MS Stem Cell Therapy Succeeds But Poses Risks

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 9, 2016 (HealthDay News) — A treatment combining chemotherapy and a stem cell transplant could represent a major advance against aggressive multiple sclerosis, experts say.

This new treatment destroys the immune system with chemo and rebuilds it with the patient’s own stem cells. Researchers say it stopped MS relapses and progression in 23 of 24 patients.

According to the results of this small trial, these 23 patients no longer needed medication to control their MS. Moreover, eight showed continued improvement for nearly eight years.

“These patients had highly active MS with lots of relapses and lots of ongoing damage to their brain, but we’ve been able to stop that,” said lead researcher Dr. Harold Atkins. He is an associate professor of clinical hematology at the University of Ottawa in Canada.

The results are noteworthy, Atkins said. “There are lots of drugs and treatments available that are able to slow the disease or temperately halt it, but this one seems to be significant in that it had a long-lasting effect,” he explained.

However, it’s not for everybody with MS. “Because of the side effects and the rigor of treatment, it is something that should be used with those with the most aggressive MS before they have real damage. This won’t work for patients who have advanced disabilities or are in a wheelchair,” he added.

And, because the immune system is destroyed, patients have no defense against infections.

Still, Dr. Paul Wright, chairman of neurology at North Shore University Hospital in Manhasset, N.Y., thinks this therapy is a “breakthrough” in MS treatment.

“For these patients, the turnaround was extremely dramatic,” Wright said. But the treatment must be tried in more patients before it can be widely used.

“A larger sample size is necessary,” Wright added. “Because the treatment is toxic and potentially life-threatening, you need to make sure before you tout this as a panacea for advanced MS that it benefits a large population of patients.”

MS is a chronic inflammatory disease of the central nervous system. It can lead to vision problems, muscle weakness, trouble with coordination and balance, and thinking and memory problems, according to the U.S. National Institutes of Health.

The new treatment involves collecting a patient’s bone marrow stem cells, purifying them and freezing them. The patient is then subjected to high levels of chemotherapy. This is similar to the treatment used to treat some lymphomas, Atkins said.

The chemotherapy is so strong that it crosses the blood-brain barrier and eliminates damaged immune cells from the central nervous system, he explained.

Once that’s done, the stem cells are thawed and returned to the patient to start the process of rebuilding the immune system, Atkins said.

A larger trial is planned, but this treatment can be used right now in hospitals that do stem cell transplants for lymphoma, according to Atkins.

In this trial, the researchers treated 24 MS patients, aged 18 to 50. Their disease was progressing rapidly and they weren’t helped by the usual MS medications.

While improvement was notable, side effects were significant. One patient died from a liver infection, and eight had moderate toxic effects. Fourteen had mild side effects, the study authors said.

After the stem cell transplant, patients remain hospitalized as the immune system begins to recover — usually about four weeks, Atkins said. It then takes up to nine months at home to fully recover and resume normal activities.

Pointing to the therapy’s success, Atkins said patients had at least one relapse a year before treatment but none during follow-up of between four and 13 years.

Also, the patients had a total of 93 brain lesions before treatment. After treatment, only one new lesion was detected, according to the study.

Moreover, three years after the therapy, six patients were able to reduce or discontinue their disability insurance and return to work or school, Atkins said.

The report was published online June 9 in the journal The Lancet.

More information

For more on MS, visit the National Multiple Sclerosis Society.

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Older Runners Can Maintain Their ‘Fuel Efficiency’

THURSDAY, June 9, 2016 (HealthDay News) — Runners over age 65 could burn oxygen at nearly the same rate as much younger runners, a new study finds.

The rate of oxygen consumption is what researchers call “running economy.” They found that even though the gait of older runners may change, they still maintain youthful energy levels, or good running economy, while exercising.

“There’s good evidence that it’s never too late to get into exercise, it’s about finding what types of exercise are right for your body,” said study author Justus Ortega, an associate professor in the department of kinesiology at Humboldt State University, in Arcata, Calif.

The finding offers another reason for people to remain active as they age, the researchers said.

For the study, Ortega and colleagues from the University of Colorado, Boulder conducted treadmill assessments of 15 older runners and 15 younger runners who ran at least three times a week for a minimum of 30 minutes per session, over six months.

There were differences between the two groups in running mechanics, indicating that older runners adjust their techniques as they age. But the older runners burned oxygen at a similar rate as younger runners at a number of different speeds.

“I like to think of it as your body is like a car with a fuel efficiency level,” Ortega said in a Humboldt State news release. “Your body has its own fuel efficiency and what we’ve seen is that the fuel efficiency in muscles is reduced in older adults who are sedentary or only walk occasionally.”

Those who continue their jogging habit will enjoy superior running economy, he said.

The researchers plan further studies to determine whether other types of exercise have the same effect on increasing muscle efficiency and whether inactive people can get the same benefits if they boost their physical activity.

The study was published recently in the journal Medicine & Science in Sports & Exercise.

More information

The U.S. National Institute on Aging has more on exercise and physical activity.

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Middle-Age Fitness Helps Ward Off Stroke Later

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 9, 2016 (HealthDay News) — Physical fitness in middle age may lower your risk of stroke after 65, a new study finds.

“It is becoming increasingly clear that healthy mid-life behaviors pay off as we age, and lower our risk of cardiovascular disease and stroke,” said Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine. He was not involved in the study.

Among nearly 20,000 adults in their mid to late 40s, researchers found the most fit had a 37 percent lower risk of having a stroke after 65, compared with the least fit.

The protective effect of fitness remained even after the researchers accounted for risk factors for stroke, such as high blood pressure, type 2 diabetes and an abnormal heart rhythm known as atrial fibrillation.

“Incorporating exercise and regular physical activity in one’s day-to-day routine is important to improve fitness and lower risk of stroke and other cardiovascular diseases in older age,” said lead researcher Dr. Ambarish Pandey. He is a cardiology fellow at the University of Texas Southwestern Medical Center in Dallas.

The American Heart Association recommends at least 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise a week.

Pandey said an exercise routine should include aerobic exercise (such as jogging, swimming, walking or biking), plus strengthening exercise (such as free weights or strength-training machines).

Stroke is the fifth leading cause of death in the United States and a leading cause of long-term disability, Pandey noted.

Most strokes occur when a blood clot blocks a blood vessel in the brain, cutting off blood and oxygen. This causes brain cells to die and can leave permanent disability.

Pandey speculated that exercise might help prevent stroke by keeping blood vessels healthier and lowering inflammation that can affect their function.

The findings suggest doctors should consider low fitness levels a risk factor for stroke, the study authors said.

While lifelong fitness is best for optimum health, starting later in life is still beneficial. “It’s never too late to exercise to lower the risk of heart attack and stroke,” Pandey said.

The report was published online June 9 in the journal Stroke.

Pandey and colleagues analyzed 1999-2009 data from a study conducted by the Cooper Institute in Dallas. It used treadmill tests to measure heart and lung exercise capacity when participants were 45 to 50.

The most interesting finding in this study, Sacco said, was that the effect of fitness was independent of some traditional risk factors. “Diet was not evaluated and can also be linked to health fitness lifestyles,” Sacco said.

Sacco agreed it’s never too late to start getting fit to reap health benefits.

“Other studies have shown that physical activity, even among older individuals, can also lower stroke risk and be associated with less silent stroke and mental decline,” Sacco said. “However, among older adults it is important to check with your physician before you start more vigorous physical activity.”

More information

For more about stroke, visit the U.S. National Institute of Neurological Disorders and Stroke.

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This Period Ad Is Like None You’ve Ever Seen Before

Everyone’s talking about the new commercial by U.K. sanitary pad brand Bodyform, and with good reason. The enthralling clip, entitled “Blood,” is just that: unapologetically bloody.

Whereas most feminine hygiene ads use a mysterious blue liquid as a stand-in for the real stuff, Bodyform skips the synthetic fluid and instead features fearless female athletes who are bloodied, but not limited, by various sports injuries.

We like Bodyform’s decision to get gory because it stomps on an unnecessarily taboo topic. But the ad is also a good reminder that exercising on your period can be a really good thing: It can help with annoying symptoms, like pain and bloating. And thanks to hormonal shifts, you may even get more out of fast-paced workouts, like high-intensity interval training, than you would at other points in your cycle.

RELATED: 9 Best Workouts to Do When You Have Your Period

With a high-energy soundtrack and inspiring imagery (from the rugby field to mountain peaks), Bodyform’s ad fully convinces us of its tagline: “No blood should hold us back.”

We agree. Period.

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Teen Smoking Down, E-Cigarette Use Up

THURSDAY, June 9, 2016 (HealthDay News) — It may seem like eye-rolling teens never listen, but a new U.S. government report finds many kids are getting some health messages loud and clear.

Smoking among high school students is at an all-time low. Slightly more than one in 10 high schoolers used cigarettes in 2015. That’s down from more than one in four in 1991, the U.S. Centers for Disease Control and Prevention reported Thursday.

However, use of e-cigarettes is up.

Also on the good-news front: premarital sex is down, as is soda consumption and illegal use of prescription drugs.

But distracted driving and sedentary lifestyles continue to be problems.

The survey — called the National Youth Risk and Behavior Survey — included more than 15,000 high school students.

A number of factors have contributed to the decline in smoking, according to Patricia Folan, director of the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y. They include “environmental tobacco bans, increased taxes on cigarettes, anti-tobacco media campaigns, as well as the removal of point-of-sale tobacco advertising from stores,” she said.

But some teens are replacing traditional cigarettes with electronic ones. Almost one-quarter of high school students said they’d used e-cigarettes in the past 30 days. And 45 percent said they’d tried an e-cigarette at least once in their life, the report found.

E-cigarettes are battery-powered devices that heat up fluid until it becomes vapor, which is then inhaled. The fluid includes nicotine and other ingredients, such as flavorings and chemicals.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said, “While cigarette smoking in high school students is at an all-time low, the rise of e-cigarette use poses a risk that teenagers will transition from ‘e’ to ‘real’ cigarettes.”

Also of concern, said Folan: e-cigarettes are “products intended to appeal to children with their candy flavoring, such as bubble gum, ‘Kaptain Krunch’, grape and thousands of other sweetened flavors.”

That may help explain why teen use of e-cigarettes is much higher than adult use. Just under 4 percent of working adults in the United States use e-cigarettes, according to the CDC.

And use of e-cigarettes may be of more concern in teens than in adults. “These products contain nicotine, an addictive substance, which has a powerful and detrimental effect on the developing brain of youth and young adults,” Folan noted.

Smoking wasn’t the only unhealthful behavior that was down among teens. In just two years — from 2013 to 2015 — the number of high school students who had a soda one or more times a day dropped from 27 percent to 20 percent, the report said.

Dana Angelo White is a registered dietitian at Quinnipiac University, in Hamden, Conn. She said, “Many kids don’t realize that each 20-ounce bottle averages 15 to 20 teaspoons of sugar. That’s a lot of extra calories they don’t need.”

Teens are also less likely to be sexually active — defined as having sexual intercourse during the past three months. In 2015, 30 percent of teens said they were sexually active. In 1991, that figure was 38 percent of teens, according to the report.

Fewer high schoolers reported illicit use of a prescription drug one or more times. In 2009, 20 percent of teens had taken prescription drugs without a prescription, compared to 17 percent in 2015.

The news was not as good when it comes to distracted driving. Nationwide, 42 percent of students who had driven a vehicle during the past 30 days said they’d texted or e-mailed while driving. This was the same rate as in 2013.

And while sexual activity rates are down, so too is condom use. Among those who are currently sexually active, condom use fell from 63 percent in 2003 to 57 percent in 2015. Adding to that troubling trend is that fewer students are getting tested for HIV. Only one in 10 high schoolers was tested for HIV in 2015, compared to 13 percent in 2011, the report found.

Finally, the percentage of kids who played video or computer games or used a computer three or more hours a day for non-school-related reasons climbed from 22 percent to 42 percent from 2003 to 2015.

Laura Kann, chief of the CDC’s School-Based Surveillance Branch, said in an agency news release, “While overall trends for the 2015 report are positive, the results highlight the continued need for improvements in reducing risks among teens.”

More information

The American Academy of Pediatrics has more on the teen years.

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Certain Steroids Raise Risk for Serious Staph Infections

THURSDAY, June 9, 2016 (HealthDay News) — People who use powerful drugs called systemic glucocorticoids are at higher risk for life-threatening staph blood infections, a new study finds.

The findings are “a reminder for clinicians to weigh carefully the elevated risk against the potential beneficial effect of glucocorticoid therapy,” said study lead author Dr. Jesper Smit, of Aarhus University Hospital in Denmark.

“This is especially pertinent in patients who are already vulnerable to infection,” he added.

Glucocorticoids — a form of steroids — are powerful immunosuppressive drugs used to treat a variety of medical conditions that involve inflammation.

The drugs are “given by mouth or by injection, are anti-inflammatory, and can suppress the immune system,” explained one U.S. expert, Dr. Gerald Bernstein.

“Usually, short-term use in otherwise healthy people does not cause a problem, but long term there could be consequences,” said Bernstein, who coordinates the Friedman Diabetes Program at Lenox Hill Hospital in New York City.

In the new study, Smit’s team reviewed the medical records of nearly 30,000 people in Denmark. The study found that those who used systemic glucocorticoids were 2.5 times more likely than non-users to develop Staphylococcus aureus bacteria-associated blood infections outside of a hospital.

Infection risk rose along with the dose of the medicines given, the findings showed. Compared to non-users, those with a 90-day cumulative corticosteroid dose less than or equal to 150 milligrams (mg) had 2.4 times higher risk, but the risk was as high as 6.3 times greater for patients with a cumulative dose of more than 1,000 mg.

Among patients with connective tissue disease or chronic lung disease, the risk of staph blood infection was highest in people who used glucocorticoids long-term, the researchers found.

Among cancer patients, the risk was highest for new users of the drugs, according to the study.

The study authors said the increased risk of staph infections needs to be weighed against the potential benefits of the steroid drugs.

And Bernstein noted that glucocorticoids come with other dangers.

“For some diseases, the long-term use of large amounts of steroids will lead to a number of consequences, including osteoporosis and elevated blood glucose,” he said.

But the drugs can also be “lifesaving” in many cases, Bernstein said. “For certain diseases, people need to remain on a small dose chronically — and very often they do not have problems. In these situations the steroid is a miracle.”

However, because glucocorticoids can suppress immune system function, it’s not a big surprise that the risk for serious infections like staph might rise, Bernstein noted.

“This study amplifies our need to have a bunch of red flags, so as to reduce the risk of this type of infection — and if the infection occurs, treat it as quickly as possible,” he said. “For the patient and the clinician, [treatment] is a constant barrage of decision-making.”

The study was published June 8 in Mayo Clinic Proceedings.

More information

The U.S. Centers for Disease Control and Prevention has more about staph infections.

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Bifocals Might Trip You Up

THURSDAY, June 9, 2016 (HealthDay News) — Wearing bifocals or progressive lenses may cause visual blurring. And that puts older people at risk of making a misstep and falling, researchers say.

The effects of blurry vision on stepping accuracy were greatest when study participants were looking ahead of where they were stepping, the findings showed.

The results serve as a reminder to watch your step, the researchers said.

Beyond that, “our findings … support the benefits of gaze training to maintain gaze position on stepping locations when undertaking precision stepping tasks,” wrote Alex Black and colleagues at Queensland University of Technology in Australia. Black suggested that this could improve stepping accuracy and minimize the risk of slips and trips.

For the study, the researchers asked 19 older adults, average age 72, to do a series of “precision stepping tasks” while wearing their normal glasses or glasses that produced blurred vision. For example, looking at a distance through bifocal or progressive (multifocal) lenses can cause blurred vision.

While the stepping errors made when wearing the blurred vision glasses were relatively small, the risk of falling may be high in places where proper foot placement is critical, such as on stairs or uneven surfaces, the study authors said.

The researchers suggested that it might be a good idea for some people — particularly active older adults — to use single-vision prescription glasses when walking.

The findings were published in the June issue of the journal Optometry and Vision Science.

“Falls for the elderly can be quite serious in consequence, so adopting strategies for avoiding falls is very important,” said journal associate editor Anthony Adams. “Our authors highlight the difficulty that bifocal and multifocal prescription glasses may create for the elderly, particularly if they gaze past the stepping point.”

More information

Learn more about how to prevent falls from the Health in Aging Foundation.

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Less Heart Care, More Strokes for Women?

THURSDAY, June 9, 2016 (HealthDay News) — Women in the United States with the common heart rhythm disorder atrial fibrillation are more likely than men with the condition to suffer a stroke, a new study shows.

Atrial fibrillation is a quivering or irregular heartbeat. This study of 1 million patients with atrial fibrillation found that women were 23 percent more likely to be hospitalized for stroke than men.

“There is a debate about whether it’s the biology and something naturally in women that predisposes them to stroke or whether health care providers are failing to give adequate care,” said researcher Dr. Ghanshyam Shantha. He is a cardiovascular disease fellow at the University of Iowa Hospitals and Clinics.

“Our findings corroborate the previous evidence that women receive less treatment and support the conclusion that the gender discrepancy is due to inadequate stroke prevention care in women and not biology,” Shantha said in a European Society of Cardiology news release.

The 15-year study looked at ischemic stroke, the most common kind, which is caused by blocked blood flow to the brain.

“There is evidence from around the world that women with atrial fibrillation receive less [blood-thinning medication] for stroke prevention than they need,” said Shantha. “Just 30 percent of women who should receive this medication actually get it, compared to nearly 60 percent of men.”

It’s also known that women don’t get state-of-the-art treatments for atrial fibrillation at the same level as men, he added. “What is not known is whether these deficiencies in access to care translate into poorer outcomes,” he added.

His study found there was no particular region of the country or time period linked to worse care for women, Shantha said.

“However you slice, dice, and divide the data, women do poorer than men in terms of admissions for acute ischemic stroke,” he said.

“In those with high socioeconomic status, women do worse than men, and among those with low socioeconomic status women do worse than men. Women have second-rate outcomes across the board,” Shantha said.

Study senior author Michael Giudici added that it doesn’t help that women tend to put everyone else first and say “Don’t worry about me.”

“They need to ‘worry about me’ a little more,” said Giudici, director of arrhythmia services at University of Iowa Hospitals and Clinics. “Women may have more subtle symptoms so they need to pay more attention to their blood sugar and blood pressure and not delay seeking treatment.”

Shantha was to present the findings Thursday at a cardiology meeting in Nice, France. Research presented at meetings is usually considered preliminary until peer-reviewed for journal publication.

More information

The U.S. National Heart, Lung, and Blood Institute has more about atrial fibrillation.

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6 Ways Women Can Take Care of Their Tickers

THURSDAY, June 9, 2016 (HealthDay News) — Heart disease is the leading cause of death among American women, but there are a number of preventive measures women can take, the U.S. Food and Drug Administration says.

“The risk of heart disease increases for everyone as they age. For women, the risk goes up after menopause, but younger women can also develop heart disease,” FDA cardiologist Dr. Shari Targum said in an agency news release.

One in four American women dies from heart disease, according to the U.S. Centers for Disease Control and Prevention. Here, the FDA offers six ways you can reduce your risk:

• Control your risk factors. Diabetes, high blood pressure and high cholesterol increase the risk of heart disease, so it’s important to manage these health conditions if you have them. Talk to your health care provider about an effective treatment plan.
• Don’t smoke. If you smoke, try to quit.
• Maintain a healthy weight and get regular physical activity. “Walking may be one easy way to start. Talk to your health care provider about how much activity is right for you,” Targum said.
• Eat a heart-healthy diet. A diet that’s full of vegetables and fruits and whole grains is good for your heart. Limit the amount of saturated fat and sugary beverages in your diet.
• Talk with your doctor about aspirin. Daily use of low-dose aspirin is not right for everyone. Aspirin can have side effects, so talk with your health care provider first.
• Know the symptoms of a heart attack. Symptoms of heart attack in women can be different from those in men. For women they may include shortness of breath; nausea; and an ache or feeling of tightness in the chest, arm, neck, jaw or abdomen. “If you have these symptoms and suspect you’re having a heart attack, call 911,” Targum said.

It’s also important for women to work with their health care team to make a plan for their heart health, the FDA recommended.

More information

The FDA’s Heart Health for Women website offers a wide range of resources.

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Americans Living Longer and Better

THURSDAY, June 9, 2016 (HealthDay News) — Americans aren’t just living longer, they’re living more years without disabilities, too, a new study shows.

Harvard University researchers reviewed federal government data. They found that in 1992, life expectancy for the average 65-year-old was 17.5 additional years, 8.9 of which were disability-free. By 2008, life expectancy for someone age 65 was an additional 18.8 years, 10.7 of which were disability-free.

“This suggests, for the typical person, there really is an act beyond work — that once you reach age 65, you can likely look forward to years of healthy activity,” said study co-author David Cutler, a professor of applied economics at Harvard.

“So this is good news for the vast bulk of people who can now look forward to healthier, disability-free life, but it’s also good news for medical care because it demonstrates the value of medical spending,” he said in a university news release.

The researchers said improvements in vision care and in heart disease prevention and treatment are major factors behind the trend towards healthier, longer lives.

“There has been an incredibly dramatic decline in deaths and disabilities from heart disease and heart failure. Some of it is the result of people smoking less, and better diet, but we estimate that as much as half of the improvement is because of medical care, especially statin drug treatment, which is both preventing heart attacks and improving people’s recovery,” Cutler said.

Cataract treatment is responsible for much of the improvement in vision health.

“In the past, cataract surgery was very lengthy and technically difficult. That same surgery today can be done in an outpatient setting, so that complications and disability are significantly ameliorated,” Cutler said.

“It used to be that when you turn 70, your occupation became managing your health. Now you can increasingly just live your life,” he concluded.

The study is described in a working paper released recently by the National Bureau of Economic Research.

More information

The U.S. Centers for Disease Control and Prevention has more on healthy aging.

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