Frequent Soccer Ball Heading May Lead to Brain Injury

BRONX, N.Y., June 11, 2013 /PRNewswire-USNewswire/ Researchers at Albert Einstein College of Medicine (http://www.einstein.yu.edu/) of Yeshiva University have shown that soccer players who frequently head the ball have brain abnormalities resembling those found in patients with concussion (mild traumatic brain injury). The study, which used advanced imaging techniques and cognitive tests that assessed memory, was published online today in the journal Radiology.


We studied soccer players because soccer is the worlds most popular sport, said Michael L. Lipton, (http://www.einstein.yu.edu/faculty/148/michael-lipton/) M.D., Ph.D., associate director of Einsteins Gruss Magnetic Resonance Research Center (http://www.einstein.yu.edu/centers/gruss-magnetic-resonance-research/) and medical director of MRI services at Montefiore, the University Hospital and academic medical center for Einstein. Soccer is widely played by people of all ages and there is concern that heading the ball—a key component of the sport—might damage the brain.  Dr. Lipton is also associate professor of radiology, of psychiatry and behavioral sciences and in the Dominick P. Purpura Department of Neuroscience at Einstein.

On average, soccer players head the ball six to 12 times during games, where balls can travel at speeds of more than 50 miles per hour. During practice drills, players commonly head the ball 30 or more times. The impact from a single heading is unlikely to cause traumatic brain damage such as laceration of nerve fibers. But scientists have worried that cumulative damage from headings repeated subconcussive impacts might be clinically significant. Repetitive heading could set off a cascade of responses that leads to degeneration of brain cells over time, noted Dr. Lipton.

To study possible brain injury from heading, the researchers used diffusion tensor imaging (DTI), an advanced MRI-based imaging technique, on 37 amateur adult soccer players (median age 31 years) who had all played the sport since childhood. Participants reported playing soccer for an average of 22 years and had played an average of 10 months over the previous year. Researchers ranked the players based on heading frequency and then compared the DTI brain images of the most frequent headers with those of the remaining players. All participants also underwent cognitive testing.

DTI sees the movement of water molecules within and along axons, the nerve fibers that constitute the brains white matter. This imaging technique allows researchers to measure the uniformity of water movement (called fractional anisotropy, or FA) throughout the brain. Abnormally low FA within white matter indicates axon damage and has previously been associated with cognitive impairment in patients with traumatic brain injury.

The DTI findings pertaining to the most frequent headers in our study showed white-matter abnormalities similar to what weve seen in patients with concussion, said Dr. Lipton. Soccer players who headed the ball above a threshold between 885 to 1,550 times a year had significantly lower FA in three areas of the temporal-occipital white matter. Dr. Lipton noted that players with more than 1,800 headings per year were also more likely to demonstrate poorer memory scores compared to participants with fewer yearly headings.

Our study provides compelling preliminary evidence that brain changes resembling mild traumatic brain injury are associated with frequently heading a soccer ball over many years, said Dr. Lipton. While further research is clearly needed, our findings suggest that controlling the amount of heading that people do may help prevent brain injury that frequent heading appears to cause.

The study is titled Soccer heading is associated with white matter microstructural and cognitive abnormalities. Other Einstein scientists involved in the research were Namhee Kim, Ph.D., Molly E. Zimmerman, Ph.D., Mimi Kim, Sc.D., Craig A. Branch, Ph.D., and Richard B. Lipton, M.D. The authors declare no relevant conflicts of interest.

The research was supported by a grant from the National Institute of Neurological Disorders and Stroke (http://www.ninds.nih.gov/) and the Dana Foundation.


Simponi Five-Year Data

Janssen Biotech, Inc. announced today new five-year data from three pivotal Phase 3 studies evaluating SIMPONI ® (golimumab) 50 mg administered subcutaneously once every four weeks in the treatment of moderately to severely active rheumatoid arthritis (RA).  The new findings from open-label, long-term extensions of the pivotal registration trials are results from the use of SIMPONI in several RA populations.  The populations studied included patients naive to methotrexate, patients with active disease despite methotrexate (MTX) and patients who had previously received anti-tumor necrosis factor (anti-TNF) agents.  Among patients continuing treatment with SIMPONI 50 mg in combination with methotrexate or other disease-modifying antirheumatic drugs (DMARDs) through five years, between 60 and 85 percent of patients experienced at least a 20 percent improvement in American College of Rheumatology criteria (ACR 20) at the end of the treatment period. The findings are being presented at the 2013 European League Against Rheumatism (EULAR) Annual Congress.

These five-year data are important and provide rheumatologists insights into how patients living with a chronic inflammatory disease like rheumatoid arthritis may respond over time, said Josef Smolen, M.D., Professor and Chairman, Department of Rheumatology, Medical University of Vienna, Vienna, Austria and lead study investigator.  Golimumab continues to be an important therapeutic option for patients living with moderately to severely active rheumatoid arthritis.


For more information about the side effects of Simponi, see http://www.pharmacydrugguide.com/Simponi_Side_Effects


Six Tips For Great Health

The context in which an individual lives is of great importance on health status and quality of life. Health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. Here are some basic tips for maintaining good health.

  1. Exercise
    You dont have to belong to a gym club. Thirty minutes walk every day will to prevent weight gain and encourage moderate weight loss.
  2. Eat healthy
    Reduce fat intake, cut down on sugar and opt for fruits and vegetables. This helps reduce cholesterol and blood pressure. Healthy food will also lead to better blood sugar control.
  3. Reduce stress
    Not everything we want we get. We have to accept that there are things that we cannot control. Managing time is also of great importance too. We must allow ourselves enough time to get things done. Set a time during the day for relaxation.
  4. Improve sleep
    Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep. Equip your bedroom with a comfortable mattress and pillows. Sleep in a dark clean and quiet environment.
  5. Meditation
    Meditation has been linked to a variety of health benefits. It has been linked to changes in metabolism, blood pressure, brain activation, and other bodily processes.
  6. Positive thinking
    People who think positively have an optimistic view of life that affects their health and well-being. Optimism has been shown to explain between 5–10% of the variation in the likelihood of developing some health conditions, notably including cardiovascular disease,stroke, depression, and cancer.

BREO™ ELLIPTA™ gains US approval for the treatment of COPD

GlaxoSmithKline plc (LSE/NYSE: GSK) and Theravance, Inc. (NASDAQ: THRX) today announced that the US Food and Drug Administration (FDA) has approved BREO™ ELLIPTA™ as an inhaled long-term, once-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.  It is also indicated to reduce exacerbations of COPD in patients with a history of exacerbations.

BREO ELLIPTA is a combination of the inhaled corticosteroid (ICS), fluticasone furoate FF, and the long-acting beta2 agonist (LABA), vilanterol VI (FF/VI 100/25 mcg).

Darrell Baker, SVP & Head, GSK Global Respiratory Franchise, said, This approval means that we can now realise our plan to bring BREO ELLIPTA to appropriate COPD patients in the US.  We know that one of the main issues for patients who have experienced a COPD exacerbation is concern about possible future episodes.  BREO ELLIPTA will help patients breathe better day-to-day and reduce the risk of future exacerbations, with a once-daily inhalation.

The FDA approval of BREO ELLIPTA brings an important inhaled, once-daily maintenance therapeutic option to COPD patients and doctors across the United States, said Rick E Winningham, Chief Executive Officer of Theravance. After more than a decade of joint respiratory research and development, the approval is a very important milestone for Theravance and GSK.

Following this approval by the FDA, it is anticipated that BREO ELLIPTA will be available in the US during the third quarter of 2013.  Under the terms of the 2002 LABA collaboration agreement, Theravance is obligated to make a milestone payment of $30 million (USD) to GSK following FDA approval of BREO ELLIPTA.

The data submitted to the FDA to support the regulatory review of FF/VI included data from a comprehensive programme of non-clinical studies, 52 clinical pharmacology studies in 1,406 patients, and 11 clinical studies in 7,851 patients with COPD.  There were four primary COPD studies: two 6-month lung-function studies and two 1-year replicate exacerbation studies.


Over-diagnosis and over-treatment of depression is common in the U.S.

Americans are over-diagnosed and over-treated for depression, according to a new study conducted at the Johns Hopkins Bloomberg School of Public Health. The study examines adults with clinician-identified depression and individuals who experienced major depressive episodes within a 12-month period. It found that when assessed for major depressive episodes using a structured interview, only 38.4 percent of adults with clinician-identified depression met the 12-month criteria for depression, despite the majority of participants being prescribed and using psychiatric medications. The results are featured in the April 2013 issue of Psychotherapy and Psychosomatics.

“Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering,” said Ramin J. Mojtabai, PhD, author of the study and an associate professor with the Bloomberg School’s Department of Mental Health. “Among study participants who were 65 years old or older with clinician-identified depression, 6 out of every 7 did not meet the 12-month major-depressive-episodes criteria. While participants who did not meet the criteria used significantly fewer services and treatment contacts, the majority of both groups used prescription psychiatric medication.”

Using a sample of 5,639 participants from the 2009-2010 United States National Survey of Drug Use and Health, Mojtabai assessed clinician-identified depression based on questions about conditions that the participants were told they had by a doctor or other medical professional in the past 12 months. The study indicates that even among participants without a lifetime history of major or minor depression, a majority reported having taken prescription psychiatric medications.

“A number of factors likely contribute to the high false-positive rate of depression diagnosis in community settings, including the relatively low prevalence of depression in these settings, clinicians’ uncertainty about the diagnostic criteria and the ambiguity regarding sub-threshold syndromes,” said Mojtabai. “Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings.  The new data suggest that the under-diagnosis and under-treatment of many who are in need of treatment occurs in conjunction with the over-diagnosis and over-treatment of others who do not need such treatment. There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.”

“Clinician-Identified Depression in Community Settings: Concordance with Structured-Interview Diagnoses,” was written by Ramin J. Mojtabai.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or [email protected].