1 in 10 patients inappropriately prescribed aspirin to prevent first heart attack, stroke

This was the conclusion of a new study published in the Journal of the American College of Cardiology, led by a team at Baylor College of Medicine in Houston, TX.
The researchers note that as aspirin is also available over the counter, it is possible that inappropriate use may be higher than their figure suggests because of patients medicating themselves against the risk of primary cardiovascular events.
In May 2014, the Food and Drug Administration (FDA) advised Americans against the general use of aspirin for primary prevention and they also recently denied a request to market the drug for such use.
To decide what constitutes inappropriate prescribing of daily aspirin for preventing a first heart attack or stroke, the researchers evaluated guidelines from organizations like the American Heart Association and the US Preventative Services Task Force.

Study analyzed large nationwide patient sample of aspirin use

From the published guidelines, the researchers determined that daily aspirin use would be inappropriate in patients whose 10-year cardiovascular risk was under 6%.
They then used this rule to analyze data on a nationwide sample of 69,000 patients receiving aspirin for primary cardiovascular disease prevention. The sample came from the National Cardiovascular Disease Registry Practice Innovation and Clinical Excellence (PINNACLE) Registry.
The patients in the sample were attending 119 practices when they were prescribed aspirin between January 2008 and June 2013. The researchers excluded patients who had already experienced a cardiovascular event - such as heart attack or stroke - or who were affected by heart conditions like atrial fibrillation.
The analysis showed nearly 12% of patients in the nationwide sample probably should not have been prescribed aspirin to prevent primary cardiovascular disease.
The team found that inappropriate use of prescribed aspirin was higher among women than men (17% versus 5%). Patients prescribed aspirin inappropriately were also on average about 16 years younger than those receiving it appropriately, they note.
However, they also found that inappropriate use fell from 14% in 2008 to 9% in 2013.
In addition, the researchers found the rate of inappropriate prescribing varied among practices, ranging from 0-72% of patients receiving aspirin for primary prevention.

In people who do not meet guidelines, risk of bleeding outweighs potential benefits

There is no evidence, note the authors, that aspirin reduces the risk of a first stroke or heart attack in people who have no history of cardiovascular events and a low risk of developing disease. However, it is linked to raised risk bleeding in the gut or stomach and of hemorrhagic strokes.
First author Dr. Ravi S. Hira, a cardiology researcher at Baylor College of Medicine, says doctors must think about whether the potential for bleeding outweighs the potential benefits of aspirin in patients who do not meet the guidelines, adding:
"Since aspirin is available over the counter, patient and public education against using aspirin without a medical provider's recommendation will also play a key role in avoiding inappropriate use."
In an editorial published with the study, Freek W.A. Verheugt - a professor of cardiology at the the Heart and Lung Center and chairman of the Department of Cardiology at Onze Lieve Vrouwe Gasthuis, both of the University Medical Centre of Nijmegen in the Netherlands - says:

"Major coronary events are reduced 18% by aspirin, but at the cost of an increase of 54% of major extracranial bleeding. Each two major coronary events have shown to be prevented by prophylactic aspirin at the cost of one major extracranial bleed. Yet, primary prevention with aspirin is widely applied."

In August 2014, Medical News Today reported a study that suggested daily aspirin could be an effective way to avoid recurrent blood clots in patients with venous thromboembolism - blood clots in the veins - who are unable to have anticoagulant therapy.

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Weight 'influenced by gut bacteria'

Past research has suggested that weight may be influenced by genes. A new study builds on this concept, revealing that our genetic makeup shapes what type of bacteria live in the gut, which may affect how heavy we are.

The results of a twin study suggest that our genes influence what type of bacteria we have in our gut, and that the abundance of bacteria could affect our weight.

The findings come from a twin study conducted by researchers from Cornell University in Ithaca, NY, and King's College London in the UK.
The research team, including Prof. Tim Spector, head of the Department of Twin Research and Genetic Epidemiology at King's College London, says the results may open the door to personalized probiotic treatments that could reduce the risk of obesity and its related diseases.
For their study, published in the journal Cell, the researchers sequenced the genes of microbes present in over 1,000 fecal samples taken from 416 pairs of twins who were part of the Twins UK data registry.
Of these twins, 171 pairs were identical and 245 were non-identical. Identical twins share 100% of their genes, while non-identical twins share around 50% of their genes.

Increasing certain strain of bacteria in the gut 'could reduce, prevent obesity'

Results of the analysis revealed that identical twins had a similar abundance of specific types of gut bacteria, compared with non-identical twins. The team says this indicates that genes influence the type of bacteria present in the gut.
What is more, the researchers found that the presence of a class of bacteria called Christensenellaceae was most influenced by genes. A certain strain of this bacteria - Christensenellaceae minuta - was found to be more common among individuals of a low body weight.
On introducing this bacteria to the guts of mice, the team found the animals gained less weight than those that did not receive the bacteria. This suggests that increasing the amount of Christensenellaceae minuta bacteria in the gut could help to reduce or prevent obesity, the researchers say.
Commenting on their results, Prof. Spector says:

"Our findings show that specific groups of microbes living in our gut could be protective against obesity - and that their abundance is influenced by our genes. The human microbiome represents an exciting new target for dietary changes and treatments aimed at combating obesity."

Senior author Ruth Ley, an associate professor of microbiology at Cornell University, notes that this study is the first to determine that specific gut microbes are heritable and that the variation of these microbes is not solely influenced by diet, environment, lifestyle and health.

Other ways in which gut bacteria may play a role in obesity

Numerous other studies have reported on the association between obesity and gut bacteria, but all of them have different theories.
In September, Medical News Today reported on a study suggesting that Granny Smith apples could protect against obesity by balancing the proportions of "good" gut bacteria.
The researchers of that study, from Washington State University, explain that the fibers and polyphenols present in Granny Smith apples are unscathed when they reach the colon, even after exposure to stomach acid and digestive enzymes. The bacteria in the colon then ferment these compounds, producing butyric acid that triggers the growth of good gut bacteria.
Another study, reported in July, detailed the creation of a probiotic that researchers say could prevent obesity.
Senior study author Sean Davies, of Vanderbilt University in Nashville, TN, and colleagues genetically modified a strain of bacteria that colonizes the human gut - Escherichia coli Nissle 1917 - to produce a compound called N-acyl-phosphatidylethanolamine (NAPE), which can reduce food intake.
On giving this bacteria to mice fed a high-fat diet for 8 weeks, the team found that it significantly reduced their food intake, body fat and incidence of hepatosteatosis (fatty liver), compared with control mice.
"There are lots of people who are doing their best to change their lifestyle and it still isn't enough for them to get to and keep a healthy weight. We think this strategy will really help them," Davies told MNT.

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Some areas of the brain 'may not slow down with aging'

Past research has suggested that as we age, our brain functions slow down. But a new study from The University of Adelaide in Australia indicates that there are areas of the brain that remain as effective in old age as they are in youth.

A  new study suggests that some areas of the brain may remain as effective in old age as they are in youth.

Dr. Joanna Brooks - who performed the study while she was a visiting research fellow at the schools of psychology and medicine at The University of Adelaide - recently presented the findings at the 12th International Cognitive Neuroscience Conference in Brisbane, Australia.
To reach her findings, Dr. Brooks analyzed the "spatial attention" skills of 60 older adults aged 55-95 and younger adults aged 18-38.
Spatial attention is the ability to focus on a particular object in an environment with an array of visual stimuli. We use spacial awareness in day-to-day life, such as when we drive, walk, and pick up and use objects.
Study participants were asked to carry out a series of spatial awareness tasks. One task, for example, required subjects to wear a blindfold while feeling a variety of wooden objects. They had to judge where they thought the center of each object was.

Results 'challenge current models of cognitive aging'

Dr. Brooks found that all participants - regardless of their age - believed the center of each object was more toward the left-hand side of where it actually was.
She notes that in other tasks involving touch and sound, participants in both age groups gave the same responses, indicating that there may be cognitive systems in the right cerebral hemisphere of the brain - responsible for spatial awareness and other functions - that are protected from aging.
This study, according to Dr. Brooks, challenges current theories about how aging affects the brain:

"When we think of aging, we think not just of the physical aspects but also the cognitive side of it, especially when it comes to issues such as reaction time, which is typically slower among older adults.
Our results challenge current models of cognitive aging because they show that the right side of the brain remains dominant for spatial processing throughout the entire adult lifespan. We now need to better understand how and why some areas of the brain seem to be more affected by aging than others."

This research is part of an international collaboration with scientists from the UK, which aims to gain a better insight into the mechanisms behind spatial attention in the human brain.
But Dr. Brooks notes that this study could also provide a better understanding of how conditions that impair cognitive functioning, such as Alzheimer's disease, affect the brain.
Medical News Today recently reported on a study by researchers from the University of Edinburgh in the UK, which suggested that older people who can process visual information quickly are more likely to stay mentally acute.
Another study, published in the journal Psychology and Aging, suggests that the brain functions of older adults work better in the morning.

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Tinnitus less common in women who drink more coffee

A new study finds that women who consume more caffeine are less likely to have tinnitus - a condition where a person perceives noise in one or both ears, or in the head, even though there is no external sound.

Researchers found that the more caffeine women consumed, the less likely they were to have tinnitus. The researchers, from Brigham and Women's Hospital (BWH) in Boston, MA, write about their findings in The American Journal of Medicine.
According to the American Tinnitus Association, around 50 million people in the US experience some degree of tinnitus, which is often described as "ringing in the ears" although some people also hear hissing, buzzing, roaring, clicking or chirping. Of these, about 1 million are so badly affected they cannot function normally day to day.
For the study, the researchers analyzed data on over 65,000 women with and without tinnitus from the Nurses' Health Study II.
The women were aged between 30 and 44 at the start of the study in 1991, when researchers collected a wealth of information on medical history, lifestyle and diet. At this point, the average caffeine intake was 242.3 mg per day - the equivalent of nearly two and a half 8-ounce cups of coffee. Most of the caffeine consumed came from coffee drinking.
In 2009, 18 years after they joined the study, the women were asked questions about tinnitus, including date of onset, where applicable. When a woman reported experiencing symptoms either daily or on a few days per week, the researchers counted it as a case. They identified a total of 5,289 cases of reported incident tinnitus.

Women who consumed more caffeine less likely to be among tinnitus cases

When they analyzed the results, the team found the more caffeine women consumed, the less likely they were to be among the tinnitus cases.
Senior author Gary Curhan, a physician-researcher in BWH's Channing Division of Network Medicine and professor of Medicine at Harvard Medical School, says:

"We observed a significant inverse association between caffeine intake and the incidence of tinnitus among these women."

He and his and colleagues found that regardless of age, rates of tinnitus were 15% lower among women who consumed 450-599 mg a day of caffeine, compared with women who drank less than 150 mg a day (about one and a half 8-ounce cups of coffee).
Prof. Curham notes that while the reason behind the finding is unclear, we know that "caffeine stimulates the central nervous system, and previous research has demonstrated that caffeine has a direct effect on the inner ear in both bench science and animal studies."
The researchers say more evidence is required before we can say whether increased caffeine intake might improve tinnitus symptoms.
Funds from the National Institutes of Health helped finance the study.
Medical News Today recently reported on another study where researchers found tinnitus affects processing of emotions. Writing in the journal Brain Research, they describe how, compared with people not affected by the condition, those with tinnitus process emotions differently in the brain.

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Arthritis drug helps bald man grow full head of hair

There is no cure or treatment for alopecia universalis, an uncommon autoimmune disease that causes loss of hair over the entire scalp and body. Now doctors at Yale University in New Haven, CT, report how they successfully restored hair on the head and other parts of the body in a 25-year- old man with the disease that had left him nearly completely hairless all over. They write about the treatment and the results in the Journal of Investigative Dermatology and say it is the first reported case of a successfully targeted treatment for this rare form of alopecia areata, which occurs when the immune system mistakenly attacks the hair follicles. After the treatment, which uses an FDA-approved drug for rheumatoid arthritis called tofacitinib citrate, the patient regained a full head of hair, eyebrows and eyelashes, plus facial, armpit, groin and other hair, none of which he had when he first sought medical help. 

Senior author Brett A. King, assistant professor of dermatology at Yale University School of Medicine, says the results were exactly what they hoped for, and represent a "huge step forward" in treating patients with the condition. He adds: "While it's one case, we anticipated the successful treatment of this man based on our current understanding of the disease and the drug. We believe the same results will be duplicated in other patients, and we plan to try." As well as alopecia universalis, the patient had also been diagnosed with another condition called plaque psoriasis, which causes scaly red areas to develop on the skin. The only hair he had on his body was in the psoriasis plaques on his head. His doctor referred him to Yale's dermatology unit for treatment of the psoriasis - he had never received treatment for alopecia universalis. Tofacitinib had already been used successfully in humans to treat psoriasis - and in lab mice, it has been shown to reverse a less extreme form of alopecia called alopecia areata. So it made sense, the researchers thought, to see if the drug could tackle the alopecia universalis as well as the psoriasis. 

"There are no good options for long-term treatment of alopecia universalis," Prof. King explains, "The best available science suggested this might work, and it has." Hair growth visible after 2 months of treatment To begin with, the team put the patient on a 5 mg twice daily dose of tofacitinib. After 2 months, his psoriasis began to improve, and he had hair on his scalp and face - for the first time in 7 years. From then on, the researchers increased the dose to 15 mg a day. After another 3 months, the patient had a full head of hair, and had also grown eyebrows and eyelashes, and hair on his face, in his armpits, and other areas. patient baldness before and after treatment The patient was administered a 5 mg twice daily dose of tofacitinib. After 2 months, his psoriasis began to improve, and he had hair on his scalp and face - for the first time in 7 years. After 8 months of treatment, all his hair had regrown, say the researchers, adding that they saw no lab abnormalities and the patient reported feeling no side effects. Prof. King suggests the drug - which is designed to treat the autoimmune disease rheumatoid arthritis - stops the immune system attacking the hair follicles. 


He has already proposed a trial using a cream form of the medicine as a treatment for alopecia areata. According to the National Organization for Rare Disorders, there are about 2.5 million Americans with alopecia areata, which affects both males and females equally and can surface at any age, but most typically during childhood. The study follows one Medical News Today reported in September 2011, also by a team at Yale, that found molecular signals that trigger hair growth in mice. Writing in the journal Cell, the researchers described how they found molecular signals from stem cells under the fatty layer of the skin were important for bringing about hair growth. Another study, reported by Medical News Today in August 2014, revealed how a bone marrow disease drug helped restore hair growth in alopecia areata patients.

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New health benefits associated with hempseed oil

Hemp is a crop full of oils with potential health benefits, according to a new study in the Journal of Agricultural and Food Chemistry.
A derivative of cannabis (marijuana), hemp has been used for millennia in textiles, medicine and food, by people all over the world.
Despite this, hempseed has been banned in North America since the 1930s, when all varieties of cannabis were made illegal due to its tetrahydrocannabinol (THC) content. THC is the compound that induces the "high" in recreational use of cannabis.
However, hemp with low THC content (0.3%) has been legalized by the European Union, and the global economic market for low-THC hemp - used in medicines, papers and fabrics - is valued at $100-200 million annually.
Researchers analyzed a portion of hempseed oil to see what beneficial qualities it may have. They found that some of its components are effective at promoting good health. These include sterols, aliphatic alcohols and linolenic acids.

Linolenic acids, sterols and aliphatic alcohols

One of the linolenic acids contained in hempseed oil is an omega-3 fatty acid that some studies have recognized as preventing coronary heart disease.

Hemp is a derivative of cannabis (marijuana) and as such was prohibited across North America in the 1930s.

Sterols are steroid alcohols. Experts know that sterols are useful in lowering cholesterol, and daily dietary intake of sterols has been linked to a lower risk of heart attack.
The aliphatic alcohols contained in hempseed oil have also been known to lower cholesterol and reduce platelet aggregation. One of these alcohols, phytol, is associated with antioxidant and anticancer benefits, and can also be found in healthy foods such as spinach, beans, raw vegetables and asparagus.
Another antioxidant in hempseed oil is tocopherol, which is known to be beneficial against degenerative diseases, such as atherosclerosis and Alzheimer's.
Among other benefits, hempseed oil has also shown a positive effect on dermatological diseases and lipid metabolism (the process by which fatty acids are broken down in the body).
Hempseed also has high levels of vitamins A, C and E and β-carotene, and it is rich in minerals like phosphorus, potassium, magnesium, sulfur and calcium. As a food, hempseed oil is nutritious - it contains an excellent balance of polyunsaturated fatty acids - and it reportedly tastes good, too. Colorado recently legalized marijuana for recreational use and some states have passed laws allowing the medicinal use of marijuana. In 2013, Medical News Today reported on a study suggesting that the THC content of marijuana may be medically beneficial for people who have an autoimmune disease.

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Men are 'more narcissistic and entitled than women'

In January, we reported on a study by researchers at Ohio State University who found that men who regularly post pictures of themselves on social media score higher on measures of narcissism and psychopathy than their peers. In particular, men who edited their selfies before posting were found to be the most narcissistic.
However, that study - published in the journal Personality and Individual Differences - did not compare data for men against data for women.
For the new study, which is published in the journal Psychological Bulletin, researchers from the University at Buffalo School of Management, NY, analyzed the gender differences in narcissism across more than 300 "journal articles, dissertations, manuscripts and technical manuals." Overall, the study took in 30 years of research and more than 475,000 participants.
In particular, the researchers focused on three aspects of narcissism:

• Leadership/authority
• Grandiose/exhibitionism
• Entitlement.

The widest gender gap in the study was in entitlement, the authors report. They say this suggests that men are more likely than women to exploit others and that they feel a greater entitlement to certain privileges.
The second largest gender gap was in leadership/authority, which led the researchers to note that men "exhibit more assertiveness and desire for power" compared with women.
However, there was no significant gender difference in regards to exhibitionism, which suggests that men and women are likely to be equally as vain or self-absorbed.
Looking at data from college students for the period 1990-2013, the team reports it found no evidence of either gender becoming more or less narcissistic over time.

How is narcissism linked with gender stereotypes?

Previous research has found that personality differences such as narcissism are related to gender stereotypes and expectations.
For instance, lead author Emily Grijalva, PhD, assistant professor of organization and human resources, notes the lack of women in senior roles of leadership could be influenced by disparities in perceptions of femininity and leadership.
"Individuals tend to observe and learn gender roles from a young age, and may face backlash for deviating from society's expectations," she suggests. "In particular, women often receive harsh criticism for being aggressive or authoritative, which creates pressure for women, more so than for men, to suppress displays of narcissistic behavior."

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