According to a recent study, people who live near major roads have higher rates of dementia.
The study, published in the Lancet, suggests that as many as 11% of dementia cases in people living within 50m of a major road could be down to traffic.
The researchers, who followed nearly 2 million people in Ontario, Canada, over 11 years (from 2001 to 2012), say air pollution or noisy traffic could be contributing to the brain’s decline.
There were 243,611 cases of dementia diagnosed during that time, but the risk was greatest in those living closest to major roads.
The study findings show that compared with those living 300m away from a major road the risk was: 7% higher within 50m; 4% higher between 50-100m; 2% higher between 101-200m.
The analysis suggests 7-11% of dementia cases within 50m of a major road could be caused by traffic.
The researchers adjusted the data to account for other risk factors like poverty, obesity, education levels and smoking so these are unlikely to explain the link.
One of the study authors, Dr. Hong Chen, from Public Health Ontario, said: “Increasing population growth and urbanization have placed many people close to heavy traffic, and with widespread exposure to traffic and growing rates of dementia, even a modest effect from near-road exposure could pose a large public health burden.
“More research to understand this link is needed, particularly into the effects of different aspects of traffic, such as air pollutants and noise.”
The researchers suggest noise, ultrafine particles, nitrogen oxides and particles from tire-wear may be involved.
However, the study looks only at where people diagnosed with dementia live. It cannot prove that the roads are causing the disease.
Nearly 50 million people around the world are diagnosed with dementia.
However, the causes of the disease, that robs people of their memories and brain power, are not understood.
The best advice to reduce the risk of dementia is to do the things that we know are healthy for the rest of the body – stop smoking, exercise and eat healthily.
According to a Scottish research, the cheap inflatable leg wraps may save the lives of patients after a stroke.
The devices regularly squeeze the legs to keep blood flowing and prevent formation of fatal blood clots.
A trial with 2,876 patients, published in the Lancet, showed there were fewer clots with the wraps.
The UK’s Stroke Association said the results were “extremely encouraging” and had the potential to save thousands of lives.
A clot in the leg, a deep vein thrombosis, is normally associated with long flights, but is a problem for hospital patients unable to move.
Doctors at Western General Hospital and the University of Edinburgh said compression socks did not improve survival and clot-busting drugs led to other problems, including bleeding on the brain.
They tested the devices, which fit around the legs and fill with air every minute. They compress the legs and force the blood back to the heart.
They were worn for a month or until the patient recovered and was able to move again.
In the study, 8.5% of patients using the compression device developed blood clots, compared with 12.1% of patients who were treated normally.
According to a Scottish research, the cheap inflatable leg wraps may save the lives of patients after a stroke
Prof. Martin Dennis said: “At last we have a simple, safe and affordable treatment that reduces the risk of deep vein thrombosis and even appears to reduce the risk of dying after a stroke.
“We estimate that this treatment could potentially help about 60,000 stroke patients each year in the UK.
“If this number were treated, we would prevent about 3,000 developing a deep vein thrombosis and perhaps save 1,500 lives.”
He said the system should also be tested in other immobile patients, such as those with pneumonia.
Prof. Tony Rudd, who chairs the Intercollegiate Stroke Guideline Group at the Royal College of Physicians, said: “This study is a major breakthrough showing how a simple and safe treatment can save lives.
“It is one of the most important research studies to emerge from the field of stroke in recent years.”
Dr. Dale Webb, of the Stroke Association charity, said: “The results of this research are extremely encouraging and show that using a compression device on the legs of patients at risk of developing blood clots could be a more effective treatment.
“This new device has the potential to save thousands of lives and we would like to see it incorporated into national clinical guidelines.”
Cognitive Behavioral Therapy (CBT) can reduce symptoms of depression in people who fail to respond to drug treatment, found a new study in the Lancet.
CBT, a type of psychotherapy, was found to benefit nearly half of the 234 patients who received it combined with normal care from their GP.
Up to two-thirds of people with depression do not respond to anti-depressants.
Patients should have access to a range of treatments, the charity Mind said.
CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behavior.
The study followed 469 patients with treatment-resistant depression picked from GP practices in Bristol, Exeter and Glasgow over 12 months.
One group of patients continued with their usual care from their GP, which could include anti-depressant medication, while the second group was also treated with CBT.
After six months, researchers found 46% of those who had received CBT reported at least a 50% reduction in their symptoms.
This compared with 22% experiencing the same reduction in the other group.
CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behavior
The study concluded CBT was effective in reducing symptoms and improving patients’ quality of life. The improvements had been maintained for a period of 12 months, it added.
The patients who did benefit from cognitive behavioral therapy spent one hour a week with a clinical psychologist learning skills to help change the way they think.
Chris Williams, professor of psychosocial psychiatry at the University of Glasgow, and part of the research team, said: “The research used a CBT intervention alongside treatment with anti-depressants. It confirms how these approaches – the psychological and physical – can complement each other.
“It was also encouraging because we found the approach worked to good effect across a wide range of people of different ages and living in a variety of settings.”
WHAT IS CBT?
Cognitive Behavioral Therapy is:
a way of talking about how you think about yourself, the world and other people
how what you do affects your thoughts and feelings
CBT can help you to change how you think (cognitive) and what you do (behavior).
Unlike some other talking treatments, it focuses on the “here and now” instead of the causes of distress or past symptoms.
Women who quit smoking by the age of 30 will almost completely avoid the risks of dying early from tobacco-related diseases, according to a study of more than a million women in the UK.
The results, published in the Lancet, showed lifelong smokers died a decade earlier than those who never started.
But those who stopped by 30 lost, on average, a month of life and if they stopped by 40 they died a year younger.
Health experts said this was not a licence for the young to smoke.
The study followed the first generation of women to start smoking during the 1950s and 60s. As women started smoking on a large scale much later than men, the impact of a lifetime of cigarettes has only just been analyzed for women.
“What we’ve shown is that if women smoke like men, they die like men,” said lead researcher Prof. Sir Richard Peto, from Oxford University.
Women who quit smoking by the age of 30 will almost completely avoid the risks of dying early from tobacco-related diseases
He said: “More than half of women who smoke and keep on smoking will get killed by tobacco.
“Stopping works, amazingly well actually. Smoking kills, stopping works and the earlier you stop the better.”
The records from 1.2 million women showed that even those who smoked fewer than 10 cigarettes a day were more likely to die sooner.
Sir Richard Peto said that it was exactly the same picture as for men.
The British Lung Foundation said the prospects for long-term health were much better if people stopped smoking before they were 30, but cautioned that this was not a licence to smoke “as much as you want in your 20s”.
Its chief executive, Dr. Penny Woods, said: “Stopping smoking can also be difficult to do – an estimated 70% of current smokers say they want to quit, so you shouldn’t start and just assume you’ll be able to quit smoking whenever you want to.
“The best thing for your health is to avoid smoking at all.”
Prof. Robert West, from the health behaviour research unit at University College London, said it was important to remember that smoking had more effects on the body than leading to an early death, such as ageing the skin.
“Around your mid-20s your lung function peaks and then declines. For most people that’s fine – by the time you’re into your 60s and 70s it’s still good enough. But if you’ve smoked, and then stopped there is irreversible damage, which combined with age-related decline can significantly affect their quality of life.
“Obviously there is an issue around smoking if they want to get pregnant because it affects fertility and then there are the dangers of smoking during and after pregnancy.”
According to US and Canadian researchers, a “spray-on skin” developed by Healthpoint Biotherapeutics in the US, which coats a wound with a layer of skin cells, could help healing leg ulcers.
The spray was tested on 228 people with leg ulcers, which are painful open wounds that can last for months.
The findings, published in the Lancet, showed that ulcers treated with the spray were more likely to heal and did so more quickly.
Experts said faster healing could save money despite the cost of the spray.
Leg ulcers are hard to treat. The best treatment, compression bandages, will heal only about 70% of ulcers after six months. Other options include taking skin from somewhere else on the body and grafting it over the wound.
Instead the spray puts a coating of donated skin cells and blood-clotting proteins over the ulcer.
A "spray-on skin" developed by Healthpoint Biotherapeutics, which coats a wound with a layer of skin cells, could help healing leg ulcers
In the study, patients who were given the spray-on-skin every 14 days showed the most improvement.
The researchers said the size of the wound “began to decrease rapidly” as soon as the treatment started. In the patients who had the spray, 70% were healed after three months compared with 46% who received other treatment.
The spray was developed by Healthpoint Biotherapeutics in the US, which also funded the research.
One of the scientists involved, Dr. Herbert Slade, said: “The treatment we tested in this study has the potential to vastly improve recovery times and overall recovery from leg ulcers, without the need for a skin graft.
“This means not only that the patient doesn’t acquire a new wound where the graft is taken from, but also that the spray-on solution can be available as soon as required – skin grafts take a certain amount of time to prepare, which exposes the patient to further discomfort and risk of infection.”
The study largely tested the safety of the spray and the best dose to use, further studies will decide if it is a practical treatment for leg ulcers.
Leg ulcers are most commonly caused by high blood pressure in the veins of the legs which damage the skin, causing it to break down and develop into an open wound.
Experts writing in the Lancet have explained that drug-resistant HIV has been increasing in parts of sub-Saharan Africa over the last decade.
Studies on 26,000 untreated HIV-positive people in developing countries were reviewed by the team.
They said resistance could build up if people fail to stick to drug regimes, and because monitoring could be poor.
The researchers, from the World Health Organization (WHO) and University College London (UCL) found the most rapid increase in drug resistance occurred in East Africa, at 29% per year. In Southern Africa, it was 14% per year.
Drug-resistant HIV has been increasing in parts of sub-Saharan Africa over the last decade
There was no change in resistance over time in Latin America and in West and Central Africa.
Writing in the Lancet, authors Dr. Silvia Bertagnolio from the WHO and Dr. Ravindra Gupta at UCL said: “Without continued and increased national and international efforts, rising HIV drug resistance could jeopardize a decade-long trend of decreasing HIV/Aids-related illness and death in low- and middle-income countries.”
Dr. Ravindra Gupta said: “Drug resistance is a consequence of people not taking their medication properly.
“We do expect to see drug resistance, and it’s at around 10% in the UK and US. But here, we monitor people regularly and switch people to different drugs if they develop resistance.”
He said that quite basic measures could help people to better adhere to drug regimes in developing countries, such as access to food and clean water so they can take their drugs, and monitoring patients as effectively as possible.
The researchers said no changes were needed to the drug regimes, but Dr. Ravindra Gupta said: “This work gives us an early-warning that things could get worse.”
British scientists have discovered another eight pieces of genetic code linked to osteoarthritis, bringing the total number to 11.
Inherited factors account for at least half of any individual’s chance of developing this common condition that affects the joints, experts believe.
And understanding these factors could offer up new treatments.
The research in The Lancet compared the DNA of 7,400 UK osteoarthritis patients with that of 11,000 healthy volunteers.
This allowed scientists to find the most promising “culprit” regions of the genetic code to study in more detail.
They repeated their work in another group of 7,500 people with osteoarthritis and about 43,000 individuals without the condition from Iceland, Estonia, the Netherlands, and the UK.
British scientists have discovered another eight pieces of genetic code linked to osteoarthritis, bringing the total number to 11
The results confirmed the three previously reported gene variants and found a further eight linked to osteoarthritis.
Further work is now needed to pinpoint the actual DNA changes within the genetic regions to establish exactly how these changes lead to osteoarthritis.
The one with the strongest effect was situated in the region of the GNL3 gene which produces a protein with an important role in cell maintenance.
Three others were in DNA regions involved in the regulation of cartilage, bone development and body weight.
One of the lead scientists, John Loughlin, who is professor of musculoskeletal research at Newcastle University, said: “We know that osteoarthritis runs in families and that this is due to the genes that people pass on, rather than their shared environment.
“In this study we were able to say with a high degree of confidence which genetic regions are the major risk factors for developing osteoarthritis: the first time that this has been possible for this common yet complex disease. It’s an important first step.”
Prof. Alan Silman, medical director of Arthritis Research UK, the charity that funded the work, said: “Until we understand the cause of this complex disease, we cannot hope to find a cure. This is a major breakthrough in our understanding of osteoarthritis, which we hope will help us to unlock the genetic basis of the disease.”
A new study suggests that an “early and aggressive” approach to people on the cusp of developing Type 2 diabetes is justified to reduce cases of the disease.
People with “pre-diabetes” have higher than normal blood sugar which has not yet reached diabetic levels.
A US study, published in the Lancet, showed restoring normal sugar levels more than halved the numbers going on to Type 2 diabetes.
Experts said the findings were clinically important.
It is thought that 7 million people have pre-diabetes in the UK and 79 million in the US. They are at heightened risk of Type 2 diabetes, heart attack and stroke. Many are undiagnosed.
A new study suggests that an "early and aggressive" approach to people on the cusp of developing Type 2 diabetes is justified to reduce cases of the disease
Some measures, such as weight loss and more exercise, can reverse pre-diabetes. The study, by the US Diabetes Prevention Program Research Group, tried to determine how effective the treatment was at preventing Type 2 diabetes.
It followed 1,990 people with pre-diabetes. Some were being treated through drugs or lifestyle change, others were not.
It showed patients who reduced their blood sugar levels to normal, even briefly, were 56% less likely to develop Type 2 diabetes during the six years of the study.
Lead author Dr. Leigh Perreault, from the University of Colorado, said: “This analysis draws attention to the significant long-term reduction in diabetes risk when someone with pre-diabetes returns to normal glucose regulation, supporting a shift in the standard of care to early and aggressive glucose-lowering treatment in patients at highest risk.”
Dr. Natalia Yakubovich, from McMaster University in Ontario, Canada, said the “findings clearly suggest” that restoring normal blood sugar levels was “of clinical relevance”.
She added: “Identification of regression to normal glucose regulation could be an important way to stratify people into those at higher and lower risk of progression to diabetes.
“Such stratification could therefore identify individuals for whom additional treatment might be needed to prevent diabetes or to slow down disease progression.”