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Oct 19
Fat teenage boys 'could be impotent and infertile later in life'
Obese teenage boys have up to 50 per cent less testosterone than their leaner pals - increasing their risk of infertility in later life, a study has found.

Researchers said the results were a 'grim message' for overweight young adults.

The study by scientists at the University at Buffalo in the U.S shows for the first time that obese young men aged 14 to 20 have around half the total testosterone than normal weight youths.

The same research team first reported in 2004 the presence of low testosterone levels - known as hypogonadism - in obese, type 2 diabetic adult males and confirmed it in 2010 in more than 2,000 obese men, both diabetic and non-diabetic.

The study's first author Dr Paresh Dandona, Distinguished Professor in the Department of Medicine, said: 'We were surprised to observe a 50 per cent reduction in testosterone in this paediatric study because these obese males were young and were not diabetic.

'The implications of our findings are, frankly, horrendous because these boys are potentially impotent and infertile. The message is a grim one with massive epidemiological implications.'

In 2009, 20 per cent of 11 to 15-year-olds boys in the UK were recorded as obese.

The study included 25 obese and 25 lean youths and was controlled for age and level of sexual maturity. Concentrations of total and free testosterone and estradiol, an oestrogen hormone, were measured in morning fasting blood samples.

Dr Dandona said the results need to be confirmed with a larger number of subjects.

However, he said: 'These findings demonstrate that the effect of obesity is powerful, even in the young, and that lifestyle and nutritional intake starting in childhood have major repercussions throughout all stages of life.'

Dr Dandona said in addition to the reproductive consequences, the absence or low levels of testosterone that were found also will increase the tendency toward abdominal fat and reduced muscle, leading to insulin resistance which contributes to diabetes.

He added: 'The good news is that we know that testosterone levels do return to normal in obese adult males who undergo gastric bypass surgery.

'It's possible that levels also will return to normal through weight loss as a result of lifestyle change, although this needs to be confirmed by larger studies.'

The researchers now intend to study whether or not weight loss accomplished either through lifestyle changes or through pharmacological intervention will restore testosterone levels in obese teenage boys.

The paper was published online in the journal Clinical Endocrinology.

Oct 19
Skipping breakfast could make you fatter
Those who skip breakfast to lose weight not only eat more for lunch, they also crave fatty and sugary foods, researchers say.

Over time, this could lead to slimmers piling on the pounds, despite their best intentions, the Daily Mail reported Tuesday.

The warning comes from doctors and scientists at Imperial College London who scanned the brains of 21 healthy young men and women while they looked at pictures of various foods.

The volunteers also rated how appealing they found the foods, which ranged from salads and vegetables to calorie-laden chocolates, desserts, cakes, pizzas and burgers.

Oct 18
Missing just two hours of sleep can erase memories: Study
Researchers have discovered that memories can be lost for ever if you dont get enough sleep, and missing even two hours of slumber can stop the brain from storing them.

Researchers from the University of Pennsylvania looked at how mice that were stopped from sleeping fared on a memory task.


The creatures were kept awake for varying amounts of time, to pinpoint just how little sleep had to be lost for their recall to be damaged, the Daily Mail reported.

"What we found is that when we deprived animals of sleep, that impaired storage of memories," researcher Ted Abel said.

"And most importantly we found out that a very short period of time would block memory consolidation, it was as short as three hours, which for mice is something like 20 per cent of their sleep over 24 hours," Abel said.

"In human terms, it would be the equivalent of dropping an eight-hour night of sleep to six hours, which is something we do all the time," Abel added.

It is thought that the replay of our memories while we are asleep is essential for their proper storage in the brain.

The study also suggested that there is a critical period after learning during in which memories are consolidated; meaning that loss of sleep at some points in time may be more damaging than at others.

Researchers added that any information lost due to lack of sleep is gone forever - meaning that sleeping longer the next night won`t bring it back.

"The important thing about sleep is that is allows the brain to do things that it is far too busy to do during the day. Sleep is the quiet time that gives the brain time to do the filing," Neil Stanley, one of Britain`s leading sleep experts, said.

The study was presented at the Society for Neuroscience`s annual conference in New Orleans.

Oct 18
Ganga water can cause cancer: Study
The river Ganga, lifeline to millions of Indians and the most holy river to Hindus, has become a source of carcinogens as well.

With pollutants being continuously dumped into the river, a study has found that people living along its course are more susceptible to cancer than anywhere else in the country.

According to the National Cancer Registry Programme (NCRP), the river is suffused with heavy metals and poisonous chemicals, especially along the stretches in Uttar Pradesh, Bihar and West Bengal.

"Ganga water is now laced with toxic industrial discharge such as arsenic, choride, fluoride and other heavy metals," Jaideep Biswas, director of Chittaranjan National Cancer Institute, an associate of the National Cancer Registry Programme, was quoted saying to a leading newspaper.

Gallbladder cancer cases in these areas are the second highest in the world and prostate cancer highest in the country.

The research revealed that of every 10,000 people surveyed, 450 men and 1,000 women were gallbladder cancer patients. Other forms of cancer were also found among the people living along the river course, such as kidney, oesophagus, liver, urinary bladder and skin cancer.

"Those who've been bathing in this poison river are equally at danger," said Biswas.

Oct 17
Depression: a dark and dreary place
What one person may experience in their lives as a challenge the other might consider a walk in the park compared to what they are going through and wonder what the 'suffering' person is complaining about. Often you will hear people exclaim, " I am so depressed!" Some people say this really believing that having a bad day or an uncomfortable situation that negatively affects his or her emotions means that s/he is depressed. Sadly, depression is about more than just having a bad day or feeling weepy for a few hours. Depression can last for weeks, months and even years if the suffering person doesn't get help from the right people. The most encouraging news or information is that depression is treatable and there is light at the end of the dark tunnel.

This week, the world commemorated the 20th anniversary of World Mental Health Day. It was held under the theme, 'Depression: A Global Crisis.' According to the World Health Organisation (WHO), "Depression affects more than 350 million people of all ages, in all communities, and is a significant contributor to the global burden of disease. Although there are known effective treatments for depression, access to treatment is a problem in most countries and in some countries fewer than 10% of those who need it receive such treatment."

Depression is defined by WHO as, "a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. Depression can be long-lasting or recurrent, substantially impairing an individual's ability to function at work or school or cope with daily life."

Not many people are willing to share their stories of being depressed because not many people like to listen to people complain about their sorrows for fear of them dampening their own mood or simply because not everyone is able to offer the right support for people who are depressed. A good friend will say things like, "Go tla siama," or, " if God brought you to it, He will bring you through it" or will offer other encouraging words and motivational quotes hoping it will snap the depressed friend out of a bad emotional space.

Sometimes this can work or motivate someone to actually focus on the positive side, but a depressed person is in need of more than just motivational words. The kind of help available for the treatment of depression includes therapy and medication. Some people get away with simply taking medication that is prescribed by a professional that will help to alter the chemical imbalance that causes their depression while others benefit from a combination of medical treatment and therapy.

The National Institute of Mental Health on http://www.nmih.nih.gov says, "the first step to getting appropriate treatment is to visit a doctor. If a medical condition and bipolar disorder can be ruled out, the physician should conduct a psychological evaluation or refer the person to a mental health professional. The doctor or mental health professional will conduct a complete diagnostic evaluation. He or she should get a complete history of symptoms, including when they started, how long they have lasted, their severity, whether they have occurred before, and if so, how they were treated. He or she should also ask if there is a family history of depression. In addition, he or she should ask if the person is using alcohol or drugs, and whether the person is thinking about death or suicide."

There is a lot of stigma against people who suffer from mental illnesses because not everyone is informed enough to appreciate or understand what mental illness. So, people will hide in the dark and dreary place that is their own world and not reach out for help. But left untreated, people who suffer from depression live lackluster lives, to say the very least, and some of those who can't bear the thought of living end up taking their own lives.

Some people turn to alcohol and drugs in an effort to numb the pain that they feel. Although these self-medication methods may work for a short period, they end up worsening a person's depressive state because of the havoc they can cause on the chemical balances of the human brain.Rather than self-medicating or denying the fact that you are suffering from depression, know that there is no shame in reaching out for help when it is needed.

Oct 17
Recycled heart devices offer new life in poor nation, study finds
For at least eight years, a Philadelphia heart specialist and his colleagues have been smuggling used cardiac devices in suitcases to India to help poor people who might die without them.

Now, Dr. Behzad B. Pavri, a cardiac electrophysiologist at Thomas Jefferson University Hospital, reports that recycled implantable cardioverter-defibrillators or ICDs -- devices that jolt a failing heart back into rhythm -- can be collected safely from U.S. patients and funeral homes, transported, sterilized and re-implanted in people who otherwise would not be able to afford them.

"The patients who are getting these devices are the sickest of the sick, the poorest of the poor," Pavri said.

In a review of 81 patients who received recycled ICDs between 2004 and 2011, Pavri and his colleagues found no evidence of infection or malfunction of the ICDs. Nine of the patients died during follow-up, but the deaths didn't appear related to the ICDs, the authors said.

Though there's been growing evidence that heart pacemakers may be safely reused, this is one of the first published reports to suggest that the more sophisticated ICD device may also be recycled, Pavri said.

"The outcomes were what we expected and hoped for," Pavri said of the study published in the latest issue of the Annals of Internal Medicine.

But the study also renews ongoing questions about the legality -- and ethics -- of reusing cardiac devices, a practice that is prohibited by federal regulators and device manufacturers in the U.S.

In an accompanying editorial, Harvard Medical School experts Dr. Paul Farmer and Dr. Gene Bukhman caution that such well-meaning efforts should be careful not to offer inferior treatment to the poor.

"Flagship projects must remain free of the taint of the secondhand, in part by making it clear when devices can safely be reused," wrote those authors. Farmer is a renowned expert in global health disparities and one of the co-founders of Partners in Health, the international health and social justice organization.

The patients in Pavri's study, conducted in cooperation with Holy Family Hospital in Mumbai, included 66 men and 15 women. They ranged in age from 27 to 79 and were all at highest risk for life-threatening irregular heart rhythms that could be treated with ICDs.

All told, the patients received 106 reused devices, including 22 who got a second device and three who received a third ICD during the course of the trial.

More than 40 percent of the patients got life-saving shocks from the ICDs, including one 27-year-old patient, Mohd Asif, who received more than 300 pacing charges or larger jolts during so-called ventricular tachycardia or ventricular fibrillation "storms," in which the heart runs wildly out of rhythm.

He is "still very much alive," said Dr. Yash Lokhandwala, a cardiologist at the Mumbai hospital who treated Asif and others.

The patients who got the ICDs were those who otherwise could not pay for them. In India, a new ICD might cost 3 lakhs, the equivalent of $6,000 U.S., far beyond the reach of ordinary Mumbai residents who earn about 1.41 lakhs a year. Those who can pay foot the bill themselves, but those who can't are treated with other, often inferior methods, including drug therapies.

Cost is the chief barrier preventing use of cardiac devices such as ICDs and pacemakers in developing nations, Pavri said. Rates of new ICD implantation are about 1 per million in many Asian and South American nations, compared with 434 per million new ICD implantations per year in the U.S., according to the World Society of Arrhythmia.

At the same time, ICDs are removed every day from patients in the U.S. who get new devices or who die each year, Pavri said. Modern ICDs have a projected battery life of six to 10 years, and many used ICDs have three years or more of remaining charge when they're explanted.

Funeral directors frequently remove ICDs from bodies to prevent explosions during cremation. Perhaps one-fifth to one-third of devices discarded by funeral homes may have sufficient battery life to save someone else.

"We don't know exactly how many but it's clearly in the thousands," said Pavri.

For his study, Pavri and his colleagues collected the devices one by one over several years from consenting patients or from funeral homes. Shipping them by traditional methods was difficult because of the explanation involved, so the doctors packed them into checked luggage and transported them themselves.

Reusing ICDs is prohibited in the U.S. by the federal Food and Drug Administration, which classifies them as single-use devices. However, the FDA has no jurisdiction over the devices if they're treated and implanted elsewhere and Lokhandwala said the Cardiological Society of India has authorized the practice.

The ICDs were collected, cleaned and sterilized during a multi-step process and then re-implanted into the new patients.

Researchers were able to follow up on 75 of the 81 patients; those who survived appeared to be doing well, Pavri said.

This study offers important new information about the apparent safety of reusing ICDs, but it also highlights obstacles, said Dr. Thomas Crawford, a cardiologist at the University of Michigan Health System in Ann Arbor who was not involved in the research.

Crawford is part of Project My Heart-Your Heart, a program that is collecting used pacemakers for future donation in developing countries. So far, they've amassed some 10,000 devices. However, researchers involved with that program have petitioned the FDA for permission to conduct a clinical trial to confirm the safety and efficacy of the reused devices in living people.

As it stands now, projects like Pavri's aren't officially sanctioned.

"It's a very uncharted territory," Crawford said. "It's not exactly legal."

Pavri acknowledged as much in the study, saying "any complications associated with such off-label use could be grounds for legal action."

But, he added, such off-label research is necessary to bolster arguments that regulators and manufacturers should allow reuse of these devices on humanitarian grounds.

"It is worse practice, in my opinion, to not offer a patient anything," Pavri said.

"A secondhand device is better than no device at all."

Oct 16
Weight loss surgery tied to increase in drinking
People who had weight loss surgery reported greater alcohol use two years after their procedures than in the weeks beforehand, in a new study.

"This is perhaps a risk. I don't think it should deter people from having surgery, but you should be cautious to monitor (alcohol use) after surgery," Alexis Conason, who worked on the study at the New York Obesity Nutrition Research Center at St. Luke's-Roosevelt Hospital Center, told Reuters Health.

Researchers said it's possible some patients may turn to drinking if surgery successfully stops their ability to overeat without addressing their underlying issues. Or, the effects of certain types of stomach-shrinking procedures on alcohol tolerance may influence drinking habits.

Still, the new study can't show whether people were drinking in a dangerous way - and there was no clear increase in drug use or smoking after surgery.

"This does not mean that everyone who has gastric bypass surgery has problems with alcohol or becomes an alcoholic," said Conason.

Her team's study involved 155 people getting gastric bypass or gastric banding surgery, mostly women. Participants started the study with an average body mass index, or BMI, of 46 - equivalent to a five-foot, six-inch person who weighs 285 pounds.

Surgery is typically recommended for people with a BMI of at least 40, or at least 35 if they also have health problems such as diabetes or severe sleep apnea.

Alcohol use dropped immediately following surgery, from 61 percent of people who initially reported drinking to 20 percent at one month post-surgery.

But by three months, drinking rates had started to creep back up. And at two years out, people were drinking significantly more often than before their procedures, according to findings published Monday in the Archives of Surgery.

That was primarily the case for those who had gastric bypass surgery, not banding. On a scale from 0 to 10 of drinking frequency, where 0 represented never, 5 was sometimes and 10 always, gastric bypass patients reported an increase from 1.86 before surgery to 3.08 two years later.

CHANGES IN TOLERANCE

Conason said gastric bypass, in particular, has been shown to drastically lower alcohol tolerance - to the point that some post-surgery patients have a blood alcohol content above the legal driving limit after just one drink. For some, that could make drinking more appealing, she added.

The new findings are "proving more support for the idea that we really need to talk to patients about alcohol use, especially those undergoing (gastric bypass)," said Wendy King, an epidemiologist and weight loss surgery researcher at the University of Pittsburgh, who wasn't part of the study team.

According to the American Society for Metabolic and Bariatric Surgery, about 200,000 people have weight loss surgery every year. The procedures cost about $20,000 each.

Although some researchers have questioned the long-term benefits of surgery, one recent study found three-quarters of people who'd undergone gastric bypass had lost and kept off at least 20 percent of their initial pre-surgery weight six years later (see Reuters Health story of September 18, 2012).

One limitation of the new study is that only one-quarter of the initial participants were still in touch to report their current alcohol and drug use at the two-year mark - so the researchers don't know how everyone else fared.

Psychiatrist Dr. James Mitchell, who has studied alcohol use after weight loss surgery at the University of North Dakota School of Medicine and Health Sciences in Grand Forks, said there's also a need for research going out more than two years - to see if alcohol use keeps increasing.

Researchers said people who've had weight loss surgery should talk with their doctors soon if they notice themselves wanting to drink more.

"The health risks of obesity are such that people with severe obesity should not forgo bariatric surgery because of this," Mitchell, who was not involved in the new study, told Reuters Health.

But he said everyone should be warned about this possibility - and people with a history of alcohol abuse should be particularly careful.

"I don't have the impression (doctors) are talking a tremendous amount about these things," Conason said. "I think we should be. I think we should be educating patients about all the potential risks and benefits."

Oct 16
Pregnant women who sleep on their back risk stillbirth
Pregnant women who sleep on their back may increase the risk of miscarriage or stillbirth, a five-year Australian study has found.

The research titled the "Sydney Stillbirth Study" looked at pregnancies of 295 women from eight hospitals around Australia, the Daily Mail reported.


The study found that women who sleep on their back are six times more likely to have a stillborn baby.

A stillborn baby is a baby born dead after 24 weeks of pregnancy. If the baby dies before 24 completed weeks, it is known as a late miscarriage.

Lead researcher Adrienne Gordon, from Sydney`s Royal Prince Alfred Hospital, said previous research suggested prolonged periods of lying in this position restricted blood flow to the baby.

It is believed that sleeping on the right side or on the back reduces blood flow through a major vein from the legs to the heart, which affects the supply to the womb, the study said.

However, the researchers said it was important that women who are currently pregnant "don`t become alarmed if they sometimes sleep on their back".

Experts said three-quarters of pregnant women sleep mostly on the left side.

The daily said this may suggest they instinctively choose a sleeping position that works best for the baby.

In almost half of stillbirths, the direct cause of the baby`s death cannot be established.

Ten percent of stillborn babies have some kind of abnormality and other possible causes include problems with the mother`s health or problems with the placenta, which links the baby`s blood supply to that of the mother.

Stillbirth Foundation Australia, which funded the study, said the research was unique as it looked exclusively at women who were more than 32 weeks pregnant.

In 2011, a University of Auckland study found that mothers who slept on their back or right-hand side on the night before giving birth were twice as likely to have a stillborn child compared to those who slept on their left.

Oct 15
New Test Helps Diagnose Alzheimer's Disease
Doctors at Baylor Irving hope new technology can pave the way for earlier detection of Alzheimer's disease.

Select patients' brains can be scanned for amyloid plaque, which is associated with the neurological disorder. Previously, it could only be detected during autopsies.

"This is the first biomarker we have for determining if amyloid plaque is present in the brain," radiologist Dr. Michael Stewart said.

Doctors inject patients with a radioactive substance called Amyvid and can scan for the specific type of plaque.

"The test by itself is not enough to make a diagnosis, but the test plus your physical exam and your memory testing can diagnose Alzheimer's earlier," neurologist Dr. Karen Bontia said.

Patients can then seek treatment options as soon as possible.

Because the process is so selective, doctors at Baylor Irving have only tested a couple of patients since the test became available in June.

Each test using costs around $5,000.

Bontia said the technology also will allow doctors to gather more data for future developments.

Doctors say their primary focus is to slow the development of Alzheimer's disease and to diagnose it as early as possible.

One out of eight adults who are 65 years old will develop Alzheimer's disease. This year, 78 million baby boomers will be 65 years old.

Lee and Pat Sneller, who celebrated their 48th wedding anniversary on Sept. 5, have been fighting an uphill battle with the debilitating disease.

"Once I found out that I had Alzheimer's, I was devastated," said Lee Sneller, who was diagnosed on Feb. 6, 2009. "I mean, it was really, really hard. I didn't know what to do and how to deal with it."

More than three and a half years later, the ailment has taken its toll on him.

"He processes things so much more slowly," Pat Sneller said. "He is a smart guy. I mean, he went to Stanford, he's an engineer, he has an MBA, and he just can't process it anymore."

The couple agreed that early detection is key and said they hope others diagnosed with Alzheimer's disease can benefit from the future developments.

"If we can delay the onset of it by five years, billions of dollars can be saved -- billions in our health care," Stewart said.

Oct 15
Women's hearts 'get twice the benefit from fish oil than men's
Eating oily fish may boost women's heart health more than men's, claim researchers.

The oils - found in fish like salmon, mackerel and tuna - are known to improve chances of surviving a repeat heart attack.

But a new study suggests women could benefit more from their effect on the heart.

Researchers at the University of Reading found fish oils have a direct impact on the muscle cells that control the elasticity of our blood vessels.

In tests, women got double the benefit compared with men as elasticity improved four-fold in women compared with two-fold in men.

In fact the beneficial effect of the fish oil in women was as potent as that of drugs that are prescribed to people with poor blood vessel elasticity, such as those with diabetes.

At least 39,000 women a year in the UK suffer heart attacks and their chances of dying are higher than a man's.

Study leader Professor Christine Williams, the University's first Hugh Sinclair Professor of Nutrition and Pro Vice-Chancellor for Research and Innovation, said: 'Studies examining women's heart health are much less common than those which study men, partly because the studies are harder to carry out in women due to the varying effects of hormones during the menstrual cycle.

'In addition, many believe men are the only ones to suffer from heart disease.

'However nearly 40,000 women die of coronary heart disease each year in the UK and we do not yet know whether all the diet recommendations which we currently advise are as effective for women as for men.

'The good news here is that current recommendations that we should all eat more oily fish appears to be more effective for women than men.'

However, two thirds of Britons never eat oily fish even though official guidelines recommend its consumption at least once a week.

In the study around 60 people, half men and women, were given test drinks containing either saturated fats or a combination with omega 3 fish oils, equivalent to a 200g portion of oily fish.

Imaging was used to check the reaction of the blood cells to the different drinks, says a report in the Journal of Lipid Research.

Prof Williams said 'As well as discovering the effect of fish oils is greater in women we also found that people with a gene variation that produces the protein eNOS, which helps to increase blood flow, also benefitted more.

'Our study showed that people who carry the rarer form of the protein, which is about 10 per cent of the UK population, respond twice as well to fish oils, suggesting they would particularly benefit from additional oily fish intake.

'This research supports the view that the effects of diets vary, being more effective in certain genders and genotypes. Our study was very carefully designed to include equal numbers of men and women and also equal numbers of people with the two types of gene variants, so that the results are very unlikely to be due to chance. 'Although the responses varied, all the subjects in the study benefitted from taking fish oils with a meal.

'However, for women and those with the gene variant, the responses were very marked indeed, and when it comes to their diet could give them considerable health benefits in the future.' The work was funded by the Biotechnology and Biological Sciences Research Council.

Fish oil is known to increase the release of nitric oxide from the lining of the blood vessel wall which causes relaxation of the vessel and increases blood flow.

However the researchers found that some of the relaxation effect on the blood vessel wall may be due to direct actions of the fish oil acting on the muscle cells themselves, rather than on the cells lining the blood vessel wall.

Professor Williams added 'This is an exciting discovery which gives us a new way of looking at how our diet affects the health of our blood vessels, and possibly more effective ways of improving heart health in the future.' The best dietary source of omega 3 fatty acids is oily fish because the human body cannot produce omega-3 fatty acids.

There has been an explosion in the number of foods fortified with omega-3 oils, such as chickens, margarine, eggs, milk and bread, but they contain only small amounts.

Types of fish that contain high levels include tuna, salmon, mackerel, herring, sardines, and anchovies.

White fish is also a healthy food including cod, haddock and plaice although it contains lower levels of essential fatty acids.

Fish oil supplements are recommended as protection against repeat heart attacks, with regular fish eaters a third more likely to survive a heart attack.

Fish oil supplements are approved for prescribing on the NHS to patients after a heart attack, or who have metabolic syndrome or high triglycerides - unhealthy blood fats.

Omacor, which is licensed for post-heart attack treatment, has been shown in clinical trials to cut the risk of sudden death by up to 45 per cent.

Omega-3 fats are important throughout adult life for mental wellbeing but in particular help heart patients, and those with arthritis, by blocking the body's response to inflammation.

They work in several ways to reduce heart attack risk by cutting blood fats, reducing the chances of a blood clot and blocking dangerous heart rhythms that might otherwise prove fatal.

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