill Chesnut, MD

Study shows decades-long decline in dementia rates

According to USA Today (2/10, Szabo), a 5,200-patient study published online in the New England Journal of Medicine reveals that “dementia rates fell steadily over the past four decades, most likely due to declining rates of heart disease.” The biggest decline was seen in rates of vascular dementia, “although rates of Alzheimer’s disease also fell.” The study’s findings were based on data collected from the Framingham Heart Study.

The New York Times (2/11, A14, Belluck, Subscription Publication) reports that the study “provides the strongest evidence to date that a more educated population and better cardiovascular health are contributing to a decline in new dementia cases over time, or,” at a minimum, are “helping more people stave off dementia for longer.” Both findings “suggest that the long-term cost of dementia care may not be as devastatingly expensive as policy makers had predicted.” Nevertheless, “the actual number of dementia patients will increase because” aging baby boomers are “living longer.”

The San Francisco Chronicle (2/10, Colliver) reports that in a separate study (pdf), published online in the journal Alzheimer’s & Dementia, investigators found that “the risk of being diagnosed with Alzheimer’s disease or other forms of dementia is significantly higher in some racial or ethnic groups than it is in others.” After tracking some 274,000 members of Northern California Kaiser Permanente for 14 years, the researchers found that “African Americans had the highest incidence of dementia-related disease.” In fact, “their risk was 65 percent higher than that of Asian Americans, who had the lowest rates” of dementia.

 

Low levels of midlife fitness may be associated with smaller brain tissue volume later

“Great study of 1,583 participants without dementia using brain scans and fitness tests. Note this:  “observed that participants who had an especially high heart rate and blood pressure during the most vigorous exercise had notably smaller brain volumes 20 years later“. Bill Chesnut, MD

Low levels of midlife fitness may be associated with smaller brain tissue volume later

Reuters (2/10, Rapaport) reports that people who are not physically fit in midlife have an increased chance of having lower brain tissue volume in late life, compared to people who take part in regular exercise during their middle years, the findings of a study published online Feb. 10 in Neurology suggest.

TIME (2/10, Sifferlin) reports that investigators “looked at 1,583 men and women who didn’t have dementia or heart disease,” all of whom “worked out on a treadmill to assess their fitness levels.” Two decades later, study participant underwent “another treadmill fitness test and had brain scans.”

Newsweek (2/10, Firger) reports that “smaller brain volume” was found to correlate “with lower levels of physical fitness.” In addition, investigators “observed that participants who had an especially high heart rate and blood pressure during the most vigorous exercise had notably smaller brain volumes” 20 years later. While the study did not “measure rates of cognitive decline” in participants, “a decrease in brain volume is a strong indicator of declining function.”

 

Concussion may increase long-term suicide risk in adults

“This brief notice links to a significant research report in Canada. It is titled Risk of suicide after a concussion. Their interpretation of their findings isAdults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends. Greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented.” Bill Chesnut, MD.

Concussion may increase long-term suicide risk in adults.   AMA Wire_2.9.16.

http://www.cmaj.ca/content/early/2016/02/08/cmaj.150790

Reuters (2/8, Doyle) reports that adults suffering a concussion may have a threefold increase in the long-term suicide risk, according to the findings of a 235,000-participant study published online Feb. 8 in the Canadian Medical Association Journal suggest.

According to AFP (2/8), “the likelihood of suicide was even greater among those whose head injury was incurred on the weekend, suggesting they had hurt themselves during a recreational activity.” Overall, whether concussions were incurred on the job or during recreation, “the average time from concussion to subsequent suicide was nearly six years.”

The ABC News (2/8, Hawkins) website reports that because “each additional concussion is associated with a further increase” in the risk for suicide, the study’s lead researcher, Donald Redelmeier, MD, “said the findings emphasize that it’s important for medical” professionals “to be aware of a patient’s concussion history.”

 

Study offers clues to genetic abnormality of C4 genes associated with schizophrenia

“The January 2016 AMA newsletter reports DNA testing showing an abnormality of the C4 genes associated with a much higher incidence of schizophrenia. Other recent publications report improvements in schizophrenia if treatment  began early and involve the family.” Bill Chesnut, MD

Study offers clues to biology behind schizophrenia

On its front page, the New York Times (1/27, A1, Carey, Subscription Publication) reports that a new study published online Jan. 27 in Nature takes “a significant step toward understanding the cause of schizophrenia,” providing “the first rigorously tested insight into the biology behind any common psychiatric disorder.”

In “Science Now,” the Los Angeles Times (1/27, Healy) reports, “After conducting genetic tests on nearly 65,000 people, the scientists followed a trail of clues to a group of genes in the” major histocompatibility complex (MHC) “called C4 genes.” Investigators “found that people with certain variants of C4 genes had unusually high odds of developing schizophrenia, even in the absence of other genetic risks.” By demonstrating “a link between C4 and synaptic pruning,” the study “builds on theories that the over-editing of brain connections in late adolescence might be ‘a contributing cause’ of schizophrenia.”

The Washington Post (1/27, Nutt) reports in “Speaking of Science” that in people “with schizophrenia, a variation in a single position in the DNA sequence marks too many synapses for removal and that pruning goes out of control,” resulting in “an abnormal loss of gray matter.” According to the Post, the “study offers a new approach to schizophrenia research, which has been largely stagnant for decades.”

AMA News 1.28.16

Ultimate cause of Alzheimer’s may be fungal, cadaver study suggests

“This new finding is remarkable in many ways. Has anyone heard about this work in the media? Pub Med includes a 2014 article in J. Alzheimers Disease of fungus  in Alzheimer’s brains. The abstract says:

To our knowledge, these findings represent the first evidence that fungal infection is detectable in brain samples from Alzheimer’s disease patients. The possibility that this may represent a risk factor or may contribute to the etiological cause of Alzheimer’s disease is discussed.  http://www.ncbi.nlm.nih.gov/pubmed/24614898

A Google review today finds the study in GIZMODO October 26, 2015.  http://gizmodo.com/new-study-suggests-alzheimers-is-associated-with-brain-1738788855

Clearly this is astoundingly good news by opening a possible treatment for Alzheimer’s. I am eager to follow this topic.” Bill Chesnut, MD

 Ultimate cause of Alzheimer’s may be fungal, cadaver study suggests

 The Economist (10/23) reports that a study published online Oct. 15 in the journal Scientific Reports suggests that “the ultimate cause of Alzheimer’s is fungal.” Researchers arrived at this conclusion after examining “brain tissue from 25 cadavers, 14 of which belonged to people who had had Alzheimer’s disease when alive.” The study authors now “think a clinical trial of anti-fungal drugs is the next logical step.

From the abstract of the study: The possibility that Alzheimer’s disease (AD) has a microbial aetiology has been proposed by several researchers. Here, we provide evidence that tissue from the central nervous system (CNS) of AD patients contain fungal cells and hyphae. Fungal material can be detected both intra- and extracellularly using specific antibodies against several fungi. Different brain regions including external frontal cortex, cerebellar hemisphere, entorhinal cortex/hippocampus and choroid plexus contain fungal material, which is absent in brain tissue from control individuals. Analysis of brain sections from ten additional AD patients reveals that all are infected with fungi. Fungal infection is also observed in blood vessels, which may explain the vascular pathology frequently detected in AD patients. Sequencing of fungal DNA extracted from frozen CNS samples identifies several fungal species. Collectively, our findings provide compelling evidence for the existence of fungal infection in the CNS from AD patients, but not in control individuals.

Pisa, D. et al. Different Brain Regions are Infected with Fungi in Alzheimer’s Disease. Sci. Rep. 5, 15015; doi: 10.1038/srep15015 (2015).

 

Why positive emotions may be the next big predictor of health

“Dr. Stellar presented by video her research about the effect of emotions on inflammation  markers in our saliva at TELMED 2015. That video is not publicly available. Do a search for her and you will find other presentations she makes. Worth a look.” Bill Chesnut, MD

 Why positive emotions may be the next big predictor of health

 http://www.ama-assn.org/ama/ama-wire/post/positive-emotions-may-next-big-predictor-of-health?&utm_source=BHClistID&utm_medium=BulletinHealthCare&utm_term=112315&utm_content=MorningRounds&utm_campaign=BHCMessageID

 What if joy or amusement could improve your health—would you smile more today? That’s precisely the question psychology researcher, Jennifer Stellar, PhD, has explored in her work. The University of Toronto postdoctoral fellow recently presented her research at TEDMED 2015. Learn about her evidence-based approach to exploring human emotions and why our feelings may have a greater impact on our well-being than we expect.

Measuring positive emotions and health

To determine whether emotions impact health, Stellar launched two studies in which she measured students’ levels of proinflammatory cytokines, which if chronically elevated for long periods of time, can have harmful health effects contributing to diabetes, cardiovascular disease and depression.

In her research, Steller specifically measured students’ levels of Interluken-6 (IL-6), a common proinflammatory cytokine, based on the emotions they exhibited.

Stellar noted that she and her research staff had an important hypothesis to test. “Our idea was that people who experience more positive emotions will have lower levels of IL-6 circulating in their body,” she said. “Why did we think this? Certain negative emotions have been associated with increases in IL-6, so we thought perhaps positive emotions would have an opposite effect leading to lower levels of this damaging biomarker.”

Stellar had students come to a lab where she measured how many positive emotions they experienced in the previous month, then collected a saliva sample to measure each student’s level of IL-6. “It turns out, our hypothesis was correct. Positive emotions predicted lower levels of proinflammatory cytokines in our student population.”

How Stellar challenged her own research, explored new emotions

This was a great discovery, but Stellar still felt compelled to approach her hypothesis differently. Not only did she want to confirm that human emotions impact IL-6 levels but she also wanted to know which specific emotions were key drivers to higher IL-6 levels, so she launched an additional survey that measured the frequency and intensity in which students experienced a core set of emotions.

The survey measured seven key emotions: amusement, awe, contentment, compassion, pride, love and joy. Stellar found that four specific emotions—joy, pride, contentment and awe—predicted lower levels of IL-6.

Interestingly, awe had the strongest negative relationship to IL-6, even when researchers controlled for the other six positive emotions, personality measures and a third method of measuring emotions.

An awe-inspiring discovery

Awe is such a powerful emotion because it signifies wonder and amazement in the world, and you don’t have to travel abroad or pursue a daring adventure to find it. “In fact, participants report feeling awe about twice a week on average, making it a more common emotion than we might expect,” she said, noting that everyday experiences— glancing up at the stars or watching athletes achieve a seemingly impossible physical feat—can inspire awe.

While researchers don’t entirely know why awe topped the list of emotions as a positive predictor of health, Stellar said she’s certain that her own studies have changed her way of thinking about awe in the world.

“I used to see a walk in nature or a trip to the museum as a luxury I could barely afford in my busy life. Now I see it as essential to my mental and physician health.”

She said her studies also remind her that as a field, psychology is transforming, and her colleagues are shifting how they think about positive emotions. “We now recognize that they’re not simply the absence of negative emotions but that they’re colorful and varied in their own right …. We still have a lot to learn about the emotion of awe, but it’s fascinating to think that in seeking out the beauty, mystery and vastness our world has to offer, we might actually find the key to our physical health.”

Interested in more TEDMED?
AMA members have complimentary virtual access to the stage program for TEDMED 2015, which brings together the global community dedicated to shaping a healthier world.

Thought leaders and change agents will share compelling personal stories as this year’s theme, “Breaking Through,” focuses on shattering the status quo and fostering a shift in our daily mindset to change established routines and habits to shape a healthier nation.

 

High-dose vitamin D3 may modulate immune system in patients with MS

AMA News 12.31.15 reports that vitamin D3 taken as a supplement to patients with multiple sclerosis showed a decrease of harmful cell activity at 10,400 international units a day. This finding is important because MS touches many of us and its effects are profound. It is easy to check possible overdoing the Vit D3 with a simple blood test. You want your blood level of Vit. D3 to be < 100 ng/dl.” Bill Chesnut, MD.

High-dose vitamin D3 may modulate immune system in patients with MS

Newsweek (12/31, Main) reports that in a study published online Dec. 30 in Neurology, researchers “tested the impact of two levels of vitamin D supplementation among 80 patients” with multiple sclerosis. Half the patients “were given 10,400 international units of Vitamin D, and the other 40 took 800 IUs of the supplement per day.” Researchers found that patients “in the high-dose group had significantly reduced levels of activity among a certain type of immune cell thought to be involved in multiple sclerosis, compared with those in the low-dose group.”

According to MedPage Today (12/31, Jackson), in patients taking high-dose vitamin D3 (cholecalciferol), researchers found “in vivo pleiotropic immunomodulatory effects” as evidenced by the “significant reduction in the proportion of interleukin-17+CD4+ T cells (P=0.016), CD161+CD4+ T cells (P=0.03), and effector memory CD4+ T cells (P=0.021),” as well as “a concomitant increase in the proportion of central memory CD4+ T cells

AMA Wire newsletter January, 2016.

FDA approves long-acting injectable schizophrenia treatment

“This is the kind of news that makes you want to stand up and dance when you read it. I am eager to learn more about the details of Aristada. Imagine the future mental health management with injectable long-lasting psychosis medications.” Bill Chesnut, MD

 FDA approves long-acting injectable schizophrenia treatment

 The Wall Street Journal (10/6, Armental, Subscription Publication) reports that the Food and Drug Administration approved Aristada (aripiprazole lauroxil), Alkermes PLC’s drug to treat schizophrenia.

Bloomberg News (10/6, Chen) reports that Aristada is “a long-acting injectable medicine with options to be taken once monthly or every six weeks,” and is “intended as an alternative to oral anti-psychotic medications taken daily.”

AMA newsletter October, 2015.

 

Changes in a person’s sense of humor may portend dementia

“This is another reason to pay attention to your humor. Others may think you’re going crazy.” Bill Chesnut. MD

Changes in a person’s sense of humor may portend dementia, study suggests

The CBS News (11/11, Cohen) website reports that changes in “a person’s sense of humor can be a sign of Alzheimer’s disease” or other forms of dementia “and may start to emerge years before other symptoms,” according to a study involving 48 patients with dementia and 21 healthy people. Researchers found that “laughing at ‘frankly inappropriate’ moments, taking jokes literally or missing the point, and preferring childish or slapstick humor are some of the behaviors highlighted in the study, published in the Journal of Alzheimer’s Disease.”

Jama 11.11.15

Casein in cheese may trigger dopamine receptors in the brain, study suggests

“This publication is available to the public through the National Institutes of Health through the US National Library of Medicine. http://www.ncbi.nlm.nih.gov/pubmed/25692302   I think dopamine response is a good thing in moderation. In four decades of medical practice, I never heard  an ER reporting an overdose of cheese.” Bill Chesnut, MD

 Casein in cheese may trigger dopamine receptors in the brain, study suggests

 NBC Nightly News (10/22, story 10, 0:20, Holt) reported that “if you ever joked you’re addicted to cheese, you may actually be right.” A study suggests that “a protein in cheese can release opiates that trigger dopamine receptors in our brain like certain drugs do.”

The Los Angeles Times (10/22, Harris) reported in “The Daily Dish” that the study, which was published Feb. 18 in PLoS One, “identified addictive foods from about 500 students who completed the Yale Food Addiction Scale, designed to measure if someone has a food addiction.” It appears that cheese is particularly “addictive because of…casein, a protein found in all milk products,” which, “during digestion…releases opiates called casomorphins” that in turn “trigger” dopamine receptors.

AMA newsletter_ 10.26.15