People afflicted with cluster headaches miss work twice as often as colleagues without the debilitating headaches, a new study finds.
Cluster headaches are extremely painful headaches that last from 15 minutes to three hours, for many days, or even weeks, in a row. They’re more common in men.
Disability days
For the study, Swedish researchers compared more than 3 200 working-age people who get cluster headaches with 16 200 people who don’t have them.
In 2010, headache sufferers averaged 16 sick days, compared to just under seven days for the headache-free group, the findings showed.
When disability days were added in, people with cluster headaches averaged 63 missed workdays a year. Those without headaches averaged 34.
And those with less education missed more work than those with more schooling: 86 days for those who completed only elementary school; 65 for those who finished high school; and 41 days for those who went to college, according to the report.
The researchers also found that women with cluster headaches took twice as many sick days (24) as men (12), and had an average of 84 sick and disability days, compared with 53 for men.
Fewer days in pain
The study was published online in the journal Neurology.
Author Dr Christina Sjostrand said the findings show that “cluster headaches dramatically interfere” with people’s capacity to work. She’s a researcher in the department of clinical neuroscience at Karolinska Institute in Stockholm.
“More research is needed on how to best treat and manage this form of headache so people who experience them have fewer days in pain and miss fewer days of work,” Sjostrand said in a journal news release.
“While it is believed that men and women experience cluster headaches in mostly similar ways, it may be that we do not yet have a full picture of sex differences in the disease,” she added. “The reasons for these sex differences are unclear and more studies are needed.”
Cluster headaches affect about one in every 1 000 people in the United States.
Concerns that cholesterol-lowering statin drugs can impair brain health appear to be unfounded, according to new research.
“Statins won’t make you stupid or cause memory loss,” said lead researcher Dr Katherine Samaras, a professor of medicine at St. Vincent’s Clinical School of Medicine in Darlinghurst, Australia.
Black box warning
And for some people at risk of dementia, statins like Lipitor (atorvastatin) and Crestor (rosuvastatin) may improve memory and mental functioning, her team found.
Many millions of people take statins because of heart disease or high cholesterol. But reports that the drugs could cause memory loss led the US Food and Drug Administration in 2012 to require a black box warning on all statin medications, she said.
However, “we could find no overall impact on memory or any other aspect of cognitive function over six years in a large population of older people, who had extensive testing every two years,” Samaras said.
The observational nature of this study means the research can’t be considered conclusive, only that a strong link exists, the researchers noted.
“Any person who takes statins and is concerned about their memory and cognition should discuss this with their doctor. However, overall, we should be greatly reassured by the study findings,” Samaras said.
For the study, she and her colleagues collected data on more than 1 000 people aged 70 to 90 who took part in the Sydney Memory and Aging Study. About 600 took statins and had done so for an average of nine years.
Slower rate of memory loss
All of the participants had their memory and cognitive skills – such as processing speed and language – tested at the start of the study. No difference was seen between statin users and nonusers, according to the report.
Some people also had MRI scans to assess their brain volume. The MRIs showed no significant difference in brain volume among statin users and nonusers over two years.
And over six years, the researchers found no significant difference between memory and mental ability among those who did and didn’t take the drugs.
Among 99 people who started taking statins during the study, however, Samaras and colleagues found statins were linked to a slower rate of memory loss.
As expected, statins did protect people with heart disease from heart attacks. Within this group, the drug also resulted in a slower rate of a decline in memory, compared with people who didn’t take statins.
Moreover, in people with heart disease, diabetes or other risk factors for dementia, statin use slowed down mental decline in comparison with nonusers who had the same conditions.
Many effects on the brain
Looking at people who had the APOE-4 gene mutation, which puts them at high risk for Alzheimer’s disease, the researchers found statins appeared to significantly slow the rate of mental decline.
However, among participants without heart disease who took statins, the rate of memory decline was similar to those who didn’t take the drug, the findings showed.
The report was published online in the Journal of the American College of Cardiology.
Dr Costantino Iadecola, a professor of neurology and neuroscience at Weill Cornell Medicine in New York City, co-authored an editorial accompanying the study. He said, “Statins have many effects on the brain.”
The brain is 80% fat and has the most cholesterol of any organ in the body, and is very sensitive to any changes in fat, said Iadecola.
“So it’s not surprising that modulating cholesterol affects the brain,” he said.
Reducing cholesterol in the brain may reduce two changes linked to Alzheimer’s, namely beta-amyloid plaques and tau tangles, he noted.
But whether statins have a positive effect on preserving cognitive function requires more study, Iadecola said.
In the meantime, he doesn’t advise taking statins for the sole purpose of maintaining your mental abilities, since these drugs can have side effects.
Mom and dad may be key in curbing the epidemic of drowsy teens, a new study suggests.
American teens aren’t getting enough sleep, which can lead to anxiety, depression and suicidal thoughts. Sleepy teens also are more likely to get into car crashes and have a greater risk of being injured while playing sports.
A sleep diary
The lack of sleep may be due to too much homework, too many extracurricular activities, too much caffeine, early school start times and too much screen time, researchers say.
But parents can play a pivotal role in helping their teens get the rest they need.
“Greater enforcement of parent-set bedtimes for teenagers aged 14 to 17 are associated with longer sleep duration,” said study lead author Jack Peltz, who conducted the research while at the University of Rochester in New York. He is now an assistant professor of psychology at Daemen College in Amherst, New York.
For the study, teens kept a sleep diary over seven days and parents gave information about their enforcement of sleep-related rules and bedtimes.
The study found that enforced bedtimes, along with later school start times, had the greatest influence on sleep duration, daytime energy and depressive symptoms. But more than 50% of parents had no specific or enforced bedtime rules.
Contrary to their expectations, the researchers didn’t find that caffeine or screen time had any effect on how long teens slept.
Circadian rhythm
The study team acknowledged that enforcing a specific bedtime for teens is difficult, but doing so improves their mental health.
“Ideally, parents should be able to work collaboratively with their teenagers to develop bedtimes that still support the child’s autonomy,” Peltz said in a University of Rochester news release.
Study co-author Dr Heidi Connolly, chief of the Division of Pediatric Sleep Medicine at Rochester, said most teens need nine to 10 hours of sleep each night. That’s also the recommendation of the American Academy of Sleep Medicine and the American Academy of Pediatrics.
“It’s inherently more difficult for teenagers to fall asleep earlier than later because of their circadian rhythm,” Connolly said in the release. “That’s why it’s so important for high school start times to be later, as the American Academy of Pediatrics has recommended across the board.”
Getting enough sleep means feeling well-rested during the day and waking up at your usual wake-up time even when allowed to sleep in, the researchers said.
Each year, hundreds of thousands of Americans develop some form of facial paralysis from a variety of causes.
The loss of facial control and expression that follows can bring sometimes devastating stigma, depression and anxiety, a new study shows.
This seems especially true for people whose facial paralysis came later in life instead of from birth, researchers noted.
There are a number of conditions that can cause facial paralysis. Some are congenital, or present at birth. Others are acquired later in life. A common cause of facial paralysis is stroke.
Stigma major predictor
“We were interested in the psychosocial factors that people with facial paralysis might experience, and if there were differences in people born with a condition compared to people who acquired facial paralysis,” said study author Kathleen Bogart. She’s director of the Disability and Social Interaction Lab at Oregon State University.
“When we looked at the major predictors of depression and anxiety, stigma was the main one. A lot of these conditions look the same from the outside, but the stigma part doesn’t change,” Bogart said.
She said there is surprisingly little public awareness of facial paralysis. And sometimes the paralysis might not be easy to recognise.
“Peoples’ faces may not be expressive, or their expressions may be unusual. The smile might look like a scowl,” Bogart explained.
The researchers said about 225 000 Americans develop facial paralysis every year. Congenital conditions, such as Moebius syndrome or birth trauma, can cause facial paralysis. Injuries or conditions like Bell’s palsy can cause acquired facial paralysis. Acquired paralysis is more common.
Highest depression and anxiety
The researchers surveyed 112 people with congenital facial paralysis and 434 people with acquired facial paralysis. The volunteers came from 37 different countries, but the majority of them were from the United States. The average age was 45 years old.
Both groups had higher rates of depression and anxiety than the general population. Those with acquired facial paralysis had the highest levels of depression and anxiety, the study found.
What might make it harder for those with acquired paralysis?
Bogart said it’s possible that people with congenital paralysis may have developed adaptive or compensatory behaviours. Typically, children learn from an early age to use expressions as a form of nonverbal communication. Since that wasn’t an option for children with facial paralysis, they found other ways to communicate. She likened it to the way young children are often adept at picking up new languages, while adults seem to struggle more.
“If you don’t encounter a language when you’re between one and three, it’s more difficult later to pick up a new language. The same thing may be going on with nonverbal emotions,” Bogart said.
Brittany LeMonda, a senior neuropsychologist at Lenox Hill Hospital in New York City, was not part of the study but reviewed the findings.
She said it makes sense that “someone born with this type of neurological presentation would learn to adjust and develop their social relationships. But if you don’t have that ability, and you experience facial paralysis later in life, it could be more challenging to learn how to accommodate.”
More tolerance is important
LeMonda noted that society is so focused on cosmetic beauty and outward appearances that acquiring paralysis later in life might make someone feel more self-conscious, as if people are staring at them even if they aren’t.
She recommended that anyone who’s having trouble with facial paralysis seek out a support group because it’s helpful to talk to people who have dealt with the same concerns. LeMonda said it’s also helpful to speak with a therapist, who can offer tools to cope.
Bogart added: “It’s human nature to notice difference, but more tolerance of diversity in facial expressions and appearance is important. People with facial paralysis are not sad and anxious because they have paralysis, per se. They’re sad and anxious because of the way society reacts to them.”
The study was published recently in Health Psychology.
The race is on to find effective treatments against the new COVID-19 coronavirus spreading through China, and two new therapies show real promise, researchers say.
One is an experimental antiviral medicine that already being used by Chinese doctors on a “compassionate” basis in coronavirus patients and has shown effectiveness in monkey trials.
The other involves transfusing the plasma of people who’ve survived COVID-19 into patients still battling the illness, in hopes of boosting the recipient’s immune defences.
The antiviral is a drug called remdesivir. It’s so new that it’s not yet approved for use by any drug regulator in the world. However, earlier this week the drug’s maker Gilead announced that remdesivir is being given to Chinese patients infected with the new coronavirus because there are no approved treatments.
And in a study published in the Proceedings of the National Academies of Science, researchers found that remdesivir prevented disease in monkeys infected with Middle East respiratory syndrome coronavirus (MERS-CoV).
Good results in monkeys and people
An outbreak of MERS first arose in Saudi Arabia in 2012 and caused worldwide concern before it was brought under control.
Importantly, the MERS virus is closely related to COVID-19, so scientists believe that any agent that works against MERS should prove effective against the new coronavirus.
The new study was led by Emmie de Wit at the US National Institute of Allergy and Infectious Diseases. Her team found that remdesivir prevented disease when given to rhesus macaques before they were infected with MERS-CoV. It also improved the monkeys’ condition when it was given to them after they were infected.
The study’s promising results support further clinical trials in humans of remdesivir for both MERS-CoV and COVID-19, the research team said.
Several clinical trials of remdesivir for COVID-19 are already underway in China, and on 4 February Bloomberg News reported that the drug was being tested in patients with the new coronavirus by a medical team at the Beijing-based China-Japan Friendship Hospital.
One of the Chinese clinical trials will assess the effectiveness of remdesivir in as many as 270 patients with mild and moderate pneumonia caused by COVID-19, according to Chinese news outlet The Paper, Bloomberg News reported.
In prior studies, remdesivir protected lab animals against a variety of viruses and has also been shown to effectively treat monkeys infected with Ebola and Nipah viruses. The drug also has been assessed as a treatment for Ebola in people.
‘Encouraging’ findings
Two experts unconnected to the NIAID study were optimistic that the drug can be a weapon against the COVID-19 outbreak, which so far has sickened more than 64 000 worldwide and killed nearly 1 400.
The new research is “really exciting news”, said Dr Eric Cioe Pena, who directs Global Health at Northwell Health in New Hyde Park, New York.
He pointed out that MERS is a much more deadly coronavirus infection compared to the new virus, so if remdesivir works against MERS, “many of those infected [with COVID-19] would benefit from treatment”.
In fact, the vast majority of patients with the new coronavirus do recover from their illness, so remdesivir might only be stockpiled and used for the more severe cases, Pena believes.
Dr Robert Glatter is an emergency physician at Lenox Hill Hospital in New York City. He agreed that “the findings of this study in primates with MERS is quite encouraging, and support further investigation into the use of remdesivir in human trials, both for preventative and therapeutic use in those with severe infections with COVID-19.”
He also believes the drug might prove especially useful for “higher-risk individuals with exposure to the virus”, such as health care workers who are in close proximity to infected patients.
Remdesivir was even tried recently in the United States, Glatter pointed out.
“With success seen against other coronavirus infections, Gilead recently provided remdesivir to a patient with COVID-19 [treated] in Seattle. The patient recovered and was released from the hospital,” Glatter said.
“The drug also appears to be safe,” he added, “but the issue of emerging resistance [to remdesivir] will also need to be evaluated in upcoming trials.”
Transfusing immunity
On Thursday, Chinese doctors announced they were trying a second strategy against COVID-19: transfusing the blood plasma of people who’d survived the illness in others already battling the disease.
As reported by The New York Times, Dr. Zhang Dingyu, who directs the Jinyintan Hospital in Wuhan, the centre of the outbreak, called on residents who’ve recovered from COVID-19 to donate plasma to help others infected.
China National Biotec Group, a state-owned company, said that its testing found that giving critically ill patients immune antibodies from plasma donated by survivors led to a big drop in inflammation within one day of administration.
It’s “a really good idea”, Benjamin Cowling, a professor of epidemiology at the University of Hong Kong, told the Times. “It’s basically transferring immunity from a patient who has recovered to a patient still fighting the infection, and then helping them to recover.”
The technique has been used in influenza epidemics, Cowling pointed out, but when it comes to COVID-19, the approach still needs to be tested in clinical trials.
So far, the coronavirus outbreak has been largely confined to China. As of Friday, the US Centers for Disease Control and Prevention has recorded only 15 cases in the United States, with no deaths and transmission within the broader community.
Urinary tract infections plague millions of Americans. Now new research suggests that what they eat might have a role to play.
The Taiwanese study compared UTI rates among nearly 10 000 Buddhists living in the island nation, about a third of whom followed a strict vegetarian diet.
Microbes via intestinal tract
The research couldn’t prove a cause-and-effect link, but it showed that people who eschewed meat had a 16% lower odds for a UTI versus those who didn’t.
The benefit was more pronounced among women. Female vegetarians had an 18% lower odds of getting a UTI compared to women who ate meat, the study found.
Why might the foods people eat dictate UTI risk? As the researchers pointed out, these troublesome infections usually have their origin in microbes introduced via the intestinal tract, “particularly the species of Escherichia coli accounting for 65–75% of all urinary tract infections.”
And they added that two meats – poultry and pork – are “the major reservoir” in the diet for E. coli.
The study was led by Dr Chin-Lon Lin of Tzu Chi University in Hualien, Taiwan, and was published in Scientific Reports.
Lower rates among vegetarians
As the researchers noted, UTIs strike about one in every 100 people worldwide, causing discomfort and distress. In women, especially, UTIs are among the most common type of bacterial infection, accounting for nearly 25% of all infections. UTI recurrence rates can range from 16%-36% in younger women to 55% in postmenopausal women.
In the new study, Lin’s group tracked UTI rates for Taiwanese Buddhists enrolled in a long-running study on the effects of a vegetarian diet on health. Of the nearly 10 000 people in the study, about 3 200 were vegetarian. Rates of UTI were tracked over a decade, and the vegetarians had significantly lower rates, the researchers found.
Two US physicians who weren’t connected to the study took differing views on the results.
“I would like the answer to UTI prevention to be as basic as to say that less meat means fewer UTIs,” said Dr Elizabeth Kavaler, a urologist at Lenox Hill Hospital in New York City. “But in the US we cook our meat thoroughly, which kills E. coli bacteria that could be transmitted though infected meat.”
“Secondly, E. coli is also present on vegetables, and can be transmitted through handling by workers with dirty hands,” Kavaler noted.
More acidic environment
Her advice: “Cook your meat through and wash your veggies, whether or not you get UTIs.”
Another specialist believes there could be more to the diet-UTI link, however.
Dr Jill Rabin is vice chair of education and development for obstetrics and gynaecology at Northwell Health in New Hyde Park, New York. She agreed that “the importance of diet and lifestyle factors in the development of urinary tract infections cannot be overstated.”
Rabin said one key reason for the finding might be that lowering the population of E. coli in the intestine “allows the gastrointestinal tract to become more acidic – it is believed that a more acidic environment in the gut [and bladder] may reduce UTIs.”
Vegetarian diets tend to also boost the level of fibre in the diet, and that might help prevent UTIs as well, Rabin added.
Caring for a grandchild might be the best way to fight the isolation of old age, new research suggests.
This conclusion is based on 2014 data collected as part of an ongoing German survey of older adults.
Higher loneliness scores
Among the nearly 3 900 grandparents in the survey, more than 1 100 said they cared for a grandchild. Those who had grandchildren to care for had lower scores on loneliness and social isolation tests, and a larger social network than those who didn’t care for grandchildren.
Meanwhile, grandparents who didn’t care for a grandchild had higher loneliness scores and were in regular contact with fewer people important to them, the study authors said.
The findings were unchanged even after the researchers took into account factors such as marital status, domestic arrangements, household income, self-rated health, physical activity levels and depressive symptoms.
The study can’t prove that taking care of grandchildren by itself makes older people less lonely, only that there appears to be an association.
It might be that grandparents who felt less lonely and isolated to start with are more likely to care for a grandchild, said study author Eleanor Quirke, of the department for health economics and health services research at Hamburg-Eppendorf University Hospital, and colleagues.
Supplementary grandchild care
The study also didn’t account for how near to their grandchildren grandparents lived or how often they provided care, all of which could have affected the findings.
The report was published online in the journal BMJ Open.
“Assisting their families to balance work and family by providing supplementary grandchild care may boost grandparents’ self-esteem, and may also facilitate ongoing positive relationships with their children and grandchildren,” Quirke’s team suggested.
“Moreover, caring for grandchildren may also expand the social circle of grandparents and allow for further opportunities to establish relationships with other parents or grandparents,” the study authors explained in a journal news release.
But it’s also possible the positive effect might wear off if grandparents have to spend so much time caring for a grandchild that it interferes with their lives, the researchers added.
Optimism might be powerful medicine when recovering from a stroke, a new study suggests.
Stroke survivors who had positive outlooks showed lower levels of inflammation, reduced stroke severity and fewer physical impairments after three months compared to more pessimistic stroke survivors, the researchers found.
“Our results suggest that optimistic people have a better disease outcome, thus, boosting morale may be an ideal way to improve mental health and recovery after a stroke,” study first author Yun-Ju Lai said in an American Heart Association (AHA) news release.
The research was funded by the US National Institute of Neurological Disorders and Stroke and the AHA. Lai is a postdoctoral fellow in the neurology department at the University of Texas Health Science Center in Houston.
New strategies
The study involved a group of 49 stroke survivors. Researchers analysed the connections between optimism, inflammation, stroke severity and physical disability. They found that as optimism increased, levels of inflammatory markers such as interlukin-6 and C-reactive protein decreased.
Getting a better understanding of the relationship between these elements could help develop new strategies for stroke recovery, Lai and her colleagues said.
Experiencing inflammation after a stroke can damage the brain and hinder recovery, they explained.
Preliminary research
The lower levels of inflammation associated with optimism translated into better patient outcomes, though the study did not prove a cause-and-effect link. Optimism levels were determined by a standard psychological test for measuring optimism.
The findings are to be presented next week at the American Stroke Association’s International Stroke Conference, in Los Angeles. Such research is considered preliminary until published in a peer-reviewed journal.
“Patients and their families should know the importance of a positive environment that could benefit the patient,” Lai said. “Mental health does affect recovery after a stroke.”
If you’re dedicating valuable time in your day to a sweat sesh, chances are you want to know it’s actually worth your time, right? Okay, now raise your hand if you’ve heard different fitness philosophies about the most-effective way to rev your heart rate. Specifically, some people say cardio is the ultimate calorie-burner, while other swear by strength training. Well, it’s time to set the record straight.
It’s true that people tend to expend more calories in the moment while doing cardio exercise like running when compared to lifting weights, says Laura Miranda, a doctor of physical therapy, fitness nutrition specialist, and certified personal trainer. “But weights, or anaerobic workouts, keep our excess post-exercise oxygen consumption (EPOC), or post-workout calorie burn, going from hours to days.” So you shouldn’t count them out entirely when you’re creating a cardio training plan.
The reason weight training has such a prolonged calorie-burn effect is because the greater the intensity, the more oxygen your body will need post-workout to recover and repair muscles, explains Miranda. By choosing exercises that ramp up that afterburn effect, “you get more bang for your buck in the long term,” she says. “Muscle is the most metabolically active tissue, so the more of it we have, the more effective we are at burning calories all day long.”
But yeah, which exercises burn the most calories exactly? Unsurprisingly, on a list of the best burners below — ranked in order of effectiveness — aerobic exercise tends to win in terms of immediate results. (FYI: Calorie burn is estimated for a 56-kilo person and a 84-kilo person, according to guidelines from the American College of Sports Medicine. The more you weigh, the more calories you tend to burn on any particular task — but a lot of other factors come in to play, too, so this isn’t an exact science.) But there a quite a few top contenders from the weight category too.
No matter which type of workouts you choose, opt for the “bonus burn” — tips from Miranda and New York City-based trainer Noam Tamir, owner of TS Fitness — to torch even more total calories.
10 Best Exercises For Weight Loss
1. Jumping rope
The burn: 667–990 calories/hour if you’re jumping at 120 skips per minute
The bonus burn: Try using a weighted jump rope to engage your arms and shoulders even more.
2. Running Up Hill/Stair Sprints
The burn: 639–946 calories/hour
The bonus burn: “You want to sprint at a pace that you can only maintain for about 20 seconds, and follow that with a recovery run at half of the intensity of the sprint and double the time,” says Miranda.
The bonus burn: Make sure you keep the rest periods between rounds of jabs and kicks super short. Aim for 30 seconds of rest for every 90 seconds of sparring.
4. Cycling intervals
The burn: 568–841 calories/hour
The bonus burn: Adding high-intensity intervals throughout a steady-state or low-intensity ride will increase the afterburn even more.
5. Running
The burn: 566–839 calories/hour at a 10-minute mile pace
The bonus burn: Run at a steady-state pace (i.e. a 7 out of 10 in terms of effort), and you’ll continue to burn extra calories over the rest of the day.
To torch more during and after your workout, add short bursts of sprints or faster running into your jog, says Tamir. He recommends keeping a 2:1 work-to-rest ratio to get the most afterburn. For example, if you run for 60 seconds, walk 30 seconds.
6. Kettlebell circuit
The burn: 554–822 calories/hour
The bonus burn: Tamir says that a HIIT circuit using kettlebells can keep the afterburn going for 36 hours after you leave the gym. To get the best results, make sure you’re not stopping to rest between each move.
Tamir recommends switching between upper- and lower-body movements so you can keep exercising for a longer period of time. Try doing a set of kettlebell swings, kettlebell squats, and kettlebell push presses. Then, rest for 15 to 20 seconds after completing the three moves.
7. Stationary bike
The burn: 498–738 calories/hour (at a vigorous pace)
The bonus burn: To get the most afterburn, Tamir says to start with 10 seconds of intense pedalling (100 RPMs or more) and 50 seconds of rest. Then, move to 15 seconds of sprints and 45 seconds of rest, and do 20 seconds of sprints 40 seconds of rest after that. Don’t forget to turn up the resistance as you progress!
The burn: 481–713 calories/hour at 150 watts, which you can check on the machine
The bonus burn: To get maximum torching power, row in super-fast, one-minute intervals (150 watts), and take 30- to 60-second active rest periods by alternating between squats, pushups, and planks.
9. Loaded kettlebell carries
The burn: 476–705 calories/hour
The bonus burn: Walking with weighted kettlebells forces you to practice strong posture and core control. “My fav method is the three-in-one,” says Miranda. “Start walking with two kettlebells overhead, walk as far as you can until you need to stop. Then, drop the bells to the front racked position and continue walking until you need to stop again. Finally, drop them down to the farmer’s carry position (at your sides), and continue walking as long as you can.” This is one cycle, rest two minutes, then repeat.
10. Stairs
The burn: 452–670 calories/hour when going 77 steps per minute
The bonus burn: To up the ante, hold a two- to four-kilo dumbbell in each hand to get your upper body fired up, too.
Bottom line: Whether you’re working the Stair Master or running steps around town, à la Rocky, stair climbing provides a good mix of aerobic and anaerobic exercise.
