Sudden death after arrest

Young men who die suddenly after being arrested by the police may be victims of a new syndrome similar to one that kills some wild animals when they are captured, Spanish researchers said on Tuesday.

Manuel Martinez Selles of Madrid's Hospital Gregorio Maranon reached the conclusion after investigating 60 cases of sudden unexplained deaths in Spain following police detention.

In one third of the cases, death occurred at the point of arrest, while in the remainder death was within 24 hours, Selles told the annual meeting of the European Society of Cardiology.

All but one of the casualties were male and their average age was just 33 years, with no previous history of cardiovascular disease.

"Something unusual is going on," Sells said.

Just why they died remains a mystery but he believes young men, in particular, may experience surges in blood levels of chemicals known as catecholamines when under severe stress.

Adrenaline is one of the most abundant catecholamines.

"We know that when a wild animal is captured, sometimes the animal dies suddenly," he said.

"Probably when these young males are captured it is very stressful and their level of catecholamines goes very high and that can finish their life by ventricular fibrillation (cardiac arrest)."

Selles compiled his study -- the first of its kind in any country -- by scouring Spanish newspapers for cases of unexplained death after police detention over the past 10 years.

Only sudden deaths with no clear causes were included and autopsy reports were checked to exclude the possibility of mistreatment or past serious medical conditions.

Twelve of the victims were drug users but Selles said this was not thought to have contributed to their deaths.

Jonathan Halperin of the Mount Sinai Medical Center in New York, who was not involved in the research, said the concept of a heart stress syndrome triggered by a flood of adrenaline or other chemicals was "a reasonable hypothesis".

"We all know stress is bad for you and this may be stress in the extreme," he said.

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Early weight gain may lead to hypertension

Babies who gain weight rapidly in the first months after birth may have an increased risk of developing high blood pressure as adults, British researchers said on Tuesday.

Researchers have been trying to understand more of the causes of high blood pressure, also called hypertension. Low birth weights also have been associated with an increased risk for high blood pressure later in life.

The new study sought to determine if growth patterns in the first five years of life also were associated with a risk of high blood pressure in adulthood. The researchers tracked 679 young adults around age 25 in Britain.

They found that those who gained weight more rapidly in the first five months after birth and again from about age 2 to 5 were more likely to have high systolic blood pressure.

Immediate weight gain after birth also was linked to higher adult diastolic blood pressure, they found.

Systolic blood pressure is the pressure in the arteries while the heart contracts. Diastolic blood pressure is the pressure when the heart relaxes between beats.

"When trying to understand why some people get high blood pressure in later life, we need to consider a life course approach that considers early life as well as adult life risk factors such as dietary salt and obesity," Yoav Ben-Shlomo of the University of Bristol in Britain, who led the study published in the journal Hypertension, said in a statement.

High blood pressure -- sometimes called the "silent killer" because it can go undetected for years -- raises a person's risk of heart disease and stroke.

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Gastric bypass anatomy leads to diabetes control

The rapid and substantial control of diabetes seen after gastric bypass surgery is due, at least in part, to the intestinal rearrangement involved in the procedure, the results of an animal study suggest.

Besides removing a substantial portion of the stomach, gastric bypass also attaches the output of the stomach to the lower intestines. The lower portion of the gut usually produces little glucose, but because of the direct input from the stomach it increases its production, French researchers report in the research journal Cell Metabolism.

The liver senses the higher level of glucose and reduces its own production of the sugar. Since the liver contributes much more to the body's overall glucose production than do the intestines, the net effect is enhanced glucose control, say Dr. Gilles Mithieux, from Universite de Lyon, and colleagues.

The increase in intestinal glucose formation was only noted with gastric bypass, not with gastric banding, which doesn't re-route the intestines. This may explain why only gastric bypass has been associated with enhanced diabetes control, the investigators conclude.

Furthermore, they note, sensors in the liver detect the elevated glucose and send an appetite-suppressing signal to the brain, which contributes to the satiety and weight loss seen with gastric bypass.

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Virus is passed from parent to child in the DNA

A virus that causes a universal childhood infection is often passed from parent to child at birth, not in the blood but in the DNA, U.S. researchers said on Tuesday.

They found that most babies infected with the HHV-6 virus, which causes roseola, had the virus integrated into their chromosomes. Not only that, but either the father or mother also had the virus in the chromosomes, suggesting it was a so-called germline transmission -- passed on in egg or sperm.

"This is really a unique mechanism for congenital infections," said Dr. Caroline Breese Hall, a pediatrician at the University of Rochester Medical Center in New York who led the study published in the journal Pediatrics.

Her team is now investigating what this means for the children.

"If you have a chromosome that has got a virus integrated into it, what does it mean? What does it do? Can it activate again? Can it start spewing out virus and cause problems? Can you get an immune response to it?" she said in a telephone interview.

The questions are critical because nearly everybody is infected with HHV-6. It is a herpes virus that causes roseola -- an infection marked by high fever and the usual vague virus symptoms that may include respiratory or stomach problems.

About 20 percent of children also have a characteristic sudden rash that appears just as the fever breaks.

Hall's team studied 250 infants, 85 with HHV-6. Of them, 43 were born with the virus and 42 were infected later.

Most of the babies born with the virus -- a congenital infection -- had the virus in the chromosome. Hall said the assumption had been that the virus somehow crossed the placenta from mother to child, but in 86 percent of cases, it was inherited directly in the genetic material.

Just 14 percent were infected across the placenta.

Tests showed either the mother or the father -- but not both -- also had HHV-6 in the chromosomes.

"Because we know a parent already had the virus in the chromosome, we know that it didn't spontaneously wiggle its way in once the baby got it," Hall said.

There were several spots where the virus integrated into the DNA, but usually right at the end of the chromosome, where a key structure called the telomere is found. Telomeres protect the chromosome and are involved in aging and immune response.

The virus is everywhere in people who inherit it, Hall said. "In your hair, your nails, your skin, your blood, and at very high titers (levels)," she said.

The babies infected this way did not appear ill but Hall wants to follow them as they grow up to see if they develop normally. They all had antibodies to HHV-6, which is evidence of an immune reaction of some sort.

There is no drug licensed to treat HHV-6 infection.

Other viruses are known to integrate into the DNA and pass on from parent to child, but these so-called human endogenous retroviruses have never been known to cause symptoms or activate an immune response.

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Exercise may improve memory in older people

Regular, moderate exercise may help improve memory in older people and delay the onset of dementia, a study in Australia shows.

The study, published in the Journal of the American Medical Association, involved 170 participants aged 50 and over who reported some memory trouble but who did not have dementia.

Half engaged in moderate exercise, such as walking, for 50 minutes three times a week, while the others did no exercise.

After six months, the participants were given memory and other tests, including recalling lists of words. Those who exercised fared markedly better than those who did not.

"The trial is the first to demonstrate that exercise improves cognitive function in older adults with subjective and objective mild cognitive impairment," according to the report.

"The benefits of physical activity were apparent after 6 months and persisted for at least another 12 months after the intervention had been discontinued."

With the ageing of populations everywhere, an estimated 37 million people worldwide now live with dementia, with Alzheimer's disease making up the majority of cases, according to the World Health Organization.

That figure is expected to increase rapidly over the next 20 years and researchers are looking for ways to help delay the onset of dementia.

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High blood calcium tied to lethal prostate cancer

Men with elevated levels of calcium in their blood may have a much higher risk of getting fatal prostate cancer, U.S. researchers said on Wednesday.

The findings indicate that a simple blood test may identify men at high risk for the most dangerous prostate tumors, and there already are drugs available that cut calcium levels in the bloodstream, the researchers said.

They tracked 2,814 men in a government health survey in which they gave blood samples that revealed calcium levels.

The men in the top third of blood calcium levels had 2.68 times the risk of developing fatal prostate cancer later in life compared to those in the bottom third, the study found.

"If serum calcium really does increase your risk for fatal prostate cancer, that's wonderfully exciting because serum calcium levels can be changed," Gary Schwartz of Wake Forest University School of Medicine, who helped lead the study, said in a telephone interview.

"One way to think of it is to think of the tremendous advances in the control of cardiovascular disease that occur from understanding that things like serum cholesterol predict heart attack," Schwartz added.

Doctors have struggled to find ways to predict if a man who gets prostate cancer will have a tumor that poses little danger, as is often the case, or one that is a killer.

Blood calcium was not very predictive of whether a man would get nonlethal prostate cancer, but was highly predictive of whether a man would get a fatal case, the researchers wrote in the American Association for Cancer Research's journal Cancer Epidemiology, Biomarkers & Prevention.

The blood samples on average were given a decade before the cancer appeared, the researchers said.

A COMMON CANCER

Prostate cancer is the second most commonly diagnosed form of cancer in men worldwide, with about 780,000 men diagnosed per year, and the sixth mostly deadly form in men, with about 250,000 deaths per year, the American Cancer Society said.

Schwartz said it is unclear whether it is the actual calcium or blood levels of parathyroid hormone, which is supposed to keep calcium levels at normal levels in the bloodstream, that is raising the risk.

Either way, he said there are drugs that can lower them, including Fontus Pharmaceuticals Inc's Rocaltrol, also called calcitriol; Genzyme Corp's Hectorol (doxercalciferol); Abbott Laboratories' Zemplar (paricalcitol); and Amgen Inc's Sensipar (cinacalcet).

People treated for high blood calcium usually have chronic kidney disease, which is associated with low vitamin D levels. Low vitamin D levels elevate parathyroid hormone levels, Schwartz said.

Halcyon Skinner of the University of Wisconsin, who also worked on the study, said there is little relationship between calcium in the diet and blood calcium levels, so these men would not benefit from eating less food rich in calcium.

Previous research had suggested a role for calcium in prostate cancer. In laboratory studies, parathyroid hormone and calcium promote the growth of prostate cancer cells.

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High doses of vitamin D safe for children

Giving school children very high doses of vitamin D is safe, and may be necessary to bring their blood levels of the nutrient up to the amount necessary for optimum bone growth and health, a new study shows.

Insufficiency in vitamin D is common in children around the world, but there is little data on how much supplementation kids need, or even how much vitamin D they should have in their blood, Dr. Ghada E.-Hajj Fuleihan of the American University of Beirut in Lebanon told Reuters Health. "In the pediatric literature, we don't have a lot to guide us," she said.

In a previous study, Fuleihan and colleagues found that giving 10- to 17-year-olds relatively high doses of vitamin D3 increased their bone mass and bone area, as well as lean mass. In the current study, they report on both the short- and long-term safety of high-dose supplementation.

The short-term study included 25 school children randomly assigned to receive a placebo or 14,000 international units (IU) of vitamin D3 per week for eight weeks. In the long-term study, 340 study participants took placebo, 1,400 IU weekly, or 14,000 IU a week, and were followed up at six and 12 months.

Currently, the Institute of Medicine recommends a daily vitamin D3 intake of 200 IU for children. The high dosage used in the current study was 2,000 IU daily, or 10 times that amount.

No signs of vitamin D intoxication were seen in any of the children, while levels of the vitamin in children treated short-term rose from 44 to 54 nanograms per milliliter (ng/mL).

In the long-term study, levels rose from 15 to 19 ng/mL in children given 1,400 IU weekly and from 15 to 36 ng/mL in the higher-dose group. Levels were initially higher in the short-term study because it was conducted among children in a higher socioeconomic group, and took place in the summer, when kids are likely to get ample sunshine and thus have adequate blood levels of the vitamin, Fuleihan and her team explain in the Journal of Clinical Endocrinology and Metabolism.

Based on studies in adults, Fuleihan said, blood levels of vitamin D below 5 ng/mL are agreed to represent deficiency, while levels above 20 ng/mL are considered adequate and most experts say 30 ng/mL is ideal.

Because every additional 100 IU of vitamin D3 consumed produces a roughly 1 ng/mL increase in blood levels, high doses may be needed for children with vitamin D insufficiency, the researcher said.

Nevertheless, she added, more research is needed to understand how much vitamin D children should be getting, and whether there are health effects of vitamin D insufficiency beyond bone and muscle, as studies in adults suggest.

"The pediatric literature is lagging maybe 10 to 15 years behind the adult literature in understanding the impact of low vitamin D on health," the researcher said.

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Lack of joy in life ups early death risk

People who don't think life is worth living are more likely to die within the next few years, research from Japan shows.

The increased death risk was mainly due to cardiovascular disease and external causes --most commonly, suicide.

The research is the largest to date to investigate how "ikigai," or "joy and a sense of well-being from being alive," affects mortality risk, and only the second to examine death from specific causes, according to Dr. Toshimasa Sone and colleagues from the Tohoku University Graduate School of Medicine in Sendai.

The investigators looked at 43,391 men and women 40 to 79 years old living in the Ohsaki region who were followed for seven years, during which time 3,048 died. All were asked, "Do you have ikigai in your life?" Fifty-nine percent said yes, 36.4 percent said they weren't sure, and 4.6 percent said no.

Those who didn't have a sense of ikigai were less likely to be married or employed, and were also less educated, in worse health, more mentally stressed, and in more bodily pain. They were also more likely to have limited physical function.

But even after the researchers used statistical techniques to adjust for these factors, people with no sense of ikigai were still at increased risk of dying over the follow-up period compared to people who did have ikigai. The relationship also was independent of history of illness and alcohol use.

Overall, people with no sense of ikigai were 50 percent more likely to die from any cause during follow-up compared to those who did have a sense that life was worth living. They had a 60 percent greater risk of death from cardiovascular disease, most commonly stroke, and were 90 percent more likely to die of "external" causes.

Of the 186 deaths due to external causes among study participants, 90 were suicides.

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Kids with older dads at higher bipolar risk

Children born to fathers older than 30 are more likely to develop bipolar disorder, a common condition sometimes known as manic depression, researchers reported on Monday.

The paternal risk also grows with the age of a father, rising to 37 percent by the time a man is 55 years, said Emma Frans, an epidemiologist at the Karolinska Institute in Sweden, who led the study.

The brain disorder causes extreme shifts in mood, energy and ability to function. It is marked by high periods of elation or irritability and low periods of sadness and hopelessness that can last months.

The findings published in the Archives of General Psychiatry bolster evidence that children of older fathers are at higher risk of psychological conditions such as bipolar disorder, autism and schizophrenia, the researchers said.

"Advanced paternal age is a risk factor for bipolar disorder in the offspring," Frans and colleagues wrote.

One explanation could be that a man's degraded sperm quality as he ages could increase the likelihood of genetic mutations that may lead to biopolar disorder, Frans said.

"Despite the robust evidence supporting the association between paternal age and severe mental disorders, the association between advanced paternal age and bipolar disorder has not been investigated," the team added.

The findings are another step toward unraveling the mystery of how the condition affecting an estimated 1 percent to 3 percent of adults worldwide arises, the researchers said.

Last month, an international research team linked two genetic variants to an increased risk for the disease, which is often treated with AstraZeneca Plc's blockbuster drug Seroquel. The condition often runs in families.

The Swedish researchers used a national medical registry to identify nearly 14,000 men and women diagnosed with bipolar disorder. For each person, they also randomly selected five people of the same sex and age without the condition.

After factoring for maternal age, the researchers found that children born to fathers older than 30 had an 11 percent higher risk of developing bipolar disorder compared to younger fathers. Children whose fathers were older than 55 had a 37 percent increased risk.

Frans said the findings did not mean that older men should not father children because the overall risk is still low, she added.

"The study sheds light on the negative effect of older fathers but most older men will still have healthy children," she said in a telephone interview.

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Study finds more allergic reactions after HPV jab

Young women in Australia who got a vaccine to prevent cervical cancer were five to 20 times more likely to have a rare but severe allergic reaction than girls who got other vaccines in comparable school-based vaccination programs, researchers said on Monday.

They said the severe allergic reactions to the human papillomavirus or HPV vaccine were unusual and manageable and that the vaccine remained safe.

The team of Australian researchers led by Dr. Julia Brotherton of The Children's Hospital at Westmead studied 114,000 young women vaccinated with Merck & Co's Gardasil vaccine as part of a 2007 vaccination program in New South Wales.

Of these, 12 had suspected cases of anaphylaxis, a potentially life-threatening allergic reaction that can cause difficulty breathing, nausea and rashes, they reported in the Canadian Medical Association Journal.

Eight out of the 12 young women had confirmed anaphylactic reactions after getting the vaccine, for an estimated rate of reaction of 2.6 per 100,000 doses administered. That compared with a rate of 0.1 per 100,000 doses in a 2003 school-based meningitis vaccination program.

Brotherton and colleagues suspect the higher rates of allergic reaction could be due to better surveillance programs to watch for such reactions, the higher tendency for young women to have such reactions compared with men and an apparent overall rise in the incidence of anaphylaxis in Australia.

Nevertheless, they said that the rates remain rare and should not discourage use of the vaccine, which targets four strains of the human papillomavirus, a common sexually transmitted virus that causes genital warts and most cases of cervical cancer.

"It's just a reminder that there are rare adverse effects," said Dr. Neal Halsey of Johns Hopkins University in Baltimore, who wrote a commentary on the study.

"It doesn't change the strong recommendations for all adolescent girls to get this vaccine but we just have to watch them to make sure they don't have this allergic reaction," he said in a telephone interview.

Last May, the U.S. Centers for Disease Control and Prevention said Gardasil has been associated with a higher risk of fainting, in some cases resulting in injury.

In the United States, Merck has distributed more than 16 million doses of Gardasil, which is approved for women and girls ages 9 to 26.

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High birth weight may raise brain tumor risk

Babies who are heavy at birth -- weighing more than 4000 grams (8.8 pounds) -- may have an increased risk for two of the most common types of brain tumors among children, German researchers report.

Astrocytomas, which form in the large cells of the nervous system, and medulloblastomas, which generally develop in the central part or within the hemispheres of the brain, account for up to about half of childhood brain tumors, note Dr. Thomas Harder and colleagues at Charite-Universitatsmedizin Berlin.

"Remarkably, for both of these types of childhood brain cancer ... high birth weight was significantly associated with increased tumor risk," Harder and colleagues report in the American Journal of Epidemiology.

The investigators found this association after looking at the combined findings from eight studies that involved more than 1.7 million children younger than 19 years old. Over 4000 of these children developed astrocytomas, medulloblastomas, or tumors in the cerebrospinal passageways of the brain known as ependymomas.

In studies reporting the development of astrocytomas, the researchers found that each 1000 gram (2.2 pound) increase in birth weight increased risk by 19 percent.

Studies reporting the development of medulloblastomas also showed a significantly increased risk among children who were heavy at birth, but risk did not appear to increase with increasing birth weight, as found with astrocytomas, the investigators note.

By contrast, they found no association between low birth weight and the development of these two tumor types; nor did they identify a link between birth weight and the development of ependymomas in the small number of studies reporting on this type of tumor.

Should follow up research find causal associations between high birth weight and childhood cancers, measures to decrease the incidence of high birth weight may be needed to curb the risk for brain tumors in children, Harder and colleagues conclude.

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