Wednesday, December 28, 2011

Risk Factors for Recurrence of Depression

Depression is a common mental health disorder that negatively affects daily functioning and quality of life. Unfortunately, depression is often a recurrent disorder.

Current treatment guidelines are based on clinical features of the disease, but new evidence points to sociodemographic and psychosocial characteristics that influence the severity and prognosis of depression. 

Specifically, a study published in the Canadian Medical Association Journal highlights smoking and a feeling of lack of control over one’s life as significant predictors of a negative long-term prognosis of depression. 

The population-based survey evaluated nearly 600 people aged 16 or older who participated in a national health survey. The national survey included more than 17,000 participants, and the subjects in this evaluation were those who had reported a major depressive episode in the first year of the survey. The participants were followed for six years. 

More than half (64.5%) of the participants were women, and, at baseline, the average age of the group was approximately 39 years. Most of the participants were white (91.7%) and earned a middle to high income (81.5%). Nearly two-thirds had achieved greater than a high school education. Over the follow-up period, slightly more than half (55.3%) of the survey population experienced repeated episodes of depression. 

The authors evaluated numerous physical, emotional, psychological, social, and demographic characteristics of the participants to examine their association with depressive episodes. Daily smoking and low mastery (feeling that life circumstances are beyond one’s control) were significant predictors of recurrent depression. 

A history of depression, which is already a well-established risk factor for future episodes of depression, was also significantly related to recurrent depressive episodes in this study. The association between risk factors and depressive episodes varied with the severity of depression. Due to the nature of the study and the small sample size, the direction of effect and causal mechanisms are unclear. However, interventions that promote smoking cessation and increase mastery may provide positive mental health outcomes. 

Smoking cessation has obvious health benefits, and high levels of mastery are linked to regular physical activity, a healthy diet, decreased metabolic risk factors, and a decreased risk of death from cardiovascular factors. In fact, high levels of mastery at baseline were protective against recurrent episodes of depression in this population.

 Smoking and mastery are simple and straightforward to assess in routine clinical practice. According to the authors of the current study, these novel prognostic factors may offer new avenues for treatment of depression and prevention of recurrent depressive episodes.

Tuesday, December 27, 2011

Eating less 'can boost your brain and help you remember more'

Eating less could help you remember more, researchers have found. Skipping dessert and having an after-dinner coffee instead could also be good for your brain, as well as your waistline. The news comes from an Italian study into ‘calorific restriction’ – the idea that near-starvation rations boost health and extend life. 

Scientists have long known of the phenomenon, but have struggled to work out just what it is about severely cutting calories that improves health. Researcher Giovambattista Pani decided to focus on a protein called CREB1 that is known to be important to memory and learning. 

In experiments on mice, he showed that cutting calories boosted learning if the animals could still make CREB1. He also showed that cutting calories boosts the amount of the protein made in the brain. The animals’ calorie count was only cut by 25 to 30 per cent. In human terms, this equates to about 600 calories a day. 

 A cup of tea or coffee may also be beneficial, with studies crediting caffeine with upping the amount of CREB1 made in the body. The research could help explain why residents of Okinawa island in Japan have more people over 100 years old per 100,000 population than anywhere else in the world. 

The Okinawans eat fewer calories than the average person due to the cultural practice of Hara Hachi Bu - eating until you are 80 per cent full. This is through to reduce the number of free radicals produced leading to a healthier heart. The work by Dr Pani, of the Catholic University of the Sacred Heart in Rome is detailed in the journal Proceedings of the National Academy of Sciences. Dr Pani said: ‘It is just 25 to 30 per cent fewer calories. It is like not eating a cake at the end of the meal. 

‘This gives us a tool to better investigate this brain circuitry and try to figure out more drugs that do the same. ‘We are trying a couple of compounds right now on animals but it is at a very preliminary stage.’ Keeping the brain young could be of huge value in an ageing population. Alzheimer's and other forms of dementia affect more than 800,000 Britons, and the number expected to double in a generation. Dr Pani said: ‘Our findings identify for the first time an important mediator of the effects of diet on the brain. 

‘This discovery has important implications to develop future therapies to keep our brain young and prevent brain degeneration and the ageing process. ‘Our hope is to find a way to activate CREB1, for example through new drugs, so to keep the brain young without the need of a strict diet.’

Sunday, December 25, 2011

Loud iPods overtake noisy workplaces as most common cause of hearing damage

Loud iPods overtake noisy workplaces as most common cause of hearing damage Millions of commuters risk hearing damage because they have set the volume level too high on their MP3 players. In the past, loud workplaces were blamed for causing the majority of harmful noise. 

However, researchers at Michigan University in the US found that noise from MP3 players has overtaken as the biggest danger to hearing. Occupational health experts found nine out of 10 people using public transport were exposed to excessive noise through listening to loud music through their headphones, rather than from the environment. 

This could be because cheap headphones fail to seal against the ear properly, causing commuters to turn up the volume to block out exterior noise. The resulting tinny noise can drive fellow passengers up the wall. Professor Rick Neitzel, who co-authored the study, said: 'It's startling that two in three people get the majority of noise exposure from music.

'I've always viewed the workplace as a primary risk for noise exposure. But this would suggest that just focusing our efforts on the workplace isn't enough, since there's lots of noise exposure happening elsewhere. 'It's a serious problem as there aren't really any other experiences where we would tolerate having nine out of 10 people exposed at a level we know is hazardous. We certainly wouldn't tolerate this with something that caused cancer or chronic disease. Yet for some reason we do for noise.' 

 Researchers looked at noise exposure among 4,500 New Yorkers who used public transport, in work and non-work related activities, MP3 player and stereo use and during domestic activities. They found the average New York public transport user spent about 380 hours using buses and trains, exposed to average noise levels of 72 to 81 decibels. For comparison, the average speaking level is 60 decibels, a busy street corner is 80, a circular saw is 90, a baby crying 115. 

The threshold for pain is about 125, and even a brief, one-time exposure above that level can cause permanent hearing loss. Prof Neitzel said: 'Lots of people appear to be exposed at hazardous levels. 'A growing number of studies show noise causes stress, sleep disturbance, and heart disease. It may be the noise which we haven't historically paid much attention to is actually contributing to some of the top health problems in developed countries today.'

Thursday, December 15, 2011

Young mother, 20, dies after taking 'a few extra paracetamol' to help cope with br*ast surgery pain


A young mother died from liver failure following routine surgery after she took 'a few extra tablets' of paracetamol each day to cope with the pain.


Desiree Phillips, 20, had a number of benign lumps on her br*ast removed earlier this year.

Doctors prescribed antibiotics and over-the-counter paracetamol to help her cope with the discomfort.


Her family suspected she was taking just ‘a few extra tablets’ a day before she was admitted to hospital with a failing liver nine days after the operation.

The single mother, from Llanelli, South Wales, endured a week of excruciating pain and a liver transplant. But she died at Birmingham Queen Elizabeth hospital on August 26.

Her grandfather Des Phillips and mother Ayshea spoke of their shock and sorrow.
Mr Phillips, 58, a chef, said: ‘She must have been taking a few extra tablets than the recommended eight a day. She seemed fine to us, then out of the blue her boyfriend found her stretched out on the sofa.

‘When we heard she was at hospital we never expected she might die. People don’t realise that an extra two over a period of time can harm your liver if you keep taking that over two to three weeks.’

He added:'We have lost part of our heart, losing her like this.'

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Mr Phillips said: ‘They said she should have a liver transplant straight away but her body rejected the new organ.’

Although an inquest is yet to be held, Desiree’s family is keen for action to be taken to try to prevent similar tragedies.

Mr Phillips said: ‘If a painkiller is that dangerous, it should be prescribed. Cigarettes have a label saying “smoking kills” but paracetamol packets don’t look dangerous.’
Desiree’s family said her one-year-old son Jayden is now being cared for by his father Simon Dewi-Jones.

Desiree’s mother Ayshea, 38, added: ‘Jayden doesn’t deserve to be growing up without a mum because of this.’

The 20-year-old's funeral was held at Llanelli Crematorium yesterday.
Dr Kenneth Simpson, of the Scottish Liver Transplantation Unit, who led a study on paracetamol-induced liver injury in 663 patients, says 161 of them had taken a ‘staggered overdose’ – taking one or two too many over several days.

‘Those who’ve taken a staggered overdose do worse, paradoxically, than the people who’ve tried to kill themselves,’ said Dr Simpson.

A Medicines and Healthcare products Regulatory Agency spokesman said: ‘Paracetamol is a safe and effective painkiller when used correctly and when dosage recommendations are followed.

‘Every pack has a warning about overdose and instructions not to take more than eight tablets in any 24-hour period.’

 
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