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High blood levels of C-reactive protein (CRP) may increase a person’s risk for heart attack and death, but not for stroke, a new study has found.

The study included 2,240 people in New York City who were 40 or older and stroke-free. At the start of the study, the participants’ blood was checked for levels of CRP (a marker for inflammation) and their heart attack and stroke risk factors were evaluated by researchers.

During an average follow-up of eight years, there were 198 strokes, 156 heart-related events and 586 deaths. People with CRP levels greater than 3 milligrams per liter of blood were 70 percent more likely to have a heart attack and 55 percent more likely to die than those with CRP levels of 1 milligram per liter or less, the researchers reported in the Oct. 20 print issue of Neurology.

After they took other risk factors into account, the study authors concluded that CRP levels didn’t influence stroke risk.

“The role of this protein in predicting risk of stroke has been controversial, although prior studies have found it to be a marker for predicting risk of heart disease,” study author Dr. Mitchell Elkind, of Columbia University Medical Center in New York City, said in a news release from the American Academy of Neurology. “However, in our large, multiethnic population, CRP levels did not play a role in predicting stroke, though they may still help determine whether someone is at risk of heart attack or early death.”

CRP levels are influenced by factors such as physical activity, smoking, alcohol consumption and diabetes.

“It appears that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death,” Elkind said.

“It may be that the failure of CRP to predict stroke in our study, unlike in some other populations, reflects the fact that our population is older and has more of these risk factors. While CRP may be predictive in generally young healthy people, it may be less useful among older, sicker people. More research needs to be done on why the protein wasn’t able to predict stroke in the same manner as heart disease,” he said.

When one identical twin develops the developmental disorder autism, the risk of the other developing it is high — substantially higher than it is for fraternal twins, a new study confirms.

The study, which gathered information from 277 twin pairs in which at least one had an autistic disorder, found that when one identical twin developed an autistic disorder, the other one also did 88 percent of the time.

That compared with 31 percent among fraternal twins. Unlike identical twins, fraternal twins are no more genetically similar than non-twin siblings.

What’s more, researchers found, identical twins also had greater similarities in the form of autism that they developed, their level of day-to-day functioning and the risk of intellectual impairment.

The findings, reported in the Archives of Pediatrics & Adolescent Medicine, confirm the importance of genes in autism development.

Autism spectrum disorders (ASDs) include several developmental brain disorders that hinder a person’s ability to communicate and interact socially. ASDs range from the more-severe cases of “classic” autism to Asperger’s syndrome — where a person has normal intelligence and verbal skills, but difficulty socializing and understanding subtler forms of communication, like body language and vocal tone.

“Autism research has been guided by one important observation for the past several decades - that autism has a large genetic component,” Dr. Paul Law, of the Kennedy Krieger Institute in Baltimore, told Reuters Health in an email. “That observation was made through twin studies.”

This new study confirms those findings using a much larger sample of twins, according to Law. The data come from an online registry called the Interactive Autism Network, which Kennedy Krieger set up two years ago to connect parents of children with autism with researchers.

Of the twin pairs in the current study, 67 were identical and 210 were fraternal. Among identical twins, all females had been diagnosed with an ASD, whereas the “concordance” was 86 percent among males.

The pattern was different among fraternal twins. Among pairs in which at least one was female, when one sibling developed an ASD, the other did 20 percent of the time. That figure was 40 percent when both twins were male.

The findings also go beyond confirming concordance in identical twins’ odds of developing an ASD, Law pointed out.

“We show that important characteristics of ASD, such as the type of ASD, level of functioning and presence of other psychiatric disorders are more similar…among identical twins,” he said. “Thus not only are they more concordant overall, but the pattern of their disease is more concordant.”

The researchers also found that among identical twins, the second sibling was unlikely to be diagnosed with an ASD once a year had passed since the first sibling’s diagnosis.

“Basically,” Law said, “our data suggests that parents of identical twins can stop worrying after about 12 months have passed since the diagnosis of their first twin.”

In contrast, he said, fraternal twins still seem to have “some degree of risk” as much as four years after the first twin is diagnosed.

While experts generally agree that genetics plays a major role in autism spectrum disorders, they also believe that environmental factors conspire with genes to make certain children vulnerable. Researchers are still trying to figure out what those environmental factors are.

Cancer researchers say they have a better treatment for patients with newly diagnosed multiple myeloma than the current standard therapy.

Their study finds that treatment with lenalidomide plus low-dose dexamethasone is associated with better short-term survival and with lower toxicity than lenalidomide plus high-dose dexamethasone, which is the mainstay of therapy for the bone marrow cancer.

The study included more than 400 patients with untreated, symptomatic myeloma who received lenalidomide (25 milligrams for 21 days) plus a high dose of dexamethasone (40 milligrams on days one to four, nine to 12, and 17 to 20 of a 28-day cycle), or who received lenalidomide on the same schedule with a low dose of dexamethasone (40 milligrams on days one, eight, 15 and 22 of a 28-day cycle).

Within four cycles, 79 percent of patients in the high-dose group and 68 percent of patients in the low-dose group had complete or partial response, the researchers found. After one year, overall survival was 96 percent in the low-dose group and 87 percent in the high-dose group. These findings led the researchers to stop the trial and switch patients in the high-dose group to low-dose therapy.

During the first four months of the study, 52 percent of patients in the high-dose group and 35 percent of those in the low-dose group had grade 3 or worse toxic effects. These included deep-vein thrombosis, fatigue and infections, including pneumonia.

Also during the first four months of the trial, 5 percent of patients in the high-dose group died, compared with less than 1 percent of those in the low-dose group, the study authors reported.

“High-dose dexamethasone in a community setting seems more toxic than low-dose dexamethasone, with more early deaths in the first four months, increased risk of thromboembolic complications, and higher overall risk of serious adverse events, particularly in patients older than 65 years,” wrote Dr. S. Vincent Rajkumar, of the Mayo Clinic, and colleagues.

The authors concluded that the trial “shows that low-dose dexamethasone in conjunction with lenalidomide is an active regimen for newly diagnosed myeloma with acceptable toxicity and low early mortality.”

They also noted that “the use of high-dose dexamethasone is not needed for the most part in the context of new active agents for myeloma, and as a result almost all current phase 3 trials have adopted low-dose dexamethasone as the standard in combination regimens.”

Vitamin B-12 is an essential vitamin that’s found in dairy foods and many types of meat. It plays a role in the health of your nervous system and in the production of red blood cells.

The American Academy of Family Physicians says here are the possible health consequences of a vitamin B-12 deficiency:
Dementia.
Depression.
Anemia.
Nervous system abnormalities.
Possible increased risk of heart disease and stroke, if you also have above normal levels of an amino acid called homocysteine.