STAT Quick reads about health topics in the news
Smoking resistance Smokers might have another tool to use in the battle to stop puffing: resistance training. A pilot study found that men and women who did several weeks of strength training had better quit rates than those who watched health and wellness videos. Researchers tracked the progress of 25 male and female smokers, all of whom received nicotine patches and a counseling session on how to stop smoking. They were then randomly split into two groups — one did three months of resistance training, and the other watched twice-weekly videos on health-related topics. The latter served as a control group. After 12 weeks, 16 percent of people in the resistance training group had quit, compared with 8 percent in the control group. The exercise paid off in other ways — those who worked out also lost a little over a pound on average, while the controls gained about the same amount of weight. – Los Angeles Times
Poultry and antibiotics
Jack Scoville, an 82-year-old Corvallis native, is taking part in a double-blind test for managing chronic obstructive pulmonary disease. ETHAN ERICKSON | TO YOUR HEALTH
Clinical trials offer medical growth Patients benefit by gaining access to new treatments and free medicines istered intravenously or via daily injections. Patients are pleased to be on this study, not only because of the relatively easy nature of here is medicine for what ails you – but how does your doctor receiving the drug, but also to cover the cost of treatment. Eshleman said MS drugs cost know it will work? “in the tens of thousands of dollars per year.” Drugs are approved by the “The study provides the drug,” she said. U.S. Food and Drug Administration after thorough research “We don’t do studies that don’t provide the and testing on real people with drug. That is a major advantage for people” – especially considering the cost of those drugs. real illnesses and real symptoms in a variety The clinic participated in clinical trials for of clinical trials. Many of those trials have Pradaxa, a drug for the prevention of stroke taken place under the careful watch of docand blood clots in patients with abnormal tors at mid-valley health care facilities, and heart rhythm (atrial fibrillation). The study participation is growing. was a success and the new drug replaces “The patients in our town are amazing people,” said Pat Eshleman, manager of clini- Coumadin, which can be difficult to take with cal research at The Corvallis Clinic. “We rec- certain foods and other drugs. Clinical research at The Corvallis Clinic ognize they are taking risks, and we care for began in 1999. Today, the clinic might have them. We are with them all the time.” about 15 trials running at any time and the The clinic makes it a goal to find studies that are of most benefit to its patients, either studies can last from six months to six years. because patients can’t get the drug any other The Pradaxa study has been ongoing for four years, was conducted internationally and had way or because of the cost of the drugs. “We have all kinds of fun stuff coming up,” 18,000 patients participating. “By study standards, that’s a huge study,” Eshleman said. “We try to pick (trials) that Eshleman said. are interesting for our doctors and patients.” The Corvallis Clinic is getting ready to Clinical trials are offered to hospitals, clintake on a grass allergy study, which is perfect ics and other medical facilities. It is up to the staff to research the study, negotiate the con- for mid-valley residents. Trials will begin in early 2012 with oral treatments that work like tract, budget and send doctors for training. current allergy injections. Already approved Enrollment at Corvallis Clinic trials comes from within the research department to doc- in Europe, the United States is just starting testing for this medicine. tors caring for patients who qualify. Doctors Participants will be given under-theapproach patients and enrollment begins. Currently in trial is an oral multiple sclero- tongue treatment instead of shots. Eshleman sis drug. Other drugs for MS are either admin- predicts this will be a very popular drug and
By MARIA L. KIRKPATRICK
doctors expect it to be a boon for pediatric patients.
Not always smooth sailing Not all clinical trials run smoothly. It can take up to a year after the study ends for U.S. Food and Drug Administration approval. For example, the clinic has been working for three years with various companies on a once-a-week injection treatment for diabetes. Patients with type 2 diabetes currently take shots once or twice a day, so the idea of only one shot a week is appealing. However, studies are winding up and the new drug has not been FDA-approved, which means patients will go back to daily shots. Companies also can abandon drugs in mid-test. Eshleman said the reason for such a move might not necessarily be that the trial uncovered unexpected side effects; it might be that the drug simply didn’t work well enough to earn approval. The value of these trials is priceless. Studies help support the cost of the Corvallis Clinic’s Clinical Research department and staff of eight. The drugs and findings are interesting to physicians and an advantage to the patients. Jack Scoville, an 82-year-old Corvallis native, is one of those patients. Scoville is taking part in a double-blind test for managing chronic obstructive pulmonary disease. The new drug could replace a powder inhalant with a liquid mist inhalant. In a double-blind test, Scoville and his SEE CLINICAL TRIALS | A7
Poultry farms that use organic methods that don’t involve antibiotics have significantly lower levels of drugresistant bacteria that can potentially spread to humans, according to a new study led by the University of Maryland’s School of Public Health. Antibiotic-resistant bacteria have become a problem for health care providers whose choices become limited in treating infection in humans, but there hasn’t been enough data on the sources. So, researchers say the findings, published online in Environmental Health Perspectives, are important. Antibiotic use has been commonplace for decades on large farms in aiding production of meat. But that has drawn the ire of environmentalists and some health advocates. The study may provide fuel to the argument. It suggests restricting antibiotic use from large-scale poultry farms can reduce resistance for some bacteria quickly. – The Baltimore Sun
Sleep and memory Forgotten how to do something you just learned yesterday? Consider the possibility that last night’s sleep was punctuated by mini-awakenings, robbing you of the ability to commit that new skill to memory. You might have gotten eight hours of sleep, and might not even feel tired. But when sleep is interrupted frequently – as it is in a wide range of disorders, including sleep apnea, alcoholism and Alzheimer’s disease – the ability to learn new things can be dramatically impaired, says a new study conducted on mice. The research, published in the Proceedings of the National Academy of Sciences, used a novel method to isolate the effects of sleep fragmentation from overall sleep quality. Studies to date have shown that when sleep is frequently interrupted, memory suffers. But no one really knew whether the memory problems they observed were the result of shorter cumulative sleep times, poor overall sleep quality, the degradation of some distinct part of the sleep cycle, or the sheer annoyance of being prodded awake repeatedly. This study suggests that even when frequent waking doesn’t affect sleep quality and doesn’t cut into overall sleep time, memory takes a hit. – Los Angeles Times
To Your Health
Tuesday, August 16, 2011
A B O U T T H I S S ECT I O N To Your Health, our popular quarterly publication, is going monthly – starting today. For our debut edition, To Your Health appears on the third Tuesday of August, but in the future, it will appear on the second Tuesday of each month. Each section will include a variety of stories about health and fitness, with datelines ranging from the mid-valley and throughout the world. Each month, you’ll also find a strong dose of local content, like this month’s story by Maria Kirkpatrick about clinical trials going on at mid-val-
CHRISTOPHER T. ASSAF | BALTIMORE SUN
Universal Fitness at the Overlea offers Drums Alive class in Baltimore, Md.
Take the work out of workouts Gym instructors say it’s OK to have fun while exercising By MEREDITH COHN THE BALTIMORE SUN
BALTIMORE — Go ahead and bang a drum, hang from the curtains and spin that hula hoop. Gym instructors say it’s good for you, even if you don’t realize it. The unconventional workouts are part of a movement to keep the masses focused on their fitness by disguising exercise as playtime, like spinach in brownies. And while more conventional spin, yoga and Latin dance-inspired Zumba aerobics classes remain gym staples, the quirky and even slightly juvenile additions have been attracting regulars. “It sounded fun. It didn’t seem like exercise,” 14year-old Tyree Roberts said about why he tested out a new class at Universal Fitness that involved banging, drum-style, on a large exercise ball. He’d come with his family to the gym, and each chose a class from a sign
KIM HAIRSTON | BALTIMORE SUN
Lynn Rosen Stone, right, leads a barre class in the Dance Studio at Rosenbloom Owings Mills Jewish Community Center in Maryland. that they’d noticed on their drive from their Perry Hall, Md., home to Baltimore. Tyree was attracted to “Drums Alive,” brought to the area from Germany by the gym owner and instructor, Patrick Leonard. To a musical backdrop, Leonard barks out steps on where and when to hit the drums, as well as on dance moves and yoga stretches. He says it’s appropriate for all ages, and on this day, Tyree was banging next to 63-year-old Pat Hodges, who said she was enjoying the mental “left brain-right
brain” exercise that was good “for someone my age.” Gym operators are learning to balance the “triedand-true” workouts that have kept their customers happy for years or decades with alternatives to attract people with different tastes, including those like Tyree and Hodges who may not normally go to a gym, said Meredith Poppler, a spokeswoman for the International Health, Racquet & Sportsclub Association, a trade group. With 120 million people worldwide now using 133,500 gyms, there are a lot
of different interests, but also a lot of ideas for sharing, Poppler said. In 2011, the association reports there are more age-appropriate offerings for aging baby boomers, increasingly sedentary youngsters and active Gen-Xers. The gyms also are adding training session for outside activities such as rock climbing and marathons and niche activities such as boxing. Group classes of all kinds are growing in popularity. Gaining the biggest followings have been cardio-kickboxing, yoga, high-impact aerobics and dance style, and strength-training classes, the association said. Dawn Moore-Guinness says her Charm City Hoops classes are a mix of aerobics and dance. Students must keep moving to keep the hoops going — and the calories burning at a rate of about 600 to 800 an hour, she said. “People like it,” she said. “You can get videos at Target, and there are a lot of others teaching it now. It’s a great workout. It’s gone a little mainstream.”
Dirty mouth can kill you By JANE GLENN HAAS THE ORANGE COUNTY REGISTER
Chances are you have a dirty mouth, and it could be killing you. The Surgeon General estimates 85 percent of Americans have gum disease — one of the six major risk factors for heart attacks and strokes. Indeed, the plaque in our mouths is the same as the plaque in our arteries, so if you have bleeding gums, that stuff is entering your bloodstream. “Our mouth is the gateway to health,” says Daniel L. Sindelar, for 30 years a practicing dentist in the St. Louis area and co-founder of the American Academy for Oral Systemic Health. Sindelar, author of the new book, “Refresh Life,” adds, “Our mouths are where our life begins, so don’t let it end there.” Question: Haven’t we all been checked for gum “pockets” over the years? Why is this more of a problem today? Answer: People don’t always exhibit visual problems. We now have a “Rinse Test” that shows us which bad bacteria are present. Dentists
need to be more aggressive with their patients about this. Think about it this way — if you have bad bacteria, that stuff is leaking into you. The scientific term for this is “portal of entry.” Question: So we all need to floss, right? Answer: Of course, but only 3 percent of the population does it regularly. Question: Why this sudden interest in gum disease? Answer: The new research shows us that — although our mouths are only a few inches from our brains — we have allowed inflammation to occur without much worrying. The old style of checking for gum disease was just observations. Measuring pocket depths, looking for bleeding, observing the color of the gums, to name a few. These are still important but now we can be much more scientific by using salivary diagnostics. Trouble shows up before gums are bleeding, teeth are loose or you have bad breath. If you have gum disease, you are two times more likely to have a heart attack; three times more likely to
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have a stroke; four times more likely to have dementia if the disease is present before age 35. Question: What should we ask the dentist to do? Answer: Your dentist should do a salivary diagnostic test that shows if the bad bacteria are present. Then that can be followed with gum therapy and nutritional counseling. Question: And at home, we should ...? Answer: Use something to clean between your teeth at least twice a day. And you should eat raw vegetables and consider some form of anti-inflammatory nutrition. Your dentist can advise you. There are several tools you can use to clean between your teeth, in addition to brushing — which you need to do twice a day minimally, of course. Indeed, in addition to brushing morning and night, you should clean your teeth after eating or drinking anything but water. And between your teeth, there is floss and interproximal brushes, also waterpick-type devices.
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ley medical facilities, and opportunities for reader participation, such as our monthly feature, “Weigh In.” To Your Health also will include short takes on health, fitness and nutrition topics. We’ve created it to be informative and entertaining – and we want to know what you think about it. Send questions and comments to Mike McInally, the editor of the section, at email@example.com. And dive in deep to our To Your Health section. – Mike McInally, editor
Taking steps to prevent memory loss Researchers say exercise can stall some forms of memory loss By KELLY HOGAN MILWAUKEE JOURNAL SENTINEL
MILWAUKEE — Long before Alzheimer’s disease is diagnosed — before it robs one of language, judgment and temperament — a person capable of normal daily activities starts to have trouble remembering things. This early form of memory loss is considered a harbinger of Alzheimer’s disease, which affects upward of 5.1 million people in the United States. Researchers at the University of WisconsinMilwaukee are studying whether exercise can stall this form of memory loss — called amnestic mild cognitive impairment, or aMCI — and stave off the progression of Alzheimer’s disease. By delaying the onset of the Alzheimer’s by just five years, the number of people affected by the disease could be cut in half, said J. Carson Smith, assistant professor of health sciences at the university and the study’s lead investigator. With rare exception, Alzheimer’s is a disease of an aging brain. According to the National Institute of Aging, most cases occur after age 60. About 40 percent of those who develop the disease have a genetic risk factor. In a paper published recently in the journal Psychiatry Research, Smith and his colleagues used neuroimaging — functional magnetic resonance imaging, or fMRI — to compare blood flow in the brains of subjects with aMCI who had either been physically active or inactive. Smith tested a particular type of memory, called semantic memory, which allows the brain to distinguish word meanings. In this
study, subjects were asked to discriminate between famous and unfamiliar names. When semantic memory was triggered, subjects who participated in physical activity showed enhanced blood flow to a piece of brain anatomy called the caudate nucleus. The role of this part of the brain in memory isn’t well understood. Studies have mostly focused on the hippocampus — a seahorseshaped brain structure critical to learning and memory, which is damaged during the progression of Alzheimer’s disease. Smith said the caudate nucleus is important because it plays a supportive role in semantic memory — the ability to differentiate, for example, a recognizable name like Frank Sinatra from that of a stranger. Alzheimer’s disease affects memory of past events, but it also inhibits semantic memory, thus eventually preventing a person from readily naming objects and people. “These are pilot studies that will lead to looking at whether exercise is changing brain function or structure,” Smith said. “Future studies will explore how those changes relate to cognitive function over time.” What isn’t clear is how much exercise is required to delay memory loss. “Minimal physical activity will offer a positive effect,” Smith said, “but the benefit of high-intensity exercise we don’t know yet.” He said, however, that he is certain of the value of an active lifestyle. “If you are sedentary and have genetic risk for Alzheimer’s disease, you are at risk for decline.” Paul Thompson, professor of neurology at University of California Los Angeles School of Medicine, said that staying active might be a good habit to adopt. “This type of evidence is a pretty good motivator to get up off the couch, especially if you’re worried about staying mentally sharp.”
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To Your Health
Each month,To Your Health will feature answers submitted by readers on a variety of health and fitness topics – favorite activities, tips to get out the door and exercise, suggestions for healthier eating and so forth. We’ll print the best responses from readers each month – and we’ll run all the responses online. Here’s the question for this month’s Weigh In feature: • Who has given you the most inspiration to get active and stay active? A
By SAM MCMANIS McCLATCHY NEWSPAPERS
You say you don’t give a fig about the sweet fruit that comes from the ficus tree? Well, you will after taking a succulent bite out of our quiz. 1. Which little critter pollinates figs, whose flowers are entirely inside the fruit? a) Bees b) Wasps c) Moths
3. Figs are renowned for their, uh, digestive aid. What percentage of the daily value of fiber does a cup of figs provide? a) 38 percent b) 58 percent c) 88 percent 4. A study published in the International Journal of Cancer found that high consumption of figs led to what percentage of a decrease in the incidence of postmenopausal breast cancer? a) 10 percent b) 29 percent c) 34 percent 5. Fig lore has it that a certain political leader ordered his citizens to consume at least one fig a day to ward off disease. Who was that leader? a) Alexander the Great of Macedonia b) Mithradates the Great of Pontus c) Xerxes the Great of Persia ANSWERS: 1: b; 2: b; 3: b; 4: c; 5: b. Sources: caloriecount.about.com; www.foodreference.com.
WEIGH I N
NUTRITION Q U I Z : F I GS
2. Now that the wasp reference has whetted your appetite, how many fewer calories does one cup of figs contain compared to a cup of raisins? a) 25 b) 63 c) 98
Tuesday, August 16, 2011
JAAP BUITENDIJK | ASSOCIATED PRESS
In this image released by Warner Bros. Pictures, from left, Emma Watson, Rupert Grint and Daniel Radcliffe are shown in a scene from ‘Harry Potter and the Deathly Hallows: Part 2.’ Stories from the Harry Potter series have played a role in medical studies on everything from genetics to social cognition to autism.
Harry Potter and the well of medical research By WILLIAM WEIR THE HARTFORD COURANT
HARTFORD, Conn. — Who knew the world of Harry Potter was such a rich source of material for medical researchers? For more than a decade, the stories of the phenomenally popular series have played a role in studies on everything from genetics to social cognition to autism. PubMed, an online database of medical studies, lists 30 studies that invoke the young wizard. A few examples: “Harry Potter and the Recessive Allele,” “Harry Potter and the Structural Biologist’s (Key)stone,” and “Harry Potter Casts a Spell on Accident-Prone Children.” This last study found that emergency department visits among children decreased significantly when new Harry Potter books went on sale. Conversely, a 2003 study in the New England Journal of Medicine found that the books were
actually causing an ailment dubbed “Hogwarts headache” among young readers who spent too much time reading the lengthy books. A few studies remain entirely within J.K. Rowling’s fictional world. The New England Center for Headache in Stamford, with the help of a Monroe, Conn., high school student, published a study in 2007 examining the causes of Harry’s headaches in “Headache: The Journal of Head and Face Pain.” More commonly, though, the studies focus on the real world and use the series as a research tool. Martha Driessnack, an assistant professor at the College of Nursing at the University of Iowa, published a study on how the books can help explain complex ideas about genetics in the Journal of Pediatric Nursing. Driessnack, who counts the character Madame Pomfrey (a nurse) as a role model, saw
relations between the wizards and muggles (“nonwizards” to the Potter-illiterate) as a good teaching tool. For instance, children might wonder why they have traits different from their parents’, or why a sibling has a hereditary disease when there’s no apparent history of it in the family. The character of Hermione illustrates the idea of recessive genes very clearly, Driessnack said. “Both her parents were Muggles, but the stories show how you could have two Muggles who — surprise! — make a wizard,” she said. Why does the caretaker Argus Filch have no magical power when both his parents do? Driessnack said this may be a case of incomplete penetrance of a gene. “Or there might have been some fishy business in his past and his father wasn’t really his father.” Hence, conveying the idea of misattributed paternity.
friend? A spouse? A child? A celebrity? Share your inspiration with others in the September edition of To Your Health. Email your answers to firstname.lastname@example.org. Or you can mail them to this address: To Your Health c/o Mike McInally 600 S.W. Jefferson Ave. Corvallis, OR 97333 Be sure to look for answers in the September edition of To Your Health, due Tuesday, Sept. 13.
Doctors debate: Should government’s ‘mystery shoppers’ spy on docs? By ANDREW DOUGHMAN THE ORLANDO SENTINEL
Doctors in nine states recently avoided what some saw as an unwelcome “mystery shopper” patient: the federal government. Government researchers were poised to secretly study doctors until public outcry scuttled the proposal. But some doctors now are saying the government made a mistake and that fear essentially derailed a study that could have provided important results about patients’access to care. “Some critics argue that such inherently deceptive study designs are unethical. But concealment is frequently used in experiments to avoid biasing results,” wrote Dr. Karin Rhodes in a commentary published in the New England Journal of Medicine. “In this case, the public, patients, and health care providers all benefit.” The federal Department of Health and Human Services had wanted to study how difficult it is for patients to get care when they need it and how their insurance played into that. In the national study, government researchers would have posed as prospective patients and called primary care physicians to schedule appointments. They wanted to
gather data about wait times to measure the extent of the oft-reported shortage of primary-care physicians. While government researchers would not identify themselves as working for the government, they also would not have released the names of doctors. When the story was first reported in The New York Times, some doctors decried the study for using intentionally deceptive “Big Brother tactics” that reduced their trust in government. Rhodes wrote that these “secret shopper” studies are common and have a long history of measuring discrimination in employment, housing and mortgage markets. Calling them audits, she said patients deserve to know average wait times and access to care based on the type of insurance they have, even if government workers posed as patients in order to gather that data. The question of access is important because as many as 38 million Americans are expected to gain health insurance in 2014 under the federal health-care overhaul. “Without reliable national baseline measures of access, how will anyone know whether health care reform is improving access to care or making it worse?”Rhodes asked.
Clinical trials Continued from page A5 doctor don’t have any idea which of the two administrations of the drug could be the test drug. His part in the study is to determine effects of the drug on older patients. Scoville is required to check in with his study director every six weeks via phone and to go into the clinic every 12 weeks. He is nearly a year into the study and won’t know any results until its completion, which could be another year or so. “It’s interesting to be a part of this,” he said. “I don’t have any idea how I’m doing.” Scoville was introduced to the study by his doctor. The theory behind the new inhalant is that it takes just a third of the dose required by the previous drug to do the same work. So Scoville didn’t see a downside: He gets to try out a drug that could be more effective at zero cost to him. “I don’t see any negatives,” Scoville said. “And I like to believe it makes me feel a lot better.”
‘We don’t want patients who want to participate in a trial to have to go to Portland or Seattle or Houston or out of the area. People feel it’s important to help advance health care and find treatments and potentially a cure. So being able to provide that locally is important.’ BARBARA CRONEY OPERATIONS MANAGER FOR THE CENTER FOR HEALTH RESEARCH & QUALITY
Review Board, made up of committees that include employees and community members who review the research with only the research subjects’ protection in mind. Doctors then are notified if they have potential candidates in their care and and Samaritan’s program patients are invited by their doctors to participate. Samaritan Health Services has a “We feel passionately that it is imporyounger clinical trials program but things already are busy at its Center for Health Re- tant to provide these opportunities to our patients and to our providers,” Croney said. search & Quality. “We’ve really only established our clini- “We don’t want patients who want to participate in a trial to have to go to Portland or cal research program for two years,” said Seattle or Houston or out of the area. PeoBarbara Croney, operations manager and ple feel it’s important to help advance institutional review board administrator health care and find treatments and potenfor the center. “For a new program, we are tially a cure. So being able to provide that pleased with what we have accomplished since our start.” locally is important.” Samaritan has three cancer clinical trials Also key is establishing research potenunder way with a fourth study soon to start tial as a part of Samaritan’s reputation. in addition to a nephrology study, two cardi- Many physicians want to be able to conduct ology trials, and a joint trial with Cardiology, research and still practice medicine in a Samaritan Internal Medicine and Samaritan community setting. Family Medicine for people with diabetes “By offering this service, when Samariwho recently have had a cardiac event. tan is recruiting new providers and doctors, The cancer studies are for breast cancer we will be able to tell them we can support and non-Hodgkin’s lymphoma, while the their research activity,” Croney said. “Docupcoming study is for non-small cell lung tors who participate in clinical research are cancer. The cancer, diabetes and nephrolo- staying up to date in clinical advances.” gy studies are sponsored by pharmaceutiSamaritan’s research center is young and cal companies. The cardiac studies are still building its financial base. Clinical trial sponsored by the National Institutes of participation brings in some funds but is not Health. a money maker. Croney said the goal is to Samaritan does very little open recruit- fund the clinic so that it breaks even and then ing for clinical trials. The hospital’s center additional funding would be put back into does its homework and finds sponsors the hospital to help pay for other research. (pharmaceutical companies and medical Different departments in the hospital device companies) to identify studies that have dabbled in research over the years but it are a good fit for its patient population and is since the establishment of the Center for organization. Health Research & Quality that things have A hospital committee reviews the recome together for serious participation. search to ensure it is appropriate and feasi“We do the legwork so our doctors don’t ble and can be supported by the organizahave to,” Croney said. tion. Finally, all research goes to the Samaritan Health Services Regional Institutional Maria Kirkpatrick is a freelance writer in Corvallis.
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