domingo, 27 de noviembre de 2016


viernes, 19 de febrero de 2016

La importancia de las horas de sueño !

A Third of U.S. Adults Don't Get Regular, Refreshing Sleep: CDC

Study finds people who work, have a college degree or are married tend to get better sleep
couple in bed
By 
HealthDay Reporter
THURSDAY, Feb. 18, 2016 (HealthDay News) -- One of every three Americans doesn't get enough sleep on a regular basis, a new study from the U.S. Centers for Disease Control and Prevention says.
About 35 percent of U.S. adults are sleeping less than seven hours a night, increasing their risk of a wide variety of health problems, CDC researchers reported on Feb. 18 in the agency's Morbidity and Mortality Weekly Report.
Getting less than seven hours of sleep a night has been associated with increased risk of obesity, type 2 diabetes, high blood pressure, heart disease, stroke, frequent mental distress and death, the study authors said.
"People have to recognize that sleep is just as important as what they're eating and how much they're exercising," said Dr. Shalini Paruthi, co-director of the Sleep Medicine and Research Center at St. Luke's Hospital in St. Louis. "It's one of the pillars of good health."
The CDC study is the first to document estimated sleep duration for all 50 states, as well as the District of Columbia, the researchers said.
The American Academy of Sleep Medicine (AASM) and the Sleep Research Society recommend that adults ages 18 to 60 sleep at least seven hours each night to promote optimal health and well-being.
"There seems to be sort of a good cutoff point, where if you get at least seven hours, your body and brain will function at their best," said Paruthi, noting that a 15-member AASM panel came to this conclusion after reviewing thousands of sleep studies.
The percentage of people getting a good night's sleep varied widely from state to state, ranging from 56 percent in Hawaii to nearly 72 percent in South Dakota, the CDC reported.
Work appears to help people get a good night's rest. People who are unable to work or are unemployed had lower healthy sleep duration (51 percent and 60 percent, respectively) than did employed folks (65 percent), researchers said.
People with higher education also appeared better able to sleep well. The percentage of people who get healthy sleep duration was highest among people with a college degree or higher (72 percent), the survey noted.
Married folks also sleep better, with 67 percent getting healthy sleep compared with 62 percent of people never married and 56 percent of those divorced, separated or widowed, the study showed.
Most people don't get enough sleep because they aren't scheduling a good night's rest as part of their busy day, Paruthi said.
"Our society is very go-go-go. There's a lot of things to get done in one day," she said. "Sleep tends to be something that people fail to prioritize."
Poor health also might play a role in robbing people of rest. About a quarter of the U.S. population suffers from sleep apnea, a condition in which breathing pauses or grows shallow during sleep, said Dr. Jordan Josephson, an ear, nose, throat and sinus specialist at Lenox Hill Hospital in New York City.
Sleep apnea is strongly linked to excess weight, according to the U.S. National Institutes of Health. The CDC researchers found that people in the southeastern region of the United States and the Appalachian Mountains got the least sleep, and notably, these regions also have high rates of obesity and other chronic conditions.
People who snore and never feel well-rested should keep in mind they might be suffering from sleep apnea, Josephson said.
"If you're snoring, chances are that even if you're getting your seven hours, it's not a good seven hours," he said. "You should see your physician and take it seriously."
The AASM has a list of "sleep hygiene" tips for people who want to improve their sleep. They include:
  • Go to bed at the same time each night and rise at the same time each morning.
  • Make sure the bedroom is a quiet, dark and relaxing environment, kept at a comfortable temperature.
  • Get a comfortable mattress and sheets, and use the bed only for sleeping and sex.
  • Exercise regularly and maintain a healthy diet.
  • Avoid exposure to screens or bright light prior to bedtime.
  • Don't eat a large meal before bedtime, and avoid alcohol and caffeine.
  • If you don't fall asleep after 20 minutes, get out of bed and do something relaxing before trying again.
More information
For more information on sleep, visit the U.S. Centers for Disease Control and Prevention.
SOURCES: Shalini Paruthi, M.D., co-director, Sleep Medicine and Research Center, St. Luke's Hospital, St. Louis; Jordan Josephson, M.D., ear, nose, throat and sinus specialist, Lenox Hill Hospital, New York City; Feb. 18, 2016, Morbidity and Mortality Weekly Report
Last Updated: 

Fuente:     http://consumer.healthday.com/public-health-information-30/centers-for-disease-control-news-120/a-third-of-u-s-adults-don-t-get-regular-refreshing-sleep-study-708206.html

martes, 15 de diciembre de 2015

The efficacy and safety of probiotics intervention in preventing diabetes

The efficacy and safety of probiotics intervention in preventing conversion of impaired glucose tolerance to diabetes: study protocol for a randomized, double-blinded, placebo controlled trial of the Probiotics Prevention Diabetes Programme (PPDP)

Qun YanXu Li and Bo Feng*
Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Jimo Road 150, Shanghai, China
For all author emails, please log on.
BMC Endocrine Disorders 2015, 15:74  doi:10.1186/s12902-015-0071-9
The electronic version of this article is the complete one and can be found online at:http://www.biomedcentral.com/1472-6823/15/74

Received:26 October 2015
Accepted:17 November 2015
Published:1 December 2015
© 2015 Yan et al. 
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

Background

Alterations in intestinal microbiota correlate with risk of development of obesity and type 2 diabetes. Probiotics have been suggested to play an important role in the management of dysglycemia, although the evidence is limited. In this study, we aim to explore the efficacy and safety of probiotics intervention in preventing type 2 diabetes in Chinese patients with impaired glucose tolerance.

Methods/Design

A 24-month randomized intervention is conducted from January 2014 to December 2016. The target sample size for intervention is 200 middle-aged men and women aged 30–65 year-old with impaired glucose tolerance. Participants with persistent impaired glucose tolerance were assigned to group A (tablet A) and B (tablet B) in sequential order. The participants and investigators were blinded to the assignment. The primary outcome is development of diabetes. The secondary outcome measures include body composition, biochemical variables and the safety of the probiotics.

Discussion

The results from this trial will provide the evidence on the efficacy and safety of probiotics administration in preventing conversion of impaired glucose tolerance to diabetes in a Chinese context.

Trial registration


Fuente: http://www.biomedcentral.com/1472-6823/15/74

miércoles, 9 de diciembre de 2015

Could Old Gout Drug Offer New CV Benefits?

Colchicine use was associated with fewer cardiovascular events and lower all-cause mortality

The elevated risk of cardiovascular events among patients with gout declined in those who used colchicine, an observational study found.
The incidence rate ratios among colchicine users compared with non-users were 0.52 (95% CI 0.29-0.92) for myocardial infarction, 0.34 (95% CI 0.14-0.71) for stroke, and 0.79 (95% CI 0.24-2.39) for transient ischemic attack, according to Daniel H. Solomon, MD, and colleagues from Brigham and Women's Hospital in Boston.
After adjustment for all covariates including age, sex, race, history of CV disease, diabetes, and hypertension, and the use of medications such as statins and aspirin, the risk of a composite CV endpoint that included all these events was 49% lower among gout patients who took colchicine (HR 0.51, 95% CI 0.30-0.88, P=0.016), the researchers reported online in Annals of the Rheumatic Diseases.
"While we are unable to confirm a causal link in a non-randomized observational study, this study provides justification for a randomized controlled trial of colchicine to reduce CV risk among patients with gout," Solomon and colleagues stated.
Because atherosclerosis is strongly associated with inflammation, there are current efforts to explore the possibility of using immunomodulatory medications including colchicine, methotrexate, and canakinumab (Ilaris) for prevention.
Colchicine "downregulates inflammation through blocking microtubule spindle formation, disrupting inflammasome function, inhibiting cytokine production, and hindering neutrophil chemotaxis," the researchers explained.
Previous studies have suggested that the drug -- used in gout for hundreds of years -- was beneficial for secondary CV prevention in the general population, but little is known about its CV prevention effects in gout patients themselves.
Therefore, the researchers analyzed data from the Brigham and Women's Hospital electronic medical records and the linked Medicare databases for the years 2006 to 2011.
They identified 501 patients with gout who had a first prescription for colchicine during that time, matching them by age, gender, and index date with gout patients without colchicine prescriptions.
Average age was 73, and two-thirds of the study participants were men. The cases and controls were similar in history of heart failure, CV disease, and chronic kidney disease, but cases had more hypertension (77% versus 28%, P<0 .0001="" 16="" allopurinol="" and="" anti-inflammatory="" body="" commonly="" drugs="" em="" especially="" had="" higher="" index="" mass="" more="" nbsp="" nonsteroidal="" statins="" style="border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" used="" versus="">P
<0 .0001="" 1.3="" follow-up="" median="" p="" was="" years.="">
While the rates of myocardial infarction, stroke, and transient ischemic attack were lower in the colchicine group, the rates of revascularization procedures were similar. For coronary artery bypass grafts, the incidence rate ratio was 3.11 (95% CI 0.71-18.62), and for percutaneous coronary intervention the ratio was 1.03 (95% CI 0.59-1.78).
In an additional analysis using all-cause mortality as the outcome, colchicine users had a lower risk, with a hazard ratio of 0.27 (95% CI 0.17-0.43, P<0 .0001="" p="">
Colchicine typically is not used for extended periods, but rather is given for the acute attack or at the initiation of urate-lowering therapy, but some patients with frequent flares have used it long term.
"These results, along with those from prior studies, suggest that long-term colchicine may provide CV risk protection among patients with gout with and without known cardiovascular disease, a group known to experience a 30% to 60% increased risk of CV events," Solomon and colleagues observed.
However, they advised that their findings should be interpreted with caution, noting that prescriptions for colchicine may have been more commonly given to patients willing to take medications, or that providers may have hesitated to prescribe the drug to the sickest patients. There also could have been residual confounding.
"Results from this study may be considered hypothesis-generating for a formal test of whether colchicine reduces CV risk in the setting of a randomized controlled trial," they concluded.
If the drug does succeed in decreasing CV risk in a formal study, it is likely that the effects derive from colchicine's immunomodulatory effects, as it does not lower uric acid, the investigators noted.
The study was supported by the National Institutes of Health.
The authors reported financial relationships with Lilly, Pfizer, Amgen, and AstraZeneca.
  • Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
LAST UPDATED