VIAGRA Info

Texting people to remind them to wear sunscreen daily actually works, research shows.

People who got text messages each morning with a brief local weather report followed by a prompt like “slap on some sunscreen today” were twice as likely to use sunscreen as people who didn’t get the texts, Dr. April W. Armstrong of the University of California-Davis Health System in Sacramento and her colleagues found.

Study participants who received the reminders still went without sunscreen a lot of the time — about 4 in 10 days, on average, the researchers report in the Archives of Dermatology.

Nevertheless, Armstrong noted in an interview, the findings show that “we can use simple low cost technologies such as text message reminders to improve healthy habits.”

Getting people to take their pills or run on medicated cream as prescribed is a perennial problem for doctors, she added, and sunscreen is no exception. Overall, just one in five Americans report using sunscreen regularly, Armstrong and her team note in their report.

The researchers recruited 70 text-savvy adults to enroll in their study, and then randomly assigned them to receive the text message reminders or a control group who didn’t get the reminders. The text reminders were worded differently every day, to avoid “message fatigue.”

All of the study participants also were given sunscreen dispensers with embedded electronic sensors that sent the date and time back to a central server every time the container was opened. “We could actually track in real time when people are using their sunscreen,” Armstrong explained.

Over the course of the 42-day study, people in the text-message group used sunscreen on about 24 days, on average, for an adherence rate of 56 percent, compared to about 13 days for the group who didn’t receive reminders, or a 30 percent adherence rate.

Sixty-nine percent of the people who got the reminders said they would want to keep using them, while 89 percent said they’d recommend the system to other people.

The study shows that “even people who know they are being monitored do not use their sunscreen well,” Bridget V. Nolan and Dr. Steven R. Feldman of the Wake Forest University School of Medicine in Winston-Salem, North Carolina and colleagues point out in an accompanying editorial.

But the findings also hint, they say, that “new technologies may provide additional means by which we can help our patients use recommended treatments better.”

Hardening of the arteries may have more of a family history — the human family tree — than was once thought.

Modern-day imaging techniques have unearthed hardening of the arteries — or atherosclerosis, which causes heart attacks and stroke — in mummies up to 3,500 years old.

Experts have long believed that atherosclerosis is a scourge of modern society, caused by meals snatched at fast-food restaurants and eaten in front of high-definition TVs.

“Perhaps atherosclerosis has been around a lot longer than we think. It might have been a malady affecting man long-term,” said Dr. Clyde Yancy, president of the American Heart Association. “It doesn’t necessarily change anything we know or do now, but perhaps some of the accoutrements of civilization are not only unhealthy now, they were also unhealthy then.”

The unusual findings were presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla., and published simultaneously in the Nov. 18 issue of the Journal of the American Medical Association.

“We can’t say that atherosclerosis was the cause of death, but the simple fact that they had it was a great surprise to us,” said study co-author Dr. Samuel Wann, chairman of the department of cardiovascular medicine at the Wisconsin Heart Hospital in Wauwatosa. “We thought it was a disease of McDonald’s. We had this vision of people 3,000 and 4,000 years ago being more pure, free-living and not subject to the evils of modern civilization, but this has been going on for a long time.”

The research started when two physicians, one American and one Egyptian, saw a sign on a mummy at the Museum of Egyptian Antiquities in Cairo, saying that the pharaoh on display had atherosclerosis.

“How did they know?” the doctors wondered. Before getting a grant to carry out the research, none of the scientific team members thought the mummies would have atherosclerosis.

Twenty-two mummies were selected for CT (computed tomography) imaging scans on a machine kept in a truck behind the museum but seldom used. Those chosen had withstood the ravages of time better than most.

“The state of preservation of some of the bodies was superb,” said Dr. Randall C. Thompson, second author of the study, who’s with the Mid-America Heart Institute in Kansas City, Mo. “There were parts of the cardiovascular system that were intact amazingly well, and on the CT scan we could tell these were arteries, heart, cardiovascular tissue — even on mummies 3,000 or 3,500 years old. Atherosclerosis looked just like it does in modern patients.”

Definite or probable atherosclerosis was found in nine of the 22 mummies, and was more common (present in seven of eight) in older mummies — that is, mummies thought to have been 45 years or older when they died, the researchers said.

Fourteen of the mummies were members of the aristocracy or the royal household, including Lady Rai, nursemaid to Queen Nefertari, along with priests or priestesses and one soldier, the researchers said.

“We have every reason to believe the others were wealthy individuals as well because of the cost of mummification,” Thompson said. “In upper-class older and middle-age Egyptians, atherosclerosis was not uncommon.”

The disease process affected men and women.

Ancient Egyptians didn’t smoke tobacco, eat processed foods or skimp on exercise as far as anyone knows, but they did farm and eat protein.

“They did eat animals. Drawings on the tomb showed they ate ducks and sheep and particularly salted fish,” Wann explained. Hieroglyphics have also depicted what might be chest pain from a heart attack, the authors said.

The salt component of the diet may have resulted in high blood pressure, but that is only speculative, Thompson said.

One mummy had calcification at the base of the heart that some researchers thought might be indicative of a heart attack.

The investigators weren’t able to tell if the mummies were obese or had diabetes.

“This gives us insights into the relative importance of risk factors versus genetics,” Thompson said. “I use this information to give my patients hope. A lot of my patients have a certain denial. Why did this happen to me? Others have a sense of guilt or blaming family members, but this disease has been around since before the time of Moses. It’s older than the pyramids, and I think this knowledge helps patients get past the guilt and denial so they begin the healing process.”

A simple telephone intervention improved mood, physical functioning, and overall quality of life in patients who were depressed after heart bypass surgery, researchers reported in a late breaking clinical trial here at the American Heart Association Scientific Sessions 2009.

In the so-called Bypassing the Blues trial, 50 percent of patients who were depressed after having coronary artery bypass surgery saw improvements of at least 50 percent in their negative mood after participating in the intervention, compared with 29 percent of control patients who received usual care.

Depressed men benefited most and were far less likely to be re-hospitalized for heart-related causes than men who got usual care, said study presenter Dr. Bruce L. Rollman, from the University of Pittsburgh, Pennsylvania.

Depression after heart surgery “is often unrecognized,” Rollman noted. When a patient still has symptoms, such as pain, the physician will order another stress test or other heart test “and they overlook the obvious sometimes. We just want people to be aware of the impact of depression and that there are safe and effective treatments available.”

In the trial, researchers screened heart bypass patients for depression before they were discharged from the hospital. Screen-positive patients were contacted again two weeks later when they were at home to see if their depression was persisting. If so, they were randomly allocated to receive an 8-month course of telephone-delivered collaborative care or usual care.

Patients in the collaborative care group received a workbook, mailed to them at home, which contained basic “talk therapy” approaches as well as recommendations for exercising, getting plenty of quality sleep, and staying connected socially.

Antidepressants were provided if patients felt it necessary. Patients who were already taking antidepressants could have their dose changed or could switch to another medication, and suggestions were made for consults with local mental health specialists if patients were not improving, Rollman said.

Trained nurse practitioners phoned the patients every other week at the start of the intervention and then once a month as the study progressed.

This simple intervention proved effective in relieving depression after heart bypass surgery, Rollman reported.

Patients should be screened for depression after heart bypass surgery, he said, because it occurs in roughly 25 percent of cases, and, as this study shows, treating depression speeds recovery.

“Many practices have care managers for helping people with their diabetes and other chronic conditions and a similar program could be used to help patients who are depressed cope after their bypass surgery,” Rollman said.

The erectile dysfunction drug sildenafil, commonly known as Viagra, boosts the heart’s pumping ability in children and young adults who’ve had the Fontan operation to correct single-ventricle heart defects, researchers report.

In the Fontan operation, doctors direct venous blood directly to the pulmonary arteries, bypassing the heart. The procedure is the third surgery in staged reconstruction for children with single-ventricle defects, explained the researchers from the Children’s Hospital of Philadelphia in a news release from the American Heart Association.

The study included 27 children and young adults who’d undergone the Fontan operation an average of 11 years earlier. The patients, average age 15, were given either a placebo or 20 milligrams of sildenafil three times daily for six weeks. That was followed by six weeks of no drug or placebo, and then the participants were switched to the opposite arm of the study for another six weeks.

Before and after each phase of the study, researchers assessed the participants’ heart function and found significant improvements in the myocardial performance index during the sildenafil phase compared to the placebo phase. They also found that taking sildenafil improved diastolic performance and increased heart output, but the differences didn’t reach statistical significance.

There was no difference in the average myocardial performance index improvement between the right ventricular dominant subgroup and the non-right ventricular dominant subgroup, indicating a benefit regardless of ventricular structure.

The findings suggest that improved ventricular performance associated with taking sildenafil may improve patients’ exercise performance and quality of life, the researchers concluded.

The study was scheduled to be presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla.