Healthy reps

Genetic testing and warfarin dosing
Blood thinners are often prescribed to help prevent blood clots that can lead to pulmonary embolism, heart attack and stroke. Though effective at preventing these clots, warfarin can cause life-threatening bleeds. Warfarin has led to more emergency room visits for older people over the last decade than any other medication. This is because it can be difficult for doctors to determine the right dose. A team of scientists led by Dr. Brian F. Gage at Washington University in St. Louis investigated whether genetic testing can help predict the best warfarin dose to give a patient. They compared outcomes for patients whose initial doses were based on clinical information alone (e.g., age, weight, etc.) to those whose initial doses were based on their genetic makeup (genotype) along with clinical factors. The researchers collected blood samples from the patients and screened for genetic differences in the genes VKORC1, CYP2C9, and CYP4F2, which are related to blood clotting and warfarin metabolism or sensitivity. Adverse events were tracked for 90 days, including major bleeding, deep vein thrombosis, and pulmonary embolism. There were fewer adverse events in the genotype-guided dosing group: 87 events, or 10.8 percent of the genetic group, versus 116 events, or 14.7 percent of the clinically guided group. No patient died during the study.

Third dose of mumps vaccine?
With the U.S. facing a growing number of mumps outbreaks, an expert panel that advises the Centers for Disease Control and Prevention recommended that people who are at risk during outbreaks (such as those on college campuses) should receive an additional, third dose of vaccine, reports STAT. The Advisory Committee on Immunization Practices unanimously voted to approve a third dose of mumps-containing vaccine as a tool for outbreak control, despite acknowledging evidence to support the practice is limited. After years of low numbers of mumps cases – fewer than 1,000 cases nationally a year – the disease has made a resurgence in the past decade. There were nearly 7,000 cases nationally in 2006 and more than 6,000 in 2016. As of early October, there were 4,667 cases in 47 states and the District of Columbia in 2017.

Memories are made of this
Using an innovative “NeuroGrid” technology, scientists showed that sleep boosts communication between two brain regions whose connection is critical for the formation of memories. The work, published in Science, was partially funded by the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, a project of the National Institutes of Health. A brain structure called the hippocampus is widely thought to turn new information into permanent memories while we sleep. The study – involving rats – confirmed the presence of ripples in the hippocampus during sleep and found them in an area on the brain’s surface involved in processing complex sensory information. As a result, the researchers theorize that such communication is important for the creation and storage of memories, and they hope to use the NeuroGrid in people undergoing brain surgery to see if the same ripples occur.

How do the biggest losers keep losing?
Researchers have been working to understand which aspects of diet and physical activity are most important for weight control. A team led by Dr. Kevin D. Hall of the National Institutes of Health studied participants in a season of “The Biggest Loser,” a televised weight loss competition. Of 16 competitors enrolled, 14 participated in a follow-up study six years later. Seven participants had maintained an average weight loss of about 25 percent of their starting weight. The other seven returned to a weight that was within 1 percent of their starting weight. The calorie intake of both groups was similarly reduced from before the competition began. The main difference was in levels of physical activity. The weight loss maintainers increased their physical activity by an average of 160 percent from before the competition began, while those who regained their weight had only a 34 percent increase. The scientists calculated that an increase of about 80 minutes per day of moderate physical activity or 35 minutes per day of vigorous activity was necessary to maintain lost weight. These amounts are much greater than current recommendations for daily physical activity.

Heartburn: The lesser of two evils?
The recent rise in the use of stomach-acid-suppressing medications might be contributing to an increased incidence of chronic liver disease, according to a team of researchers led by Dr. Bernd Schnabl at the University of California San Diego School of Medicine. The researchers found that mice lacking stomach acid had higher levels of intestinal bacteria as well as imbalances among the microbes. In particular, the mice had increased levels of Enterococcus in their guts. Further experiments suggested that these bacteria can reach the liver, where they can cause liver inflammation and damage. The team looked at whether people taking proton pump inhibitors – heartburn medication – have similar microbiota changes. They collected fecal samples from healthy people before and after PPI treatment. After two weeks, those taking the PPI treatment also had a higher number of Enterococcus.

Steady as she goes
One in four Americans aged 65+ falls each year, resulting in more than 2.8 million injuries treated in emergency departments annually, and more than 27,000 deaths, per the U.S. Centers for Disease Control and Prevention. The National Council on Aging leads the National Falls Prevention Resource Center, which supports awareness and educational efforts about falls, and promotes evidence-based falls-prevention programs (such as exercises). For more information, go to www.ncoa.org/fallsprevention

Vacation deprivation
Americans are struggling to use their vacation time, per Expedia.com’s Vacation Deprivation® report. Millennials are the most vacation-deprived age group (62 percent) and receive the least vacation time. They are also the most likely to shorten their trips due to impending workload (53 percent). But it’s not just millennials who are struggling to achieve work/life balance. Around half of workers in the U.S. report feeling somewhat or very vacation-deprived, and were projected to lose approximately 462 million vacation days in 2017. The primary reasons cited for not taking time off are budget (43 percent), the desire to save up vacation days for a longer holiday (30 percent), and not being able to get away from work (22 percent).

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