Lack of Vitamin D predicts senility

Posted on November 29, 2014 by Maurice Preter MD

Vitamin D and senility – another relevant data set.

 Vitamin D deficiency predicts cognitive decline in older men and women

The Pro.V.A. Study

  1. Elena D. Toffanello, MD,
  2. Alessandra Coin, MD,
  3. Egle Perissinotto, ScD,
  4. Sabina Zambon, MD,
  5. Silvia Sarti, MD,
  6. Nicola Veronese, MD,
  7. Marina De Rui, MD,
  8. Francesco Bolzetta, MD,
  9. Maria-Chiara Corti, MD, MSH,
  10. Gaetano Crepaldi, MD,
  11. Enzo Manzato, MD and
  12. Giuseppe Sergi, MD

+AUTHOR AFFILIATIONS

| + SHOW FULL DISCLOSURES


  1. From the Department of Medical and Surgical Sciences (Department of Medicine–DIMED), Geriatrics Division (E.D.T., A.C., S.S., N.V., D.R.M., F.B., E.M., G.S.), and Departments of Cardiac, Thoracic and Vascular Sciences (E.P.) and Medical and Surgical Sciences (S.Z.), University of Padova; National Research Council (S.Z., G.C., E.M.), Aging Branch, Institute of Neuroscience, Padova; and Azienda Unità Locale Socio Sanitaria 16 (M.-C.C.), Padova, Italy.
  1. Correspondence to Dr. Toffanello: elenadebora.toffanello@sanita.padova.it
  1. Published online before print November 5, 2014, doi: http://dx.doi.org/10.1212/WNL.0000000000001080Neurology 10.1212/WNL.0000000000001080

ABSTRACT

Objective: To test the hypothesis that hypovitaminosis D is associated with a higher risk of cognitive decline over a 4.4-year follow-up in a large sample of older adults.

Methods: This research was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study of 1,927 elderly subjects. Serum 25-hydroxyvitamin D (25OHD) levels were measured at the baseline. Global cognitive function was measured with the Mini-Mental State Examination (MMSE); scores lower than 24 were indicative of cognitive dysfunction, and a decline of 3 or more points on the MMSE over the follow-up was considered as clinically significant. Analyses were adjusted for relevant confounders, including health and performance status.

Results: Participants with 25OHD deficiency (<50 nmol/L) or insufficiency (50–75 nmol/L) were more likely to have declining MMSE scores during the follow-up than those who were 25OHD sufficient (≥75 nmol/L). Among participants cognitively intact (baseline MMSE scores ≥24 and without diagnosis of dementia), the multivariate adjusted relative risk (95% confidence interval [CI]) of the onset of cognitive dysfunction was 1.36 (95% CI: 1.04–1.80; p = 0.02) for those with vitamin D deficiency and 1.29 (95% CI: 1.00–1.76; p = 0.05) for those with vitamin D insufficiency by comparison with individuals with normal 25OHD levels.

Conclusion: The results of our study support an independent association between low 25OHD levels and cognitive decline in elderly individuals. In cognitively intact elderly subjects, 25OHD levels below 75 nmol/L are already predictive of global cognitive dysfunction at 4.4 years.

  • Received June 18, 2014.
  • Accepted in final form September 11, 2014.

FOLLOW NEUROLOGY:     

Neurology
Print ISSN: 0028-3878
Online ISSN: 1526-632X
    • American Academy of Neurology
    • HighWire
    • Wolters Kluwer Lippincott Williams Wilkins
WriteClick is a trademark of the AAN, registered in the U.S.
© 2014 American Academy of Neurology | Help | Feedback | Advertise
Posted in Aging, epigenetics, Health, keto, News, Psychiatry/Neurology | Tagged , |

Low Testosterone: No consistent evidence of an increased risk of heart problems with testosterone medicines

Posted on November 29, 2014 by Maurice Preter MD

No consistent evidence of an increased risk of heart problems with testosterone medicines

The  Coordination Group for Mutual Recognition and Decentralised Procedures – Human (CMDh), a regulatory body representing EU Member States, has agreed by consensus that there is no consistent evidence of an increased risk of heart problems with testosterone medicines in men who lack the hormone (a condition known as hypogonadism). However, the product information is to be updated in line with the most current available evidence on safety, and with warnings that the lack of testosterone should be confirmed by signs and symptoms and laboratory tests before treating men with these medicines.

The CMDh position follows a review by the EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) which looked at the risk of serious problems affecting the heart and circulation, particularly heart attacks, in men treated with these medicines. The review was started because of some recent studies suggesting an increase in heart problems in men using testosterone, compared with men not using it. The PRAC considered these studies along with available data from other studies and analyses, and information on safety collected since marketing, and found that the evidence regarding the risk of heart problems was inconsistent: some studies suggested increased risk, while others did not, and some of the studies had problems with the design that limited the conclusions that could be drawn from them. The PRAC also noted that the lack of testosterone itself could increase the risk of heart problems.

The PRAC recommended updating the product information in line with the latest evidence and to provide warnings about those who might be at increased risk of heart problems. The product information should make it clear that testosterone should only be used when an abnormally low level of the hormone has been confirmed by signs and symptoms and appropriate laboratory tests. Testosterone levels naturally fall somewhat with age, but restoration of these levels in healthy older men is not an authorised use of the medicine in the EU. The PRAC further considered that the risks of effects on the heart and circulation, and any potential mechanisms for such effects should continue to be monitored, and information from ongoing studies should be provided as part of the next regular safety review (to which these medicines, like all medicines in the EU, are subject).

The CMDh has endorsed the PRAC recommendations by consensus and they will now be directly implemented according to an agreed timetable by the Member States where the medicines are authorised.

Expand all items in this list

Information to patients
Information to healthcare professionals
More about the medicine
More about the procedure
Posted in keto, News |

Mobile phone and cordless phone use and brain tumor risk

Posted on November 29, 2014 by Maurice Preter MD

Available online 29 October 2014

Mobile phone and cordless phone use and the risk for glioma – Analysis of pooled case-control studies in Sweden, 1997–2003 and 2007–2009

Choose an option to locate/access this article:
Check if you have access through your login credentials or your institution

Check access

Purchase $31.50

doi:10.1016/j.pathophys.2014.10.001
Get rights and content

Abstract

We made a pooled analysis of two case-control studies on malignant brain tumours with patients diagnosed during 1997–2003 and 2007–2009. They were aged 20–80 years and 18–75 years, respectively, at the time of diagnosis. Only cases with histopathological verification of the tumour were included. Population-based controls, matched on age and gender, were used. Exposures were assessed by questionnaire. The whole reference group was used in the unconditional regression analysis adjusted for gender, age, year of diagnosis, and socio-economic index. In total, 1498 (89%) cases and 3530 (87%) controls participated. Mobile phone use increased the risk of glioma, OR = 1.3, 95% CI = 1.1–1.6 overall, increasing to OR = 3.0, 95% CI = 1.7–5.2 in the >25 year latency group. Use of cordless phones increased the risk to OR = 1.4, 95% CI = 1.1–1.7, with highest risk in the >15–20 years latency group yielding OR = 1.7, 95% CI = 1.1–2.5. The OR increased statistically significant both per 100 h of cumulative use, and per year of latency for mobile and cordless phone use. Highest ORs overall were found for ipsilateral mobile or cordless phone use, OR = 1.8, 95% CI = 1.4–2.2 and OR = 1.7, 95% CI = 1.3–2.1, respectively. The highest risk was found for glioma in the temporal lobe. First use of mobile or cordless phone before the age of 20 gave higher OR for glioma than in later age groups.

Keywords

  • Ipsilateral;
  • 25 years latency;
  • Time since first exposure;
  • Glioma;
  • Wireless phones
Corresponding author. Tel.: +46 196021000; fax: +46 19183510.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Posted in Events, Fifth Avenue Concierge Medicine, Health, keto, News | Tagged |

New Book Alert: Panic Disorder: Neurobiological and Treatment Aspects

Posted on November 24, 2014 by Maurice Preter MD
Panic Disorder

Panic Disorder

Neurobiological and Treatment Aspects

Nardi, Antonio Egidio, Freire, Rafael Christophe R (Eds.)

2015, Approx. 300 p. 20 illus., 5 illus. in color.

Available Formats:

eBook
Information
Hardcover
Information
approx. $189.00

(net) price for USA

ISBN 978-3-319-12537-4

free shipping for individuals worldwide

Due: July 25, 2015

 

add to marked items

  • All updated neurobiological aspects in just one book
  • Researchers from different countries working together
  • Psychopharmacological aspects based on research data described in a clear and practical way to clinicians
  • Neuroimaging and respiratory data
The book focuses on the neurobiological and treatment aspects of panic disorder. It describes the most recent research data and pharmacological therapeutic aspects of panic disorder. The biochemical, respiratory, imaging, and translational aspects will be together with diagnostic and pharmacological discussion. We have the collaboration of important and recognized researchers from various countries – Brazil, USA, Italy, Spain, United Kingdom, and Switzerland – all of them with a continuous and relevant work on anxiety disorders. “Panic Disorder: Neurobiological and Treatment Aspects” is intended to be a reference book for those who research or treat panic disorder and anxiety disorder patients.

Content Level » Professional/practitioner

Keywords » Diagnosis – Imaging – Neuropharmacology – Panic disorder – Treatment

Related subjects » Biomedical Sciences – Neuroscience – Psychiatry – Psychology

TABLE OF CONTENTS

1. Panic disorder respiratory subtype.- 2. A neural systems approach to the study of panic disorder.- 3. Benzodiazepines in panic disorder.- 4. Pharmacological treatment with  the Serotonin Selective Receptores inhibitors.- 5. The psychological development of panic disorder: implications for neurobiology and treatment.- 6. Panic Disorder, is it really a mental disorder? From body functions to the homeostatic brain.- 7. Panic disorder and personality disorders.- 8. Panic Disorder and general medical comorbidities.- 9. Repetitive transcranial magnetic stimulation to treat panic disorder.- 10. The hippocampus and Panic Disorder: evidence from animal and human studies.- 11. Circadian Rhythm in Panic Disorder.- 12. Myocardial Perfusion and Panic Disorder.- 13. Exercise in Panic Disorder: implications for maintenance, treatment and physical health.- 14. Pulmonary thromboembolism as a differential diagnosis of respiratory panic disorder.- 15. Panic disorder and cardiovascular death: what’s beneath?.- 16. Update on genetics of panic disorder.- 17. Panic and Self-consciousness.- 18. Lifelong opioidergic vulnerability through early life separation: A recent extension of the false suffocation alarm theory of panic disorder.

NEW BOOK ALERT

Get alerted on new Springer publications in the subject area of Psychiatry.


 

Posted in Events, keto, News, Psychiatry/Neurology | Tagged , |

Clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss.

Posted on November 21, 2014 by Maurice Preter MD
Obes Rev. 2014 Nov 17. doi: 10.1111/obr.12230. [Epub ahead of print]

Do ketogenic diets really suppress appetite? A systematic review and meta-analysis.

Abstract

Very-low-energy diets (VLEDs) and ketogenic low-carbohydrate diets (KLCDs) are two dietary strategies that have been associated with a suppression of appetite. However, the results of clinical trials investigating the effect of ketogenic diets on appetite are inconsistent. To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, we conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analogue scales before (in energy balance) and during (while in ketosis) adherence to VLED or KLCD. Individuals were less hungry and exhibited greater fullness/satiety while adhering to VLED, and individuals adhering to KLCD were less hungry and had a reduced desire to eat. Although these absolute changes in appetite were small, they occurred within the context of energy restriction, which is known to increase appetite in obese people. Thus, the clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss, although individuals may indeed feel slightly less hungry (or more full or satisfied). Ketosis appears to provide a plausible explanation for this suppression of appetite. Future studies should investigate the minimum level of ketosis required to achieve appetite suppression during ketogenic weight loss diets, as this could enable inclusion of a greater variety of healthy carbohydrate-containing foods into the diet.

© 2014 International Association for the Study of Obesity (IASO).

KEYWORDS:

Appetite; ketogenic diet; low carbohydrate; very-low-energy diet

Posted in dietary, Health, keto, News | Tagged , |