Andy Health blog

The increased beating of the heart that one experiences when in a stressful situation is just one part of the body’s response to stress, something often known as the "fight-or-flight response". Another component of the fight-or-flight response is the suppression of pain, also known as stress-induced analgesia (SIA). Some of the nerves and nerve-produced peptides that are responsible for SIA have been identified, but much remains to be discovered. In a new study, a team of researchers in California, from AfaSci, Inc., Burlingame, and SRI International, Menlo Park, has revealed that nerves producing the peptide N/ORQ and nerves producing the peptide Hcrt are key in regulating SIA in mice.
Generic levitra pills no prescription The research team, which was led by Xinmin Xie and Thomas Kilduff, showed that in the brain of normal mice, Hcrt-producing nerve cells (Hcrt neurons) and N/ORQ-producing nerve cells interacted. N/ORQ affected the electrical current across Hcrt neurons and the release of neurotransmitters by these cells. Furthermore, administration of N/ORQ blocked SIA in normal mice, but this was overcome by administration of Hcrt at the same time. The authors therefore conclude that N/ORQ likely influences a variety of Hcrt-mediated processes, in addition to SIA, and suggest that these pathways might contribute to medical conditions caused by excessive stress, such as anxiety and post-traumatic stress disorder.
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Article adapted by Medical News Today from original press release.
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TITLE: Hypocretin/orexin and nociceptin/orphanin FQ coordinately regulate analgesia in a mouse model of stress-induced analgesia
Author Contact:
Xinmin (Simon) Xie
AfaSci Inc., Burlingame, California, USA.
Thomas S. Kilduff
SRI International, Menlo Park, California, USA.
View the PDF of this article at: https://www.the-jci.org/article.php?id=35115
Source: Karen Honey
Journal of Clinical Investigation
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University of Florida researchers have identified a
gene variation in heart disease patients who appear especially
vulnerable to the physical effects of mental stress - to the point where
blood flow to the heart is greatly reduced.
"Searching for the presence of this gene may be one way to better
identify patients who are at an increased risk for the phenomenon," said
David S. Sheps, M.D., a professor and associate chairman of
cardiovascular medicine at UF’s College of Medicine and the Malcom
Randall Veterans Affairs Medical Center.
Those with the gene variation are three times more likely to experience
dangerous decreases in blood flow to the heart - a condition doctors
call ischemia - than heart disease patients without it. Ischemia
increases the chance these patients will suffer a heart attack, heart
rhythm abnormalities or sudden death, UF researchers report in the April
14 issue of Archives of Internal Medicine.
"There’s no question that in certain populations it is associated with
worse prognosis than in patients who do not have mental stress-induced
ischemia in terms of overall adverse events and also mortality," Sheps
said. "And it has become apparent that it is far more prevalent than we
initially thought. Most of the studies that have been published to date
have involved populations of patients who had coronary disease and
positive exercise stress tests. But recently we and other investigators
have shown that a much broader category of patients also are prone to
mental stress ischemia."
Past studies have shown that as many as two-thirds of patients with
coronary artery disease who experience exercise-related reductions in
blood flow to the heart respond similarly to mental stress. These bouts
often produce no symptoms of chest pain and are rarely detectable on a
standard electrocardiogram. Yet previous UF research has shown that
these patients have a threefold greater risk of dying - as large a risk
factor as cigarette smoking or high cholesterol. Other studies have
linked stress experienced after mass disasters or natural catastrophes
with a rise in heart attacks and sudden death.
Psychological stress can leave the heart more prone to developing
arrhythmias or electrical instability and the blood more prone to
clotting. Stress appears to raise heart rate and rapidly hike blood
pressure, increasing the heart’s need for oxygen-rich blood, Sheps said.
Yet less oxygen is supplied, in part because coronary arteries
constrict, impeding blood flow. Doctors are concerned that this reaction
to stress in the laboratory is simply a snapshot of how patients respond
to the stress of life on a daily basis.
An estimated 10 percent of all patients with coronary disease experience
detectable mental stress-induced reductions in blood flow to the heart.
In some subsets of patients the phenomenon may be even more prevalent,
involving up to 40 percent of these patients.
UF researchers studied 148 patients with coronary artery disease who
were on average about 65 years old. Participants were asked to perform a
public speaking test designed to induce stress. Images were taken of
blood flow to the heart at rest and during the speech task. Blood
samples also were collected and analyzed for five common gene
variations.
About a fourth of the patients experienced mental stress-induced reduced
blood flow to the heart, and about two-thirds of them harbored a
particular variation of the adrenergic beta-1 receptor genotype that was
associated with a three-fold increased risk of this phenomenon, said
Mustafa Hassan, M.D., the study’s lead author and a research fellow in
UF’s division of cardiovascular medicine. This receptor typically helps
the body respond to stress by regulating blood pressure and heart rate,
but a common variability in its gene may make certain patients more
vulnerable to the effects of psychological stress.
The study was funded by the National Heart, Lung and Blood Institute and
also was supported by the Department of Veterans Affairs Medical Center
and the Buy lexapro pills UF colleges of Pharmacy and Dentistry.
Why does mental stress restrict blood flow in some patients even when
exercise fails to have the same effect? The effects of mental stress
could predominantly affect the heart’s smaller vessels, causing them to
spasm and temporarily limiting blood flow, Sheps speculated. In
contrast, exercise tends to affect the heart’s blood supply through
different mechanisms.
"We should focus our research on two areas," he said. "One is better
identification of patients who are prone to have this problem and two is
looking for effective treatments once we know they have it. We need to
know whether we can reverse this phenomenon. We are embarking on other
treatment studies fairly soon."
UF researchers are hunting for other genetic subtypes that could
identify other patients at increased risk, he added.
"One of the advantages of detecting these sorts of things is that we may
be able to in the future be more specific about what kind of treatment
might work better in certain patients depending on their genetic
makeup," Sheps said. "That is one of the important things happening in
many fields of medicine. There are many diseases that already have been
shown to respond differently to different types of treatment based on
genetic differences."
The University of Florida Health Science Center - the most comprehensive
academic health center in the Southeast - is dedicated to high-quality
programs of education, research, patient care and public service. The
Health Science Center encompasses the colleges of Dentistry, Public
Health and Health Professions, Medicine, Nursing, Pharmacy and
Veterinary Medicine, as well as the Veterinary Medical Teaching Hospital
and an academic campus in Jacksonville offering graduate education
programs in dentistry, medicine, nursing and pharmacy. Patient care
activities, under the banner UF&Shands, are provided through teaching
hospitals and a network of clinics in Gainesville and Jacksonville. The
Health Science Center also has a statewide presence through satellite
medical, dental and nursing clinics staffed by UF health professionals;
and affiliations with community-based health-care facilities stretching
from Hialeah and Miami to the Florida Panhandle.
University of Florida Health Science Center
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Americans spent $11 billion on doctors’ bills, prescription drugs, and other medical care to relieve allergy symptoms such as itchy or watery eyes, stuffy noses, wheezing, coughing, and headaches in 2005, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The cost is nearly double the $6 billion spent in 2000.
AHRQ’s analysis looked at spending on allergies, such as hay fever and other allergies caused plant pollens, dust, or dander such as animal hair.
AHRQ’s data indicated that:
– In 2005, about 22 million Americans reported visiting a doctor, obtaining a prescription drug, being hospitalized, getting home care or experiencing allergy symptoms.
– Visits to doctors’ office and hospital outpatient departments for allergies care accounted for $4 billion. The remaining roughly $7 billion was spent mostly on prescription drugs.
– Between 2000 and 2005, average annual spending on treatment of allergies jumped from $350 per person to $520 per person.
AHRQ, which is part of the U.S. Department of Health and Human Services, works to enhance the quality, safety, efficiency, and effectiveness of health care in the United States. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey, a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid.
Buy diflucan without prescription For more information, go to Allergic Rhinitis: Trends in Use and Expenditures, 2000 and 2005 (PDF).

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Men’s Health News
An Oregon Health & Science University Cancer Institute researcher has identified a protein that is a strong indicator of survival for men with advanced prostate cancer. The C-reactive protein, also known as CRP, is a special type of protein produced by the liver that is elevated in the presence of inflammation.
"This could mean that a simple blood test that is already available could help in clinical decision making and patient counseling. Patients and doctors would know better what to expect from the prostate cancer they are facing," said Tomasz Beer, M.D., director of the Prostate Cancer Research Program at the OHSU Cancer Institute, associate professor of medicine (hematology/medical oncology), OHSU School of Medicine.
Beer’s research will be published online in the journal Cancer on Monday, April 21.
Past research has shown that cancer causes an inflammatory response. This research also suggests that inflammation may play an important role in driving prostate cancer progression and resistance to therapy. Inflammatory cells are attracted to cancer sites and this local inflammation can lead to a release of inflammatory markers, like CRP.
"While inflammation may sometimes slow the progression of the cancer, an increasing body of evidence suggests that cancer can actually take advantage of the inflammatory response, and the reaction of the immune system may fuel cancer progression. To the extent that our hypothesis proves true, C-reactive protein may be reflecting the overall intensity of the inflammation," Beer said.
Buy generic lasix The finding that higher CRP is associated with shorter survival and a lower probability of response to chemotherapy is a result of a secondary analysis of inflammatory markers in patients enrolled in the ASCENT study, a large Phase 2 clinical trial that evaluated treatment with docetaxel and DN-101, a high dose formulation of calcitriol or docetaxel with placebo. This analysis included patients from both groups. The analyses were supported by Novacea Inc., the sponsor of the ASCENT study. This new finding was in collaboration with Novacea.
Because this is the first time CRP has been linked with both response and survival in study subjects with advanced prostate cancer receiving chemotherapy, it will be important to confirm this finding in an independent data set before this can become a routine blood test for men with advanced prostate cancer, Beer explained.
"If confirmed, besides providing useful information for the patient, this finding could also provide us with vital insight into the fundamental role of inflammation in the progression of advanced prostate cancer. A better understanding of this process could provide us with novel therapeutic interventions for control of this disease and its symptoms," Beer said.

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Wyeth Pharmaceuticals, a division of Wyeth (NYSE: WYE), announced that PRISTIQTM (desvenlafaxine), a new serotonin-norepinephrine reuptake inhibitor (SNRI) approved to treat adult patients with major depressive disorder (MDD), is now available in U.S. retail pharmacies nationwide. The recommended dose of PRISTIQ is 50 milligrams (mg) once daily. The Company begins full-scale selling and educational efforts regarding PRISTIQ for physicians this week.
"We are proud to make PRISTIQ available as a new treatment option for the millions of American adults who struggle with depression," comments Philip Ninan, M.D., Vice President, Wyeth Medical Affairs, Neuroscience. "The recommended therapeutic dose of PRISTIQ is 50 mg once daily. Titration is not required to reach the recommended therapeutic dose." Dosage adjustment (50 mg every other day) is necessary, however, in patients with severe renal impairment or end-stage renal disease.
About PRISTIQ
PRISTIQ, an SNRI approved by the U.S. Food and Drug Administration on February 29, 2008, is an important new treatment option for the millions of adults in the United States who have MDD. Discovered and developed by Wyeth, PRISTIQ demonstrates the Company’s significant and continued commitment to developing new therapies in the field of neuroscience.
At the recommended dose of 50 mg, the discontinuation rate due to an adverse experience for PRISTIQ (4.1 percent) was similar to the rate for placebo (3.8 percent) in clinical studies. The most commonly observed adverse reactions in patients taking PRISTIQ for MDD in short-term, fixed-dose studies (incidence > 5 percent and at least twice the rate of placebo in the 50 mg dose groups) were nausea, dizziness, hyperhidrosis, constipation and decreased appetite.
About Major Depressive Disorder
Major depressive disorder (MDD) is a common mental disorder, affecting about 121 million people worldwide. In the United States, MDD affects approximately 15 million adults, or 6.7 percent of the U.S. population age 18 and older in a given year. In fact, depression is among the leading causes of disability and the fourth leading contributor to the global burden of disease. Further, a research study estimated that the total economic burden of depression was $83.1 billion in 2000, including direct treatment costs and suicide- and work-related costs.
Important Treatment Considerations
WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
– Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of Major Depressive Disorder (MDD) and other psychiatric disorders.
– Anyone considering the use of PRISTIQ or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.
– Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.
– Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
– Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber.
– PRISTIQ is not approved for use in pediatric patients.
Contraindications
– PRISTIQ is contraindicated in patients with a known hypersensitivity to PRISTIQ or venlafaxine.
– PRISTIQ must not be used concomitantly with an MAOI or within 14 days of stopping an MAOI. Allow 7 days after stopping PRISTIQ before starting an MAOI.
Warnings and Precautions
– All patients treated with antidepressants should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the first few months of treatment and when changing the dose. Consider changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse or includes symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, mania, or suicidality that are severe, abrupt in onset, or were not part of the patient??s presenting symptoms. Families and caregivers of patients being treated with antidepressants should be alerted about the need to monitor patients.
– Development of a potentially life-threatening serotonin syndrome may occur with SNRIs and SSRIs, including PRISTIQ, particularly with concomitant use of serotonergic drugs, including triptans, and with drugs that impair the metabolism of serotonin (including MAOIs). If concomitant use is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases. Buy propecia pills Concomitant use of PRISTIQ with serotonin precursors is not recommended.
– Patients receiving PRISTIQ should have regular monitoring of blood pressure since sustained increases in blood pressure were observed in clinical studies. Pre-existing hypertension should be controlled before starting PRISTIQ. Caution should be exercised in treating patients with pre-existing hypertension or other underlying conditions that might be compromised by increases in blood pressure. Cases of elevated blood pressure requiring immediate treatment have been reported. For patients who experience a sustained increase in blood pressure, either dose reduction or discontinuation should be considered.
– SSRIs and SNRIs, including PRISTIQ, may increase the risk of bleeding events. Concomitant use of aspirin, NSAIDs, warfarin, and other anticoagulants may add to this risk.
– Mydriasis has been reported in association with PRISTIQ; therefore, patients with raised intraocular pressure or those at risk of acute narrow-angle glaucoma (angle-closure glaucoma) should be monitored.
– PRISTIQ is not approved for use in bipolar depression. Prior to initiating treatment with an antidepressant, patients should be adequately screened to determine the risk of bipolar disorder.
– As with all antidepressants, PRISTIQ should be used cautiously in patients with a history or family history of mania or hypomania, or with a history of seizure disorder.
– Caution is advised in administering PRISTIQ to patients with cardiovascular, cerebrovascular, or lipid metabolism disorders. Increases in blood pressure and small increases in heart rate were observed in clinical studies with PRISTIQ. PRISTIQ has not been evaluated systematically in patients with a recent history of myocardial infarction, unstable heart disease, uncontrolled hypertension, or cerebrovascular disease.
– Dose-related elevations in fasting serum total cholesterol, LDL (low density lipoprotein) cholesterol, and triglycerides were observed in clinical studies. Measurement of serum lipids should be considered during PRISTIQ treatment.
– On discontinuation, adverse events, some of which may be serious, have been reported with PRISTIQ and other SSRIs and SNRIs. Abrupt discontinuation of PRISTIQ has been associated with the appearance of new symptoms. Patients should be monitored for symptoms when discontinuing treatment. A gradual reduction in dose (by giving 50 mg of PRISTIQ less frequently) rather than abrupt cessation is recommended whenever possible.
– Dosage adjustment (50 mg every other day) is necessary in patients with severe renal impairment or end-stage renal disease (ESRD). The dose should not be escalated in patients with moderate or severe renal impairment or ESRD.
– Products containing desvenlafaxine and products containing venlafaxine should not be used concomitantly with PRISTIQ.
– Hyponatremia may occur as a result of treatment with SSRIs and SNRIs, including PRISTIQ. Discontinuation of PRISTIQ should be considered in patients with symptomatic hyponatremia.
– Interstitial lung disease and eosinophilic pneumonia associated with venlafaxine (the parent drug of PRISTIQ) therapy have been rarely reported.
Adverse Reactions
The most commonly observed adverse reactions in patients taking PRISTIQ vs placebo for MDD in short-term fixed-dose premarketing studies (incidence ?