smokeless tobacco products, including Ariva, are displayed in Richmond, Va. In the smoker-heavy state of Kentucky, a cancer center is suggesting something that most health experts won’t and the tobacco industry can’t: If you really want to quit, switch to smoke-free tobacco
Heavy drinking tied to stomach cancer War vets with PTSD fight sleep disorder

HONOLULU, Oct 30, (RTRS): New research shows high rates of sleep disorders among veterans of America’s wars in Iraq and Afghanistan who have post-traumatic stress disorder (PTSD) or head injuries.
The study conducted at Walter Reed Army Medical Center in Washington, DC, found that among some 300 soldiers with PTSD, head injuries or both, more than half had sleep apnea — a serious interruption of breathing during sleep — and nearly half had insomnia.
“Sleep complaints were universal,” wrote Dr Jacob Collen and his colleagues in their research summary. Collen’s team presented their findings this week at the annual meeting of the American College of Chest Physicians in Honolulu.

The researchers studied 135 soldiers with PTSD, 116 with traumatic brain injury and 66 with both conditions.
Sleep testing performed on most of the patients found obstructive sleep apnea in 56 percent of them and insomnia in 49 percent.

More than two-thirds (71 percent) of the soldiers had restless nights of fragmented sleep. Nearly nine in ten (87 percent) were “hypersomniacs,” sleepy during waking hours, Collen said.
“We found that sleep disorders appear to break down by presence or absence of injury and by the type of injury,” he noted.
In soldiers with traumatic brain injury, he said, “blast injuries appeared to be associated with insomnia and anxiety,” and blunt head trauma was more closely linked to sleep apnea.
Among the traumatic brain injury victims, 63 percent with blast injuries had insomnia, compared to 40 percent of those with blunt trauma. But only 26 percent of those with blast injuries had sleep apnea, compared to 54 percent of those with blunt trauma.

Overall, sleep apnea was significantly more common (78 percent) in patients without traumatic brain injuries, the researchers found.
And in the PTSD patients, sleep apnea was more common in those who hadn’t suffered any physical injuries. Among the soldiers with PTSD and sleep apnea, only about a third had battle injuries (37 percent), whereas more than two-thirds of veterans with PTSD but without sleep apnea had been injured in battle (71 percent).

The PTSD data “raise the question of whether having undiagnosed obstructive sleep apnea before you deploy could act as a risk factor for developing PTSD,” Collen said. “We don’t have data to support that, it was just an interesting question.”

Dr Brian Carlin, a pulmonologist and sleep medicine specialist at Allegheny General Hospital in Pittsburgh, who was not involved in the study, called the rates of sleep problems among the soldiers “inordinately high.”
Insomnia among head-injury victims was not a surprise, Carlin said, but sleep apnea is. “Almost half of the soldiers who had blunt trauma had sleep apnea.

In a presumably healthy and relatively fit population (similar to the soldiers), the rate of sleep apnea is probably four percent to five percent,” Carlin said.
“You just wonder now what is the relationship between trauma to the head and sleep disorders.”
Collen told Reuters Health that military and civilian doctors treating recent veterans should keep an eye out for sleep disorders, which can have long-term consequences to health.
“These are durable diseases. Untreated sleep apnea, untreated PTSD — the (effects) of those go on for some time,” Collen said. “So... it’s important for non-military physicians who really aren’t as familiar with this to pursue a comprehensive sleep evaluation.”

Heavy drinking: Men who down more than four alcoholic drinks in a day may have a heightened risk of stomach cancer, a large European analysis suggests.
A number of studies have looked at whether people’s drinking habits are related to their risk of stomach cancer, and come to mixed conclusions.

These latest findings, from a study of more than 500,000 European adults, suggest that heavy-drinking men are more likely to develop the cancer than light drinkers are.
At the start of the study, 10,000-plus men said they averaged more than four drinks per day. And their odds of developing stomach cancer over the next decade were twice those of light drinkers (who had the equivalent of about half a drink per day or less).

When the researchers looked more closely at the type of alcohol people consumed, they found that beer, in particular — as opposed to wine or liquor — seemed to be connected to stomach cancer risk.
There were no similar connections seen in women, according to the researchers, led by Dr Eric J. Duell of the Catalan Institute of Oncology in Barcelona, Spain. But there were also far fewer heavy drinkers among the female participants (just under 2,300).

The findings, reported in the American Journal of Clinical Nutrition, do not prove that alcohol itself leads to stomach cancer in some men.

And the absolute risk for any one heavy drinker may be small. Of nearly 13,000 men and women who were heavy drinkers when they entered the study, just 33 developed stomach cancer over the follow-up period.
Still, experts already recommend that people who drink do so only in moderation. That generally means no more than two drinks per day for men, and no more than one for women.

Heavy drinking is linked to cancers of the mouth and throat, as well as other serious conditions like scarring of the liver.

Stomach cancer is relatively uncommon in the U.S. and other Western countries, though it’s much more prevalent in other parts of the world, particularly developing nations. About 21,500 Americans will be diagnosed with stomach cancer this year, according to the American Cancer Society.
Smoking is one of the risk factors for the disease. And in some past studies, it’s been hard to separate the possible effects of heavy drinking on stomach cancer from those of smoking — since the same people often have both habits.

In the current study, though, Duell’s team found that heavy drinking was linked to stomach cancer in men regardless of smoking habits.

The link also held when the researchers factored in people’s diet habits (red and processed meats, for example, have been tied to stomach cancer) and any infection with H. pylori — a type of bacteria that contributes to ulcers.

While most people with H. pylori do not develop cancer, persistent infection is thought to raise the risk of stomach cancer in certain people.

If heavy drinking is a cause of stomach cancer, it may be related to one of the metabolic byproducts of alcohol — called acetaldehyde. The substance is a known human carcinogen, Duell’s team notes.
On top of that, beer contains compounds known as nitrosamines, which cause cancer in animals. So it’s possible, the researchers speculate, that the combination of those substances and acetaldehyde could explain why beer, in particular, was tied to stomach cancer in this study.

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