CDC: US Death Rates Rise for Many Leading Diseases

Megan Brooks

February 26, 2016

From October 2014 to September 2015, more Americans died than during the same period 1 year earlier, according to a preliminary analysis of death records.

The age-adjusted death rate in the United States for the 12-month period ending with the third quarter of 2015 was 731.4 deaths per 100,000 population, up from a rate of nearly 720 per 100,000 during the same period a year earlier, according to the Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics (NCHS).

The findings are part of the Vital Statistics Rapid Release program, a quarterly release of data on various leading causes of death in the United States, the CDC says.

The preliminary analysis shows that age-adjusted death rates (per 100,000 population) were higher in 2014-2015 than during the same period 1 year earlier for many leading causes of death, including heart disease, stroke, Alzheimer's disease, liver disease/cirrhosis, and Parkinson's disease. For other causes, including cancer, diabetes, and HIV, death rates held steady or fell slightly.

Table. Age-Adjusted Death Rates (per 100,000) in 2015 vs 2014

Cause of Death	2015 vs 2014
Heart disease	168 vs 166.1
Stroke	37.5 vs 35.9
Alzheimer's disease	28.9 vs 24.2
Liver disease/cirrhosis	10.6 vs 10.3
Chronic respiratory disease	41.6 vs 40.1
Pneumonia/influenza	15.7 vs 14.9
Hypertension	8.4 vs 8.2
Kidney disease	13.4 vs 13.1
Parkinson's disease	7.7 vs 7.3
Cancer	158.7 vs 161.2
Diabetes	21.2 vs 20.9
HIV	1.9 vs 2.0

The report also notes that the age-adjusted death rate for drug overdose for the 12-month period ending with the first quarter of 2015 was higher than for the comparable period in 2014 (14.8 vs 14.0 per 100,000 population). Also higher in the 2015 period than in the 2014 period were age-adjusted death rates for falls among the elderly (59.1 vs 56.8); deaths from homicides held steady (5.2 vs 5.1 per 100,000), as did deaths from firearm-related injury (10.6 vs 10.3).

The age-adjusted death for suicide was similar for 2015 and 2014 (13.2 vs 12.5); the rate for unintentional death was higher in 2015 than in 2014 (40.8 vs 39.6).

These provisional estimates are based on a snapshot of all the vital statistical data from the 50 states and the District of Columbia that were received and processed by the NCHS as of a specified cutoff date, the report notes.

Vital Statistics Rapid Release

Crude and age-adjusted death rates for parkinson's disease: 2014–Quarter 3, 2015

• For 2015, the crude death rate for Parkinson’s disease was 9.6 deaths per 100,000 population for the first quarter, 8.2 for the second quarter, and 8.1 for the third quarter. The rates for the first three quarters of 2015 were higher than the rates for the same quarters of 2014 (8.4, 7.9, and 7.6, respectively). The age-adjusted death rates for the first and third quarters of 2015 (8.5 and 7.1, respectively) were higher than the rates in 2014 (7.6 and 6.8, respectively). The second quarter rates were the same in 2015 and 2014 (7.2).
• The crude death rate for Parkinson’s disease for the 12-month period ending with the third quarter of 2015 was 8.7 deaths per 100,000 population, higher than that for the same period of 2014 (8.1). The age-adjusted rate remained higher in 2015 than in 2014 for the comparable period (7.7 and 7.3, respectively).

Quarter	Parkinson's disease, 3-month period (Crude rate)	Parkinson's disease, 12 months ending with quarter (Crude rate)
2014 Q1	8.4	7.8
2014 Q2	7.9	8.0
2014 Q3	7.6	8.1
2014 Q4	8.9	8.2
2015 Q1	9.6	8.5
2015 Q2	8.2	8.5
2015 Q3	8.1	8.7

http://www.medscape.com/viewarticle/859486?src=wnl_edit_tpal 

inviCRO brings in $45.8M to offer its imaging services and analysis technology

By NICOLE ORAN

Feb. 26, 2016

An MRI of a brain tumor

inviCRO has raised $45.8 million in its first disclosed financing. The money will be used to offer imaging services and analysis to aid drug research and development, according to a regulatory filing.

This news comes just after the Boston-based startup acquired Molecular Neuroimaging (MNI), expanding its neurological imaging options.

As Fierce Medical Devices reported, inviCRO helped open the Translational Imaging Center in Mattawan, MI that it co-manages with MNI Research and 3D Imaging; inviCRO provides molecular imaging, while 3D imaging offers radiopharmaceutical services and MNI contributes its CRO services.

The company is continuing to expand, considering last year it also acquired a Seattle-based histology team.

Essentially the company’s goal with these acquisitions and expansion is to provide imaging that goes from exploring to tissue captures to additionally providing information for additional drug discovery and research development. MNI will help with the neurology angle.

http://medcitynews.com/2016/02/invicro-brings-in-45-8m-for-offer-its-imaging-services-and-analysis-technology/?utm_source=MedCity+News+Subscribers&utm_campaign=10f8bb7d36-MCN+Daily+Email&utm_medium=email&utm_term=0_5092836c41-10f8bb7d36-408817989

Nationwide Movement to Help End Parkinson's Disease; 2016 APDA Optimism Walk Series Launches to Raise Critical Funds & Awareness

 February 26, 2016

Thousands Will Walk and Fundraise to Help Ease The Burden – Find The Cure for Parkinson’s Disease

Thousands of participants will walk this year to raise awareness of Parkinson's disease and funds to support the American Parkinson Disease Association's (APDA) dual purpose to Ease the Burden – Find the Cure. The 2016 Optimism Walks are part of a nationwide movement to mobilize and inspire people to step up and help put an end to Parkinson’s disease. Optimism Walks will take place in cities across the country including, Boston, MA; Chicago, IL; Waterford, Westport and West Hartford, CT; Madison, WI; Nashville, TN; Omaha, NE; Phoenix, AZ; Warwick, RI; San Antonio, TX; Seattle, WA; Reno, NV; Boca Raton, FL; and others throughout the United States. 

Each APDA Optimism Walk is a fundraising event that offers a short walk (between 1-3 miles, distance varies by location) and an important opportunity for friends, families, and individuals coping with Parkinson's to take their passion and concern and turn it into a positive experience aimed to help end the devastation of Parkinson’s disease. Optimism Walks offer additional support, educational opportunities, family-friendly activities and the chance to bond with others who are similarly connected.

"There has been great progress in Parkinson’s disease treatments and programs, but there is still much more to be done to end this disease and the challenges endured by those living with Parkinson’s,” said APDA President and CEO Leslie A. Chambers. “The funds raised through the Optimism Walks will enable APDA to continue providing information, education, and support to those impacted by Parkinson's disease and fund scientific research into the causes, prevention, treatments and ultimately the cure. Every dollar raised makes an important difference."

Pharmaceutical companies Lundbeck and US WorldMeds have joined as National Sponsors of the Optimism Walk 2016 event series. Representatives from both companies will be on hand at every event to meet members of the Parkinson’s community and demonstrate their special commitment to the lives of people with Parkinson’s disease, families and care partners as they work tirelessly to bring innovative solutions to those living with this disease.

In 2015 the Optimism Walk campaign drew thousands of participants and raised more than $700,000 to fund critical research and patient services. The goal for this year's Optimism Walk campaign is to surpass that and make 2016 the organization’s most successful year yet.

“APDA's Optimism Walks run from April through October and are a great way for both people with Parkinson's and the general community to get out for a day of fun and exercise, while playing a part in the fight against this disease," Chambers said.About the American Parkinson Disease Association (APDA) 

APDA was founded in 1961 with the dual purpose to Ease the Burden - Find the Cure for Parkinson's disease. Since its founding, APDA has raised and invested more than $87 million to support scientific research, patient services and education, and elevate public awareness. As the country's largest Parkinson's grassroots organization, APDA is here to serve the more than one million Americans with Parkinson's disease and their families through a national network of Chapters, Information and Referral (I&R) Centers, and support groups. APDA also funds Centers for Advanced Research and awards grants to fund the most promising research toward discovering the cause(s) and finding the cure for Parkinson's disease.

http://health.einnews.com/article/313808499/cLmwbELA5yQU--Gy

Why we should treat this ‘damaging’ study on physiotherapy in Parkinson’s with caution

Author: Mariella GrazianoPublished: 25 February 2016

After results emerged from a study that claimed physiotherapy and occupational therapy for people with Parkinson’s was ineffective, leading figures in the community have criticised the study and urged caution when interpreting what it means for physiotherapy as a treatment. Mariella Graziano, president of the Association of Physiotherapists in Parkinson’s Disease Europe, writes why she thinks the study is “damaging if not taken with caution”

A recent study published online in JAMA Neurology questioned the clinical effectiveness of physiotherapy and occupational therapy for people with mild-to-moderate Parkinson’s (1). The results of the study named the ‘PD REHAB trial’ showed no meaningful clinical improvement in activities of daily living (ADL) or quality of Life (QoL), when comparing the effect of combined physiotherapy and occupational therapy versus no therapy in a sample group of people (with a mean age of 70 years from 38 outpatient centres in the UK from October 2009 to June 2012). However, some leading academics and healthcare professionsals – myself included – have raised concerns with these findings and urge people with Parkinson’s and their practitioners to interpret them with caution.

A recap of the study

Over 15 months, half of the study participants were randomised to a standard therapy practice structured in a person-centered goal-directed therapy, and the other half to no therapy. Physiotherapy practice focused on Parkinson’s-related issues such as gait, posture, balance, physical conditioning, and transfers. Therapy sessions were one hour long and people received on average four sessions over eight weeks for both therapies combined.

There were no differences at 3, 9, and 15 months between groups on the ADL or QoL measures, reported Dr Carl Clarke of the Sandwell and West Birmingham Hospitals National Health Service Trust in Birmingham, UK. Dr Clarke and his team concluded: “This evidence does not support the use of low-dose, goal-directed physiotherapy and occupational therapy in the early stages of Parkinson’s”.

Potential flaws

These results must be taken with caution by people living with Parkinson’s and professionals alike, however, given the existing level of evidence that these therapies have a positive impact on a patient’s general functioning and wellbeing. Moreover, substantial, though indirect, evidence shows that ongoing vigorous aerobic exercises may have a protective effect and consequently slow down Parkinson’s progression(2).

In response to the results, Dr J Eric Ahlskog of the Mayo Clinic in Minnesota, US, pointed out that the outcome of this study “should be interpreted with attention to the study details.”(4) He said that the study didn’t focus on therapy for targeted problems, and that therapy should focus on specific problems that are likely to benefit”.

Furthermore most participants in the PD REHAB study had mild-to-moderate Parkinson’s at randomisation, while the physiotherapy programme that was delivered is more commonly used for people in a moderate-to-late stage, when falls or near falls start to be a problem.

Early referrals are key

The European Physiotherapy Guideline for Parkinson’s published in 2014(3) recommends that referrals to Parkinson’s-specific physiotherapy should start soon after diagnosis and be in accordance with stages on the Hoehn and Yahr scale (which highlights impairments and limitations as the condition progresses)(5).

At an early stage, Parkinson’s-specific physiotherapy intervention focuses on self-management advice, education, participation on leisure programmes, and general fitness, where exercise plays a central role. A problem-specific, person-centered goal-directed programme is set according to the individual’s lifestyle, impairments, limitations and participation in society.

At a moderate stage, people-specific physiotherapy problems are more related to impairments concerning physical capacity and activities, like walking, transferring, balance, manual activities or respiratory function. People may also require a pain management programme. In addition to ongoing education and self-management advice, physiotherapy intervention teaches movement strategies to compensate for the progressive difficulty in generating automatic movement. Use of external cues (auditory, tactile, visual and sensory) or internal cues (mental rehearsal and visualisation) are applied according to the person’s preference and strategy efficacy. At this stage, physiotherapy intervention also trains dual task activities, self-instruction and concentrates on improving attention span.

Problem-specific physiotherapy is essential

It seems that the PD REHAB trial did not identify the fine tuning problem-specific impairments that are characteristic at an early stage of Parkinson’s. Problem-specific early referrals to a Parkinson’s-specific physiotherapist are essential for people with Parkinson’s.

There is a vast amount of literature and, above all, clinical observations that reiterate Parkinson’s is not the same from person to person – every patient is different and the impact of physical and non-motor symptoms are not the same from one to the other.

By the time a person hears the devastating sentence: “You have Parkinson’s disease”, he or she may already move slower than before, their steps may be shorter and the use of one hand may not be the same anymore. These impairments have an impact on the activities of daily life, which were not identified by the scales used to measure change in the PD Rehab study.

However, these impairments are obvious to a physiotherapist with a trained eye and can be tackled on time to prevent physical changes and delay the effects. This is only achieved with a problem-specific referral. We should not underestimate the value of self-management advice and education. A person who knows what to do to manage his specific problems and the impact they have in their daily life, will save taxpayers’ money.

Exercise caution

Considering the increasing literature supporting the possible neuro-protective effect of vigorous regular aerobic exercises (2), in line with the European Physiotherapy Guideline for Parkinson’s,(3) which identifies exercise as one of the main interventions of Parkinson’s-specific physiotherapy, and in agreement with Ahlskog(4), the results of the PD REHAB trial, shouldn’t have an impact on the benefits of aerobic exercise in Parkinson’s, starting soon after diagnosis. What’s clear is that all referrals to physiotherapy need to be problem-specific and tailored according to disease stage in order to achieve full effectiveness.

The PD REHAB study is thought provoking but it can be damaging if not taken with caution, as policymakers may interpret it as a reason to reduce funding, professionals may understand it as no need of an early referral, and – most critically – people with Parkinson’s and their families will lose precious time. We do not need to wait for more evidence to emerge to call for what people need today: problem-specific early referral to a Parkinson’s-specific physiotherapist.

Mariella Graziano and friends

Refererences

1. JAMA Neurology Source Reference: Clarke CE, et al “Physiotherapy and occupational therapy vs no therapy in mild-to-moderate parkinson disease: A randomised clinical trial” JAMA Neurol 2016; DOI: 10.1001/jamaneurol.2015.4452.
2. Ahlskog JE. Does vigorous exercise have a neuro-protective effect in Parkinson disease? Neurology. 2011;77(3):288-294.
3. Keus SHJ, Munneke M, Graziano M, et al European Physiotherapy Guideline for Parkinson’s Disease. 2014; KNGF/ParkinsonNet, The Netherlands
4. JAMA Neurology Source Reference: Ahlskog JE “New and appropriate goals for Parkinson Disease physical therapy” JAMA Neurol. 2016; DOI: 10.1001/jamaneurol.2015.4449.
5. Ramaswamy B, Jones A. Clinical Update: Parkinson’s. Frontline, 6 January 2016, 22(2). Chartered Society of Physiotherapy.http://www.csp.org.uk/frontline/article/clinical-update-parkinsons [accessed 12 February 2016]

The APPDE mission is to support physiotherapy expertise in Parkinson’s disease.

Aims:

• To facilitate individuals continuous professional development.
• To provide mentoring amongst peers.
• To support networking amongst individuals and like-minded associations.
• To promote research based physiotherapy tailored to the needs of PWP, their families and carers, and to nations’ health care systems.
• To enable the development of educational programs.
• http://parkinsonslife.eu/rwhy-we-should-treat-this-damaging-study-on-physiotherapy-in-parkinsons-with-caution/

Home News NHS England is Letting People with Parkinson's Down

26 February 2016

Today, an influential group of MPs (the Public Accounts Committee) have released a report reviewing the state of neurology services across England.

They confirm what we already know - that people with neurological conditions, like Parkinson's, are being seriously let down.

Postcode lottery

We believe that the quality of treatment, and the speed at which people with Parkinson's receive support shouldn't be impacted by where you live.

Unfortunately, this is the case for people with Parkinson's. Diagnosis and treatment depends on how each local area arranges their neurology services.

Public Accounts Committee report

The report found that there are disparities in outcomes for people living with conditions like Parkinson's. It also comments on the costs that the NHS incurs as a result of poor care.

The Committee found this to be particularly alarming given that NHS England have abolished the National Clinical Director for Adult Neurology role, which the inquiry found to have had a positive impact whilst in post.

You can read more about what they found in their report 'Services to people with neurological conditions: progress review'.

Campaigning for neurology leadership

NHS England confirmed in January 2016 that they would be cutting the National Clinical Director for Adult Neurology post. We have been campaigning to keep this role as it champions neurology services within the NHS.

This means that people with Parkinson's no longer have a representative at the top. It is concerning that neurology is not being seen as a priority for the NHS.

Steve Ford, Parkinson's UK Chief Executive commented:

NHS England cannot afford to bury its head in the sand. They need to urgently put the PAC's recommendations into action.

Steve Ford

"We hear time and again from people with Parkinson's that their experience of care varies hugely across the country.

In 2012/13 people with Parkinson's spent over 128,000 excess days in hospital at a cost of more than £20 million to NHS England.

Providing the right care, at the right time has the potential to radically improve services for people with Parkinson's and save the NHS money."

Share your experience to improve services

Last year over 7,500 people shared their experiences of health and care services with us through our UK Parkinson's audit and the 'your life your services' survey.

This will help the work we are doing with professionals to ensure that people with Parkinson's get access to high quality services at the right time.

If you'd like to share your experiences of health and care services, good or bad, please email campaigns@parkinsons.org.uk. To speak to someone about any medical issues, including symptoms or your medication, please contact our helpline on 0800 800 0303.

- See more at: http://www.parkinsons.org.uk/news/26-february-2016/nhs-england-letting-people-parkinsons-down#sthash.Ytbl3W3I.dpuf

http://www.parkinsons.org.uk/news/26-february-2016/nhs-england-letting-people-parkinsons-down

Michael J. Fox enjoys a night out in spite of his Parkinson's disease

Feb. 26, 2016

Michael J. Fox enjoyed a night out with his wife even though he cannot easily get around any more

Michael J. Fox may have Parkinson’s disease, but he is not letting it stop him from enjoying a night out according to Radar Online, Feb 26, 2016. The “Back to the Future” star needed help getting into a car so he could enjoy being out with his wife Tracy Pollan.

Michael J. Fox‘s body is being ravaged by the effects of Parkinson’s, leaving him with slurred speech and unable to walk normally as he used to do. He now has a limp and drags his left foot a source told Radar Online reported.

“It was heartbreaking. Michael’s bravery knows no bounds. But as the disease takes its toll on his body, even he is beginning to see that his battle is a losing one.”

As the Parkinson’s disease progresses, it will leave eventually leave Michael unable to walk even with assistance. He will be in a wheelchair and some medical experts believe this will happen before Michael reaches the age of 60.

However, that is not the only health crisis that Michael may have to face, according to the experts. They believe that the Parkinson’s disease may also cause dementia.

“Michael sees every day as a gift, as well as an opportunity to help other sufferers,” said the insider. “His Michael J. Fox Foundation for Parkinson’s Research has done so much and has raised millions of dollars, but a cure remains well out of reach.”

Michael learned that he had Parkinson’s disease in 1991, but he continued with his life and kept his condition a secret. In 1999, Michael publically announced that he had the disease after undergoing brain surgery to control his shaking. At that time, Michael had a successful show, “Spin City” and he made the decision to leave the series and undergo a more extensive treatment for his condition.

Michael did not stay away from the television screen for long and in 2013, he returned with “The Michael J. Fox Show.” However, anyone who has a disease or medical condition, obtaining insurance is hard, if not almost impossible and very costly. The insurance companies were very concerned that they would have to pay millions, should something happen to him during the taping.

After a lot of looking, figuring and haggling back and forth, they finally found a coverage that would give Michael the opportunity to continue doing the thing he loved, and that was being on TV. Michael was able to film the first season of “The Michael J. Fox Show,” without any problems. However, his insurance ran out in December 2013, and because he was unable to renew it, the show was cancelled.

One can only hope and pray that before Michael or anyone else who suffers from this disease becomes confined to a wheelchair or diagnosed with Parkinson's, a cure will be found to reverse and/or cure this disease.

http://www.examiner.com/article/michael-j-fox-enjoys-a-night-out-spite-of-his-parkinson-s-disease

Molecular 'brake' prevents excessive inflammation

Feb. 26, 2016

Protein p62 keeps macrophages in check.

Inflammation is a Catch-22: the body needs it to eliminate invasive organisms and foreign irritants, but excessive inflammation can harm healthy cells, contributing to aging and sometimes leading to organ failure and death. Researchers at University of California, San Diego School of Medicine have discovered that a protein known as p62 acts as a molecular brake to keep inflammation in check and avoid collateral damage. The mouse study is published February 25 in Cell.

Macrophage (yellow, center) in the liver. 

Credit: UC San Diego Health

"In addition to explaining how our bodies can turn off inflammation when it's no longer needed, these findings could have important implications for many age-related diseases," said Michael Karin, PhD, Distinguished Professor of Pharmacology and Pathology at UC San Diego School of Medicine. Karin led the study with Zhenyu Zhong, PhD, a postdoctoral researcher in his lab, and collaborators at Sanford Burnham Prebys Medical Discovery Institute.

Macrophages are cells that play a major role in inflammation -- they detect and swallow invading microbes and foreign particles, such as asbestos microfibers. At the same time, activated macrophages release cytokines, small proteins that serve as signals to recruit and activate other immune cells for assistance. To produce and secrete one major inflammatory cytokine, interleukin-1beta (IL-1beta), macrophages employ molecular machines called inflammasomes. One of the most functionally diverse inflammasomes is the NLRP3-inflammasome, which releases IL-1beta when stimulated by toxins and microparticles such as silica, asbestos or cholesterol microcrystals.

However, foreign particles don't act directly on the NLRP3-inflammasome. Instead, Karin's team found, foreign particles damage the macrophage's mitochondria -- the cell's energy-producing "power plant." In turn, damaged mitochondria release signals that activate the NLRP3-inflammasome and keep it cranking out IL-1beta.

That's a good thing if your body needs to clear out invading particles or microbes, but continuous production of IL-1beta is very dangerous -- it can easily lead to an inflammatory chain reaction that results in multi-organ failure, septic shock and death. The body needs a way to turn off IL-1beta production by NLRP3-inflammasomes.

To do this, Karin's team discovered, macrophages responding to foreign microbes and irritants also bump up production of p62. This protein coats damaged mitochondria that release inflammasome-activating signals and ensures they are eliminated. Once these damaged mitochondria are removed, the NLRP3-inflammasome de-activates and IL-1beta production is turned off.

"We've suspected for quite some time that damage to mitochondria caused by either genetic or environmental factors is the root cause of many age-related diseases, all of which are associated with chronic, low-grade inflammation," said Zhong. "Therefore, p62 -- and its part in eliminating damaged mitochondria -- could provide a new target for preventing such diseases. Indeed, we already know that another protein that collaborates with p62 to eliminate damaged mitochondria is Parkin, which plays a role in a rare form of Parkinson's disease."

http://www.medicalnewstoday.com/releases/307108.php