Be Healthy Human

Thursday 20 March 2014

Slow people die faster

According to a study published in PlosOne people whose reaction time is slow or variable are also more likely to die young. The followers of the slow would they be safe? In any case that suggests a study published in PlusOne , conducted by a team from University College London and the University of Edinburgh. Researchers have passed 5134 adults, aged 20-59 years, a simple test reactivity: it was to press a button when an image appeared on a computer screen. This type of measure, say the researchers, is a good indicator of cognitive abilities of individuals.

And unlike more complex exercises or require to make a choice, it has the advantage of not penalizing undecided or uneducated ... Participants were tested at fifty times without benefit of any prior training. Then the researchers followed them for fifteen years, during which 378 study participants (7.4%) died. Finding researchers: those with the time of the slower reaction at the beginning of the study, as were those whose reaction time varied from one test to another, who were also statistically were most likely to die young. The reflection of a worn central nervous system? The "slow" and had 25% risk of dying young (all causes of death combined) and inconsistent 36% additional risk, regardless of age, gender or ethnic origin. "The socio-economic status, lifestyle factors and cardiovascular risk proved explain partially, but not completely, these associations," the researchers said. Hypothesis raised by Dr Gareth Hagger-Johnson, who led the study: time to slow or variable response reflect a central nervous system deteriorates at the same time as the rest of the body.

Dr. Hagger-Johnson believes that if these results were confirmed by other studies, a simple test reactivity past a doctor could predict life expectancy. Remains unclear whether it is useful to know if you have more or less likely to die 15 years later ... Wisely, the author of the study agrees that "for the moment, a healthy lifestyle is the best thing that people can do to live longer. "

68 Prescribing drugs to be avoided

Specialized in pharmacology journal publishes in its January issue its updated to avoid drugs because of their side effects list. They are " drugs away for better care , "according to the magazine prescribe who does not hesitate to specify its target in its editorial: "Without waiting for the decisions of the authorities, patients and caregivers should choose to exclude care and prefer best proven treatments. " A call for patients and doctors to take things in hand, not always wait for the official decision. It must be said that the procedures for suspension or prohibition by the health authorities are often slow, especially when they require a European consensus. Protelos , one of the drugs contained in the blacklist Prescribing , the illustrates perfectly. For years Prescribing and other experts believe that the risk / benefit ratio of this drug was indicated in the osteoporosis is severe adverse. In 2011, the French Medicines Agency (MSNA) already asked European revaluation, before settling down to note the drug and reduce its reimbursement rates.

But it was not until January 10 that the reassessment finally enters the terminal phase, with a recommendation to suspend the European Pharmacovigilance Committee. However, it will take several weeks before it is effective. Subscribers doctors prescribe will probably not waited so long. The case study Probably as they have already banned their personal pharmacopoeia quinine (Hexaquinine, Okimus, Quinine vitamin C Grand) sometimes given to treat cramps when he is, reminds Prescribing , a drug that "exposed to serious adverse effects, sometimes fatal. " Again, the reaction of the French authorities seem timid . The Transparency Committee estimated in April 2011 that "given the low efficiency of benign conditions that resolve spontaneously and the risk of rare but severe allergic accident, these proprietary medical service is considered insufficient" . Conclusion: withdrawal? No, simple delisting. Even more inexplicable, the case of Motilium , whose medical service is only "moderate" for the "relief of symptoms of nausea and vomiting-type" and frankly "insufficient" in other directions, as assessed by the 'MSNA in 2007. Just check the package leaflet on the new Public Database drugs to see the potential cardiac toxicity mentioned in chapter

(4) of the very few possible side effects (affects less than one in 10,000 patients): " unexpected death resulting from sudden cessation of cardiac function in a person who may or may not have known heart disease. " Low activity potentially fatal withdrawal? No, European ongoing reassessment. Last example, among the 68 blacklisted Prescribing the Xolair , recent drug administered by injection every two weeks, which cost the improvement of medical service rendered "remains minor in the usual care of allergic asthmatic patients severe poorly controlled (balanced, Ed) by high-dose inhaled corticosteroids plus a beta2-agonist long-acting, "according to the opinion of the High Health Authority . Prescribing notes that "open to infection, anaphylaxis, serum disease, arterial thromboembolism, heart and brain. " Banned? No, he has just received the European level of an expansion of its indications ! It could soon be given against ... hives. When looking closer, yes it is good, sometimes not rely entirely on the work of health authorities.

Hearing loss accelerates cognitive decline

The hearing loss , even partial or progressive, is never trivial. Even when it is not linked to a serious disease, it remains a major handicap that has a significant impact on daily life. Work, couple, family, friends ... all social relations are based on speech. Any hearing problem inevitably makes the laborious communication, promoting a progressive social withdrawal: first we renounce to loud parties and to engage some conversations, even in the most extreme, out of home event. We exclude gradually to life in society. In his novel The Life muted , David Lodge writes: "The sounds have meaning, they convey information or communicate an aesthetic pleasure. The sound is ugly and meaningless. Deafness of both converts sounds into sounds that you prefer to opt for silence. "Enough said. The French do not seem to take this problem seriously. "The image has become so important in our society that we sometimes forget how the sound is important," asserts Christian Hugonnet, acoustical engineer.

To raise awareness of the sound problems, he founded his Week , a national event whose 11th edition this year will take place from January 27 to February 9. "A French two will never see his life a specialist to check his hearing," worries Jean-Louis Horvilleur, audiologist involved in organizing the event. When people go willingly suffer from tinnitus (ringing or whistling ghost) and hyperacusis (hypersensitivity annoying at certain frequencies). But are more difficult to realize an incipient deafness. "An early treatment with hearing aids adapted yet allows in most cases live a normal life," says Professor Hung Thai-Van, Head of Audiology Department (CHU Lyon, Centre for Neuroscience). "It also helps to slow the loss of hearing." When a person starts to get a bit dull, it is usually because the inner ear is damaged. "We have a capital of 12 500 outer hair cells, 3,000 internal and 30,000 auditory neurons that do not recur," says the doctor. "From the age of 20, we lose between 3.5 and 7% of these hair cells per decade." Different trauma (prolonged listening with headphones, working in a noisy environment, concerts, etc..) Can accelerate the phenomenon . With the loss of these cells, which play a fundamental role in the amplification of sound, hearing becomes less fine, especially in the treble. "As nature abhors a vacuum, the brain regions that manage these frequency ranges will be assigned to other tasks." This neuronal reorganization has the effect of amplifying the deaf patient. "When fitted with prostheses adapted, however, the deaf will retain or recover the brain capacity to process these sounds." Research has shown that deaf seniors also had deleterious effects on the brain. "By listening situation competitive in a noisy canteen for example, the deaf will mobilize his prefrontal lobe to try to isolate certain sounds and analyze them," says Hung Thai-Van.

The normal functioning of this part of the brain, usually devoted to working memory (management and processing of information in the short term) is affected. Cognitive decline and is 30-40% faster in elderly people with presbycusis (slowly progressive bilateral deafness). And the risk of dementia is increased. Regularly testing As the ear is often very gradual decline, experts urge everyone to perform regular tests, even the youngest, which deteriorate more ears constantly having screwed ears headphones diffusing its full volume. "We are now able to anticipate hearing loss by detecting anomalies in the vibrations of ciliated cells, otoacoustic emissions, when stimulated," says Hung Thai-Van. Only problem, hearing tests are very poorly paid, whether by Social Security or mutuals. The hearing screening is free and systematic for infants under 3 months (since May 2012 only). For others, it is unfortunately pay a high price: forty euros per consultation.

The low life expectancy in Russia attributed to vodka

A study confirms that heavy alcohol consumption in Russia is causing an abnormal mortality in men under 55. Alcoholism havoc in Russia. This plague had just been confirmed by a study showing that alcohol, particularly vodka, is responsible for the death of a quarter of men aged under 55. These results were published Friday in the journal Lancet .

To assess the impact of excess alcohol on the population, researchers from the Russian Centre of Moscow against cancer interviewed between 1999 and 2008 more than 151,000 men and women aged 35-74 years in three typical industrial cities northern Russia. Having realized that the most important consumers of alcohol were smokers, researchers are in a second phase focused on this group of individuals. More than 2 times more deaths Among the 57,361 smokers showed no disease at the beginning of the study, the risk of dying between 35 and 54 years was 16% for men consuming less than half a liter of vodka a week, against 20% for consumption between 1 and 3 a half-liter of 35% for 3 or more half liters. For more than 55 years (55-74 years), the risks were 50%, 54% and 64%. Extremely high rates of premature mortality confirmed, according to the study, the responsibility of alcohol and vodka on these early deaths. In ten years, more than 2,000 men in the study population died of favored by alcohol, such as diseases of liver cancer and throat , the tuberculosis , the pneumonia or diseases of the pancreas , as well poisoning with alcohol (often adulterated), accidents, violence or suicide.

Historical fluctuations According to a report by the World Health Organization (WHO) published in 2011, annual alcohol consumption in Russia amounted to 15.7 liters per person, while a French drinks 13.7 liters. If these figures are not so far apart, the difference between the death rates in each country before age 55 is colossal. A Russian five died of his drinking, while this is the case for only a French 20. Same gap on life expectancy, which in Russia has not changed for 10 years. Women live to 75.1 years against 63.2 years for men, according to WHO statistics. This is much less than its European neighbors, who live to 77.4 years for men and 83.2 years for women. "Death rates Russians have fluctuated over the past 30 years, restrictions on alcohol and social climate has varied considerably under Presidents Gorbachev, Yeltsin and Putin. And the main element that guide these fluctuations is the vodka, "says Professor Richard Peto of Oxford University in Britain, who participated in the study.

Currently, alcohol consumption in Russia fell. Under Mikhail Gorbachev in the 1980s, thanks to the restrictions it had decreased by 25% and mortality was followed this downward trend, before increasing again in the fall of communism. Since 2006, consumption and the risk of death fell by one third thanks to the rising price of vodka and advertising bans. At January 1, the price of a bottle of the cheapest pint in the market has undergone a further increase from 3.75 euros to 4.40 euros. The legal age to purchase alcohol could be increased from 18 years to 21 years.

Animals can help to heal?

AAT is based on the idea that the presence of an animal is a soothing element in the life of a patient with disability or a heavy medical condition. Florence Nightingale, the instigator of many techniques of modern health care, kept a tortoise in his service during the Crimean War as it was observed that the presence of an animal decreased anxiety wounded soldiers. More recently, an American psychotherapist observed in the 1950s, the comforting influence of his dog on one of his autistic patients and launched psychotherapy facilitated by the animal. Anglo-Saxon countries use much these approaches, despite the lack of large cohort studies necessary for an objective validation. AAT, which includes all types of therapy involving animals remains controversial, even in countries where it is used. Its worst detractors accuse pose a health risk to patients and endanger animals for an effect that would be enough to get robots and other specialists, more moderate recognize an effect only related to a placebo effect or increased by the simple event presentation to an animal socialization.

Without objective scientific data, the use of these methods remains a matter of conviction and personal experience of the therapist, who plays a key role anyway. A "mediator" The most common use of animals in medical practice is around the elderly . Many associations do indeed come from the same dogs or cats in homes or services of palliative care with the sole aim to encourage older people to leave their rooms and their silence. Patients caress animals, question their lifestyle and discuss these visits long after their departure. Animals and affect the morale of the patients but also their health by forcing them to move more. Many GPs also recommend to their patients retired to adopt a dog to encourage them to keep regular physical activity. For those who are isolated, the animal gives a reason to get up, thinking about the need to eat and go out to be in contact with other dog walkers.

In France, experts speak more readily animal mediation, recognizing the role of the animal rather as an intermediate care or improving the quality of life factor. Thus, guide dogs can not cure blindness, but they can facilitate many daily tasks, thus reducing the burden of disability. Other types of dog can assist patients with motor disabilities by turning on lights, opening the fridge or finding the remote control fell under the couch! Finally, the use of horses to raise children usually immobilized in a wheelchair can bring a smile on their face but also on the people who accompany them and who often feel powerless to help.

Peanut allergy: Steps towards effective desensitization

Allergy to peanut has exploded in the last twenty years. Affecting 0.5 to 1.4% of children in developed countries, it is food allergy that causes the most severe life-threatening reactions. No cure exists and it is difficult to identify those most at risk. The instructions given to parents of children with allergies is to avoid any food containing even that traces of peanuts, which strongly affects the quality of life of the family and induces a lot of stress.

However, the track desensitization developed by several teams in recent years with encouraging results. Particularly those of British researchers, published Thursday in the journal Lancet .

The team of Dr. Katherine Anagnostou (University of Cambridge) has 85 children to ingest a meal-based protein peanut in increasing doses, so that their immune system gets used to the allergen.Increased quantities every 15 days for 6 months, 2 mg at baseline (equivalent to a 70th peanut) to 800 mg. At each step change, the child received the first dose at the hospital so that doctors can intervene in case of reaction. The rest was taken home. After six months, more than 84% of young patients tolerated the daily intake of 5 peanuts and almost one in two could eat 10. Few allergic reactions have been reported and they were subdued.

"I could eat a donut! "

"For them, this is a dramatic change, says Dr. Andrew Clark, co-author of the article. Before this test, these children do not tolerate even tiny bits of peanut and their parents should scrutinize the labels of everything they ingest. "The goal of this treatment is to put these children away from hazard if swallowed peanut, not allow them to eat large quantities. "I've never eaten donuts before my 11 years because they could contain traces of peanut, shows Lena, who participated in the study. When you offered me one after the treatment, it was so good that I finished the package! "

In an accompanying commentary, Dr. Matthew Greenhawt, Central Food Allergy at the University of Michigan (United States), welcomes the results "exceptionally promising" but recalls that remain unknown. Including the duration of the protective effect, previous studies have shown that it may fade. "That is why it is very important that patients take their daily dose of peanut," says the Figaro Dr. Patrick Rufin, an allergist at the Necker Hospital in Paris, some patients were treated similarly.

In France also

Adverse side effects long term must also be studied. "The experimental research phase will still take years before possible generalization of treatment routine," warns Greenhawt. Meanwhile, it is not advised to attempt a desensitization of this type by itself, the risks can be fatal.

In France, a handful of hospitals (CHU de Toulouse, Hôpital Saint Vincent de Paul in Lille, Epinal hospital) already offer oral immunotherapy against peanuts. Dr. Dominique Sabouraud pediatrician allergist CHU Reims, practice for four years using a slightly different method, since only the first dose is given at the hospital, after Evalution of the minimum dose eliciting a reaction in the child. Control then takes place at 6 months and one year. "Some of our patients can now eat 15 peanuts a day," she says in Figaro . "This is a big change for these people: there ten years, they were told that their allergy was final and had to take it everywhere with them an emergency kit in case of a severe reaction. It was very anxiety. "

heal after a cardiovascular disease

It may happen that the cardiac pump is no longer able to take the energy needs of the body, which usually manifests as abnormal shortness of breath, sometimes with edema, swelling of the lower limbs resulting in particular from the fact that the body tends to retain excess salt and water. This is called theheart failure . Shortness of breath, accompanied by palpitations, may also result from a disruption of the heart rhythm called arrhythmia complete with atrial fibrillation, with a major risk of blood clots within the heart chambers. These clots can break, migrate particularly in cerebral vessels and cause strokes.

In both cases, the patient should not passively his illness, but be conscious actor. He must acquire skills appropriate care to his own case, in collaboration with the physician and other health professionals involved in the monitoring and treatment of the disease, knowing that it is monitored and care over a long period, or even chronic, that is to say life. This is called therapeutic education.

Avoid dietary errors

With regard to heart failure, the goal of patient education is first to avoid dietary errors. It does not prohibit arbitrarily, but to understand why the patient must avoid eating foods such as oysters salt, cheese, meats, etc..

Should also know that the warning symptoms of decompensation. Excessive and rapid weight gain, an increase in shortness of breath, the appearance of edema of the lower limbs, all signs that should alert him immediately. A good knowledge of these symptoms can prevent hospitalizations are often multiple and prolonged (210,000 hospitalizations lasting an average of nine days in 2010 in our country) and thus significantly improve the comfort of living. Finally, the goal of patient education is to clearly explain to the patient the benefits of different drug treatments or non-medicated proposed (angiotensin converting enzyme inhibitors, beta-receptor antagonists mineralocorticosteroids, etc..), Their side effects, and most importantly, the imperative to observe scrupulously the treatment every day, all year round necessity.

Therapeutic education is usually done within specialized structures at the hospital and involves not only cardiologists but also dieticians and nurses. In France, a national program called I-Care has been developed to enable, through fun activities, acquire necessary for proper management of the disease knowledge.

Complete arrhythmia by atrial fibrillation, requires for its share of the therapeutic focus education on proper medication use anticoagulants . These drugs have the advantage of making the blood more fluid and thus effectively prevent the occurrence of stroke . Their disadvantage is that they increase the risk of hemorrhage. It is therefore crucial to educate patients on dosages to use biological tests to be performed, the effective area of anticoagulation (INR for vitamin K antagonists), interactions with other drugs that may either mitigate the effectiveness or increase the risk hémoragique the cons-indications and the first steps to take in case of abnormal bleeding. Since this year, to address the misuse responsible each year in France 17,000 hospitalizations and 4,000 deaths, patients AVK can benefit from personalized monitoring in the form of one or other meetings per year with their pharmacist.

Cardiovascular diseases are among the most common chronic diseases in number and more serious in terms of mortality and morbidity. Develop therapeutic education in the city is now a major objective of reducing hospitalization costs. The patient must become a partner of the players health to treat his illness, but beyond that, win a real benefit in terms of comfort of life.

Women and fertility

"How are babies made?" The traditional interviewing children is supposed to be set at an age when we are about to establish itself a family. But if the basics are learned, the more specific knowledge of the factors that promote or not the conception of a baby are not known to all women planning to become mothers. Sometimes significant gaps, according to a U.S. study published Monday in the journal Fertility and Sterility.

According to the survey, conducted among a thousand Americans interviewed by telephone in March, one in two women of childbearing age (18-40 years) had never broached the subject with her fertility doctor. Yet they are 40% say concern about their ability to get pregnant.

The study also reveals that many are unaware of what can influence their chances of getting pregnant. Thus, only one in ten knew he better have sex in the days before ovulation rather than those who follow. More than one in four did not know that smoking, obesity, irregular cycles or some sexually transmitted infections (gonorrhea, chlamydia) reduce the success rate of each month. But the effect is far from negligible: a woman smoking 10 cigarettes per day sees his chances of getting pregnant halved. If obese, 1.5. Conversely, some misconceptions are common: one in two women thought that having several reports per day increases the chances of conceiving, and one in three believes that certain positions are preferred.

Preconception consultation

A survey conducted in France there are five years on the same subject, the National College of Gynaecologists and Obstetricians French had also demonstrated "a certain ignorance of French in fertility or at least a good number of ideas received, "according to the findings of the BVA.

For example, respondents (989 men and women) felt that a woman of 30 years had a 55% chance of getting pregnant each month, while the actual rate is 12%. Respondents also stared in about 40 years the age at which becomes more difficult to get pregnant, when in reality the odds drop from 35 years. Overestimation of the same chances of pregnancy was found for couples using medical assistance to procreation.

These results hardly surprise Dr. Gilles Grange, obstetrician-gynecologist at the Cochin Hospital in Paris. "Women themselves unfamiliar with the operation of their cycles, perhaps because school education on this subject is inadequate, he says. Now this is the minimum that is to put the odds on his side. "

Until 2008, the bride and groom were required to premarital medical examination, which allowed usefully address certain issues before pregnancy. "For example, for diabetics, epilepsy or suffering from certain psychiatric disorders patients, it is necessary to change the treatment before conception to prevent fetal malformations," says obstetrician Figaro . Now, no preconception consultation is dedicated officially recommended, but "it does not mean that everything goes well most of the time" puts Dr. Grangé. Especially the anticipation is not always possible: "40% of pregnancies in France are not programmed," he says.

On average, it is recommended that couples seek medical advice if their attempts to have a child have not worked for a year.

Obesity: junk food is not only responsible

Food fast food is far from being the major cause of the rapid rise in obesity in children and adolescents. For years, they pointed to this kind of food in the obesity epidemic. But this is only the tip of a more general problem: the poor nutritional habits of young people throughout the day, "learned" at home but also relayed by some university canteens or restaurants. This is one of the results of a study conducted by scientists at the University of North Carolina, published in the American Journal of Clinical Nutrition .

The researchers used the results of a U.S. national study conducted between 2007 and 2010, including 4466 children and adolescents aged 2-18 years. Their food intake was listed, both in terms of in terms of calories and drinks from food, fast food establishments or other. The children were able to be classified into three categories: those 50% who did not eat fast food, those 40% who were low consumers of this type of food, that is to say, it gave them less than 30% of calories ingested, and those 10%, which were major consumers of fast food, the latter giving them more than 30% of calories from their meals. This allowed researchers to determine what were the most critical factors in the relationship between diet and the risk of obesity.

Conclusion: if eating fast food in large quantities is not recommended, this factor is only a small part of a general picture of poor eating habits, with insufficient consumption of fruits and vegetables while conversely , so-called "industrial" foods and sugary drinks are the majority.

Parents who cook less

"This is what really determines obesity in children and adolescents, says Professor Barry Popkin, who led the study. Eating at fast food is just one of the behaviors that result from poor feeding habits. The fact that children who eat a lot of fast food are actually more at risk of becoming obese does not prove that it is the calories from these meals should bear the largest share of responsibility. "

Professor Popkin, who said he might not be a fan of fast food, says, "maybe, children who eat fast food do so because their parents do not have the desire or time to cook fresh and healthy home products. "

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