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Cholesterol drug cuts amputation risk for diabetics



Sunday, May 24, 2009
The anti-cholesterol drug fenofibrate appears to reduce risks of amputation for diabetics by as much as 36 percent, a study has found.

The study was published in a special edition on diabetes by The Lancet, which included another study on how rigorous monitoring and control of blood sugar reduces heart attacks. In the first study, researchers in Australia ran a 5-year trial involving 9,795 diabetic patients. 4,895 of them were given fenofibrate, produced by Belgian drugs maker Solvay, while the rest were given a placebo.

By the end of the trial, 115 patients had had lower-limb amputations. The risk of first time amputation was 36 percent lower for patients given fenofibrate compared with a placebo. “Treatment with fenofibrate was associated with a lower risk of amputations, particularly minor amputations (below the ankle),” wrote the team, led by Anthony Keech and Kushwin Rajamani at the National Health and Medical Research Council Clinical Trials Center, University of Sydney, Australia. “These findings could lead to a change in standard treatment for the prevention of diabetes-related lower-limb amputations.”

An amputation due to diabetes occurs every 30 seconds around the world and imposes a huge burden not only on the victims and their families, but healthcare systems too.

High blood sugar can damage nerves and blood vessels in the lower extremities that can lead to gangrene. Severe damage might require toe, foot or even leg amputation.

Curing restless legs: Restless leg syndrome (RLS), or Ekbom syndrome, as it is sometimes known, is a common cause of sleep disturbance that is thought to affect at least one British adult in 20 to some degree.

The classic symptom, first described by the Swedish neurologist Karl Ekbom in 1945, is an intense, irresistible urge to move the legs, often accompanied by a creeping sensation under the skin. It is typically worse when at rest, is temporarily relieved by movement and generally becomes a problem in the evening or in bed.

RLS can occur at any age, including childhood, but most cases develop in people over 40 and it is a problem mainly in women. Surprisingly, little is known about the underlying cause of RLS but there is thought to be a strong genetic component and there is often a strong family history of similar problems in parents or siblings. It has been shown to be more common during pregnancy, in people who have low levels of iron in their bodies, and may be linked to folic acid and magnesium deficiencies.

There is no definitive test for RLS but most GPs will do a set of routine blood tests, which, among other things, can be used to rule out iron deficiency. It is also important to take a detailed drug history, as RLS may be a side-effect of various commonly used medicines such as cold and flu remedies, antihistamines and drugs used to treat nausea, depression and schizophrenia.

Treatment involves a few simple self-help measures, combined with prescribed drugs where appropriate.

Music holds the key to working out successfully: Forget costly personal trainers: according to the results of a 21-year study, your MP3 playlist could be the only fitness instructor that you will ever need. In the mid-1980s, scientists became convinced of the ability of music to transform our workout; one sports psychologist has dedicated more than two decades of research to finding the reason why.

Costas Karageorghis, who led the study, has discovered that training to music lowers your perception of effort and can trick your mind into feeling less fatigued during a workout. The result is that you are less likely to suffer from the breathlessness that can stop you completing that “uphill” setting on the treadmill.

The results of the Brunel University study reveal how the cardiovascular benefits of training can be boosted by running in time to your favourite beats. Matching the beat of the music with the tempo of the exercise can also regulate your movement and reduce the oxygen required during running by up to 6 per cent. Athletes have long suspected that music boosts their performance: the marathon runner Haile Gebrselassie reportedly trains to the 1994 dance smash Scatman. Some athletes consider music with a fast tempo to be a legal drug with no unwanted side-effects and use it to pump them up before competition, or use slower music to calm their nerves and help them to focus.

But this is the first time research has looked in detail at the phenomenon. The results, published in the Journal of Sport & Exercise Psychology, reveal that plugging into correctly paced music increases stamina on a treadmill by 20 per cent. They also show that listening to music that matches the pace of your footfall can give you such a psychological boost at critical points of exhaustion and fatigue that it helps you to fight through the pain barrier.

Karageorghis says: “When you exercise, you go into a state of arousal, at which point the human brain looks for stimuli in your external environment to match. Slow-tempo music of 80 to 110 beats per minute [such as the Beatles’ Let it Be, which is 80 bpm] would be counterproductive, because your brain wouldn’t be able to create a harmony with running fast and the slow beat.” The ideal workout tempo is 120 to 150 bpm, for example Duffy’s Mercy.

To build up a successful collection of workout music, Karageorghis recommends counting how many times your feet hit the ground during a one-minute run. Next you should source music with a rhythm that either matches it or is a few beats per minute above that number.

The research has inspired Men’s Health magazine to launch a CD of fitness tracks mixed by the DJ Tom Middleton, while the record label audiofuel.co.uk is pioneering a service in which fitness fanatics can download compilations specially composed as a workout routine. One of its composers is Howie Saunders, who has written music for films such as The Matrix and Charlie’s Angels. “There have always been fitness music compilations, but we compose ours from scratch,” Saunders says. “Music that’s good to run to usually has 150 bpm, but that can be too hardcore for some because it’s usually music such as drum and bass or techno. The challenge is to compose music that is palatable and fits the rate.”

Karageorghis’s research is already being used by big companies. Last month Sony Ericsson called on joggers to sign up to its Run to the Beat half-marathon. Competitors run to the rhythm of their choice, downloaded on to their mobile phone or MP3 player.

Mobile phones such as Sony Ericsson’s W902 are being designed to serve the music fitness craze, developing Bluetooth technology so that users can run wire-free, as well as containing fitness tools such as a pedometer, stopwatch, calorie counters and running maps. And this is just the start. According to Karageorghis, despite 21 years of research, “our understanding of why music has such a big impact on our performance is only beginning”.

http://www.thenews.com.pk/daily_detail.asp?id=179273
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