Presidential Healthcare center

We provide the same Preventive Executive Physical Program as received by the President of the United States.


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Knowing What’s In Your Supplements

Supplements 1Last week, the New York State attorney general’s office uncovered another example of what appeared to be widespread fraud in the dietary supplement industry. The office accused four of the country’s biggest retail stores of selling herbal products that in many cases were contaminated or did not contain any of the herb listed on the label.

For many readers, the news raised an urgent question: Which supplements can I trust?

Experts say that there is no guarantee that supplements will do what they say they do, or that they are safe or won’t interact with any medications Supplements 3you may be taking. But there are several steps people can take to give themselves some reassurance that at least some of the supplements they buy actually contain what they advertise on the label – and nothing else.

For one, you can look for products that receive a seal of approval from the United States Pharmacopeial Convention, an independent, nonprofit organization of scientists that sets high standards for medicine, food ingredients and dietary supplements. The United States Pharmacopeia has a voluntary program through which supplement companies can have their Supplements 4products and facilities tested and reviewed.

Companies whose supplements meet the group’s standards – which ensure purity, identity and potency, among other things – are allowed to carry an official “USP Verified” seal on their labels. The group maintains an evolving list of the brands that have received its seal and the places where they can be purchased.

Source: The New York Times


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Smoking and Mortality

smoking 4Mortality among current smokers is 2 to 3 times as high as that among persons who never smoked. Most of this excess mortality is believed to be explained by 21 common diseases that have been formally established as caused by cigarette smoking and are included in official estimates of smoking-attributable mortality in the United States. However, if smoking causes additional diseases, these official estimates may significantly underestimate the number of deaths attributable to smoking.

We pooled data from five contemporary U.S. cohort studies including 421,378 men and 532,651 women 55 years of age or older. Participants were followed from 2000 through 2011, and relative risks and 95% confidence intervals were estimated with the use of Cox proportional-hazards models adjusted for age, race, educational level, daily alcohol consumption, and cohort.Smoking 2

During the follow-up period, there were 181,377 deaths, including 16,475 among current smokers. Overall, approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking. These included associations between current smoking and deaths from renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory smoking 3diseases, breast cancer, and prostate cancer. Among former smokers, the relative risk for each of these outcomes declined as the number of years since quitting increased.

A substantial portion of the excess mortality among current smokers between 2000 and 2011 was due to associations with diseases that have not been formally established as caused by smoking. These associations should be investigated further and, when appropriate, taken into account when the mortality burden of smoking is investigated.

Source: The New England Journal of Medicine


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Adverse Events Following Measles, Mumps, and Rubella Vaccine in Adults Reported

MMR 3Limited data exists on the safety of MMR vaccine in adults. We reviewed reports of adverse events (AEs) to the Vaccine Adverse Event Reporting System (VAERS) to assess safety in this previously under-studied group.

VAERS is the national spontaneous vaccine safety surveillance system co-administered by CDC and the FDA. We searched the VAERS database for US reports of adults aged 19 years and older who received MMR vaccine from January 1, 2003 to July 31, 2013. We clinically reviewed reports and available medical records for serious AEs, pregnancy reports, and reports for selected pre-specified outcomes.

During this period, VAERS received 3,175 US reports after MMR vaccine in adults. Of these, 168 (5%) were classified as serious, including 7 reports of death. Females accounted for 77% of reports. The most common signs and symptoms for all reports were pyrexia (19%), rash (17%), pain (13%) and arthralgia (13%). We did not detect any new safety findings in empirical Bayesian data mining. We identified 131 reports of MMR vaccine administered to a pregnant woman; the majority of these vaccinations were in the first trimester and in 83 (62%), noMMR 2 AE was reported.

In our review of VAERS data, we did not detect any new or unexpected safety concerns for MMR vaccination in adults. We identified reports of pregnant women exposed to MMR which is a group in whom the vaccine is contraindicated, suggesting the need for continued provider education on vaccine recommendations and screening.

Source: Oxford Journals


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Systolic Pressure May Signal Risk in Young

Blood pressure 3Isolated systolic hypertension in young and middle-age adults was associated with an increased risk of death from cardiovascular causes later in life, according to a study done over 3 decades.

Men in the study with systolic blood pressure (BP) levels of 140 mmHg or higher and diastolic BP below 90 had a 28% increased risk for death from coronary heart disease compared with men with normal BP (hazard ratio 1.28, 95% CI 1.04-1.58), reported Donald M. Lloyd-Jones, MD, of Northwestern University Feinberg School of Medicine in Chicago.

In addition, women with isolated systolic hypertension (ISH) had a more than twofold greater death risk (HR 2.12, 95% CI Blook Pressure 21.49-3.01) than women with optimal BP, they wrote in the Journal of the American College of Cardiology.

The findings provide strong evidence that ISH is a clinically meaningful condition in young and middle-age adults and not just pseudo or ‘white-coat’ hypertension, Lloyd-Jones told MedPage Today.

“It is not well supported by science, but there has been a belief by many that elevated systolic and not diastolic blood pressure in younger adults is benign,” he said. “Most previous research hasn’t really examined hypertension by subtype. That’s why we did this study.”

blood pressureISH is defined as a systolic BP of 140 mmHg or greater with a diastolic BP of less than 90 mmHg. It is common in the elderly, but relatively uncommon in younger and middle-age adults, the researchers wrote.

NHANES data suggest that the overall prevalence of ISH among adults in their 20s and 30s has more than doubled in recent decades, from 0.7% between 1988 and 1994 to 1.6% between 1999 and 2004, but there is still a great deal of uncertainty about the clinical consequences of ISH in younger adults.

Source: MedPage Today


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Can Compression Clothing Enhance Your Workout?

clothes 2In recent years, many people who exercise have begun wearing compression clothes. These snug-fitting socks, shorts, tights or shirts, which squeeze muscles as tightly as sausage casings, are reputed to improve performance during exercise and speed recovery afterward.

But a new study and several reviews of relevant research raise interesting questions about whether the garments really function as expected and help people to exercise better and, if they do, whether it is the clothing or people’s expectations doing most of the work.

The rationales for wearing compression clothing are logical enough. “The garments supposedly increase blood circulation and thus oxygen delivery for improved sport performance,”clothes 3 said Abigail Stickford, a postdoctoral researcher at the Institute for Exercise and Environmental Medicine at the University of Texas Southwestern Medical Center in Dallas, who led the new study of compression clothes.

The clothes also are thought to refine proprioception, which is someone’s sense of how the body is positioned in space. Better proprioception should, in theory at least, clothes 5improve the efficiency of movement and reduce the number of muscles that need to be activated, making exercise less tiring.

Meanwhile, the clothes also are believed to reduce fatigue and soreness after exercise by literally squeezing the muscles with a kind of no-hands massage and, by increasing blood flow to muscles, help to flush out unwanted exercise-related biochemical.

 

Source: The New York Times


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Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010

Colon 5Both the incidence and mortality rates of Colon and Rectal Cancers have been decreasing in the United States, a trend that is largely attributed to the widespread screening of persons 50 years and older.

However, researchers from the University of Texas MD Anderson Cancer Center in Houston have highlighted a concerning trend: incidence rates are actually rising in young adults.

The most pronounced increase, which was observed in patients between 20 and 34 years old, was in the incidence of colon and rectal cancer at all stages (localized, regional, and distant).Colon 2

Authors of a recent study analyzed Surveillance, Epidemiology, and End Results data for 393,241 patients with CRC between 1975 and 2010 and evaluated the age at diagnosis in 15-year intervals, beginning at age 20 years.

The overall age-adjusted incidence rates decreased by 0.92% during the study period.

Colon 4However, although there has been a steady decrease in incidence among persons 50 years and older, the opposite is true for those in younger age groups, according to the authors, led by principal investigator George J. Chang, MD, associate professor, Departments of Surgical Oncology and Health Services Research at MD Anderson.

Source: The JAMA Network

 

 

*The Center’s Executive Physical includes Colon and Rectal Cancer screening and tumor marker tracking.

 


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Year Born May Determine Obesity Risk

obesity1Investigators working to unravel the impact of genetics versus environment on traits such as obesity may also need to consider a new factor: when individuals were born.

In the current issue of PNAS Early Edition a multi-institutional research team reports finding that the impact of a variant in the FTO gene that previous research has linked to obesity risk largely depends on birth year, with no correlation between gene variant and obesity in study participants born in earlier years and a far stronger correlation than previously reported for those born in later years.

“Looking at participants in the Framingham Heart Study, we found that the correlation between the best known obesity-obesity 2associated gene variant and body mass index increased significantly as the year of birth of participants increased,” says Harvard Medical School instructor James Niels Rosenquist of the Massachusetts General Hospital (MGH) Department of Psychiatry, lead author of the report. “These results — to our knowledge the first of their kind — suggest that this and perhaps other correlations between gene variants and physical traits may vary significantly depending on when individuals were born, even for those born into the same families.”

obesity 3The authors note that most studies of interactions between genes and the environment have looked at differences within specific birth cohorts —groups born during a particular span of years — which would not account for changes in the larger environment that take place over time. To investigate whether different conditions experienced by different age groups might alter the impact of a gene variant, they analyzed data from participants in the Framingham Offspring Study (which follows the children of participants in the original study) gathered between 1971, when participants ranged in age from 27 to 63, and 2008.

Source: Harvard Gazette

*The Presidential Healthcare Center can design a personalized exercise prescription for you.

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