A report from The Netherlands adds to the evidence tying chronic gum disease to heart disease and stroke.

In a study of more than 60,000 dental patients, those with gum disease were twice as likely to have had a heart attack, stroke or severe chest pain.

Previous studies have linked periodontitis and clogged arteries, but this is the first to investigate the link in a group of people this large, the researchers say.

At the Academic Centre for Dentistry Amsterdam, the largest dental school in the Netherlands, investigators reviewed the medical records of 60,174 patients age 35 and older, looking for an association between periodontal gum disease and atherosclerotic cardiovascular diseases such as angina, heart attack and stroke.

About 4 percent of patients with periodontitis had atherosclerotic cardiovascular disease, compared to 2 percent without periodontitis, the researchers found.

Even after taking other risk factors for cardiovascular disease into account, such as high blood pressure, high cholesterol, diabetes, and smoking, those with periodontal disease were still 59 percent more likely to have a history of heart problems, according to a report in the Journal of Epidemiology and Community Health.

In periodontal disease, the advanced stage of the gum disease gingivitis, the gums pull away from the teeth and create pockets that can become infected. Periodontitis has also been tied to other conditions such as skin disease and dementia.

“It’s clear that periodontitis is associated with chronic inflammation, so it makes sense biologically that if you have a heavy infection in your mouth, you also have a level of inflammation that will contribute to heart conditions,” said Panos Papapanou of Columbia University in New York, who has studied the association between gum disease and heart disease but wasn’t involved in the current study.

The research team suggests that gum disease develops first and may promote heart disease through chronic infection and bacteria in the circulatory system.

Dr. Bruno Loos, the senior author of the new report, said by email that “plausible mechanisms to explain the relationship” may include a common genetic background for the way the body handles inflammation, oral bacteria and immune responses.

Still, this kind of observational study can’t prove that gum disease causes heart problems.

“The association … does not provide proof (of causation), even when the results from our study corroborate findings from previous similar research,” study coauthor Geert van der Heijden said by email.

Papapanou told Reuters Health that while the new findings are from patients with a relatively high socioeconomic status, “we’re repeatedly seeing the same conclusion.”

“It seems all over the globe we have to consider this relationship,” Loos said.

In the U.S., heart disease is the leading cause of death, according to the Centers for Disease Control and Prevention. Each year, more than 600,000 people die from heart disease, which accounts for one in four deaths.

Dr. Frank Scannapieco, chairman of the Department of Oral Biology at the University at Buffalo in New York, who wasn’t involved with the study, commented to Reuters Health that while the association of periodontitis and coronary disease is “robust,” the strength of the link is “moderate compared to traditional risk factors such as hypertension.”

Papapanou advises: “Take care of your oral health for oral health itself. If you know there’s a positive association between oral health and other diseases, would you ignore it? I wouldn’t.”

source: Reuters Health
http://www.reuters.com/article/us-health-gums-heart-idUSKCN10Y238

 

MRI images obtained in the case of an 18-year-old woman, first seen for rash at 10 weeks of pregnancy, with confirmed Zika virus infection, are seen in an undated handout picture released for a study on congenital Zika virus infection found in the Instituto de Pesquisa in... REUTERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

   

A report released on Tuesday shows in graphic detail the kind of damage Zika infections can do to the developing brain - damage that goes well beyond the devastating           birth defect known as microcephaly, in which the baby's head is smaller than normal.

The current Zika outbreak was first detected last year in Brazil, where the virus has been linked to more than 1,800 cases of microcephaly, which can cause severe developmental problems.

Prior research has shown the Zika virus attacks neural progenitor cells - a type of stem cell that develops into different types of nerve or brain cells.

The latest research, published in the journal Radiology, draws from imaging and autopsy findings linked with confirmed Zika infections done on 17 infants and fetuses cared for at the Instituto de Pesquisa, in Campina Grande in the state of Paraiba in northeastern Brazil, where the infection has been especially severe.

The study also included reports on 28 fetuses or newborns with brain anomalies whose mothers were suspected of having Zika during pregnancy.

Nearly all babies in each group had ventriculomegaly, a condition in which the ventricles, or fluid-filled spaces in the brain, are enlarged.

While most of the fetuses had at least one exam showing abnormally small head circumference, suggesting they had microcephaly, three of the fetuses with ventriculomegaly had normal head circumference, but severe ventriculomegaly.

Nearly all of the fetuses or babies in the confirmed Zika group and nearly 80 percent of those in the presumed Zika group also had abnormalities of the corpus callosum - a large bundle of nerves that facilitates communication between the left and right hemispheres of the brain.

In all but one of the cases studied, the researchers found instances in which developing neurons did not travel to their proper destination in the brain.

In many cases, the babies' skulls seemed to have collapsed on themselves, with overlapping tissues and abnormal skin folds suggestive of a brain that had stopped growing.

"From an imaging standpoint, the abnormalities in the brain are very severe when compared to other congenital infections,” said study co-author Dr. Deborah Levine of Beth Israel Deaconess Medical Center and a radiology professor at Harvard Medical School.

As with other reports, the paper suggests that Zika does the most harm in the first trimester of pregnancy. The researchers plan to keep following the cases to see what impact prenatal Zika infections have on future brain development.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

Zika is carried by mosquitoes, which transmit the virus to humans. A small number of cases of sexual transmission have been reported in the United States and elsewhere.

source: Reuters Health
http://www.reuters.com/article/us-health-zika-imaging-idUSKCN10Y28A

Among women aged 50 to 74, those without a high risk for breast cancer or dense breast tissue didn’t have an increase in breast cancer deaths if they went for mammography every three years instead of every two years.

But with dense breasts and a higher risk for these tumors, yearly mammograms were associated with fewer breast cancer deaths than screening every other year, researchers report in the Annals of Internal Medicine.

“Women at low risk and low breast density will experience more harms with little added benefit with annual and biennial screening compared to triennial screening, whereas women with dense breasts and high breast cancer risk may have added benefit from annual compared to biennial mammography,” lead study author Amy Trentham-Dietz of the University of Wisconsin-Madison said by email.

Doctors are conflicted about when and how often to recommend routine screening mammograms for women who don’t have lumps or discomfort in their breasts. Even though these exams can save lives, they can sometimes subject women to unnecessary and painful treatments that don’t find tumors or lower their risk of dying from cancer.

Last year, the American Cancer Society shifted its guidelines to encourage women to start annual screenings at 45 instead of 40 and to cut back to every other year once they turn 55.

The U.S. Preventive Services Task Force recommends mammograms every other year for women ages 50 to 74.

Worldwide, breast cancer is the most common malignancy in women. About one in nine women will eventually develop it, and the risk increases with age and when a woman’s mother, sister or daughter has been diagnosed with the disease.

Typically, if there is a suspicious area on a mammogram, women get additional imaging to rule out cancer, followed by a biopsy if more information is still needed to determine if the suspect cells are malignant. When the extra tests don’t find cancer, the mammogram result is considered a “false positive.”

For the current study, researchers estimated the odds of false positive mammograms, biopsies that didn’t find cancer and deaths averted based on age, cancer risk factors and breast density.

Compared with screening every two years, getting mammograms every three years could reduce false positives, biopsies and over-diagnosis without much effect on the number of cancer deaths averted for the majority of women – the ones with average cancer risk and lower breast density.

When women had a high risk of breast cancer, however, annual screening was better regardless of breast density, noted Dr. Christine Berg of Johns Hopkins University School of Medicine in Baltimore, who wrote an accompanying editorial.

However, “breast cancers are also more difficult to detect in dense breasts,” Berg added by email. “Therefore annual mammograms allow for comparison of subtle changes.”

The way women know if they have dense breasts is to get a mammogram - and density can change over time, noted Dr. Pamela DiPiro of the Dana Farber Cancer Institute in Boston.

“Annual mammography is a patient's best chance of detecting breast cancer early, with the known caveat that additional imaging, ultrasound or even a benign biopsy may be recommended,” DiPiro, who wasn’t involved in the study, said by email.

Still, the take-home message for women is complicated, said Dr. Kathryn Evers, director of mammography at Fox Chase Cancer Center in Philadelphia.

“There are numerous risk factors for breast cancer and women have different levels of comfort with the risks and benefits involved,” Evers, who wasn’t involved in the study, said by email.

“The fact that there are so many different recommendations regarding when and how often women should be screened points out that there are no definitive answers – women should talk to their doctors about what regimen will be best for them, taking all of these factors into account,” Evers added.

source: Reuters Health
http://www.reuters.com/article/us-health-mammography-dense-breasts-idUSKCN10X25W

Dr. Augusto D. Litonjua, president of the Philippine Center for Diabetes Education Foundation, Inc., that there are two major causes why this is: the increasing number of fast food joints and call centers.

He said call center work results in a wayward body rhythm that causes stress and internal confusion. The normal body clock has people awake in the day and asleep at night, but call center agents do the reverse since they have to process calls at night from the US and Europe where it is daytime. This reversal of the normal body clock stresses their bodies. “Stress precipitates diabetes,” said Dr. Litonjua. In addition, the lack of sleep causes people to overeat and choose the more convenient options: fast food.

“Fast foods are high in fat and are calorie-dense… Can we eliminate the fast food joints in the Philippines? No,” he said.

Dr. Litonjua was speaking at a press conference during Sweet Escape: Hataw Galaw on Aug. 12 at Quezon City’s Fisher Mall. The event, which promotes public awareness of diabetes, also featured the Sweet Escape: Hataw Galaw Intercollegiate Urban Dance Competition, a Zumba party, diabetes lay forums, exhibition booths, and games for people living with diabetes, families, advocacy and support groups, magazine readers and diabetes specialists.

GROWING NUMBERS
The World Health Organization (WHO) says diabetes is the fourth leading non-communicable disease in the world. Cardiovascular diseases top the list followed by cancer and respiratory diseases.

“We’re more afraid of dengue, HIV, Zika virus, and AIDS,” said Dr. Litonjua, “when many [more] people die of diabetes.”

According to the WHO data, 415 million people have diabetes worldwide. One third, or 150 million people, live in the West Pacific Region (WPR) which includes the Philippines and 20 other nations.

Over six million Filipinos have diabetes in the total population of more than 100 million, a disease prevalence of 6.1%. Projections say that by 2040, the numbers will swell by 215 million victims in the WPR area alone, and 12 million of these will live in the Philippines.

Worldwide, one person dies of diabetes every six seconds said Dr. Litonjua. He attributes the increasing number of diabetes victims to three “Ka”: katabaan (obesity), katakawan (gluttony); and katamaran (indolence).

Dr. Joy C. Fontanilla, editor in chief of DiabetEASE magazine and the head of the diabetes center of Asian Hospital and Medical Center, said those with a family history of diabetes, those who are overweight, the sedentary, smokers, and those who have hypertension are at greater risk. She suggests losing 5% to 7% of one’s body weight by doing at least 30 minutes of moderate exercise every day. Moderate, she says, is when you can still have a conversation but are too exhausted to sing a song.

Dr. Litonjua suggests that everyone — especially those who already have the disease and those on the borderline — exercise in cold places. When we exercise in a hot room, he said we only lose water, and gets the liquid back when we drink. But when we exercise in the cold, he said body fat burns easier.

And eat food rich in fiber and not in refined or white sugar.

source: Business World
http://www.weekender.bworldonline.com/2016/08/19/phl-is-losing-war-against-diabetes/