TIME medicine

In The Latest Issue

Painkiller Addiction Time Magazine Cover
Photo-Illustration by Bartholomew Cooke for TIME

Why America Can’t Kick Its Painkiller Problem
The price we pay for relief

Will This Be America’s Next Economic Crisis?
The Fed kept the engine from stalling. Getting it to speed again will be harder

Democrats Get a Primary
Why candidates O’Malley and Sanders will make it a race

Burma’s Nowhere People
Thousands of migrants have fled oppression only to meet death on the seas—or face an uncertain future in refugee camps

Love in the Age of Like
Human beings have never had as many romantic options as they do now. Will that doom love or save it?

The Culture

Pop Chart

Hollywood’s New Domestic Divas
Finding a second act selling the good life

Melissa McCarthy: Bond Girl
Spy is this summer’s smart blockbuster

Review: The Gluten Wars
Two new books tackle today’s most controversial food

‘Open the Garage Door, Hal’
Talking gadgets are great at taking my orders. The trick is remembering that I’m still human

10 Questions With Barbara Bush
Turning 90, the former first lady reflects on her husband’s favorite pastime, the advantages of age and her second son’s jump into the 2016 race

Briefing

Payback Is Coming to Rand Paul
By outmaneuvering the Senate, he took on his own party

Making a Deal With Iran
Negotiating isn’t easy, but it’s the smart thing to do

Snoozing and Losing With Sleep Apnea
The disorder is increasingly common—but still often undiagnosed

Rick Perry’s Lone Star Do-Over
The former Texas governor has practically moved to Iowa. Why that may not be enough

Rising Violence
After decades of decline, crime ticks back up

Milestones

Beau Biden
American son

Dennis Hastert
Former Speaker

World

What Matters, what Doesn’t

Unmasking New Threats

Why Online Dating is a Boon for Women

What You Said About …

TIME neuroscience

Game-Changing Discovery Links the Brain and the Immune System

New research could affect how we approach everything from Alzheimer's to autism

Researchers at the University of Virginia School of Medicine have made a dazzling discovery, published this week in Nature: the brain is directly connected to the immune system by previously unknown vessels.

“The first time these guys showed me the basic result, I just said one sentence: ‘They’ll have to change the textbooks,'” Kevin Lee, chairman of the UVA Department of Neuroscience, told Science Daily. He added that the discovery “will fundamentally change the way people look at the central nervous system’s relationship with the immune system.”

The discovery of these new vessels has enormous implications for every neurological disease with an immune component, from Alzheimer’s to multiple sclerosis. It could open up entirely new avenues for research and treatment alike, all stemming from the kind of discovery that has become extraordinarily rare in the 21st century.

“I really did not believe there are structures in the body that we are not aware of. I thought the body was mapped,” said director of UVA’s Center for Brain Immunology and Glia Jonathan Kipnis, who worked on the research. “I thought that these discoveries ended somewhere around the middle of the last century. But apparently they have not.”

Read more at Science Daily

TIME medicine

Health Experts Reveal How Much Standing At Work You Should Actually Be Doing

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Hero Images—Getty Images/Hero Images

The UK has developed the first set of health recommendations about sitting down at work

By now, the advice from health experts is clear: we should all sit less. That’s different from their advice to exercise more, because recent research shows that even regular exercise may not make much of a difference if you spend the rest of the day planted on a chair.

Now, the UK government’s Public Health England and a community advocacy group, Active Working CIC, have combed through the data on sitting and developed the first set of recommendations to let people know exactly how much time they should spend standing each day.

MORE: Sitting Is Killing You

According to the recommendation, written by health experts and published in the British Journal of Sports Medicine, people should aim to stand at least two hours a day during working hours. This doesn’t have to be all at once, but can be broken up into small periods of standing, pacing, fidgeting or walking—anything but sitting still.

It’s merely a recommendation, not a health mandate, the authors stress, and they don’t even suggest it as guidance that doctors should use to prescribe specific amounts of non-sitting behavior a day. But getting people to think about how much time they spend on their seats and how little time they spend on their feet is the point, the authors say. According to the data cited in the paper, an office worker spends up to 75% of his or her day sitting, and more than half of that comes in long episodes of nearly inert sedentariness lasting 30 minutes or more. Sedentary behavior is linked to a higher risk of chronic conditions such as diabetes, obesity and heart disease. “This is an initial guidance, which we do expect to have to evolve with time,” says John Buckley, from the Institute of Medicine at the University of Chester and lead author of the paper in a statement. “As we get more evidence we will hopefully gain more precision.”

MORE: Sitting Can Increase Your Risk of Cancer By Up to 66%

Standing for at least two hours a day is just a first step; the recommendation encourages a standing goal of four working hours a day, roughly half of your working life. Even if you can’t leave your desk long enough to take a walk, trips to the break room or restroom count—as does anything that breaks up a long stretch of time in a chair.

Buckley and his group are already working on gathering more scientific data to refine the recommendation and help employers, workers and doctors get a better handle on how much non-sitting is needed to improve health. The researchers are studying a Virgin Media call center in Sheffield in the UK, where employees are given a choice of a sit-stand desk; the scientists hope to learn more about switching up working positions can impact health, as well as productivity and performance.

MORE: Sitting At Your Desk Is Killing You. Here’s What It Costs To Stop the Destruction

“This is so new, so we’re very excited about seeing whether some of our theories that we’re testing will become clearer,” he says. And hopefully by then, more of the world will be standing when they read the results.

TIME medicine

Go to Sleep: It May Be the Best Way to Avoid Getting Alzheimer’s

Bed sleep
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Poor sleep may be contributing to the buildup of the brain plaques that drive the disease

Doctors studying Alzheimer’s disease have known for a while now that their patients are poor sleepers. But does the disease result in disrupted sleep, or do unhealthy sleep habits contribute to the disease?

Reporting in Nature Neuroscience, researchers led by Matthew Walker at the University of California, Berkeley, describe for the first time a unique pattern of sleep brain waves that seems to be linked to a higher risk of building up the brain proteins that can lead to impaired memory.

When the team studied 26 cognitively normal older adults, they found that higher amounts of amyloid, the protein responsible for the hallmark plaques found in Alzheimer’s disease, were linked with more disrupted deep sleep patterns. More importantly, the higher amount of amyloid and the disturbed sleep were also associated with worse performance on simple paired-word memory tests, which the researchers gave the volunteers both before and after a night’s sleep.

MORE: Many Doctors Don’t Tell Patients They Have Alzheimer’s

“It wasn’t just all of deep sleep that was disrupted but a very specific electrical signature deficit that we found,” says Walker. “It’s very particular and very unique, so my hope is that it’s so specific that it may really offer quite a high degree of sensitivity and specificity for the changes we see associated with Alzheimer’s disease.”

He stresses that in the current study, all of the volunteers were cognitively normal, and that the researchers did not follow them to determine if they eventually developed mild cognitive impairment—which often precedes Alzheimer’s—or Alzheimer’s itself. But the fact that the build-up of amyloid was connected to worse performance on the memory task highlights how early the disease process of Alzheimer’s may start: well before people experience any change in their intellectual skills. And one of the factors that may contribute to the accumulation of amyloid may be poor sleep. “Sleep is a great early warning beacon, a distress call that we can latch onto, to potentially alert us to the beginnings of Alzheimer’s,” says Walker.

MORE: New Research on Understanding Alzheimer’s

“What we think we found is a new way that disruption of sleep contributes to the pathology that can disrupt the cementing of memories,” says Bryce Mander, a post doctoral fellow at University of California, Berkeley, and lead author of the paper. The findings also resolve one of the puzzling questions in Alzheimer’s disease: why buildup of amyloid starts initially in areas of the brain that don’t have anything to do with memory. Mander and Walker’s team found that the protein does deposit, however, in areas of the brain that generate the wave patterns of deep sleep.

The relationship between sleep and amyloid is likely a two-way street, they say, in which the more amyloid that builds up, the worse the sleep, and the more disrupted the sleep, the more amyloid that gets deposited. Other studies have shown that deep sleep can cement memories as well as clear away amyloid. Not getting enough deep sleep, then, perpetuates the poor memory cycle.

What that means is that it might be possible to slow down some of the damage done by piled-up amyloid. If poor, disrupted sleep is promoting buildup, then getting more deep sleep might be able to reduce the protein burden in the brain. “If my parents and friends in their 50s, 60s or 70s ask me if they should pay attention to sleep and prioritize sleep in terms of their health risk of developing Alzheimer’s, I would say at this stage very much, ‘yes,’” says Walker. “It’s very clear now that sleep is an under-appreciated factor contributing to cognitive decline later in life, and it seems, to the pathology behind Alzheimer’s.”

TIME Cancer

New Cancer Drug Combination Shrinks Tumors in 60% of Patients, Says Study

Melanoma Cell
Science Source/Getty Images

However, the associated side-effects of the dual treatment are amplified

Two cancer drugs, when taken in concert, can shrink tumors in nearly 60% of people with advanced-stage melanoma, according to a new study.

The trial, which enrolled 945 patients at 137 sites worldwide, found that treating the cancer with medications ipilimumab and nivolumab stopped its advance for almost a year in more than half of cases, the BBC reports, citing a presentation by U.K. doctors this weekend at the American Society of Clinical Oncology annual conference.

Both drugs are designed to bring the body’s natural defenses in on the fight against the cancer. While the immune system is generally a potent agent in combatting disease, certain built-in “brakes” keep the body from attacking its own tissue — a loophole that cancers can use to continue growing unchecked. But both medications turn those “brakes” off.

In the study, 58% of patients taking both medicines saw their tumours shrink by at least a third over the course of almost a year. Still, perhaps the most important information — how long patients treated with the two medications live — is unknown, and will remain so for some time.

Skin cancer is among the most common cancers; according to the American Cancer Society (ACS), while melanoma accounts for less than 2% of skin cancers, it causes the majority of skin cancer deaths. The ACS predicts that nearly 10,000 Americans will die of skin cancer in 2015.

[BBC]

TIME medicine

How an Italian Boy Survived 42 Minutes Underwater

It’s unusual, but not impossible to survive that long while submerged

An Italian boy who fell into a canal in Milan is the latest “miracle” drowning survivor. The 14 year old was jumping off a bridge with friends into 6.5-foot water when he failed to come up. It took rescuers creating a human chain and 42 minutes before they could find him in the murky water and bring him back up; he had no pulse and was unconscious.

After a month in the hospital, where doctors attached him to a machine that took over for his lungs and heart to keep his body oxygenated, he woke, apparently alert and able to talk to his parents (and ask about his favorite professional soccer team).

But how did he survive underwater for nearly an hour?

MORE: How the Teen Stowaway Survived His Trans-Pacific Flight in a Wheel Well

Michael isn’t the first to recover from being underwater for so long; there’s a report of a person surviving after being submerged for an hour. Other young boys have recovered after going under in frigid lakes, ponds and oceans for anywhere from 15 to 45 minutes.

Experts say it’s no accident that most of the survivors are young; the automatic reflex to drop the heart rate and divert oxygen to the brain, especially in cold water, is more robust in younger children than in adults. Keeping the brain bathed in oxygen is critical; after about four minutes without oxygen, brain damage can occur.

And the colder the water, the more likely the brain is to be sustained in this way; frigid temperatures help the body divert its resources primarily to the brain. The canal into which Michael fell was about 59 degrees.

Doctors say there is no way to fully explain how the boy survived, much less how his brain remained relatively intact. But Michael’s case, and those of the other survivors, stress how important it is to administer emergency CPR as soon as possible after a drowning.

TIME medicine

Newer Birth Control Pills Raise the Risk of Blood Clots

A new study puts a number on the risk of developing potentially fatal blood clots after using the pill

Blood clots have been a known risk of oral contraceptives since the 1990s, but for most women, the chances seemed small enough to justify taking the Pill. Now, in a report published in The BMJ, scientists led by Yana Vinogradova, a research fellow at the University of Nottingham, found that using the Pill was linked to anywhere from a two- to more than four-fold increased risk of developing clots compared to women who didn’t take oral contraceptives.

“Our study suggests that the newer contraceptives have a higher risk of [blood clots] than the older agents,” Vinogradova tells TIME in an email. Overall, the risk for women on the Pill was nearly three times that of women not taking the medication. The risk was highest for people taking Pills that contain newer types of the progestogen hormone, such as drospirenone, desogestrel, gestodene, and cyproterone, as compared to people taking the Pill with first-generation versions of the hormone (levonorgestrel and norethisterone).

The difference essentially boils down to the progesterone part of the drug; since the original pill was introduced in 1960, drug developers have tweaked the progesterone to lower side effects such as acne, headache, weight gain and breakthrough bleeding. But the price for those modifications may be more blood clots.

Even after Vinogradova and her team adjusted for the potential contributions of things like cancer, heart disease, varicose veins, arthritis, smoking and obesity on the risk of blood clots, the link between the newer contraceptives and increased risk remained strong.

“While [blood clots] are a relatively rare problem, they are serious and potentially avoidable with the appropriate drug choice,” says Vinogradova. “Doctors need to consider all health issues when prescribing contraceptives, selecting a drug type associated with the lowest risk for patients with particular susceptibilities.”

Whether that means that doctors should start with prescribing the older formulations first—as well non-hormonal birth control like the copper IUD—isn’t clear yet, since the newer forms have certain advantages, including the fact that they disturb the cholesterol system less, which may be important for diabetic women.

The blood clot risk, however, is something that doctors should consider when prescribing the Pill. And since there are different formulations available, Vinogradova says doctors should monitor their patients for any potential symptoms of poor circulation and switch to other formulations if needed.

TIME Cancer

How a Common Childhood Vaccine Helps Ward Off Cancer

It reduces the risk of childhood leukemia by 20%

Scientists now understand why a common childhood vaccine reduces the risk of leukemia.

Researchers previously knew that the vaccine against Haemophilus influenza type B, or HiB, reduces the risk of acute lymphoblastic leukemia, the most common form of childhood cancer. But now a new study published in Nature Immunology explains why this is the case.

Dr. Markus Müschen and his team on the study used a mouse model and found that recurring HiB infections, which can happen easily in children who have not been vaccinated, can cause certain enzymes to activate and push common precancerous blood cells into cancer. So, vaccines against HiB infections also protect children from this path to leukemia.

Müschen told the New York Times that the HiB vaccine, which is routinely given to children, has led to a 20% reduction in the risk for leukemia.

 

TIME medicine

Tylenol During Pregnancy Could Harm Male Babies, Study Shows

It reduces testosterone production in the womb

Taking too much Tylenol during pregnancy could reduce testosterone levels in male babies, according to a new study.

The study, published in Science Translational Medicine, found that prolonged use of acetaminophen, the drug in Tylenol, by a pregnant mother reduced production of testosterone in her unborn son.

The study used mice that carried grafts of human tissue. After one day of exposure to the drug there was no effect on testosterone production, but after seven days the amount of testosterone was down by 45 percent.

Limited testosterone in the womb is related to increased risk of infertility, testicular cancer and undescended testicles.

“We would advise that pregnant women should follow current guidance that the painkiller be taken at the lowest effective dose for the shortest possible time,” said Rod Mitchell, one of the authors of the study from the University of Edinburgh.

Acetaminophen drugs like Tylenol or Panadol are the most common medicine for managing pain or fevers during pregnancy.

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