News Author: Megan Brooks
CME Author: Désirée Lie, MD, MSEd

 

GoogleNews.com, Medscape.com, November 10, 2009 – Treatment with statins in patients with chronic obstructive pulmonary disease (COPD) was associated with a reduced risk of death from extrapulmonary cancer in a Dutch study.

Although COPD has a well-known association with lung cancer, its relationship with extrapulmonary cancers is less well defined, and furthermore, “it is not known whether the risk of COPD and cancer mortality can be modulated by pharmacologic treatment,” Dr. Don Poldermans, from Erasmus Medical Center in Rotterdam told Reuters Health in an email.

“Several studies suggest that statins may reduce the risk of cancer while others have suggested that statins may promote the development of new carcinomas,” Dr. Poldermans added.

To investigate, he and his colleagues studied 3,371 patients with peripheral arterial disease who underwent elective vascular surgery between 1990 and 2006.

According to their report in the November issue of Thorax, the largely male cohort (73%) included 1,310 patients with COPD. COPD was characterized as mild in 578, moderate in 579, and severe in 153. At baseline, 810 subjects were using statins, including 26% of the current smokers and 23% of the never/ex-smokers (p = 0.20). The average age of study participants was 66 years.

During a median follow-up of 5 years, 316 patients (9%) died from cancer. The risk of cancer mortality in patients with no, mild, moderate and severe COPD was 8%, 10%, 14%, and 12%, respectively (p<0.001).

One hundred two patients died from lung cancer. The risk of lung cancer mortality with no, mild, moderate and severe COPD was 2%, 3%, 5%, and 6%, respectively (p < 0.001).

COPD was independently associated with total cancer mortality, with a hazard ratio of 1.61, and the hazard ratio between COPD and lung cancer mortality was even higher (HR, 2.06). This association, the authors point out, was largely driven by the group of patients with moderate and severe COPD (FEV1 < 80% predicted), which were both strongly related to lung cancer mortality (HR, 2.51 and 3.38, respectively).

“As the risk increases with disease severity, it is important to prevent deterioration of pulmonary function by reducing risk factors associated with COPD,” Dr. Poldermans said.

COPD was also associated with an increased risk of death from extrapulmonary cancer, with a hazard ratio of 1.43. The relationship was significant for moderate COPD (HR, 1.70), but not for severe COPD (HR, 1.38), “probably due to competing risks for mortality,” nor for patients with mild COPD (HR, 1.22).

Dr. Poldermans and his colleagues also report a trend toward a lower risk of cancer mortality among patients with COPD who used statins compared with patients with COPD who did not (HR, 0.57).

“Interestingly,” Dr. Poldermans said, “statins were even related to reduced risk for extrapulmonary cancer mortality” in COPD patients (HR, 0.49).

Overall, according to the report, 6% of statin-treated patients and 11% of no-statin patients died from cancer during the follow-up period. After excluding patients with lung cancer, 4% of statin users and 7% of non-statin-users died from extrapulmonary cancers.

COPD is a worldwide epidemic, the researchers point out in their report. The findings from this study, they add, suggest that statins may be effective in reducing deaths, especially from extrapulmonary cancers, in COPD patients.

The findings, they note, are in line with previous epidemiological studies that have suggested that statins may lower cancer risk.

However, “randomized controlled trials are needed to confirm our findings,” Dr. Poldermans said.

Thorax. 2009;64:963-967.

The-Scientist.com, November 10, 2009, by Jef Akst  —  Scientists have figured out how stress experienced early in life can cause long-lasting changes in physiology and behavior — via epigenetics.

Specifically, early stress appears to induce epigenetic changes in a specific regulatory region of the genome, affecting the expression of a hormone important in controlling mood and cognition into adulthood, according to a study published online today (November 8) in Nature Neuroscience.

This is the first study to depict a molecular mechanism by which “stress early in life can cause effects that remain later in life,” said epigeneticist Moshe Szyf of McGill University in Montreal. “This can explain a lot of things that happen to us as humans and our behavior later in life.”

Stress endured early in life can influence the quality of physical and mental health in adulthood, such as by causing hormonal alterations associated with mood and cognitive disorders. But until now, scientists did not understand the mechanism by which early life experiences can produce such long-lasting effects.

According to a common hypothesis, the environment affects mental heath by causing alterations to the physical properties of the genome that influence gene expression — the epigenome. Indeed, research suggests that DNA methylation, one of the most intensely studied forms of epigenetics, may explain why maternal care has a long-term influence on behavior and hormones in rats.

To explore whether DNA methylation is behind the changes associated with stress experienced early in life, molecular biologists Chris Murgatroyd and Dietmar Spengler of the Max Planck Institute of Psychiatry in Germany and colleagues examined the methylation patterns of mice that were separated from their mothers for three hours a day for the first ten days of their lives. Specifically, the researchers looked for differences in the gene that encodes arginine vasopressin (AVP), a hormone associated with mood and cognitive behaviors. The AVP receptor is also a promising therapeutic target for stress-related disorders.

From 6 weeks of age all the way up to 1 year, mice that experienced early stress — and showed the predicted behavioral and hormonal differences — also displayed significantly lower levels of methylation in the regulatory region of the Avp gene in the brain. This hypomethylation was specific to a subset of neurons in the hypothalamic paraventricular nucleus — a brain area involved in regulating hormones linked to stress. These mice also had higher levels of Avp mRNA, suggesting that lower methylation levels do indeed affect hormone levels.

“Essentially the genome memorizes that [early life] stress,” said Szyf, who was not involved in the study. “Stress changes methylation, and that stays the whole life.”

The researchers further determined that the decreases in methylation in stressed mice result from the inactivation of a protein known as MeCP2, which is involved in the initial recruitment of proteins that methylate the DNA.

The concept that social states in early life can affect health in later life is “a completely revolutionary idea,” Szyf said. This paper provides a “detailed” molecular mechanism by which this can occur, and “gives substance” to this theory.

Understanding the molecular details underlying this phenomenon is essential to developing potential therapies for mental disorders that stem from early adverse experiences, Murgatroyd added. “This has given us new insight in how to possibly develop drugs for [these illnesses].”

Treatments for reversing the effects of early life stress should begin as early as possible, Spengler said. Reversing the inactivation of MeCP2 might be possible, but “once [methylation] is laid down, you cannot erase [it],” he said. “This is a mark that is very stable.” Treatments given later in life, then, must find ways to ameliorate the phenotype, such as by blocking AVP receptors in animals with higher AVP levels, he added.

Laurie Barclay, MD

 

GoogleNews.com, Medscape.com, November 10, 2009 – Posttraumatic stress disorder (PTSD) is linked to patient-reported cardiovascular health status in patients with heart disease, according to the results of a cross-sectional study reported in the November issue of Archives of General Psychiatry.

“…PTSD is increasingly recognized as a cause of substantial disability,” write Beth E. Cohen, MD, MAS, from University of California-San Francisco, and colleagues. “In addition to its tremendous mental health burden, PTSD has been associated with worse physical health status and an increased risk of cardiovascular disease.”

The goal of this study was to evaluate whether PTSD is associated with cardiovascular health status in patients with heart disease and whether this association is independent of cardiac function. The study sample was 1022 men and women with coronary heart disease enrolled in The Heart and Soul Study, a prospective cohort study of psychological factors and health outcomes in adults with stable cardiovascular disease.

The Computerized Diagnostic Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was used to detect PTSD, and stress echocardiography allowed evaluation of cardiac function in left ventricular ejection fraction, treadmill exercise capacity, and inducible ischemia. The symptom burden, physical limitation, and quality-of-life subscales of the Seattle Angina Questionnaire allowed determination of disease-specific health status. The association of PTSD with health status was examined with ordinal logistic regression, after adjustment for objective measures of cardiac function.

Current PTSD was diagnosed in 95 (9%) of the 1022 participants. These patients were more likely to report at least mild symptom burden (57% vs 36%), mild physical limitation (59% vs 44%), and mildly decreased quality of life (62% vs 35%; all P ≤ .001). PTSD was still independently associated with these outcomes after adjustment for cardiovascular risk factors and objective measures of cardiac function. Odds ratios were 1.9 for symptom burden (95% confidence interval [CI], 1.2 – 2.9; P = .004), 2.2 for physical limitation (95% CI, 1.4 – 3.6; P = .001), and 2.5 for worse quality of life (95% CI, 1.6 – 3.9; P < .001). After exclusion of participants with depression, findings were similar.

Limitations of this study include cross-sectional design, precluding determination of causality; study sample of mostly older men with cardiovascular disease, limiting generalizability to other populations or comorbid physical diseases; and lack of data on duration or severity of PTSD symptoms.

“Among patients with heart disease, PTSD is more strongly associated with patient-reported cardiovascular health status than objective measures of cardiac function,” the study authors write. “Future studies should explore whether assessing and treating PTSD symptoms can improve function and quality of life in patients with heart disease.”

The Heart and Soul Study was funded by the Department of Veterans Affairs; the National Heart, Lung, and Blood Institute; the American Federation for Aging Research; the Robert Wood Johnson Foundation; the Ischemia Research and Education Foundation; and the Nancy Kirwan Heart Research Fund. Dr. Cohen was supported by a National Institutes of Health/National Center for Research Resources University of California, San Francisco, Clinical and Translational Science grant and a Department of Defense/NCIRE grant. The other study authors have disclosed no relevant financial relationships.

The conclusions of the investigators are solely their responsibility and do not necessarily represent the official views of any of the funding agencies.

Arch Gen Psychiatry. 2009;66:1214-1220. Abstract

Authors and Disclosures

Journalist

Laurie Barclay, MD

Freelance writer and reviewer, MedscapeCME

Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

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AlterNet.com, November 9, 2009, by Sara Novak  —   More and more people are passing on meat for a wide variety of reasons. For starters, it reduces your impact on the planet. Some simply can’t bare the despicable factory farming industry in this country. And the third weighing issue on the minds of the more than 2.8 percent of the U.S. population that considers themselves vegetarian, are health issues. And studies show that there are plenty of them.

Sicknesses Associated With Eating Meat

1. Prostate Cancer

According to a study published in the Journal of Epidemiology, researchers examined the dietary habits of 175,313 middle-aged men and followed them for nine years. They discovered that men who ate a diet heavy in red meat and processed meats were diagnosed with prostate cancer more often than men who ate little meat. “HCAs, a family of mutagenic compounds, are produced during the cooking process of many animal products, including chicken, beef, pork, and fish,” the article said. And this is not reserved for a well done steak. The mutagens form when meat is cooked at a normal level and it is present in grilling, frying, or broiling. It appears to grow worse as the meat is cooked longer. In the end, the consumption of meat increased the risk of prostate cancer by 12 percent.

2. Heart Disease
More than 864,480 Americans died of heart disease in 2005, according to the American Heart Association. And according to a study at Beth Israel Deaconess Medical Center (a teaching hospital for Harvard), heart disease is directly related to meat consumption. The study involved 617,119 men and women who were 50 to 71 years old at the start of the study. At the beginning of the study, patients filled out diet information surveys and 10 years later deaths from cardiovascular disease were noted.

Results of the Study:

“Compared to people in the lowest levels of red meat consumption (average 0.32 ounces per 1000 calories), men with the highest levels of red meat consumption (average 2.39 ounces per 1000 calories) experienced a 27 percent higher risk of cardiovascular disease.

For women with the highest levels of red meat consumption (average 2.32 ounces per 1000 calories) the results were even more dramatic. They experienced a 50 percent higher risk of cardiovascular disease.”

3. Osteoporosis
A group of studies done at the Cornell-China-Oxford Project on Nutrition Health and Environment, by nutritional biochemist T. Colin Campbell and his colleagues, links bone density with meat consumption. The less meat that you eat the less you’ll experience a loss in bone density as you age. Osteoporosis is a reduction in bone density that occurs as we age and in turn causes bone fractures and breaks in older individuals. The disease impacts 25 million Americans, 80 percent of whom are women. According to Campbell, the study is a great explanation for why Americans, who include more calcium in their diets than Asian cultures, have five times the rate of osteoporosis compared with many Chinese and other Asians. Our much larger meat consumption rate is working against us.

4. Kidney Stones
Kidney stones are deposits that form in your kidneys in varying sizes. They are a common problem, but can be super painful. Kidney stones range in size from that of a grain of sand to the size of a marble or larger. According to Physicians Desktop Reference, foods that are high in protein, such as meat could, “encourage the formation of kidney stones.”

5. Food-borne Illnesses
Food-borne illnesses have been swirling through the news all year long and it hasn’t been pretty. The New York Times wrote that according to the Centers for Disease Control and Prevention, poultry is the number one source of food-borne illness. It doesn’t matter how much antibiotics they pump into an abused chicken population because even still up to 60 percent of chickens sold at the supermarket are infected with live salmonella bacteria.

6. Pancreatic Cancer
High intake of dietary fats from red meat and dairy products is associated with a higher risk of pancreatic cancer, according to a study published in the Journal of the National Cancer Institute.

“[W]e observed positive associations between pancreatic cancer and intakes of total, saturated, and monounsaturated fat overall, particularly from red meat and dairy food sources,” the authors write. “Altogether, these results suggest a role for animal fat in pancreatic carcinogenesis.”

 

7. Type 2 Diabetes in Women
A study done on women by the American Diabetes Association, found that there was a positive relationship between meat consumption and instances of Type 2 Diabetes. The study documented 1,558 recorded cases of Type 2 diabetes. After adjusting for age, BMI, total energy intake, exercise, alcohol intake, cigarette smoking, and family history of diabetes, “our data indicates that higher consumption of total red meat, especially various processed meats, may increase risk of developing Type 2 diabetes in women.”

ZDNet.com, November 10, 2009, by Chris Jablonski  —  LaserMotive, a Seattle-area company specializing in laser power beaming, has claimed a $900,000 prize with their photovoltaic-powered machine that has climbed nearly 3,000 feet (1 km) at an average speed greater than 2 meters per second, or just over four minutes.

With a payload in tote, the robotic climbed a long cable suspended from a helicopter to test ideas that can potentially lead to the realization of space elevators.

The accomplishment took place on the first day of the Power Beaming competition in the 2010 Space Elevator Games at NASA’s Dryden Flight Research Center in California’s Mojave Desert.

While the LaserMotive team fell short of reaching NASA’s top-level prize of up to $2 million for climbing the entire length of the cable in three minutes or less (about five meters per second), they still hold bragging rights as the first in the 3-year history of NASA’s space elevator contest to climb a 2,953-foot-long ribbon.

Here is a video of one of LaserMotive’s attempts:

Be very patient while watching this video.

The company doesn’t have plans to use the technology to access space via an elevator climbing a cable, but rather to develop a business based on the idea of beaming power. In fact, the prize will serve as seed money to develop technology and system prototypes for use in aerospace and other industries. For instance, it can potentially be used to provide power to remote areas of military bases or to operate electrically powered unmanned aircraft for extended periods.

Here are additional sources covering the story:

CBS News.com, SmartPlanet, The 2009 Space Elevator Games Blog, PhysOrg.com