|New Harvard Health Information
5/22/2013 8:00:00 AM
Looking to stop "brain fog" or frequent bouts of forgetfulness? Exercise turns out to be an excellent way to protect and enhance brain health, according to the May 2013 issue of the Harvard Men's Health Watch.
"There's a lot you can do to prevent cognitive decline, or slow it down, or recover memory function that you might feel you have lost," says Dr. John Ratey, associate clinical professor of psychiatry at Harvard Medical School.
One key strategy is regular, moderately intense exercise. It helps maintain healthy blood pressure and weight, improves energy, lifts mood, lowers stress and anxiety, and keeps the heart healthy, all of which contribute to brain health. But exercise also stimulates brain regions that are involved in memory function to release a chemical called brain-derived neurotrophic factor (BDNF). BDNF rewires memory circuits so they work better. "When you exercise and move around, you are using more brain cells," says Dr. Ratey, who is also the author of Spark: The Revolutionary New Science of Exercise and the Brain (2008). "Using more brain cells turns on genes to make more BDNF."
BDNF isn't available in a pill. Only the brain can make it, and only with regular exercise. That means 30 minutes of moderate-intensity exercise, ideally five days a week. The threshold for brain benefit seems to be raising your heart rate to 70% of maximum. For men, the maximum heart rate is roughly 220 minus age.
Exercising once or twice a week is just not going to do it. "It's probably good for your body," Dr. Ratey says, "but it won't get you there in terms of the cognitive benefits. You also have to continue to do it to continue accruing the benefits."
Read the full-length article: "Get your heart pumping in the fight against forgetfulness"
5/22/2013 8:00:00 AM
For years, osteoarthritis treatments have focused on relieving symptoms: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen to control pain, steroid injections to bring down inflammation, and viscosupplements to replace a joint's natural lubricant. The May 2013 Harvard Women's Health Watch looks at some on-the-horizon therapies that could change the way this degenerative disease is treated.
"We're beginning to understand that osteoarthritis is a disease of the entire joint," explains Dr. Antonios Aliprantis, director of the Osteoarthritis Center at Harvard-affiliated Brigham and Women's Hospital. "Much of the research over the last 20 or 30 years has focused on cartilage as the target. But we're beginning to realize that there are important changes happening in the bone underneath the cartilage, and in the joint lining itself. As we begin to understand osteoarthritis as a disease of the entire joint, new treatment targets will emerge."
One treatment in development is a drug called strontium ranelate, which has been used in Europe to treat osteoporosis-related bone loss. It's now finding a new purpose for knee osteoarthritis. Strontium appears to inhibit the activity of cells called osteoclasts, which break down bone. It is possible that in a joint affected by osteoarthritis, strontium ranelate may protect bone under the cartilage.
Stem cells, which are able to transform into many different types of cells, also show potential for treating osteoarthritis. The hope is that injecting stem cells into damaged joints might regenerate healthy tissue.
Osteoarthritisis is a localized disease, so the ideal treatment would be injected directly into the joint. That would avoid the body-wide side effects of current osteoarthritis drugs. Dr. Aliprantis envisions a medication embedded in a gel-like substance that would release the drug slowly into the joint, as it's needed, to repair damaged tissue, "sort of like an on-demand system," he says.
While it may take time for these new therapies to come to fruition, there are several options that can help relieve osteoarthritis pain and stiffness, including:
- oral pain medications such as acetaminophen and NSAIDs (ibuprofen, naproxen)
- topical pain-relieving creams and rubs applied to the skin over the painful joint
- hyaluronic acid injections (viscosupplements) to replace the fluid that naturally lubricates the joint
Read the full-length article: "New ways to beat osteoarthritis pain"
5/22/2013 8:00:00 AM
Doctors can't easily "open the hood" and peer into the heart, making it difficult to determine the cause of chest pain or identify a person at high risk of having a heart attack. As explained in the May 2013 issue of the Harvard Heart Letter, certain tests can spot the presence or absence of heart disease, help gauge the risk of having a heart attack, and guide what treatment, if any, is needed.
The first test is usually noninvasive, meaning nothing is put into the body and it is not opened in any way. This starter, the treadmill stress test, records how well the heart performs when it is forced to work harder. It may be combined with echocardiography, a nuclear perfusion study, or magnetic resonance imaging to "see" if there are blockages in the coronary arteries that nourish the heart and how much of the heart muscle is affected by poor blood flow. The results of these tests are used to determine whether blood flow can be improved with medication and lifestyle changes, or if a procedure such as angioplasty plus stent placement or bypass surgery is needed.
When a stress test is "positive," indicating one or more cholesterol-filled plaques restricting blood flow, a second test is needed to pinpoint their location. This invasive test is usually a special x-ray called an angiogram, performed during cardiac catheterization. It involves inserting a small tube called a catheter into an artery in the groin and maneuvering it into the heart. A dye released from the catheter makes the coronary arteries show up more clearly on an x-ray. Angiograms are excellent for mapping narrowed or blocked sections of an artery.
When it comes to artery-narrowing plaque, bigger isn't necessarily badder. Some small plaques that hardly narrow a coronary artery and cause no symptoms can rupture, causing a heart attack. Many companies are trying to find ways to identify these dangerous lesions before they rupture.
Read the full-length article: "Tests your doctor may order to determine whether you have heart disease"
5/22/2013 8:00:00 AM
Poison ivy poses real problems to gardeners and outdoor enthusiasts. But some of the "facts" that people know about this plant are really myths, reports the May 2013 Harvard Health Letter.
Plants employ a variety of defenses to protect themselves. Poison ivy, poison oak, and poison sumac secrete an oil that some people are allergic to. Contact with the oil triggers an allergic reaction that shows up in two to 10 days as a red, swollen, itchy, blistering rash known as allergic contact dermatitis.
Myths about poison ivy and its kin can put you and others at risk.
Myth #1: The rash is contagious. Not true. It looks unpleasant, but it won't spread on yourself or to another person, even when you see oozing blisters.
Myth #2: If you have the rash once, you can't get it again. Not true. One exposure doesn't make you immune to it. In fact, if you get it once you'll likely get it again if you come in contact with the oil. "For some people, one exposure to a plant is all it takes to become allergic to it," says Dr. Kenneth Arndt, a clinical professor of dermatology at Harvard Medical School.
Myth #3: You have to touch a poison ivy plant to be affected by it. Not necessarily true. Breathing in smoke given off by burning poison ivy can cause an allergic reaction in the lungs that may require immediate medical attention.
The easiest way to avoid an allergic reaction to one of these plants is by wearing protective clothing, like gloves, long sleeves, and pants, when gardening or spending time outdoors. Soap and water can remove poison ivy oil, but only if used right away. "If you wash immediately, most of the plant oil will diminish or come off," says Dr. Arndt. "If you wait 10 to 15 minutes, half of the oil will come off. If you wait an hour, none will come off."
Read the full-length article: "Dodging skin irritations from problem plants"
5/22/2013 8:00:00 AM
Does it make sense to get an exercise stress test, "just in case," to make the your heart is still ticking like a fine Swiss watch? Probably not—unless you have symptoms of heart disease, according to the April 2013 issue of the Harvard Men's Health Watch.
About one-third of all medical tests are unnecessary. Besides wasting time and money, unnecessary tests can lead to useless and potentially harmful follow-up tests and procedures. Exercise stress testing is often needed for individuals with symptoms like chest pain, unexplained fatigue, or feeling winded in response to normal physical activity. In such cases, it can help a doctor figure out what is wrong, or at least rule out heart trouble. In a person who feels fine, though, just-in-case stress testing is unlikely to reveal a heart problem.
In the classic exercise stress test, a person walks on a treadmill that makes the heart work progressively harder. The heart's rate and electrical rhythms are monitored, along with blood pressure and the appearance of symptoms like chest discomfort or fatigue. Abnormalities in blood pressure, heart rate, or heart rhythms, or worsening symptoms could point to coronary artery disease: fatty deposits (plaques) that reduce the flow of oxygen-rich blood to the heart muscle.
The U.S. Preventive Services Task Force, an independent panel that makes recommendations to doctors, has urged doctors not to routinely offer exercise stress testing to people without symptoms or strong risk factors for coronary artery disease. Physician groups like the American College of Cardiology support this recommendation.
The final decision, though, must come from a conversation with a trusted doctor. "The guidelines leave a lot to physician judgment, because we're sometimes in a gray zone where we don't really know what's the 'right' thing to do for everyone," says Dr. Deepak Bhatt, professor of medicine at Harvard Medical School and chief of chief of cardiology for the VA Boston Healthcare System.
Read the full-length article: "Cardiac stress testing: What it can and cannot tell you"
5/22/2013 8:00:00 AM
In the trendy world of popular diets, the latest catchphrase is gluten-free. This eating style is absolutely essential for people with celiac disease, who can't tolerate even small amounts of the protein gluten, which is found in grains such as wheat, rye, and barley. As many as two million Americans may have celiac disease, though only 300,000 or so have been diagnosed with it. Many people without celiac disease are also following a gluten-free diet, reports the April 2013 Harvard Health Letter.
"It's a popular diet of the moment, but it really does seem to provide some improvement in gastrointestinal problems for a segment of the population," says Dr. Daniel Leffler, an international authority on celiac disease and an assistant professor at Harvard Medical School.
When a person with celiac disease eats gluten, his or her immune system attacks the lining of the small intestine. The damage that results causes symptoms such as gas, bloating, diarrhea, constipation, headache, trouble concentrating, and fatigue. It can also lead to weight loss and malnutrition. Celiac disease was long believed to be the only condition triggered by gluten. But there is now good evidence that a condition called nonceliac gluten sensitivity causes similar symptoms but no intestinal damage.
The key treatment for both celiac disease and nonceliac gluten sensitivity is cutting gluten out of the diet. But that's more than just a matter of buying gluten-free products in the grocery store and avoiding obvious foods with rye, barley, or wheat—such as bread, cereal, pasta, and pizza. "It takes a long time to learn how to live gluten-free," says Dr. Leffler. You have to become a gluten detective, scouring food labels and looking for hidden gluten. That's because gluten is in everything from frozen vegetables to soy sauce and medications.
Read the full-length article: "Considering a gluten-free diet"