Archive for February, 2010

Loneliness May Be Catching

Sunday, February 21st, 2010

A new study suggests that lonely people attract fellow “lonelies” and influence others to feel lonely, too.

“Loneliness can spread from person to person to person — up to three degrees of separation,” said James H. Fowler, co-author of the study published in the December issue of the Journal of Personality and Social Psychology, and professor of political science at the University of California, San Diego.

“What this means is that if I don’t know anything about you, but I know your friend’s friend is lonely, then I can do better than chance at predicting whether or not you will be lonely,” he said.

Indeed, the study suggests that not only is loneliness contagious, but lonely people tend to isolate themselves in small groups that somehow compound or increase those feelings of solitude.

According to Fowler, the data suggests that the average person feels lonely about 48 days a year, but for the lonely, that feeling can be ever-present. In addition, the study indicated that people who felt lonely were more likely to be friendless, or constantly shedding friends, a few years later: Compared with those who are never lonely, lonely people can lose about 8 percent of their friends over a four-year period, for instance.

Fowler co-authored the findings, funded by the U.S. National Institute on Aging, with John T. Cacioppo, professor at the University of Chicago, and Nicholas A. Christakis, professor at Harvard University. The researchers worked with more than 5,100 participants who were the offspring of the original subjects of the landmark Framingham Heart Study.

The team constructed graphs tracking the participants’ ongoing friendship patterns over two to four years. They found that, among neighbors, an increase of loneliness of just one day per week triggered a rise in loneliness among neighbor-friends, as well. And that loneliness actually spread throughout the community as affected neighbors saw each other less, the researchers said.

Women appeared more vulnerable than men to “catching” loneliness, the researchers found.

Mark R. Leary, professor and director of the social psychology program at Duke University, whose work zeroes in on the need for social acceptance, called the study impressive in its sample, analysis and conclusion. He added that the contagion of loneliness could be, to some degree, a situation of people mimicking the styles of those around them.

“Non-lonely people who are exposed to lonely people may make others in their network a little more lonely by behaving in these less-affirming ways. Perhaps this is why the effect of loneliness can be seen at three degrees of separation. My friend has a lonely friend, so my friend starts acting less affirming overall, which makes me act a little less positively, which then affects my other friends.”

So what can be done to help the lonely, to integrate them better with others? Leary suggested that those who interact with lonely people recognize that their tendency to pull inward emotionally and be less outgoing is a trait of loneliness, not of something else. “It reflects loneliness and a need for connection, rather than indifference, dislike or rejection. People can reach out to their lonely loved one rather than withdraw themselves,” he said.

Fowler agreed. “For the mental health provider, this means treating not just the patient, but potentially also the patient’s friends,” he said. “For the employer, this means emphasizing activities that help their employees to connect to one another socially. For the family member, this means you should tend to your own networks, too, while you help your kin feel more connected.”

Taxol Boosts Odds of Chronic Pain

Monday, February 15th, 2010

The chemotherapy drug paclitaxel (Taxol) increases the risk of chronic neuropathic pain in breast cancer survivors, a new study shows.

It included 240 women who took part in clinical trials of Taxol between 1994 and 2001. Those who experienced chemotherapy-induced peripheral neuropathy during their treatment with Taxol were three times more likely to eventually be diagnosed with chronic neuropathic pain.

The study is published in the November issue of the Journal of Pain.

The findings indicate that patients treated with Taxol should be regularly monitored for neuropathic pain after their chemotherapy ends, said the researchers from the University of Texas M.D. Anderson Cancer Center.

In certain cases, patients and doctors should review the risks and benefits for continuing treatment with Taxol if a patient is likely to experience worsening neuropathy, the study authors added.

They noted that the same cellular mechanism that’s altered by Taxol to kill tumors can be toxic to normal tissue.

New Heart Attack Treatment Guidelines Stress Coordination

Sunday, February 7th, 2010

There’s a message for doctors, hospitals and communities in new guidelines for treatment of coronary disease and heart attacks: Get organized.

Every community should have an organized system of emergency care for heart attacks, including programs to identify patients before they get to hospitals and strategies for getting them to medical centers equipped to perform artery-opening procedures, say the guidelines issued by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.

“The focus on integrated systems for patients with STEMI is important,” said Dr. Sidney C. Smith Jr., a professor of medicine at the University of North Carolina, a past president of the American Heart Association and co-chair of the group that wrote the guidelines. “It affects a large number of the population that have heart attacks and will improve their treatment for sure.”

STEMI is an acronym derived from the pattern seen on an electrocardiogram in the most severe form of heart attacks. The goal is to get a heart attack victim as quickly as possible to a medical center for what is formally called percutaneous coronary intervention (PCI) — insertion of a balloon-tipped catheter into a blocked heart artery to reopen the blood vessel, usually followed by implantation of a stent, a thin tube, to be sure it remains open.

“The general recommendation is to move a patient if at all possible directly to hospitals where they are able to do immediate angioplasty [PCI],” said Dr. Spencer B. King III, president of the St. Joseph’s Heart and Vascular Institute in Atlanta, a past president of the American College of Cardiology and co-chair of the guidelines group. “If that is not possible, then there should be very rapid transport to hospitals that do angioplasty.”

The guidelines include recommendations on changes in treatment of heart attacks and coronary disease based on new research findings. For example, stenting now is recommended in many cases where the left main coronary artery, which provides blood to the majority of the heart, is blocked.

“It was previously thought not advisable to do it, but to go directly to bypass surgery,” King said. “But evidence continues to build that for some patients with left main blockage, stenting should be considered.”

Several studies, notably one from Korea, found similar outcomes for stenting or surgery in treating left main artery blockage, King said.

Other technical issues covered by the guidelines include:
Recommendations on use of a powerful new clot-dissolving drug, prasugrel (Effient), as an alternative to clopidogrel (Plavix), commonly prescribed after PCI. The greater ability of the new drug to dissolve clots does carry an added danger of excessive bleeding.
Use of a wire threaded into the coronary artery to gauge whether build-up of plaque deposits are great enough to warrant PCI.
Use of aspiration thrombectomy, in which the clot causing a heart attack is sucked out before a stent is implanted.
Recommendations on use of blood thinners and clot-dissolvers before, during or after PCI.
Recommendations on the types of X-ray dye used to view the heart arteries during PCI in patients with chronic kidney disease.

“But the big recommendation is that we need to improve the system of how patients get into one hospital when they are having a heart attack and then get into another hospital, if necessary,” Smith said.