Health Research Report

143rd Issue Date 30 NOV 2012

Compiled By Ralph Turchiano

www.vit.bz

www.youtube.com/vhfilm www.facebook.com/engineeringevil

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Editors Top Five:

1. Trial results ‘do not support the use of general health checks’ warn experts
2. More Facebook friends means more stress, says report
3. Bothered by Negative, Unwanted Thoughts? Just Throw Them Away
4. New review associates vitamin D with lower rates of tooth decay
5. Potentially toxic flame retardants found in many US couches

In this issue:

1. Low muscle strength in adolescence linked to increased risk of early death
2. Trial results ‘do not support the use of general health checks’ warn experts
3. Dance boosts young girls’ mental health
4. Sweat glands play major role in healing human wounds, U-M research shows
5. Is Facebook a Factor in Psychotic Symptoms?
6. Grapefruit–medication interactions increasing
7. Exposure to traffic pollution in pregnancy, first year of life appears associated with autism
8. More Facebook friends means more stress, says report
9. Bothered by Negative, Unwanted Thoughts? Just Throw Them Away
10. Brief exercise immediately enhances memory, UCI study finds
11. 4 common antipsychotic drugs found to lack safety and effectiveness in older adults
12. Compound found in rosemary protects against macular degeneration in laboratory model
13. New review associates vitamin D with lower rates of tooth decay
14. Potentially toxic flame retardants found in many US couches

Low muscle strength in adolescence linked to increased risk of early death

Effect similar to classic risk factors such as weight and blood pressure

Research: Muscular strength in male adolescents and premature death: cohort study of one million participants

Low muscle strength in adolescence is strongly associated with a greater risk of early death from several major causes, suggests a large study published on bmj.com today.

The effect is similar to well established risk factors for early death like being overweight or having high blood pressure, leading the authors to call for young people, particularly those with very low strength, to engage in regular physical activity to boost their muscular fitness.

High body mass index (BMI) and high blood pressure at a young age are known risk factors for premature death, but whether muscular strength in childhood or adolescence can predict mortality is unclear.

So a team of researchers, led by Professor Finn Rasmussen at the Karolinska Institutet in Sweden, tracked more than one million Swedish male adolescents aged 16 to 19 years over a period of 24 years.

Participants underwent three reliable muscular strength tests at the start of the study (knee extension strength, handgrip strength and elbow flexion strength). BMI and blood pressure were also measured. Premature death was defined as death before age 55 years.

During the follow-up period, 26,145 participants (2.3% of the group) died. Suicide was the most common cause of death (22.3%) compared with cardiovascular diseases (7.8%) or cancer (14.9%).

High muscular strength was associated with a 20-35% lower risk of early death from any cause and also from cardiovascular diseases, independently of BMI or blood pressure. No association was seen with cancer deaths.

Stronger adolescents also had a 20-30% lower risk of early death from suicide and were up to 65% less likely to have any psychiatric diagnosis, such as schizophrenia and mood disorders. These results suggest that physically weaker individuals might be more mentally vulnerable, say the authors.

In contrast, male adolescents with the lowest level of muscular strength showed the greatest all-cause mortality and also the greatest mortality in cardiovascular disease and suicide before age 55 years.

Death rates from any cause (per 100,000 person years) ranged between 122.3 and 86.9 for weakest and strongest adolescents respectively. Rates for cardiovascular diseases were 9.5 and 5.6 and for suicide were 24.6 and 16.9.

The authors say that low muscular strength in adolescents “is an emerging risk factor for major causes of death in young adulthood, such as suicide and cardiovascular diseases.” The effect sizes of these associations “are similar to classic risk factors such as body mass index and blood pressure,” they add.

They suggest that muscular strength tests, in particular handgrip strength, could be assessed with good reliability in almost any place, including clinical settings, schools and workplaces.

They also support the need for regular physical activity in childhood and adolescence, saying: “People at increased risk of long term mortality, because of lower muscular strength, should be encouraged to engage in exercise programmes and other forms of physical activity.”

Trial results ‘do not support the use of general health checks’ warn experts

Checks have not reduced number of deaths from cardiovascular disease or cancer

Research: General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis

Editorial: The value of conducting periodic health checks

Researchers have found that routine general health checks, which have become common practice in some countries, do not reduce the number of deaths from cardiovascular disease or cancer. They do, however, increase the number of new diagnoses.

Health checks were defined as screening for more than one disease or risk factor in more than one organ system offered to a general population unselected for disease or risk factors.

Health checks were introduced with the intention of reducing morbidity and prolonging life and there are many potential benefits, including: detection of both increased risk factors and precursors to disease (thus preventing cancer from developing); counselling on diet, weight and smoking; reassuring healthy people thus reducing worry about potential disease.

However, screening healthy people can be harmful and can lead to overdiagnosis and overtreatment, a topic which was featured in the BMJ in October. The researchers also point out that invasive diagnostic tests may cause harm. Being labelled as having a disease may also negatively impact healthy people’s views of themselves and their health behaviour.

Few of the individual tests commonly used in health checks have been adequately studied in trials and it is not clear whether they do more harm than good. When tests have been studied in trials, the results have been varied. Authors from the Nordic Cochrane Centre in Denmark therefore carried out a review of a total of 14 trials that looked at systematic health checks. The studies had between 1 and 22 years of follow-up.

Nine of the 14 trials had data on mortality and included 182,880 participants, 11,940 of whom died during the study period. 76,403 were invited to health checks and the remainder were not. All participants were over 18 years old and the study excluded trials specifically targeting older people or trials that only enrolled people aged 65 or over.

Despite some variation regarding the risk of death from cardiovascular disease and cancer, no evidence was found for a reduction of either total mortality, cardiovascular mortality, or cancer mortality. Unsurprisingly, the researchers found that health checks led to more diagnoses and more medical treatment for hypertension, although this was infrequently studied.

The lack of beneficial effects indicates that the interventions did not work as intended in the included trials. Health checks are likely to increase the number of diagnoses, but in the absence of benefits, this suggests over-diagnosis and overtreatment.

The researchers also note that people who accept a health check invitation are often different from those who do not, so the checks might not reach those who need prevention the most. Plus, many physicians already carry out testing for cardiovascular risk factors or diseases in patients that they judge to be at risk when they see them for other reasons.

In conclusion, the results do not support the use of general health checks aimed at the general population. The researchers say that further research should “be directed at the individual components of health checks e.g. screening for cardiovascular risk factors, chronic obstructive pulmonary disease, diabetes, or kidney disease”.

In an accompanying editorial, Professor Macauley, Primary Care Editor at the BMJ, agrees that although health checks are “seductive” and “seem sensible” there is little evidence to show that they reduce morbidity and mortality. As well questioning whether they do more harm than good, Dr Macauley says that Krogsbøll and colleagues’ study finds that “regular health checks are ineffective” and show “evidence of little effect” and adds that policy should be based on “wellbeing rather than […] well meant good intentions”.

Dance boosts young girls’ mental health

Young girls can dance their way to better mental health. Symptoms like depression, stress, fatigue, and headaches are alleviated with regular dancing. This is shown in a study run by Anna Duberg, a physical therapist at Örebro University Hospital and a doctoral candidate at Örebro University in Sweden. Regular dance training can thereby be regarded as a strategy for preventing and treating low spirits and depression. Dance also brings enhanced self-esteem and a greater capacity to deal with everyday problems.

The dance study included 112 Swedish girls 13 to 19 years of age. On multiple occasions, these girls had gone to see the school nurse for symptoms such as anxiety and depression, fatigue, headaches, and back, neck, and shoulder pain. In the study, 59 of the girls were randomized to a group that regularly danced together two days a week and 53 girls to a control group where the girls did not change their living habits.

The study results indicated that the girls in the dance group, despite all the challenges entailed by being a teenage girl, increased their self-esteem compared with the control group. The positive effect persisted at follow-ups four and eight months after the dance training ended. Fully 91 percent of the girls in the dance group felt that the dance study had been a positive experience. In the long run this may also lead to a more healthful lifestyle.

Sweat glands play major role in healing human wounds, U-M research shows

As poor wound healing from diabetic ulcers and other ailments takes heavy toll on healthcare costs, U-M findings pave way for new efficient therapies

ANN ARBOR, Mich. — Turns out the same glands that make you sweat are responsible for another job vital to your health: they help heal wounds.

Human skin is rich with millions of eccrine sweat glands that help your body cool down after a trip to the gym or on a warm day. These same glands, new University of Michigan Health System research shows, also happen to play a key role in providing cells for recovering skin wounds – such as scrapes, burns and ulcers.

The findings were released online ahead of print in the American Journal of Pathology.

“Skin ulcers – including those caused by diabetes or bed sores – and other non-healing wounds remain a tremendous burden on health services and communities around the world,” says lead author Laure Rittié, Ph.D., research assistant professor of dermatology at the University of Michigan Medical School.

“Treating chronic wounds costs tens of billions of dollars annually in the United States alone, and this price tag just keeps rising. Something isn’t working.”

Now, U-M researchers believe they have discovered one of the body’s most powerful secret weapons in healing.

“By identifying a key process of wound closure, we can examine drug therapies with a new target in mind: sweat glands, which are very under-studied,” Rittié says. “We’re hoping this will stimulate research in a promising, new direction.”

Previous understanding of wound closure was that new skin cells originate from hair follicles and from intact skin at the edge of the wound. The U-M findings demonstrate that cells arise from beneath the wound, and suggest that human eccrine sweat glands also store an important reservoir of adult stem cells that can quickly be recruited to aid wound healing.

“It may be surprising that it’s taken until now to discover the sweat glands’ vital role in wound repair,” Rittié says. “But there’s a good reason why these specific glands are under-studied – eccrine sweat glands are unique to humans and absent in the body skin of laboratory animals that are commonly used for wound healing research.

“We have discovered that humans heal their skin in a very unique way, different from other mammals,” Rittié adds. “The regenerative potential of sweat glands has been one of our body’s best-kept secrets. Our findings certainly advance our understanding of the normal healing process and will hopefully pave the way for designing better, targeted therapies.”

Additional Authors: Dana L. Sachs, M.D.; Jeffrey S. Orringer, M.D.; John J. Voorhees, M.D.; and Gary J. Fisher, Ph.D., all of the University of Michigan Department of Dermatology.

Funding: U-M Dermatology Research Fund, the Dermatology Foundation, and the National Institutes of Health (NIH/NIAMS grant K01-AR059678)

Is Facebook a Factor in Psychotic Symptoms?

Tuesday, November 20, 2012

TAU researcher connects computer communications and psychosis

As Internet access becomes increasingly widespread, so do related psychopathologies such as Internet addiction and delusions related to the technology and to virtual relationships. Computer communications such as Facebook and chat groups are an important part of this story, says Dr. Uri Nitzan of Tel Aviv University‘s Sackler Faculty of Medicine and the Shalvata Mental Health Care Center in a new paper published in the Israel Journal of Psychiatry and Related Sciences.

In his study, the researcher presented three in-depth case studies linking psychotic episodes to Internet communications from his own practice. According to Dr. Nitzan, patients shared some crucial characteristics, including loneliness or vulnerability due to the loss of or separation from a loved one, relative inexperience with technology, and no prior history of psychosis or substance abuse. In each case, a connection was found between the gradual development and exacerbation of psychotic symptoms, including delusions, anxiety, confusion, and intensified use of computer communications.

The good news is that all of the patients, who willingly sought out treatment on their own, were able to make a full recovery with proper treatment and care, Dr. Nitzan says.

Behind the screen

The Internet is a free and liberal space that many individuals use on a daily basis and a growing part of a normal social life. But while technologies such as Facebook have numerous advantages, some patients are harmed by these social networking sites, which can attract those who are lonely or vulnerable in their day-to-day lives or act as a platform for cyber-bullying and other predatory behavior.

All three of Dr. Nitzan’s patients sought refuge from a lonely situation and found solace in intense virtual relationships. Although these relationships were positive at first, they eventually led to feelings of hurt, betrayal, and invasion of privacy, reports Dr. Nitzan. “All of the patients developed psychotic symptoms related to the situation, including delusions regarding the person behind the screen and their connection through the computer,” he says. Two patients began to feel vulnerable as a result of sharing private information, and one even experienced tactile hallucinations, believing that the person beyond the screen was physically touching her.

Some of the problematic features of the Internet relate to issues of geographical and spatial distortion, the absence of non-verbal cues, and the tendency to idealize the person with whom someone is communicating, becoming intimate without ever meeting face-to-face. All of these factors can contribute to a patient’s break with reality, and the development of a psychotic state.

A changing social landscape

Dr. Nitzan and his colleagues plan to do more in-depth research on Facebook, studying the features and applications that have the potential to harm patients emotionally or permit patients to cause emotional harm to others. Some psychotic patients use the Internet to disturb people, abusing their ability to interact anonymously, he says.

Because social media are now such an important part of our culture, mental health professionals should not overlook their influence when speaking to patients, Dr. Nitzan counsels. “When you ask somebody about their social life, it’s very sensible to ask about Facebook and social networking habits, as well as Internet use. How people conduct themselves on the Internet is quite important to psychiatrists, who shouldn’t ignore this dimension of their patients’ behavior patterns.”

Grapefruit–medication interactions increasing

The number of prescription drugs that can have serious adverse effects from interactions with grapefruit are markedly increasing, yet many physicians may be unaware of these effects, states an article published in CMAJ (Canadian Medical Association Journal). The article, a review by the researchers who discovered the interactions more than 20 years ago, summarizes evidence to help clinicians better understand the serious effects this common food can have when consumed with certain prescription drugs.

“Many of the drugs that interact with grapefruit are highly prescribed and are essential for the treatment of important or common medical conditions,” writes Dr. David Bailey, Lawson Health Research Institute, London, Ont., with coauthors. “Recently, however, a disturbing trend has been seen. Between 2008 and 2012, the number of medications with the potential to interact with grapefruit and cause serious adverse effects…has increased from 17 to 43, representing an average rate of increase exceeding 6 drugs per year. This increase is a result of the introduction of new chemical entities and formulations.”

Adverse effects include sudden death, acute kidney failure, respiratory failure, gastrointestinal bleeding, bone marrow suppression in immunocompromised people, renal toxicity and other serious side effects.

“Unless health care professionals are aware of the possibility that the adverse event they are seeing might have an origin in the recent addition of grapefruit to the patient’s diet, it is very unlikely that they will investigate it,” write the authors. “In addition, the patient may not volunteer this information. Thus, we contend that there remains a lack of knowledge about this interaction in the general healthcare community.”

There are more than 85 drugs that may interact with grapefruit, and 43 can have serious side effects. Other citrus fruits such as Seville oranges, often used in marmalade, limes and pomelos also contain the active ingredients (furanocoumarins). These chemicals are innate to the fruit and cause the interaction by irreversible inhibition of the drug metabolizing CYP3A4 enzyme that normally inactivates the effects of an estimated 50% of all medication. Drugs that interact with these chemicals have three characteristics: they are administered orally, they have very low to intermediate bioavailability (percentage of the oral dose of drug absorbed into the blood circulation unchanged) and they undergo drug metabolism in the gastrointestinal tract by CYP3A4. For drugs with very low bioavailability, ingestion of a single normal amount of grapefruit can be analogous to consuming multiple doses of the drug alone.

This interaction can occur even if grapefruit is consumed many hours before taking the medication. Thus, a modest solitary quantity of grapefruit can affect interacting drugs that are taken once a day at any time during the dosing interval. Frequent daily consumption of a regular amount can further augment the effect. For example, simvastatin, a commonly used statin, combined with a 200-mL glass of grapefruit juice once a day for 3 days, produced a 330% systemic concentration of the drug compared with water.

People older than 45 years are the prime purchasers of grapefruit and receive the most prescriptions for drugs. Because of the size of this population, substantial exposure to this interaction is likely. As well, older adults can have decreased ability to tolerate excessive systemic drug concentrations. Consequently, older people are especially vulnerable to these interactions.

“The current trend of increasing numbers of newly marketed grapefruit-affected drugs possessing substantial adverse clinical effects necessitates an understanding of this interaction and the application of this knowledge for the safe and effective use of drugs in general practice,” conclude the authors

Exposure to traffic pollution in pregnancy, first year of life appears associated with autism

CHICAGO – Exposure to traffic-related air pollution, particulate matter and nitrogen dioxide during pregnancy and during the first year of a child’s life appears to be associated with an increased risk of autism, according to a report published Online First by Archives of General Psychiatry, a JAMA Network publication.

Autism is a diverse disorder with genetic and environmental factors likely contributing to its origins. Autism spectrum disorders are commonly characterized by problems in communication, social interaction and repetitive behaviors. Emerging evidence suggests the environment plays a role in autism, but only limited information is available about what exposures are relevant, their mechanisms of action, the stages in development in which they act and the development of effective of preventive measures, the authors write in the study background.

Heather E. Volk, Ph.D., M.P.H., of the University of Southern California, and colleagues examined the relationship between traffic-related air pollution, air quality and autism in a study that included data obtained from 279 children with autism and control group of 245 children with typical development who were enrolled in the Childhood Autism Risks from Genetics and the Environment study in California.

“Exposures to traffic-related air pollution, PM [particulate matter] and nitrogen dioxide were associated with an increased risk of autism. These effects were observed using measures of air pollution with variation on both local and regional levels, suggesting the need for further study to understand both individual pollutant contributions and the effects of pollutant mixtures on disease,” the authors comment.

The authors used mothers’ addresses to estimate exposure for each pregnancy trimester and for a child’s first year of life. Traffic-related air pollution was estimated based on a model and regional air pollutant measures were based on the Environmental Protection Agency’s Air Quality System data.

Children living in homes with the highest levels of modeled traffic-related air pollution were three times as likely to have autism compared with children living in homes with the lowest exposure. The higher levels of exposure to [particulate matter less than 2.5 and 10 µm in diameter] PM 2.5, PM 10 and nitrogen dioxide based on the EPA’s regional air quality monitoring program were associated with an increased risk of autism.

“Research on the effects of exposure to pollutants and their interaction with susceptibility factors may lead to the identification of the biologic pathways that are activated in autism and to improved prevention and therapeutic strategies. Although additional research to replicate these findings is needed, the public health implications of these findings are large because air pollution exposure is common and may have lasting neurological effects,” the authors conclude.

(Arch Gen Psychiatry. Published online November 26, 2012. doi:10.1001/jamapsychiatry.2013.266. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: This work was supported by grants from the National Institute of Environmental Health Sciences and by the MIND Institute’s matching funds and pilot grant program. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Dramatic Rise in Autism Prevalence Parallels Research Explosion

In an editorial, Geraldine Dawson, Ph.D., of the University of North Carolina at Chapel Hill, writes: “This issue of the journal features three articles on autism. A decade ago, the journal published about the same number of autism articles per year. This reflects a broad expansion in the number and diversity of research publications on autism spectrum disorder (ASD).”

“The upsurge of research parallels a dramatic increase in autism prevalence during the same period. In the past six years alone, the prevalence of ASD has increased 78 percent and the estimated annual cost of autism has more than tripled,” Dawson continues.

“These articles point to an urgent need for more research on prenatal and early postnatal brain development in autism, with a focus on how genes and environmental risk factors combine to increase risk for ASD. Despite a substantial increase in autism research publications and funding during the past decade, we have not yet fully described the causes of ASD or developed effective medical treatments for it. More research is needed to develop strategies for preventing or reducing the disabling symptoms associated with this highly prevalent and costly neurodevelopmental disorder,” Dawson concludes.

(Arch Gen Psychiatry. Published online November 26, 2012. doi:10.1001/jamapsychiatry.2013.488. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

More Facebook friends means more stress, says report

A large number of friends on Facebook may appear impressive but, according to a new report, the more social circles a person is linked to online the more likely social media will be a source of stress.

A report from the University of Edinburgh Business School has found that the more groups of people in someone’s Facebook friends, the greater potential to cause offence. In particular, adding employers or parents resulted in the greatest increase in anxiety.

Stress arises when a user presents a version of themself on Facebook that is unacceptable to some of their online ‘friends’, such as posts displaying behaviour such as swearing, recklessness, drinking and smoking.

As older people join the site, this has become an increasing problem as their expectations may be very different from those of younger users.

Some 55 per cent of parents follow their children on Facebook. Likewise, more than half of employers claim not to have hired someone based on their Facebook page.

Researchers found that on average people are Facebook friends with seven different social circles. The most common group was friends known offline (97 per cent added them as friends online), followed by extended family (81 per cent), siblings (80 per cent), friends of friends (69 per cent), and colleagues (65 per cent).

The report also discovered that more people are Facebook friends with their former partners than with their current relationship partner. Only 56 per cent of users were friends with their boyfriend, girlfriend or spouse online, compared with 64 per cent of exes.

The report surveyed more than 300 people on Facebook, mostly students, with an average age of 21.

It also discovered that only one third use the listing privacy setting on their Facebook profile, which can be used to control the information seen by different types of friends.

Ben Marder, author of the report and early career fellow in marketing at the Business School, said: “Facebook used to be like a great party for all your friends where you can dance, drink and flirt. But now with your Mum, Dad and boss there the party becomes an anxious event full of potential social landmines.”

Bothered by Negative, Unwanted Thoughts? Just Throw Them Away

COLUMBUS, Ohio — If you want to get rid of unwanted, negative thoughts, try just ripping them up and tossing them in the trash.

In a new study, researchers found that when people wrote down their thoughts on a piece of paper and then threw the paper away, they mentally discarded the thoughts as well.

On the other hand, people were more likely to use their thoughts when making judgments if they first wrote them down on a piece of paper and tucked the paper in a pocket to protect it.

“However you tag your thoughts — as trash or as worthy of protection — seems to make a difference in how you use those thoughts,” said Richard Petty, co-author of the study and professor of psychology at Ohio State University.

Some types of psychological therapy use variations of this concept by trying to get patients to discard their negative thoughts. But Petty said this is the first study he is aware of that has validated that approach.

“At some level, it can sound silly. But we found that it really works — by physically throwing away or protecting your thoughts, you influence how you end up using those thoughts. Merely imagining engaging in these actions has no effect.”

The findings suggest that people can treat their thoughts as material, concrete objects, Petty said. That is evident in the language we use.

“We talk about our thoughts as if we can visualize them. We hold our thoughts. We take stances on issues, we lean this way or that way. This all makes our thoughts more real to us.”

Petty conducted the research with Pablo Briñol, Margarita Gascó and Javier Horcajo, all of the Universidad Autónoma de Madrid in Spain.

The results are published online in the journal Psychological Science and will appear in a future print edition.

For the study, the researchers conducted three related experiments.

In the first experiment, 83 Spanish high school students participated in a study they were told was about body image. Each participant was told to write down either positive or negative thoughts about his or her body during a three-minute period.

All the participants were asked to look back at the thoughts they wrote. Researchers told half of the students to contemplate their thoughts and then throw them in the trash can located in the room, “because their thoughts did not have to remain with them.” The other half were told to contemplate their thoughts and check for any grammar or spelling mistakes.

The participants then rated their attitudes about their own bodies on three 9-point scales (bad-good, unattractive-attractive, like-dislike).

Results showed that for those who kept their thoughts and checked them for mistakes, it mattered whether they generated positive or negative thoughts about their bodies. As would be expected, participants who wrote positive thoughts had more positive attitudes toward their bodies a few minutes later than did those who wrote negative thoughts.

However, those who threw their thoughts away showed no difference in how they rated their bodies, regardless of whether they wrote positive or negative thoughts.

“When they threw their thoughts away, they didn’t consider them anymore, whether they were positive or negative,” Petty said.

In a second study, 284 students participated in a similar experiment, except this time they were asked to write negative or positive thoughts about something most people believe is good: the Mediterranean diet (the diet emphasizes high consumption of fruits, vegetables, legumes and unrefined cereals, with olive oil as the basic fat).

In this case, some threw the thoughts away, some left them on their desk, and some were told to put the paper in their pocket, wallet or purse and keep it with them.

All participants were then asked to rate their attitudes toward the diet and intentions to use the diet for themselves.

As in the first study, those who kept the list of thoughts at their desk were more influenced by them when evaluating the diet than were those who threw them away. However, those who protected their thoughts by putting them in a pocket or purse were even more influenced than those who kept the thoughts on their desk.

In other words, those who wrote positive thoughts about the Mediterranean diet and put those thoughts in their pocket rated the diet more favorably than those who wrote positive thoughts and simply kept those thoughts on their desk. And, those who wrote negative thoughts and put them in their pocket rated the diet more negatively than those who kept their thoughts on the desk.

“This suggests you can magnify your thoughts, and make them more important to you, by keeping them with you in your wallet or purse,” Petty said.

But how important is the physical action of throwing these thoughts away or keeping them in your pocket? To find out, the researchers conducted a third experiment using computers. In this case, 78 Spanish college students wrote their thoughts in a computer word-processing document. Some later used a mouse to drag the file into the computer recycle bin, while others moved the file to a storage disk.

Just as in the previous studies, participants made less use of negative thoughts that they had trashed — by dragging them to the recycle bin — than did those who saved the thoughts by transferring them to a disk.

In one other condition, some participants were told to simply imagine dragging their negative thoughts to the recycle bin or saving them to a disk. But that had no effect on their later judgments.

“The more convinced the person is that the thoughts are really gone, the better,” Petty said. “Just imagining that you throw them away doesn’t seem to work.

“Of course, even if you throw the thoughts in a garbage can or put them in the recycle bin on the computer, they are not really gone — you can regenerate them. But the representations of those thoughts are gone, at least temporarily, and it seems to make it easier to not think about them.”

Petty said the researchers plan to see if this technique could work to help people who have recurrent negative thoughts that are intrusive and bothersome, such as thoughts about the death of a loved one.

“It is often difficult to get rid of these thoughts. We want to find out if there is a way to keep those thoughts from coming back, at least for longer periods of time.”

The study was supported by grants from the U.S. National Science Foundation and the equivalent agency in Spain.

Brief exercise immediately enhances memory, UCI study finds

Sabrina Segal.

Results apply to older adults both with and without cognitive deficits

Irvine, Calif., Nov. 26, 2012 — A short burst of moderate exercise enhances the consolidation of memories in both healthy older adults and those with mild cognitive impairment, scientists with UC Irvine’s Center for the Neurobiology of Learning & Memory have discovered.

Most research has focused on the benefits of a long-term exercise program on overall health and cognitive function with age. But the UCI work is the first to examine the immediate effects of a brief bout of exercise on memory.

In their study, post-doctoral researcher Sabrina Segal and neurobiologists Carl Cotman and Lawrence Cahill had people 50 to 85 years old with and without memory deficits view pleasant images – such as photos of nature and animals – and then exercise on a stationary bicycle for six minutes at 70 percent of their maximum capacity immediately afterward.

One hour later, the participants were given a surprise recall test on the previously viewed images. Results showed a striking enhancement of memory by exercise in both the healthy and cognitively impaired adults, compared with subjects who did not ride the bike.

“We found that a single, short instance of moderately intense exercise particularly improved memory in individuals with memory deficits,” Segal said. “Because of its implications and the need to better understand the mechanism by which exercise may enhance memory, we’re following up this study with an investigation of potential underlying biological factors.”

She believes the improved memory may be related to the exercise-induced release of norepinephrine, a chemical messenger in the brain known to play a strong role in memory modulation. This hypothesis is based on previous work demonstrating that increasing norepinephrine through pharmacological manipulation sharpens memory and that blocking norepinephrine impairs memory.

In the more recent research, Segal and her colleagues discovered that levels of salivary alpha amylase, a biomarker that reflects norepinephrine activity in the brain, significantly increased in participants after exercise. This correlation was especially strong in people with memory impairment.

“The current findings offer a natural and relatively safe alternative to pharmacological interventions for memory enhancement in healthy older individuals as well as those who suffer from cognitive deficits,” Segal noted. “With a growing population of the aged, the need for improvement of quality of life and prevention of mental decline is more important than ever before.”

Study results appear in the November issue (Volume 32, Number 4) of the Journal of Alzheimer’s Disease. UCI’s Alzheimer’s Disease Research Center and the National Institute of Mental Health (grant number 575082), a division of the National Institutes of Health, supported the research.

4 common antipsychotic drugs found to lack safety and effectiveness in older adults

In older adults, antipsychotic drugs are commonly prescribed off-label for a number of disorders outside of their Food and Drug Administration (FDA)-approved indications – schizophrenia and bipolar disorder. The largest number of antipsychotic prescriptions in older adults is for behavioral disturbances associated with dementia, some of which carry FDA warnings on prescription information for these drugs.

In a new study – led by researchers at the University of California, San Diego School of Medicine, Stanford University and the University of Iowa, and funded by the National Institute of Mental Health – four of the antipsychotics most commonly prescribed off label for use in patients over 40 were found to lack both safety and effectiveness. The results will be published November 27 in The Journal of Clinical Psychiatry.

The study looked at four atypical antipsychotics (AAPs) – aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal) – in 332 patients over the age of 40 diagnosed with psychosis associated with schizophrenia, mood disorders, PTSD, or dementia.

“Our study suggests that off-label use of these drugs in older people should be short-term, and undertaken with caution,” said Dilip V. Jeste, MD, Estelle and Edgar Levi Chair in Aging, Distinguished Professor of Psychiatry and Neurosciences, and director of the Stein Institute for Research on Aging at UC San Diego.

Results of the five-year study led by Jeste, who is also current president of the American Psychiatric Association (which was not involved in this research), showed that within one year of treatment, one-third of the patients enrolled in the study developed metabolic syndrome (medical disorders that can increase the risk of cardiovascular disease or diabetes). Within two years, nearly a quarter of the patients developed serious adverse effects and just over half developed non-serious adverse effects.

Because the patients enrolled in the study were all diagnosed with conditions with psychotic symptoms that required antipsychotic drug treatment according to their treating physicians, no placebo was used in the trial. Instead, the researchers used a technique called “equipoise stratified randomization” which is a hybrid of complete randomization and a clinician’s choice method.

“Our goal was to ensure clinical relevance,” said Jeste. Patients had to agree to be randomized to 2, 3 or 4 of the study drugs, as they or their physicians were allowed to exclude one or two of the study AAPs, due to past experience or anticipated risk of the particular drug. Treating clinicians could determine the optimal dosage. “We attempted to make the study as ‘user-friendly’ as possible, to allow the drugs the best chance of success, while seeking to minimize the amount of bias,” he explained.

While the researchers’ intent was to continue the patients on the randomized medications for two years, the average length turned out to be only six months, after which the medications were halted or switched because they didn’t work and/or had side effects.

Because of a notably high incidence of serious adverse events, quetiapine had to be discontinued midway through the trial. The researchers found that there were significant differences among patients willing to be randomized to different AAPs – thus, treating clinicians tended to exclude olanzapine and prefer aripiprazole as one of the possible choices in patients with existing metabolic problems. Yet, the different AAP groups did not appreciably differ in most outcome measures.

Using a common scale called the Brief Psychiatric Rating Scale (BPRS), to measure symptoms such as delusions, hallucinations, unusual behavior, depression, and anxiety, assessments were made at 6 weeks, 12 weeks, and then every 12 weeks. Results using “blind” raters showed no significant improvement in BPRS over a six-month period.

“While there were a few significant differences among the four drugs, the overall risk-benefit ratio for the AAPs in patients over age 40 was not favorable, irrespective of diagnosis and drug,” said Jeste.

Jeste points out that clinicians, patients, and caregivers are often left with difficult and unclear choices for treatment for older persons with psychosis, such as that associated with dementia. Not only are psychosis and agitation common in persons with dementia but they also frequently cause considerable caregiver distress and hasten institutionalization of patients. At the same time, there are no FDA-approved alternatives to antipsychotics for this population, and the high cost of newer AAPs also makes their use problematic.

While the researchers say their findings do not suggest that these AAPs should be banned in older patients with psychiatric disorders, they do indicate that considerable caution is warranted in off-label, long-term use of the drugs in older persons.

“When these medications are used off-label, they should be given in low dosages and for short durations, and their side effects monitored closely,” said Jeste. “Clearly, there is also a critical need to develop and test new interventions that are safe and effective in older people with psychotic disorders.”

Compound found in rosemary protects against macular degeneration in laboratory model

Sanford-Burnham researchers discover that carnosic acid, a component of the herb rosemary, promotes eye health in rodents—providing a possible new approach for treating conditions such as age-related macular degeneration

LA JOLLA, Calif., November 27, 2012 – Herbs widely used throughout history in Asian and early European cultures have received renewed attention by Western medicine in recent years. Scientists are now isolating the active compounds in many medicinal herbs and documenting their antioxidant and anti-inflammatory activities. In a study published in the journal Investigative Ophthalmology & Visual Science, Stuart A. Lipton, M.D., Ph.D. and colleagues at Sanford-Burnham Medical Research Institute (Sanford-Burnham) report that carnosic acid, a component of the herb rosemary, promotes eye health.

Lipton’s team found that carnosic acid protects retinas from degeneration and toxicity in cell culture and in rodent models of light-induced retinal damage. Their findings suggest that carnosic acid may have clinical applications for diseases affecting the outer retina, including age-related macular degeneration, the most common eye disease in the U.S.

Age-related macular degeneration

Age-related macular degeneration likely has many underlying causes. Yet previous studies suggest that the disease might be slowed or improved by chemicals that fight free radicals—reactive compounds related to oxygen and nitrogen that damage membranes and other cell processes.

Lipton’s team first discovered a few years ago that carnosic acid fights off free radical damage in the brain. In their latest study, Lipton and colleagues, including Tayebeh Rezaie, Ph.D. and Takumi Satoh, Ph.D., initially investigated carnosic acid’s protective mechanism in laboratory cultures of retinal cells.

The researchers exposed the cells growing in the dish to hydrogen peroxide in order to induce oxidative stress, a factor thought to contribute to disease progression in eye conditions such as macular degeneration and retinitis pigmentosa. They found that cells treated with carnosic acid triggered antioxidant enzyme production in the cells, which in turn lowered levels of reactive oxygen and nitrogen species (cell-damaging free radicals and peroxides).

Rosemary’s therapeutic potential

Lipton, Rezaie, Satoh and colleagues next tested carnosic acid in an animal model of light-induced damage to photoreceptors—the part of the eye that converts light to electrical signals, enabling visual perception. As compared to the untreated group, rodents pre-treated with carnosic acid retained a thicker outer nuclear layer in the eye, indicating that their photoreceptors were protected. The carnosic acid-treated rodents also exhibited better electroretinogram activity, a measure of healthy photoreceptor function.

What’s next for carnosic acid? “We’re now developing improved derivatives of carnosic acid and related compounds to protect the retina and other brain areas from a number of degenerative conditions, including age-related macular degeneration and various forms of dementia,” said Lipton, director of Sanford-Burnham’s Del E. Webb Neuroscience, Aging, and Stem Cell Research Center and an active clinical neurologist.

New review associates vitamin D with lower rates of tooth decay

Studies of children in several countries linked vitamin D to a 50 percent reduction in the incidence of dental caries

A new review of existing studies points toward a potential role for vitamin D in helping to prevent dental caries, or tooth decay.

The review, published in the December issue of Nutrition Reviews, encompassed 24 controlled clinical trials, spanning the 1920s to the 1980s, on approximately 3,000 children in several countries. These trials showed that vitamin D was associated with an approximately 50 percent reduction in the incidence of tooth decay.

“My main goal was to summarize the clinical trial database so that we could take a fresh look at this vitamin D question,” said Dr. Philippe Hujoel of the University of Washington, who conducted the review.

While vitamin D’s role in supporting bone health has not been disputed, significant disagreement has historically existed over its role in preventing caries, Hujoel noted. The American Medical Association and the U.S. National Research Council concluded around 1950 that vitamin D was beneficial in managing dental caries. The American Dental Association said otherwise – based on the same evidence. In 1989, the National Research Council, despite new evidence supporting vitamin D’s caries-fighting benefits, called the issue “unresolved.”

Current reviews by the Institute of Medicine, the U.S. Department of Human Health and Service and the American Dental Association draw no conclusions on the vitamin D evidence as it relates to dental caries.

“Such inconsistent conclusions by different organizations do not make much sense from an evidence-based perspective,” Hujoel said. The trials he reviewed increased vitamin D levels in children through the use of supplemental UV radiation or by supplementing the children’s diet with cod-liver oil or other products containing the vitamin.

The clinical trials he reviewed were conducted in the United States, Great Britain, Canada, Austria, New Zealand and Sweden. Trials were conducted in institutional settings, schools, medical and dental practices, or hospitals. The subjects were children or young adults between the ages of 2 and 16 years, with a weighted mean age of 10 years.

Hujoel’s findings come as no surprise to researchers familiar with past vitamin D studies. According to Dr. Michael Hollick, professor of medicine at the Boston University Medical Center, “the findings from the University of Washington reaffirm the importance of vitamin D for dental health.” He said that “children who are vitamin D deficient have poor and delayed teeth eruption and are prone to dental caries.”

The vitamin D question takes on greater importance in the light of current public health trends. Vitamin D levels in many populations are decreasing while dental caries levels in young children are increasing.

“Whether this is more than just a coincidence is open to debate,” Hujoel said. “In the meantime, pregnant women or young mothers can do little harm by realizing that vitamin D is essential to their offspring’s health. Vitamin D does lead to teeth and bones that are better mineralized.”

Hujoel added a note of caution to his findings: “One has to be careful with the interpretation of this systematic review. The trials had weaknesses which could have biased the result, and most of the trial participants lived in an era that differs profoundly from today’s environment. ”

Hujoel has joint appointments as a professor in the University of Washington School of Dentistry’s Department of Oral Health Sciences and as an adjunct professor of epidemiology in the UW School of Public Health. His research has concentrated on nutrition with a focus on low-carbohydrate diets, harmful effects of diagnostic radiation, and evidence-based methodology and applications.

His research has also covered sugar substitutes, the use of antibiotics in the treatment of periodontal disease, and cleft lip and cleft palate. He has also studied the link between dental disease and systemic disease, as well as trends in disease prevalence.

Potentially toxic flame retardants found in many US couches

DURHAM, N.C. — More than half of all couches tested in a Duke University-led study contained potentially toxic or untested chemical flame retardants that may pose risks to human health.

Among the chemicals detected was “Tris,” a chlorinated flame retardant that is considered a probable human carcinogen based on animal studies.

“Tris was phased out from use in baby pajamas back in 1977 because of its health risks, but it still showed up in 41 percent of the couch foam samples we tested,” said Heather Stapleton, associate professor of environmental chemistry at Duke’s Nicholas School of the Environment.

More manufacturers in recent years are treating their couches’ foam padding with chemical flame retardants to adhere to California Technical Bulletin 117 (TB 117), she said.  TB 177 requires all residential furniture sold in California to withstand a 12-second exposure to a small open flame without igniting, to help reduce deaths and injuries from accidental home fires. Over the years, the statewide standard essentially has become a de facto national standard, due to the economic importance of the California market.

In many cases, the manufacturer may not know what chemicals have been used.  Most manufacturers buy their foam padding from a vendor who, in turn, buys the chemicals used to treat it from another vendor. The identity of the chemical flame retardants often gets lost along the way, or is protected under law as proprietary.

Stapleton and her colleagues analyzed 102 polyurethane foam samples from couches purchased for home use in the United States between 1985 and 2010.  They published their findings in a peer-reviewed study released Wednesday in the journal Environmental Science & Technology.

In addition to finding Tris, the tests revealed that 17 percent of the foam samples contained the flame-retardant pentaBDE, which is banned in 172 countries and 12 U.S. states and was voluntarily phased out by U.S manufacturers in 2005.

PentaBDEs are long-lasting chemicals that over time migrate into the environment and accumulate in living organisms. Studies show they can disrupt endocrine activity and affect thyroid regulation and brain development. Early exposure to them has been linked to low birth weight, lowered IQ and impaired motor and behavioral development in children.

PentaBDE and Tris were the only flame retardants found in couches purchased before 2005.  After 2005, Tris was the most common flame retardant found. In addition, Stapleton and her colleagues identified two new flame-retardant chemical mixtures in more recently purchases couches for which there is little or no health data available.

“Overall, we detected flame-retardant chemicals in 85 percent of the couches we tested and in 94 percent of those purchased after 2005,” Stapleton said.  “More than half of all samples, regardless of the age of the couch, contained flame retardants that are potentially toxic or have undergone little or no independent testing for human health risks.”

“If a couch has a California TB 117 label, you can all but guarantee it contains chemical flame retardants,” Stapleton said. “But this is where labeling requirements get confusing:  the lack of a TB 117 label on a couch does not guarantee the absence of chemical flame retardants. It’s not that cut-and-dried.”

Stapleton said that so many new proprietary chemical flame retardants have been introduced in recent years that it has become very difficult for scientists to identify them all or determine their presence consumer products.

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