PTSD Awareness Day

June 27, 2019 is PTSD Awareness Day

Raising Awareness for PTSD

In an interview with 60 Minutes news Correspondent Bill Whitaker, Sgt. First Class John Zehring described his post-traumatic stress disorder (PTSD) as being, “…like having a monster on your back that controls your entire life.” 

Sgt. Zehring spent 15 months in the eastern province of Afghanistan fighting off daily attacks from the Taliban. Sgt. Zehring was exposed to what medical professionals might call complex PTSD, which is prolonged and/or repeated exposure to trauma. However, Sgt. Zehring’s self-described monster doesn’t come in a one size fits all, simple PTSD can arise after just a single traumatic experience. 

Simple and Complex PTSD 

Symptoms associated with having simple PTSD from a singular event usually include feelings of fear and helplessness, and a combination of behaviors that involve avoidance, confusion, and shock. Those with complex PTSD will have similar symptoms but might also have persistent changes in personality, an inability to relate to others, a loss of identity, and difficulty with decision-making. Some individuals might not display these symptoms, but may have other clinical symptoms such as anxiety and depression, and are easily prone to substance-abuse. 

Whether simple or complex, PTSD is caused by traumas that can range from a loss, a near death experience, injury, sexual assault, abuse, neglect, and violence. More importantly, these monsters aren’t only carried on the backs of our military and veterans. All types of people across all ages, including children, can be affected by PTSD. 

There is an overwhelming amount of evidence from studies reporting that women are also twice as likely to develop PTSD than men, despite having generally fewer overall traumas. Sexual abuse and violence were the major causes for PTSD among a majority of women, usually stemming from childhood traumas. Nevertheless, men, women and children all suffer from this sometimes paralyzing mental health condition. 

PTSD Therapies 

On a brighter note, there is a growing amount of awareness being raised around the subject of mental health. For instance, the #TimeToChange campaign is a movement that started in England in 2007 as an effort to end discrimination around mental health. They report that 1 in 4 people will experience a mental health problem in any given year. They advocate that even though most will say they’re fine, asking whether someone is okay, twice, can go along way. Having strong social networks is one of the key ways to help those with mental health problems, and decrease the stigma around having them. 

Alongside a strong social network, there is a growing number of therapies that help treat the symptoms of PTSD. The most common treatments include Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE). CPT will teach you new ways to think about your trauma by evaluating the facts and how they align with your thoughts, so you can ultimately decide to take on a new approach. PE will gradually teach you to confront your trauma-related memories, feelings and triggers you may have been avoiding, in an effort to help you face your fears and regain control of your life. 

There are also other more recent therapies that include Eye Movement Desensitization and Reprocessing (EMDR) and Narrative Exposure Therapy (NET). EMDR is where you would recall a disturbing event while a therapist guides you to shift your thoughts to more pleasant ones, in an effort to make the event less debilitating. NET is usually done in a group setting where you would share your life story so that traumatic, as well as positive, events are told in chronological order, and bad experience(s) become less fragmented, more refined and understood in a coherent autobiographical story. 

An Experimental Treatment for the Military and Veterans

In a whirlwind of media, there is an ongoing experimental treatment being funded by the US military, especially granted to those war veterans suffering from PTSD. Sgt. Zehring and other combat veterans, appear to be taking their lives back from these monsters that have so long controlled their civilian lives. The new therapy is called Stellate Ganglion Block (STG), and has been used for nearly a century as an anesthetic during low risk pain procedures. STG is an injection to a bundle of nerves in the neck called the stellate ganglion. These nerves block signals to certain sympathetic regions in the brain (i.e. amygdala), which might otherwise trigger traumatic memories. The injection serves as a kind of reboot of the brain, allowing many to go back to their pre-trauma state. It has been reported to work as soon as 30 minutes and has been said to last for years.

There is hope on the horizon for those suffering from PTSD and mental illness, a growing community, and raised awareness around mental health conditions. Different movements and treatments are gaining traction, but we must continue listening, learning and helping those in need. 

If you’re interested in learning more, please visit the following links:
https://www.ptsd.va.gov/index.asp
https://www.apa.org/ptsd-guideline/index

Contributing Blog Writer Marpessa Rietbergen is a HealthLynked provider administrator.

References:
https://www.cbsnews.com/news/sgb-a-possible-breakthrough-treatment-for-ptsd-60-minutes-2019-06-16/
https://honorone.org/blogs/the-honor-one-blog/can-a-single-injection-conquer-ptsd-the-army-wants-to-find-out
https://www.voa.org/understanding-ptsd
https://www.ptsd.va.gov/understand/what/avoidance.asp
https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma/effects
https://www.time-to-change.org.uk/about-us
https://www.apa.org/pubs/journals/releases/bul-1326959.pdf
https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp
https://www.ptsd.va.gov/understand_tx/prolonged_exposure.asp
https://www.webmd.com/mental-health/emdr-what-is-it#1
https://www.apa.org/ptsd-guideline/treatments/narrative-exposure-therapy
https://www.anxiety.org/stellate-ganglion-block-sgb-for-ptsd-research-update

World Blood Donor Day

Happy World Blood Donor Day!
June 14, 2019

Michelle from Denver, North Carolina, had witnessed many transfusions for her late son BJ, who passed away from leukemia at 15 years old. She would tell those who would want to help, “… go give blood, because it not only helps BJ, but it also helps other kids, other people in our community. I’m thankful those donors gave me more time with my son…”

Did you know that every 2 seconds someone in the US needs blood? Or that one pint of blood could help save up to 3 lives? Therefore, if you’re looking for an easy and effective way to help your community, then go donate blood at your local blood bank. Why not donate today? Afterall, it is World Blood Donor Day today!

Don’t just stop there! You can donate blood as often as every 56 days. This translates to over 5 donations a year, which means you can potentially help up to 15 people with just one year’s supply of blood. Now do the math, and imagine if you were to carry on this good deed over your lifetime…. that’s a lot of blood–and a lot of people you might help!

All kinds of people, of all ages can benefit from your blood donation. For instance, if you are an O- blood type, then your blood is in the highest demand when it comes to emergency situations. That’s because carriers of O- are universal blood donors, matching across all blood types. Hospitals also prefer the O- blood type for those with underdeveloped immune systems, such as premature babies in need. The O- blood type is only common among 7% of the population. Check out this link to RedCrossBlood to see which blood types are the rarest.

Blood in three parts

Blood can be divided into three parts: red blood cells, plasma and platelets. Red blood cells are important for boosting iron and hemoglobin. They are needed for people in accidents or undertaking surgery, for those with blood disorders, such as sickle cell anemia, or for those needing transplants or undergoing cancer treatment. Blood transfusions are also common among pregnant women, not only during childbirth, but also in non-emergency situations such as having low iron levels. During delivery, even being slightly anemic or iron deficient can potentially lead to complications.

Red blood cells are found in plasma, a yellowish liquid made up of mostly water, proteins, and enzymes. Plasma is crucial for the transfer of important nutrients and further contains clotting factors that help prevent an injured person from bleeding out. Plasma transfusions are given to patients suffering liver failure, severe infections, and burns. Interestingly, O- blood types are not universal donors for plasma. Instead, both the positive and negative AB blood type are universal donors for plasma, making up only 4% of the US population.

Lastly, blood can be separated into platelets. You might be wondering, what the heck are those? Well, your bone marrow produces about a million of these tiny cells daily. They are extremely useful as they are especially designed to clot blood and stop bleeding. When you get a cut or scrape, the scab that forms over it is formed by platelets. Without platelets, that little cut would never stop bleeding and could easily become infected. Therefore, nearly 38% of all platelet transfusions are given to people fighting cancer because most treatments, such as chemotherapy and surgical procedures, can easily lead to internal bleeding.

Requirements for donating blood

Okay, okay. Now that we’ve covered a few facts about donating blood, it’s also important to address some key requirements before donating blood. Well the obvious requirement is…

  • You must be in good health. Don’t even think about donating blood if you’re fighting off a cold or infection!
  • You need to be at least 16 years old
  • Weigh at least 110 lbs
  • You cannot be iron deficient
  • Certain restrictions do apply for people who have lived in or traveled to certain regions or countries
  • If you have a tattoo, no problem! In the state of Florida, as long as you have received your recent tattoo(s) from a licensed tattoo parlor or professional, you’re in the clear. Otherwise there’s a 12-month wait time that applies. If you’re not in Florida, check out this link for more on eligibility requirements.

So get your blood drawn today, enjoy a free health screening that includes your pulse, blood pressure, hematocrit (red blood cell count) and temperature, and ask about your blood type if you don’t already know it. So with that, in the words of Louis from Apopka, Florida, “Just go out there and do it, you never know who you could help.”

Happy World Blood Donor Day, ya’ll!

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

References:
www.redcrossblood.org
www.oneblood.org

Contributing Blog Writer Marpessa Rietbergen is a HealthLynked provider administrator.

National Medical Transcriptionist Week

Medical transcriptionists work behind the scenes. Most of us don’t see them or use the product of their work, but they are incredibly important to the health care industry. There are about 60,000 transcriptionists in the nation. They spend their days listening to recordings by doctors and other health care workers and converting them into written reports. Often they edit medical documents and convert medical terminology and abbreviations into more complete written documentation.

Join us in celebrating them and their work this week during National Medical Transcriptionist Week. Thank you!

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

How to Prepare for a Doctor’s Appointment

A basic plan can help you make the most of your appointment whether you are starting with a new doctor or continuing with the doctor you’ve seen for years. The following tips will make it easier for you and your doctor to cover everything you need to talk about.

List and Prioritize Your Concerns

Make a list of what you want to discuss. For example, do you have a new symptom you want to ask the doctor about? Do you want to get a flu shot? Are you concerned about how a treatment is affecting your daily life? If you have more than a few items to discuss, put them in order and ask about the most important ones first. Don’t put off the things that are really on your mind until the end of your appointment—bring them up right away!

Take Information with You

Some doctors suggest you put all your prescription drugs, over-the-counter medicines, vitamins, and herbal remedies or supplements in a bag and bring them with you. Others recommend you bring a list of everything you take and the dose. You should also take your insurance cards, names and phone numbers of other doctors you see, and your medical records if the doctor doesn’t already have them.

Consider Bringing a Family Member or Friend

Sometimes it is helpful to bring a family member or close friend with you. Let your family member or friend know in advance what you want from your visit. Your companion can remind you what you planned to discuss with the doctor if you forget. She or he can take notes for you and can help you remember what the doctor said.

Be Sure You Can See and Hear As Well As Possible

Many older people use glasses or need aids for hearing. Remember to take your eyeglasses to the doctor’s visit. If you have a hearing aid, make sure that it is working well and wear it. Let the doctor and staff know if you have a hard time seeing or hearing. For example, you may want to say: “My hearing makes it hard to understand everything you’re saying. It helps a lot when you speak slowly.”

Plan to Update the Doctor

Let your doctor know what has happened in your life since your last visit. If you have been treated in the emergency room or by a specialist, tell the doctor right away. Mention any changes you have noticed in your appetite, weight, sleep, or energy level. Also tell the doctor about any recent changes in any medications you take or the effects they have had on you.

Request an Interpreter if You Know You’ll Need One

If the doctor you selected or were referred to doesn’t speak your language, ask the doctor’s office to provide an interpreter. Even though some English-speaking doctors know basic medical terms in Spanish or other languages, you may feel more comfortable speaking in your own language, especially when it comes to sensitive subjects, such as sexuality or depression. Call the doctor’s office ahead of time, as they may need to plan for an interpreter to be available.

Always let the doctor, your interpreter, or the staff know if you do not understand your diagnosis or the instructions the doctor gives you. Don’t let language barriers stop you from asking questions or voicing your concerns.

Source

To find a health professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store your health information. Download our HealthLynked app available on Apple and Android devices.

Today is Metastatic Breast Cancer Awareness Day | What are the MBC Statistics?

For more than 160,000 women and men living in the U.S. with advanced, stage IV breast cancer, the situation is dire.  The odds are against them, and Breast Cancer Awareness Month often leaves them with Pink Fatigue.  They cannot turn off the barrage even when they turn off their TV sets or avoid pink-decorated malls and pink splashed social feeds. 

October is for the 70% of folks whose cancer is contained.  Instead, those living and coping with the metastatic form of the disease, active treatments, and side effects are all too aware there is no known cure. Their outlook is tempered, maybe best portrayed in a spectrum of gray.

In October of 2009, the U.S. Senate and House voted to support the designation of October 13 as a National Metastatic Breast Cancer Awareness Day. The point of those proclamations was to draw attention to the needs of the metastatic breast cancer community.

What is Metastatic Breast Cancer?

Metastatic breast cancer – cancer that travels from the breast and spreads to other parts of the body – is treatable, but not curable. Though exact statistics are unknown, an estimated 160,000 people are living with the disease in the United States.

Those with metastatic breast cancer face challenges different from those with early stage because metastatic breast cancer patients are always in treatment. They experience ongoing anxiety and fear knowing they will die one day from the disease.

Metastatic Breast Cancer:  A Fact A Day — 31 days of October

What is Metastatic Breast Cancer?  (pronounced as Met-a-STA-tic)

MBC also known as Stage IV is cancer that has spread outside of the breast to other organs such as bones, liver, lung or brain. This process is called metastasis. (pronounced as Me-TAS-ta-sis)

What happens when breast cancer spreads?

Breast cancer that spreads to another organ, such as bones, lung, or liver, is still breast cancer and does not become bone cancer or liver cancer or lung cancer.  Under a microscope, the tumor cells will still look and act like breast cancer and will be treated as breast cancer.

Who gets metastatic breast cancer?

No one brings metastatic disease on themselves. The sad truth is that anyone who has had an earlier stage of breast cancer can experience a metastatic recurrence and some women have metastatic disease on their initial diagnosis of cancer–despite mammograms and early detection!

Why does breast cancer metastasize? (pronounced as Me-TAS-ta-size)

Researchers at this time can’t explain why metastatic disease occurs, but they’re working on finding answers. Early detection is a detection tool, but it does not a cure or prevent an early cancer from coming back in the future as metastatic disease.

What are the statistics on incidence of metastatic breast cancer?

There are estimates that 20-30% of patients with an early stage cancer will have their cancer return as metastatic, even if they were told their early stage cancer had been “cured.” Another 8% of new breast cancer cases are found to be metastatic at their initial diagnosis.

What is the main difference between early stage breast cancer and metastatic breast cancer?

Metastatic Breast Cancer (mbc) is treatable but no longer curable. Treatment is lifelong and focuses on preventing further spread of the disease and managing symptoms. The goal is for patients to live a good quality of life for as long as possible.

How is metastatic breast cancer treated?

Depending primarily on the kind or subtype of mbc, patients may be on either targeted therapies or systemic chemotherapy. Radiation and surgery are also sometimes used.

What are the different kinds (subtypes) of metastatic breast cancer?

Subtypes for early stage and metastatic breast cancer are the same: An estimated 65% of patients have Hormonal (estrogen or progesterone driven), also called ER+/PR+; 20% have Her2+(fueled by a protein identified as Her2 neu) and 15% have Triple Negative Breast Cancer (TNBC- which does not have any of the 3 above known biomarkers: ER. PR or HER2). These numbers are approximate, because some people have more than one subtype ( HER2+ and ER+) or their subtype may change over time.

How many women and men die of breast cancer each year?

Approximately 40,000 die of breast cancer each year—a number that essentially is unchanged over the last 20 years. All deaths from breast cancer are caused by metastatic breast cancer.

How many people are living with mbc in the US?

Although the National Cancer Institute collects statistics of patients who have an initial diagnosis of mbc, the NCI does not count metastatic breast cancer recurrences.  Studies estimate that there are over 155,000 women and men living with metastatic breast cancer in the US–and doing our best to live well!

Is metastatic breast cancer a chronic disease?

Not yet, but that is an important goal. As researchers identify more and better treatments, MBC could become a chronic disease like diabetes or HIV/AIDS, where patients can be stable on medications for 20 or more years.

How much is spent on research funding for metastatic breast cancer?

Several years ago, the Metastatic Breast Cancer Alliance did a study that found that of all research grants, funded by major public and private sources from 2006-2013, only 7% of funds studied metastatic breast cancer, even though metastasis is what causes breast cancer to become a deadly disease.

What is National Metastatic Breast Cancer Awareness Day?

October 13 was sent aside by unanimous House and Senate resolutions in 2009, establishing that one day in October should recognize and bring awareness to metastatic breast cancer. One day is not enough, but it’s a start for year-round awareness of what mbc is and why it’s important for all of us. History of MBC National Awareness Day >

Do men get breast cancer?

Yes, men do get breast cancer and they are often misdiagnosed initially. They represent about 1% of the new cases of breast cancer and 1% of the deaths from metastatic breast cancer. (410 deaths in 2012)

Do young women get metastatic breast cancer?

YES. For young women under 40: 5% of the new cases of breast cancer and 3% of the deaths. Metastatic breast cancer is the leading cause of cancer deaths in this age group. For young women under 50: 27% of the new cases of breast cancer and 16% of the deaths.

How is metastatic breast cancer monitored?

Usually MBC is monitored by periodic imaging tests (CT, PET or bone scans or MRIs), blood tests measuring tumor markers and assessment of how the patient is feeling.

How often are patients living with metastatic breast cancer scanned?

Usually we are scanned every 3 months; if metastases remain stable or shrink, scans may be done less frequently (eg every 6 months).

What is scanxiety?

Scanxiety refers to patient anxiety over scans and occurs as their scan date approaches. Good test results refer to stable disease (mets are not growing or spreading) or NED (no evidence of disease) on scans.

What is NED (no evidence of disease) and how does it differ from being ‘in remission’ or being ‘cancer free’?

No Evidence of Disease means that the metastases are no longer detectable on an imaging scan. This is great news, but because breast cancer cells are still circulating in the body, treatment continues. ‘In remission’ is an older term and not usually used in metastatic breast cancer. Once you are metastatic, you are never ‘cancer-free,’ but being NED or being stable are still wonderful words to hear from your oncologist.

Why does treatment for metastatic disease seem ‘less aggressive’ than treatment for early stage disease? Why does everything feel less urgent, despite a much more serious prognosis?

Treatment of early stage disease focuses on curing the cancer and therefore is immediate and aggressive. Because there is no cure for mbc at this time, treatment focuses on controlling the disease and permits a more measured, long-term approach to therapy, with hopefully more attention directed to long term quality of life and reducing or preventing adverse side effects of treatments.

People often ask, ‘Why do you look so good, if you have an incurable cancer?’

Metastatic breast cancer has its ups and downs. Sometimes, we may be feeling relatively good and are living with stable disease. Other times we may be experiencing a lot of side effects. If hair loss isn’t one of them, people may not notice. Even when the disease is progressing, we may still look ok, up to a certain point.

What are clinical trials and are they a ‘last resort’ when all other treatments fail?

Not at all. Clinical trials are controlled treatment studies on new drugs and are the method used to obtain FDA approval of new treatments. They should be an option considered right from the beginning of treatment for MBC patients, along with standard treatments. A clinical trial may or may not be right for an individual and should be discussed with the oncologist.

What are the types of clinical trials and what’s the advantage to participating?

Phase 1 and 2 trials involve a relatively small sample size of people (sometimes less than 100) and determine dosage, safety and effectiveness of the new drug. If results are favorable, a phase 3 study is launched which is on a large scale, involving multiple clinical sites across the country (and sometimes worldwide).  A trial compares the current standard of care to the new treatment. While there are always risks and benefits, participation, especially in a phase 3 study, can give someone access to the latest promising drug, long before it comes to market. Clinical Trials Q&A

What does it take in terms of time, money and research to bring a new drug to market?

On average, it takes 8-10 years and approximately $1 Billion for a new drug to go from a chemistry model to FDA approval. Overall only 11% of drugs that start in clinical trials are eventually approved, but 34% of Phase 3 Clinical Trial drugs are approved. “Every advance in breast cancer treatment and care has been the result of a clinical trial.”

Why are people living with MBC seldom acknowledged during breast cancer awareness events?

As a practical matter, someone with metastatic breast cancer will be outnumbered…at awareness walks, at treatments centers, everywhere. Of the 3.5 million US people living with a history of breast cancer (all stages), an estimated 155,000 have Stage IV breast cancer. This means when the average person thinks about breast cancer, they aren’t thinking about people with MBC. They are thinking about family and friends who had early-stage disease, were treated and, to their knowledge, are fine. This is certainly understandable–but an ongoing challenge and one we must address if we want to make any meaningful progress in terms of education, awareness and scientific progress. We need early-stage breast cancer patients to help us out–to advocate for more research, encourage greater clinical trial participation and address health inequities.

The first thing many people say, when they get breast cancer, is that they have no family history, so how can this be happening to them?

Family history is a risk factor for less than 15% of those diagnosed, which means that 85% of breast cancers are not caused by family history.

What does being BRCA positive mean?

Having an abnormal or mutated BRCA1 or BRCA2 gene means that the risk of developing breast or ovarian cancer dramatically increases, but not everyone with a BRCA mutation will get cancer. Mutations in these genes are rare in the general population and higher in certain ethnic subgroups, such as those of Ashkenazi Jewish descent. Overall, BRCA mutations account for 5% of all breast cancers.

What is Inflammatory Breast Cancer?

Inflammatory breast cancer (IBC) is a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast. This type of breast cancer is called “inflammatory” because the breast often looks swollen and red, or “inflamed.” Because it is difficult to diagnose and often mistaken for other conditions, patients with IBC are usually diagnosed at stage III or IV. http://1.usa.gov/jrbWt

Is there a difference between palliative care and hospice care?

Yes! Although many people think they are synonymous, palliative care should be part of each person’s cancer care right from the beginning. Palliative care is treatment of side effects, stress and pain. Studies have shown that palliative care not only improves quality of life, but also can extend life by several months.

Why should everyone care about metastatic breast cancer?

Early detection does not guarantee a lifetime cure, and treating early stage breast cancer does not mean the person will never have breast cancer again. Metastatic breast cancer can occur 5, 10 or 15+ years after a person’s original diagnosis and successful treatment. An estimated 20-30% of women initially diagnosed with an early stage cancer will go on to be diagnosed with metastatic breast cancer.

What’s the message from those of us living with metastatic breast cancer for this last day of Breast Cancer Awareness Month?

Live Life Fully Every Day! Let’s celebrate that we survived another PinkTober!

Conclusion

Women (and men) do not die from breast cancer. They die when their breast cancer metastasizes and spreads to other parts of the body. There has been a huge push for breast cancer awareness in the past two decades, with a tremendous focus on prevention and early detection.

We wish these efforts had been successful. But the simple truth is that after two decades and billions of dollars, breast cancer has not been prevented and early detection has proven no guarantee against metastasis and death.  While these billions have been focused elsewhere, almost 1,000,000 American women and men have died while waiting for research funds to finally be shifted to metastasis research. This tragic truth is lost in the sea of pink promotions. 

Too often, breast cancer organizations and even breast cancer surgeons and oncologists imply metastasis is rare or the fault of the patient.  Breast cancer survivors are often in complete denial that MBC could ever happen to them.  The “pink world” goes to great lengths to suppress the reality of our disease — that it happens to one-third of the breast cancer community, largely for unknown reasons.  The Elephant in the Pink Room campaign by Metavivor pushed recognition of metastatic disease because with recognition, the support so necessary for the MBC patient and the research that could halt death for so many, will continue to be minimal.

Thirty percent of women and men who are diagnosed with breast cancer will eventually develop stage 4 (metastatic) breast cancer and die. Yet of all the money dedicated to breast cancer research, only 2% is earmarked specifically for metastatic research. Cancer organizations must devote thirty percent of their research budget to research that will help the 30 percent of women and men whose cancer metastasizes. The surest way to save the lives of patients already diagnosed with breast cancer is to find a way to make MBC survivable.

For metastatic breast cancer patients, it’s about time. Time to spend with their families, time to cross something off their bucket list, time to simply drive the carpool or cook a meal.

It’s also about time we increased awareness of the disease, time we developed more treatments to help metastatic patients live longer, time there was more recognition and support of those managing this disease.

As we approach the middle of Breast Cancer Awareness month, take time to raise awareness about metastatic breast cancer. Consider what time means to you and your family?  What would you do with more time?

The reality of metastatic breast cancer can be frightening for patients and their families.  Find great medical teams working to give you more time in our comprehensive platform built to connect patients with their families and the physicians who care for them

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Sources
Mbcn.org
METAvivor.org
HuffingtonPost.com

Noticing Memory Problems? What to Do Next

We’ve all forgotten a name, where we put our keys, or if we locked the front door. It’s normal to forget things once in a while. But serious memory problems make it hard to do everyday things. Forgetting how to make change, use the telephone, or find your way home may be signs of a more serious memory problem.

For some older people, memory problems are a sign of mild cognitive impairment, Alzheimer’s disease, or a related dementia. People who are worried about memory problems should see a doctor. Signs that it might be time to talk to a doctor include:

  • Asking the same questions over and over again
  • Getting lost in places a person knows well
  • Not being able to follow directions
  • Becoming more confused about time, people, and places
  • Not taking care of oneself—eating poorly, not bathing, or being unsafe

People with memory complaints should make a follow-up appointment to check their memory after 6 months to a year. They can ask a family member, friend, or the doctor’s office to remind them if they’re worried they’ll forget.

Source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Will At Home Testing Improve Screening and Lower Cancer Rates?

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, report researchers at the University of North Carolina Comprehensive Cancer Center.

In collaboration with the Mecklenburg County Health Department in Charlotte, researchers with UNC Lineberger’s Carolina Cancer Screening Initiative examined the impact of targeted outreach to more than 2,100 people insured by Medicaid who were not up-to-date with colorectal cancer screening. The project resulted in a nearly 9 percentage point percent increase in screening rates for patients who received a screening kit in the mail compared with patients who just received a reminder, and it demonstrated that their method could serve as a model to improve screening on a larger scale. The findings were published in the journal Cancer.

The American Cancer Society estimates that more than 97,000 people will be diagnosed with colorectal cancer in the United States this year, and it will result in approximately 50,600 deaths. It is third most common type of cancer in the United States, and the second leading cause of cancer death.  Cancer, overall, is the second killer in the US, behind heart disease.

While colorectal cancer screening has proven effective in reducing cancer deaths, researchers report too few people are getting screened. Current guidelines from ACS recommend regular screening with either a high-sensitivity stool-based test or a structural (visual) exam for average-risk people aged 45 years and older, and that all positive results should be followed with colonoscopy.

Despite these recommendation, studies have identified notable gaps in screening rates, including by race, geographic region and other socioeconomic factors. Among patients who are insured, people with Medicaid have the lowest rates of colorectal cancer testing.

“There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease, but screening rates are only about 63 percent, and low-income, and otherwise vulnerable populations, tend to be screened at even lower rates,” said the study’s first author UNC Lineberger’s Alison Brenner, Ph.D., MPH, research assistant professor in the UNC School of Medicine Department of Internal Medicine.

For the project, researchers either mailed reminders about colorectal cancer screening and instructions on how to arrange one with the health department, or reminders plus a fecal immunochemical test, or FIT kit, which can detect blood in the stool—a symptom of colon cancer. The patient completes the test at home and returns it to a provider for analysis. Patients who have a positive FIT kit result will be scheduled for a colonoscopy.

The UNC Lineberger researchers worked with the Mecklenburg County Health Department staff, who coordinated the reminders and mailings and ran the test analyses. They also partnered with Medicaid care coordinators to provide patient navigation support to patients who had abnormal test results and required a colonoscopy.

Twenty-one percent of patients who received FIT kits in the mail completed the screening test, compared with 12 percent of patients who just received a reminder. Eighteen people who completed FIT tests had abnormal results, and 15 of those people were eligible for a colonoscopy. Of the 10 who completed the colonoscopy, one patient had an abnormal result.

“Preventive care amongst vulnerable populations rarely rises to the top of the mental queue of things that need to get done,” Brenner said. “In North Carolina, many Medicaid recipients are on disability. Making something like colorectal cancer screening as simple and seamless as possible is really important. If it’s right in front of someone, it’s more likely to get done, even if there are simple barriers in place.”

Brenner said the study shows the potential to harness resources like the county health department for health prevention services.

“This collaborative and pragmatic quality improvement effort demonstrates the feasibility, acceptability, and efficiency of using existing health services resources and infrastructure, including Medicaid-based navigation to colonoscopy to deliver timely cancer screening services to low income populations,” said UNC Lineberger’s Stephanie Wheeler, Ph.D., MPH, associate professor in the UNC Gillings School of Global Public Health and the study’s senior author.

She said researchers plan to move forward to study whether they can implement their approach on a larger scale, and to understand all of the cost implications.

“This is looking at expanding the medical neighborhood—to harness community resources to target patients and in this case, insured patients, who are maybe not getting this from a primary health care organization, and how to increase screening rates in these types of vulnerable populations,” Brenner said.


If you are looking for a doctor to discuss the need for colon cancer screening or your results, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Source:  originally printed, “By sending tests in the mail, researchers boost colorectal cancer screening.”  July 14, 2018 , UNC Lineberger Comprehensive Cancer Center

More information: Alison T. Brenner et al, Comparative effectiveness of mailed reminders with and without fecal immunochemical tests for Medicaid beneficiaries at a large county health department: A randomized controlled trial, Cancer (2018).  DOI: 10.1002/cncr.31566

Provided by: UNC Lineberger Comprehensive Cancer Center

July is Sarcoma Awareness Month – Raise Awareness for this “Forgotten Cancer”

If you see yellow ribbons around your community during the month of July, it may mean something different than the usual “Support Our Troops” many think of when first sighted. Instead, they could be displayed in honor of Sarcoma Awareness Month, observed each July.

Sarcoma is a soft-tissue cancer that may occur in a variety of the body’s soft tissues, including the nerves, muscles, joints, blood vessels, fat and more. Sarcoma may also occur in the bones.  Although rare in adults, making up just ONE percent of adult cancers, sarcoma is relatively common in children, accounting for fifteen percent of childhood cancer cases.  Bone and joint cancer is most frequently diagnosed among teenagers, while soft tissue cancers typically affect those 55 years or older.

Sarcoma is most often found in the arms and legs, where the majority of connective tissues are located, but it can occur virtually anywhere. Because the disease often starts deep in the body, it may not be noticeable until a large lump or bump appears — and at this point the cancer may be difficult to treat.

The Sarcoma Foundation of America (SFA) estimates that about 20 percent of sarcoma cases are curable by surgery while another 30 percent may be effectively treated with surgery, chemotherapy and/or radiation. However, in about half of cases, the disease is resistant to all form of treatments, highlighting an urgent need for new therapies.

Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat; rhabdomyosarcomas form in muscle; and Ewing sarcomas form in bone and soft tissue.

In 2018, over 13,000 cases of soft tissue sarcoma and 3,400 cases of bone sarcomas are expected to be diagnosed in the United States, according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER). Approximately 5,100 and 1,590 people are expected to die from soft tissue and bone sarcomas, respectively. The five-year survival rate for soft tissue sarcomas is 50 percent, while the survival rate is 66 percent for bone sarcomas.

Because sarcomas are difficult to distinguish from other cancers when they are found within organs, their incidence is probably underestimated, according to the National Cancer Institute.

 Fast facts on sarcoma

  • There are over 50 types of soft tissue sarcoma.
  • Symptoms may not be apparent; often, the only sign of sarcoma is a lump.
  • Pain may occur depending on where the tumor is located, or if it presses on nearby nerves.
  • Treatment, as for other forms of cancer, can include surgery, radiation therapy, and chemotherapy.

Symptoms of soft tissue sarcoma

People with soft tissue sarcomas often have no symptoms. There may be no signs until the lump grows to a large size and can be felt; however, even this may go unnoticed. The main symptoms are:

  • Pain – the most obvious symptom. Once the tumor affects local tissues, nerves, or muscles, it can be felt as pain in the general area.
  • Inflammation – the tumor grows and eventually affects the area with inflammation and swelling.
  • Location specific symptoms – inability to move limbs properly (if the sarcoma is on the arms or legs for example) and other impairments depending on the location.

Specific symptoms may reflect the particular type of sarcoma. For instance, tumors in the gastrointestinal system may bleed, so these sarcomas might produce symptoms like blood in the stool, or a stool that has a black, tarry appearance.

Types of sarcoma

Types of soft tissue sarcoma are defined by the specific tissue or location affected; they include:

  • Undifferentiated pleomorphic sarcoma – previously known as malignant fibrous histiocytoma – this tumor is most often found in the arms or legs but sometimes at the back of the abdomen.
  • Gastrointestinal stromal tumor (GIST) – this affects specialized neuromuscular cells of the gut.
  • Liposarcoma – sarcoma of fat tissue.
  • Leiomyosarcoma – affects smooth muscle in organ walls.
  • Synovial sarcomas – these are usually found around a joint in the arms or legs.
  • Malignant peripheral nerve sheath tumor – also known as neurofibrosarcoma, it affects the protective lining of the nerves.
  • Rhabdomyosarcoma – this forms in muscle and is a childhood cancer. While rare overall, it is a relatively common tumor in children.
  • Angiosarcomas – these develop in the cells of the blood or lymph vessels.
  • Fibrosarcomas – sarcomas that usually form in the limbs or on the trunk, forming from fibroblasts, the most common cell type in connective tissue.
  • Kaposi’s sarcoma – a sarcoma that affects the skin and is caused by a virus. The most common form of Kaposi’s sarcoma is related to AIDS.  Kaposi’s tumors often produce distinctive skin lesions but also affect other soft tissues.  Kaposi’s sarcoma is caused by the human herpesvirus 8.
  • Further examples – these include dermatofibrosarcoma protuberans, a skin lesion; epithelioid sarcoma, which often affects young adults’ hands or feet; myxoma, which affects older adults, usually in the arms and legs; mesenchymomas, which are rare and combine elements of other sarcomas and can be found in any part of the body; vascular sarcomas, containing many blood vessels; and malignant neurilemmoma (also known as schwannoma).  Sarcoma of the bone includes osteosarcoma, Ewing sarcoma, and chondrosarcoma.

Causes of sarcoma

The causes behind sarcoma are unknown, but there are some known risk factors. In adults, for instance, exposure to phenoxy acetic acid in herbicides or chlorophenols in wood preservatives may increase the risk. High doses of radiation are also known to cause sarcomas in some people, as are certain rare genetic alterations. The following inherited diseases are also associated with an increase sarcoma risk, according to SFA:

  • Li-Fraumeni syndrome, which is associated with alterations in the p53 gene
  • Von Recklinghausen’s disease (neurofibromatosis), which is associated with alterations in the NF1 gene

Having certain inherited disorders can increase the risk for other soft tissue sarcomas, including retinoblastoma, tuberous sclerosis, Werner syndrome, and nevoid basal cell carcinoma syndrome. Other risk factors for soft tissue sarcoma include past treatment with radiation therapy for certain cancers; exposure to certain chemicals, such as thorium dioxide, vinyl chloride, or arsenic; and long-term lymphedema in the arms or legs.

Past treatment with radiation can increase the risk of osteosarcoma and other types of bone cancers. Other risk factors for osteosarcoma include treatment with anticancer drugs called alkylating agents, having a certain change in the retinoblastoma gene, and having certain conditions including Paget disease, Diamond-Blackfan anemia, and Werner syndrome.

Tests and diagnosis of sarcoma

After understanding a patient’s medical history and completing a medical examination, medical imaging scans will help to inform a diagnosis, which will need to be confirmed through laboratory analysis of a tumor sample.

The following physical features should prompt a doctor to investigate:

  1. larger than 2 inches in diameter or growing in size
  2. fixed, immovable, or deep
  3. painful
  4. return of tumor previously removed

Medical imaging helps to locate, characterize, and give further information about a tumor to guide diagnosis. It may also be used to gauge the success of treatment or to look for spread of cancer.

Imaging techniques include X-rays, CT scan (computed tomography), MRI(magnetic resonance imaging), ultrasound, and PET (positron emission tomography).

Treatments for soft tissue sarcoma

The following treatment options can be used for sarcomas:

  • Surgery – the most common sarcoma treatment. It aims to remove the tumor and even some of the normal surrounding tissue. A biopsy sample is often taken at the same time to confirm the exact type of tumor.
  • Radiation therapy – this destroys cancer cells and may be done in addition to surgery, before or after the operation.
  • Chemotherapy – this could also be used in addition to surgery, though less often than radiation therapy.

Some soft tissue sarcomas have other available treatments, such as specific drug treatments, gene-targeted therapies, or biological therapies such as immunotherapy.

Treatment choice and intensity are also guided by the stage and grade of cancer, by the size of the tumor, and extent of any spread.

Prevention of sarcoma

Sarcoma is not typically preventable. Radiation therapy is a risk factor, so reducing exposure to it may be preventive, although a need for radiation therapy usually outweighs any subsequent sarcoma risk.

Observing Sarcoma Awareness Month

Sarcoma is still considered to be the “forgotten cancer.”  Efforts to encourage research and drug development are made more challenging due to a lack of awareness and understanding.  How as a community do we raise funds for vital research if people don’t know that this cancer exists?

Though the Sarcoma Foundation of America works tirelessly every day to raise awareness, during Sarcoma Awareness Month, they aim to further highlight the extraordinary challenges sarcoma patients face and the need for more sarcoma research and better sarcoma therapies.  Please join in efforts and pledge to bring awareness to your community.  Here are a few ways you can help highlight the need for ongoing research on sarcoma:

  • This July, take a moment to share a message via social media or speak with your friends and family about this relatively unknown condition.
  • Join sarcoma patients, survivors and their loved ones for the Steps to Cure Sarcoma.  Every dollar raised will be used to fund research, patient advocacy and education.
  • Take a moment to listen to a Sarcoma Awareness Month Public Service Announcement campaign. Share it online to raise awareness.
  • Get together with others in the sarcoma community and donate today!

Getting Help

Since sarcoma is a rare cancer, many people are unfamiliar with the disease and have not been affected personally. However, many children’s lives have been altered because of this disease, and advances in early detection and treatment could help save lives.

A number of clinical trails are underway for people with sarcoma. If you’ve been recently diagnosed, ask your doctor if a clinical trial, which could give you access to novel treatment options, is right for you.

Trying to find the right doctor to determine if that lump or new pain is something more than just a little annoying is made easy at HealthLynked.  We are the first ever social ecosystem designed to connect physicians and patients in a truly collaborative platform to Improve HealthCare.

Ready to get Lynked?  Sign up for free today and take control of your wellness!

Sources:

Han, MD, Seunggu.  “Sarcoma: Symptoms, types, treatments, and causes.” Medical News Today.  23 May 2017.

Sarcoma Awareness Month

https://www.aacrfoundation.org/Pages/sarcoma_awareness_month.aspx

https://www.gatewaycr.org/gateway-blog/posts/2017/july/july-is-sarcoma-awareness-month-what-is-sarcoma/

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

How is Excess Body Fat Priming Our Brains for Mental Decline?

As today marks the 81st birthday of Krispy Kreme – an American doughnut company and coffeehouse chain based in Winston-Salem, North Carolina built off an ancient, secret cajun recipe – it seems a fitting day to talk about obesity, fat, and its effect on the brain.  Let’s start with “skinny fat”.

Sarcopenia, which is the loss of muscle mass, tends to happen naturally with age. So, in older people with sarcopenia, excess body fat may not be readily visible. But hidden fat, paired with muscle mass loss later in life, could predict Alzheimer’s risk, researchers warn, and Sarcopenic obesity may exacerbate the risk of other cognitive decline later in life.

A recent study — the results of which have been published in the journal Clinical Interventions in Aging — has found that sarcopenia and obesity (independently, but especially when occurring together) can heighten the risk of cognitive function impairments later in life.

The research was conducted by scientists at the Comprehensive Center for Brain Health at the Charles E. Schmidt College of Medicine of Florida Atlantic University in Boca Raton.

“Sarcopenia,” explains senior study author Dr. James Galvin, “has been linked to global cognitive impairment and dysfunction in specific cognitive skills including memory, speed, and executive functions.”

“Understanding the mechanisms through which this syndrome may affect cognition is important as it may inform efforts to prevent cognitive decline in later life by targeting at-risk groups with an imbalance between lean and fat mass.”

Dr. James Galvin

“They may benefit from programs addressing loss of cognitive function by maintaining and improving strength and preventing obesity,” he adds.

Beware sarcopenic obesity

The scientists analyzed health-related data collected from 353 participants — aged 69, on average — all of whom registered to take part in community-based studies on aging and memory.

To establish whether or not there was a link between sarcopenic obesity — that is, the presence of excess body fat in conjunction with muscle mass loss — and cognitive decline, the team assessed participants’ performance on tests evaluating cognitive function, including the Montreal Cognitive Assessment and animal-naming exercises.

Also, the participants’ muscle strength and mass were evaluated through grip strength tests and chair stands, and they also underwent body compositions assessments, which looked at muscle mass, body mass index (BMI), and the amount of body fat.

The researchers discovered that the participants with sarcopenic obesity had the poorest performance on cognition-related tests.  The next poorest performance on cognition tests was seen in people with sarcopenia alone, followed by participants who only had obesity.

Both when occurring independently and when occurring in concert, obesity and loss of muscle mass were linked with impaired working memory — which is the type of memory we use when making spontaneous decisions on a daily basis — as well as less mental flexibility, poorer orientation, and worse self-control.

Keep changes in body composition in check

The scientists explain that obesity could exacerbate the risk of cognitive decline through biological mechanisms that influence vascular health, metabolism, and inflammation.

Moreover, they warn that in people who already face impaired executive functioning, obesity might also impact energy resources through poor self-control that affects nutrition.

As for sarcopenia, the researchers note that it could influence brain mechanisms related to conflict resolution skills and selective attention.

Based on the study’s findings, Dr. Galvin and his colleagues are particularly concerned that a mix of sarcopenia and excess body fat in older adults could become a serious public health issue, so they believe that any significant changes in body mass composition should be closely monitored to prevent negative health outcomes.

“Sarcopenia either alone or in the presence of obesity, can be used in clinical practice to estimate potential risk of cognitive impairment,” notes study co-author Magdalena Tolea.

But such health issues can be kept under control, and the risks associated with them averted, she suggests.

“Testing grip strength by dynamometry can be easily administered within the time constraints of a clinic visit, and body mass index is usually collected as part of annual wellness visits,” concludes Tolea.

How Aging and Obesity Prime the Brain for Alzheimer’s

According to another new study, the effects of natural aging processes, combined with those of obesity and a poor diet, affect certain brain mechanisms, thereby boosting the risk of Alzheimer’s. The new study, conducted on mice, uncovered how a high-fat, high-sugar diet renders the aging brain more vulnerable to Alzheimer’s.

Alzheimer’s disease is a neurodegenerative condition that is characterized primarily by memory loss and impaired cognition.  Some risk factors for the development of this disease are aging and metabolic conditions such as obesity and diabetes.  However, many of the biological mechanisms underlying the onset and progression of this disease remain unknown.

This is despite the fact that our understanding of the predisposing risk factors is growing all the time.  Now, Rebecca MacPherson, Bradley Baranowski, and Kirsten Bott — of Brock University in Ontario, Canada — have conducted a study that has allowed them to uncover some more of the mechanics at play in the development of this type of dementia.

The team worked with aging mice to investigate how a high-fat, high-sugar (HFS) diet that fueled obesity might also prime the brain for neurodegeneration in this sample.  Their findings are described in a paper now published in the journal Physiological Reports.

How unhealthful diets impact the brain

Specifically, the researchers examined how an HFS diet, in conjunction with the effects of normal biological aging, would affect insulin signaling, which helps to regulate the amount of glucose (simple sugar) absorbed by muscles and different organs.

They also looked at how this obesity-inducing diet might alter biomarkers relating to inflammation and cellular stress.

To understand the impact of an HFS diet on aging mice, the research team put some mice on a regular type diet, while others were given food that had a high fat and sugar content.

After the mice had been fed their respective diets for a period of 13 weeks, the team looked for signs of inflammation and measured cellular stress levels in two brain areas associated with memory and cognitive behavior: the hippocampus and the prefrontal cortex.

The researchers also compared the effects of an HFS diet on the brains of aging rodents’ baseline measurements effected on the brains of younger mice.

They found older mice on an obesity-inducing diet had high levels of brain inflammation and cellular stress, as well as insulin resistance in parts of the hippocampus linked to the development of Alzheimer’s disease.

Although more markers of insulin resistance were observed in the prefrontal cortices of mice that had been on an HFS diet, inflammation status and cellular stress markers remained the same.

The study authors hypothesize that “region-specific differences between the prefrontal cortex and hippocampus in response to aging with an HFS diet [suggest] that the disease pathology is not uniform throughout the brain.”

Obesity boosts aging’s negative effect

Notably, the researchers also found that brain inflammation levels had also increased in the mice that had been on a regular diet, compared with baseline measurements.

The researchers note that this could be taken as evidence of aging’s role as an independent risk factor in Alzheimer’s. Obesity, they add, boosts the risk by affecting key mechanisms in the brain.

“This study,” they claim, “provides novel information in relation to the mechanistic link between obesity and the transition from adulthood to middle age and signaling cascades that may be related to [Alzheimer’s] pathology later in life.”

“These results add to our basic understanding of the pathways involved in the early progression of [Alzheimer’s] pathogenesis and demonstrate the negative effects of an HFS diet on both the prefrontal cortex and hippocampal regions.”

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

Cohut, Maria. ”Skinny fat’ linked to cognitive decline, study warns.” Medical News Today, Friday 6 July 2018

Cohut, Maria. ”Aging, obesity may prime the brain for Alzheimer’s.” Medical News Today, Monday 2 July 2018

Will We Soon Reverse Diabetes and Obesity with Gene Therapy?

New research shows that gene therapy can completely reverse markers of Type 2 diabetes and obesity in rodents.  If the theory holds, small alterations to our genes could soon repair metabolic disorders such as obesity and Type 2 diabetes in humans.

The prevalence of diabetes, or the total number of existing cases, is on the rise in the United States and globally.  According to recent estimates, over 30 million U.S. adults had diabetes in 2015.

Although the number has been relatively steady in the past few years, rates of newly diagnosed cases among children and teenagers have increased sharply.  And, worldwide, the situation is even more alarming; the number of people with diabetes almost quadrupled between 1980 and 2014, according to the World Health Organization (WHO).

Now, new research brings much-needed hope of curing this metabolic disorder.  Scientists led by Fatima Bosch, a professor at the Universitat Autònoma de Barcelona (UAB) in Catalunya, Spain, have successfully reversed the disorder in rodents.  Prof. Bosch and her colleagues achieved this using gene therapy, a technique that introduces new genetic material into cells to create beneficial proteins or to offset the effects of malfunctioning genes.  The findings were published in the journal EMBO Molecular Medicine.

Using the FGF21 gene to reverse diabetes

Prof. Bosch and team designed two mouse models of obesity and type 2 diabetes. One was diet-induced, and the other one was genetically modified.  Using an adeno-associated viral vector as “transport,” the team delivered the fibroblast growth factor 21 (FGF21) gene.

This gene is responsible for encoding the FGF21 protein, which is seen as a “major metabolic regulator” that stimulates the absorption of blood sugar in adipose tissue.  By delivering this gene, the researchers stimulated the production of the protein, which caused the rodents to lose weight and lowered their insulin resistance — a major risk factor for type 2 diabetes. Additionally, the mice lost weight and the treatment reduced the fat and inflammation in their adipose tissue.

The fat content, inflammation, and fibrosis of the rodents’ livers were completely reversed, with no side effects. In turn, these improvements increased insulin sensitivity.  These beneficial effects were noted in both murine models. Also, the team found that administering FGF21 to healthy mice prevented age-related weight gain and led to healthy aging.

Gene therapy was used to alter three tissue types: liver tissue, adipose tissue, and skeletal muscle.  “This gives a great flexibility to the therapy,” explains Prof. Bosch, “since it allows [us] to select each time the most appropriate tissue, and in case some complication prevents manipulating any of the tissues, it can be applied to any of the others.”

“When a tissue produces FGF21 protein and secretes it into the bloodstream, it will be distributed throughout the body,” adds Prof. Bosch.

First reversion of obesity, insulin resistance

Study co-author and UAB researcher Claudia Jambrina explains that their findings are particularly significant given that “the prevalence of type 2 diabetes and obesity is growing at alarming rates around the world.”

The team also says that delivering FGF21 as a conventional drug would not yield the same benefits as gene therapy; firstly, the drug would have to be administered periodically for long-term benefits, and secondly, its toxicity would be high.  Using gene therapy, however, is free of side effects, and a single administration is enough to make the mice produce the protein naturally for several years.

“This is the first time that long-term reversion of obesity and insulin resistance have been achieved upon a one-time administration of a gene therapy, in an animal model that resembles obesity and type 2 diabetes in humans.”

First study author Veronica Jimenez, a UAB researcher

“The results demonstrate that it is a safe and effective therapy,” she adds. The next steps will be to “test this therapy in larger animals before moving to clinical trials with patients,” notes Prof. Bosch.  “[The] therapy described in this study,” she concludes, “constitutes the basis for the future clinical translation of FGF21 gene transfer to treat type 2 diabetes, obesity, and related comorbidities.”

Statistics and facts about type 2 diabetes

Diabetes mellitus, or diabetes, is a disease that causes high blood sugar. It occurs when there is a problem with insulin.

Insulin is a hormone that takes sugar from foods and moves it to the body’s cells. If the body does not make enough insulin or does not use insulin well, the sugar from food stays in the blood, resulting in high blood sugar.

Diabetes is a key health concern worldwide. In the United States, the rate of new cases rose sharply from the 1990s, but it fell between 2008 and 2015, and it continues to fall, according to the Centers for Disease Control and Prevention’s (CDC) National Diabetes Report, 2017. Meanwhile, the number of adults living with diabetes continues to rise.

The most common of diabetes is type 2. According to the CDC, 90 to 95 percent of people with diabetes in the United States have type 2. Just 5 percent of people have type 1.

Key facts

Diabetes is at an all-time high in the U.S. The CDC’s Division of Diabetes Translation states that 1 percent of the population, which is about a half of a million people, had diagnosed diabetes in 1958.

In 2015, around 9.4 percent of the population in the U.S. had diabetes, including 30.2 million adults aged 18 years and over. Nearly a quarter of those with the condition do not know they have it.

Between 1990 and 2010, the number of people living with diabetes more than tripled, and the number of new cases doubled every year.

Figures suggest that the incidence is levelling off and may even be falling, but it remains unclear whether this will continue as other factors come into play, such as the aging population.

The risk of developing diabetes increases with age.

The CDC report that 4.0 percent of people aged 18 to 44 years are living with diabetes, 17 percent of those aged 45 to 64 years, and 25.2 percent of those aged over 65 years.

Causes

Type 2 diabetes is thought to result from a combination of genetic and lifestyle factors.

The exact cause is unknown, but risk factors appear to include:

  • excess body fat
  • high blood pressure or cholesterol
  • having a close family member with the condition
  • a history of gestational diabetes
  • higher age

As obesity has become more prevalent over the past few decades, so too has the rate of type 2 diabetes. In 2013, more than 1 in 3 people in the U.S. were considered to have obesity, and over 2 in 3 were either overweight or had obesity.

In 1995, obesity affected 15.3 percent of Americans, and in 2008, the figure was 25.6 percent. From 1998 to 2008, the incidence of diabetes increased by 90 percent.

Although the link between obesity and diabetes is well known, the reasons they are connected remain unclear. A report in the Journal of Clinical Endocrinology and Metabolism asks why obesity does not always lead to diabetes, given the established link between the two conditions.

The same report notes that the location of body fat appears to play a role. People with more fat in the upper body area and around the waist are more likely to get diabetes than those who carry their body fat around the hips and lower body.

Diabetes and ethnicity

Rates of diabetes vary between ethnic groups.

There may be a combination of factors, including:

  • genetics
  • health conditions
  • lifestyle
  • finances
  • environment
  • access to healthcare

The CDC’s National Diabetes Statistics Report, 2017, found that, among people aged 20 years and over, diabetes affects:

  • 7.4 percent of Non-Hispanic whites
  • 8.0 percent of Asian Americans
  • 12.1 percent of Hispanics
  • 12.7 percent of Non-Hispanic Blacks
  • 15.1 percent of American Indians and Alaska Natives

Why diabetes is serious

Diabetes can have serious health consequences.

The ADA report that more Americans die from diabetes every year than from AIDS and breast cancer combined.

According to the CDC, 79,535 deaths occur each year due to diabetes. The number of fatalities related to diabetes may be underreported.

Why and how does diabetes damage the body and cause complications?

The ADA says:

  • Adults with diabetes are significantly more likely to die from a heart attack or stroke.
  • More than a quarter of all Americans with diabetes have diabetic retinopathy, which can cause vision loss and blindness.
  • Each year, nearly 50,000 Americans begin treatment for kidney failure due to diabetes. Diabetes accounts for 44 percent of all new cases of kidney failure.
  • Each year, diabetes causes about 73,000 lower limb amputations, which accounts for 60 percent of all lower limb amputations (not including amputations due to trauma).

Costs

Because of its high prevalence and link to numerous health problems, diabetes has a significant impact on healthcare costs.

The productivity loss for reduced performance at work due to diabetes in 2012 was 113 million days, or $20.8 billion, according to the ADA.

Diabetes cost the U.S. $327 billion in 2017, including $237 billion in medical costs and $90 billion in reduced productivity.

However, this number does not include:

  • the millions of people who have diabetes but are undiagnosed
  • the cost of prevention programs for people with diabetes, which are not counted under standard medical costs
  • over-the-counter medications for eye and dental problems, which are more common in people with diabetes.
  • administrative costs for insurance claims
  • the cost of reduced quality of life, lost productivity of family members, and other factors that cannot be measured directly

Because diabetes affects various parts of the body, the medical costs span different areas of specialty. The ADA report that:

  • 30 percent of medical costs associated with diabetes are for circulation problems that reduce blood flow to the limbs
  • 29 percent of medical costs associated with diabetes are for kidney conditions
  • 28 percent of medical costs associated with diabetes are for nervous system conditions

Despite its complications, people can manage their diabetes with a comprehensive plan that includes lifestyle changes and proper medical care. If they control their blood sugar levels well, many people with diabetes can lead full, active lives.

Difference between types 1 and 2

In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. As a result, the body does not produce insulin, and people with this condition must take insulin by injection or pump every day.

Type 1 diabetes usually develops in children or young adults, but it can occur at any age. There is no known way to prevent type 1 diabetes, and there is no cure.

In 2011-2012, around 17,900 children under the age of 18 years received a diagnosis of type 1 diabetes in the U.S., or around 49 children each day. Type 1 diabetes affects around 1.25 million American adults and children.

People with type 2 diabetes may still have insulin in their bodies, but not enough for proper blood sugar control. Or, the body may not be able to use the insulin it has properly. As a result, blood sugar levels can become too high.

Typically, adults are diagnosed with type 2 diabetes, but children can get it too. Certain factors increase a person’s risk of getting type 2 diabetes, including:

  • obesity
  • older age
  • a family history of diabetes
  • lack of exercise
  • problems with glucose metabolism

The annual relative increase for type 1 diabetes in 2002-2012 in the U.S. was 1.8 percent, but the annual increase for type 2 diabetes was 4.8 percent.

If diabetes or any other medical concern has you running a little slow, join our ecosystem designed to support your well being.  HealthLynked is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

[1]  Murrell MD, Daniel.  “Statistics and facts about type 2 diabetes.” Medical News Today. 12 June 2018

[2]  Sandoiu, Ana. “Type 2 diabetes, obesity may soon be reversed with gene therapy.”  Medical News Today, 12 July 2018

Loneliness – A Gene Deep Epidemic that Raises Health Risks and Can Be Spread

A 2016 survey of more than 2,000 American adults found 72 percent report having felt a sense of loneliness, with nearly a third (31 percent) experiencing loneliness at least once a week. The survey was conducted online by Harris Poll on behalf of the American Osteopathic Association in September.

Isolation is often an underlying factor in many of the most common health conditions, including chronic pain, substance abuse and depression, according to osteopathic physicians.

Long working hours, increased use of social media—in many cases surpassing in-person interaction—and a mobile workforce traveling or living far from family contribute to the high rates of loneliness, noted Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine.

“Loneliness is an invisible epidemic masked by our online personas, which are rarely representative of our real emotions,” said Dr. Caudle. “It’s important for patients to understand how their mental and emotional well-being directly affects the body. By taking a whole-person approach to care, osteopathic physicians are trained to address these underlying issues that can quietly erode patients’ health.”

Damage to the Immune Response

Research links loneliness to a number of dysfunctional immune responses, suggesting that being lonely has the potential to harm overall health.

In one study, researchers found that people who were more lonely showed signs of elevated latent herpes virus reactivation and produced more inflammation-related proteins in response to acute stress than did people who felt more socially connected.

These proteins signal the presence of inflammation, and chronic inflammation is linked to numerous conditions, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer’s disease, as well as the frailty and functional decline that can accompany aging.

Reactivation of a latent herpes virus is known to be associated with stress, suggesting that loneliness functions as a chronic stressor that triggers a poorly controlled immune response.

“It is clear from previous research that poor-quality relationships are linked to a number of health problems, including premature mortality and all sorts of other very serious health conditions. And people who are lonely clearly feel like they are in poor-quality relationships,” said Lisa Jaremka, a postdoctoral fellow at the Institute for Behavioral Medicine Research at Ohio State University and lead author of the research.

“One reason this type of research is important is to understand how loneliness and relationships broadly affect health. The more we understand about the process, the more potential there is to counter those negative effects – to perhaps intervene. If we don’t know the physiological processes, what are we going to do to change them?”

The results are based on a series of studies conducted with two populations: a healthy group of overweight middle-aged adults and a group of breast cancer survivors. The researchers measured loneliness in all studies using the UCLA Loneliness Scale, a questionnaire that assesses perceptions of social isolation and loneliness.

Jaremka presented the research at the Society for Personality and Social Psychology annual meeting in New Orleans.

The researchers first sought to obtain a snapshot of immune system behavior related to loneliness by gauging levels of antibodies in the blood that are produced when herpes viruses are reactivated.

Participants were 200 breast cancer survivors who were between two months and three years past completion of cancer treatment with an average age of 51 years. Their blood was analyzed for the presence of antibodies against Epstein-Barr virus and cytomegalovirus.

Both are herpes viruses that infect a majority of Americans. About half of infections do not produce illness, but once a person is infected, the viruses remain dormant in the body and can be reactivated, resulting in elevated antibody levels, or titers – again, often producing no symptoms but hinting at regulatory problems in the cellular immune system.

Lonelier participants had higher levels of antibodies against cytomegalovirus than did less lonely participants, and those higher antibody levels were related to more pain, depression and fatigue symptoms. No difference was seen in Epstein-Barr virus antibody levels, possibly because this reactivation is linked to age and many of these participants were somewhat older, meaning reactivation related to loneliness would be difficult to detect, Jaremka said.

Previous research has suggested that stress can promote reactivation of these viruses, also resulting in elevated antibody titers.

“The same processes involved in stress and reactivation of these viruses is probably also relevant to the loneliness findings,” Jaremka said. “Loneliness has been thought of in many ways as a chronic stressor – a socially painful situation that can last for quite a long time.”

In an additional set of studies, the scientists sought to determine how loneliness affected the production of proinflammatory proteins, or cytokines, in response to stress. These studies were conducted with 144 women from the same group of breast cancer survivors and a group of 134 overweight middle-aged and older adults with no major health problems.

Baseline blood samples were taken from all participants, who were then subjected to stress – they were asked to deliver an impromptu five-minute speech and perform a mental arithmetic task in front of a video camera and three panelists. Researchers followed by stimulating the participants’ immune systems with lipopolysaccharide, a compound found on bacterial cell walls that is known to trigger an immune response.

In both populations, those who were lonelier produced significantly higher levels of a cytokine called interleukin-6, or IL-6, in response to acute stress than did participants who were more socially connected. Levels of another cytokine, tumor necrosis factor-alpha, also rose more dramatically in lonelier participants than in less lonely participants, but the findings were significant by statistical standards in only one study group, the healthy adults.

In the study with breast cancer survivors, researchers also tested for levels of the cytokine interleukin 1-beta, which was produced at higher levels in lonelier participants.

When the scientists controlled for a number of factors, including sleep quality, age and general health measures, the results were the same.  “We saw consistency in the sense that more lonely people in both studies had more inflammation than less lonely people,” Jaremka said.

“It’s also important to remember the flip side, which is that people who feel very socially connected are experiencing more positive outcomes,” she said.

Loneliness Can Add 30 Points To Your Blood Pressure

In another study conducted at the Center for Cognitive and Social Neuroscience at the University of Chicago, researchers found that if you are over 50 and lonely, you could be adding 30 points to your blood pressure and raising significantly your chances of suffering from hypertension.   The increase in blood pressure due to loneliness was present after taking into account a person’s emotional state (how sad or stressed the person was).

The older the lonely person gets, the higher his/her blood pressure seems to get, said the researchers.   Lead researcher, Louise Hawkley, said “The take-home message is that feelings of loneliness are a health risk, in that the lonelier you are, the higher your blood pressure. And we know that high blood pressure has all kinds of negative consequences.”

229 people were monitored in this study, aged 50-68. The participants had to answer a questionnaire which determined each person’s level of loneliness.

Hawkley said it is not as simple as that. She said “Remember, people can feel lonely even if they are with a lot of people. You can think of Marilyn Monroe or Princess Diana – there was certainly nothing lacking in their social lives, yet they claimed to have felt intensely lonely. They may want to go out and make friends, and yet they have a nagging lack of trust with whomever they want to interact with, or they may feel hostile. So, they end up behaving in ways that force potential partners away.”

Loneliness Is Gene Deep

Loneliness has a molecular signature is reflected in the lonely person’s DNA. This was the conclusion of a new US study by scientists at the University of California Los Angeles (UCLA) and other US academic centers.

The study is published in an issue of the journal, Genome Biology.  The researchers discovered a distinct pattern of gene expression in immune cells of people who are chronically extremely lonely.

Study author Steve Cole, associate professor of medicine at the Division of Hematology and Oncology at the David Geffen School of Medicine at UCLA, member of the Cousins Center for Psychoneuroimmunology, and member of UCLA’s Jonsson Comprehensive Cancer Center said in a press release that:

“What this study shows is that the biological impact of social isolation reaches down into some of our most basic internal processes: the activity of our genes.”  Cole and colleagues suggest that feelings of isolation are linked to changes in gene expression that drive inflammation, one of the first responses of the immune system.  They hope the study gives a framework for understanding how social factors and increased risk of heart disease, viral infections and cancer are linked.

Scientists already know that social environments affect health. People who are lonely and socially isolated die earlier.  What they don’t know is if the higher rate of death among lonely people is because of reduced social resources or because of the effect of isolation on their bodily functions, or perhaps both.

However, Cole and the other researchers found that changes in the way immune cells express their genes were directly linked to the “subjective experience of social distance”.  The differences were independent of other known risk factors like health status, weight, age and use of medication, they said.  “The changes were even independent of the objective size of a person’s social network,” said Cole.

Cole and colleagues enrolled 14 participants from the Chicago Health, Aging, and Social Relations Study and scanned their DNA using a chip technology called DNA microarrays that allowed them to survey all known human genes in the samples.  6 of the participants scored in the top 15 per cent of a well known psychological test for loneliness that was developed in the 70s called the UCLA Loneliness Scale.  The remaining 8 participants scored in the bottom 15 per cent of the Loneliness Scale.

The DNA survey showed that 209 gene transcripts (where the gene gets its code ready to start making proteins) were expressed differently between the two groups. All the genes coded for leucocytes, agents of the immune system.  78 of the gene transcripts were “over expressed” (resulting in too much protein) and 131 were “under expressed” (not enough protein) in the lonely individuals compared to the others.

The over expressed genes included many that control immune system functions like inflammation.  However, it was also interesting that the under expressed genes were those involved in antiviral responses and production of antibodies.

“These data provide the first indication that human genome-wide transcriptional activity is altered in association with a social epidemiological risk factor. Impaired transcription of glucocorticoid response genes and increased activity of pro-inflammatory transcription control pathways provide a functional genomic explanation for elevated risk of inflammatory disease in individuals who experience chronically high levels of subjective social isolation.”

Distinguishing between the various aspects of loneliness that are closely linked to these changes in gene expression, the scientists discovered:  “What counts at the level of gene expression is not how many people you know, it’s how many you feel really close to over time,” said Cole.  He added that the findings could identify molecular targets for blocking the negative health impact of social isolation.

Loneliness Can Spread Through Social Networks

A US study of social networks found that a person’s loneliness can spread to others, in that when they become lonely they move to the edge of the network and transmit feelings of loneliness to their few remaining friends who also become lonely, leading to an effect that the researchers described as an unravelling at the edges of our social fabric.

The study, which was sponsored by the National Institute on Aging, is the work of John T Cacciopo of the University of Chicago, James H Fowler of the University of California, San Diego, and Nicholas A Christakis of Harvard University and is about to be published in the December issue of the Journal of Personality and Social Psychology.

Cacciopo, a social neuroscientist and lead investigator on the study, is Tiffany and Margaret Blake Distinguished Service Professor in Psychology at Chicago. He told the press that:

“We detected an extraordinary pattern of contagion that leads people to be moved to the edge of the social network when they become lonely.”

“On the periphery people have fewer friends, yet their loneliness leads them to losing the few ties they have left,” he added.

Loneliness is often associated with mental and physical diseases that can shorten life, said Cacioppo, so it is important for us to recognize it and help people reconnect with their social group before they move to the edges.

He and his co-authors wrote that while previous studies have already shown that a person’s loneliness and the number of people they are connected to in a network are linked, we don’t know much about “the placement of loneliness within, or the spread of loneliness through, social networks”.

Using longitudinal data from a large-scale study, they found that loneliness, like a bad cold, spreads in groups: people share their loneliness with others.

Cacioppo and colleagues used data on 5,124 people in the second generation of participants from the Framingham Heart Study, which has been tracking the health of individuals and their descendants for more than 60 years. The data set included information taken every two to four years on participants’ friends and social contacts.

For the study, Cacioppo and colleagues charted the friendship histories of participants and linked them to their reports of loneliness. This showed a pattern of loneliness that spread as people reported fewer close friends, and that lonely people appeared to transmit loneliness to others, and then moved to the edges of their social networks.

“Loneliness is disproportionately represented at the periphery of social networks and spreads through a contagious process,” wrote the researchers.

For example, one pattern might start when a participant reports one extra day a week of loneliness. This is followed by similar reports among his or her next-door neighbors who are also close friends. The pattern of loneliness then spreads as the neighbors spend less time together.

“These reinforcing effects mean that our social fabric can fray at the edges, like a yarn that comes loose at the end of a crocheted sweater,” explained Cacioppo.

The researchers also found that:

  • Women were more likely to report “catching loneliness from others” than men (perhaps reinforcing findings from studies that suggest women rely more on emotional support than men).
  • Loneliness occurred in clusters and extended up to three degrees of separation.
  • A person’s chances of reporting increased loneliness were more likely to be linked to changes in friendship networks than changes in family networks.

The authors concluded that the study helps us better understand the social forces that drive loneliness.

Society may benefit by “aggressively targeting the people in the periphery to help repair their social networks and to create a protective barrier against loneliness that can keep the whole network from unraveling,” they added.

Other studies suggest that as people become lonely they trust other people less and less, and this leads to a cycle of less trusting and more loneliness, which leads to less trusting, and so on, and as time goes by it becomes harder and harder to make friends.

Cacioppo said researchers have seen this social tendency reflected in monkey colonies that drive out members who have been removed and then reintroduced.  He said such a pattern makes it all the more important for us to recognize and offset loneliness before it spreads.

Overcoming Loneliness

The first step in addressing loneliness is to determine whether those feelings are caused by depression. A physician can diagnose any existing mental health conditions and suggest treatment options. To limit loneliness, physicians recommend some simple steps to help increase real social engagement:

  1. Consider a digital cleanse. Social networks can offer real connections, but the curated platforms may over-emphasize the success of others, which can lead to feelings of inadequacy. For more empowering activities, consider enrolling in a continuing education course or spending time enjoying nature.
  2. Exercise with others. Participating in a running club, group fitness course or team sport can have dual benefits, creating opportunities to meet new people while also improving physical health. Many sports stores, churches and community groups offer free weekly activities including fun runs and yoga.
  3. Buy local. Developing a routine that includes visiting a local shopkeeper, coffee shop, farmers’ market or gym builds roots in the community. Creating relationships with local vendors can lead to a sense of shared history and camaraderie.
  4. Step out of your comfort zone. Introducing yourself to nearby neighbors or engaging with people in the building elevator—while initially uncomfortable—can begin the process of developing community and has the added bonus of alleviating loneliness for others.
  5. Change jobs, schools or cities. This drastic option is not always possible, and certainly not easy, but it may have the most significant impact. Start by identifying the culture that would best fit your personality and work toward a transition.

“Face-to-face communication is critical for emotional and mental health,” Dr. Caudle added. “Seeking out meaningful human interactions makes patients happier and, ultimately, healthier overall.”

Conclusion

Loneliness has negative effects on your immune system, creates a genetic signature and can spread through social networks.  Our digital addictions seem to be contributing to our disconnectedness.  Additional studies indicate loneliness significantly shortens lives and can lead to or magnify dementia and Alzheimer’s.

Today is National Cheer up the Lonely Day.  Visit with the lonely and bring happy things to talk about. Keep the conversation upbeat, and lively. When you leave, give a big hug and let them know you enjoyed the stay. Sending cards or making a phone call is okay if they live too far away to visit, but what a lonely person really needs is face to face time with other people.

If you are feeling lonely, other studies indicate you are more likely to see a physician with increased frequency. To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

[1] Caldwell, Emily. The Immune System Taxed By Loneliness, Similar To The Effect Of Chronic Stress.  Medical News Today, Tuesday 22 January 2013

This work was supported by grants from the National Institutes of Health, the American Cancer Society Postdoctoral Fellowship and a Pelotonia Postdoctoral Fellowship from Ohio State’s Comprehensive Cancer Center.

Co-authors include Christopher Fagundes of the Institute for Behavioral Medicine Research (IBMR); Juan Peng of the College of Public Health; Jeanette Bennett of the Division of Oral Biology; Ronald Glaser of the Department of Molecular Virology, Immunology and Medical Genetics; William Malarkey of the Department of Internal Medicine; and Janice Kiecolt-Glaser of the Department of Psychiatry, all at Ohio State. Bennett, Glaser, Malarkey and Kiecolt-Glaser are also IBMR investigators.

[2] Lombardi, Yvonne. Loneliness Can Add 30 Points To Your Blood Pressure If You Are Over 50.  Medical News Today. Wednesday, 29 March 2006.

[3] Paddock, Catharine PhD.  Loneliness Is Gene Deep. Medical News Today. Friday, 14 September 2007

“Effects of loneliness on gene expression.”
Cole SW, Hawkley LC, Arevalo JM, Sung CY, Rose RM, Cacioppo JT.
Genome Biology 2007, 8:R189.
doi:10.1186/gb-2007-8-9-r189
Published online 13 September 2007 (provisional version).

[4]  Paddock, Catharine PhD.  Loneliness Can Spread Through Social Networks.  Medical News Today. Wednesday, 2 December 2009

“Alone in the Crowd: The Structure and Spread of Loneliness in a Large Social Network.”
John T Cacciopo, James H Fowler, Nicholas A Christakis.
Journal of Personality and Social Psychology, December 2009 (pre-publication proof).
DOI:10.1037/a0016076

[5] American Osteopathic Association.  Survey Finds Nearly Three-Quarters (72%) of Americans Feel Lonely: Osteopathic Physicians Say Silent ‘Loneliness Epidemic’ Contributes to Nation’s Health Woes. PRN. Oct 11, 2016.

 

Is Working Long Hours Raising Your Risk for Diabetes?

Women who work 45 hours or more each week may be upping their risk of diabetes, new research finds. Men who work the same number of hours, however, are not affected.

While prior research has suggested a link between a long work week and an increased risk of diabetes, most of these studies focused on men.  Interestingly, this recent research seems to find the opposite effect in males: the longer the work week, the lower the incidence of diabetes.

For women who work 45 hours per week or more, though, their risk was considerably higher.  When compared with women who work 35–40 hours each week, they had a 63 percent higher risk of developing diabetes.

The authors of the new study, which was published in BMJ Open Diabetes Research and Care, looked at data from the 2003 Canadian Community Health survey, which included respondents aged 35–74.

They also looked at the Ontario Health Insurance Plan database for physician services, as well as the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions.

In all, over 7,000 Canadian employees were included in the research. As well as looking at hours worked, the researchers also included other factors in their analysis, such as: sex, marital status, parenthood, ethnicity, place of birth, place of residence, long-term health conditions, lifestyle, weight, and body mass index (BMI).

They also considered unique workplace factors, such as shift work and the type of job the respondents did — for instance, whether it was predominantly active or sedentary.

Overall, the risk of diabetes was “only slightly reduced” when factors such as smoking and alcohol levels were considered.

While the researchers could not establish a definitive cause and effect from these data, they note that encouraging women to work fewer hours may be a key component of reducing the number of diabetes cases.

The shape of diabetes

Diabetes is a widespread issue around the world and impacts many lives. When someone has diabetes, their body does not utilize insulin properly; the pancreas increases production of the hormone until it can no longer keep up with the body’s demands.

This leads to higher-than-normal blood glucose levels and can eventually cause a wide range of problems throughout the body.

The American Diabetes Association say that over 30 million people in the United States have diabetes, and 7 million of these individuals are unaware of it.

Diabetes remains the seventh leading cause of death in the U.S., and, each year, doctors discover 1.5 million new cases. Worldwide, this number jumps to 425 million adults, with half remaining undiagnosed.

Diabetes prevention and management, then, are an essential facet of public health. Studies such as this one can help doctors to create guidelines that can positively impact the health of their patients and lead to fewer cases of diabetes down the road.

Limitations and next steps

Although the records used in this study did not distinguish between type 1 and type 2 diabetes, it is estimated that type 1 diabetes accounts for around 5 percent of cases among those aged 18 or over, so most of these cases were likely to be type 2.

In the future, if further studies agree with these findings, healthcare providers may recommend that women work 40 hours per week or under.

The study authors write, “Considering the rapid and substantial increase of diabetes prevalence…worldwide, identifying modifiable risk factors such as long work hours is of major importance to improve prevention and orient policy making, as it could prevent numerous cases of diabetes and diabetes-related chronic diseases.”


If working long hours is causing you to feel poorly, consider talking to a physician. To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Source:
Beyer, Monica. “Diabetes risk increased in women who work long hours.” Medical News Today. Sunday, 8 July 2018.