Depression May Sometimes Foreshadow Parkinson's Diagnosis

By Denise Mann
HealthDay Reporter

WEDNESDAY, Oct. 2 (HealthDay News) -- Depressed people -- particularly those 65 or older or with hard-to-treat depression -- are more than three times as likely to develop Parkinson's disease as their peers without depression, a new study indicates.

The new findings don't imply that depression causes Parkinson's disease. Instead, they suggest that depression may precede Parkinson's in some cases, said study author Dr. Albert Yang, an attending psychiatrist at Taipei Veterans General Hospital, in Taiwan.

The researchers looked at information from a national Taiwan health insurance database. During a decade of follow-up, 1.43 percent of about 4,600 people with depression were diagnosed with Parkinson's disease. By contrast, only 0.52 percent of more than 18,500 people with no history of depression were diagnosed with Parkinson's.

After accounting for age and sex, people with depression were 3.24 times more likely to develop Parkinson's disease, according to the study published in the Oct. 2 online issue of Neurology.

"Depression is an important risk for Parkinson's disease, but mainly for [the] elderly and those with long-term and difficult-to-treat depression," said Yang, who is also a visiting assistant professor at Harvard Medical School. "Our study does not implicate all depressions are risky for Parkinson's disease."

Nearly 1 million people in the United States have Parkinson's disease, a chronic and progressive movement disorder. Motor symptoms may include tremor, rigidity and trouble walking.

In the study, difficult-to-treat depression was defined as two or more treatment changes during the first two years after a depression diagnosis.

Depressed seniors were slightly more likely to be diagnosed with Parkinson's disease than their younger counterparts with depression, and those with hard-to-treat depression were more than twice as likely to be diagnosed with Parkinson's disease as those whose depression was easier to treat.

Depression and Parkinson's disease are known to travel together. Up to 60 percent of people with Parkinson's will show some symptoms of depression, according to the Parkinson's Disease Foundation.

"Depression can come after a Parkinson's diagnosis and is highly prevalent in Parkinson's disease patients, but it can also come on years before the actual onset, thus it's difficult to say whether depression causes Parkinson's or Parkinson's causes depression," Yang said.

One theory is that, as with the loss of a sense of smell, depression may be an early symptom of Parkinson's disease. The researchers attempted to control for this possibility by excluding all people who were diagnosed with Parkinson's disease within two to five years of a depression diagnosis. Even so, Parkinson's risk remained elevated, which suggests that depression is a risk factor for the development of Parkinson's, not a symptom.

More study is needed to understand the connection, Yang said. "Screening for Parkinson's disease would only be reasonable among elderly individuals and those with difficult-to-treat depression," he added.

The new study had some limitations. The researchers did not have any information on family history of Parkinson's disease, smoking, coffee drinking and environmental factors such as exposure to pesticides -- all factors that have been linked to the development of Parkinson's disease.

Outside experts said that the findings add a new dimension to the link between depression and Parkinson's disease, but point out that more study is needed before any conclusions can be drawn.

"Overall, a very small number of people with depression will go on to develop Parkinson's disease. It's an important link, but it is not a given," said James Beck, vice president of scientific affairs at the Parkinson's' Disease Foundation.

Dr. Roy Alcalay, an advisor for the Parkinson's Disease Foundation, said, "It is too early to say that hard-to-treat depression should be a red flag for Parkinson's disease, but it is something to think about when we see people with this type of depression who have Parkinson's disease in their family."

"We know that depression and Parkinson's disease are associated, and if depression is a risk factor for Parkinson's, it is possible that treating it could postpone the onset of the disease," added Alcalay, an assistant professor of neurology at Columbia University Medical Center, in New York City.

In any event, it's important that depression be treated: "Depression is bad for the brain, and so is Parkinson's," Alcalay said.

Dr. David Straker, an adjunct assistant clinical professor of psychiatry at Columbia University Medical Center, agreed that depression should be treated promptly and aggressively. But "we always want to rule out other neurologic diseases when a person has symptoms of depression," he added.

Both depression and Parkinson's disease involve some of the same brain chemicals, notably dopamine, Straker said. He added that certain medications used to treat depression can also cause symptoms of Parkinson's disease. However, antidepressants did not appear to increase risk for Parkinson's in the new study.

More information

Learn more about the causes of Parkinson's disease at the Parkinson's Disease Foundation.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Albert Yang, M.D., Ph.D., attending psychiatrist, Taipei Veterans General Hospital, Taiwan, and visiting assistant professor, Harvard Medical School, Boston; David Straker, D.O., adjunct assistant clinical professor, psychiatry, Columbia University Medical Center, New York City; Roy Alcalay, M.D., assistant professor, neurology, Columbia University Medical Center, New York City; James Beck, Ph.D., vice president, scientific affairs, Parkinson's Disease Foundation, New York City; Oct. 2, 2013, Neurology, online

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Skin Cancer Patients Not Avoiding Sun, Study Suggests

WEDNESDAY, Oct. 2 (HealthDay News) -- Some people with melanoma aren't cautious about sun exposure, a small new study suggests, even though ultraviolet (UV) radiation from the sun is a major cause of skin cancer.

Researchers looked at 20 patients with malignant melanoma -- the most deadly type of skin cancer -- and a comparison group of 20 people without melanoma, all of whom carried portable UV-dose-detection devices and kept sun exposure diaries to measure their exposure to UV radiation.

Patients' overall daily UV radiation exposure rose 25 percent from the first to second summer after their melanoma diagnosis, and increased 33 percent from the first to the third summer, found the study published online Oct. 2 in the journal JAMA Dermatology.

The patients' UV exposure was also higher on vacation days and when they traveled to other countries, said Dr. Luise Winkel Idorn, of Bispebjerg Hospital and the University of Copenhagen in Denmark, and colleagues.

In comparison, people without melanoma had steady levels of UV radiation exposure, according to a journal news release.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: JAMA Dermatology, news release, Oct. 2, 2013

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Study Questions Discovery of 'New' Hepatitis Virus

WEDNESDAY, Oct. 2 (HealthDay News) -- A reported discovery earlier this year of a new hepatitis virus was a false alarm, and the "virus" was actually a contaminant present in a type of glassware used in many research laboratories, a new study contends.

The findings highlight both the promise and drawbacks of powerful "next-generation" lab techniques used to identify new causes of disease, the University of California, San Francisco researchers said.

The new hepatitis virus was first identified by a scientific team led by researchers at the U.S. National Institutes of Health after they analyzed blood samples from 92 people in China who had serious cases of hepatitis not caused by any of the five known hepatitis viruses.

In separate research, Dr. Charles Chiu and colleagues at UCSF discovered the same virus -- called parvovirus-like hybrid virus (PHV) -- in a different set of hepatitis patients whose disease did not appear to be caused by known viruses.

However, further investigation by Chiu's team revealed the true nature of the supposedly new hepatitis virus.

"At first we thought this was a genuine hepatitis virus, but later we found it in data sets from patients with many other diseases and even from animals," Chiu, a professor of laboratory medicine and director of the UCSF Viral Diagnostics and Discovery Center, said in a UCSF news release.

They determined that the new virus was actually due to contamination of a certain type of lab glassware when it was made. The contaminant was tiny diatoms, a type of oceanic algae that plays no role in human disease, according to the study recently published in the Journal of Virology.

This episode shows the importance of repeating experiments with good controls to ensure that results are accurate, Chiu said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: University of California, San Francisco, news release, Sept. 27, 2013

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Cholesterol Drugs May Boost Your Gums' Health, Too

By Serena Gordon
HealthDay Reporter

WEDNESDAY, Oct. 2 (HealthDay News) -- The statin medications you take for your heart may have an unexpected side benefit: They help reduce inflammation of the gums, according to new research.

Using advanced imaging techniques, researchers were able to see that when people with gum disease took higher doses of the commonly prescribed cholesterol-lowering drugs, their gum inflammation decreased.

During the 12-week study, the researchers also looked for evidence of inflammation or hardening of the blood vessels (atherosclerotic disease) in the study volunteers, and they found that reduced gum inflammation was correlated with improved blood vessel health.

"There is a building, growing body of literature that draws a line between gum disease and atherosclerotic disease. In our study, benefits in the gums correlated with benefits in the arteries," said the study's senior author, Dr. Ahmed Tawakol, co-director of the Cardiac Imaging Trials Program at Massachusetts General Hospital and Harvard Medical School in Boston. "People with [gum disease] and atherosclerotic disease should likely be that much more vigilant in treating their gum disease."

The study was published online Oct. 2 in the Journal of the American College of Cardiology. Funding was provided by drug manufacturer Merck and Co., which does not produce the statin used in this study.

Currently, statins are prescribed to lower high levels of "bad" cholesterol, also known as LDL cholesterol. When there's too much LDL cholesterol, it can start to build up on blood vessel walls, leading to hardening of the arteries.

In the United States, more than 30 million people take statins, and as many as 200 million people worldwide take these cholesterol-lowering medications, according to a journal editorial accompanying the study. Periodontal disease (or gum disease) affects nearly half of U.S. adults.

According to editorial author Dr. Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore, a "consistent stream of data" shows that statins have benefits beyond their cholesterol-lowering properties.

"There are three big categories of how statins likely exert their effects: lowering LDL, reducing inflammation, and by modulating plaque," said Blaha.

The current study lends support to the idea that statins can reduce inflammation. It included 83 adults who had risk factors for, or already had, atherosclerosis. They were randomly assigned to take either 10 or 80 milligrams of a statin called atorvastatin (brand name Lipitor) for three months.

Everyone underwent imaging at the start of the study, again after four weeks and then at 12 weeks.

At the end of the study, the investigators had complete data on 59 people. They found a significant reduction in gum inflammation for the people taking 80 mg of atorvastatin compared to those on the 10-mg dose. Changes began as early as four weeks after people started taking the higher-dose drug.

There was a more significant reduction in gum inflammation for people who had more serious gum disease at the start of the study and took a higher dose of the statin. The researchers also found that a reduction in gum inflammation correlated with reduced blood vessel inflammation.

"It was really those on the higher-dose statins that had the benefit," noted Tawakol. But, "I would not recommend the use of statins outside the current guidelines," he added. "We see this trial more as a proof-of-principle trial. Our findings need to be confirmed in a larger clinical trial."

Still, he said, there's little harm in telling people to take care of gum disease. "Patients with known heart disease and known gum disease should have their gum disease evaluated and treated," Tawakol said.

Blaha agreed that it's too soon to change practice guidelines either for treating heart disease risk factors or for gum disease.

Still, "this study and others like it have tremendous implications," Blaha said. "We've never had a drug that worked this well and for so many different groups of patients."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Ahmed Tawakol, M.D., co-director, Cardiac Imaging Trials Program, Massachusetts General Hospital and Harvard Medical School, Boston; Michael Blaha, M.D., M.P.H., associate professor of cardiology and epidemiology, and director of clinical research, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore; Oct. 2, 2013, Journal of the American College of Cardiology, online

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Fatty, High-Calorie Diet Linked to Pancreatic Cancer in Mouse Study

WEDNESDAY, Oct. 2 (HealthDay News) -- A high-fat, high-calorie diet may increase the risk of deadly pancreatic cancer, a new animal study suggests.

Researchers found that mice who became obese by eating high-calorie, high-fat diets developed abnormally high numbers of lesions known to be precursors to pancreatic cancer.

The study, published Sept. 30 in the journal Cancer Prevention Research, is the first to show a direct link in animals between obesity and the risk of pancreatic cancer, according to the researchers at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles.

However, findings in animals do not always bear out in human trials and while the study showed an association, it did not prove a cause-and-effect link between diet and pancreatic cancer risk.

The researchers did say that their findings support eating a low-fat, low-calorie diet as a way to prevent pancreatic cancer.

"The development of these lesions in mice is very similar to what happens in humans," study leader Dr. Guido Eibl said in a UCLA news release. "These lesions take a long time to develop into cancer, so there is enough time for cancer-preventive strategies, such as changing to a lower-fat, lower-calorie diet, to have a positive effect."

The researchers found that the mice fed the high-calorie, high-fat foods gained significantly more weight than mice on a lower-fat, lower-calorie regimen. They also had metabolic abnormalities, increased insulin levels and inflammation of pancreatic tissue.

Pancreatic cancer is one of the deadliest types of cancers. Overall five-year survival rates for this type of cancer are 3 percent to 5 percent, and the average length of survival after diagnosis is four to six months.

In many cases, patients only begin to develop symptoms when pancreatic cancer is in the advanced stages. There is a lack of effective treatments, so researchers are focusing on prevention strategies.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: University of California, Los Angeles, news release, Sept. 30, 2013

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Health Tip: Practice Good Seat Belt Habits

(HealthDay News) -- Wearing a seat belt can save your life in the event of a crash. Parents can help protect kids by making sure they follow good seat belt habits.

The U.S. Centers for Disease Control and Prevention offers this advice:

Parents should set a good example for children by always buckling up.Even for a very short trip in the car, always wear a seat belt.Make sure children are appropriately strapped into their car seats, booster seats or seat belts -- as appropriate for their age, height and weight.Always buckle children age 12 and under into the backseat, never in the front.Do not allow a child to sit in a seat with an airbag in front.Strap your child into the middle seat in the back of the car, as it is the safest spot.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Computer Problems Still Vex Day 2 of Health Insurance Exchange Rollout

By Karen Pallarito
HealthDay Reporter

WEDNESDAY, Oct. 2 (HealthDay News) -- Computer troubles continued to plague the launch of the Affordable Care Act's health insurance exchanges on Wednesday.

But Obama administration officials said Wednesday that the computer glitches were a reflection of heavy consumer interest in the exchanges, not flaws with the online registration system.

The exchanges -- marketplaces created for uninsured consumers to search for more affordable health care coverage -- are a cornerstone of what's being called Obamacare, the sweeping and controversial health reform legislation.

The U.S. Department of Health and Human Services offered so-called survival tips for frustrated consumers after 4.7 million unique visitors logged onto the HealthCare.gov website on Tuesday, the day the exchanges were unveiled, the Associated Press reported.

HHS spokeswoman Joanne Peters urged people who find themselves on a "holding page" when they arrive at the website not to hit the refresh button on their computers or leave the page. Doing so will cost them their place in line, the AP reported.

"While this overwhelming interest is continuing to cause wait times, there will be continuing improvements in the coming hours and days," she said.

Peters added that consumers have until Dec. 15 to sign up for insurance if they want coverage to start Jan. 1. The open enrollment period ends March 31, 2014.

The story was much the same Tuesday -- launch day for the registration process -- as health insurance exchanges from Florida to Hawaii got off to a rough start with many consumers encountering long delays and computer system snafus.

In 34 states where the federal government is running the exchanges, the troubles surfaced early on Tuesday. Consumers got error messages on their computers, were unable to review health plan options or couldn't enroll online.

In Florida, many visitors to HealthCare.gov were unable to create accounts to shop for health plans and enroll, the Miami Herald reported.

Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, assured reporters during a late Tuesday afternoon press conference that the glitch had been fixed.

But reports of problems persisted throughout the day. And by 3 p.m. ET Wednesday, a visitor to HealthCare.gov looking to compare plans or enroll in coverage in Florida still encountered this message: "We have a lot of visitors on the site right now. Please stay on this page. We're working to make the experience better, and we don't want you to lose your place in line. We'll send you to the login page as soon as we can. Thanks for your patience!"

The scope of the problems, however, suggested that the controversial law -- which triggered an historic clash between Republicans and Democrats that produced the government shutdown on Tuesday -- could be just what the doctor ordered for many Americans lacking insurance. The initial interest in exploring coverage options hinted at pent-up demand for the kind of coverage now being offered, the AP reported.

But states running their own exchanges also had problems on Tuesday. Among them:

Many consumers visiting Connect for Colorado were unable to create accounts early in the day due to a high volume of traffic. Officials said the glitch was fixed within hours. They added that they had anticipated worse computer problems than those that occurred, The Denver Post reported. In Hawaii, people could not compare actual plans and prices for another month as insurers continue to test and review rates, according to the AP. Attempts to log on to New York State of Health often produced error messages, the Buffalo News reported. Kentucky's exchange, kynect, experienced a glitch that prevented users from filing applications for several hours due to a crush of demand, but service was later restored, Gov. Steve Beshear said in a statement.

Officials at the Centers for Medicare and Medicaid Services would not say how many people were able to enroll in an insurance plan through HealthCare.gov on Tuesday.

"This is day one of a process. We're in a marathon, not a sprint, and we need your help," Tavenner, the CMS administrator, said.

The rollout of the exchanges, or marketplaces, marks a key step in expanding access to health insurance for millions of uninsured Americans beginning in 2014. Under the law, most people without insurance face the prospect of a fine.

Once fully operational, the exchanges are intended to make it easier for people who are uninsured or have limited coverage to shop for health coverage. And consumers with low and modest incomes may qualify for federal tax credits and cost-sharing subsidies to reduce their monthly premiums and out-of-pocket costs.

"Now keep in mind that while this is the first day you can sign up, it is certainly not the last," Tavenner reminded consumers on Tuesday.

Some 7 million people are expected to enroll in private health coverage through the exchanges in 2014, according to estimates by the nonpartisan Congressional Budget Office. Another 9 million will enroll in Medicaid and the Children's Health Insurance Program, according to the research outfit's projections.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Centers for Medicare and Medicaid Services, news briefing, Oct. 1, 2013, with Marilyn Tavenner, agency administrator; Oct. 1, 2013, news reports, Associated Press, Miami Herald, The Denver Post, Buffalo News; Oct. 1, 2013, news release, Kentucky Gov. Steve Beshear, Communications Office

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