While the mental decline may be invisible to the individual, the fact that the drop-off starts accumulating in middle age puts diabetics at greater risk later on because of reduced “brain reserves,” Dr. David Knopman, of the Mayo Clinic in Rochester, Minnesota, told Reuters Health.

“Like a bicycle tire that’s been partially deflated — you’ll be OK riding around but if you develop another little leak you’ll be much closer to a flat tire much faster,” said Knopman, who was not involved in the Dutch study.

Astrid Nooyens and colleagues at the National Institute for Public Health and the Environment in the Netherlands examined the health records and mental acuity scores of more than 2,600 men and women between the ages of 45 and 70 who enrolled in a large ongoing study into lifestyle effects on health.

At the five-year mark, of the 139 participants with type 2 diabetes, 61 were diabetics at the beginning of the study and 78 developed the chronic disease within the next five years.

The study confirmed the findings of earlier research, by Knopman and others, of an association between diabetes and declines in such mental functions as the ability to think quickly and recall words, but this is the first project to test memory and demonstrate how quickly the drop-off can occur.

Over a five-year period, decline in overall mental functioning in people with type 2 diabetes, while small, was nearly 3 times more pronounced than in non-diabetics.

But it didn’t take many years for the impact to be felt. Even those who developed diabetes after beginning the study saw twice as much of a decline as their non-diabetic counterparts.

Compared to the “healthy” participants, participants who had long-term diabetes registered the largest declines in mental function. Those who developed diabetes during the trial saw less pronounced declines than their long-term counterparts in most areas except information processing, where they appeared to do a little better than the “healthy” people.

Type 2 diabetes is characterized by high blood sugar levels caused by the body’s inability to process sugar properly. The illness can usually be controlled through diet and exercise but may also require drugs.

The Nooyens group found that while memory continues to decline for those with diabetes, the drop-off in thinking speed appears to occur in the first five years and then level off. That led the authors to suggest that early treatment and control of blood sugar levels could help thinking speed, but probably not memory, they note in the journal Diabetes Care.

The researchers found that for a small group of people who had lived with diabetes for nearly seven year, blood sugar levels did not explain the entire decline in mental function. In those people, they suspect other conditions related to diabetes such as high blood pressure and obesity.

The study did not look at whether patients with well-controlled diabetes experienced less mental decline compared to their poorly controlled counterparts, although the authors point out that there are other reasons, such as heart disease, to control sugar levels as well.

They also note that the random blood tests of both the long- and short-term diabetics suggested what treatment they were getting was “insufficient.”

SOURCE: http://link.reuters.com/xyd69k

This eating pattern, which includes lots of fruits and vegetables, nuts, vegetable oils, low-fat dairy products, legumes, whole grains, and fish, has been shown to help shield people from heart disease and may also ward off certain cancers, Dr. Christina Chrysohoou of the University of Athens and her colleagues note in their report.

But less information is available on whether the Mediterranean diet might be helpful for people who already have heart disease.

To investigate, Chrysohoou and her team looked at 1,000 patients who had suffered heart attacks or severe chest pain while at rest or with only light exertion. They rated each patient on a scale of 0 to 55 based on how closely their eating matched the Mediterranean ideal.

Nearly half of the patients experienced a second heart-related event within two years after their original hospital discharge.

But patients with the most Mediterranean-style diets were at 31 percent lower risk of suffering another heart attack or experiencing chest pain during the first month after they were discharged from the hospital.

They were only half as likely as those with the least Mediterranean eating habits to have another heart-related event within a year, and nearly 40 percent less likely to experience repeat heart problems within two years.

For every additional point on the 55-point Mediterranean Diet Score, a person’s risk of having another heart-related event over the next two years fell by 12 percent, the researchers found. Patients with the most Mediterranean diets were also the least likely to experience reductions in the ability of the heart’s main pumping chamber to work at full capacity, as well as harmful structural changes to the heart known as cardiac remodeling.

When the researchers looked at different components of the Mediterranean diet separately, they found that vegetables and salad and nuts were the only foods that cut risk; people who ate vegetables and salad or nuts daily or weekly were at 20 percent lower risk of repeat heart problems within two years of their initial hospitalization compared to people who ate these foods monthly or less often.

Based on the findings, Chrysohoou and her team conclude, strategies to reduce mortality and illness due to heart disease should include a “diet that contains the favorable characteristics of the Mediterranean diet.”

SOURCE: http://www.ajcn.org/cgi/content/abstract/ajcn.2009.28982v1 American Journal of Clinical Nutrition.

The Bad Ad Program is an FDA-sponsored educational outreach effort administered by the agency’s Division of Drug Marketing, Advertising, and Communications (DDMAC), in the FDA’s Center for Drug Evaluation and Research.

“The Bad Ad Program will help health care providers recognize misleading prescription drug promotion and provide them with an easy way to report this activity to the agency,” said Thomas Abrams, director of DDMAC.

The program will be rolled out in three phases. In Phase 1, DDMAC will engage health care providers at specifically-selected medical conventions and partner with specific medical societies to distribute educational materials. Phases 2 and 3 will expand the FDA’s collaborative efforts and update the educational materials developed for Phase 1.

The FDA’s traditional regulatory activities for monitoring prescription drug promotion primarily rely on review of promotional pieces submitted to the agency by sponsoring drug companies, industry complaints, and field surveillance at large medical conventions. Although these efforts are effective, the agency has limited ability to monitor promotional activities that occur in private.

Health care professionals are encouraged to report a potential violation in drug promotion by sending an email to badad@fda.gov or calling 877-RX-DDMAC. Reports can be submitted anonymously; however, the FDA encourages providers to include contact information so that DDMAC officials can follow-up, if necessary.

Researchers from the University of Essex found that as little as five minutes of a “green activity” such as walking, gardening, cycling or farming can boost mood and self esteem.

“We believe that there would be a large potential benefit to individuals, society and to the costs of the health service if all groups of people were to self-medicate more with green exercise,” Barton said in a statement about the study, which was published in the journal Environmental Science & Technology.

Many studies have shown that outdoor exercise can reduce the risk of mental illness and improve a sense of well-being, but Jules Pretty and Jo Barton, who led this study, said that until now no one knew how much time needed to be spent on green exercise for the benefits to show.

Barton and Pretty looked at data from 1,252 people of different ages, genders and mental health status taken from 10 existing studies in Britain.

They analyzed activities such as walking, gardening, cycling, fishing, boating, horse-riding and farming.

They found that the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited. The largest positive effect on self-esteem came from a five-minute dose of “green exercise.”

All natural environments were beneficial, including parks in towns or cities, they said, but green areas with water appeared to have a more positive effect.

OxyContin is made to slowly release the potent opioid oxycodone to treat patients who require a continuous, around-the-clock opioid analgesic for management of their moderate to severe pain for an extended period of time. Because of its controlled-release properties, each OxyContin tablet contains a large quantity of oxycodone, which allows patients to take their drug less often. However, people intent on abusing the previous formulation have been able to release high levels of oxycodone all at once, which can result in a fatal overdose and contributes to high rates of OxyContin abuse.

The reformulated OxyContin is intended to prevent the opioid medication from being cut, broken, chewed, crushed or dissolved to release more medication. The new formulation may be an improvement that may result in less risk of overdose due to tampering, and will likely result in less abuse by snorting or injection; but it still can be abused or misused by simply ingesting larger doses than are recommended.

“Although this new formulation of OxyContin may provide only an incremental advantage over the current version of the drug, it is still a step in the right direction,” said Bob Rappaport, M.D., director of the Division of Anesthesia and Analgesia Products in the FDA’s Center for Drug Evaluation and Research.

“As with all opioids, safety is an important consideration,” he said. “Prescribers and patients need to know that its tamper-resistant properties are limited and need to carefully weigh the benefits and risks of using this medication to treat pain.”

According to the U.S. Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, approximately half a million people used OxyContin non-medically for the first time in 2008.

The manufacturer of OxyContin, Purdue Pharma L.P., will be required to conduct a postmarket study to collect data on the extent to which the new formulation reduces abuse and misuse of this opioid. The FDA is also requiring a REMS (Risk Evaluation and Mitigation Strategy) that will include the issuance of a Medication Guide to patients and a requirement for prescriber education regarding the appropriate use of opioid analgesics in the treatment of pain.

Purdue Pharma is based in Stamford, Conn.

The Poison Prevention Week Council has designated March 14-20, 2010 as Poison Prevention Week. This observance is focused on raising awareness about unintentional poisoning—a serious and often unrecognized problem.

Any substance, including medications, can be poisonous if too much is taken. When the person taking or giving a substance did not mean to cause harm, this is an unintentional poisoning.

What You Should Know
In 2006, a total of 27,531 people in the United States died from unintentional poisoning.
In 2008, more than 2,000 people a day— a total of 732,316— were seen in emergency departments after a poisoning incident.
Unintentional poisoning deaths are on the rise. Poisoning death rates in the United States increased by 63% from 1999 to 2004.
96% of unintentional poisoning deaths are a result of drug poisoning—and more than half of them are due to prescription drugs.
An estimated 71,000 children (18 years old and younger) are seen in emergency departments each year because of medication poisonings (excluding recreational drug use). Over 80% were because an unsupervised child found and consumed.

What You Can Do
To keep yourself and others safe from unintentional poisoning:
Follow directions on labels when you give or take medicines. Some medicines cannot be taken safely with other medications or with alcohol.
To avoid drug interactions, check with your doctor if you are taking more than one prescription medication at a time.
Keep medicines in their original bottles or containers.
Never share or sell your prescription drugs to others, including family members.
Keep all pain medications, such as methadone, hydrocodone, and oxycodone, in a safe place only reachable by people for whom use is prescribed.
Monitor the use of medicines for children and teenagers, such as medicines for attention deficit disorder, or ADD, and cold and cough medications.
Follow federal guidelines for disposal of unused, unneeded, or expired prescription drugs.

To protect children from poisoning:

Keep medicines and toxic products, such as cleaning solutions, in locked or childproof cabinets.
Put the nationwide poison control center phone number, 1-800-222-1222, on or near every telephone in your home. You should also program it into your cellular phone. Call poison control if you think a child has been poisoned and if they are awake and alert. Call 911 if you have a poison emergency and your child has collapsed or is not breathing.
Follow label directions and read all warnings when giving medicines to children.
Always secure the child safety cap and put medicine away immediately after you use it.

Nor is it the strength and speed of the connections throughout the brain or such features as total brain volume.

Instead, new research shows, it’s the connections between very specific areas of the brain that determine intelligence and often, by extension, how well someone does in life.

“General intelligence actually relies on a specific network inside the brain, and this is the connections between the gray matter, or cell bodies, and the white matter, or connecting fibers between neurons,” said Jan Glascher, lead author of a paper appearing in this week’s issue of the Proceedings of the National Academy of Sciences. “General intelligence relies on the connection between the frontal and the parietal [situated behind the frontal] parts of the brain.”

The results weren’t entirely unexpected, said Keith Young, vice chairman of research in psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine in Temple, but “it is confirmation of the idea that good communication between various parts of brain are very important for this generalized intelligence.”

General intelligence is an abstract notion developed in 1904 that has always been somewhat controversial.

“People noticed a long time ago that, in general, people who are good test-takers did well in a lot of different subjects,” explained Young. “If you’re good in mathematics, you’re also usually good in English. Researchers came up with this idea that this represented a kind of overall intelligence.”

“General intelligence is this notion that smart people tend to be smart across all different kinds of domains,” added Glascher, who is a postdoctoral fellow in the department of humanities and social sciences at the California Institute of Technology in Pasadena.

Hoping to learn more, the authors located 241 patients who had some sort of brain lesion. They then diagrammed the location of their lesions and had them take IQ tests.

“We took patients who had damaged parts of their brain, tested them on intelligence to see where they were good and where they were bad, then we correlated those scores across all the patients with the location of the brain lesions,” Glascher explained. “That way, you can highlight the areas that are associated with reduced performance on these tests which, by the reverse inference, means these areas are really important for general intelligence.”

“These studies infer results based on the absence of brain tissue,” added Paul Sanberg, distinguished professor of neurosurgery and director of the University of South Florida Center for Aging and Brain Repair in Tampa. “It allows them to systemize and pinpoint areas important to intelligence.”

Young said the findings echo what’s come before. “The map they came up with was what we expected and involves areas of the cortex we thought would be involved — the parietal and frontal cortex. They’re important for language and mathematics,” he said.

In an earlier study, the same team of investigators found that this brain network was also important for working memory, “the ability to hold a certain number of items [in your mind],” Glascher said. “In the past, people have associated general intelligence very strongly with enhanced working memory capacity so there’s a close theoretical connection with that.”

SOURCES: Paul Sanberg, Ph.D., D.Sc., distinguished professor, neurosurgery, and director, University of South Florida Center for Aging and Brain Repair, Tampa; Keith Young, Ph.D., vice chairman, research in psychiatry and behavioral science, Texas A&M Health Science Center College of Medicine, Temple, and neuroimaging and genetics core leader, VA Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System; Jan Glascher, Ph.D., postdoctoral fellow, department of humanities and social sciences, California Institute of Technology, Pasadena.

“Very sick patients require close monitoring by healthcare professionals,” Dr. Phillip H. Factor from Beth Israel Hospital, New York, told Reuters Health by email. “Relying on electronic monitors is not sufficient in the sickest of the sick; these patients require direct observation.”

Factor was the senior researcher on a study of 664 patients in a medical ICU (as opposed to a surgical ICU). Roughly two-thirds of the patients were assigned to rooms with unimpeded visibility from the central nursing station. The remaining third were in corner rooms that couldn’t be seen clearly from the nurses’ station.

In the journal Chest, Factor and his coauthors report that overall, there was no difference in survival rates between patients in the rooms with good visibility and those that couldn’t be seen as easily.

The researchers also considered whether the severity of patients’ illnesses affected their risk in the different rooms. They used a standard tool known as the APACHE II score to judge how sick the patients were.

They found that the very sickest individuals – those with APACHE II scores above 30 – had a higher likelihood of dying while in the ICU, or while still in the hospital, if they were assigned to a low-visibility ICU room. This was true no matter what disease they were hospitalized for.

Why more deaths occurred among severely ill patients in the low-visibility rooms isn’t clear yet. “Whether they are due to late identification of…deterioration or less time spent by healthcare providers at the bedside or other undiscovered variables is unknown and requires additional study,” the authors wrote.

In a phone call with Reuters Health, the lead author, Dr. David Leaf from Columbia University College of Physicians and Surgeons in New York City emphasized, “This is the first article that addresses this issue, so the results should be interpreted cautiously.”

But, Leaf continued, “It’s both intuitive and now supported by some evidence that corner rooms with low visibility may be associated with poorer outcomes and therefore should be avoided whenever possible in the case of extremely sick patients.”

His colleague Dr. Factor pointed out that some ICUs may have special routines in place to improve the care of patients in lower-visibility rooms, such as increased nurse-to-patient ratios.

Even so, Leaf said, in the case of extremely sick patients, “if there is an empty room closer to the nurses’ station, it wouldn’t be unreasonable to ask to have the patient moved.”

SOURCE: Chest

The condition, plantar fasciitis, or inflamed tissue and swelling of the sole of the foot, can become chronic if steps aren’t taken to relieve it, according to Dr. Benedict DiGiovanni, an associate professor of orthopaedics at the University of Rochester Medical Center.

Weight gain or spending lots of time walking or standing can bring on the condition. The first signs of plantar fasciitis are typically heel pain when stepping out of bed, according to information in a news release from the American Orthopaedic Foot & Ankle Society.

If not dealt with, the pain of plantar fasciitis can worsen and possibly lead to problems with the foot, knee, hip and back due to gait changes. Plantar fasciitis can even impact pro athletes. Last fall, New York Giants quarterback Eli Manning struggled with the condition and a subsequent stress reaction in his foot for most of the season.

It’s hard, of course, to stay off your feet when you have things to do. So, to treat plantar fasciitis, DiGiovanni recommends taking it easy until the initial inflammation subsides, icing the sore area for 20 minutes, three or four times a day, and performing exercises to stretch the Achilles tendon in the back of the lower leg and plantar fascia, or the connective tissue that supports the arch of the foot.

The stretches should be performed before stepping out of bed in the morning and before taking a first step after being inactive for awhile. The stretches should be repeated four or five times per day for the first month, and then as needed, DiGiovanni explained. Also stretch the Achilles tendon twice a day, morning and evening.

Other options include over-the-counter anti-inflammatory medicine, over-the-counter soft arch supports, supportive shoes with shock-absorbing soles or taping the foot to support the arch.

By taking these steps, about 90 percent of people with plantar fasciitis see significant improvements within two months, DiGiovanni said.

If the pain continues or gets worse, orthopedic surgeons often suggest heel injections with steroidal anti-inflammatory medications, walking casts or positional splints.

To help ensure the health and safety of young athletes, CDC developed the Heads Up: Concussion in Youth Sports initiative to offer information about concussions—a type of traumatic brain injury—to coaches, parents, and athletes involved in youth sports. The “Heads Up” initiative provides important information on preventing, recognizing, and responding to a concussion.

CDC wants to equip coaches, parents, and young athletes across the country with the “Heads Up: Concussion in Youth Sports” tool kit, which contains a:
Fact sheet for coaches on concussion
Fact sheet for athletes on concussion
Fact sheet for parents on concussion
Clipboard with concussion facts for coaches
Magnet with concussion facts for coaches and parents
Poster with concussion facts for coaches and sports administrators
Quiz for coaches, athletes, and parents to test their concussion knowledge