The collapse of the firm responsible for collecting NHS clinical and human waste in Scotland has sent costs soaring.

Physical fitness is good for the heart, brain and overall health. But a specific type called cardiorespiratory fitness may help predict the odds of having a heart attack, especially for women, new research shows.

Higher cardiorespiratory fitness translated to lower heart attack risk, with women appearing to benefit the most. The findings suggest “cardiorespiratory fitness can be used as a risk calculator for first heart attacks,” said Rajesh Shigdel, lead author of the Norwegian study published Wednesday in the Journal of the American Heart Association.

Length and intensity of physical activity

“Measuring cardiorespiratory fitness will tell you which risk group you are in,” said Shigdel, a researcher in the Department of Public Health and Nursing at Norwegian University of Science and Technology in Trondheim, Norway.

Cardiorespiratory fitness reflects the body’s ability to transport oxygen during sustained physical activity. It can be measured using VO2 max, the maximum amount of oxygen the body can use during exercise. A higher VO2 max indicates higher cardiorespiratory fitness.

Relying on data from one of the largest health studies ever performed, Shigdel and his team estimated cardiorespiratory fitness for more than 26 000 Norwegians who were 56 years old on average and free of heart disease when the study began. Researchers tracked their health for up to 15 years.

Because VO2 max scores were not available for all participants, researchers estimated cardiorespiratory fitness based on the length and intensity of physical activity each week. Among women, those with high levels of cardiorespiratory fitness were 25% less likely to have a first heart attack than those with low levels, whereas men with high levels of fitness were 10% less likely to suffer a heart attack than those in the low fitness group.

People who want to increase cardiorespiratory fitness should strive to be physically active at least 150 minutes each week and minimise time spent being sedentary, Shigdel said.

But that doesn’t have to mean spending hours at the gym each day. “Those who are somewhat active will still have some benefit,” he said. “It’s better to have something than nothing.”

Heart attacks are not always fatal

It’s unclear why exercise affects men and women differently, said Dr Aaron L. Baggish, director of the Cardiovascular Performance Program at Massachusetts General Hospital in Boston. But he cautioned against placing too much weight on the finding that women reaped a greater protective benefit than men.

“The take-home message for this study should not be that fitness doesn’t matter for men,” said Baggish, who wrote an editorial accompanying the study. “The message should be that the fitter you are, the less likely you are to have your first heart attack.”

Previous studies have consistently shown higher levels of cardiorespiratory fitness are associated with fewer heart problems. However, most prior studies either haven’t included women or didn’t report findings by gender, said Shigdel, despite the fact that heart disease behaves differently in women versus men. For example, women ages 45 and older are more likely to die within a year of a first heart attack than men of the same age.

Most research also has looked only at whether fitness was related to a higher risk of death from cardiovascular disease, rather than a first heart attack – an important distinction because heart attacks are not always fatal. “Our results are better suited for assessing disease risk,” the authors noted.

In terms of cardiovascular risk, Baggish warned against focusing on physical fitness at the exclusion of other factors. It is equally important, he said, to quit smoking, eat a diet rich in fruits and vegetables, stay away from processed foods and avoid stress.

“If you have high blood pressure, high cholesterol and other risk factors, you can’t exercise yourself out of trouble,” he said. “Nobody can exercise enough to get complete immunity from heart disease.”

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Chronic fatigue syndrome is such a mysterious illness that it took years to be recognised as a legitimate ailment, and doctors still struggle to accurately diagnose it.

Now, an experimental blood test has successfully spotted the syndrome, also known as CFS, in a finding that hopefully provides new insights into the inscrutable illness.

No lab test

The test tracks changes in the electrical pattern of a person’s cells, and it accurately flagged all CFS patients in a small group of 40 people, researchers report.

“When we stress the cells, we can easily differentiate them based on the signal they are showing,” said lead author Rahim Esfandyarpour. “It’s a huge difference.”

Esfandyarpour worked on the test with a team while at Stanford University in California. He’s now an assistant professor of electrical engineering and computer science at the University of California, Irvine.

Currently, doctors must diagnose CFS based on the symptoms a patient has developed. There’s no lab test that can provide a definitive diagnosis.

“There is no biomarker or diagnostic tool,” Esfandyarpour said. “It’s all based on the symptoms.”

Sometimes people are even told it’s all in their imagination. As many as 2.5 million Americans suffer from CFS, and 9 of 10 have not been diagnosed, according to estimates from the US Centers for Disease Control and Prevention.

Electrical activity of cells

One of the classic CFS symptoms is extreme fatigue that occurs after a person exerts themselves, either physically or mentally, researchers said in background notes.

Esfandyarpour and the Stanford team hypothesised that this fatigue might occur all the way down to the cellular level, with a CFS patient’s blood cells responding to stress in a more sluggish manner than those of healthy people.

So they created a way to track the metabolism of cells by observing their electrical activity.

Cells are exposed to a dose of salt, placing them in a state of stress.

Researchers then run an electrical current through the cell samples, to see how stress affects the cells’ response to the current. Big changes in current indicate that the blood cells are flailing under stress, unable of mustering a proper response — a sign they are potentially hampered by CFS.

All blood samples from 20 CFS patients created a clear spike in the test, while those from 20 healthy controls indicated that they were better at handling stress.

More research needed

The test needs further examination in larger patient pools, both to verify its accuracy and to better understand what’s happening to these cells, Esfandyarpour said.

“We know we see a big difference between CFS patients and healthy controls, but we still need to run more experiments to understand the contributing mechanisms behind this result we’re observing and make sure this response is specific to CFS,” Esfandyarpour said.

Mayo Clinic chronic fatigue expert Dr Phil Fischer noted that the new test reveals a “striking difference between fatigued patients and healthy control patients”.

But Fisher, who wasn’t involved with the study, agreed more research is needed to hone in on exactly what’s happening here.

“We don’t yet know if the difference is from the chronic fatigue or due to a secondary consequence of fatigue such as reduced physical exercise,” said Fischer. “We don’t yet know how this marker would change from the beginning of the fatigue until later, and we don’t know if it would be affected by treatment. We also don’t yet know just what this marker means for potential targeted treatment.”

A ‘real product’

The ultimate goal is to create a portable, hand-held and easy-to-use device that would allow doctors to easily detect CFS, Esfandyarpour said.

“Hopefully it’s not going to be just a study and never have any real practical platform,” Esfandyarpour said of these results. “We are trying to push it to become a real product that can be used by physicians.”

The device also could be used to lab-test drugs for treating CFS prior to clinical trials, Esfandyarpour added.

The findings were published online in the Proceedings of the National Academy of Sciences.

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Ira Goodman woke up in the middle of the night drenched with sweat. His head pounded like nothing he’d experienced in all his 31 years. The room spun and he felt extremely nauseous.

He’d eaten an enchilada the night before, so he figured these were symptoms of food poisoning.

Worse than food poisoning

He stumbled to the bathroom, vomited and returned to bed. He slept fitfully. By the time morning arrived, he’d staggered to the bathroom several times, once falling into a wall and sending a framed photograph crashing to the floor.

The next day, Ira called his father, Marc Goodman, and described his symptoms, which included feeling dehydrated. Marc stopped by that evening to deliver some Gatorade.

“The way he looked, and with that headache, it seemed a lot worse than food poisoning,” Marc said.

He decided to take his son to the emergency room of the NYU Medical Center. On their way from the apartment building, Ira was so limp that Marc had to prop him up.

Doctors had no idea what was wrong with Ira until they performed a CT scan and an MRI of his brain and neck.

“Your son had a major stroke,” doctors told Marc.

Mounting problems

Doctors concluded that Ira had torn or damaged the inner lining of an artery in his neck, which is called a vertebral artery dissection. It causes a clot to form, which expands until it suppresses blood flow to the brain. They had no idea why it happened to Ira.

The next day, problems mounted. Damage from the stroke was causing fluid to build up in Ira’s brain, causing dangerous pressure.

“They said they had to drain it and that Ira had a 50-50 chance of making it, which is not what you want to hear with your child,” Marc said.

The procedure was successful. In a few days, Ira was transferred from the neurosurgery ICU to the stroke unit.

“Amazingly, I felt normal pretty quickly,” Ira said. “I had headaches and was tired, but that was to be expected. I was definitely the youngest patient – about the same age as many of my doctors.”

He was sent to the rehabilitation wing for five days of balance and occupational therapy, which to him felt unnecessary. Again, he was the youngest patient around. So many friends visited that he was moved to a different room, so as not to disturb his elderly roommate.

Ascending aortic aneurysm

Within a few months, Ira made a full recovery.

“Honestly, I felt even healthier than before,” he said, though he was shaken by the fact he could have died.

Three and a half years later, Ira was 35 and undergoing a routine physical that led to the discovery of a new problem: an ascending aortic aneurysm, an abnormal bulge in the wall of the aorta, the major blood vessel that carries blood from the heart to the body. Because Ira had no earlier chest MRI to compare it to, a cardiac surgeon advised him to wait six months to check it again.

Ira didn’t like that idea. So he saw an aorta specialist.

“He told me I could be fine forever, but there was no way of knowing,” Ira said. “It could just tear or burst.”

Rather than wait for the worst-case scenario, Ira underwent an operation in which the damaged section of his aorta was replaced with a synthetic graft.

As with the stroke, doctors aren’t sure what caused the aneurysm.

A strong fundraising story

Ira is now 39 and back to being physically active. He plays softball, golf, tennis and goes to the gym.

He’s also active with the American Heart Association’s Young Professionals Committee in New York City, which works to raise awareness and funds for heart and stroke issues and research. He values the friends he’s made through the group.

“Everything I’ve been through is a part of me now, but not everyone can relate to it,” he said. “It’s nice to have friends who can.”

Not only is Ira the chair of the group’s board, he’s been their top fundraiser for the past two years, raising around $15,000 (R218 000) each year through their main event, the Young Professionals Red Ball.

“People ask, ‘What’s your secret?'” he said. “A stroke and an aneurysm by the time I was 35? That combination makes for a strong fundraising story.”

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Calls grow for inquiry into accusations that families are inventing children’s illnesses.

A fainting episode causing traumatic nerve damage affecting his right hand could be why Leonardo da Vinci’s painting skills were hampered in his late career. While the impairment affected his ability to hold palettes and brushes to paint with his right hand, he was able to continue teaching and drawing with his left hand. According to most authors, the origin of da Vinci’s right hand palsy was related to a stroke.

The brain’s capacity for simultaneously learning and memorizing large amounts of information while requiring little energy has inspired an entire field to pursue brain-like — or neuromorphic — computers. Researchers at Stanford University and Sandia National Laboratories previously developed one portion of such a computer: a device that acts as an artificial synapse, mimicking the way neurons communicate in the brain.

Have you started feeling like your allergies are acting up earlier every year, or maybe they’re lasting longer?

New research suggests it’s not just your imagination – climate change appears to be disrupting nature’s usual calendar. Areas with an earlier spring had a 14% higher rate of seasonal allergies (hay fever), the researchers found.

High-resolution satellite data

“Climate change is real. It’s impacting our ecosystem now, and that, in turn, is impacting our health,” said study author Amir Sapkota. He’s an associate professor at the Maryland Institute for Applied Environmental Health in College Park, Maryland.

For the study, the investigators used high-resolution satellite data provided by NASA to identify the start of spring throughout the United States. They linked this information to data from a nationally representative sample of Americans collected by the US Centers for Disease Control and Prevention.

Sapkota said the researchers looked at what happened if spring began earlier or later than normal.

“When spring starts early, the burden of allergic disease – or hay fever – goes up. But we also saw high hay fever prevalence when spring was late, too. It’s like mortality with extreme temperatures. Temperatures that are very hot or very cold can kill us. There’s a sweet spot that’s OK,” Sapkota explained.

If the season starts early, trees bloom and release pollen earlier than usual and may release pollen for a longer time. “This is not a good thing if you’re suffering from allergies,” he said.

Changes aren’t uniform

Sapkota said the findings for increased problems if spring was delayed were a surprise. He doesn’t know exactly why the late spring would make allergies worse, but suspects it may be because everything then blooms at once – trees, flowers, grasses.

“All of a sudden, things go gangbusters at one time. The season may end up shorter, but you’re bombarded by it,” he said.

Dr John Balbus, senior advisor for public health at the US National Institute of Environmental Health Sciences, reviewed the study.

He said, “This is the first confirmation from health data that changes in the length and timing of spring could lead to a higher prevalence of allergy symptoms.”

Balbus said the changes in spring’s timing aren’t uniform across the United States. “There’s a trend over time to earlier pollen seasons as you go up to more Northern latitudes attributable to climate change. It’s up to a few weeks earlier by the Canadian border, but not so much in Texas,” he noted.

More medication may be necessary

But an earlier spring isn’t always the case. “What we are seeing in a lot of meteorological data is a trend to increasing variability,” Balbus said. For example, the East Coast had a colder winter due to a drop in the polar vortex, which may delay the blooming season.

So what does all this mean for allergy sufferers?

Allergist Dr Punita Ponda from Northwell Health in Great Neck, New York, said, “For most allergy sufferers, the old dogma of starting preventive medications in mid-March or so is not going to be enough.”

She said people with spring allergies will have to start paying attention to pollen counts in April and may need to start taking their allergy prevention drugs in late February if pollen counts start spiking. And, she said, they may need to continue taking these medications until at least mid-June.

“They may need to take medications for longer. And for brief periods of time, more medication may be necessary,” she said. She advised people to contact their doctor for specific instructions based on their situation.

The report was published online recently in the journal PLoS ONE.

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More than a quarter of people who could benefit from taking statins don’t, and a new survey suggests that while not enough doctors are prescribing the cholesterol-lowering drugs, fears about side effects also play a part.

“There is so much misinformation about statins in the media that it’s clearly permeated and now is affecting people’s ability to take these medications and improve their cardiovascular health,” said lead author Dr Corey Bradley. She’s a researcher at the Duke Clinical Research Institute in Durham, North Carolina.

Side effects

The new survey focused on almost 5 700 older adults who’d been recommended for statin therapy, based on data kept in a national registry that tracks cholesterol management and heart disease treatment.

Popular prescribed statins include atorvastatin (Lipitor), rosuvastatin (Crestor), pravastatin (Pravachol) and simvastatin (Zocor).

More than 26% of the patients, 1 511, were not taking statins even though they’d benefit from them, the survey revealed.

About 3% of those not taking statins said they’d tried the drugs but stopped, and another 10% said they turned down the medication outright when a doctor recommended it, researchers found.

Side effects were the most common reason given by these folks, and they were less likely to believe statins are safe than people who used the medication.

However, there’s also strong evidence that doctors aren’t doing everything they can to prescribe these medications for those who need them.

Ineffective conversations

Fifty-nine percent of adults not taking statins said they weren’t because a doctor had never offered them a prescription.

It’s possible that some of these people were offered statins and forgot, but that in itself is damning, Bradley said.

“If a patient didn’t remember the conversation, it likely wasn’t an effective one,” she said. “We need to improve the way we frame these conversations and continue to have them.”

The findings were published in the Journal of the American Heart Association.

Bad or misleading information circulating about statins is overwhelming doctors’ efforts to get patients to take the cholesterol-fighting medications, said Dr Nieca Goldberg, who wasn’t involved with the study. She’s a cardiologist and medical director of the NYU Langone Joan H. Tisch Center for Women’s Health in New York City.

Estimates are that about one in every 10 patients have a side effect from statins, Goldberg said. Muscle aches are the most commonly reported side effect.

Better ways to talk about statins

Despite this, clinical trials have shown that the difference in muscle ache symptoms between people on statins and those taking placebos is less than 1%, and about 0.1% for people who stopped taking statins due to muscle pain, according to a December review published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

“When patients get a new medicine, they discuss it with their friends or they look it up online, and they get so much information,” Goldberg said. “Some of patients who really are concerned about taking the medicine are really only focused on the side effects. They go online and get the side effects of the medicine, and that data is not put into perspective for them by anyone.”

Patients were more likely to report never being offered a statin if they were female (22% higher odds), black (48% higher), or uninsured (38% higher). Those seen by a cardiologist were more likely to be offered a statin than those in primary care.

Bradley and Goldberg said doctors need to come up with better ways to talk with patients about statins and the drugs’ perceived side effects, especially if the person has stopped taking them.

Continuing dialogue

Despite their concerns, about 60% of the patients who stopped taking a statin would consider retrying it, the survey showed.

“We have a tendency to view that if a patient stops a medication they were previously on, then that’s a closed door,” Bradley said. “This study suggests we should re-engage with the patient and discuss their concerns.”

Goldberg said she encourages her patients to forward their questions and concerns through a secure internet portal, “so there’s a continuing dialogue.

“We don’t start the day wanting to prescribe medicine to everyone, but we do want to lower a person’s risk, and sometimes lowering risk for heart disease involves not only diet and exercise, but needing a medication,” Goldberg said.

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Health Secretary says he will “consider all options” to boost child immunisation uptake in England.