The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
March 10, 2005

Important Medical Disclaimer: The content displayed in Personal Health is designed to educate and inform. Under no circumstances is it meant to replace the expert care and advice of a qualified physician. Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Personal Health assumes no responsibility for how information presented is used.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL HEALTH for the week of February 5 - 11

  

  1. Patients with Serious Illness Appear to Adapt Well
  2. Study: PMS May Cost Employers Millions
  3. Vitamin D, Calcium OK for Crohn's-Related Bone Loss
  4. Flu Shots for Kids Would Protect Many Adults
  5. Survey Finds Pain Common in Children and Teenagers
  6. Many Overrate Pre-Surgery Back Pain
  7. Mortality Not Higher for Most with Prostate Cancer
  8. Timely Tips for Teens and Their Teeth
  9. Herbal Remedy as Good as Drug for Depression: Study
  10. Bioartificial Kidney Promising in Early Trials
  11. Breast Exam Adds Little to Mammography: Study
  12. Health Tip: Rhinitis + Sinusitis = Misery
  13. Antibiotic Overuse Linked to High Resistance Rates
  14. Gene Mutations May Explain Women's Higher MS Rate
  15. Bone Thinning Occurs Faster Among Whites: Study
  16. Rainforest Plant Yields Breast Cancer Fighter
  17. Vaccine Advisers Call for Teen Meningitis Jab
  18. Foods Like Fish May Buoy Your Mental Health
  19. When Your Biological Clock Says Time's Up
  20. Scientists Find Clue to Brain Development
  21. FDA Says May Study Hyperactivity Drug Risk
  22. Mouse Allergen Ups Asthma Risk in Inner-City Homes
  23. Babies Learn Words Long Before Speaking
  24. Mom's Work Schedule Affects Child's Development
  25. Health Tip: Preventing Birth Defects
  26. Family Stress Linked to Diabetes in Children
  27. Health Tip: Controlling Hunger While Dieting
  28. Crunch! Carrots May Cut Cancer Risk
  29. Protein from Red Meat, Dairy Tied to Heart Risks
  30. Stretching Artery-Opening Stents Deemed Safe
  31. Pain Disorders Linked to Patient's Perception
  32. Gene May Spur Childhood Brain Cancer
  33. High-Protein Infant Diet Could Lead to Wrong Diagnosis
  34. Health Tip: Treating Knee Pain
  35. Blood Pressure Therapy Boosts Cerebral Blood Flow
  36. Cardiac Stem Cells Found in Newborns
  37. Eating Well Staves Off Disability
  38. Awareness May Remain After Severe Brain Injury
  39. Depressed Moms Raise Risk for Kids' Behavioral Woes
  40. Fibromylgia Doesn't Mean Inactivity, Study Finds
  41. Researchers Fish for Clues to Cancerous Moles
  42. Sweet Drinks Help Some Preschoolers Pack on Pounds
  43. Gene Variant Ups Osteoporosis Risk
  44. Cancer Raises Blood Clot Risk by Sevenfold
  45. Health Tip: Steps to Less Stress
  46. Blood Infection More Likely in Diabetics
  47. Health Tip: Detecting Ear Infections in Children
  48. Sleep Hormone May Affect Sex Organs, Study Finds
  49. Study Links Autism and Mother's Illnesses
  50. Infant Infection May Impair Adult Memory
  51. Diet Lowers Cholesterol as Well as Drug Study
  52. Health Tip: Taking Your Medicine
  53. Sunlight May Have Unexpected Anti-Cancer Effects
  54. Sweet Gene Steers Kids Away From Vegetables
  55. Study Adds Evidence -- Bad Teeth Equal Bad Heart
  56. Some Hospital Transfers in Heart Cases Potentially Harmful
  57. Birth Size Linked to Some Adult Cancers
  58. 3 Risky Diabetes Drugs May Be Safe for Heart Patients
  59. Marijuana Affects Brain Long-Term, Study Finds
  60. No, Nicotine Probably Doesn't Ward Off Alzheimer's
  61. Black Asthma Patients Seen Less Responsive to Drugs
  62. Bone Density Returns After Teens Stop Depo-Provera
  63. Most Obese Kids Not Depressed: Study
  64. Shed Light on SAD to Ease Winter Blues
  65. Alcohol Ads in Magazines, Stores Raise Teen Drinking

 

  Friday, February 11, 2005

 

Patients with Serious Illness Appear to Adapt Well

 

By Alison McCook

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Most people who live with serious disability or illness, such as kidney failure, appear to adapt well and maintain a healthy outlook on life, new research reports.

This trend may be surprising to some -- the report also found that people without serious illnesses tended to underestimate the level of happiness in these patients.

"We think it is encouraging that for at least some illnesses, life seems to (eventually) go on and that people come to experience good and even normal mood levels," study author Dr. Jason Riis of Princeton University in New Jersey told Reuters Health.

"We cannot adapt to anything. But we are generally more resilient than we think," he said.

In the Journal of Experimental Psychology, Riis and his colleagues note that this is not the first study to show that people can adjust to good and bad life events. For instance, a nearly 30-year old study found that paraplegics were not that much less happy than lottery winners.

In the current study, Riis and his colleagues asked 49 dialysis patients to rate their moods on a regular basis. These patients were matched by age, sex and race to 49 people not on dialysis who were asked to imagine what their life would be like on dialysis. Eighty-two subjects completed the study.

The investigators found that dialysis patients were generally just as happy as people not on dialysis. While healthy people expected that they would have low moods most of the time if they were on dialysis, dialysis patients had low moods "quite infrequently," Riis said.

This finding suggests that emotional highs and lows gradually dissipate over time, Riis noted. For instance, getting married usually makes people feel great, while getting divorced often has the opposite effect. "But over time the emotions of the new circumstance stabilize so that being married is not that great and being divorced is not that bad," he explained.

Similarly, the dialysis patients said they believed they would be happier if they had never developed kidney disease -- an unlikely event, given that they were generally just as happy as the subjects without kidney disease, Riis noted. This suggests that patients also don't realize that the happiness they would feel at being cured would eventually fade over time, he said.

In another experiment, Riis and his team asked people who were or were not on dialysis to rate their moods periodically, and then recall later how they felt on those days.

They found that dialysis patients remembered fairly accurately how they felt, while healthy people tended to rate their previous moods as worse than they actually were.

This finding offers another, more subtle explanation for why generally healthy people believe that being very ill can give you a negative outlook on life, Riis noted.

"If healthy people underestimate their own moods, they would also tend to underestimate the moods of other people, including patients," he said.

Just why healthy people do this is somewhat of a mystery, Riis noted. "We speculate that the hardships of illness may make sick people more likely to savor good moments, but we do not have evidence for this," he said.

Source:  Journal of Experimental Psychology, February 2005.

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Study: PMS May Cost Employers Millions

 

HealthDayNews

Friday, February 11, 2005

FRIDAY, Feb. 11 (HealthDayNews) -- Lost productivity and missed work time mean premenstrual syndrome (PMS) can greatly increase costs for employers, a new study finds.

The researchers, led by Dr. Jeff Borenstein of Cedars-Sinai Medical Center in Los Angeles, assessed PMS symptoms in 374 working women, aged 18 to 45. For two months, the women recorded any PMS symptoms, along with PMS-related missed work time and lost productivity.

Based on the diaries, the researchers concluded that 30 percent of the women had PMS. Those women also had an average of $59 more per year in insurance claims than women without PMS.

But the largest impact of PMS was on missed work time and productivity. Women with PMS had an average 14 percent reduction in expected work hours per week and a 15 percent reduction in work productivity, compared to women without PMS.

Overall, total indirect employer costs for women with PMS were about $4,333 more per year than for women without PMS, the study found.

The researchers estimated that in a health plan with 10,000 women aged 18 to 45, PMS would increase indirect costs by close to $13 million a year, along with $175,000 more in direct health costs.

Helping female employees cope with their symptoms would go a long way to reducing this fiscal burden, the researchers conclude. "Corporate benefits plans that support the use of clinically effective PMS therapies are likely to be a cost-effective investment," they wrote.

The study appears in a recent issue of the Journal of Occupational and Environmental Medicine.

More information

The U.S. National Women's Health Information Center has more about PMS.

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Vitamin D, Calcium OK for Crohn's-Related Bone Loss

 

By Megan Rauscher

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Adding etidronate to calcium and vitamin D therapy is not necessary in the treatment of bone loss in patients with Crohn's disease, results of a new study indicate. "The addition of the bone-building drug etidronate adds no additional advantage," Dr. Richard N. Fedorak told Reuters Health.

"This is an important finding," he noted, "since the bone-building drugs can have additional side effects including diarrhea and stomach upset that could make a Crohn's patient feel worse."

Etidronate, sold under the trade name Didronel (Procter & Gamble Pharmaceuticals), is one of the bisphosphonate drugs, used to treat osteoporosis.

Fedorak, at the University of Alberta in Edmonton, Canada, and colleagues, studied the effects of 2 years of calcium plus vitamin D supplementation, with or without etidronate therapy, in 154 Crohn's disease patients with low bone mineral density.

The subjects were randomly assigned to oral etidronate (400 mg) or no treatment for 14 days. Both groups then received calcium (500 mg) and vitamin D (400 IU) for the next 76 days. This cycle was repeated every 3 months for 2 years.

Bone mineral density in the lower spine, forearm and upper thighbone -- but not the total hip -- increased steadily, significantly, and similarly in both treatment groups, the investigators report in the journal Clinical Gastroenterology and Hepatology.

A large number of patients with Crohn's disease have low bone density due to treatment with steroids, poor nutrition, active inflammation, and calcium and vitamin D deficiencies, Fedorak told Reuters Health.

For Crohn's patients with low bone density, "our trial demonstrates that treatment with calcium and vitamin D supplementation alone will increase bone density by about 4 percent per year," he said. Adding etidronate does not appear to enhance the effects of calcium and vitamin D.

In an editorial, Dr. Charles Bernstein from the University of Manitoba in Winnipeg says this study provides reassurance that bisphosphonates are "rarely needed in inflammatory bowel disease patients" most of whom have low bone mineral density scores and many of whom are using steroids.

Source: Clinical Gastroenterology and Hepatology, February 2005.

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Flu Shots for Kids Would Protect Many Adults

By Janice Billingsley
HealthDay Reporter

HealthDayNews

Friday, February 11, 2005

FRIDAY, Feb. 11 (HealthDay News) -- U.S. flu rates would drop dramatically if the majority of schoolchildren, as well as members of high-risk groups, were vaccinated every fall, a new study suggests.

"Children are the most responsible for transmission of the flu. So, by vaccinating children in large enough percentages -- over 50 percent -- you could shut off transmission [to much of the population] in quantifiable amounts," said Ira Longini, a professor of biostatistics at Emory University's Rollins School of Public Health.

The results of his mathematical model appear in the Feb. 15 issue of The American Journal of Epidemiology.

In an encouraging development, federal statistics released Thursday showed that 57.3 percent of children aged 6 months to 23 months of age were vaccinated from September through December 2004, the first year that influenza vaccination was added to the childhood immunization schedule. A 2002 survey showed that only 7.7 percent of children in the same age group were vaccinated for influenza, according to the U.S. Centers for Disease Control and Prevention (news - web sites).

"It is wonderful news that so many children are being vaccinated against a potentially life-threatening illness like influenza," said Dr. Julie Gerberding, CDC director. "We must continue to urge parents to vaccinate their children and urge those at high risk for serious complications from influenza to step up and get vaccinated because the shot can save lives."

Children who are aged 6 to 18 tend to transmit the flu virus more readily than any other group of individuals due to their exposure potential to each other and because they have less immunity than adults, Longini said. So, the more children who are vaccinated against the flu, the less likely overall transmission to the entire population, his study concluded.

Longini pointed to several earlier studies that found a significant drop in flu rates when a large-scale vaccination program was undertaken among schoolchildren. A community trial in Michigan in 1968 found that when 85 percent of schoolchildren were vaccinated against a type of influenza that year, there was a 67 percent drop in flu rates among all townspeople, compared to a neighboring community that did not conduct a child vaccination program, he said.

Similarly, the Japanese government vaccinated approximately 80 percent of schoolchildren each year against the flu from 1962 to 1987, preventing an estimated 37,000 to 49,000 deaths annually among the elderly, Longini said.

It was the weight of these studies, combined with the shortage of flu vaccine in the United States this season, that prompted Longini and his colleague, Elizabeth Halloran, to do their analysis.

"I thought, 'There's a better way to do this,'" he said.

Using mathematical models, Longini determined that if 60 percent of all U.S. schoolchildren between 6 and 18 were vaccinated, as well as high-risk seniors, the number of flu cases among children up to 18 years old would drop from 17 million to about 500,000. And, the number of deaths among those over 65 would fall from 34,000 annually to 6,600.

Longini said that while these figures are compelling, there are a number of reasons why there is no broad-based program to vaccinate schoolchildren each year.

"Not everyone accepts this idea. The thinking is that if you vaccinate someone, that's who you're protecting. But that's not true," he said. "Once you get enough people vaccinated up to a threshold level, the transmission drops dramatically" across the board.

Also complicating efforts, he said, is the question of allocation of health resources.

"Flu isn't perceived as a big problem," Longini said. "And the question is, should the resources be used for other things, like cancer?

Dr. Keith Powell, Noah Miller Chair of Pediatrics at Akron Children's Hospital in Ohio and a member of the American Academy of Pediatrics' infectious diseases committee, said the data from Longini's analysis is compelling. A comprehensive child flu vaccine initiative would be very cost-effective and should be studied further, he added.

"If we really want to stop transmission, we could do a better job," Powell said. "I would do a demonstration project in the United States, taking a few geographic areas and comparing morbidity and costs with those areas that don't have the vaccination project. And if the answers are as clear as the mathematical model, I would make it a policy."

There are about 60 million schoolchildren in the country, so 42 million doses would be needed to reach the threshold of a 70 percent vaccination rate among children, the optimal level, Longini said.

Longini said that if the federal government guaranteed the purchase of this amount of vaccine, manufacturers would step forward to produce it on an annual basis.

More information

The latest guidelines on flu vaccination can be found at the U.S. Centers for Disease Control and Prevention.

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Survey Finds Pain Common in Children and Teenagers

Reuters Health

Friday, February 11, 2005  

NEW YORK (Reuters Health) - Most children and adolescents commonly experience pain, such as headache or gastric discomfort, which often restricts activities of daily living, according to a study conducted in Germany.

Dr. Angela Roth-Isigkeit, at the University of Schleswig-Holstein in Luebeck, and colleagues examined the impact of perceived pain on the daily lives and activities of 749 schoolchildren.

Parents of children in grades one to four were asked to complete pain questionnaires for their children. Children and adolescents from grade five onward completed the questionnaires themselves during class.

The researchers defined chronic pain as any continuous or recurrent pain lasting for three months or longer. The results of the study are published in the journal Pediatrics.

Of the children and adolescents included in the study, 622 (83 percent) reported that they had experienced pain within the last three months. The most prevalent types of pain were headache (61 percent), abdominal pain (43 percent), limb pain (34 percent) and back pain (30 percent).

The most frequent self-perceived triggers for pain were weather conditions (33 percent), illness (31 percent) and physical exertion (22 percent). These self-reported triggers varied between girls and boys.

Those who reported pain indicated that their pain caused sleep problems, inability to pursue hobbies, eating problems, school absences and inability to meet friends.

The prevalence of these restrictions in daily living increased with age, varied among participants with pain in different locations, and was significantly higher among girls than among boys of the same age, except between the ages of 4 and 9 years.

Overall, 51 percent of subjects with pain sought professional help for their conditions, and 52 percent reported using pain medications. The prevalence of physician visits and medication use increased with age.

"Health care utilization was predicted by increasing age, greater intensity of pain, and longer duration of pain but not by the frequency of pain," Roth-Isigkeit's team reports. "Only the intensity of pain was predictive of the degree of restrictions in daily activities resulting from pain."

The researchers say more information is needed to "enable parents, teachers, and health care professionals to assist young people with pain management, allowing the young people to intervene positively in their conditions before they become recurrent or persistent."

Source: Pediatrics, February 2005.

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Many Overrate Pre-Surgery Back Pain

HealthDayNews

Friday, February 11, 2005

FRIDAY, Feb. 11 (HealthDay News) -- While many patients believe spinal surgeries do wonders in relieving their back pain, a new study suggests many may also overrate just how bad their pre-surgery pain was.

Researchers in Spain say patients who had spinal surgery for back pain years previously recalled their pre-surgery pain as far worse than what they actually reported at the time.

The study included 58 people who had lumbar fusion surgery for chronic low back pain. Before their surgery, the patients completed standard evaluations of back pain and related disability. Those ratings were compared with retrospective pain ratings made by the patients an average of three years after surgery.

In their retrospective ratings, the patients consistently rated their pre-surgery pain as worse than they did in their original pre-surgery questionnaires.

The researchers, from the Hospital Vall d'Hebron, Barcelona, said the findings suggest that studies relying on patients' post-surgery ratings of pre-surgery pain may overestimate the effectiveness of spinal surgery to relieve chronic back pain.

The findings were published in the current issue of Spine.

More information

The American Academy of Family Physicians (news - web sites) has more about low back pain.

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Mortality Not Higher for Most with Prostate Cancer

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - The mortality rates for most men diagnosed with prostate cancer in the United States are no higher than those in the general population, a new analysis shows. "The bottom line is that most men diagnosed with the disease today can expect to live as long as, or longer than, men their age without the disease," two editorialists comment.

The value of prostate specific antigen (PSA) screening in reducing prostate cancer mortality is still in question, Dr. Hermann Brenner and Dr. Volker Arndt of the German Center for Research on Aging in Heidelberg report in the Journal of Clinical Oncology.

Widespread use of the PSA test in the US since the late 1980s means many more men are living with a diagnosis of prostate cancer, the physicians point out.

They used "the recently introduced period analysis methodology" to evaluate 5- and 10-year survival rates for 183,484 men diagnosed with prostate cancer between 1990 and 2000 included in the Surveillance, Epidemiology and End Results Program (SEER), a large US database.

Overall, relative 5-year survival rates for prostate cancer patients were 99 percent, and 10-year survival rates were 95 percent, Drs. Brenner and Arndt found. "That is, excess mortality compared with the general population was as low as 1 percent and 5 percent within 5 and 10 years following diagnosis, respectively," they explain.

For the two thirds of men with well or moderately differentiated localized or regional prostate cancer, there was no excess mortality at all.

The researchers note that it is possible that earlier diagnosis might not in itself mean longer survival. The question of whether PSA screening does in fact reduce mortality from prostate cancer must be answered by large-scale clinical trials, which are currently underway, they add.

In an accompanying editorial, Dr. George Wilding and Patrick Remington of the Comprehensive Cancer Center at the University of Wisconsin in Madison write: "Given the many uncertainties about this disease, this information alone will be helpful for clinicians and their patients when discussing treatment options and when considering what life will be like living as a prostate cancer survivor."

Source: Journal of Clinical Oncology, January 20, 2005.

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Timely Tips for Teens and Their Teeth

HealthDayNews

Friday, February 11, 2005

FRIDAY, Feb. 11 (HealthDay News) -- Teens may pay close attention to fashion and music, but many don't seem to devote much effort into looking after their oral health, says the Academy of General Dentistry (AGD).

"Many teens do not see a dentist for regular dental care and some have never even been to the dentist," AGD spokesperson Cindy Bauer said in a prepared statement. "They don't get the care they need or the proper oral education to make smart decisions on the foods they eat and on how to practice good oral hygiene habits at home."

As part of National Children's Dental Health Month in February, the AGD is offering the following oral health advice for teens:

More information

 

The U.S. Centers for Disease Control and Prevention (news - web sites) has more about oral health.

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Herbal Remedy as Good as Drug for Depression: Study

Reuters

Friday, February 11, 2005

LONDON (Reuters) - An extract of the herbal remedy St. John's wort is as effective as a commonly prescribed drug for people with moderate-to-severe depression, researchers reported this week Friday.

They compared the extract called WS 5570, which is made by the German company Dr. Willmar Schwabe Pharmaceuticals, and the antidepressant paroxetine sold by GlaxoSmithKline Plc under the brand name Paxil or Seroxat.

St. John's wort is also known as hypericum perforatum.

"In the treatment of moderate to severe major depression, hypericum extract WS 5570 is at least as effective as paroxetine and is better tolerated," Professor Armin Szegedi of the Charite-Universitatsmedizin, part of the University of Berlin, said in a report published online by the British Medical Journal.

In a study funded by the German company, the researchers compared the treatments in 251 patients, between 18 and 70 years of age, for six weeks. Half of the patients taking the extract reported an improvement, compared with one third taking paroxetine.

Patients taking the extract also reported fewer side effects, such as stomach disorders, according to the researchers.

Paroxetine belongs to a class of drugs known as selective serotonin re-uptake inhibitors (SSRIs). British and European health authorities have voiced concern that these antidepressants may increase the risk of suicide in young people.

"Our results support the use of hypericum extract WS 5570 as an alternative to standard antidepressants in moderate-to-severe depression, especially as it is well tolerated," Szegedi added.

St. John's wort has been called nature's alternative to Prozac, but researchers have warned that it can interfere with hormone treatment, antibiotics and chemotherapy.

Earlier studies have shown the herbal remedy is also effective for treating patients with mild depression.

The researchers called for further studies to confirm their findings.

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Bioartificial Kidney Promising in Early Trials

HealthDayNews

Friday, February 11, 2005

FRIDAY, Feb. 11 (HealthDay News) -- A number of intensive care units across the United States are taking part in a study to determine if a bioartificial kidney that contains billions of donor kidney cells can help kidney failure patients survive.

Preliminary research on 10 patients at the University of Michigan Medical Center and Cleveland Clinic Foundation found the device to be safe and effective. The current study is examining the effectiveness of the device over 72 hours.

"If you have renal [kidney] failure in the ICU, your mortality is extremely high. Anywhere from 50 to 70 percent of those patients die and over the past 20 years, despite dialysis, that has not changed much," one of the study's principal investigators, Dr. Harold M. Szerlip, a Medical College of Georgia nephrologist who specializes in acute renal failure, said in a prepared statement.

He said he hoped this new renal assist device, developed at the University of Michigan, could help kidney failure patients by mimicking the many important body functions handled by the kidneys.

"Existing forms of dialysis have only replaced the ability of the kidneys to rid the body of waste products and correct abnormalities in blood chemistry; they don't replace kidney function," Szerlip explained.

Those functions include modulating immune response, regulating vitamin D, hormone secretion, stimulating red blood cell production, and helping regulate blood pressure.

The bioartifical kidney utilizes billions of kidney cells that can perform many of these vital functions. The cells are grown into the walls of thousands of hollow fibers that are contained in a cartridge that's similar to those used for traditional dialysis.

More information

The U.S. National Kidney and Urologic Diseases Information Clearinghouse has more about treatments for kidney failure.

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Breast Exam Adds Little to Mammography: Study

By Amy Norton

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Having a doctor examine the breasts for potential signs of cancer may add little to the benefits of mammography screening, a large study suggests.

Researchers found that among nearly 62,000 women age 40 or older, the combination of mammography and a clinical breast exam detected only a small number of additional breast cancers compared with mammography alone.

Although the clinical exam did help catch cancers in women with dense breast tissue, in particular, it also put these women at greater risk of being told they might have cancer when they did not.

However, the findings should not be interpreted as a recommendation against clinical breast exams, according to the study's lead author.

"We're just trying to lay out the information for women," said Dr. Nina Oestreicher, a researcher at Kaiser Permanente in Oakland, California.

"It's really up to women and their doctors to make the decision," she told Reuters Health, noting that many factors, including a woman's personal risk of breast cancer and her degree of concern about the disease, could influence the choice to have regular clinical breast exams in addition to mammography.

Experts recommend that women at average risk of breast cancer have a mammogram every one to two years starting at age 40. Though mammography is imperfect, it is credited with reducing breast cancer death rates in a number of countries where the test is routinely performed.

However, the value of also having regular clinical breast exams, in which a doctor observes and feels the breasts for lumps and other abnormalities, has been unclear.

The new study, published in the American Journal of Roentgenology, suggests that much depends on the density of a woman's breasts. Oestreicher and her colleagues found that clinical breast exams carried a greater benefit for women with more dense breast tissue, compared with those with more fatty tissue.

Dense breasts contain more glandular and connective tissue than fat, making it easier for tumors to be obscured on mammograms. So in some cases, palpating the breast for lumps can catch a tumor missed on the imaging test.

On the flip side, study patients with dense breasts were also nearly twice as likely to get a false-positive result from a clinical breast exam, which can lead to unnecessary biopsies.

According to Oestreicher, women should discuss these pros and cons of clinical breast exams with their doctors, then base their decisions on their own circumstances. For example, she noted, a woman who is particularly concerned about breast cancer may feel that the modest benefit of clinical breast exams is worth the possibility of getting a false alarm.

Since women with denser breasts benefit more from clinical exams, it might be helpful, Oestreicher said, for women to find out their breast density, which can be determined when they have a mammogram.

The current study included 61,688 women who had undergone at least one screening with mammography and a breast exam.

The researchers found that mammography detected 78 percent of the cancers in these women, while breast exams were able to catch 21 percent. The addition of a clinical exam to mammography picked up 25 cancer cases (4 percent) in addition to those detected by mammography alone.

Source: American Journal of Roentgenology, February 2005.

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Health Tip: Rhinitis + Sinusitis = Misery

HealthDayNews

Friday, February 11, 2005

(HealthDay News) -- Nearly 40 million Americans are plagued by what seems like a constant runny, stuffed-up nose and a headache around the eyes, nose and temples. They may well suffer from two very common medical problems -- rhinitis and sinusitis, which are inflammations of the nose and sinuses respectively.

Those with allergies are especially prone. Although not life-threatening, rhinitis and sinusitis can make you just plain miserable.

The best course for preventing rhinitis and sinusitis, says the Asthma and Allergy Foundation of America, is to keep your nasal passages as free and clear as possible. This is particularly important if you have allergies.

If you have chronic rhinitis and tend to get repeated bouts of sinusitis, your doctor may prescribe a steroid nasal spray. Taken every day, this medication will help to keep the nasal and sinus passages from becoming inflamed.

To the extent possible, avoid exposure to the things that trigger your allergies. Keep cigarette smoke out of your home and avoid it in other places as much as possible.

Most important, keep your doctor informed of your progress.

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Antibiotic Overuse Linked to High Resistance Rates

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Overprescribing antibiotics to patients is associated with high rates of antibiotic resistance in southern and eastern Europe, according to a report from the Netherlands. If the situation is not corrected, "we will lose the miracle drugs of the 20th century," the investigators write in this week's issue of The Lancet.

"In view of the emergence of bacterial resistance and the decline in the rate of development of novel antibiotics, effective professional and public strategies to encourage appropriate prescribing of antibiotics should be studied and implemented," Dr. Herman Goossens, from the University of Antwerp in Belgium, and colleagues state.

Goossens' team assessed outpatient antibiotic use in 26 European countries by analyzing data provided between 1997 and 2002. In addition, the researchers correlated such use with antibiotic resistance rates.

The countries varied greatly in antibiotic use, with physicians in France prescribing the most antibodies and physicians in the Netherlands prescribing the least. In general, antibiotic use was higher in southern and eastern Europe and lower in northern Europe.

During the study period, the authors noted an overall shift toward using newer broad-spectrum antibiotics rather than the older narrow-spectrum agents.

Dramatic seasonal variations in antibiotic use were also seen, the investigators note. In particular, countries with high annual use of antibiotics showed heightened peaks of use in the winter.

As noted, a strong correlation was seen between antibiotic use and the development of drug resistance. For example, France, which had the highest outpatient use of penicillins in 2002, also had the highest rate of Streptococcus pneumoniae infections that were resistant to penicillin. Conversely, both of these parameters were lowest in the Netherlands.

"Population-based studies are needed to determine the motivations, expectations, and incentives that lead individuals to use or not use antibiotics," the investigators note.

"The ethics of promoting antibiotics in clinical situations in which they are unnecessary should be given serious consideration," they add.

Source: The Lancet, February 12, 2005.

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Gene Mutations May Explain Women's Higher MS Rate

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Women are about twice as likely to develop multiple sclerosis (MS) as men and new research suggests that this may be related to variations in the gene for interferon (IFN)-gamma, a protein involved in the immune system.

"It's a very promising lead about gender differences that may pertain to susceptibility to other disease too, such as rheumatoid arthritis," Dr. Brian G. Weinshenker said in a statement.

IFN-gamma therapy is known to have an adverse effect on MS outcomes, and women are known to express more IFN-gamma than men. These observations led Weinshenker, from the Mayo Clinic in Rochester, Minnesota, and colleagues to evaluate the association between IFN-gamma gene mutations and MS risk in a study involving three different populations.

In populations of men in the US and Northern Ireland, gene mutations resulting in increased IFN-gamma expression were associated with a heightened risk of MS, the researchers report in the online issue of Genes and Immunity.

A similar, but non-statistically significant, trend was also observed among Belgian men.

So what does this have to do with the gender bias in MS? As it turns out, women are more likely to harbor these mutations than men, the researchers report.

"Our finding isn't the whole genetic cause," Weinshenker said, "but it's a helpful step that could lead us to a more complete understanding of MS -- and ultimately, effective treatment.

Source: Genes and Immunity, January 27, 2005.

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Bone Thinning Occurs Faster Among Whites: Study

By Charnicia E. Huggins

Reuters Health

Friday, February 11, 2005

NEW YORK (Reuters Health) - Black women are known to have higher bone mineral density, associated with stronger bones, than white women. New findings suggest that one reason for this may be due to the slower rate of bone loss among elderly black women.

A team of researchers studied 6,007 Caucasian women and 482 African-American women, aged 65 to 94 years, and found that the rate of bone density loss was roughly two times slower in the black women than among their white counterparts.

"This observation is consistent with the lower rate of fracture observed in African-American women," study author Dr. Jane A. Cauley, of the University of Pittsburgh, and her colleagues write in this month's issue of the Journal of the American Geriatrics Society.

Previous research shows that African-American women have a 50-percent lower risk of experiencing hip fracture and other fractures. The reason for black women's higher bone mineral density is unclear, yet, such differences have been found to be evident even during the childhood years.

Studies have shown that the higher bone mineral density found among African-American children, in comparison to white children, seems to persist into old age, in some cases, even among women in their 80s or older.

In the current study, Cauley and her colleagues investigated rates of bone loss, which might explain the differences in bone mineral density among black and white women. To determine changes in bone mineral density, they evaluated the women's hip bones -- the site best known to predict hip fracture -- at the start of the study and again a few years later.

As mentioned, they found that the Caucasian women lost bone density at twice the rate of the African-American women. Each year white women lost an average of 0.58 percent bone mineral density of the total hip, compared with a 0.31-percent loss in black women, the report indicates.

Based on this finding, Cauley and her team estimated that the white women would lose an average 3 percent of hip bone mineral density over a five-year period, while black women would lose 1.5 percent.

In other findings, older women who were 75 years of age or older experienced a higher rate of bone mineral density loss than did younger women.

"Rates of bone loss increase in both groups," Cauley told Reuters Health. This finding was particularly evident among African-American women, which suggests that "very old African-American women may start to have an increasing rate of fracture," Cauley said.

Women who used hormone therapy had a slower rate of bone loss than non-users, but the rate of bone loss was slower among African-American hormone therapy users than among their Caucasian counterparts.

The reason for the slower bone mineral density loss among African-American women is unknown. Cauley intends to study the potential influence of vitamin D, as well as sex and growth hormones.

While the current findings point to the increased risk of bone thinning among white women, Cauley maintains that it is important for all women to be aware of the factors that increase their risk of bone fracture and the brittle-bone disease, osteoporosis.

African-American women are often overlooked for these conditions since they are known to be at lower risk, but "there are still African-American women who have osteoporosis," Cauley said.

All elderly women who are thin, experienced early menopause or have other risk factors should get a bone density test, Cauley advised.

In 2002, the US Preventive Services Task Force issued recommendations advising women age 65 or older to undergo routine screening for osteoporosis. Their recommendations, published in the Annals of Internal Medicine, were based on increasing evidence suggesting that a woman's risk of osteoporosis increases with increasing age, and that bone density tests can determine her risk of fracture in the short term.

Source: Journal of the American Geriatrics Society, February 2005.

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Thursday, February 10, 2005

 

Rainforest Plant Yields Breast Cancer Fighter

 

HealthDayNews

Thursday, February 10, 2005

THURSDAY, Feb 10 (HealthDay News) -- A compound derived from a rare South American plant shows promise as a treatment for breast cancer, according to a University of Virginia Health System study.

The compound, called SL0101, comes from the plant Forsteronia refracta, a member of the dogbane family that grows in the Amazonian rainforest.

The Virginia researchers say SL0101 stopped the growth of human breast cancer cells in laboratory cultures. The compound inhibits the action of a protein called RSK, which is important for controlling the growth of breast cancer cells but does not alter the growth of normal breast cells.

"By preventing RSK from working, we completely stopped the growth of breast cancer cells, but did not affect the growth of normal breast cells," researcher Deborah Lannigan, an assistant professor of microbiology at the University of Virginia Cancer Center, said in a prepared statement.

She and a colleague are now testing whether SL0101 can prevent the growth of human tumor cells in mice. It would likely be years before any human clinical trials took place, Lannigan said.

The study was published in a recent issue of Cancer Research.

More information

The U.S. National Cancer Institute (news - web sites) has more about breast cancer.

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Vaccine Advisers Call for Teen Meningitis Jab

 

Reuters

Thursday, February 10, 2005

WASHINGTON (Reuters) - Teen-agers and preteens should be routinely immunized against meningitis using Sanofi-Aventis's newly approved Menactra, U.S. vaccine advisers agreed on Thursday.

The vaccine can prevent a serious form of meningitis that can kill adolescents, the U.S. Centers for Disease Control and Prevention (news - web sites)'s Advisory Committee on Immunization Practices said.

It protects against four strains of Neisseria meningitidis bacteria and is licensed for use in adolescents and adults aged 11 to 55.

The new recommendations advise that children 11 and 12, teens entering high school at age 15 and college freshmen living in dormitories should be immunized against meningococcal meningitis.

"Meningococcal meningitis, caused by the bacterium Neisseria meningitidis, is a dangerous, potentially fatal bacterial infection that strikes nearly 3,000 Americans each year," the National Meningitis Association said in a statement endorsing the recommendation.

"The NMA believes these new recommendations will help save the lives of teens and college students across the country," said NMA executive director Lynn Bozof.

"Research shows adolescents and young adults are at increased risk for meningococcal disease and more likely to die as a result of the disease than younger children or older adults," Bozof said.

Meningitis starts out with flu-like symptoms but can progress rapidly to cause hearing loss, brain damage, limb amputation and death.

Symptoms include high fever, headache, stiff neck, confusion, nausea, vomiting and exhaustion.

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Foods Like Fish May Buoy Your Mental Health

 

By Ed Edelson
HealthDay Reporter

HealthDayNews

Thursday, February 10, 2005  

THURSDAY, Feb. 10 (HealthDay News) -- In research that literally offers food for thought, scientists have found that omega-3 fatty acids and uridine -- a natural substance found in foods -- work as well as antidepressants in preventing signs of depression.

The rat experiments used a well-established animal model of depression, according to the researchers from Harvard-affiliated McLean Hospital in Belmont, Mass.

The rats were placed in a tank of water, where they had no choice but to swim. After a while, the rats realized swimming was futile, so they simply began to float, a sign of surrender to depression. Given an antidepressant drug, however, they started swimming again, the researchers said.

But combined doses of omega-3 fatty acids and uridine were as effective as three different antidepressants in prompting the rats to start swimming again, said study author William Carlezon, director of McLean's Behavioral Genetics Laboratory.

"We had given these two components [omega-3 fatty acids and uridine] separately," Carlezon said. "As it became clear that each treatment in its own way was having an effect, we came up with the idea of giving them together to see if there would be a synergistic effect, because they act on the same system."

The drugs and the dietary components used in the study probably act on mitochondria in brain cells, he said. "Mitochondria produce energy for brain cells," Carlezon explained. "Imagine what happens if your brain does not have enough energy. Basically, we were giving the brain more fuel on which to run."

The findings appear in the Feb. 15 issue of Biological Psychiatry.

Omega-3 fatty acids are well-known ingredients in many fish, and are most abundant in oily species such as salmon and tuna. Cardiologists recommend a diet rich in oily fish because omega-3 fatty acids are good for the circulatory system. And what's good for the heart is also good for the brain, said Dr. Bruce Cohen, president and psychiatrist-in-chief at McLean Hospital.

"If you study people around the world and take people of similar background, the group eating more fish has a lower rate of heart disease and depressive illnesses," Cohen said.

Omega-3 fatty acids are best obtained by eating fish rather than in dietary supplements, he said. "In fish, they are fresh and in the form you need," Cohen said.

Uridine is a different matter. It's not found in high levels in any particular food, Carlezon said. It is an important element in mother's milk, and baby formula is enriched with uridine because it is essential for early nerve growth, he said.

There are no uridine supplements now on the market, but there might be a case for them, Carlezon said. More studies are needed to see whether uridine in the diet affects mental capacity and learning, he added.

There are growing indications that mitochondria are involved in psychiatric conditions other than depression, Carlezon said. McLean researchers have found major alterations in the genes for mitochondria in people with bipolar disorder, a condition that includes cycles of depression.

More information

The National Institute of Mental Health offers a guide to depression and its treatment.

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When Your Biological Clock Says Time's Up

 

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Thursday, February 10, 2005

FRIDAY, Feb. 11 (HealthDayNews) -- More women are waiting longer to have children as they pursue college degrees and careers or simply enjoy young adulthood without kids in tow.

That trend could have sharp repercussions for women and couples eventually hoping to start a family. Those who wait too long could have trouble getting pregnant. Wouldn't it be nice for a woman to know in advance how many fertile years she has left?

Researchers in the United Kingdom say they've found a revolutionary way to read the tea leaves. By measuring a woman's ovarian volume using ultrasound and plugging that information into a computer model, it should be possible to predict when a woman will enter menopause and how much time is left on her biological clock, they said.

At least that's the theory.

"We are now looking for funding for a clinical study to prove our hypothesis that there is a very strong relationship between ovarian volume and ovarian reserve/age at menopause," said Dr. W. Hamish Wallace, a consultant pediatric oncologist at the Royal Hospital for Sick Children in Edinburgh, Scotland.

He and colleague Thomas W. Kelsey, a senior research fellow at the University of St. Andrews in Scotland, first unveiled their methodology last June in the journal Human Reproduction.

The occasional headline-grabbing tale of a 50-something woman becoming a new mother does not erase the fact that age remains a critical factor in determining female fertility. As a woman grows older, her ovaries produce fewer eggs. Fertility problems affect about a third of couples in which the woman is over 35, according to the National Women's Health Information Center.

A woman who delays pregnancy into her late 30s or 40s could miss the boat entirely if menopause precedes motherhood. When her monthly periods stop for good, she can no longer produce eggs or become pregnant.

Women who've had their ovaries surgically removed may experience menopause at any age. For most women, menopause occurs naturally around age 51, when the ovaries stop producing estrogen, according to the American Menopause Foundation.

But determining the precise onset of menopause is tricky. "Some women enter menopause prematurely at very young ages -- even less than 30," said Dr. Robert Schenken, president of the American Society for Reproductive Medicine and chairman of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio.

Having an accurate model for predicting when a 39-year-old will become menopausal could influence her decision about when to become pregnant, Schenken observed. "I think it's certainly worthy of further study," he said.

Physicians already use a variety of tests to evaluate female infertility, including a blood test that detects levels of follicle-stimulating hormone (FSH).

"That can tell us how hard the brain has to work to stimulate the ovaries," explained Dr. Alan Copperman, director of reproductive medicine at Mount Sinai Medical Center in New York City.

FSH and other hormone tests are generally administered as part of the workup of candidates for assisted reproductive techniques, including in vitro fertilization. But no current test is sufficiently accurate in predicting the precise age of menopause, fertility experts said; existing tests provide only pieces of the puzzle.

And there is a larger question: How many women really want to know when their baby-making days are over? "I think a lot of people don't want to know or, certainly, don't want to know bad news," Copperman said.

On the other hand, now that modern medicine has made it possible to freeze eggs for future use, a predictive test could be quite useful to a young woman who learns that she's less likely to be fertile in her mid- to late-30s, he conceded. She might consider putting away some of her eggs "almost as an insurance policy," he suggested.

Even if further studies validate Wallace's method for predicting menopause, it could be quite some time before it is recognized as a standard diagnostic tool. As far as he knows, no physicians or clinics in the United States or the United Kingdom are currently using it.

If you're trying to conceive, don't despair.

"I do not believe this paper gives any more information to women presently planning therapy than already exists," said Dr. William D. Schlaff, immediate past president of the Society for Reproductive Endocrinology and Infertility and chief of endocrinology and infertility at the University of Colorado Health Sciences Center in Denver.

More information

Visit the National Women's Health Information Center for more on infertility.

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Scientists Find Clue to Brain Development

 

HealthDayNews

Thursday, February 10, 2005

THURSDAY, Feb. 10 (HealthDay News) -- Abundant but poorly understood brain cells called glia turn out to be essential in the development of synapses -- critical connections that form between neurons in the brain during its development, according to a new study.

While scientists have long known that glia supported neurons in adults, this is the first time that researchers have identified the role of glia in forming the connections between neurons, says researchers at Stanford University School of Medicine, in California.

They announced their finding in the Feb. 11 issue of Cell.

The Stanford study also pinpointed two proteins called thrombospondins, made by glial cells that signal synapse formation. Mice genetically engineered to lack thrombospondins produced 40 pecent fewer synapses on average, compared with normal mice.

The findings may help lead to a better understanding of conditions such as epilepsy and addiction, where the brain forms too many synapses. The research could also lead to new ways to treat people with brain damage, the researchers said.

"We knew glia had a close relationship with neurons. We never thought that synapses would entirely fail to form without the glia," research leader Dr. Ben Barres, a professor of neurobiology, said in a prepared statement.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about the brain.

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FDA Says May Study Hyperactivity Drug Risk

 

By Deena Beasley

Reuters

Thursday, February 10, 2005

LOS ANGELES (Reuters) - The U.S. Food and Drug Administration (news - web sites) has warned that people with heart problems should not take the hyperactivity drug Adderall, and studies may be done to see if it raises risk in others, a top official at the agency said on Thursday.

The FDA (news - web sites) is aware that children have died after taking the drug, but cannot tell whether the rate is higher than it is in the general population, said Dr. Robert Temple, director of the FDA's Office of Medical Policy.

"There is a background rate of sudden death in children," he said.

Canadian regulators on Thursday suspended sales of Adderall XR, a drug for attention deficit hyperactivity disorder (ADHD) made by Britain's Shire Pharmaceuticals Group Plc, after the company said 20 people taking the drug, including 12 children, had suddenly died between 1999 and 2003.

The U.S. FDA last September ordered Shire to add a warning to the drug's label indicating that it should not be given to people with structural heart defects, but has not taken further action.

"We were aware of these reports of sudden deaths ... what we concluded was that five of the cases involved people with evidence of heart disease," Temple said.

Another case involved a child with Type 1 diabetes, a couple of the children had toxic levels of the drug in their blood and one child was exercised in the heat "until he was half dead from that," the FDA official said.

Over the same time period, the FDA's reporting system logged seven sudden deaths of children taking other ADHD stimulants -- Concerta, sold by Johnson & Johnson and Ritalin (news - web sites), made by Novartis AG .

All three drugs are amphetamines.

"The benefits of ADHD medicines are clear and the risks of undertreating patients are also clear," said Dr. Lenard Adler, director of the ADHD program at New York University School of Medicine. Untreated patients are more prone to be involved in automobile accidents, become divorced, to be unemployed, to smoke and to have substance abuse problems, he said.

Many patients who have previously had electrocardiograms will know whether they have cardiac problems. "For other patients, you have to discuss with them whether they should get an electrocardiogram," he said.

The rates of death -- Adderall has been prescribed for 700,000 Americans according to Shire -- are too low for a randomized clinical trial to detect, but the FDA is considering conducting epidemiological studies to determine risk, Temple said.

In addition, the agency may compare results from its reporting system for patients on Adderall, Concerta and Ritalin to results for patients taking Strattera, the first non-stimulant approved to treat hyperactivity.

Strattera is made by Eli Lilly . (Additional reporting by Ransdell Pierson in New York)

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Mouse Allergen Ups Asthma Risk in Inner-City Homes

 

HealthDayNews

Thursday, February 10, 2005

THURSDAY, Feb. 10 (HealthDay News) -- Airborne levels of mouse allergen in many inner-city homes may be high enough to trigger asthma attacks in children.

That's the conclusion of a Johns Hopkins Children's Center study in the February issue of the Journal of Allergy and Clinical Immunology.

The researchers analyzed air and dust samples from the bedrooms of 100 inner-city children with asthma and found that 84 percent of the bedrooms had detectable levels of mouse allergen. The study also found that 25 percent of the homes sampled had levels of airborne mouse allergen known to aggravate asthma symptoms in animal research lab workers who have asthma.

The researchers recommended routine mouse allergy testing for inner-city children with asthma.

"Children in inner-city homes are continuously exposed to the allergy-causing substance found in mouse urine that is circulating in the air," study lead author and pediatric allergist Dr. Elizabeth Matsui said in a prepared statement.

"This exposure increases their risk for developing allergic sensitivity to mice, just as it does for laboratory workers who constantly work with rodents," Matsui said.

Once they're sensitized, children exposed to high levels of airborne mouse allergen may be at greater risk for asthma symptoms, which could lead to full-blown asthma attacks.

"One of the best ways parents can manage their child's asthma is to control the home environment and remove any asthma triggers, including mouse allergen. They can do this by sealing cracks and holes in doors and walls, thoroughly disposing of all food remains, and having pest exterminators treat their home," Matsui said.

More information

The American Lung Association has more about childhood asthma.

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Babies Learn Words Long Before Speaking

 

HealthDayNews

Thursday, February 10, 2005

THURSDAY, Feb. 10 (HealthDay News) -- Children less than 1 year old are already learning to match up words with common objects, according to a new study.

In the study, an adult spoke simple words -- "fish" or "apple," for example -- and watched as infants turned to look at images of exactly those objects, indicating they had already learned the word's meaning. Only children who had been exposed to structured language learning through their parents were able to recognize the words, however.

"[Parents] should be aware that there may be no 'lower limit' to the age at which their children are able to learn new words," researcher Graham Schafer, of the University of Reading in the United Kingdom, said in a prepared statement.

The study appears in the latest issue of Child Development.

Schafer's findings contradict the current belief held by many educators and researchers that children aren't able to learn specific words until they're well into their second year. He said the findings suggest that what's considered "formal" learning of words may be underway in children long before they actually start to speak.

The study included 52 9-month-old babies. Their parents were instructed to show pictures of common objects such as apples, fish and chairs to the children during simple games four times a week for up to 10 minutes a session.

The games involved naming and pointing, sorting and identifying objects that didn't belong with others.

Three months into the study, the children were given a test of word understanding. They were each shown pairs of pictures and asked to identify one of them based on what the researcher said. For example, the researcher might instruct the child to look at a picture of a fish while holding a picture of a fish and an apple. The children were scored on whether they looked at the correct picture.

The children who'd been through the training sessions with their parents looked at the correct pictures. Untrained children in a control group weren't successful.

"This was notable because in the test, the pictures, voices and the context were all new to the children. So we can conclude that the children who had taken part in the games with their parents had learned these particular words, and not in a way linked to a special context," Schafer said.

Based on the findings, "it appears that young children may understand word use more flexibly than scientists and parents have previously thought," he said. The findings also suggest that "parents should definitely talk to their young children, even more than they may already do," Schafer added.

More information

The American Speech-Language-Hearing Association offers tips on how to encourage speech and language development in children.

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Mom's Work Schedule Affects Child's Development

 

By Alison McCook

Reuters Health

Thursday, February 10, 2005

NEW YORK (Reuters Health) - Children whose mothers work nights, evenings or rotating shifts are more likely to be behind the curve in mental development at age 2 and in language ability at age 3, new research reports.

Study author Dr. Wen-Jui Han explained that it's likely not the work itself that may affect kids, but other factors that arise when women work non-traditional shifts.

For instance, research shows that young children whose mothers work nights and rotating shifts are more likely to be looked after by fathers and relatives and less likely to attend day care, which can help their growing brain, the researcher noted.

"This does not suggest that father care or relative care is not good," said Han, who is based at Columbia University in New York. "It rather suggests that these children whose mothers work nonstandard hours may miss out on an opportunity."

Han stressed that parents who work nights, evenings or rotating shifts should not blame themselves for how their children develop.

Mothers who work non-traditional shifts "are doing the best they can, so it is time for the nation to take a serious look at our family and childcare policies -- we need policies to support these families to do their best," Han noted.

An increasing number of men and women are working nights, evenings and rotating shifts, Han and colleagues report in the journal Child Development. For instance, a 1999 study showed that 27 percent of men and 33 percent of women who work full-time have non-standard shifts, an increase from the 1980s.

Previous research has shown these schedules can be hard on adults' physical and psychological well being, increasing the risk of depression, fatigue and marital instability. However, researchers have done little to examine how the schedules -- and their effect on adults -- influence young children.

To investigate, the researchers followed approximately 900 children through age 3, conducting a series of home visits and phone interviews. All of the mothers had worked during the child's first three years of life.

Night shifts included working hours from 11 PM to 7 AM, while evening shifts lasted from 3 PM to 12 AM.

The authors found that approximately one half of mothers worked a non-standard shift during their children's first years of life.

Children whose mothers worked non-standard shifts were more likely to be behind their peers in terms of mental development at age 2 and language ability at age 3.

Hopefully, this study will "open the dialogue" about the relationship between mothers' work and children's development, Han said.

"When parents are doing the best they can, and children may still suffer from the best, it only suggests that it does take a nation to raise a child," Han added.

Source: Child Development, January/February 2005.

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Health Tip: Preventing Birth Defects

HealthDayNews

Thursday, February 10, 2005

(HealthDay News) -- Not all birth defects can be prevented, but a woman can take some actions that help her chances of having a healthy baby. Many birth defects happen very early in pregnancy, sometimes before a woman even knows that she's pregnant.

If you are planning to get pregnant or are already pregnant, one of the most important things you can do is to see your health care provider. Prenatal (before birth) care can help find some problems early in pregnancy so that they can be monitored or treated before birth.

The National Center of Birth Defects and Developmental Disabilities suggests you also do the following:

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Family Stress Linked to Diabetes in Children

Reuters Health

Thursday, February 10, 2005

NEW YORK (Reuters Health) - Psychological strain within families may help trigger diabetes-related autoimmunity in infants, as well as accelerate the progression of the disease in children who are already diagnosed with diabetes, according to new study findings. Moreover, researchers found that this association is seen even in families without a history of diabetes.

As Dr. Anneli Sepa and colleagues from Linkoping University, Sweden, point out in Diabetes Care that "a number of disparate environmental factors (including experiences of serious life events) have been proposed as trigger mechanisms for type 1 diabetes or the autoimmune process behind the disease."

They hypothesized that psychosocial stress in families "may affect children negatively due to a link to hormonal levels and nervous signals that in turn influence both insulin sensitivity/insulin need and the immune system."

To examine this idea, the researchers studied the first 4400 consecutive 1-year-old children from a large population-based study. Parents of the children completed questionnaires at birth and 1 year on several measures of psychosocial stress and socio-demographic background.

The infants had blood samples drawn at age 1 to look for type 1 diabetes-associated autoantibodies.

Infants with diabetes-related autoimmunity were more likely to have negative psychosocial factors, such as parents with high stress levels or families that had experienced a serious life event. This association was also observed in children with foreign-born mothers or with fathers who had low education levels.

"Our results support the view that psychosocial stress in the family induces stress in the child that is severe enough to trigger or promote the progression of beta-cell-related autoimmunity in infants," Sepa's team concludes.

Source: Diabetes Care, February 2005.

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Health Tip: Controlling Hunger While Dieting

HealthDayNews

Thursday, February 10, 2005

(HealthDay News) -- No matter what kind of diet you're on -- low-fat, high-protein, or low-carb -- hunger may be lurking to derail many weeks of discipline.

Ways to manage those hunger pangs include: minimizing the intake of trigger foods like potato chips or other foods with "hidden" fat or calories; following a diet plan that uses a meal replacement approach and portion-controlled meals to reduce caloric intake; aerobic and heavy resistance exercise; relapse prevention; social support; and stress reduction.

Regular physical activity is essential for long-term weight control, stress reduction, and overall health. Experts recommend that you participate in both aerobic activity and resistance exercise. Aerobic activity strengthens the heart and burns calories. Resistance exercise strengthens bones, builds muscle, and increases metabolism. But before you begin any new exercise program, the UCLA Health Network recommends you speak to your doctor.

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Wednesday, February 9, 2005

 

Crunch! Carrots May Cut Cancer Risk

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Wednesday, February 9, 2005

WEDNESDAY, Feb. 9 (HealthDayNews) -- There's more good news from the garden: A compound in carrots may be a potent cancer fighter, reducing malignancies in rats by a third, a European study claims.

"One of the natural pesticides in carrots is responsible for the cancer-preventing effect of carrots," said lead researcher Kirsten Brandt, a senior lecturer at the University of Newcastle upon Tyne, in England. "We now have identified a compound which seems to have an effect that can explain this benefit."

Nutrition experts have long recommended that people eat carrots because of their apparent ability to prevent cancer, but, until now, the particular compound driving this effect was not known. Epidemiological studies have shown that individuals with the highest carrot consumption can lower their risk of cancer by up to 40 percent.

Now, Brandt's team says that falcarinol, a compound that protects the vegetable from fungal diseases, may be the prime reason carrots are so unfriendly to cancers. One previous study had suggested that might be the case, but results were inconclusive.

To find out if falcarinol really does prevent cancer, Brandt's team studied 24 rats with precancerous tumors that mimicked human colorectal cancer. The rats were assigned to three groups, and each group was given a different diet.

After 18 weeks, Brandt's group found that rats that ate carrots along with their ordinary feed, as well as a second group that had falcarinol added to their feed, were one-third less likely to develop cancerous tumors compared with rats that were not given either, according to the report in the February issue of the Journal of Agricultural and Food Chemistry.

Brandt said the exact mechanism behind falcarinol's anti-cancer activity remains unknown. The researchers also don't know if the results seen in rats would be seen in humans. "But, it is encouraging that the data fits with what we have seen in humans," Brandt said.

These findings reinforce the message that people should eat five servings of fruit and vegetables everyday, she said.

"We have now tested carrots," she added. "But there are a lot of other vegetables that we have not tested, which might have the same properties. There are lots of other similar compounds in other vegetables."

However, whether the beneficial effect of falcarinol is diluted or eliminated when carrots are cooked or juiced is unknown. That needs to be tested, Brandt said.

The researchers were intrigued that the vegetable's natural pesticides may be the real cancer-fighters, not vitamins or other nutrients. According to Brandt, the discovery may answer the longstanding question, "Why is it that eating vegetables is so much better for your health than just taking a vitamin pill with the same amount of vitamins and minerals?"

In addition, the finding might be important in developing new cancer treatments, she said. However, Brandt believes the quickest benefit can be achieved by simply developing carrots that have more falcarinol. "We might be able to double the intake of falcarinol, and that might have large benefits for public health," she said.

Another expert, Vicky Stevens, a research scientist at the American Cancer Society (news - web sites), remains cautious. "It is a little difficult to know where this is going to go in relation to humans," she said "It is worthy of further research."

Stevens believes falcarinol might be just one weapon in the vegetable anti-cancer armamentarium. "We don't expect that there is going to be one single magic bullet. It is still important to consider the rest of the carrot, and other vegetables," she said.

"Perhaps the single most significant implication of this study is that it reaffirms dietary common sense in our era of dietary silliness," said Dr. David L. Katz, an associate clinical professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

Katz noted that some of the popular "low-carb" diets actually banish carrots because they have a high glycemic (sugar) index. "Brandt helps reveal the folly of this oversimplified and rigid interpretation of what constitutes good food," he said.

"We may have to wait to know for sure that falcarinol can help prevent cancer in humans," Katz said. "But we needn't wait to derive likely health benefits from eating carrots often -- and I, for one, don't intend to."

More information

The American Cancer Society can tell you more about diet and cancer.

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Protein from Red Meat, Dairy Tied to Heart Risks

 

By Amy Norton

Reuters Health

Wednesday, February 9, 2005  

NEW YORK (Reuters Health) - Older women who eat a relatively large amount of protein from red meat or dairy products may have an elevated risk of dying from heart disease, the results of a large study suggest.

The findings, say researchers, call into question the long-term safety of high-protein diets -- at least the ones that don't distinguish the protein in steak and cream from that in tofu and nuts.

The investigators found that among more than 29,000 postmenopausal women, those who reported the highest intake of protein from red meat and dairy products had a roughly 40 percent higher risk of dying from heart disease over the next 15 years compared with women with the lowest intake of these foods.

The risk would seem to stem from the protein intake itself, according to lead author Dr. Linda E. Kelemen, because her group considered the subjects' overall diet -- including intake of fat, fiber and total calories -- and factors such as exercise, smoking and body weight.

The findings are published in the current issue of the American Journal of Epidemiology.

High-protein and fatty foods are staples of Atkins-style diets that shun carbohydrates such as white bread and pasta. Though these diets have been shown to spur weight loss and dips in blood cholesterol in the short term, many experts worry that if people stick with such a menu over time, it could spell trouble for the blood vessels and heart.

Although the new study looked at women's normal protein intake -- and not high-protein, low-carb diets -- it has implications for adherents to those weight-loss plans, said Kelemen, an assistant professor of epidemiology at the Mayo Clinic College of Medicine in Rochester, Minnesota.

"I think it's very relevant to them," she told Reuters Health. First and foremost, Kelemen said, people should recognize that "not all proteins are equal," and replacing white bread and other highly processed carbs with steak and butter is not the way to go.

More healthful choices, according to Kelemen, include fish and chicken, which were not linked to heart disease mortality in this study.

Better still, perhaps, would be vegetable protein sources, such as beans, nuts, tofu and peanut butter; the study found that women with the highest intakes of these foods had a 30 percent lower risk of heart disease death than women with the lowest intakes.

In contrast, the findings indicate that a woman who opts for two servings of red meat every day instead of a similar number of calories from carbs would have a 44 percent higher risk of dying from heart disease over the next 15 years. A similar pattern emerged when the researchers looked at dairy foods, including milk, cream, ice cream, yogurt and cheese.

Exactly why protein from red meat and dairy products might boost heart risks is unclear, and it's possible, Kelemen said, that factors not captured in this study could explain the association.

However, she noted, there is animal research showing that protein from animal sources, independent of fat and cholesterol content, can promote artery-clogging plaques. Soy protein, on the other hand, showed no such effects.

Source: American Journal of Epidemiology, February 1, 2005.

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Stretching Artery-Opening Stents Deemed Safe

HealthDayNews

Wednesday, February 9, 2005

WEDNESDAY, Feb. 9 (HealthDayNews) -- Stretching the diameter of special drug-emitting, artery-opening stents won't weaken the stent or increase risks for artery re-closure, say Italian researchers.

Stents are tiny mesh devices used to prop open narrowed arteries. In recent years, new drug-eluting (emitting) stents have improved cardiac care, since they contain medicines that help prevent the vessel from re-narrowing.

One key factor in the success of any stent is how snugly it fits within the artery. In some cases, surgeons may stretch the diameter of the device beyond its intended size. But does this adjustment compromise stent strength or effectiveness?

In their study, researchers in Milan followed 254 patients whose diseased coronary arteries were treated with a drug-eluting stent. In 168 of the patients, the stent was extended to its intended 3 millimeter diameter. In the other 86 patients, the stent had to be extended to between 3.5 and 4 millimeters.

The researchers say they found no difference between the two groups in long-term rates of serious cardiac illness or restenosis -- a build up of scar tissue that can eventually re-block the artery.

"The need to overdilate a stent is frequently present when the artery is larger than the stent balloon system. It is important to know that such a procedure is not deleterious," investigator Dr. Antonio Colombo, of EMO Centro Cuore Columbus, said in a prepared statement.

The study appears in the February issue of the journal Catheterization and Cardiovascular Interventions.

More information

The U.S. Food and Drug Administration (news - web sites) has more about stents.

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Pain Disorders Linked to Patient's Perception

Reuters Health

Wednesday, February 9, 2005

NEW YORK (Reuters Health) - Patients with chronic pain disorders, such as fibromyalgia, appear to have abnormalities in the self-monitoring mechanism that allows the discrimination of internally produced versus externally produced stimuli, new research shows.

The findings, which appear in Psychosomatic Medicine, are based on a study of 20 patients with a chronic pain disorder (including 10 with fibromyalgia),10 with schizophrenia, and 10 normal controls.

The subjects were asked to rate a tactile sensation to the hands that was either self-produced by the patient moving the hand, or produced externally by an experimenter.

In normal subjects, the sensation from self-produced stimuli was rated as less intense than the sensation from the same externally produced stimuli, lead author Dr. Matthias Karst, from Hannover Medical School in Germany, and colleagues note.

In contrast, patients in the other groups rated these sensations as being comparable, the investigators point out. Further analysis showed that this observation was largely confined to patients with a chronic pain disorder.

"This is the first study of the self-monitoring in patients with chronic widespread pain," the researchers state.

The results suggest that chronic pain disorders "interfere with the correct function of the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced tactile stimuli."

Source: Psychosomatic Medicine, January/February 2005.

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Gene May Spur Childhood Brain Cancer

HealthDayNews

Wednesday, February 9, 2005

WEDNESDAY, Feb. 9 (HealthDay News) -- A gene that's normally switched off after fulfilling its role in brain development appears linked to a common childhood brain cancer, says a study in the Feb. 1 issue of Cancer Research.

The study found that multiple extra copies of this gene, called OTX2, had been switched back on in tumor cells taken from children with medulloblastoma, the most common form of pediatric brain cancer. Medulloblastoma accounts for nearly a third of all brain tumors occurring in children in the United States.

The scientists also found that trans-retinoic acid (ATRA), a powerful derivative of vitamin A, suppressed growth and induced death in tumor cells carrying switched-on OTX2. Treatment with ATRA had an effect on more than half of medulloblastomas grown in the laboratory.

"The response that ATRA imposes upon these medulloblastoma brain tumor cell lines suggests that this type of tumor may respond favorably to ATRA-based therapy," principal investigator Dr. Hai Yan, of the Brain Tumor Center at Duke University Medical Center, said in a prepared statement.

"ATRA is already clinically approved for the treatment of acute promyelocytic leukemia. These studies lay the conceptual and practical framework for clinical trials using ATRA in the treatment of a commonly lethal pediatric disease," Yan said.

More information

The U.S. National Cancer Institute (news - web sites) has more about medulloblastoma.

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High-Protein Infant Diet Could Lead to Wrong Diagnosis

Reuters Health

Wednesday, February 9, 2005

NEW YORK (Reuters Health) - Certain high-protein infant diets may cause elevated levels of the amino acids tyrosine and phenylalanine, which may in turn produce a positive test result for a metabolic disorder, according to the findings of two case reports described in the Journal of Pediatrics.

The first case involved a full-term male infant who tested positive for phenylketonuria (PKU) at 7 days of age, lead author Dr. Chulaluck Techakittiroj, from Tulane University in New Orleans, and colleagues note. However, when first tested between 24 and 48 hours of life, the results were negative.

Initially, the child was fed with Enfamil, but because of spitting up and jaundice, he was changed to a higher protein formula, Shaklee Slim Plan Drink Mix, on day 5. Aside from elevated tyrosine and phenylalanine levels, the child appeared normal at 2 weeks. Transient elevated tyrosine levels were detected but after changing to a lower protein diet, Isomil, the levels quickly returned to normal.

The second case involved a female infant with a similar history. In this case, however, the high protein diet was Pet evaporated milk. A switch to Similac brought the elevated tyrosine and phenylalanine levels back down.

In each case, the high protein diets provided around 8 g/kg per day of protein, whereas the standard formulas provided about 4 g/kg per day, the report indicates.

"These cases highlight the importance of following infant nutritional guidelines," the authors state. "Both patients were normal at the time of diagnosis, but the long-term effects of high protein intake in infants have not been" adequately studied, they add.

Source: Journal of Pediatrics, February 2005.

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Health Tip: Treating Knee Pain

HealthDayNews

Wednesday, February 9, 2005

(HealthDay News) -- Knee pain can result from being overweight, overuse, poor posture during physical activity, not warming up or cooling down, or inadequate stretching.

Many causes of knee pain, especially those related to overuse or physical activity, respond well to self-care, according to The National Institutes of Health (news - web sites):

You should call your doctor if you cannot bear weight on your knee; you have severe pain, even when not bearing weight; your knee buckles, clicks or locks; your knee is deformed or misshapen; you have a fever, redness or warmth around the knee, or significant swelling; you have pain, swelling, numbness, tingling or bluish discoloration in the calf below the sore knee; or you still have pain after three days of home treatment.

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Blood Pressure Therapy Boosts Cerebral Blood Flow

By David Douglas

Reuters Health

Wednesday, February 9, 2005

NEW YORK (Reuters Health) - In elderly patients with elevated systolic blood pressure -- the upper number in a blood pressure reading - effective blood pressure therapy increases blood flow to the brain, researchers report.

Contrary to widely held beliefs, the elderly have as much or more to gain from aggressive therapy for high blood pressure as young people do, lead author Dr. Lewis A. Lipsitz told Reuters Health.

"Many physicians are reluctant to lower blood pressure to recommended levels in elderly people because they believe this will reduce blood flow to the brain through stiff and narrowed carotid arteries," he added.

To investigate the effects of treatment, Lipsitz of the Hebrew Rehabilitation Center for Aged, Boston and colleagues studied patients 65 years old or older. The findings are reported in the journal Hypertension.

The patient groups consisted of 19 with normal blood pressure, 18 with high blood pressure that was effectively controlled with treatment, and 18 with uncontrolled high blood pressure -- systolic blood pressure greater than 160 mm Hg at study entry.

The uncontrolled group underwent aggressive treatment with lisinopril and other agents for 6 months. The other two groups were simply observed during this period.

At the end of the 6-month term of successful treatment, the previously uncontrolled group had significant increases in cerebral blood flow velocity and carotid artery flexibility on Doppler ultrasound imaging that was not seen in the other groups. None of the patients developed reduced blood flow to the brain.

These findings show that 6 months of blood pressure treatment improves blood flow to the brain and actually reduces the stiffness of the carotid arteries in elderly patients, Lipsitz concluded.

Source: Hypertension, February 2005.

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Cardiac Stem Cells Found in Newborns

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Wednesday, February 9, 2005

WEDNESDAY, Feb. 9 (HealthDay News) -- For the first time, researchers have found signs of stem cells in the hearts of rats, mice and humans after they were born.

The fact that the cells, which form in the right side of the heart, continue to exist after birth means they could be used to repair damage to the heart, explained Dr. Karl-Ludwig Laugwitz, co-first author of a paper appearing in the Feb. 10 issue of Nature.

Not only could the cells themselves be isolated for use, but it might also be possible to stimulate the cells in the adult heart, said Paul Sanberg, a distinguished professor of neurosurgery and director of the Center for Aging and Brain Repair at the University of South Florida in Tampa.

"It's exciting work and it has a lot of application, but it's clearly a bit away from showing that these will restore [heart] function," added Sanberg, who was not involved with the study.

Much medical hope has been pinned on stem cells, which are essentially the biological equivalent of blank slates, capable of differentiating into all types of cells needed in the body. It is hoped that one day stem cells may be able to replace or repair damaged areas of the body, including the heart.

Other research groups have reported the existence of heart stem cells, but did not provide evidence that these stem cells contributed to the development of the heart.

The current researchers first found these stem cells, called isl1+ cells, in the atrium (one of the heart's pumping chambers) of newborn mice and rats. By placing a kind of genetic 'tag' on the cells, the researchers were able to show that they went on to form beating heart muscle. According to the study authors, these stem cells evolved into fully mature and functional cells.

The cells were then found in tissue taken from five human newborns who were having surgery to correct congenital heart defects. In these types of procedures, surgeons usually throw away the region of the atrium in which these cells were found.

The cells may be involved in remodeling the heart after birth, ensuring that any defects are fixed and development is complete, the researchers speculated.

Importantly, the cells could also be cultured into millions more cells when placed on a layer of neighboring heart cells called fibroblasts. The isl1+ cells adopted the characteristics of the cells they were placed near.

The hope is that a person's own stem cells could be used to correct various medical problems. According to the researchers, these stem cells might be able to provide a cell therapy-based approach to heart disease in infants and children.

One day, Laugwitz explained, it might be possible to take a tissue specimen from a human infant undergoing surgery for a congenital heart defect, isolate the stem cells out of the tissue, amplify and differentiate them in the laboratory and return them to the infant to help grow healthy cardiac tissue.

The stem cells might also be usable for filling up holes in the heart, they said.

The next step is to try to isolate these stem cells from human beings and to transplant the isl1+ cells into living animals to observe their role in heart repair.

More information

Visit the International Society for Stem Cell Research for more on stem cells.

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Tuesday, February 8, 2005

 

Eating Well Staves Off Disability

 

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Tuesday, February 8, 2005

TUESDAY, Feb. 8 (HealthDayNews) -- Eating a diet rich in fruits, vegetables and dairy products appears to help maintain your ability to function normally as you age, a new study reports.

Older people who consumed more of these foods had less risk of physical limitations, such as the inability to walk a quarter mile or climb 10 steps, which are often the first signs of disability.

And those who ate the most fruits and vegetables had a lower risk of functional limitations nine years after they were initially evaluated, said study author Denise Houston, a research associate at Wake Forest University.

The results are published in the February issue of the American Journal of Clinical Nutrition (news - web sites).

In their study, Houston and her team initially collected data on 9,404 healthy black and white men and women, 45 to 64 years of age. They were part of the Atherosclerosis Risk in Communities Study.

Nine years later, the researchers looked at the participants' diet and levels of disability. They tested the people's ability to perform 12 daily activities, such as dressing and feeding themselves, being able to cook and manage their money, and being able to walk a quarter mile and walk up 10 steps without resting.

The researchers found that eating more dairy products and fruits and vegetables was associated with a lower risk of functional limitations. This was particularly true for black women, who were 50 percent less likely to struggle with some type of limitation, the study found.

Those eating the highest amounts of dairy products and fruits and vegetables consumed two servings of dairy, three servings of fruit and three servings of vegetables a day. Those eating the lowest amounts ate less than half a serving of dairy and one or less servings of fruits and vegetables a day, the researchers reported.

Currently, dietary recommendations call for three cups a day of low-fat or fat-free dairy products, two cups of fruit and two-and-a-half cups of vegetables, the researchers said.

Houston believes that because fruits and vegetables contain high levels of antioxidants, they can help to prevent cellular damage associated with aging. "Diseases associated with oxidative damage, like cardiovascular disease and cancer, can also lead to functional limitation," she said.

"A diet that's higher in fruit and vegetables and dairy products does have effects other than on chronic conditions like cardiovascular disease and cancer," Houston added. "It is possible that by eating a healthy diet you can also reduce the probability of having functional limitations and disability."

But Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said, "This study does not establish cause-and-effect. Both dietary intake, and disability, were self-reported and prone to inaccuracies."

Katz noted that living a healthy lifestyle may have influenced not just diet, but other practices related to risk of disability. "People who take care of themselves in one way tend to be people who take care of themselves in other ways, although attempts were made [by the researchers] to control for this," he said.

Katz added that healthy eating is a good thing whether it reduces the risk of disability or not. "There are health benefits from eating plenty of produce and low- or non-fat dairy. This is true whether or not it's time to add reduced risk of disability to the list."

More information

The U.S. Department of Agriculture can tell you more about healthful eating.

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Awareness May Remain After Severe Brain Injury

 

Reuters Health

Tuesday, February 8, 2005

NEW YORK (Reuters Health) - Patients in a minimally conscious state (MCS) -- those with severe brain damage who demonstrate intermittent awareness of their environment -- may retain some degree of cognitive function, even though they can't follow simple instructions or communicate, the findings from a small study suggest.

Using a special type of "functional" MRI scan, researchers found that such patients exhibit brain responses to speech similar to those seen in healthy individuals. The findings appear in the medical journal Neurology

"These findings raise important questions related to whether MCS patients have a greater capacity to experience subjective states but also to benefit from therapeutic interventions," Dr. Joy Hirsch, at Columbia University in New York, and her colleagues suggest in their report.

Hirsch's group performed functional MRI on two brain-injured patients in a minimally conscious state and on seven healthy subjects as they listened to narratives by family members. Functional MRI was also performed while the subjects' hands were touched.

"The MCS patients studied here showed remarkably similar brain activity to that evoked in healthy control subjects," the authors report.

"In our subjects, the resting MCS brain preserves an ability to recruit (nerve) networks necessary for cognition and interaction," Hirsch's group reports. This possibility "presents a humanitarian imperative to further investigate the state of consciousness of these and other brain-injured patients."

Source: Neurology, February 8, 2005.

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Depressed Moms Raise Risk for Kids' Behavioral Woes

 

HealthDayNews

Tuesday, February 8, 2005

TUESDAY, Feb. 8 (HealthDay News) -- A mother's depression may raise the risk for antisocial behavior in her child, especially when depression occurs early in her child's development, British researchers say.

Researchers at King's College, London studied 1,116 sets of twins and found much higher levels of antisocial behavior in 7-year-old kids whose mothers had suffered depression during the child's first five years of life.

The greatest risk for problem behaviors occurred in children whose mothers suffered from depression and also showed symptoms of antisocial personality disorder.

A family history of antisocial behavior "accounted for approximately one-third of the observed association between maternal depression and children's antisocial behavior," the study authors explained in a prepared statement. They say the study findings also suggest a strong environmental component linking exposure to a mother's depression with behavioral problems in her offspring.

The UK team believe a combination of three factors might explain the association between antisocial behavior in children and depression in mothers: First, depressed women are more likely to have antisocial personality traits related to depression; second, they are more likely to have children with men who also display antisocial behaviors; and third, children of depressed mothers may simply be genetically predisposed to antisocial disorders.

More information

The American Academy of Pediatrics has more about child behavior.

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Fibromylgia Doesn't Mean Inactivity, Study Finds

 

HealthDayNews

Tuesday, February 8, 2005

TUESDAY, Feb. 8 (HealthDayNews) -- Many people with fibromyalgia and other chronic pain conditions can be active without experiencing increased pain, says a study by researchers at the University of Michigan (U-M) Health System and the Uniformed Services University of the Health Sciences in Bethesda, Md.

The study included 38 people with fibromyalgia, chronic fatigue syndrome or both conditions, and 27 healthy subjects in a control group. Rather than relying on the study volunteers' self-reporting of their activity levels, the researchers conducted round-the-clock monitoring of the subjects using high-tech devices that track daily movement.

"When you ask people with fibromyalgia about their level of function in terms of activity levels, they'll report a lower function than almost any other group," senior author Dr. Dan Clauw, director of the U-M Chronic Pain and Fatigue Research Group and a professor of rheumatology at U-M Medical School, said in a prepared statement.

"The surprising thing that we found was that their average level of activity was about the same as someone who didn't have fibromyalgia," Clauw said.

However, he and his colleagues did find that those with fibromyalgia, chronic fatigue syndrome, or both, spent much less time doing high-level activities than those in the control group.

According to Clauw, the results suggest that fibromyalgia patients report poor physical function and increased pain after activity because they report only intense activities that do cause them higher levels of pain. They don't report -- and may not realize -- that they manage some level of activity without suffering increased pain.

"We've probably been thinking about fibromyalgia incorrectly. This group was impaired, but they weren't impaired in the way they though they would be. This is good news for fibromyalgia patients," Clauw said.

The findings could lead to changes in the treatment of people with chronic pain in the muscles and soft tissue, he noted.

"Exercise and activity are essential to the well-being of people with fibromyalgia. Our research shows that higher activity is not, in fact, leading people to increased pain, and it could be used to show patients that they can be active," Clauw said.

The study appears in the current issue of Arthritis & Rheumatism.

More information

The National Fibromyalgia Association has more about fibromyalgia.

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Researchers Fish for Clues to Cancerous Moles

 

HealthDayNews

Tuesday, February 8, 2005

TUESDAY, Feb. 8 (HealthDay News) -- Research in fish is shedding new light on how human skin moles develop into the deadly skin cancer melanoma.

Studying zebrafish, scientists at Children's Hospital Boston and the Dana-Farber Cancer Institute found that a specific mutation in a gene called BRAF is essential to mole development. When combined with another mutation in a gene called p53, moles developed into melanoma.

The findings are outlined in the Feb. 8 issue of the journal Current Biology.

Previous research found that the BRAF gene is mutated in about 75 percent of melanomas. But its role in causing this form of cancer wasn't clear.

In this study, scientists focused on genetically engineered zebrafish, an ideal candidate for genetic research since its genome is fully mapped and resembles that of humans. Female zebrafish can also give birth to more than 300 babies per week, allowing researchers to track genes as they are passed on.

The Boston team engineered zebrafish to produce the mutated form of human BRAF. These fish developed black-pigmented moles on their skin but did not develop melanoma.

However, when the fish were also engineered to be deficient in the p53 gene, which normally suppresses tumor growth, moles developed into invasive melanomas.

When cells from these tumors were injected into healthy zebrafish, they also developed melanomas, the researchers add

"We now know that BRAF, when activated, is sufficient to make moles. We also know that it's insufficient to make cancer -- you need other mutations, like a deficiency in the p53 tumor suppressor gene, to get melanoma," researcher Dr Leonard Zon said in a prepared statement.

He and his colleagues plan to search for gene mutations other than the p53 mutation that may also play a role in turning moles in melanoma.

"Some of these genes may lead us to excellent pharmaceutical targets for treatment of melanoma," Zon said.

More information

The American Academy of Family Physicians (news - web sites) has more about melanoma.

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Sweet Drinks Help Some Preschoolers Pack on Pounds

 

By Charnicia E. Huggins

Reuters Health

Tuesday, February 8, 2005

NEW YORK (Reuters Health) - Preschoolers who drink at least one serving of soda, fruit juice or other sweet beverage every day are likely to become overweight, new study findings show.

"Minimizing a child's consumption of sweet drinks might be one way to help manage their weight," study author Jean A. Welsh, of the Atlanta-based Centers for Disease Control and Prevention (news - web sites), told Reuters Health.

Welsh and a team of researchers looked at the association between the risk of becoming overweight and the consumption of sweet drinks in a follow-up study of nearly 11,000 low-income preschoolers, between 2 and 3 years old.

At the start of the study, nearly one quarter of the children were already overweight or at risk of becoming overweight. One year later, 3 percent of the normal or underweight children had become overweight, as did 25 percent of those at risk of becoming overweight, and 67 percent of the overweight children were still overweight.

On average, the children drank about three sweet drinks per day. Nearly 90 percent of children drank sweet drinks at least once every day, while 41 percent drank sweet drinks no fewer than three times each day.

Preschoolers who were at risk of becoming overweight at the start of the study who drank as few as one sweet drink per day were twice as likely to be overweight at follow-up as those who drank less than one sweet drink per day, Welsh and her team report in this month's Pediatrics. Those who drank three or more sweet drinks daily were nearly twice as likely as their peers to be overweight one year later.

Overweight children who drank sweet drinks daily -- one drink or more than three -- were about twice as likely to remain overweight as those who drank less than one sweet drink every day, study findings indicate.

It wasn't just too much soda that helped preschoolers to pack on the pounds, study findings suggest. When the researchers excluded soda from their analysis, the association remained "strongly positive" among overweight children and those at risk of becoming overweight.

The association also remained after the investigators took into account the preschoolers' consumption of high-calorie foods that have previously been linked to weight gain, such as ice cream, potato chips and cookies, the report indicates.

How the consumption of sweet drinks promotes weight gain and weight retention among overweight preschoolers and those at risk of becoming overweight is unclear.

According to Welsh, "one possibility is that we respond differently to calories taken in liquid form than to those consumed as solids."

"Previous studies indicate that when we consume extra calories in the form of solids we accommodate them pretty well by reducing our subsequent intake," she explained. "This accommodation does not appear to be as effective when the extra calories are consumed as liquids, making it more likely that these calories will be in addition to what we need to maintain our weight."

Based on the current study, parents who are concerned about their preschoolers' weight would do well to "limit the consumption of sweet drinks to less than one per day," Welsh said.

"Healthy alternatives include water and low-fat milk for a thirsty child and whole fruit as a healthy snack," she added.

Source: Pediatrics, February 2005.

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Gene Variant Ups Osteoporosis Risk

HealthDayNews

Tuesday, February 8, 2005

TUESDAY, Feb. 8 (HealthDay News) -- About one in five people carry a variant of a gene that may increase their risk for osteoporosis, researchers report.

When found in women, a variant of the CYP1A1 gene appears to speed the breakdown of the female hormone estrogen, which normally helps protect women against bone loss. Women with the gene mutation were more prone to with low bone density at the hips, according to researchers at the Washington University School of Medicine in St. Louis.

The study appears in the February issue of the Journal of Bone and Mineral Research.

There are several variations of the CYP1A1 gene, which makes a enzyme that detoxifies foreign substances in the body and also breaks down estrogen as part of maintaining proper estrogen balance.

"Previous studies showed that some CYP1A1 variants are linked to estrogen-related cancers, such as breast, ovarian or endometrial cancers," researcher Dr. Reina Armamento-Villareal, an assistant professor of medicine in the division of bone and mineral diseases, said in a prepared statement.

"The link to estrogen suggested that the gene could also affect bone density," she explained. "No one had ever investigated that possibility, so we set up a study to evaluate the relation between bone density and variations of the CYP1A1 gene."

The study included 156 postmenopausal women averaging 63.5 years of age. The genetic sequence of each woman's CYP1A1 gene was analyzed to determine which variant they had.

One variant, found in 19 percent of the population, was found in women with much lower blood estrogen levels and higher levels of urinary estrogen breakdown products than normal. The women with this variant also had much lower bone density in the upper femur near the hip joint.

"The data suggest that this particular variation of the gene produces an enzyme that breaks down estrogen faster than usual, leading to low [blood] estrogen levels and high levels of estrogen metabolites. Low levels of estrogen put a woman at risk for osteoporosis, and our data showed a strong correlation between the genetic variant and low bone density," Villareal said.

"Our study suggests that this genetic variation specifically affects the hip bones. For those with this form of the CYP1A1 gene, that's not good news. Low density in the hip can lead to hip fractures, which can be devastating," Villareal said.

This variant may prove a useful genetic marker for early identification of females with a high risk of osteoporosis of the hip, enabling them to receive a head start on treatment to prevent osteoporosis.

More information

The American College of Rheumatology has more about osteoporosis.

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Cancer Raises Blood Clot Risk by Sevenfold

Reuters Health

Tuesday, February 8, 2005

NEW YORK (Reuters Health) - Cancer greatly increases the risk that the patients will develop a blood clot in a vein (venous thrombosis), especially in recently diagnosed patients, patients with cancer that has spread to distant sites (metastases), and those with certain genetic mutations, according to Dutch researchers. While anticoagulant therapy might be beneficial, they say, the associated increased risk of bleeding has to be considered.

The findings, reported in the Journal of the American Medical Association (news - web sites), are based on a survey of 3220 consecutive patients who were diagnosed with a blood clot in the leg or lung between 1999 and 2002 at six clinics in the Netherlands. The group of 2131 partners of the patients was used as a comparison.

Cancer increased the risk of venous thrombosis 6.7-fold, Dr. Frits R. Rosendaal and colleagues, from Leiden University Medical Center, note. Patients with cancers of the blood system had the highest increased risk -- 28.0-fold -- followed by patients with lung cancer and GI cancer.

The highest risk of clots occurred within 3 months of the cancer diagnosis. At this point, cancer patients were 58.2-times more likely to develop venous thrombosis than were controls.

The presence of distant metastases raised the risk of thrombosis, over and above that seen with cancer alone, by 19.8-fold.

Furthermore, cancer patients who were also carriers of the factor V Leiden mutation or the prothrombin 20210A mutation were 12-times more likely to develop a clot than healthy non-carrier patients.

The author suggest that future studies address the issue of giving preventive anticoagulant therapy to patients with cancer in the first months after the diagnosis and to patients with distant metastases. "However, since these patients also have an increased risk of hemorrhage, this needs to be cautiously evaluated."

Source: Journal of the American Medical Association, February 9, 2005.

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Health Tip: Steps to Less Stress

HealthDayNews

Tuesday, February 8, 2005

(HealthDay News) -- Who isn't stressed these days? Whether it's your job, family, finances, social life, or illness, no one is immune.

Learning to manage the stress in your life can help you live healthier and happier; enjoy your job, family and friends more; and focus your energies on the things in life that really count.

The AARP recommends these steps to less stress:

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Blood Infection More Likely in Diabetics

Reuters Health

Tuesday, February 8, 2005

NEW YORK (Reuters Health) - Patients with diabetes are at increased risk of blood infections caused by a microbe called enterobacteria, Danish researchers have found. Frequently, these infections start in the urinary tract before spreading to the blood.

"Diabetic persons with signs and symptoms of urinary tract infection or (blood infections) should be told to seek medical care promptly," Dr. Reimar W. Thomsen said, "and physicians should keep a high level of suspicion for these infections if the patient has diabetes."

Thomsen from Aarhus University Hospital in Aalborg and colleagues examined diabetes as a risk factor for enterobacterial blood infections in a study involving 1317 patients with blood infections and 13,170 comparison subjects without infection.

Patients with diabetes were three times as likely to develop enterobacterial blood infections as were patients without diabetes, the investigators report in the medical journal Clinical Infectious Diseases. Diabetics under 65 years of age and those who were female were at the highest risk.

The authors also found that these infections were more deadly in diabetics than non-diabetics. For example, after 30 days of infection, 17 percent of diabetics had died compared with 13 percent of non-diabetics.

"We conclude that diabetes has a considerable public health impact on the risk for and prognosis of enterobacteria (blood infections) acquired in the community," the investigators write. "Preventive measures for diabetic patients might include increased surveillance and avoidance of well-known risk factors for urinary tract infections."

In addition to the treatments that would be applied to any patient with enterobacteria blood infections, Thomsen emphasized that control of blood sugar is very important for diabetic patients.

The researchers are currently investigating the effect that diabetes has on blood infections caused by other microbes.

Source: Clinical Infectious Diseases, February 15, 2005.

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Health Tip: Detecting Ear Infections in Children

HealthDayNews

Tuesday, February 8, 2005

(HealthDay News) -- It is not always easy to know if your child has an ear infection, especially if he hasn't learned to talk.

If your child is not old enough to say, "My ear hurts," you need to look for warning signals, the National Institute on Deafness and Other Communication Disorders says.

Here are a few signs your child might have an ear infection:

If you see any of these signs in your child, call a doctor.

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Monday, February 7, 2005

 

Sleep Hormone May Affect Sex Organs, Study Finds

 

Reuters

Monday, February 7, 2005

WASHINGTON (Reuters) - Melatonin, a hormone available in over-the-counter supplements and popped freely by many frequent air travelers, may affect the sex glands, U.S. and Japanese researchers reported on Monday.

Tests on Japanese quail showed the hormone regulates a sexual pathway believed to be involved in seasonal breeding patterns.

It is likely to affect human gonads as well, the researchers said.

"It really amazes me that melatonin is available in any pharmacy," said biologist George Bentley of the University of Washington and the University of California, Berkeley.

"It is a powerful hormone, and yet people don't realize that it's as 'powerful' as any steroid. I'm sure that many people who take it wouldn't take steroids so glibly," added Bentley, who worked on the study.

"It could have a multitude of effects on the underlying physiology of an organism, but we know so little about how it interacts with other hormone systems."

Writing in the Proceedings of the National Academy of Sciences (news - web sites), Bentley and colleagues at Hiroshima University in Japan said they were studying melatonin's effects on a brain hormone called gonadotropin-inhibitory hormone or GnIH.

They removed all melatonin-producing organs from the birds -- the eyes and the pineal glands -- and found GnIH levels fell. When they gave the birds melatonin, levels of GnIH went back up.

This is important because GnIH has been found to have the opposite effect to the key hormone that primes the body for sex -- gonadotropin releasing hormone or GnRH. In birds, switching off GnRH causes the gonads -- the testes and ovary -- to shrink as part of the birds' yearly cycle.

In humans, GnRH brings on puberty.

Melatonin regulates the sleep-wake cycle in many animals, including humans. It is produced at night by the pineal gland at the base of the brain, bringing on drowsiness.

Light causes levels to drop, and melatonin pills are often used by travelers to help them sleep through jet lag and by shift workers who have trouble sleeping.

Bentley said the team has found a gene for a hormone like GnIH in hamsters, and he found evidence of a GnIH gene in the map of the human genome.

Such a hormone would be important for many species, he said.

"Reproduction is energetically costly. It takes its toll," Bentley said in a telephone interview.

"So that is why a lot of animals breed seasonally. They can only afford to do it at certain times of year."

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Study Links Autism and Mother's Illnesses

 

Reuters

Monday, February 7, 2005

CHICAGO (Reuters) - Expectant mothers suffering from asthma, allergies or a type of skin disease have a higher risk of giving birth to an autistic child, a study said on Monday.

Asthma, allergies and psoriasis symptoms during pregnancy -- especially if diagnosed in the second trimester -- doubled the risk of autism in children compared to children who were not afflicted, researchers from Kaiser Permanente in Oakland, California, said.

Autism is a mysterious condition that strikes roughly six in 1,000 children, mostly boys, and is associated with diminished social skills and an adherence to routines.

The study looked at 88,000 children belonging to the Kaiser Permanente health plan born in Northern California between 1995 and mid-1999, 420 of whom were diagnosed with autism.

The researchers said there was no statistical link between autism in children and 44 autoimmune diseases in mothers, including rheumatoid arthritis, lupus and multiple sclerosis. The exception was psoriasis, which doubled the risk of autism.

Previous research has suggested there may be a link between autoimmune disease during pregnancy and autism, because autistic children often have high levels of autoimmune response chemicals in their bloodstreams. Women make up 78 percent of patients with autoimmune diseases, where the body's immune system attacks its own tissues.

The report, which was published in The Archives of Pediatrics and Adolescent Medicine, speculated that there may be a common underlying genetic cause to such ailments as asthma and autism.

Or, because the mother's condition was frequently diagnosed in the second trimester, the flare-up may have caused her immune system to produce more cytokines, which are associated with inflammation and could have damaged fetal brain development.

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Infant Infection May Impair Adult Memory

 

HealthDayNews

Monday, February 7, 2005

MONDAY, Feb. 7 (HealthDay News) -- Infections in early childhood may affect memory function in later life, suggests a study in rats.

The study from researchers at the University of Colorado at Boulder found that rats with a history of infections as newborns displayed memory problems as adults whenever their immune systems were under stress, as happens during illness.

Rats infected with the E. coli bacteria as pups displayed memory lapses in special behavioral experiments, researchers say. These memory lapses only appeared when the adult rats were sick. The memories of adult rats with no history of post-natal infection remained strong, however, regardless of whether they were sick or not.

Researchers say the study, published in the February issue of Behavioral Neuroscience, adds to a growing body of evidence that even a single infection can permanently alter physiological systems.

Gaining a better idea of how infection in newborns can impair memory in immune-challenged adults may help researchers grasp how exposure to environmental stressors or germs before or just after birth may make people more prone to neuropsychiatric and neurodegenerative diseases, they said.

The study authors pointed out that prenatal viral infection has been linked to autism, cerebral palsy and schizophrenia. Bacterial infection is also a risk factor for Parkinson's disease (news - web sites).

It's estimated that complications involving infections of the uterus and its contents occur in up to 20 percent of pregnancies.

More information

The American Society for Microbiology has more about viruses and bacteria.

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Diet Lowers Cholesterol as Well as Drug Study

 

Reuters

Monday, February 7, 2005

WASHINGTON (Reuters) - A diet rich in fiber and vegetables lowered cholesterol just as much as taking a statin drug, Canadian researchers reported on Monday.

They said people who cannot tolerate the statin drugs because of side-effects can turn to the diet, which they said their volunteers could easily follow.

David Jenkins of St. Michael's Hospital and the University of Toronto and colleagues created what they called a diet "portfolio" high in soy protein, almonds, and cereal fiber as well as plant sterols -- tree-based compounds used in cholesterol-lowering margarines, salad dressing and other products.

They tested their diet on 34 overweight men and women, comparing it with a low-fat diet and with a normal diet plus a generic statin drug, lovastatin.

Each volunteer followed each regimen for a month, with a break in between each treatment cycle.

Writing in the American Journal of Clinical Nutrition (news - web sites), Jenkins and colleagues said the low-fat diet lowered LDL -- the low-density lipoprotein or "bad" cholesterol -- by 8.5 percent after a month. Statins lowered LDL by 33 percent and the "portfolio" diet lowered LDL by nearly 30 percent.

The portfolio was rich in soy milk, soy burgers, almonds, oats, barley, psyllium seeds, okra and eggplant. The Almond Board of California helped fund the study, as did several food makers and the Canadian Natural Sciences and Engineering Research Council of Canada.

They also included a plant sterol margarine product. Several of these have been proven to lower cholesterol.

The researchers said nine volunteers, or a quarter of the group, got their lowest LDL levels from being on the portfolio diet.

The volunteers all felt full on the, diets although the "portfolio" diet resulted in more bowel movements, the researchers said.

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Health Tip: Taking Your Medicine

 

HealthDayNews

Monday, February 7, 2005

(HealthDay News) - Even as adults, taking your medicine and staying on it may take more than a spoon full of sugar. When it comes to some medicines such as cholesterol-lowering drugs, it represents a lifelong commitment.

The National Heart, Lung, and Blood Institute says you need to understand what you are taking and why. Be sure to ask your doctor:

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Sunlight May Have Unexpected Anti-Cancer Effects

 

By Anthony J. Brown, MD

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - Two new studies suggest that exposure to sunlight might not be as risky for cancer as is generally believed.

Scandinavian researchers show that high UV radiation exposure is associated with a reduced risk of lymphoma, while another team reports that sunlight-related melanoma skin cancers appear to be inherently less aggressive than those that arise in non-exposed areas.

Dr. Karin Elkstrom Smedby, from the Karolinska Institute in Stockholm, and colleagues investigated ultraviolet radiation exposure as a possible cause for the increasing rates of malignant lymphoma seen in recent decades.

Instead, the researchers found that high UV radiation exposure, as measured by frequent sunbathing and sunburns, cut the risk of the non-Hogkins type of lymphoma by up to 40 percent depending on the level of exposure.

The study involved 3740 patients with malignant lymphomas who were compared with 3187 matched "controls" from the general population. High UV radiation exposure also seemed to protect again the Hodgkin's type of lymphoma, but the association was weaker than with non-Hodgkin's disease.

In another study, also reported in the Journal of the National Cancer Institute (news - web sites), researchers note that sun exposure has been linked to better survival in patients with melanoma. The new research suggests that this is due, at least in part, to sunlight-related tumors being inherently less aggressive than those not tied to sun exposure.

"Our findings provide the strongest evidence to date that the better prognosis of (sunlight-related) melanomas is not simply due to earlier detection of these types," Dr. Marianne Berwick told Reuters Health.

Berwick, a researcher from the University of New Mexico in Albuquerque, noted that "further studies are needed to determine how sun exposure might reduce melanoma aggressiveness," but said that it could have something to do with increased production of vitamin D, or involve an enhanced ability of cells to repair DNA damage.

The findings stem from a study of 528 melanoma patients who were entered in the Connecticut Tumor Registry.

Sunburn, high intermittent sun exposure, self-reported skin awareness, and solar elastosis -- a marker of sun damaged-skin -- were all linked to increased survival from melanoma.

Upon analysis, skin awareness was a strong predictor of better survival, consistent with the belief that earlier detection leads to better outcomes. However, solar elastosis, which does not relate to detection, was found to be an even stronger predictor of increased survival.

Berwick emphasized that these findings have no bearing on current recommendations that "avoiding sun exposure reduces the risk of melanoma." Moreover, she added that they also do not suggest that exposing melanomas to sunlight after they've developed will improve survival.

Source: Journal of the National Cancer Institute, February 2, 2005.

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Sweet Gene Steers Kids Away From Vegetables

By Serena Gordon
HealthDay Reporter

HealthDayNews

Monday, February 7, 2005

MONDAY, Feb. 7 (HealthDay News) -- If you couldn't get enough of sweets when you were young, chances are your child will share your palate's passion.

That's because your taste preferences are, at least in part, influenced by your genes. However, age and culture can eventually override this genetic influence, a new study finds.

And that means kids who steer clear of vegetables may warm to them in a few years.

Building off the recent discovery of taste genes, especially the TAS2R38 genotype that has receptors for bitter taste, researchers compared taste preferences between mothers and their children.

"This gene can predict sensitivity to one type of bitter taste," said study author Julie Mennella, a developmental psychobiologist at the Monell Chemical Senses Center in Philadelphia.

However, even when both mother and child shared the same taste genes, Mennella said, "When you compare children to adults, children were much more sensitive than adults." That difference, she said, "may be reflecting developmental changes that occur with age."

Results of the study appear in the February issue of Pediatrics.

The researchers obtained genetic samples from 143 children between 5 and 10 years old and their mothers. Based on the genetic analysis, they were then divided into three groups: Type AA with two bitter-insensitive genes, type PP with two bitter-sensitive genes and type AP with one of each.

All were asked to drink three different concentrations of a bitter-tasting substance and rate it as either "like water" or "bitter or yucky."

Seventy percent of children and half of the mothers who were either type PP or AP said they tasted bitterness in the weakest solution, but less than 10 percent of those in the AA group did.

Age affected the ability to taste bitterness. Only 43 percent of the mothers in the AP group said they could taste the bitterness in the weakest solution, compared to 64 percent of the children in that group.

In mothers, Mennella said, the strongest predictor of a preference for sweet tastes was culture. According to the study, people of African descent are much more likely to prefer sweet tastes than people of European descent.

This study "may help health-care professionals understand parents' lost battles over mealtime, because there may be a genetic predisposition to disliking vegetables," said Angela Kurtz, a pediatric nutritionist at New York University Medical Center. But, "despite genetics, parents need to make sound decisions when it comes to feeding their children and making choices at the supermarket."

"You can always find another choice that's a little bit better," said Kurtz. Instead of muffins and frosted cereals, she suggests pound cake or graham crackers. If your child likes sweet beverages, then buy 100 percent juice and dilute it, and avoid the high-fructose brands. This way, she said, they're still getting sweet things, but they're healthier choices.

And, she said, it's important to keep introducing new healthy foods, though she admitted that can be a challenge.

"Some studies have found that it may take being exposed to a new food 50 times before it no longer seems new," said Kurtz. So, keep putting one piece of broccoli on your child's plate, but never force him or her to eat it. Suggest they try it, and let them see you eating it. Eventually, they might try it, she said.

Mennella said her study highlights the need for parents to appreciate the difference between adults and children.

"Children live in their own sensory world," she said. "A child may reject a food that mother or father feels tastes good, but the child may be perceiving a different taste."

She recommended introducing vegetables to your children when they're young.

Someday, she said, this knowledge might lead to new ways to prepare foods that could mask the bitter taste.

More information

For more information on healthy eating habits for children, visit the American Dietetic Association.

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Study Adds Evidence -- Bad Teeth Equal Bad Heart

Reuters

Monday, February 7, 2005

WASHINGTON (Reuters) - People with more bacteria in their mouths also have more evidence of heart disease, researchers said on Monday in a study strengthening the evidence for a link between gum disease and heart disease.

The study of 657 people who had no history of stroke or heart attack showed that people with more bacteria that cause periodontal disease also had thicker carotid arteries -- a strong indicator of clogged blood vessels.

Writing in the American Heart Association (news - web sites)'s journal Circulation, the team at Columbia University in New York said the association held even when other heart risk factors were taken into account.

"This is the most direct evidence yet that gum disease may lead to stroke or cardiovascular disease," said Dr. Moise Desvarieux at Columbia University Medical Center, who led the study.

"And because gum infections are preventable and treatable, taking care of your oral health could very well have a significant impact on your cardiovascular health."

Researchers believe the bacteria that cause the gum disease may spread into the bloodstream and stimulate the immune system, causing inflammation that results in the clogging of arteries. Hardening of the arteries involves the inflammation process, and other studies have strongly linked heart disease with inflammation.

The researchers used ultrasound to measure the thickness of the carotid artery, which leads from the heart to the brain. They also made sure that they were measuring only levels of bacteria associated with both gum disease and heart disease.

These are Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola.

"Although more than 600 bacteria have been shown to colonize the mouth, each person tends to carry different proportions of these microbes," said Dr. Panos Papapanou, a periodontist who worked on the study.

Now they need to show which came first -- the bacteria or the heart disease.

"We will re-examine the participants in less than three years, and, at that point, we can better evaluate the progression of the atherosclerosis and, hopefully, begin to establish a time frame underlying the diseases," said Dr. Ralph Sacco, who also worked on the study.

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Some Hospital Transfers in Heart Cases Potentially Harmful

By Ed Edelson
HealthDay Reporter

HealthDayNews

Monday, February 7, 2005

MONDAY, Feb. 7 (HealthDay News) -- Transferring a heart attack patient to a hospital equipped for advanced artery-opening surgery such as angioplasty, rather than the quick use of clot-dissolving drugs, can cause potentially harmful delays in treatment, a new study finds.

That's because long transport times mean patients may not receive angioplasty within the time limit recommended by treatment guidelines, explained Dr. Harlan Krumholz, a professor of medicine at Yale University School of Medicine, and lead author of a report focusing on more than 4,000 of these patient transfers.

In a second study, experts say they've devised a guide to help surgeons decide whether patients with heart attack are better off undergoing bypass or less invasive angioplasty.

Both studies appear in the Feb. 7 online issue of Circulation.

Angioplasty, in which surgeons use a tiny balloon to open a blocked artery, should begin no more than 90 minutes after hospital admission for heart attack, according to guidelines set by the American Heart Association (news - web sites) (AHA), the American College of Cardiology and the European College of Cardiology.

The same guidelines also mandate that clot-busting drug treatments be started within 30 minutes, especially because they are usually less effective in re-opening arteries than surgical interventions such as angioplasty.

However, in their study of nearly 4,300 patients transferred to 419 hospitals, Krumholz' team found that just 4.2 percent of patients received needed angioplasty within 90 minutes of first admission for suspected heart attack. In 55 percent of patients, delays lasted for between two to four hours, while for nearly 29 percent more, delays lasted four hours or more.

"That's a long time if you're having a heart attack," Krumholz said. "Coming to a hospital with a heart attack means that every minute counts. We need to think of ways to do it faster."

If transfers are made, hospitals on both the sending and receiving end need to minimize the time required for angioplasty to begin, he said.

"If you are a transfer hospital, you should be working in parallel with the sending hospital," he said. "If the patient is on the way, you should be getting everything ready. Sometimes the hospitals work in sequence, re-evaluating the patient all over again in the transfer hospital."

Transfers need to be carefully considered because a number of studies suggest the best strategy is to get heart attack patients to the nearest hospital emergency room -- whether or not it is equipped for angioplasty, Krumholz said. While only about 25 percent of U.S. acute-care hospitals are equipped to perform angioplasty, clot-busting drug treatment is now available in any emergency room, he said.

"There is a slight advantage to angioplasty, because it is less invasive and is less likely to cause bleeding," he said. "But if you can't do it quickly, you can use a clot-busting drug."

The new study should spur hospitals to re-examine the time needed to transfer patients and make decisions accordingly, Krumholz said.

"If the two hospitals are side by side, transfer makes a lot of sense," he said. "But if there are possible delays because of distance or traffic, the effects of delay should be included in a decision. Hospitals tend to look only at their own data, to see whether a patient is treated within two hours or so after admission. Nobody is counting the total time to treatment."

Another report in the same issue of the journal concerns a longer-term decision regarding heart attack treatment: Whether a patient will be better off getting bypass surgery, to reduce the need for repeat angioplasties due to artery re-closing.

"That is often a difficult decision," said Dr. John Spertus, director of cardiovascular education and outcomes research at the St. Luke's Mid-America Heart Institute in Kansas City, Mo. "At this point, it's often based on the [hospital's] technical ability to do both procedures."

Spertus and his colleagues have devised a new rating scale to guide doctors making this difficult decision. Each patient is assigned a point score based on his or her medical conditions. For example, four points are given for diabetes, having daily chest pain is worth three points, having a past angioplasty is worth two points.

In 546 patients with a point score of four or less, the researchers found no benefit to bypass over angioplasty. Bypass surgery had the greatest advantage in terms of reduced incidence of recurrent chest pain, angina, in the 235 patients with a score of eight or more.

"We envision this scale as a real help to a physician in making the decision," Spertus said. "We are re-examining this model and are starting to build additional predictive models of patient outcome. We are also trying to understand what additional information could be bundled into the scale, so that doctors could be able to select the right therapy for the right patient."

More information

A guide to heart attack treatment is available at the American Heart Association.

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Birth Size Linked to Some Adult Cancers

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - Bigger babies seem to have a greater risk of developing certain cancers as adults, a new study finds.

Dr. Valeria A. McCormack from London School of Hygiene & Tropical Medicine in London, UK, and colleagues used Sweden's Uppsala Birth Cohort Study to investigate the relationship of birth characteristics with overall cancer rates and rates for cancers of specific sites in the body.

Higher birth weight was associated with a 13 percent increase in the rate of cancers of the digestive tract, and a 17 percent increase in the rate of blood cancers, the authors report in the International Journal of Cancer.

Larger birth size was also associated with an increased rate of all cancers combined, excluding those involving the reproductive system.

Higher birth weight was associated with increased rates of breast cancer in women under age 50, but on the other hand, women with higher birth weight had only about half the rate of endometrial cancer compared to women with lower birth weight.

"We have found some evidence supporting the hypothesis that larger birth size is associated with increased risk of certain adult cancers," the researchers conclude. "However, our findings suggest that positive associations were not uniform across all cancer sites, but were particular to just a few sites."

McCormack's team adds, "Birth size for gestational age is unlikely to be a risk factor for adult disease in itself, but may be a marker for some aspects of the fetal environment that are related to risk."

Source: International Journal of Cancer, online February 7, 2005.

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3 Risky Diabetes Drugs May Be Safe for Heart Patients

By Ed Edelson
HealthDay Reporter

HealthDayNews

Monday, February 7, 2005

MONDAY, Feb. 7 (HealthDay News) -- Three drugs that the U.S. Food and Drug Administration (news - web sites) says should not be prescribed for diabetics who have heart failure may actually help many of those patients, a new study suggests.

The drugs are Actos and Avandia, both classified as thiazolidinediones, and Glucophage, a member of a different chemical family. All are prescribed to help control blood sugar levels in persons with type 2 diabetes, the kind that typically strikes in adulthood. They act by making the body more sensitive to insulin, the hormone that helps cells use blood sugar for energy.

The FDA (news - web sites) cautions against using Actos and Avandia in people with advanced heart failure, in which the heart's ability to pump blood is greatly reduced. And the agency requires a "black box" warning against prescribing Glucophage for patients with heart failure that requires drug treatment.

Nevertheless, many physicians prescribe these drugs for these high-risk patients, said study author Dr. Frederick A. Masoudi, a professor of medicine at the University of Colorado Health Sciences Center. And his study of more than 16,000 diabetes patients hospitalized for heart failure found a lower death rate over the following year for those who got one or another of the drugs than for those who didn't.

The findings appear in the Feb. 8 issue of Circulation.

"We did an earlier study to show that despite the warnings, these drugs are used extensively in patients with heart failure and diabetes," Masoudi said. "Perhaps physicians feel that their benefits more than outweigh their side effects."

The new study found that the one-year death rate for 2,226 patients prescribed either Actos or Avandia was 13 percent lower than for patients who did not take either of the drugs. For patients prescribed both drugs, the one-year death rate was 14 percent lower. And for those prescribed either Actos or Avandia plus Glucophage, the one-year death rate was 24 percent lower.

"There doesn't appear to be any initial harm from prescribing these drugs, and there may be significant benefits," Masoudi said.

But the study results must be confirmed by carefully controlled trials before the warning against these drugs could be relaxed, Masoudi said. He said he and his colleagues have had "some initial conversations about conducting such studies" with the companies that market the drugs, but it will take years for such trials to be planned and implemented.

Meanwhile, he said, the decision about using the drugs must be made on a case-by-case basis.

"The physician and the patient should discuss their use thoroughly," Masoudi said. "The physician should carefully assess any issues involved in their use."

That's the correct approach, said Dr. Robert Rizza, president-elect of the American Diabetes Association.

"You should consult with your physician regarding proper treatment for your diabetes," he said. "Your physician should discuss in detail the possible benefits and known risks associated with these drugs."

Controlled trials with people who have diabetes and heart failure are needed because the kind of study reported by Masoudi and his colleagues "cannot tell whether people who were less ill were placed on these drugs," Rizza said. A controlled trial would include information on the severity of illness in the participants, he said.

One such study already is under way, Rizza said. "It examines the use of these drugs in people with coronary artery disease, not heart failure, but it should yield useful information," he said.

More information

Almost anything you need to know about diabetes is available from the American Diabetes Association.

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Marijuana Affects Brain Long-Term, Study Finds

Reuters

Monday, February 7, 2005

WASHINGTON (Reuters) - Marijuana users have faster blood flow in their brains, even after a month of not smoking, U.S. researchers reported on Monday.

The findings suggest they have narrowed arteries, similar to patients with high blood pressure and dementia, and could help explain reports that heavy marijuana users have trouble on memory tests, said the researchers at the National Institute on Drug Abuse in Baltimore.

Ronald Herning and Jean Lud Cadet tested 54 marijuana users, who smoked anywhere between two and 350 joints a week, and 18 non-smokers.

They used Doppler sonograms to measure blood flow in volunteers' brains at the beginning of the study and a month later, after everyone agreed to abstain from marijuana for the four weeks.

The smokers had faster blood flow, both at the start and after a month of abstinence, Herning and Cadet reported in the journal Neurology.

The smokers also had a higher pulsatility index score, or PI, which measures the amount of resistance to blood flow. The researchers believe the higher PI is caused by narrower blood vessels.

"The marijuana users had PI values that were somewhat higher than those of people with chronic high blood pressure and diabetes," Herning said in a statement.

"However, their values were lower than those of people with dementia. This suggests that marijuana use leads to abnormalities in the small blood vessels in the brain."

They found that blood flow improved in people who smoked up to 70 marijuana cigarettes a week -- people they defined as moderate users -- after a month of avoiding cannabis.

Heavy users, who smoked up to 350 joints a week, saw no change in blood flow even after a month, the researchers said.

Researchers at Toronto's McGill University have reported that chronic consumers of cannabis lose molecules called CB1 receptors in the brain's arteries.

This reduces blood flow to the brain, causing attention deficits, memory loss, and impaired learning ability.

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No, Nicotine Probably Doesn't Ward Off Alzheimer's

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - The final excuse for smoking -- that it might reduce the risk of developing Alzheimer's disease (news - web sites) -- has just been stubbed out, findings from an animal study suggest.

Past animal and human studies have indicated that nicotine exposure inhibits the formation of amyloid plaque, a key feature of Alzheimer's disease. However, the new study shows that chronic nicotine use appears to worsen the effects of a brain protein called tau, which is responsible for the fibrous tangles that are the other hallmark of the disease.

So, at best, the effects of nicotine are probably canceled out, according to the researchers.

Dr. Frank M. LaFerla, from the University of California at Irvine, and colleagues administered nicotine to a genetically engineered strain of mice that develops Alzheimer's disease.

Nicotine treatment produced an increase in nicotine receptors in the animals' brains that correlated with a dramatic rise in the aggregation and activity of the tau protein. This indicates that the disease-causing effects of tau were worsened, the team reports in the Proceedings of the National Academy of Sciences (news - web sites).

Moreover, in these experiments, chronic nicotine administration had no effect on levels of soluble amyloid, the researchers point out.

The results emphasize the importance of assessing nicotine's affects on all aspects of the disease, they write. "Our findings suggest that the use of nicotine as a potential therapy for Alzheimer's disease should be reevaluated."

Source: Proceedings of the National Academy of Sciences, early edition February 7, 2005.

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Black Asthma Patients Seen Less Responsive to Drugs

 

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - Steroid therapy for asthma appears to be less effective for African Americans than whites, which may help explain why asthma often seems more severe in blacks, according to a new report.

"Regardless of asthma status or severity, African-Americans in our study required higher doses of a (steroid) than Caucasians " to stop the production of inflammatory cells, lead author Dr. Ronina A. Covar, from the National Jewish Medical and Research Center in Denver, said in a statement.

The findings, reported in the medical journal Chest, are based on a study of 395 asthmatic subjects and 202 healthy subjects who underwent various tests to assess their responsiveness to steroids. Twenty-seven percent of the asthmatic subjects were black as were 52 percent of those without asthma.

As noted, the researchers found that the amount of steroid needed to block immune cell production was much higher in blacks than in whites, a finding that held true in both the asthmatic and non-asthmatic groups.

"African-Americans' suboptimal response to asthma medications may contribute to poor asthma control and, therefore, an increased prevalence of asthma-related" problems in this population, Covar noted.

As such, black patients with poorly controlled asthma on standard doses may require higher doses or the use of additional drugs, she added.

Source: Chest, February 2005.

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Bone Density Returns After Teens Stop Depo-Provera

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - The long-acting injected contraceptive Depo-Provera, popular among adolescent women, produces a significant drop in bone mineral density -- but it seems to rebound once the drug is stopped, new research shows.

"These findings are reassuring for those concerned about future risk of fractures," the study's lead author, Dr. Delia Scholes, from the Group Health Cooperative in Seattle, said in a statement.

"This information can be useful in helping young women balance the need to avoid unintended pregnancies with the need to build strong bones."

The findings, which appear in the Archives of Pediatrics and Adolescent, are based on a study of 80 teenagers who used Depo-Provera (also known as depot medroxyprogesterone acetate, or DMPA) and a comparison group of 90 young women who did not use the contraceptive.

Compared with this "control" group, bone mineral density at the hip and spine dropped significantly among DMPA users, the investigators note. Moreover, bone loss occurred more rapidly in new users than in longer-term users.

During the 3-year follow-up period, 61 of the users stopped getting injections of Depo-Provera. These women experienced a significant rise in bone density at all body sites compared with controls, suggesting that the loss in bone density was reversible.

"Given the increasing public health importance of osteoporosis, factors that may affect peak bone mass attainment and maintenance have received deservedly greater emphasis," the authors note. The current findings suggest that the reversibility of DMPA-induced bone loss seen in older women also applies to younger users.

Sources: Archives of Pediatrics and Adolescent Medicine, February 2005.

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Most Obese Kids Not Depressed: Study

Reuters Health

Monday, February 7, 2005

NEW YORK (Reuters Health) - Overweight and obese adolescents may be more likely to have physical problems than their normal-weight peers but they don't seem to be worse off mentally, according to national study findings.

"Using a nationally representative sample, we found that obesity in adolescence is linked with poor physical quality of life," write study author Dr. Karen C. Swallen, of the University of Wisconsin, and her co-authors in the medical journal Pediatrics.

"However, in the general population, adolescents with above normal body mass did not report poorer emotional, school, or social functioning, "they add.

Today, about one out of every seven children and adolescents in the US are overweight. One study found that the prevalence of overweight and obesity increased by up to 120 percent, particularly among black and Hispanic children and adolescents, between 1986 and 1998. Overweight youngsters are known to be at risk for various health problems including diabetes and heart disease.

Swallen and her team investigated the association between obesity and health-related quality of life using data collected from more than 4,000 students in grades 7 to 12 who were involved in the National Longitudinal Study of Adolescent Health.

The researchers found that overweight adolescents were more than twice as likely to have worse self-reported health than their normal-weight peers. Obese adolescents were more than four times as likely to report poorer health.

Overweight and obese adolescents were also more likely than their peers to have difficulty performing household chores, problems with personal care and hygiene or some other type of functional limitation. Yet, the same was true of underweight adolescents, the authors note.

In fact, study participants' ability to perform various tasks without any limitations decreased as their body mass index moved farther away from the norm -- whether toward overweight or underweight, the study findings show. Body mass index is a measure of weight that takes height into consideration.

While being overweight or obese did not appear to influence most study participants' emotional health, depression or school or social functioning, it did have a "deleterious effect" on depression, self-esteem and school and social functioning among the youngest adolescents, the researchers note.

Obese 12- to 14-year-olds, for example, were more than three times as likely to say they had low self-esteem and more than twice as likely to report poor school/social functioning as were their normal-weight peers. They were also up to three times as likely to be depressed, the report indicates.

Why the same was not true among the older adolescents is unknown. It may be that young Americans are "more tolerant of weight differences" than their same-age peers were in the past, or that being overweight is simply more common among adolescents. It is also possible that the adolescents studied did not report all of the health problems they experienced, Swallen and her team speculate.

Source: Pediatrics, February 2005.

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Sunday, February 6, 2005

 

Shed Light on SAD to Ease Winter Blues

 

By E.J. Mundell
HealthDay Reporter

HealthDayNews

Sunday, February 6, 2005

SUNDAY, Feb. 6 (HealthDayNews) -- Come the dark days of winter, everyone can feel a bit down from time to time.

But for an estimated 15 million Americans, these shorter, colder days bring on seasonal affective disorder (SAD), a condition characterized by depression, social withdrawal, overeating and weight gain.

"It's a fairly large problem," said Randall Flory, a SAD researcher at Hollins University in Roanoke, Va. "It's estimated that in the U.S. about 6 to 7 percent of people have a pretty severe form of SAD."

Luckily, the best therapy so far for SAD may also be one of the safest -- light.

In a five-year study that was the first of its kind, Randall found that daily light box therapy consistently outperformed antidepressant drug therapy or air ionizers as the best remedy for the seasonal condition.

"We estimate that 80 percent of people affected will find benefit from [exposure to] bright light," said Flory, who first presented his findings at the 2003 annual meeting of the American Psychological Association.

Individuals with SAD tend to dread the onset of winter, said Anie Kalayjian, a professor of psychology at Fordham University in New York City, and a spokeswoman for the American Psychological Association.

"They have real difficulty motivating themselves to do ordinary things, even taking care of themselves and those they are responsible for," she said. As winter sets in and deepens, SAD sufferers tend to retreat into activities such as sleeping (often three to four hours longer per day than in the summer months) and overeating, with rapid weight gain.

No one is quite sure what causes SAD, although the fact that women are four times more likely to report the condition than men points to hormonal causes. However, men may simply be underreporting their true incidence of SAD, Kalayjian said.

"Women tend to express themselves more -- they don't have the societal hang-ups that say 'Oh, I can't talk about this,'" she said. "Men tend to rely more on things like drinking, or they become aggressive, or cover it up."

Kalayjian said she's also seeing more and more children with SAD in her practice. "There was a recent study that found that 3 to 5 percent of children have the disorder."

In his study, Flory's team observed the progress of 140 women with SAD over four consecutive winters. The researchers compared the effectiveness of two popular non-pharmaceutical treatments: 30 minutes per day of exposure to a box emitting powerful UV light; and air-cleaning devices that increase airborne levels of negatively charged ion. Scientists believe wintertime changes in the ionization of air may play some role in SAD.

The light boxes were the clear winner in terms of long-term symptom reduction, Flory reported, although the ionizers did have some ameliorative effect. According to Flory, this suggests that SAD is caused by a combination of environmental factors, including reduced wintertime light and changes in air ionization.

Both Flory and Kalayjian said they avoid treating SAD with antidepressant drugs whenever possible. One reason is price -- while buying a light box costs a patient about $60 a year over four years, the annual cost of an SSRI antidepressant such as Prozac or Zoloft can easily top $300 annually, Flory said.

"Some people with very, very severe SAD do use SSRIs," Kalayjian said, "but I would really encourage patients to look at preventive ways -- knowing your body and mind, and working with them."

Besides heightened exposure to light, Kalayjian has a few more tips she's seen work with SAD patients:

More information

To learn more about SAD, visit the National Mental Health Association.

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Saturday, February 5, 2005

 

Alcohol Ads in Magazines, Stores Raise Teen Drinking

 

HealthDayNews

Saturday, February 5, 2005

SATURDAY, Feb. 5 (HealthDay News) -- Magazine and supermarket ads featuring alcohol, as well as beer concession stands at sports and music events, have an especially powerful impact in spurring teens to start drinking or increase the amount they drink, a new study suggests.

"It appears that it's a combination of message and venue that helps influence adolescent drinking. Advertising that links alcohol with everyday life -- such as supermarket store displays -- appears to have more influence on drinking initiation," lead author Phyllis Ellickson, of the nonprofit Rand Corp., said in a prepared statement.

Adolescents did not appear to be as strongly influenced by television ads for alcoholic beverages, although more study may be needed to confirm that finding, the researchers said.

The study appears in the Feb. 5 issue of Addiction.

The study of 3,111 South Dakota teens concluded that those who frequently saw prominent beer advertising displays in grocery and convenience stores were more likely to start drinking alcohol than teens who saw fewer of those kinds of advertising displays.

Teens who had already tried drinking were more likely to increase their alcohol consumption by a greater amount the more they saw alcohol ads in magazines and the more they observed beer concessions stands at sporting and music events, the study said.

The study found no evidence that television ads for alcohol products encouraged teens to start drinking, but that doesn't mean it has no long-term impact.

"We don't feel this is enough information to say that TV advertising does not have an effect on kids. It may be that TV beer advertising has a cumulative effect over a longer period of time or may have an influence on younger children. These are two issues we didn't examine," study co-author and Rand psychologist Rebecca Collins said in a prepared statement.

Rand Health is the largest independent health policy research program in the United States. This study was supported by the U.S. National Institute on Alcohol Abuse and Alcoholism.

More information

The American Academy of Family Physicians (news - web sites) has more about teens and alcohol.

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