Diabetes Cases To Double In United States By 2034

The number of people with diabetes in the United States is expected to double over the next 25 years.

The study published in the December issue of Diabetes Care predicts that by 2034 about 44.1 million people will have the disease, up from 23.7 million today. At the same time, the cost of treating people with diabetes will triple, rising from an estimated $113 billion in 2009 to $336 billion in 2034.

Researchers note that a key factor driving the soaring costs is the number of people living with diabetes for lengthy periods. Over time, the cost of caring for someone with diabetes tends to rise along with their risk for developing complications, such as end-stage renal disease, which requires costly dialysis according to the American Association for Critical Illness Insurance.

In making their estimates, researchers at the University of Chicago used data on people 24 to 85 years old who took part in the U.S. Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey and the National Health Interview Study.

Prior forecasts, including the ones currently used by the federal government's budget analysts, have underestimated the burden, the researchers noted. A 1991 study, for example, predicted that 11.6 million people would have diabetes in 2030. In 2009, there were already more than twice that many living with diabetes.

Among Medicare beneficiaries, the number with diabetes is expected to rise from 8.2 million to 14.6 million in 2034, with an accompanying rise in spending from $45 billion to $171 billion the study reveals. The high cost of chronic disease is one of the most pressing issues facing the United States as legislators grapple with financial strains on Medicare and the larger issue of health-care reform, the researchers explained.

Factors driving the increase in diabetes cases include the aging population and continued high rates of obesity, both of which are risk factors for type 2 diabetes, in which the body does not produce enough insulin or the cells don't use it correctly. In the study, the researchers assumed that the obesity rate would remain relatively stable, topping out at about 30 percent in the next decade and then declining slightly to about 27 percent in 2033.

Kidney Transplant Plus Sleep Disorder Adds Up to Trouble

Kidney transplant patients with sleep apnea are at increased risk for high blood pressure, heart disease and stroke. 

Researchers in Hungary conducted a study of kidney transplant recipients and found that 25 percent had moderate to severe sleep apnea, a rate similar to that seen in kidney disease patients on dialysis awaiting a transplant. 

The findings they note indicate that both types of patients who have the breathing-related sleep disorder should be considered at high risk for serious heart-related complications.  Transplant recipients with sleep apnea were more than twice as likely as those without the syndrome to be taking three or more anti-hypertensive drugs, but still had higher blood pressure than those without the sleep disorder. Obesity increased a transplant patient's risk of developing sleep apnea. 

Organ transplants are increasingly available according to the American Association for Critical Illness Insurance.  Some critical illness policies will provide a cash benefit when a transplant is received.

When the Hungarian medical researchers calculated risk scores, they found that kidney disease patients with sleep apnea were twice as likely to suffer heart disease or stroke than those without sleep apnea.  They recommend that physicians should screen transplant patients for obstructive sleep apnea and offer appropriate treatment," the study authors concluded. 

The study will be published in January in the Clinical Journal of the American Society of Nephrology.

Moderate Drinking May Help Your Heart

A Spanish study has found that long-term moderate drinking decreased the risk of heart disease by up to one-third in men and to a lesser degree in women.

The type of alcohol -- beer, wine or spirits -- made no difference, the researchers reported in the Nov. 19 online issue of Heart. The Spanish analysis used 10-year data on over 40,000 men and women who were participants in the European Prospective Investigation into Cancer study.

 But for men, there was a point at which the coronary benefits of alcohol declined, and risk began to rise again.  The rate of coronary heart disease for non-drinking women in the study was 56 per 100,000. For women listed as low drinkers, averaging less than 5 grams a day, it was 42. For women who were moderate drinkers (5 to 30 grams a day), it was 36; for high drinkers (30 to 90 grams a day) it was 12; and for heavy drinkers (more than 90 grams a day) it was 12.

The rates for men were 398 per 100,000 for those who never drank, 318 for low drinkers, 255 for moderate drinkers, 278 for high drinkers and 334 for heavy drinkers, the researchers reported.

The report showing that the source of alcohol made no difference does help puncture one explanation for what has come to be called the "French paradox," the low level of heart disease seen in that country despite consumption of what Americans would describe as an unhealthy, fat-rich diet. Some experts have attributed the paradox to the beneficial effects of red wine.

A number of well-done studies have shown that people who drink have higher levels of HDL cholesterol.  HDL cholesterol is the "good" kind that prevents formation of artery-blocking plaque deposits.

The American Heart Association recommendation is that "if you drink, do so in moderation." That means one to two drinks a day for a man, one drink a day for a woman, with a drink defined as 12 ounces of beer, 4 ounces of wine or 1 ounce of 100-proof spirits.

Every 34 seconds an American will suffer a heart attack according to the American Association for Critical Illness Insurance. 

SOURCES: Eric B. Rimm, Sc.D., associate professor, epidemiology and nutrition, Harvard School of Public Health, Boston; Kenneth Mukamal, M.D., internist, Beth Israel Deaconess Hospital, associate professor, medicine, Harvard Medical School, Boston; Nov. 19, 2009, Heart, online.

Migraine Increases Likelihood Of Stroke New Study Reports

People who suffer migraines have more than double the risk of ischemic stroke, and the risk is especially high in women.

Ischemic stroke, the most common type of stroke, occurs when blood supply to the brain is cut off by plaque accumulation or a blood clot.

In astudy presented at the American Heart Association's annual meeting in Orlando, Florida, researchers from Johns Hopkins University School of Medicine reviewed the findings of 21 studies that included a total of 622,381 men and women, aged 18 to 70, in Europe and North America.

Those with migraines were 2.3 times more likely than people without migraines to suffer ischemic stroke. The risk was 2.5 times higher for migraine sufferers who experienced aura (visual disturbances such as flashing lights, zigzag lines and blurred vision), and for women experiencing aura, 2.9 times higher.

The findings reinforce the link between migraine and stroke and also correct some discrepancies in previous analyses that yielded mixed results, according to Hopkins cardiologist and senior study investigator Dr. Saman Nazarian.

Nazarian said nearly 1,800 articles have been written about the relationship between migraine and stroke, but the Hopkins review is believed to be the largest of its kind and was more selective, including only studies that used similar designs and groups of people.

"Identifying people at highest risk is crucial to preventing disabling strokes. Based on this data, physicians should consider addressing stroke risk factors in patients with a history or signs of light flashes and blurry vision associated with severe headaches," Nazarian said in a Hopkins news release.

There are a number of migraine prevention and treatment options, including smoking cessation, taking medications to lower blood pressure or taking blood-thinning drugs such as aspirin, Nazarian added. For women with migraines, additional options include discontinuing use of birth control pills or stopping hormone replacement therapy.

For information on critical illness insurance visit the website of the American Association for Critical Illness Insurance where you can obtain free, no obligation costs for this important protection.

Rapid Cooling May Help When Heart Attack Hits

Rapid cooling of heart attack patients may boost their chance of survival without brain damage.

Swedish researchers examined the use of a device called RhinoChill, which cools the brains of heart attack patients during ongoing cardiopulmonary resuscitation (CPR).

The median time between cardiac arrest onset and the start of cooling was 23 minutes. On arrival at hospital, the average body temperature of cooled patients was 93.56 degrees F, compared with 95.9 degrees for standard care patients.

The study found that 46.7 percent of patients in the cooling group survived to hospital discharge, compared with 31 percent of patients who received standard care.   In addition, some 36.7 percent of those in the cooling group and 21.4 percent of those in the standard care group were in good neurological condition when discharged from the hospital.

Patients who received a combination of early CPR -- started within six minutes of collapse -- and cooling had the best outcomes.   The researchers noted that the earlier you can do the cooling, the better. When resuscitation efforts were delayed, there was no significant difference in survival. 

The study was to be presented Nov. 15 at an American Heart Association's annual meeting in Orlando, Fla.

According to the American Association for Critical Illness Insurance, some785,000 Americans will have a new cornary attack this year.

Study Drug Shrinks Lung Cancer Tumors In Mice

A potential new drug for lung cancer has eliminated tumors in 50% of mice.

Researchers report that the drug also stopped lung cancer tumors from growing and becoming resistant to treatment. 

One in five people with lung cancer have small cell lung cancer and only three per cent of these people are expected to survive for five years. With this form of lung cancer, tumors spread quickly so it is rarely possible to remove the tumors surgically. Because of this, small cell lung cancer is treated with chemotherapy, with or without additional radiotherapy.

Initially, the treatment often appears to work, reducing the size of the tumors. However, the tumors usually grow back rapidly and then become resistant to further treatment.

The researchers have identified a drug that, in some mice, was able to completely shrink tumors away. In the mouse models, it was also able to stop tumors from growing and it helped other forms of chemotherapy to work more effectively. If the drug proves successful in humans, the researchers hope that it could help patients with this kind of lung cancer to live longer.

The Section of Molecular Oncology and Lung Cancer Research at Imperial College London which conducted the study suggests that it may be possible to develop the drug PD173074 into a new targeted therapy for small cell lung cancer. We hope to take this drug, or a similar drug that also stops FGF-2 from working, into clinical trials next year to see if it is a successful treatment for lung cancer in humans. An added bonus of this drug is that it could be taken orally, which would make it less invasive than some other forms of cancer therapy.

Lung cancer is one of the most common cancer killer in the world according to the American Association for Critical Illness Insurance.   Around one in five of people diagnosed with lung cancer will have small cell lung cancer. Although it responds to chemotherapy initially, the tumors soon become resistant to treatment and sadly nearly all people with the disease do not survive.

The Cancer Treatment and Research Trust, Cancer Research UK and the UK Department of Health funded the research. 

Walking And Exercise May Lower Prostate Cancer Risk

Men who regularly get moderate exercise may have a lower risk of developing prostate cancer. 

Researchers examined men who underwent biopsies for possible prostate cancer.  Those who exercised moderately, the equivalent of three to six hours of walking per week, were less likely to be diagnosed with the disease. 

The study found that compared with their sedentary counterparts, these men were two-thirds less likely to have a biopsy positive for prostate cancer. In addition, men who performed one to three hours of walking each week had an 86 percent lower chance of having an aggressive form of the cancer. 

According to the American Association for Critical Illness Insurance, some 745,000 men are diagnosed with cancer each week.  Prostate cancer is the leading cancer impacting men.  The study findings which appear in the current issue of the Journal of Urology do not prove that exercise helps prevent prostate cancer the researchers point out. But it could offer men another incentive to get active. 

A number of studies have looked at the relationship between exercise and prostate cancer, and while most have pointed to a protective effect, about one-third have found no association.  The medical experts found that among the 111 sedentary men in the study, half were diagnosed with cancer after biopsy. That compared with 27 percent of those men who got the equivalent of three to six hours of walking each week. 

And among men diagnosed with prostate cancer, 51 percent of sedentary patients had more-aggressive cancer, versus 22 percent of those who had been mildly active -- getting the equivalent of one to three hours of moderate walking per week.

Exercise itself remained linked to a lower risk of prostate cancer after the researchers accounted for a number of other factors, like age, weight and race.  Exercise has been shown to lower blood levels of testosterone and other hormones that may stimulate prostate tumor growth. Exercise is also believed to stimulate the immune system and the body's natural antioxidant mechanisms, both of which may help prevent the development of prostate cancer.

More Adults At Risk Of Heart Disease

Only 7.5 percent of Americans are now in the clear when it comes to heart disease risk factors according to a new study.

Resaerchers found that several decades of steady reductions in heart disease may be on the wane.  The obesity epidemic affecting millions of Americans bears much of the blame for the increased risk.  As a result, the decline in cardiovascular disease mortality in the U.S. seems to be coming to an end and may even reverse itself.

A worsening cardiovascular risk profile in the population could potentially lead to increases in the incidence and prevalence of cardiovascular disease, noted researchers from the U.S. Centers for Disease Control and Prevention.   The increases in cardiovascular disease and diabetes will affect the nation's medical costs, stated Jesse Slome, director of the American Association for Critical Illness Insurance.  Medical costs account for two-thirds of all U.S. bankruptcies, he noted.

The researchers collected data on adults 25 to 74 years of age looking for low-risk factors for heart disease.  These include items such as not smoking, having low blood cholesterol, normal blood pressure, normal weight and no sign of diabetes.

Using data from the U.S. National Health and Nutrition Examination Surveys, the study found that in 1971 to 1975, a paltry 4.4 percent of adults had all five of these heart-healthy factors. However, by 1994 that number had risen to 10.5 percent of adults. 

The latest data, from 2004, found that the fraction of American adults with all five healthy characteristics had dropped to 7.5 percent.  Minorities tended to fare worst, since whites tended to have more low-risk factors than either blacks or Mexican-Americans, the report found.

The reserachers identified three reasons for the backslide in health; decreases in the percentages of adults who were not overweight or obese, a decrease in those who had a favorable blood pressure, and an increase in the number who have diabetes.  There was one bright spot in the report, a decrease in the percentage of adults who were not currently smoking.

Because excess weight is a major cause of diabetes and hypertension, it is critical that the percentage of adults who are overweight or obese be reduced, the researchers noted.  "This alarming development is occurring despite great improvements in medical interventions to prevent cardiovascular diseases," he said. "It is of particular concern that these trends do not yet reflect the consequences of the current epidemic of childhood obesity."

If these trends continue, the recent gains in life expectancy in the U.S. will be lost, the medical experts noted.

The study was published in the Sept. 14 online edition of Circulation.

SOURCES: Earl S. Ford, M.D., M.P.H., U.S. Centers for Disease Control and Prevention, Atlanta; Rob M. van Dam, Ph.D., assistant professor, medicine, Harvard Medical School; Boston; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Sept. 14, 2009, Circulation, online.

Eating Red Meat Linked To Prostate Cancer

Men who consumer red meat or processed red meats may have a higher risk of developing prostate cancer than those who limit such foods.

Researchers at the National Cancer Institute report the findings of a major study.  Researchers followed more than 175,000 men for nine years.  Those who ate the most red and processed meats had heightened risks of developing any stage of prostate cancer, or advanced cancer in particular.  Prostate cancer is the most commong cancer in men according to the American Association for Critical Illness Insurance, followed by lung and colon. 

The findings which were reported in the American Journal of Epidemiology add to a conflicting body of research on meat intake and prostate cancer risk.   Prior studies have come to different conclusions.  However, medical experts generally consider the evidence linking red and processed meats to the disease to be limited and inconclusive. 

These latest findings do not settle the question. The researchers explain that they do suggest that processed red meats and high-heat cooking methods -- namely, grilling and barbecuing -- may be particularly connected to prostate cancer risk. 

The researchers followed 175,300 U.S. men between the ages of 50 and 71 who were surveyed about their diets.  Specifically, the study looked at how much and what type of meat the participants typically ate.  They also studied the cooking methods used.

The researchers used that information to estimate the levels of certain potentially cancer-promoting chemicals in the men's diets.  Over the next nine years, 10,313 study participants developed prostate cancer and 419 died from the disease. 

Overall, the researchers found, the 20 percent of men with the highest intakes of red meat, which in this study included beef and pork, were 12 percent more likely than those who consumed the least to develop prostate cancer. That's after a range of other factors, like smoking, exercise habits and education, were taken into account. 

There was a stronger connection to advanced prostate cancer -- with that risk being almost one-third higher among those who ate the most red meat versus those who ate the least. 

Similar findings were seen with processed meat. But when the researchers broke the men's diet information down further, they found that red processed meats -- like bacon and red-meat sausage and hot dogs -- were related to higher prostate cancer risk, while white processed meats, like poultry cold cuts, were not. 

When it came to cooking methods, the only one that was linked to prostate cancer was grilling or barbecuing.

The finding is in line with the theory that meats cooked at high temperatures may be particularly linked to cancer because the cooking process produces certain chemicals -- including polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines -- that are known to cause cancer in animals. 

The researchers also found that higher dietary levels of a PAH called benzo-alpha-pyrene were related to a higher risk of prostate cancer. A similar pattern emerged when the investigators looked at men's intake of nitrites and nitrates -- chemicals used to preserve and flavor processed and cured meats like ham, bacon and sausage.  In the body, nitrites and nitrates can promote the production of potentially cancer-promoting chemicals called nitrosamines.

Obesity Causes 100,000 U.S. Cancer Cases

Obesity causes more than 100,000 cases of cancer in the United States each year according to a report from the American Association for Critical Illness Insurance, creating a greater financial strain on health insurance companies and American families. 

Researchers estimate that obesity-related diseases account for nearly 10 percent of all medical spending in the United States or an estimated $147 billion a year.  Cancer is the second-leading cause of death in the United States after heart disease. The American Cancer Society reports that nearl 1.5 million people will be diagnosed with cancer this year and 562,000 will die of the disease. 

Medical researchers at the American Institute for Cancer Research reported that having too much body fat causes nearly half the cases of endometrial cancer, which is a type of cancer of the uterus.  Too much body fat they note was also responsible for one third of esophageal cancer cases.

The researchers expect the number of cancer cases will likely rise as Americans get fatter.  Nearly a third of Americans are overweight, defined as having a BMI of 25 to 30.  

More than 26 percent of Americans are obese, defined as having a body mass index of 30 or higher. BMI is equal to weight in kilograms divided by height in meters squared. A person 5 feet 5 inches tall becomes obese at 180 pounds (82 kg). 

The American Institute for Cancer Research reported the percented of cancer cases that would be prevented if everyone in the United States maintained a healthy weight.  Here are some of its estimates of cancer types that could be prevented annually if Americans stayed slender:

Endometrium - 49 percent of cases or 20,700 people

Esophageal - 35 percent of cases or 5,800 people

Pancreatic - 28 percent or 11,900 people

Kidney - 24 percent or 13,900 people

Gallbladder - 21 percent or 2,000 people

Breast - 17 percent or 33,000 people

Colon - 9 percent or 13,200 people

 

Race, Income, Marital Status Has No Impact On Prostate Cancer Outcome

A patient's income, martial status and race has absolutely no impact on their outcome following curative radiation therapy for the treatment of prostate cancer.

A study conducted at the Henry Ford Hospital in Detroit found that socioeconomic status factors had no impact on predicting the outcome of treatment. All patients did equally well, based on the known prognostic factors.

The study, presented this week at the American Society for Radiation Oncology meeting in Chicago is unique in that nearly 50 percent of patients in the analysis are African American.

Prostate cancer affects one in six men in the United States according to the American Association for Critical Illness Insurance and the majority of all prostate cancer are diagnosed in men older than 65.  Most individuals diagnosed with the illness will survive.  Only one in 35 will die of prostate cancer.   Radiation therapy involves administering high-energy X-rays to kill cancer cells. 

According to the study's lead researcher, prior studies on socioeconomic status and cancer outcomes done by other groups have had conflicting results.  One study, for example, suggested that African Americans with breast or colon cancer do much worse than white patients because they receive care at hospitals with less expertise. 

Another study the medical experts noted show that men with prostate cancer who are married have better outcomes than those who are unmarried or without a partner. And yet other studies suggested that hospitals with large minority patient populations have higher mortality for cancer.

A shortcoming of many of the studies is the fact that they include a relatively small percentage of African American patients.  By comparison, almost half of the Ford study group was African American, which allowed researchers to undertake a more accurate assessment of how socioeconomic status affects prostate cancer outcomes.

The study included 788 Henry Ford Hospital patients with localized prostate cancer who were treated with external beam radiation therapy. Among those in the study, 48.5 percent were African American with a median household income $36,917, and 46 percent were white with a median household income of $60,190. The patients' ages ranged from 44 to 90.

While there was a large difference in median household income among African Americans and whites, none of the socioeconomic factors examined predicted for patient outcome. Only known disease risk factors determined overall survival or biochemical (PSA) control rates.

Low Cholesterol Could Be Sign Of Cancer In Men Especially

Low total cholesterol may be a sign of cancer according to researchers.

Previously, some medical experts had thought that low cholesterol may have been a cause.  According to researchers reporting this week, findings suggest that men who have low cholesterol actually have a lower risk of developing high-risk prostate cancer.

There were some 1.4 million cancer cases in the United States last year according to the American Association for Critical Illness Insurance.  The cost of caring for medical conditions caused over 60 percent of the 1.5 million Americans to declare bankruptcy. 

A study of more than 5,000 U.S. men conducted by Johns Hopkins University in Baltimore found a link between low cholesterol and a lower risk of high-grade prostate cancer among men over age 55.

The researchers report that if men had total cholesterol of less than 200 milligrams/deciliter, they had a nearly 60 percent lower risk of developing high-grade prostate cancer, the riskiest kind. 

It is not clear whether taking cholesterol-lowering statin drugs might help men with prostate cancer. That would need to be studied, the medical experts noted.  The study was reported in the journal Cancer Epidemiology, Biomarkers & Prevention. 

For years, researchers had noticed that people who have lower total cholesterol -- a combination of both low-density lipoprotein or LDL, the "bad" kind, and high-density lipoprotein or HDL, the "good" kind -- appeared more likely to have certain types of cancers than other people. 

They report this finding was worrisome because having low cholesterol, and particularly low levels of "bad" LDL cholesterol, has been shown to protect against heart attacks and strokes. 

An expert at the National Cancer Institute, part of the National Institutes of Health, said in a statement, "The study affirms that lower total cholesterol may be caused by undiagnosed cancer.  In terms of a public health message, we found that higher levels of 'good' cholesterol seem to be protective for all cancers." 

An 18-year study of nearly 30,000 Finnish male smokers, the largest and longest of its kind, found that over the nearly two decades some 7,545 men developed cancer.  The men with lower total cholesterol levels -- below 230 milligrams/deciliter -- had an 18 percent higher risk of cancer overall. 

But, when the researchers excluded cancers that occurred in the first nine years of the study, this risk disappears.  The findings the researchers notes support the idea that the lower serum total cholesterol level we detected as a possible cancer risk factor may actually have been the result of undiagnosed cancers.

Study Reports Cholesterol Medicines Effective Against Cancer

Research shows that medicines based on statins used to lower blood cholesterol may also be effective in the treatment of cancer.

Statins lower cholesterol by blocking certain enzymes involved in metabolism.   Medical experts note that  they have also been shown to help proteins attach to cell membranes.  Because many of the proteins that are lipid-modified cause cancer, there are now hopes that it will be possible to use statins in the treatment of cancer.

Researchers at the University of Gothenburg, Germany, conducted studies that show statins can have a dramatic inhibitory effect on growth and development.  The researchers note that their results support the idea that statins can be used in more ways than just to lower cholesterol.  Not least that they can prevent the growth of cancer cells caused by lipid-modified proteins, but also that they can be effective in the treatment of diabetes and neurological disorders such as Parkinson's. 

The findings were published in the article Statins Inhibit Protein Lipidation and Induce the Unfolded Protein Response in the Non-Sterol Producing Nematode C. elegans, published in the journal PNAS.  The study is the result of a research partnership between the University of Gothenburg, Chalmers University of Technology.

Information on critical illness is gathered and posted by the American Association for Critical Illness Insurance, the national trade organization focused on helping individuals understand the importance of protecting their financial futures.

Low Vitamin D Linked To Heart, Stroke Deaths

Low vitamin D levels in the may be deadly causing a higher risk of death from heart disease or stroke.

According to the American Association for Critical Illness Insurance, the non-profit industry organization, some 785,000 Americans will have a new coronary attack this year.  From 1995 to 2005, the death rate from coronary heart disease declined 34 percent. 

The new study published in the American Journal of Epidemiology reports that adults with lower, versus higher, vitamin D levels in their blood may be more likely to die from heart disease or stroke.

Vitamin D is an essential vitamin mostly obtained from direct sunlight exposure, but also found in foods and multivitamins. Researchers at the National Institute for Health and Welfare in Helsinki, Finland compared blood levels of vitamin D and deaths from heart disease or stroke over time in several thousand men and 3,402 women.

Participants were just over 49 years old on average at the beginning of the research and had no indicators of cardiovascular disease. During follow-up of about 27 years on average, 640 of the participants (358 men) died from heart disease and another 293 (122 men) died from stroke. Compared with participants' with the highest vitamin D, those with the lowest had 25 percent higher risk of dying from heart disease or stroke, the researchers noted.

There was a "particularly striking association" between vitamin D levels and stroke deaths, they explain. Those having the lowest vitamin D seemed to confer "twice the risk," compared with those having the highest vitamin D. Allowing for age, gender, and other demographic factors, plus alcohol intake, smoking, physical activity, and season in which vitamin D levels were obtained did not significantly alter these associations.

In this study, vitamin D levels were "substantially lower" than levels thought to be sufficient, and "somewhat lower" than those reported in previous studies in other European and American populations.

High-def Colonoscopy Detects More Polyps

A high-definition (HD) colonoscopy is much more sensitive than standard colonoscopy in finding polyps that could morph into cancer.

According to researchers from the Mayo Clinic it appears that high-definition colonoscopy detects more precancerous polyps. The difference could be as much as 20 percent.

Approximately 14 million colonoscopies are performed each year according to the American Association for Critical Illness Insurance, the industry organization that tracks and reports data related to critical illnesses. Some 745,000 men were diagnosed with cancer each year, roughly 10 percent with colon cancer.

 A study was conducted between September 2006 and December 2007 when the Mayo Clinic in Florida was switching its six colonoscopy procedure rooms from standard colonoscopy endoscopes to high-definition endoscopes.

The findings, presented at the annual meeting of the American College of Gastroenterology in San Diego, Calif., are not only important because a large group (2,430) of patients participated, but they resulted from the only study to date that has compared these two methods in a general clinical practice setting, among all the patients who needed a colonoscopy and with all the physicians who performed it.

An endoscope is the lighted tube inserted into the colon and rectum to look for, and remove, polyps. A high-definition endoscope uses both a high-definition video chip and HD monitors (like HD television) that increase the resolution of the image. Patients were not assigned to one scope or the other. Instead, they were placed in whatever room was available and assigned a gastroenterologist who was on duty at the time.

Researchers found that the rate of detection of adenomas -- polyps that are likely to become cancerous -- was 29 percent among patients who were scanned with high-definition endoscopes, versus 24 percent for those in which standard endoscopes were used.

The study was funded by Mayo Clinic, and the authors declare no conflict of interest nor do they endorse the products mentioned in the study.

Fitness Level, Not Body Fat, Stronger Predictor Of Longevity After 60

Want to live longer?  Focus on fitness.  A study reveals that adults over age 60 who had higher levels of cardiorespiratory fitness lived longer than unfit adults, independent of their levels of body fat. 

Prior studies have provided evidence that obesity and physical inactivity each can produce a higher risk of death in middle-aged adults. Whether this is also true for older adults is uncertain, according to background information in the article.

According to the American Association for Critical Illness Insurance, which tracks important developments and news that can help Americans remain healthy and avoid critical illness including heart disease, stroke and cancer, Medical researchers at the University of South Carolina, Columbia examined the associations between cardiorespiratory fitness, various clinical measures of adiposity (body fat) and death in older women and men. The study included 2,603 adults age 60 years or older (average age, 64.4 years; 19.8 percent women) enrolled in the Aerobics Center Longitudinal Study who completed a baseline health examination during 1979-2001. Fitness was assessed by a treadmill exercise test and adiposity was assessed by body mass index (BMI), waist circumference, and percent body fat. Low fitness was defined as the lowest fifth of the sex-specific distribution of treadmill exercise test duration. There were 450 deaths during an average follow-up of 12 years. 

The researchers found that those who died were older, had lower fitness levels, and had more cardiovascular risk factors than survivors. However, there were no significant differences in adiposity measures. Participants in the higher fitness groups were for the most part less likely to have risk factors for cardiovascular disease, such as hypertension, diabetes, or high cholesterol levels. 

Fit participants had lower death rates than unfit participants within each stratum of adiposity, except for two of the obesity groups. In most instances, death rates for those with higher fitness were less than half of rates for those who were unfit. 

Higher levels of fitness were inversely related to all-cause death in both normal-weight and overweight BMI subgroups, in those with a normal waist circumference and in those with abdominal obesity, and in those who have normal percent body fat and those who have excessive percent body fat. 

The data provided further evidence regarding the complex long-term relationship among fitness, body size, and survival. It may be possible to reduce all-cause death rates among older adults, including those who are obese, by promoting regular physical activity, such as brisk walking for 30 minutes or more on most days of the week (about 8 kcal/kg per week), which will keep most individuals out of the low-fitness category. Enhancing functional capacity also should allow older adults to achieve a healthy lifestyle and to enjoy longer life in better health, they noted.

 

Women Have More Heart Attacks; Survival More Likely

Hearts attacks among middle-aged American women have increased over the past two decades.  That news is accompanied by a report that their chance of survival has improved.

Two new studies reveal that men still have a higher prevalence of heart attack than women.  Medical researchers report that the gap has narrowed as heart attacks among women have increased while they have decreased among men.

A study by researchers at the University of Southern California revealed that 2.5 percent of the men and 0.7 percent of the women reported a history of heart attacks in the prior surveys.  In the more recent study, they found 2.2 percent of men and 1 percent of women reported heart attacks.

 Every 34 seconds an American will suffer a heart attack according to the American Association for Critical Illness Insurance.  Some 785,000 Americans will have a new coronary attack and nearly half a million will have a recurrent attack. 

The narrowing of the male-female difference is easily explained, according to medical experts.  They point to the fact that risk factors are being better controlled in men than in women.  In men, levels of "bad" LDL cholesterol remained the same between the two surveys, while levels of "good" HDL cholesterol improved. Blood pressure levels improved, and fewer men smoked. 

Researchers noted that the improvements for women were marginal, with LDL cholesterol levels about the same. The only risk factor that improved in women was HDL cholesterol. Diabetes and obesity increased in both men and women, the study found. 

They noted that societal changes may play a role.  With more women in the work force, rising rates of obesity and diabetes can be attributed to job demands.   

A second study used information from a different data bank listing death rate trends from 1994 to 2006. Researchers found a marked reduction in hospital deaths from heart attacks in all patients, especially among women. For women under 55, the risk of dying dropped by 53 percent, which was the greatest improvement noted. The least reduction, 33 percent, was seen in men under 55. 

The studies are reported in the October 26 issue of Archives of Internal Medicine.

 

Drinking Coffee May Slow Development Of Liver Disease

Coffee slows the progression of advanced liver disease in people with chronic hepatitis C.

New research published in the November issue of the journal Hepatology reveals information on the first study to address the association between liver disease progression related to hepatitis C and coffee intake. 

Researchers studies nearly 800 patients infected with hepatitis C virus (HCV) who were asked to report their intake of coffee, green tea and black tea. The patients were seen every three months during the nearly four-year study, and liver biopsies were taken at 18 months and 3.5 years to determine the progression of liver disease. 

Patients who drank three or more cups of coffee per day were 53 percent less likely to have liver disease progression than those who didn't drink coffee. Green and black tea didn't appear to have an effect, but tea consumption was low among the study participants, the researchers noted in the report. 

Given the large number of people affected by HCV, the researchers noted the importance of identifying modifiable risk factors associated with the progression of liver disease.  Although we cannot rule out a possible role for other factors that go along with drinking coffee, results from our study suggest that patients with high coffee intake had a lower risk of disease progression, the study concluded.

HCV infects about 2.2 percent of the worldwide population, including more than 3 million Americans according to the Ameriocan Association for Critical Illness Insurance. The virus is the leading cause of liver transplantation in the United States and is responsible for 8,000 to 10,000 deaths in the country each year, according to the U.S. Centers for Disease Control and Prevention.

Researchers Report Tie Between Depression And Chronic Kidney Disease

A new study finds that one in five patients with chronic kidney disease is depressed, even before beginning long-term dialysis therapy or developing end-stage renal disease.

Researchers at UT Southwestern Medical Center conducted the first study to examine the relationship. 

Medical experts have noted that patients in the early stages of chronic kidney disease are at increased risk for clinical depression according to the study in the current issue of the American Journal of Kidney Diseases.

Previous research has shown that depression rates in the general community are 2 percent to 4 percent.  Among diabetes patients, the rate is 11 percent.  Among congestive heart failure patients, 14 percent; and among coronary artery disease after heart attack patients, 16 percent.

Chronic kidney disease patient depression numbers may be higher due to the presence of the same simultaneously occurring conditions that resulted in progressive kidney disease, such as diabetes and atherosclerotic vascular disease, one of the researchers noted.  Patients such as diabetics, who are depressed, may develop progressive kidney disease because of non-adherence to medications and physicians' advice.

From May 2005 to November 2006, researchers invited patients at the Dallas VA Medical Center who were visiting the clinic for chronic kidney disease appointments to join the study. Patients who agreed to participate then underwent a structured clinical interview to determine if they had a current major depressive episode, based on the DSM IV definition of major depressive disorder.

Some 21 percent were found to be depressed. The mean age of depressed patients was about 65.  The researchers also found that diabetic patients were twice as likely to be depressed as those without diabetes; 63 percent of patients had at least three other medical conditions; and 41 percent had at least four other diseases.

According to the American Association for Critical Illness Insurance, some 26 million Americans have chronic kidney disease and millions more are at increased risk. If treatment does not begin early, the condition progresses to end-stage renal disease. At that point, a patient's kidneys have failed to the point where dialysis is needed.  Dialysis involves filtering of toxic chemicals in the blood and removing fluid to help control blood pressure.

Expenditures for end-stage renal disease patients totaled $15.5 billion, which is approximately 6 percent of the entire Medicare budget, and are projected to consume $28 billion by 2010.

Protein May Predict Heart Attack

October 21, 2009.  People with high levels of a protein called C-reactive protein may be at higher risk for heart attack. 

According to a study published in the medical journal of the American Academy of Neurology the C-reactive protein (CRP), a marker for inflammation in the blood, may predict those at higher risk for heart attack and death but not stroke.

 The study involved over 2,200 people who were 40 years old or older and stroke-free.  All participants had their blood tested for CRP levels and were evaluated for stroke and heart attack risk factors.

Participants were followed for an average of eight years. In that time, there were 198 strokes, 156 heart-related events and 586 deaths.  The group was comprised of 63 percent Hispanic, 20 percent non-Hispanic black and 15 percent non-Hispanic white residents.

The study's researchers found that people with CRP levels greater than three milligrams per liter were 70 percent more likely to suffer a heart attack and 55 percent more likely to die early compared to people who had levels of one milligram per liter or less of the protein in their blood. The protein was not associated with an increased risk of stroke once other risk factors were taken into account.

Prior studies have found the C-reactive protein to be a marker for predicting risk of heart disease.  CRP protein levels are associated with such medical and lifestyle risk factors as diabetes, smoking, alcohol consumption and physical activity.   A lead researcher noted that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death.

The study was supported by the National Institutes of Health.  Reported by Jesse Slome, American Association for Critical Illness Insurance.