Harvard Health Blog

Some encouraging Alzheimer’s news from Sweden: a vaccine called CAD106 appears to be safe and ramps up the body’s immune system against a protein likely involved in Alzheimer’s. The hope is that this vaccine will slow the progression of Alzheimer’s disease, and possibly even stop it. The vaccine is designed to activate the body’s immune system against beta amyloid, a protein fragment that forms deposits called amyloid plaques between nerve cells in the brain. Three-quarters of those who received CAD106 developed antibodies against beta amyloid protein. Virtually all of them—including those getting the placebo—reported one or more side effects, ranging from inflammation of the nose and throat to headache, muscle pain, and fatigue. None, though, developed meningoencephalitis, an inflammation of brain tissue that derailed work on an earlier version of the vaccine. The next step in the development of CAD106 is a larger clinical trial to confirm the vaccine’s safety and to see if it is effective at slowing the relentless progression of Alzheimer’s disease.

Fifty years ago this week, the first installment of Silent Spring appeared in the pages of The New Yorker. The book, published a few months later, was a sustained, meticulously reported account of the toll that widespread aerial spraying of DDT, dieldrin, aldrin, chlordane, heptachlor, and other synthetic pesticides was taking on birds, raccoons, fish, bees, and even the supposed beneficiaries of spraying—humans. Silent Spring is often portrayed as a book about saving birds and other wildlife. Another important theme is the essential but fragile connections between environmental health and human health. Silent Spring was instrumental in banning the use of many dangerous pesticides. It helped spark the modern environmental movement, launch the Environmental Protection Agency, and pass the Clean Water Act and the Endangered Species Acts. It is in the Modern Library’s 100 best nonfiction books, and Discover magazine named it one of the 25 greatest science books of all time.

Millions of people depend on the blood thinner warfarin to prevent clots from forming in their blood. It’s an important drug, but tricky to use. One problem with warfarin (Coumadin, Jantoven, generic) is that it interacts in potentially harmful ways with other medications. Two problematic types are antibiotics and antifungal agents. As we write in the June issue of the Harvard Heart Letter, this isn’t just a problem with pills, but can also happen with ointments, creams, and suppositories. Adding an antibiotic such as cotrimoxazole, cephalexin, or penicillin, or an antifungal medicine such as itraconazole or ketoconazole on top of warfarin can heighten warfarin’s blood-thinning ability. This raises the risk of internal bleeding or sustained bleeding after an injury.

Exercise makes cells burn extra energy—that’s one way it helps control weight. It also generates a newly discovered hormone, called irisin, that transforms energy-storing white fat cells into energy-burning brown fat cells. Irisin also appears to help prevent or overcome cellular changes that lead to type 2 diabetes. The hormone does this by helping transform energy-storing white fat cells into energy-burning brown fat cells. White adipose tissue, more commonly known as body fat, is the tissue that dimples thighs, enlarges waists and derrieres, and pads internal organs. Each white fat cell stores a large droplet of fat. Brown fat, in comparison, is chock full of energy-burning mitochondria. Its main function is to generate body heat by burning fat. A team led by Dr. Bruce Spiegelman, professor of cell biology and medicine at Harvard Medical School, has identified irisin in mice and humans and showed how irisin transforms white fat cells into brown ones, at least in mice.

The symptoms of a stroke are sometimes obvious, like numbness or weakness on one side of the face, trouble speaking, difficulty walking, and vision problems. Some strokes, though, pass completely unnoticed—at least right away. But as reported in the June issue of the Harvard Women’s Health Watch, the damage these so-called silent strokes cause to fragile brain tissue can have significant and lasting effects on memory. Although silent strokes don’t cause any obvious symptoms, the interruption in blood flow to the brain can harm the processes needed to form or recall memories, especially if several of them occur over time. You can help prevent silent strokes the same way you others, by controlling blood pressure and cholesterol, not smoking, eating a healthy diet, and exercising.

Aspirin, ibuprofen, and naproxen can subdue a pounding headache and ease arthritic aches. Could these and other nonsteroidal anti-inflammatory drugs (NSAID) serve double duty, protecting against skin cancer even while they relieve pain? A new study published online in the journal Cancer suggests they might. But based on the current evidence, cancer prevention alone doesn’t […]

When you polish off a piece of chocolate cake and immediately start thinking about having another, you might suspect that eating for pleasure may trigger overeating. A new study out of Italy, where they know a thing or two about good food, supports this notion. Researchers from Naples and Salerno found that eating for enjoyment […]

Calcium supplements are being called on the carpet after new research showed they significantly increased risk of heart attack among women getting extra calcium from pills, but not among those who got their calcium from food. What’s the connection? Over time, calcium can accumulate in arteries. It also builds up in plaque, the cholesterol-filled pockets that can cause angina or a heart attack. Three Harvard professors say the new study doesn’t prove that calcium supplements cause heart disease, but advocate that it’s almost always best to get vitamins and minerals from food, not pills.

Every Memorial Day we remember the men and women who died while serving in the United States Armed Forces. We do this with parades, church services, and placing flags on graves. Another way to honor the fallen is by paying attention to the physical and mental health of those who served and returned. A three-month […]

Breast cancer isn’t just a woman’s disease. Men can get it, too—about 1% of breast cancer is diagnosed in men. Since few men know that, they often fail to recognize its earliest signs and end up seeing a doctor later in the process than women do. The result: Men face treatment for larger and more advanced tumors, and their cancer is more likely to have spread to other parts of the body. The largest study to date on outcomes in men with breast cancer indicates that the five-year survival rate for women with breast cancer was 83%, compared to 74% for men. Even men diagnosed with early stage breast cancer still fared worse than women, although the gap closed for men and women diagnosed with later-stage disease. Since breast cancer in men isn’t often on doctors’ radar screens, men should be aware and check themselves.

Yesterday’s announcement that men should not get routine PSA tests to check for hidden prostate cancer is sure to spark controversy for months to come. But the U.S. Preventive Services Task Force (USPSTF) made the right decision. On the surface, rejecting the use of a simple blood test that can detect cancer in its early and still-treatable stage sounds foolish. Cynics have been saying it is the handiwork of a group concerned more about health-care rationing and cutting costs than about health. The decision is wise, not foolish, and will improve men’s health, not harm it. The word “cancer” usually brings to mind images of a fast-growing cluster of cells that, without aggressive treatment, will invade other parts of the body, damage health, and potentially kill. That certainly describes many cancers. But not most prostate cancers. Most of the time, prostate cancer is sloth-like. It tends to grow slowly and remain confined to the prostate gland, with many men never knowing during their entire lives that a cancer was present. These slow-growing prostate cancers cause no symptoms and never threaten health or longevity. That means many men with prostate “cancer” never need treatment.

A simple blood test to check seemingly healthy men for hidden prostate cancer does more harm than good and shouldn’t be part of routine medical care. That’s the long-awaited final recommendation from the United States Preventive Services Task Force (USPSTF), published today in Annals of Internal Medicine. About half of men over age 40 get this test as part of a regular checkup. It measures the amount of a protein called prostate-specific antigen, or PSA, in the bloodstream. An above-normal PSA level can signal hidden prostate cancer. But it can also be a sign of prostate infection, an enlarged prostate, and other problems. Hunting for hidden disease in the absence of any outward signs or symptoms is called screening. The task force says that for every 1,000 men who have routine PSA tests, 0 to 1 deaths from prostate cancer will be prevented. But that is offset by 3 serious cardiovascular deaths due to treatment, along with 47 men who will live with treatment-related erectile dysfunction or incontinence.

Since bisphosphonates such as alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), and zoledronic acid (Reclast) were first introduced in the mid-1990s, they’ve become a staple of osteoporosis treatment. Yet an FDA review recently published in The New England Journal of Medicine questions whether there’s any benefit to staying on these drugs long-term—especially considering their potential for side effects. A report released today in the Archives of Internal Medicine highlights one of those side effects, linking bisphosphonate use to a higher risk of unusual fractures in the femur (thighbone). If you’ve been taking bisphosphonates long-term, you may be wondering, “What now?” If you’ve been taking bisphosphonates for less than five years you probably don’t need to change what you’re doing. But if you’ve been on these drugs for more than five years, talk to your doctor about whether it’s worth continuing.

Millions of people with heart disease who take the blood thinner clopidogrel (Plavix) can now look forward to having fatter wallets. Plavix lost its patent protection this month, and on May 17 the Food and Drug Administration gave several companies the okay to sell its generic form. Clopidogrel users can now buy brand-name Plavix for a premium price, or equally effective generic clopidogrel in a 75-mg dose at a much lower cost. The change may also save lives. “We have seen more than a few patients have heart attacks because they had stopped taking clopidogrel due to the expense,” said Dr. Thomas Lee, professor of medicine at Harvard Medical School and Co-Editor in Chief of the Harvard Heart Letter. “I think the lower price is going to save some lives.” Before a company can sell a generic version of a drug, it must prove to the FDA that the drug is as effective and safe as the original.

In an effort to stem the smoldering epidemic of hepatitis C, the Centers for Disease Control and Prevention is proposing today that all Baby Boomers—anyone born between 1945 and 1965—have a one-time test for hepatitis C. This widespread but often silent disease can lead to liver damage, and even death.

A new series of books is bringing readers the kind of inspirational stories that have made Chicken Soup for the Soul books international bestsellers plus with trusted health advice from Harvard Medical School. The combination of stories providing hope, inspiration, and great person-to-person advice plus straight talk and life-changing medical information from Harvard doctors will help readers live healthier, more satisfying lives. Each book focuses on a single topic. The first four will be available beginning May 22, 2012. They are Chicken Soup for the Soul: Boost Your Brain Power! by top neurologist Dr. Marie Pasinski; Chicken Soup for the Soul: Say Goodbye to Back Pain! by leading physical medicine expert Dr. Julie Silver; Chicken Soup for the Soul: Say Goodbye to Stress! by noted psychologist Dr. Jeff Brown; and Chicken Soup for the Soul: Say Hello to a Better Body! by respected internist Dr. Suzanne Koven.

An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.

The other day I saw a mother hand an iPhone to a young baby in a stroller. I cringed because it made me think of how much time my young kids spend on the iPad and in front of the TV. It’s a dilemma for parents. Is it okay to let your daughter play with your phone so you can get five minutes of quiet in a restaurant, or will that permanently scuttle her attention span? Ann Densmore, Ed.D., an expert in speech and language development and co-author of Your Successful Preschooler, offers some practical advice for parents. “Screen time is here to stay for young children and we can’t stop it,” she told me. “The world is now inescapably online and digital. Even schools are replacing textbooks with iPads and digital texts. So moms and dads really need to figure out what’s right for their families.”

Over the past decade, the percentage of Americans with high cholesterol has been declining, from 19.1% to 14.3% of women, and 17.2% to 12.2% of men, according to a new report from the National Center for Health Statistics. Where we’re falling short is in checking our cholesterol. About 70% of women and 66% of men had their cholesterol tested in the past 5 years—slightly under the 80% objective. If your numbers aren’t quite where they should be, there are a number of ways you can help bring them back into a healthy range. Many people turn to a statin or other cholesterol-lowering medication. But it makes sense to try diet and exercise first.

Surviving cancer was once a challenging achievement. Today, more than 12 million Americans are cancer survivors, and many live long after their diagnoses. New guidelines from the American Cancer Society (ACS) offer them science-based advice for eating better and staying active—two keys to healthy living for cancer survivors and everyone else. The report, called Nutrition and Physical Activity Guidelines for Cancer Survivors, is available for free from the ACS website. The guidelines provide specific advice for survivors of a variety of major cancers: prostate, colorectal, lung, breast, ovarian, endometrial, upper GI, head and neck, and hematologic. They urge cancer survivors to maintain a healthy weight, avoid inactivity and return to normal daily activities as soon as possible following diagnosis, eventually aim to exercise at least 150 minutes per week, and follow an eating pattern that is rich in vegetables, fruits, and whole grains.