The research, in Stroke: Journal of the American Heart Association, said doctors should be aware people with depression may neglect their general health.

UK stroke experts said depression alone was unlikely to increase stroke risk.

Indicator

The women, all aged 54-79, who were all taking part in the long-running Nurses’ Health Study which has been following women across the US since the mid 1970s.

In this study, the researchers looked at data from 2000 to 2006.

None had had a stroke before the study began, while 22% had been diagnosed with depression.

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Women suffering from depression may be less motivated to maintain good health or control other medical conditions”

Dr Peter Coleman The Stroke Association

Compared to women without a history of depression, depressed women were more likely to be single, smokers and less physically active. They were also slightly younger, had a higher body mass index and conditions such as high blood pressure, heart disease and diabetes.

During the course of the research, 1,033 women had a stroke.

As well as the increased risk for those who had been diagnosed with depression at any point, the researchers also found women who had used anti-depressants particularly SSRIs (selective serotonin reuptake inhibitors) at any point in the two years prior to the study, was 39% higher.

Bur Dr Kathryn Rexrode, who led the research, said the medicines were more likely to be an indication someone was more seriously ill, rather than a cause of the stroke.

“I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”

She added: “Depression can prevent individuals from controlling other medical problems such as diabetes and hypertension, from taking medications regularly or pursuing other healthy lifestyle measures such as exercise. All these factors could contribute to increased risk.”

Lifestyle

Dr An Pan of the Harvard School of Public Health, who also worked on the research, said inflammation could be the physical mechanism linking depression and stroke.

But he added: “Regardless of the mechanism, recognising that depressed individuals may be at a higher risk of stroke may help the physician focus on not only treating the depression, but treating stroke risk factors such as hypertension, diabetes and elevated cholesterol as well as addressing lifestyle behaviours such as smoking and exercise.”

Dr Peter Coleman, deputy director of research at the UK’s Stroke Association, said: “Depression is a very serious condition which needs to be treated carefully by healthcare professionals.

“This research appears to indicate that women suffering from depression may be less motivated to maintain good health or control other medical conditions such as diabetes and high blood pressure, which have an associated increased risk of stroke.

“However, it is very hard to determine whether there is a direct link between depression and stroke risk and a lot more research is needed in this area before depression alone can be viewed as a stroke risk factor.

“It’s important that anyone taking antidepressants should continue doing so, and anyone concerned about their overall stroke risk should speak to their GP.”

A study of 2.4 million people, published in the Lancet, showed a 25% difference in increased risk.

The reasons are unclear, say researchers.

The British Heart Foundation said the findings were “alarming” especially as women tended to smoke fewer cigarettes.

The World Health Organization lists heart disease as the world’s biggest killer, affecting more than seven million people each year.

The illness is largely down to lifestyle choice and smoking is one of the main causes. A study by the University of Minnesota showed women are at greater risk from smoking than men.

It analysed 75 sets of data produced by studies between 1966 and 2010.

The report showed that: “Women had a significant 25% increased risk for coronary heart disease conferred by cigarette smoking compared with men.”

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Smoking cessation policies and practice should take account of differences between the genders in order to optimise effectiveness in targeting both men and women”

Jules Payne Heart UK

Smoking was thought to double the risk of a heart attack for both men and women. The report’s author Rachel Huxley said the risks adjusted for each sex were not available – but she roughly estimated them to be around a 1.8 fold increase if men start smoking and around a 2.3 fold increase for women.

Reason unknown

The researchers admit that the explanation for the increased risk is “unclear”, but likely explanations fall into two categories.

Biological differences between the sexes could mean women are more vulnerable to coronary heart disease or there could be differences in the way women smoke.

The authors suggested: “Women might extract a greater quantity of carcinogens and other toxic agents from the same number of cigarettes than men.”

Ellen Mason, senior cardiac nurse at the British Heart Foundation, said: “It’s alarming to see such a large study confirm that women are so much more at risk of heart disease from smoking than men.

“Despite women generally smoking fewer cigarettes a day than men, women appear to be substantially more at risk of getting heart disease.

The chief executive of Heart UK, Jules Payne, said: “Smoking cessation policies and practice should take account of differences between the genders in order to optimise effectiveness in targeting both men and women.”

Jane Landon, deputy chief executive of the National Heart Forum, said: “In many countries around the world, women are viewed as a growth market by tobacco companies.

“Government plans for plain packaging of tobacco products are urgently needed to stop the cynical marketing that particularly targets young women with slim cigarettes in small, attractive packs in appealing textures and colours.”

But despite nearly 788,000 using the services in England this year, less than half succeed, figures from the NHS Information Centre reveal.

And many of those who do quit – 384,000 in 2010/11 – later relapse.

This means a fifth of adults in England are smokers, even though more are using quit smoking services at a cost of £84.3m in 2010/11.

This is nearly half a million pounds more than in the previous year and almost £60m more than t10 years ago.

Experts said the figures suggest that while there is a greater resolve within society to quit smoking, over half of all attempts fail.

NHS Information Centre chief executive Tim Straughan said: “NHS Stop Smoking Services in England saw more quit dates set with it in the last financial year than ever before; and indeed the greatest ever number of successful quit attempts.

“But while a bigger number of quit dates are being set with the service and the number of attempts to successfully kick the habit have also risen, overall the success rate is hovering at just below half.”

Martin Dockrell, Director of Policy and Research at Action on Smoking and Health, said: “This shows how much people want to quit and yet how hard it can be. The Stop Smoking Services provide the best chance of success in helping a person to stop smoking. Few smokers will manage to quit first time so it is encouraging that a greater number of smokers are getting the best available help.”

A spokesman for the Department of Health said smoking was one of the biggest challenges in public health.

Little Insects, Big Allergic Reactions

June 16, 2011 — Insect stings are little more than painful nuisances for most people. But for others, the venom from insects can cause severe allergic reactions and even death. That’s according to a joint task force of the American College of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma & Immunology, and the Joint Council of Allergy, Asthma and Immunology, which has updated practice guidelines for diagnosing and treating stinging insect allergies.

Serious allergic reactions to insect stings cause at least 40 deaths each year in the U.S. Experts estimate that life-threatening reactions to insect stings occur in 3% of adults and up to 0.8% of children.

Richard Nicklas, MD, a clinical professor of medicine at George Washington Medical Center in Washington, D.C., and one of the authors of the guidelines, says that for most people insect stings usually cause temporary pain, swelling, and redness, symptoms that can be treated at home.

Some Stings May Require Immediate Medical Attention

“An allergic reaction is more severe and often includes hives, itching, and swelling in areas other than the sting site,” Nicklas says in a news release. “These reactions require immediate medical attention.”

Symptoms of a serious life-threatening allergic reaction, also called anaphylaxis, can include tightness of the chest, difficulty breathing, hives, swelling of the tongue, throat, nose, and lips; nausea, cramps, diarrhea, headache, dizziness, or loss of consciousness. The updated guidelines say research indicates that allergy shots, also known as immunotherapy, could prevent many adverse reactions. With allergy shots, people could build up their immune system’s tolerance to insect venom.

The task force also says some insects considered fairly harmless may be dangerous, such as bumblebees.

The practice guidelines say people who feel they are at increased risk of serious reactions should see an allergist for evaluation and possible treatment. People at highest risk include those who have asthma or a history of severe reactions to insect stings, and people with heart disease, high blood pressure, or people taking certain medications for those conditions may require special attention.

The statement says people who have a history of serious adverse reactions to insect stings should:

• Educate themselves about bees and other stinging insects so that they can avoid them.
• Carry epinephrine at all times for emergency self-treatment and receive instructions on how to properly use the medication. Consider a prescription for an additional injector because some people with anaphylaxis may need more than one epinephrine injection.
• Undergo testing for specific antibodies to stinging insects.
• Be considered for immunotherapy (allergy shots) if test results for the antibodies are positive.

Consider carrying medical identification (like a bracelet or pendant) stating their insect sting allergy.

Know Where Bees Live

The practice guidelines also advise that people be aware of where stinging insects might be found to avoid getting stung.

For example, yellow jackets tend to build nests in the ground and can be stirred into attack. Hornets, which are highly aggressive, build large nests, usually in trees, the statement says, and wasp nests generally are found in shrubs and under eaves of houses or barns. Domestic honeybees are found in commercial hives, but their wild cousins live in tree hollows or old logs.

The statement notes that Africanized honeybees are hybrids, descendants of domestic honeybees and African honeybees in South America, and are much more aggressive, so much so that they often attack in swarms.

Fire ants can also produce painful stings and dangerous reactions.

The identification of the stinging insect can be useful to people and doctors in diagnosing and treatment, as well as for educating patients in avoidance.

Other tips noted to help people avoid stings include keeping food covered when eating outdoors and avoiding drinking beverages from cans or straws when outdoors. That’s because stinging insects are attracted to sweet liquids and may crawl inside the can or straw. Also, people should keep outdoor garbage cans covered with tight-fitting lids.

SOURCES: News release, American College of Allergy, Asthma and Immunology.Golden, D. Journa

WEDNESDAY, July 6 (HealthDay News) — Women, older people and minorities are under-represented in lung cancer drug trials in the United States, according to a new study.

Researchers say that this could have a significant impact on the efficacy and safety of new treatments among these groups, particularly the elderly.

“Our results suggest that the trial population used for approval of drugs do not represent well the U.S. population who may receive the marketed agent,” the study’s principal investigator, Dr. Shakun Malik, a medical officer at the U.S. Food and Drug Administration in Silver Spring, Md., said in a news release.

“This fact is concerning particularly for older patients who may experience greater toxicity when given the same dose and combination of drugs based on testing in a younger population,” Malik explained in the release from the International Association for the Study of Lung Cancer.

In conducting the study, which was slated for presentation Wednesday at the 14th World Conference on Lung Cancer in Amsterdam, researchers reviewed 10 years of trial data for the treatment of non-small cell lung cancer submitted to the U.S. Food and Drug Administration.

The study revealed that although 42% of patients diagnosed with lung cancer in the United States between 1975 and 2008 were women, only 32% of enrollees in 10 national and international drug trials for non-small cell lung cancer between 2000 and 2010 were women.

Moreover, although 73% of lung cancer patients in the United States are older than 65, only 36% of the drug trial population was in that age group.

Blacks also develop lung cancer at higher rates than whites, but they only comprised 2% of trial participants in the 10-year period, the study found. Meanwhile, researchers noted that whites made up 78% of enrollees, Asians comprised 15%, Hispanics 2% and “other” accounted for 2%.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

– Mary Elizabeth Dallas

Woman is free of rice diet after 12 years of allergies

A former caterer who survived on meals of rice after developing acute food allergies 12 years ago said her diet was finally changing for the better.

Micaela Stafford, from Normanton-on-Soar in Leicestershire, said the pain caused by her intolerances had left her desperate and “wanting to die”.

With help from a nutritionist the 53-year-old is now gradually widening her diet, and already feeling the benefits.

“I just feel like [she] has given me my life back,” she said.

Ms Stafford said doctors had been unable to understand what was causing her migraines and sickness.

“I just felt that anything else made me feel so poorly and in a desperate, desperate struggle to try and have any quality of life whatsoever I lived on rice,” she said.

But the shots aren’t for everyone. The American Academy of Asthma, Allergy and Immunology says they’re not appropriate for food allergies.

Before deciding to begin allergy shots, the academy says you should consider these factors:

• The severity of your allergy symptoms.
• How long your allergy season lasts.
• The effectiveness of antihistamines in treating your allergy symptoms.
• Your desire and ability to take antihistamines and other medications over the long-term.
• Your ability to visit an allergist consistently to get allergy shots.
• Your ability to pay any costs associated with allergy shots.

– Diana Kohnle

Some recommendations from a Seminar to prevent SUDEP have recently been published Online First in The Lancet. It states that reducing the occurrence of tonic-clonic seizures, less frequent or gradual changes to antiepileptic drugs (AEDs), night-time surveillance of high-risk patients, close supervision immediately after a seizure, and counselling patients about the risks and prevention strategies could help protect against SUDEP.

Simon Shorvon from University College London Institute of Neurology, London, UK and Torbjorn Tomson from the Karolinska Institute, Stockholm, Sweden were the lead scientists for this research paper. They reviewed all previously available information regarding interventions to minimise the possibility of sudden death and provide advice to clinicians managing patients with epilepsy.

Results of the research have revealed that patients who experience a high number of generalised tonic-clonic seizures (the most common type of generalized seizure that affects the entire brain) are at the highest risk of unexpected death. The researchers state:

“Compared with patients with up to two seizures in the previous year, the relative risk [the number of times greater the risk is compared to the general population] of SUDEP is 7.21 in those with a history of three to 12 seizures, 8.64 in those with 13-50 seizures, and 10.16 in those with a history of more than 50.”

Other predisposing factors identified by the researchers include taking a combined regimen of AEDs (polytherapy), not taking AEDs as prescribed, sudden or frequent changes to AEDs, early onset of epilepsy (before the age of 16 years), having epilepsy for longer than 15 years, having seizures during sleep, and having seizures when alone. Males were identified to be more prone to SUDEP when compared with females.

Researchers believe that modifying these risk factors in patients with epilepsy may help reduce the incidence of sudden death. Most important recommendations include effective drug treatment and compliance to control seizures, changing treatment in a step-by-step manner and acting upon bradycardia or apnoea, which are warning signs in patients with pre-existing heart or respiratory illness. Other preventive measures include supervision at night for high-risk patients, choosing AEDs without associated cardio-respiratory adverse effects, and close observation of patients after a seizure until full consciousness is regained.

Scientists also analyzed whether the risk of sudden death should be discussed with epilepsy patients and the appropriate time to do so. Some scientists have argued that to inform even low risk patients causes unnecessary stress and anxiety.

But the authors urge:

“We believe that most patients should have information about SUDEP, because although epilepsy is not usually a life-threatening condition, a small number of people do die in epileptic seizures from accidents and SUDEP, and the risk can be minimised by controlling tonic-clonic seizures. This information is best provided as part of comprehensive counselling about risks and prevention. Putting the risks in perspective is sometimes helpful – for example, comparing the risk of SUDEP (10-35 in 100 000 person-years) with the similar yearly risks of accidental death in a motor accident (about 18 in 100 000 cars or 55 per 100 000 motorcycles).”

The research paper has also drawn attention to the need for standardised autopsy protocols in all suspected SUDEP cases to enable data on the incidence of SUDEP in different regions, monitoring of time trends, and intervention strategies to be assessed.

Link To Abstract in The Lancet

Written by Anne Hudsmith

Copyright: Medical News Today

• Allergy involves an exaggerated response of the immune system.
• The immune system is the body’s organized defense mechanism against foreign invaders, particularly infections.
• Allergens are substances that are foreign to the body and can cause an allergic reaction.
• IgE is the allergy antibody.
• Allergies can develop at any age.
• Your risk of developing allergies is related to your parents’ allergy history.

Allergy facts
What does an allergy mean?
What causes allergies?
Who is at risk and why?
What are common allergic conditions, and what are allergy symptoms and signs?
Hay Fever
Asthma
Allergic Eyes
Allergic Eczema
Hives
Allergic Shock
Where are allergens? Everywhere
In the air we breathe
In what we ingest
Touching our skin
Injected into our body
Patient Discussions: Allergy – Symptoms
Patient Discussions: Allergies – Describe Your Experience
Find a local Asthma & Allergy Specialist in your town

Allergic Cascade

The immune system is very specific and goal oriented. Although you may be allergic to a number of substances, allergic reactions are directed at specific allergens. For example, you may be allergic to Bermuda grass, but not oysters. At times, however, two or more foreign substances might appear similar in nature to the immune system, which may mistake one for the other and react to both.

• Who are the “players” in the allergic cascade?
• What about a more detailed look at the “players?”
• What are cytokines?
• What is the “early phase” of an allergic reaction?
• What is the “late phase” of an allergic reaction?
• What are the consequences of the allergic cascade?
• How does understanding the allergic cascade help?
• Allergic Cascade At A Glance