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Neuroscience Articles

  • Athletes' biological clocks affect their performance

    By Andrew M. Seaman

    (Reuters Health) - A week before the Super Bowl, a new study suggests that players' performances may depend at least in part on how the game's timing aligns with their body clocks.

    Athletes' performances are best predicted by how long it's been since their body's natural wake-up time, researchers found.

    "The reason why we did this study is that all the existing literature talking about circadian rhythm in sports performance came to the same conclusion: that athletes give their best performance in the evening," said Roland Brandstaetter, the study's senior author from the University of Birmingham in the UK.

    As reported in the journal Current Biology, Brandstaetter and colleagues studied the performance of 121 athletes who competed in competitions.

    When the researchers separated the athletes into three groups based on their internal clocks, they found that those who naturally get up early reached peak performance in the early afternoon. Those who naturally sleep the latest would likely reach their peak in the evening.

    Specifically, natural early and intermediate risers reached their peak performances about six hours after their internal wakeup time. Late risers reached their peaks about 11 hours after their internal wakeup time.

    Overall, the researchers found that individual performance during the day can vary by 7 to 10 percent among early and intermediate risers, and by up to 26 percent among late risers.

    The researchers say that just a 1 percent improvement among the fourth place athletes in the women's road race, 400 meter swim or 400 meter sprint at the 2008 Olympics may have propelled them to a gold medal.

    Brandstaetter said the improvements in peak performance may easily apply to areas other than sports.

    "Physical performance and mental performance go hand in hand," he said. "If you're physically exhausted, then your brain isn't working either. . . . Also, if you're mentally tired, you won't be at the top of your physical performance."

    While it's possible to change the body's internal clock, Brandstaetter said it takes time.

    "If you just change your wakeup time on the day of the competition or the day of your performance, it wouldn't make much of a difference," he said. "You would need to start in advance and retrain your biological clock."

    Brandstaetter said it might be difficult for people to know when their internal wakeup times are. It's not simply the time the alarm clock goes off in the morning.

    "If you're really agenda free and not going out until one o'clock in the morning, then you start getting an idea about it," he said.

    "Try to listen and understand your internal biological clock," Brandstaetter said. "Try to live with it instead of trying to live against it."

    SOURCE: http://bit.ly/1vfHoir Current Biology, online January 29, 2015.

  • Computer tracks eye movements to detect concussions

    By Andrew M. Seaman

    (Reuters Health) - A new piece of technology that tracks eye movements after a head injury might be able to detect concussions and determine their severity, researchers say.

    The new technology is essentially like a doctor moving a finger in front of a person's eyes after a hit to the head - except now it's automated, said Dr. Uzma Samadani of NYU Langone Medical Center in New York City.

    And the results are reproducible, whereas with the follow-my-finger method, Samadani said, "Each doctor is going to have variability in how well they're going to be able to assess how well a person is getting better."

    Samadani said she developed the new technology because she needed a reliable way to assess concussions. Accurate diagnoses would improve patients' care, allowing for more accurate assessments of when they could safely return to work or play after a hit to the head, she said.

    The Centers for Disease Control and Prevention defines a concussion as a type of brain injury "caused by a bump, blow, or jolt to the head that can change the way your brain normally works."

    In her team's study, 75 people who'd been in accidents (but not necessarily head accidents) plus 64 healthy volunteers all watched a four-minute video while their eye movement was tracked by a computer. The computer could tell when their eyes are moving in opposite directions. So-called disconjugated eye movement has been tied to brain injuries for centuries.

    People with hits to the head had less ability to control their eye movements, compared to people who had no known injuries, the researchers wrote in the Journal of Neurotrauma.

    The computer also detected signs of concussion in some patients without any noticeable brain injury on a CT scan.

    Images, like those from a CT scan, "tell you what (the brain) looks like - not how it functions," Samadani said.

    The researchers also found that the severity of symptoms from concussion was tied to the severity of their eye movement problems.

    The technology is currently only available in research settings, but Samadani hopes the U.S. Food and Drug Administration will clear it for use by the end of this year.

    "I think we're going to change how we diagnose and define brain injury and concussion," she said.

    Future research needs to focus on other factors that may influence the results of the test, such as alcohol, morphine and sleep deprivation.

    "What we're finding so far is that these things affect eye movement, but in different ways than brain injury does," Samadani said. "So we're hoping to tease out the differences."

    SOURCE: http://bit.ly/1CI4Cyx The Journal of Neurotrauma, online January 29, 2015.

  • U.S. proposes effort to analyze DNA from 1 million people

    By Toni Clarke and Sharon Begley

    WASHINGTON (Reuters) - The United States has proposed analyzing genetic information from more than 1 million American volunteers as part of a new initiative to understand human disease and develop medicines targeted to an individual's genetic make-up.

    At the heart of the initiative, to be announced on Friday by President Barack Obama, is the creation of a pool of people - healthy and ill, men and women, old and young - who would be studied to learn how genetic variants affect health and disease.

    Officials hope genetic data from several hundred thousand participants in ongoing genetic studies would be used, and other volunteers recruited to reach the 1 million total.

    The near-term goal is to create more and better treatments for cancer, Dr. Francis Collins, director of the National Institutes of Health (NIH), told reporters on a conference call on Thursday. Longer term, he said, the project would provide information on how to individualize treatment for a range of diseases.

    The initial focus on cancer, he said, is due partly to the lethality of the disease and partly because targeted medicine, known also as precision medicine, has made significant advances in cancer, although much more work is needed.

    The president has proposed $215 million in his 2016 budget for the initiative. Of that, $130 million would go to the NIH to fund the research cohort and $70 million to NIH's National Cancer Institute to intensify efforts to identify molecular drivers of cancer and apply that knowledge to drug development.

    A further $10 million would go to the Food and Drug Administration to develop databases on which to build an appropriate regulatory structure; $5 million would go to the Office of the National Coordinator for Health Information Technology to develop privacy standards and ensure the secure exchange of data.

    The effort may raise alarm bells for privacy rights advocates who in the past have questioned the government's ability to guarantee that DNA information is kept anonymous. They have expressed fear participants may become identifiable or face discrimination.

    SEQUENCING 1 MILLION GENOMES

    The funding is not nearly enough to sequence 1 million genomes from scratch. Whole-genome sequencing, though plummeting in price, still costs about $1,000 per genome, Collins said, meaning this component alone would cost $1 billion.

    Instead, he said, the national cohort would be assembled both from new volunteers interested in "an opportunity to take part in something historic," and existing cohorts that are already linking genomic data to medical outcomes.

    The most ambitious of these is the Million Veteran Program, launched in 2011 by the Department of Veterans Affairs. Aimed at making genomic discoveries and bringing personalized medicine to veterans, it has enrolled more than 300,000 veterans and determined the DNA sequences of about 200,000.

    The VA was a pioneer in electronic health records, which it will use to link the genotypes to vets' medical histories.

    Academic centers have, with NIH funding, also amassed thousands of genomes and linked them to the risk of disease and other health outcomes. The Electronic Medical Records and Genomics Network, announced by NIH in 2007, aims to combine DNA information on more than 300,000 people and look for connections to diseases as varied as autism, appendicitis, cataracts, diabetes and dementia.

    In 2014, Regeneron Pharmaceuticals Inc launched a collaboration with Pennsylvania-based Geisinger Health System to sequence the DNA of 100,000 Geisinger patients and, using their anonymous medical records, look for correlations between genes and disease. The company has finished 50,000 samples, spokeswoman Hala Mirza said.

    Perhaps the most audacious effort is by the non-profit Human Longevity Inc, headed by Craig Venter. In 2013 it launched a project to sequence 1 million genomes by 2020. Privately funded, it will be made available to pharmaceutical companies such as Roche Holding AG, with which the institute has a research partnership.

    "We're happy to work with them to help move the science," Venter said in an interview, referring to the administration's initiative.

    But because of the many regulations surrounding medical privacy and human volunteers, he said, "we can't just mingle databases. It sounds like a naive assumption" if the White House expects existing cohorts to merge into its 1-million-genomes project.

    Venter raced the government-funded Human Genome Project to a draw in 2000, sequencing the entire human genome using private funding in less time than it took the public effort.

    ALTERING THE REGULATORY LANDSCAPE

    Collins conceded that mingling the databases would be a challenge but insisted it is doable.

    "It is something that can be achieved but obviously there is a lot that needs to be done," he said.

    Collating, analyzing and applying all this data to the development of new drugs will require changes to how products are reviewed and approved by health regulators.

    Dr. Margaret Hamburg, the FDA's commissioner, said on the conference call that the emerging field of precision medicine "presents a set of new issues for us at FDA." The agency is discussing new ways to approach the review process for personalized medicines and tests, she added.

  • Medical marijuana advocates concerned by Illinois licensing delay

    By Mary Wisniewski

    CHICAGO (Reuters) - Advocates for medical marijuana in Illinois are concerned that delays in issuing distribution licenses, exacerbated by a change in governors, is keeping the drug from patients who need it.

    Former Democratic Governor Pat Quinn, who supported medical marijuana, left office in January without issuing licenses for growth and distribution, leaving it to his successor, Republican Governor Bruce Rauner.

    Rauner, who has expressed skepticism about the licensing process, wants a thorough legal review, his office said, which means more time before the 2013 law can be implemented.

    For patients that means no hope of getting the drug until at least June even if the Rauner administration issues licenses in the next month, said Chris Lindsey, legislative analyst for the Marijuana Policy Project, a Washington, D.C.-based non-profit.

    The law requires plants to be grown in Illinois, which takes 4-1/2 months in the best of circumstances.

    "We're pretty concerned - we've been waiting for a long time," Lindsey said. Supporters had hoped licenses would be issued last fall.

    Illinois is one of 23 states plus the District of Columbia that permit medical marijuana. Illinois' trial program expires in 2017.

    Lindsey said he believes Rauner is "trying to be careful, but in the process he's really failing our seriously ill patients in Illinois."

    The Quinn administration prepared lists of businesses qualified to receive the licenses before he left office, according to recently released documents.

    A Quinn administration spokesperson said that while state agencies made substantial progress evaluating applicants, Quinn decided to turn the job over to Rauner for proper review.

    Rauner's office said it will refer its findings to the state Attorney General's office.

    Democratic State Representative Lou Lang, a medical marijuana supporter, said Quinn's staff used blind scoring procedures to eliminate favoritism in picking who should get licenses, and it was a shame Quinn didn't issue them.

    "Now we have a governor who's not a big fan of the program and has to be convinced to move forward," Lang said.

    Lang said a patient or potential distributor who got a high qualifying score may sue to move things along.

    Marla Levi, 51, who has multiple sclerosis, said she felt betrayed by Quinn.

    But she doesn't mind the Rauner administration going through the lists again to ensure the right people will be growing and dispensing the drug.

    "We know how government has worked in Illinois ... we want to know everything," Levi said.

  • After heart attacks, most don't get enough statins

    By Kathryn Doyle

    (Reuters Health) - In the U.S., less than a third of older heart "event" patients being discharged from the hospital get the recommended high-intensity statins, according to a new study that looked at prescriptions filled.

    National guidelines from the American College of Cardiology and American Heart Association say the majority of patients should be on a high-dose statin following a serious heart disease-related event like heart attack or bypass surgery.

    "It appears that there's tremendous reticence in prescription of statin therapy," said lead author Dr. Robert S. Rosenson of the Icahn School of Medicine at Mount Sinai in New York.

    "Whatever the dose of statin people were taking when they came to the hospital was the dose they went out on, the acute event didn't change it," he told Reuters Health. "This is very disappointing."

    The authors studied a random sample of Medicare beneficiaries ages 65 to 74 who filled a statin prescription after having a heart attack or bypass surgery between 2007 and 2009.

    Of more than 8,000 people who filled a statin prescription after one of these events, only 27 percent of the first post-discharge prescriptions were for "high-intensity" statins, such as 40 to 80 milligrams of atorvastatin (Lipitor) or 80 milligrams of simvastatin (Zocor).

    Less than 25 percent of people who were not taking a statin before their hospitalization filled a high-intensity statin prescription on their release, and less than 10 percent of those who had been taking a low-intensity statin switched to a high-intensity one.

    About 80 percent of people who had already been taking high-intensity statins filled another such prescription immediately upon leaving the hospital, according to the results in the Journal of the American College of Cardiology.

    Of the patients whose first post-discharge prescription fill was for a low-intensity statin, less than 12 percent switched to a high-intensity dosage within the following year.

    "There's a tremendous amount of confusion," Rosenson said. Though the clinical guidelines, which are supported by rigorous studies and high quality results, indicate that high dose statins are better than low dose statins after an acute cardiac event, many doctors appear not to be following them.

    High intensity statins have been linked to better health outcomes in the short and long term for these patients, he said.

    "It could be that either the doctors are not aware of the guidelines that high intensity therapy is proven to be better, or more likely they are focusing on the (low-density lipoprotein) cholesterol level," he said.

    There has been confusion on whether or not to dose statins based on LDL cholesterol readings for some patients, but for those who have suffered an acute cardiac event, a high dose is better, he said.

    "If statins are fairly safe and highly effective agents particularly for these types of patients, yet only about 50 to 60 percent of these patients are on what has been recommended and proved, why is that?" asked Dr. Prakash Deedwania of the University of California San Francisco School of Medicine in Fresno who wrote an editorial accompanying the new results.

    Side effects from statins are rare, he noted, and cost of the drugs - which are mostly generic, inexpensive, and covered by insurance including Medicare - should not be an issue. There is some risk of developing what is know as "chemical diabetes," but the benefits of the drugs far outweigh this risk, Deedwania told Reuters Health.

    "The benefit is 10-fold greater than any sort of harm," he said.

    When doctors know that an oversight body is going to be looking at their prescribing data, they are more likely to follow guidelines, he said.

    "We should be doing this without anyone looking, but unfortunately it doesn't work like that," Deedwania said.

    Though the authors focus on doctors likely not prescribing the recommended statin dose, there could be confusion or reluctance on the patient side as well, he said.

    Much like blood pressure medication, statins don't provide immediate symptom relief while they are acting in the body. Since patients don't feel a difference when they take the medication, they may not be motivated to continue taking it, he said.

    "The burden is on us to educate our patients, tell them precisely in simple terms what are the benefits of statins," Deedwania said.

    In addition to reducing the risk of another heart attack and making a bypass graft more durable over time, statins reduce the risk of stroke, he said.

    "That resonates really well," Deedwania said. "Everybody wants to get extra benefits,"

    SOURCE: http://bit.ly/1CQS8Tc JACC, online January 19, 2015.

Oncology Articles

  • POM Wonderful loses bid to tout health benefits in drink ads

    By Reuters Staff

    WASHINGTON (Reuters) - Pomegranate juice maker POM Wonderful cannot advertise that its pomegranate drinks treat or prevent heart disease or other ailments unless it has proof, a U.S. appeals court said Friday, upholding an order by the Federal Trade Commission.

    The U.S. Court of Appeals for the D.C. Circuit largely upheld a 2010 order by the Federal Trade Commission, which found that POM Wonderful's advertising was misleading in claiming its products would treat or reduce the risk of diseases ranging from heart disease to prostate cancer to erectile dysfunction.

    The advertisements that the FTC challenged appeared in Parade, Fitness and Prevention magazines, as well as online, and on product tags, the FTC said.

    "Many of those ads mischaracterized the scientific evidence concerning the health benefits of POM's products with regard to those diseases. The FTC Act proscribes - and the First Amendment does not protect - deceptive and misleading advertisements," the court said in its ruling.

    But the appeals court said the FTC went too far in requiring two human clinical trial studies to support any health claims in advertising, saying there was "inadequate justification" for that demand.

    POM said it was pleased with this portion of the decision.

    "We are grateful that the court substantially reduced the requirement that the FTC tried to enforce on us to conduct multiple double-blind, placebo-controlled studies," the company said in a statement.

    The FTC said the decision was a victory for consumers.

    "It is in keeping with established law that advertisers who market products for serious health conditions must have rigorous science to back up those claims," wrote FTC Chairwoman Edith Ramirez in a statement. "The court specifically recognized that this applies to food and dietary supplement marketers such as POM."

    The advertisements that most concerned the FTC were discontinued in 2005 and others were halted in 2007, said lawyer Thomas Goldstein when he argued for POM Wonderful before the judges in May 2014.

    The case is in the U.S. Court of Appeals for the D.C. Circuit. It is POM Wonderful, LLC v. Federal Trade Commission and is No. 13-1060.

  • Cancer organization partners with NFL on prostate treatment

    By Reuters Staff

    PHOENIX (Reuters) - A U.S. cancer organization has partnered with the NFL alumni association ahead of Sunday's Super Bowl XLIX to raise awareness about screening, diagnosis and treatment for prostate cancer, a disease that kills tens of thousands of U.S. men a year.

    The Cancer Treatment Centers of America (CTCA), a private, for-profit operator of cancer treatment hospitals and outpatient clinics, will treat NFL Alumni who are fighting prostate cancer, which afflicts almost one in seven U.S. men, at its five hospitals in Atlanta, Chicago, Philadelphia, Phoenix and Tulsa.

    "CTCA is proud to partner with NFLA and we look forward to making a difference in the lives of those alums who are or will be diagnosed with prostate cancer," Gerard van Grinsven, chief executive and president of CTCA, said in a statement Thursday.

    Prostate cancer is one of the most common cancers among men in the United States, second only to non-melanoma skin cancer. It also is the second leading cause of cancer death in U.S. men.

    "This new partnership addresses one of the biggest health concerns among men today," said NFL Alumni head Joe Pisarcik.

    The CTCA is already sponsoring sunblock dispensers for fans at pre-game events in downtown Phoenix ahead of the game between the Seattle Seahawks and New England Patriots.

    The NFL Alumni Association is a group of former league players, coaches and other employees who help ex-players and their families with medical, financial and social programs.

  • UK to launch 100,000 genomes project as Obama backs DNA drive

    By Ben Hirschler

    LONDON (Reuters) - Gene research is getting a boost on both sides of the Atlantic, with scientists in England set to launch a project on Feb. 2 to analyze 100,000 entire human genomes and U.S. President Barack Obama backing a big new DNA data drive.

    The twin projects show the accelerating work by researchers to understand the underlying basis of diseases and develop medicines targeted to the genetic profile of individual patients.

    Obama will announce the U.S. plan to analyze genetic information from more than 1 million American volunteers on Friday as a central part of an initiative to promote so-called precision medicine, officials said.

    The 100,000 genomes project in England, meanwhile, was first unveiled by the British government two years ago -- but the 11 centers charged with collecting samples will only begin full-scale recruitment from next week. The aim is to complete the program by the end of 2017.

    Such large-scale genomic research has become possible because the cost of genome sequencing has plummeted in recent years to around $1,000 per genome. That is a far cry from 15 years ago when it cost some $3 billion to get the first human genome.

    In the case of the British project, all the sequencing will be carried out by U.S. biotech company Illumina, which has pioneered fast and cheap technology to read genetic code.

    The 100,000 genomes project is focusing on patients with rare diseases, and their families, as well as people with common cancers. The idea is to tease out the common drivers of disease to help develop better drugs and diagnostic tests.

    In addition to helping doctors understand more about disease, the government also hopes the scheme will make the state-run National Health Service a world leader in science and boost Britain's life sciences industry.

    The project will actually recruit around 75,000 participants, rather than 100,000, since people with cancer will provide two genomes -- one derived from the healthy cells in their body and one from their tumor. By comparing the two, experts hope to find the exact genetic changes causing cancer.

  • U.S. proposes effort to analyze DNA from 1 million people

    By Toni Clarke and Sharon Begley

    WASHINGTON (Reuters) - The United States has proposed analyzing genetic information from more than 1 million American volunteers as part of a new initiative to understand human disease and develop medicines targeted to an individual's genetic make-up.

    At the heart of the initiative, to be announced on Friday by President Barack Obama, is the creation of a pool of people - healthy and ill, men and women, old and young - who would be studied to learn how genetic variants affect health and disease.

    Officials hope genetic data from several hundred thousand participants in ongoing genetic studies would be used, and other volunteers recruited to reach the 1 million total.

    The near-term goal is to create more and better treatments for cancer, Dr. Francis Collins, director of the National Institutes of Health (NIH), told reporters on a conference call on Thursday. Longer term, he said, the project would provide information on how to individualize treatment for a range of diseases.

    The initial focus on cancer, he said, is due partly to the lethality of the disease and partly because targeted medicine, known also as precision medicine, has made significant advances in cancer, although much more work is needed.

    The president has proposed $215 million in his 2016 budget for the initiative. Of that, $130 million would go to the NIH to fund the research cohort and $70 million to NIH's National Cancer Institute to intensify efforts to identify molecular drivers of cancer and apply that knowledge to drug development.

    A further $10 million would go to the Food and Drug Administration to develop databases on which to build an appropriate regulatory structure; $5 million would go to the Office of the National Coordinator for Health Information Technology to develop privacy standards and ensure the secure exchange of data.

    The effort may raise alarm bells for privacy rights advocates who in the past have questioned the government's ability to guarantee that DNA information is kept anonymous. They have expressed fear participants may become identifiable or face discrimination.

    SEQUENCING 1 MILLION GENOMES

    The funding is not nearly enough to sequence 1 million genomes from scratch. Whole-genome sequencing, though plummeting in price, still costs about $1,000 per genome, Collins said, meaning this component alone would cost $1 billion.

    Instead, he said, the national cohort would be assembled both from new volunteers interested in "an opportunity to take part in something historic," and existing cohorts that are already linking genomic data to medical outcomes.

    The most ambitious of these is the Million Veteran Program, launched in 2011 by the Department of Veterans Affairs. Aimed at making genomic discoveries and bringing personalized medicine to veterans, it has enrolled more than 300,000 veterans and determined the DNA sequences of about 200,000.

    The VA was a pioneer in electronic health records, which it will use to link the genotypes to vets' medical histories.

    Academic centers have, with NIH funding, also amassed thousands of genomes and linked them to the risk of disease and other health outcomes. The Electronic Medical Records and Genomics Network, announced by NIH in 2007, aims to combine DNA information on more than 300,000 people and look for connections to diseases as varied as autism, appendicitis, cataracts, diabetes and dementia.

    In 2014, Regeneron Pharmaceuticals Inc launched a collaboration with Pennsylvania-based Geisinger Health System to sequence the DNA of 100,000 Geisinger patients and, using their anonymous medical records, look for correlations between genes and disease. The company has finished 50,000 samples, spokeswoman Hala Mirza said.

    Perhaps the most audacious effort is by the non-profit Human Longevity Inc, headed by Craig Venter. In 2013 it launched a project to sequence 1 million genomes by 2020. Privately funded, it will be made available to pharmaceutical companies such as Roche Holding AG, with which the institute has a research partnership.

    "We're happy to work with them to help move the science," Venter said in an interview, referring to the administration's initiative.

    But because of the many regulations surrounding medical privacy and human volunteers, he said, "we can't just mingle databases. It sounds like a naive assumption" if the White House expects existing cohorts to merge into its 1-million-genomes project.

    Venter raced the government-funded Human Genome Project to a draw in 2000, sequencing the entire human genome using private funding in less time than it took the public effort.

    ALTERING THE REGULATORY LANDSCAPE

    Collins conceded that mingling the databases would be a challenge but insisted it is doable.

    "It is something that can be achieved but obviously there is a lot that needs to be done," he said.

    Collating, analyzing and applying all this data to the development of new drugs will require changes to how products are reviewed and approved by health regulators.

    Dr. Margaret Hamburg, the FDA's commissioner, said on the conference call that the emerging field of precision medicine "presents a set of new issues for us at FDA." The agency is discussing new ways to approach the review process for personalized medicines and tests, she added.

  • Medical marijuana advocates concerned by Illinois licensing delay

    By Mary Wisniewski

    CHICAGO (Reuters) - Advocates for medical marijuana in Illinois are concerned that delays in issuing distribution licenses, exacerbated by a change in governors, is keeping the drug from patients who need it.

    Former Democratic Governor Pat Quinn, who supported medical marijuana, left office in January without issuing licenses for growth and distribution, leaving it to his successor, Republican Governor Bruce Rauner.

    Rauner, who has expressed skepticism about the licensing process, wants a thorough legal review, his office said, which means more time before the 2013 law can be implemented.

    For patients that means no hope of getting the drug until at least June even if the Rauner administration issues licenses in the next month, said Chris Lindsey, legislative analyst for the Marijuana Policy Project, a Washington, D.C.-based non-profit.

    The law requires plants to be grown in Illinois, which takes 4-1/2 months in the best of circumstances.

    "We're pretty concerned - we've been waiting for a long time," Lindsey said. Supporters had hoped licenses would be issued last fall.

    Illinois is one of 23 states plus the District of Columbia that permit medical marijuana. Illinois' trial program expires in 2017.

    Lindsey said he believes Rauner is "trying to be careful, but in the process he's really failing our seriously ill patients in Illinois."

    The Quinn administration prepared lists of businesses qualified to receive the licenses before he left office, according to recently released documents.

    A Quinn administration spokesperson said that while state agencies made substantial progress evaluating applicants, Quinn decided to turn the job over to Rauner for proper review.

    Rauner's office said it will refer its findings to the state Attorney General's office.

    Democratic State Representative Lou Lang, a medical marijuana supporter, said Quinn's staff used blind scoring procedures to eliminate favoritism in picking who should get licenses, and it was a shame Quinn didn't issue them.

    "Now we have a governor who's not a big fan of the program and has to be convinced to move forward," Lang said.

    Lang said a patient or potential distributor who got a high qualifying score may sue to move things along.

    Marla Levi, 51, who has multiple sclerosis, said she felt betrayed by Quinn.

    But she doesn't mind the Rauner administration going through the lists again to ensure the right people will be growing and dispensing the drug.

    "We know how government has worked in Illinois ... we want to know everything," Levi said.

Orthopedic Articles

  • Computer tracks eye movements to detect concussions

    By Andrew M. Seaman

    (Reuters Health) - A new piece of technology that tracks eye movements after a head injury might be able to detect concussions and determine their severity, researchers say.

    The new technology is essentially like a doctor moving a finger in front of a person's eyes after a hit to the head - except now it's automated, said Dr. Uzma Samadani of NYU Langone Medical Center in New York City.

    And the results are reproducible, whereas with the follow-my-finger method, Samadani said, "Each doctor is going to have variability in how well they're going to be able to assess how well a person is getting better."

    Samadani said she developed the new technology because she needed a reliable way to assess concussions. Accurate diagnoses would improve patients' care, allowing for more accurate assessments of when they could safely return to work or play after a hit to the head, she said.

    The Centers for Disease Control and Prevention defines a concussion as a type of brain injury "caused by a bump, blow, or jolt to the head that can change the way your brain normally works."

    In her team's study, 75 people who'd been in accidents (but not necessarily head accidents) plus 64 healthy volunteers all watched a four-minute video while their eye movement was tracked by a computer. The computer could tell when their eyes are moving in opposite directions. So-called disconjugated eye movement has been tied to brain injuries for centuries.

    People with hits to the head had less ability to control their eye movements, compared to people who had no known injuries, the researchers wrote in the Journal of Neurotrauma.

    The computer also detected signs of concussion in some patients without any noticeable brain injury on a CT scan.

    Images, like those from a CT scan, "tell you what (the brain) looks like - not how it functions," Samadani said.

    The researchers also found that the severity of symptoms from concussion was tied to the severity of their eye movement problems.

    The technology is currently only available in research settings, but Samadani hopes the U.S. Food and Drug Administration will clear it for use by the end of this year.

    "I think we're going to change how we diagnose and define brain injury and concussion," she said.

    Future research needs to focus on other factors that may influence the results of the test, such as alcohol, morphine and sleep deprivation.

    "What we're finding so far is that these things affect eye movement, but in different ways than brain injury does," Samadani said. "So we're hoping to tease out the differences."

    SOURCE: http://bit.ly/1CI4Cyx The Journal of Neurotrauma, online January 29, 2015.

  • Should 'High T' determine eligibility for women's sports?

    By Kathryn Doyle

    (Reuters Health) - According to controversial new regulations, female athletes with as much testosterone in their blood as some men are not allowed to compete in women's sporting events.

    In 2011 and 2012, the International Association of Athletics Federations (IAAF) and the International Olympic Committee (IOC) implemented new rules barring a female from competing in the women's category if her blood testosterone level is above 10 nanomoles of testosterone per liter (nmol/L).

    That's the bottom end of what's considered a normal range for men. Women usually have less than three nmol/L, according to Dr. Peter Sonksen of Kings College London. Men tend to have 10 to 30 nmol/L.

    But 2.5 percent of women have hyperandrogenism, meaning more testosterone in their blood than the reference range for females, usually due to genetics, Sonksen told Reuters Health by email.

    "In most cases it is of no consequence to health but in some cases there may be a tendency to greasy skin and excess body hair and this may be associated with menstrual irregularity and infertility," and in rare cases can lead to adrenal tumors, he said.

    Experts disagree about whether testosterone actually enhances athletic performance, and if this should be a determinant of sports eligibility. That's one major sticking point in dueling commentaries published in the Journal of Clinical Endocrinology and Metabolism.

    "Sports, athleticism in general is inherently unfair," said Dr. Eric Vilain of the UCLA School of Medicine, who coauthored a commentary in support of the current regulations.

    Sporting ability depends on a variety of genetic and environmental factors, including height, proportion and access to high quality training facilities, Vilain told Reuters Health.

    "We could have men and women compete against each other in the same categories, that's a model we would be fine with, but for the exception that women in most events would systematically lose," he said.

    He allowed that segregation of male and female sports is an artificial social construct, but since the construct exists it does need to be enforced somehow.

    One option is to have athletes simply identify themselves as male or female.

    "All women who have been functioning as such in their everyday lives should be allowed to compete on the field of sport," said Sonksen, who coauthored the commentary opposing the current regulations.

    "The notion that female athletes are in need of protection reflects paternalistic and heterosexist assumptions about what 'real' women should look like and how they ought to perform," he said.

    But allowing women to self-identify would open the door to men competing as women and committing fraud, Vilain said.

    "Sports authorities accept the fact that there are huge variabilites between women in terms of their characteristics, but is there a parameter, is there something that we can easily measure that is very different between men and women and relevant to sport performance?" Vilain said.

    In the past, the Y chromosome was the determinant of women's sports eligibility, but the Y chromosome per se is not very relevant to athletic performance, he said. Some women do carry a Y chromosome but are insensitive to male hormones and develop physiologically as a woman. They would be wrongly disqualified by a chromosome rule, he said.

    Shifting from the Y chromosome to testosterone takes the emphasis off of male or female identity, Vilain said.

    "There is no good evidence that naturally occurring hyperandrogenism enhances athletic performance," Sonksen said.

    Many athletes who "dope" do so with testosterone or related products, Vilain said, noting that if the hormone were not improving performance, athletes would not use it to cheat.

    Testosterone is linked to bone and muscle development, and it is not far-fetched to say that it is related to athletic performance, Vilain said.

    "It is a natural 'in-built' and 'genetically-determined' attribute akin to height, hand and foot size, body build etc.," Sonksen said. "In addition, it is unfair to exclude any athlete based on a genetic condition that they have no control over," he said.

    Depending on the international federation governing the particular sport, T testing is mandatory for some women but not others, he noted. If a female athlete tests high for testosterone, she would need to undergo surgical or hormonal procedures to be eligible for the women's competition, he said.

    However, no one is banned from competing altogether based on testosterone, Vilain said. A woman with T in the male range could compete in the men's category.

    The situation is even more complicated for transgender athletes. According to the IOC Stockholm Consensus, issued in 2003, a male to female transgender athlete may compete if she has had her gonads removed at least two years previously, has taken female hormones and has a legal "change of sex," which is not an option in many countries and in several U.S. states, Vilain said.

    The IOM is looking into revisiting this guideline, he noted.

    "At the end of the day, these kinds of biological measures will always be imperfect," he said.

    SOURCE: http://bit.ly/1us9KQx and http://bit.ly/1JC205C Journal of Clinical Endocrinology and Metabolism, online January 14, 2015.

Transplant Articles

  • New fund eases expenses for organ donors

    By Randi Belisomo

    (Reuters Health) - When Sigrid Fry-Revere decided to donate a kidney to a friend in 2010, she thought she knew what to expect.

    She was medically compatible and insured. She planned surgery during the Christmas holidays, so her husband and college-aged sons could take time off to help her recover at their 10-acre Virginia farm.

    What she didn't consider was the factor that ultimately disqualified her: personal expenses.

    The transplant team required an eight-week recovery plan. Her caregivers, however, could only be home for a month, so she would need to hire a farmhand. With this unanticipated and unaffordable expense, she was quickly eliminated.

    "I was dumbfounded," Fry-Revere said. "They would rather let him die than give me time to figure out how to take care of myself."

    According to the American Journal of Nephrology, living donors incur out-of-pocket expenses averaging $5,000, and sometimes up to four times that amount.

    Fry-Revere's friend did die. Last fall, she established the non-profit American Living Organ Donor Fund to help donors cover lost wages and donor-related costs. With donations from an online Kickstarter campaign, the fund has granted three requests so far. Three others are under review.

    According to the U.S. Organ Procurement and Transplantation Network, more than 123,000 Americans are waiting for organ transplants. Roughly 102,000 need kidneys and more than 15,000 need livers - and many of them could be helped by living donors.

    But a study by the National Bureau of Economic Research found that half of Americans would struggle to come up with $2,000 in a pinch, let alone the much higher amounts donors generally need.

    The transplant recipient's insurance covers the donor's medical expenses, but not transportation, lodging, childcare or lost wages.

    The 1984 National Organ Transplant Act made it illegal to compensate organ donors - and while the need for living donations is widely recognized, some fear Fry-Revere's fund enters ethically murky territory.

    "It rings a little close to payment for organs," said Dr. Talia Baker, a Northwestern University transplant surgeon. "It makes me a little uncomfortable."

    As a member of the American Society of Transplant Surgeons' Living Donor Committee, Baker does not oppose the fund - if it assists potential donors achieve goals to which they're already committed.

    "If this is the only possible donor, if it wouldn't coerce that donor or be a final reason for donating, then it is fine," she said.

    Thirty-one-year-old single mother Melissa Brincks of Carroll, Iowa, said that without the fund, she would not have been able to donate a kidney to her brother. She was his only compatible relative.

    Her boss at a carpet cleaning company said he would be forced to lay her off and hire her back after her six-week recovery.

    "I didn't understand how someone could do a good thing and then not know how to take care of their own life in the meantime," Brincks said.

    After her brother's transplant this week, Fry-Revere's fund provided her with a grant to cover 40 percent of her lost wages. That check, along with unemployment insurance and caregiving help from her parents, made donation possible.

    Seven hundred dollars from an online campaign and church friends was all the assistance 46-year-old Stephanie Washington of Hayward, California, believed she could get while planning to donate a kidney to her 24-year-old niece, a gunshot victim.

    "I didn't know how she was going to pay her bills," said her sister, Faye Herald, whose research led her to Fry-Revere's fund. Washington runs a cleaning service and would receive no income during recovery.

    Herald applied, submitting documentation that Washington was self-employed. Washington received a check to cover two months of rent and bills following surgery earlier this month.

    "It's such a blessing and relief," Washington said. "I can relax, and that's one of the reasons my recovery is going so good. I don't have to worry."

  • New fund eases expenses for organ donors

    By Randi Belisomo

    (Reuters Health) - When Sigrid Fry-Revere decided to donate a kidney to a friend in 2010, she thought she knew what to expect.

    She was medically compatible and insured. She planned surgery during the Christmas holidays, so her husband and college-aged sons could take time off to help her recover at their 10-acre Virginia farm.

    What she didn't consider was the factor that ultimately disqualified her: personal expenses.

    The transplant team required an eight-week recovery plan. Her caregivers, however, could only be home for a month, so she would need to hire a farmhand. With this unanticipated and unaffordable expense, she was quickly eliminated.

    "I was dumbfounded," Fry-Revere said. "They would rather let him die than give me time to figure out how to take care of myself."

    According to the American Journal of Nephrology, living donors incur out-of-pocket expenses averaging $5,000, and sometimes up to four times that amount.

    Fry-Revere's friend did die. Last fall, she established the non-profit American Living Organ Donor Fund to help donors cover lost wages and donor-related costs. With donations from an online Kickstarter campaign, the fund has granted three requests so far. Three others are under review.

    According to the U.S. Organ Procurement and Transplantation Network, more than 123,000 Americans are waiting for organ transplants. Roughly 102,000 need kidneys and more than 15,000 need livers - and many of them could be helped by living donors.

    But a study by the National Bureau of Economic Research found that half of Americans would struggle to come up with $2,000 in a pinch, let alone the much higher amounts donors generally need.

    The transplant recipient's insurance covers the donor's medical expenses, but not transportation, lodging, childcare or lost wages.

    The 1984 National Organ Transplant Act made it illegal to compensate organ donors - and while the need for living donations is widely recognized, some fear Fry-Revere's fund enters ethically murky territory.

    "It rings a little close to payment for organs," said Dr. Talia Baker, a Northwestern University transplant surgeon. "It makes me a little uncomfortable."

    As a member of the American Society of Transplant Surgeons' Living Donor Committee, Baker does not oppose the fund - if it assists potential donors achieve goals to which they're already committed.

    "If this is the only possible donor, if it wouldn't coerce that donor or be a final reason for donating, then it is fine," she said.

    Thirty-one-year-old single mother Melissa Brincks of Carroll, Iowa, said that without the fund, she would not have been able to donate a kidney to her brother. She was his only compatible relative.

    Her boss at a carpet cleaning company said he would be forced to lay her off and hire her back after her six-week recovery.

    "I didn't understand how someone could do a good thing and then not know how to take care of their own life in the meantime," Brincks said.

    After her brother's transplant this week, Fry-Revere's fund provided her with a grant to cover 40 percent of her lost wages. That check, along with unemployment insurance and caregiving help from her parents, made donation possible.

    Seven hundred dollars from an online campaign and church friends was all the assistance 46-year-old Stephanie Washington of Hayward, California, believed she could get while planning to donate a kidney to her 24-year-old niece, a gunshot victim.

    "I didn't know how she was going to pay her bills," said her sister, Faye Herald, whose research led her to Fry-Revere's fund. Washington runs a cleaning service and would receive no income during recovery.

    Herald applied, submitting documentation that Washington was self-employed. Washington received a check to cover two months of rent and bills following surgery earlier this month.

    "It's such a blessing and relief," Washington said. "I can relax, and that's one of the reasons my recovery is going so good. I don't have to worry."

  • New fund eases expenses for organ donors

    By Randi Belisomo

    (Reuters Health) - When Sigrid Fry-Revere decided to donate a kidney to a friend in 2010, she thought she knew what to expect.

    She was medically compatible and insured. She planned surgery during the Christmas holidays, so her husband and college-aged sons could take time off to help her recover at their 10-acre Virginia farm.

    What she didn't consider was the factor that ultimately disqualified her: personal expenses.

    The transplant team required an eight-week recovery plan. Her caregivers, however, could only be home for a month, so she would need to hire a farmhand. With this unanticipated and unaffordable expense, she was quickly eliminated.

    "I was dumbfounded," Fry-Revere said. "They would rather let him die than give me time to figure out how to take care of myself."

    According to the American Journal of Nephrology, living donors incur out-of-pocket expenses averaging $5,000, and sometimes up to four times that amount.

    Fry-Revere's friend did die. Last fall, she established the non-profit American Living Organ Donor Fund to help donors cover lost wages and donor-related costs. With donations from an online Kickstarter campaign, the fund has granted three requests so far. Three others are under review.

    According to the U.S. Organ Procurement and Transplantation Network, more than 123,000 Americans are waiting for organ transplants. Roughly 102,000 need kidneys and more than 15,000 need livers - and many of them could be helped by living donors.

    But a study by the National Bureau of Economic Research found that half of Americans would struggle to come up with $2,000 in a pinch, let alone the much higher amounts donors generally need.

    The transplant recipient's insurance covers the donor's medical expenses, but not transportation, lodging, childcare or lost wages.

    The 1984 National Organ Transplant Act made it illegal to compensate organ donors - and while the need for living donations is widely recognized, some fear Fry-Revere's fund enters ethically murky territory.

    "It rings a little close to payment for organs," said Dr. Talia Baker, a Northwestern University transplant surgeon. "It makes me a little uncomfortable."

    As a member of the American Society of Transplant Surgeons' Living Donor Committee, Baker does not oppose the fund - if it assists potential donors achieve goals to which they're already committed.

    "If this is the only possible donor, if it wouldn't coerce that donor or be a final reason for donating, then it is fine," she said.

    Thirty-one-year-old single mother Melissa Brincks of Carroll, Iowa, said that without the fund, she would not have been able to donate a kidney to her brother. She was his only compatible relative.

    Her boss at a carpet cleaning company said he would be forced to lay her off and hire her back after her six-week recovery.

    "I didn't understand how someone could do a good thing and then not know how to take care of their own life in the meantime," Brincks said.

    After her brother's transplant this week, Fry-Revere's fund provided her with a grant to cover 40 percent of her lost wages. That check, along with unemployment insurance and caregiving help from her parents, made donation possible.

    Seven hundred dollars from an online campaign and church friends was all the assistance 46-year-old Stephanie Washington of Hayward, California, believed she could get while planning to donate a kidney to her 24-year-old niece, a gunshot victim.

    "I didn't know how she was going to pay her bills," said her sister, Faye Herald, whose research led her to Fry-Revere's fund. Washington runs a cleaning service and would receive no income during recovery.

    Herald applied, submitting documentation that Washington was self-employed. Washington received a check to cover two months of rent and bills following surgery earlier this month.

    "It's such a blessing and relief," Washington said. "I can relax, and that's one of the reasons my recovery is going so good. I don't have to worry."

Women’s Health Articles

  • CORRECTED-FDA approves ADHD drug Vyvanse for binge-eating disorder

    (Corrects to show disorder affects 2.8 million people, not 28 million, in fifth paragraph)

    By Toni Clarke

    WASHINGTON (Reuters) - The U.S. Food and Drug Administration on Friday approved the stimulant lisdexamfetamine (Vyvanse, Shire) to treat binge-eating disorder, the first product to be approved for the condition.

    Vyvanse is currently approved to treat attention deficit hyperactivity disorder (ADHD).

    Binge-eating disorder, characterized by repeated episodes of uncontrolled eating, accompanied by guilt and shame, affects roughly 2.8 million people in the United States, according to Shire.

    "Binge eating can cause serious health problems and difficulties with work, home, and social life," said Dr. Mitchell Mathis, director of the FDA's division of psychiatry products. "The approval of Vyvanse provides physicians and patients with an effective option to help curb episodes of binge eating."

    In clinical studies, patients taking Vyvanse were shown to have significantly fewer binge days per week than those taking a placebo.

    At the time of entry to the study, the average number of binge days per week was 4.79. At week 12, average binge days per week had fallen to less than one. Patients taking a placebo, by comparison, saw a reduction of little more than 2 days a week.

    Vyvanse is an amphetamine which, like other amphetamines, carries the potential for abuse and addiction. They also have been associated with increases in blood presssure and heart rate, sudden death, stroke, heart attack, insomnia and psychiatric side effects such as hallucinations and mania.

    The drug is not approved for weight loss.

  • CORRECTED-FDA approves ADHD drug Vyvanse for binge-eating disorder

    (Corrects to show disorder affects 2.8 million people, not 28 million, in fifth paragraph)

    By Toni Clarke

    WASHINGTON (Reuters) - The U.S. Food and Drug Administration on Friday approved the stimulant lisdexamfetamine (Vyvanse, Shire) to treat binge-eating disorder, the first product to be approved for the condition.

    Vyvanse is currently approved to treat attention deficit hyperactivity disorder (ADHD).

    Binge-eating disorder, characterized by repeated episodes of uncontrolled eating, accompanied by guilt and shame, affects roughly 2.8 million people in the United States, according to Shire.

    "Binge eating can cause serious health problems and difficulties with work, home, and social life," said Dr. Mitchell Mathis, director of the FDA's division of psychiatry products. "The approval of Vyvanse provides physicians and patients with an effective option to help curb episodes of binge eating."

    In clinical studies, patients taking Vyvanse were shown to have significantly fewer binge days per week than those taking a placebo.

    At the time of entry to the study, the average number of binge days per week was 4.79. At week 12, average binge days per week had fallen to less than one. Patients taking a placebo, by comparison, saw a reduction of little more than 2 days a week.

    Vyvanse is an amphetamine which, like other amphetamines, carries the potential for abuse and addiction. They also have been associated with increases in blood presssure and heart rate, sudden death, stroke, heart attack, insomnia and psychiatric side effects such as hallucinations and mania.

    The drug is not approved for weight loss.

  • POM Wonderful loses bid to tout health benefits in drink ads

    By Reuters Staff

    WASHINGTON (Reuters) - Pomegranate juice maker POM Wonderful cannot advertise that its pomegranate drinks treat or prevent heart disease or other ailments unless it has proof, a U.S. appeals court said Friday, upholding an order by the Federal Trade Commission.

    The U.S. Court of Appeals for the D.C. Circuit largely upheld a 2010 order by the Federal Trade Commission, which found that POM Wonderful's advertising was misleading in claiming its products would treat or reduce the risk of diseases ranging from heart disease to prostate cancer to erectile dysfunction.

    The advertisements that the FTC challenged appeared in Parade, Fitness and Prevention magazines, as well as online, and on product tags, the FTC said.

    "Many of those ads mischaracterized the scientific evidence concerning the health benefits of POM's products with regard to those diseases. The FTC Act proscribes - and the First Amendment does not protect - deceptive and misleading advertisements," the court said in its ruling.

    But the appeals court said the FTC went too far in requiring two human clinical trial studies to support any health claims in advertising, saying there was "inadequate justification" for that demand.

    POM said it was pleased with this portion of the decision.

    "We are grateful that the court substantially reduced the requirement that the FTC tried to enforce on us to conduct multiple double-blind, placebo-controlled studies," the company said in a statement.

    The FTC said the decision was a victory for consumers.

    "It is in keeping with established law that advertisers who market products for serious health conditions must have rigorous science to back up those claims," wrote FTC Chairwoman Edith Ramirez in a statement. "The court specifically recognized that this applies to food and dietary supplement marketers such as POM."

    The advertisements that most concerned the FTC were discontinued in 2005 and others were halted in 2007, said lawyer Thomas Goldstein when he argued for POM Wonderful before the judges in May 2014.

    The case is in the U.S. Court of Appeals for the D.C. Circuit. It is POM Wonderful, LLC v. Federal Trade Commission and is No. 13-1060.

  • U.S. government releases draft plan for electronic health data

    By Reuters Staff

    WASHINGTON (Reuters) - The Obama administration on Friday proposed a plan to move most doctors, hospitals and their patients to national standards for handling electronic clinical data by the end of 2017.

    The U.S. Department of Health and Human Services (HHS), as part of an effort to propel the $2.9 trillion U.S. healthcare system away from a costly fee-for-service system, released a report draft aimed at establishing an inter operable health information technology system that can be accessed by patients and their healthcare providers.

    Policy experts say that national health IT standards would lead to transparency in medical data, prices and provider performance, while helping support hospitals and medical practices in pursuing care-delivery models that emphasize care quality and savings over quantity.

    Earlier this week, Health and Human Services Secretary Sylvia Burwell announced the goal of moving 50 percent of fee-for-service Medicare payments to quality-care focused providers by the end of 2018.

    An industry task force has also been formed to facilitate a similar transformation for the private healthcare sector.

    HHS said the new IT roadmap "focuses on actions that will enable a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017."

    The release was warmly received by consumer advocates who support the administration's care-delivery goals.

    "We are especially pleased that the new roadmap focuses on interoperability not just among providers, but also patients and their family caregivers, recognizing them as equal partners in the continuum of care," Debra Ness, president of the National Partnership for Women & Families, said in a statement.

    The document covers core technical standards and functions, certification, privacy, security and governance. Public comment period on the draft closes April 3.

    HHS released a separate advisory listing available standards and implementation specifications. Public comment on the standards advisory closes May 1.

  • Regular walking can help ease depression

    By Janice Neumann

    (Reuters Health) - Moderate-intensity exercise, or even just walking, can improve quality of life for depressed middle-aged women, a large Australian study suggests.

    Women who averaged 150 minutes of moderate exercise (golf, tennis, aerobics classes, swimming or line-dancing) or 200 minutes of walking every week had more energy, socialized more, felt better emotionally and weren't as limited by their depression when researchers followed up after three years.

    They also had less pain and did better physically, although the psychological benefit was greater.

    With depression so prevalent, "there is an urgent need" to identify treatments, including non-medical options that people can do themselves, said Kristiann Heesch, who led the study.

    Heesch, senior lecturer at Queensland University of Technology, and her colleagues point out in the American Journal of Preventive Medicine that depression is expected to be the second-leading cause of global disease by 2030 and the leading cause in high-income countries.

    One in 10 U.S. adults suffers from depression, according to the Centers for Disease Control and Prevention. Women are 70 percent more likely to be depressed at some point in their lives than men, according to the National Institute of Mental Health.

    In previous research, Heesch found that exercise and walking could boost physical and emotional health in women who are not depressed.

    In fact, Heesch said in an email, physical activity may have an even greater effect on psychological health-related quality of life in women in their 50s and 60s who are depressed.

    Her team analyzed data on 1,904 women born in 1946-1951 who answered questions about their exercise habits, physical health and mental health in 2001, 2004, 2007 and 2010. In 2001, all of them had reported at least 10 depressive symptoms, indicating mild to moderate depression.

    But over time, their physical health, mental health, pain, physical functioning, vitality and social functioning all improved when they did 150 minutes of moderate-intensity physical activity or 200 minutes of walking in an average week.

    More exercise was linked to greater improvements, but even low amounts of exercise had benefits.

    "The good news is that while the most benefits require 150 minutes per week of moderate-intensity physical activity or 200 minutes of walking, even smaller amounts . . . can improve well-being," Heesch said.

    Dr. Madhukar Trivedi, who holds the Betty Jo Hay Distinguished Chair in Mental Health at University of Texas Southwestern Medical Center in Dallas, said the study had some major strengths, including its large number of women, their physical and psychological improvements over time and the estimate of how much exercise was needed to improve quality of life.

    Trivedi, who was not involved in the study, also noted that it focused on women at "the very age where risks (for depression) are high."

    "It does improve quality of life. That is not a new finding but there remains skepticism in the culture that walking really does anything for depression or vitality - and this shows that it does," said Trivedi.

    He noted that the benefits in the study were much stronger in the immediate future than in the long run, and that being consistently and vigorously active proved most beneficial.

    These days, "more and more of these larger prospective studies are beginning to show that people with depression benefit from this," he said.

    But, Trivedi noted, more research should be done on how much exercise is needed to lift depression. He said research could become more objective by using new technology, such as iPhones, to monitor physical activity instead of relying on self-reports.

    "My speculation is that those women who did not see the benefit probably stopped or reduced their activity . . . it may be those are the women who need a more vigorous exercise to benefit," Trivedi said.

    SOURCE: http://bit.ly/1Cdrh5o American Journal of Preventive Medicine, online January 13, 2015.