Personal Health
Joel P. Rutkowski, Ph.D., Editor
May 1, 2006
- Hip exercises aid common knee problem
- Cholesterol-lowering food combo effective
- High Rate of Sleep Apnea in Down Syndrome Kids
- Probiotic yogurt aids in eliminating ulcer bug
- Gene Protects Against Diabetes, Heart Disease
- Home exercise may aid heavy heart failure patients
- Asthma Drug Might Help Fight Heart Failure
- High blood pressure tied to hot weather in infancy
- Researchers Will Test 'Fat-Dissolving' Therapy Claims
- Dry Eye Strikes Many Menopausal Women
- Diet change may improve ovary disease outcomes
- Obesity Driving Diabetes Epidemic
- Chronic fatigue may have genetic basis
- Pituitary Hormone May Be Linked to Osteoporosis
- Blood tests effective in detecting latent TB: study
- Insulin Pump Also Monitors Blood Sugar
- Health Tip: Begin an Exercise Program
- Health Tip: Prevent Heartburn
- Fatal ODs on Rx Meds a Growing Problem
- Cognitive decline in elderly linked to slow gait
- Hiccups a possible sign of cancer: study
- Steroid Therapy Fails Patients With Deadly Lung Disease
- Alzheimer's up on 2004 list of
- Hormones boost breast cancer risk for black women
- Cell-Growth 'Switch' Holds Clues to Cancer
- Lower-intensity exercise may melt more pounds
- Health Tip: What to Expect From Gallbladder Surgery
- Teens not learning lesson from mom's skin cancer
- Cornea Scratches Don't Need Eye Patches
- Signs of long-term problems seen in teens' dieting
- Skin cancer epidemic underway in the US
- Natural Protein Might Ward Off Obesity
- Experts Suggest Spacing Pregnancies
- Health Tip: Get Your Kids to Eat Healthy
- Unhappy marriage may harm older adults' health
- Health Tip: Living With MS
- Mushrooms Are Unlikely Source of Vitamin D
- Preeclampsia a risk factor for future stroke
- Education Level Linked to Heart Disease: Study
- Depression not tied to diabetes control in elderly
- Blood Sugar Control Boosts Diabetics' Recovery After Surgery
- Whites fare poorly with HIV and hepatitis C
- Half of Older Diabetics Go Without Key Heart Drugs
- Breast implants don't affect cancer risk: study
- Elderly Cancer Survivors at Disability Risk
- No brain damage from dental fillings, studies show
- Mediterranean Diet May Help Prevent Alzheimer's
- TV time linked to overweight risk for some kids
- Younger Moms' Kids Get Longevity Edge
- Obesity Finds Niche in American Marketing
- Free Guidebooks Make for Heart-Healthy
- Women with diabetes breast-feed despite obstacles
- Chronic Stress May Help Cause Depression
- McDonald's to Tout Healthier Menu Choices
- Fewer Mammograms May Boost Black Women's Breast Cancer Risk
- Assisted reproduction kids do well psychologically
- Study Finds Activity Key in Weight Gain
- Evista as good as tamoxifen for breast cancer: study
- Melanoma That Recurs More Prevalent Than Thought
- Warmer Weather Brings Wheezing, Sneezing
- Needling Away Wrinkles
- Experts Push for Rosacea Awareness
- More Doctors Shunning Cumbersome Casts
Friday, April 21, 2006
Hip exercises aid common knee problem
By Amy Norton
Reuters Health
Friday, April 21, 2006
People with chronic knee pain known as patellofemoral pain syndrome may find relief from exercises that strengthen and stretch the hip muscles, research suggests.
In a study of 35 adults with the condition, researchers found that when patients were able to increase their hip strength and flexibility through physical therapy, their knee pain significantly diminished.
Patellofemoral pain occurs under and around the kneecap, and often worsens after activity or long periods of sitting with the knees bent. As it moves, the kneecap tracks along the groove of the thigh bone, and incorrect alignment between these bones is thought to play a major role in patellofemoral pain.
Typically, therapy for patellofemoral pain focuses on the kneecap - akin to bringing the "train back on the track," explained Timothy Tyler, a physical therapist at
In contrast, he told Reuters Health, exercises for the hip muscles - which stabilize the thighbone and pelvis - essentially "bring the track back to the train."
For their study, published in the American Journal of Sports Medicine, Tyler and his colleagues followed 35 patients who went through six weeks of physical therapy for patellofemoral pain. The regimen focused on strengthening and improving flexibility in various muscles that act on the hip.
Overall, the study found, the therapy was successful for two-thirds of the patients, and strengthening the hip flexors -- muscles that bring the thigh and torso toward each other - was a key to success.
Of the 26 knees that were treated successfully, strength in the hip flexor muscles improved by an average of 35 percent. On other hand, in all cases where patellofemoral pain did not improve, there was no gain in hip flexor strength.
Patients also benefited from boosting their flexibility -- namely, in muscles that flex the hip and in the iliotibial band, a long stretch of connective tissue that runs along the outer thigh, from the hip to just below the knee.
"Hopefully, this will spread,"
Source: American Journal of Sports Medicine, April 2006.
By Amanda Gardner
HealthDay Reporter
HealthDay News
Friday, April 21, 2006
FRIDAY, April 21 (HealthDay News) -- As the Bush administration puts the final touches on a massive response plan for a potential avian flu pandemic, experts -- including top-level administration officials -- are predicting that if and when the avian flu reaches American shores, it's not likely to be the disaster most once feared.
"It is impossible to predict whether we're going to have an H5N1 [the current strain of avian flu] pandemic and, if so, how severe it's going to be," Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told HealthDay.
Fauci had earlier told the Associated Press that he thought it "very unlikely that there is going to be the type of situation [here that] we see everywhere, from
That sentiment was echoed by Dr. Julie Gerberding, head of the U.S. Centers for Disease Control and Prevention. Speaking to attendees at a recent meeting in
For Fauci, however, planning for a worst-case scenario remains a necessity, even if, realistically, it is highly unlikely to transpire.
"We, the public health people, in order to make sure that we don't tragically undershoot our preparedness, must assume that the worst-case scenario will occur even though the fact is there really is no guarantee that it will occur," Fauci said. "The American people should not be worried. They should execute some degree of reasonably intelligent, non-panicky, non-hysterical preparedness, which really means 'have a plan for your family.'"
Another expert believes panic over a possible pandemic is unwarranted.
Dr. Marc Siegel, author of False Alarm: The Truth About the Epidemic of Fear and a clinical associate professor of medicine at New York University School of Medicine in
"The whole problem with the topic is the blurring of the distinction between birds and people. I'd be worried if I was a bird -- maybe. But not even all birds should be worried," Siegel said.
The current H5N1 virus has generated more fear than normal because of its virulence and ease of transmission among flocks of domestic birds, said Dr. Alan I. Hartstein, professor of clinical medicine at the University of Miami Miller School of Medicine.
So far, bird flu has killed 110 people in nine countries, the lion's share in
Human casualties remain largely confined to
That fear may be intensified with the looming threat that migrating birds may soon bring the virus to American shores. The U.S. Fish and Wildlife Service and
There's no question that this is a very serious infection -- for birds. "This is a pretty bad one, probably the worst one we've seen in birds, but that doesn't correlate to what's going to happen to humans," Siegel said.
But the fact remains that what people are seeing is still the bird flu, he said.
"The threat to people is minimal," Siegel said. "In
So far, the virus has shown no ability to jump from human to human. To gain that ability, it would need to undergo genetic mutations.
"Any influenza virus that can cause a pandemic must gain the ability to be easily transmitted from person to person," said Hartstein. "Thus far, the H5N1 viruses do not have this capability and cannot cause a pandemic."
There may not even be much of a threat to poultry, as long as
Said Fauci, "Would I be surprised if sometime in the future a migratory bird somewhere within the borders of the
So, is the
Not at all, Hartstein said.
There were three flu pandemics last century. "The threat of a new influenza pandemic is real and thought to be inevitable at some point in time," Hartstein said. "People can only guess when this will occur."
One question is whether the plan will include the elements many experts deem crucial.
"When I think of human preparedness, I think of long-term preparedness," Siegel said. "We need to improve how we make vaccines using 21st century technology so that, instead of reacting, we could anticipate a threat." Wetlands also need to be preserved, he added, so that migratory birds have a place to go that is geographically removed from poultry.
"We're better off now than we were six months ago, and it's extremely likely that six months or a year from now we'll be even better prepared," Fauci said. "Is anybody in the world optimally prepared for the worst-case scenario? The answer is an unqualified no."
More information
For more on bird flu, visit the U.S. Centers for Disease Control and Prevention.
Cholesterol-lowering food combo effective
By Anne Harding
Reuters Health
Friday, April 21, 2006
Eating four cholesterol-lowering foods each day can cut cholesterol levels as effectively as taking a first-generation statin drug, Canadian researchers report.
The only side effects seen with the diet, which includes large quantities of fiber and soy along with plant sterols and almonds, was "mild weight loss," the study's lead author, Dr. David J. A. Jenkins of St. Michael's Hospital in
"We're hoping to make cholesterol control within the grasp of the average person more than it has been," he added. "The advice that's been offered so far has left many people with no option other than to take a statin."
Jenkins' research, reported in the American Journal of Clinical Nutrition, is unique because some participants had previously participated in a study of statins, so he and his colleagues were able to compare the effects of diet and drugs in the same person.
The researchers instructed 66 people with high cholesterol to eat seven servings of foods containing viscous fiber -- for example, a slice of oat bran bread, or two teaspoons of psyllium, or two cups of raw eggplant; seven servings of foods rich in soy protein, such as a cup of soy beverage or a soy burger; 5 teaspoons of margarine containing plant sterols; and 42 grams, or 1.5 ounces, of almonds.
Study participants were able to consume close to the required amount of almonds and plant sterols, but had a tougher time eating the full amount of fiber and soy. Fifty-five people completed the yearlong study.
At 12 weeks, participants' level of "bad (LDL) cholesterol had dropped by 14 percent. One year later, it remained 13 percent below pre-study levels. Just under one third of study participants had LDL cholesterol reductions greater than 20 percent.
Among the study participants who slashed their bad cholesterol more than 20 percent -- who, Jenkins and his team hypothesized, had adhered most closely to the diet --there was no difference in the results seen with the diet and with statin treatment.
The 20 percent-plus reduction is similar to that seen with first-generation statin drugs, Jenkins and his team note, which have been linked to a 25 percent to 35 percent reduction in death from heart disease.
He and his colleagues conclude that diets like those used in the study will become increasingly attractive to people who choose not to take statins for personal reasons or who experience side effects from the drugs, especially as more foods containing soy, fiber, almonds and plant sterols become available.
Source: American Journal of Clinical Nutrition, March 2006.
High Rate of Sleep Apnea in Down Syndrome Kids
HealthDay News
Friday, April 21, 2006
FRIDAY, April 21 (HealthDay News) -- Abnormal sleep patterns and obstructive sleep apnea affect more than half of children with Down syndrome, but parents may not know whether their children have these problems, U.S. researchers report.
Based on the findings, they also advise that all parents of youngsters with Down syndrome get their child's sleep patterns tested by polysomnography by age 3 or 4.
Researchers at the Cincinnati Children's
The results showed that that 32 (57 percent) of the children had abnormal polysomnography results and evidence of obstructive sleep apnea. When the researchers included an elevated "arousal index" (10 or more disturbances in sleep per hour), they found that 80 percent of the children had abnormal results.
Reporting in the April Archives of Otolaryngology - Head & Neck Surgery, they also noted that rapid eye movement (REM) sleep should make up 25 percent to 30 percent of sleep time in children younger than age five. Only nine of the children in this study spent more than 25 percent of their sleep time in REM sleep, however.
As part of the study, the children's parents were asked to complete surveys about their youngsters' sleep habits. Of the 35 parents who completed surveys, 69 percent reported that their children had no sleep problems -- even though 54 percent of those parents' children had abnormal polysomnography results.
Abnormal polysomnography results were found in 36 percent of children whose parents did report sleep problems in their children.
The findings lead the
More information
The National Down Syndrome Society has more about Down syndrome and health.
Probiotic yogurt aids in eliminating ulcer bug
By Megan Rauscher
Reuters Health
Friday, April 21, 2006
The stomach bug Helicobacter pylori is the cause of most stomach ulcers, so doctors often try to eradicate the trouble-maker with antibiotic therapy. When this doesn't work, as is the case 10-23 percent of the time, a yogurt may help, according to a study conducted in
Specifically, eating yogurt containing the beneficial bacteria Lactobacillus and Bifidobacterium (AB-yogurt) before trying a second round of combo antibiotic therapy can improve its efficacy in eradicating residual H. pylori, the researchers found.
"The pretreatment can decrease the bacterial loads of H. pylori," Dr. Bor-Shyang Sheu from
Sheu and colleagues randomly assigned 138 patients, in whom the ulcer bug persisted after triple-antibiotic therapy, to quadruple-antibiotic therapy with or without four preceding weeks of taking AB-yogurt daily.
The investigators report in the American Journal of Clinical Nutrition that H. pylori decreased significantly more in the yogurt pretreatment group compared with the quadruple therapy-only group.
Ultimately, the eradication rate of H. pylori was 91 percent in the yogurt-plus-quadruple therapy group compared with 77 percent in the other.
"These findings," conclude the authors, "provide support for the ingestion of AB-yogurt for 4 weeks before the start of quadruple therapy ... thus obtaining improved rescue efficacy after failed triple therapy."
Source: American Journal of Clinical Nutrition, April 2006.
Gene Protects Against Diabetes, Heart Disease
By Randy Dotinga
HealthDay Reporter
HealthDay News
Friday, April 21, 2006
FRIDAY, April 21 (HealthDay News) -- People lucky enough to carry a variant in a single gene get added protection against both type 2 diabetes and heart disease, a new study finds.
Individuals with the trait aren't immune from the conditions, researchers say, but a study of nearly 7,900 subjects found that they are as much as 48 percent less likely to suffer from either illness.
"This gives us insight into how heart disease and diabetes may develop," said co-author Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health in
Scientists don't think diabetes and heart disease are inherited, but genes can play a major role, they say. "We do know there are genes that make people more susceptible to becoming diabetic if they're exposed to the right environmental factors," Rimm said. Specific genes have also been linked to heart disease.
In mice, a gene variation appears to provide protection against type 2 diabetes and clogged arteries. In the new study, Rimm's team examined the medical and genetic records of 7,899 people to see if the variation did the same thing for humans.
The study findings appear in this week's issue of the Proceedings of the National Academy of Sciences.
A total of 4.3 percent of the people studied had one copy of the variant gene, Rimm said.
These people appear to have won a kind of genetic lottery, because levels of triglycerides -- a potentially dangerous type of blood fat -- were 12 percent lower in their blood than in the other subjects. Their risk of heart disease was also 34 percent lower, and if they were obese, their risk for type 2 diabetes was 48 percent less than that of obese individuals who did not carry the gene variant.
Rimm suspects that the genetic variation helps control molecular signals that influence how triglycerides circulate in the blood.
What next? It's possible that a better understanding of the genetics of diabetes and heart disease could lead to more effective treatments, Rimm said. "If you could emulate what this form of this gene is doing, maybe you could lower someone's risk of heart disease or diabetes by copying the same type of physiological effects," he added.
The research raises another possibility: genetic tests that could alert people if they have a higher likelihood of getting diabetes later in life.
Ideally, "if you know in advance that you're at risk, that would make people think and give them the opportunity to protect themselves," said Dr. Larry C. Deeb, the American Diabetes Association's president-elect of medicine and science.
After all, he said, diabetes is largely preventable.
More information
Learn how to prevent diabetes at the American Diabetes Association.
Home exercise may aid heavy heart failure patients
Reuters Health
Friday, April 21, 2006
A home-based exercise program for overweight or obese patients with advanced heart failure results in significant weight loss after six months, researchers in
It's well established that exercise is important for long-term weight control for overweight people, Dr. Lorraine S. Evangelista, of the
To look into this, the researchers assigned 99 heart failure patients, classified as at least overweight, to a low-level, home-based exercise program or to a comparison "control" group. The participants' average age was 53 years, and most were male, white and married, according to the report in the American Journal of Cardiology.
Those in the exercise program were asked to walk for 45 minutes at least four times a week at a speed that raised their heart rate to 60 percent of maximum. After six weeks, a light resistive training component was added to the exercise regimen.
Compared with individuals in the control group, those in the exercise group had significant weight reduction after 6 months, with a weight loss of 14 pounds versus a bit more than half a pound among the controls.
Moreover, significantly fewer hospital admissions occurred in the exercise-group patients compared with the control-group patients -- average 0.63 versus 1.07, respectively.
Modest weight loss of 5 percent or more was associated with higher exercise levels at 6 months, as well as decreased levels of depression and hostility, Evangelista and colleagues report.
Nonetheless, the authors note in their article that others have found that being overweight doesn't seem to raise the odds of heart failure patients dying, and that involuntary weight loss in severe heart failure is a poor sign. They therefore conclude that the benefits of deliberate weight loss are uncertain.
Source: American Journal of Cardiology, March 15, 2006.
Asthma Drug Might Help Fight Heart Failure
By Amanda Gardner
HealthDay Reporter
HealthDay News
Friday, April 21, 2006
FRIDAY, April 21 (HealthDay News) -- Body builders sometimes turn, illicitly, to the asthma drug clenbuterol to help them bulk up, but now researchers say the drug might also help heart failure patients stay strong without the need for heart transplant.
The first
The trial, which is a precursor to bigger trials, is an example of how far doctors will go to find solutions to the growing problem of heart failure.
And like many other avenues of research, the promise is still a faint one.
"We've learned the hard way that any pharmacological intervention in this very fragile group of patients needs to be studied very cautiously and thoroughly," cautioned Dr. Ann Bolger, a spokeswoman for the American Heart Association and professor of medicine at the
The end step for many heart failure patients is a heart transplant. But with a worldwide shortage of organ donors, many patients have to survive on heart pumps. Is there a way to avoid both heart pumps and transplants? Possibly, the experts say.
"The idea is to one day develop strategies to promote cardiac recovery while patients are supported with a heart pump. That would obviate the need for heart transplants," said Dr. Simon Maybaum, medical director of the Center for Advanced Cardiac Therapy and the Cardiac Transplant and Assist Device Program at
Maybaum was lead author of the study, which was presented recently at a meeting of the International Society of Heart and Lung Transplantation in
"We're looking for ways to make the transition off the pump and potentially go forward from there," Bolger added. "We need more tools to save lives."
Studies done by one British center found that clenbuterol resulted in significant improvement in cardiac function in patients with heart pumps awaiting heart transplants. In fact, the pumps could be taken out in more than half of the patients, meaning they no longer were in need of transplant. Those studies used doses 20 times those typically used by asthma patients and athletes.
Clenbuterol is not approved in the
Maybaum, however, managed to obtain permission from the U.S. Food and Drug Administration to conduct a small pilot study using high-dose clenbuterol.
There were two parts to the study: The first tested high-dose clenbuterol in heart pump patients. The second focused on whether the drug in lower doses would improve muscle function and quality of life in heart failure patients without heart pumps (those with milder heart failure). Seven patients completed the study.
Clenbuterol did increase skeletal muscle mass and strength, and was safe at the doses given -- 10 to 15 times that usually taken by asthmatics and athletes. There was no significant change in heart function. However, Maybaum pointed out that the study was not designed to look at this.
Data from the second part of the study is still blinded to researchers, and therefore not yet available.
The next step will be to conduct a multi-center trial in the
However, some experts voiced major concerns.
"Patients in heart failure have a pretty broad spectrum of responses to all kinds of therapies, so we have to be very careful. In some situations, this type of drug can be very dangerous with respect to arrhythmias, blood pressure changes and even stroke," Bolger said. "Medications that seem to give the heart an extra boost sometimes make patients feel better, but increase early mortality."
On the other hand, Bolger added, muscle-building strategies including physical fitness, have already been shown to benefit heart failure patients.
Even the study authors were cautious about the odds of success.
"Whenever there are such novel results which have the potential to dramatically affect such a difficult disease process, we go into the research with a mixture of excitement and skepticism," Maybaum acknowledged. "We're optimistic that we will find solution, but we're not sure which one will bear out. We will definitely live in an era where we will be able to repair the heart as opposed to replace it."
More information
For more on heart failure, head to the American Heart Association.
High blood pressure tied to hot weather in infancy
Reuters Health
Friday, April 21, 2006
People who were born during hot, dry years seem to have higher blood pressures, a study in the American Journal of Epidemiology indicates.
The link could be the occurrence of dehydration in infancy. "Animal studies suggest that severe dehydration in infancy results in greater sodium retention and a taste for salty foods throughout life," Dr. Debbie A. Lawlor, of the University of Bristol, UK, and colleagues explain.
This effect may be a result of "natural selection over generations produced by the survival advantage associated with the ability to retain sodium and hence water in the face of severe dehydration." However, in contemporary life, the retention of sodium in response to environmental conditions may have a down side, such as elevated blood pressure.
To investigate the link between climate conditions in infancy and adult blood pressure, Lawlor's group evaluated 3964 randomly selected
The researchers found that those who experienced the hottest and driest summers in the first year of life were more likely to have suffered severe infant diarrhea and dehydration than those who experienced cooler and wetter summers.
Also, a high average summer temperature in the first year of life correlated with a higher systolic blood pressure (the upper reading) in adulthood. Conversely, higher average summer rainfall was linked to a lower adult systolic blood pressure.
"If established, our hypothesis would have important public health implications," Lawlor's team concludes, by "highlighting the importance of avoiding dehydration in infancy not just for short-term health improvement but also for benefits to long-term cardiovascular health."
Source: American Journal of Epidemiology, April 1, 2006.
Researchers Will Test 'Fat-Dissolving' Therapy Claims
HealthDay News
Friday, April 21, 2006
FRIDAY, April 21 (HealthDay News) -- An increasingly popular "fat-dissolving" treatment called mesotherapy, better known as Lipodissolve, promises to help users drop weight -- but is it safe, and does it really work?
To find out, the American Society for Aesthetic Plastic Surgery (ASAPS) announced Friday it is launching a double-blind placebo study focused on the treatment. They made the announcement at the annual meeting of the Aesthetic Society in
Mesotherapy was developed as a separate medical specialty in
The treatment involves the injection of various compounds into the skin in order to break down fat cells, but the absence of proper protocols and regulation of this therapy may put patients at risk. The goal of the study is to provide doctors and patients with more specific and standardized protocols, as well as more information about the possible risks and benefits of this therapy.
"Our goal is to provide physicians and their patients with the information they need to make good decisions. Currently, we cannot endorse the injection of phosphatidylcholine, sodium deoxycholate, or any drugs, vitamins, plant extracts or hormones into subcutaneous fat as practiced in mesotherapy/Lipodissolve treatments, because we don't have enough clinical data or FDA approval to support their use," Dr. Mark Jewell, ASAPS president, said in a prepared statement.
The study was designed by the Aesthetic Society and funded by the Aesthetic Surgery Education and Research Foundation. The findings are expected to be published in the Aesthetic Surgery Journal, the peer-reviewed journal of the ASAPS.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers advice on selecting a safe and effective weight loss program.
Thursday, April 20, 2006
Dry Eye Strikes Many Menopausal Women
By Steven Reinberg
HealthDay Reporter
HealthDay News
Thursday, April 20, 2006
THURSDAY, April 20 (HealthDay News) -- While 62 percent of older women experience dry eye, only 16 percent know it's linked to menopause, a new survey shows.
"The prevalence of dry eye is very high, and growing," said Phyllis E. Greenberger, president and chief executive officer of the Society for Women's Health Research. "Dry eye impacts the quality of life, as well as the physical health, of 10 million Americans each year."
The survey, which was released Thursday and sponsored by the Society for Women's Health Research, polled 304 menopausal and perimenopausal women about dry eye.
Of those women who had experienced dry eye, only 59 percent had spoken to their doctor about the condition, the survey found. When it came to treatment for dry eye, 58 percent had tried over-the-counter eye drops to ease their symptoms.
Approximately 3.2 million American women over the age of 50 are affected by chronic dry eye, Greenberger said. "For many women, dry eye is related to the change in hormone levels of menopause," she noted.
Since risk of dry eye increases with age, the number of people affected will increase as the population ages. Many more women suffer from dry eye than men. In fact, dry eye is about two to three times more common in women.
Dry eye results from insufficient tear production, excessive tear evaporation, or from the production of toxic tears, which can be caused by inflammation. The condition can be a mild, episodic feeling of discomfort associated with exposure to dry, hot or windy environments. But it can also be a chronic condition that can lead to increased risk of infection or visual impairment. Chronic dry eye can impact the quality of life, interfering with reading, work, using a computer and night driving.
"Dry eye is a part of the aging process for all of us," said Dr. Laurie Barber, a professor of ophthalmology at the
These factors include medications and diseases patients may have, including autoimmune diseases such as lupus. Symptoms may include irritation, burning, stinging, discomfort, grittiness, foreign body sensation, blurred vision and sensitivity to light, Barber said.
"If not treated, persistent visual problems may haunt the patient and decrease the ability to complete daily activities," Barber said.
Treatments for dry eye are based not only on disease, but also on the cause of the disease. There are three main treatment options -- artificial tears, prescription therapies and surgery. One of the latest therapies is a prescription that increases tear production in patients with dry eye resulting from inflammation, Barber said.
In some cases, when inflammation is the cause of dry eye, treatment can include topical cyclosporin, Barber said. In addition, nutrition may play a role in treatment. Recent studies have found that omega-3 fatty acids -- found in fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon -- may also be of benefit in treating the condition, Barber noted.
One expert agrees that dry eye is a growing health problem.
"Dry eye can be caused by conditions such as lacrimal gland disease that affects tear production, or conditions that decrease corneal sensation, such as LASIK eye surgery, long-term contact lens wear and diabetes," said Dr. Jeffrey P. Gilbard, of the Department of Ophthalmology at
Dry eye is becoming more common, Gilbard said. "If somebody has sandy, gritty irritation of a foreign body sensation that has been around for more than three months and gets worse as the day goes on, they have dry eye until proven otherwise," he said.
Gilbard, who invented an eye drop and nutritional supplement specifically to treat dry eye, believes using drops and increasing the intake of omega-3 fatty acids, which appear to fight inflammation and increase tear production, is the preferred treatment.
"If you have symptoms of dry eye, you should go to an eye doctor to find out why," Gilbard said.
More information
The National Library of Medicine can tell you more about dry eye syndrome.
Diet change may improve ovary disease outcomes
Reuters Health
Thursday, April 20, 2006
The fertility problems and hormone irregularities that plague women with polycystic ovary syndrome (PCOS) may improve on a low-carbohydrate diet, according to a new study.
In polycystic ovary syndrome, a woman's ovaries develop multiple cysts. Symptoms can include excessive hairiness, obesity, menstrual abnormalities, and infertility. PCOS is also believed to increase the likelihood of developing diabetes.
The lead investigator of the current study, Dr. Crystal C. Douglas, told Reuters Health, "Our results suggest that a moderate reduction in dietary carbohydrate may decrease insulin, and over time, this dietary modification may lead to improvements in the metabolic and reproductive outcomes in women with PCOS, independent of weight loss."
Douglas, at the
The 11 women who were available for follow-up had each been put on three different diets for 16-day periods, separated by two 3-week "washout" periods, according to the team's report in the March issue of Fertility and Sterility.
The regimens consisted of a standard diet made up of about 56 percent carbohydrate, 31 percent fat and the rest protein; an enriched monounsaturated fatty acid diet with about 55 percent carbohydrate, 33 percent fat and the remainder protein; and a reduced carbohydrate diet with about 43 percent carbohydrate and 45 percent fat and the rest consisting of protein.
Compared with the standard diet, the low-carbohydrate diet lowered insulin levels. In addition, the usual jump in insulin in response to glucose was reduced after the low carbohydrate diet compared with the enriched monounsaturated fatty acid diet.
No differences were seen in circulating reproductive hormones.
Given these findings, the researchers conclude that dietary management may be a useful addition to PCOS treatment. As they explain, high insulin levels are thought to contribute to the hormone abnormalities seen with PCOS, so reduced insulin could lead to an improved hormone profile.
Source: Fertility and Sterility, March 2006.
Obesity Driving Diabetes Epidemic
By Kathleen Doheny
HealthDay Reporter
HealthDay News
Thursday, April 20, 2006
THURSDAY, April 20 (HealthDay News) -- America's obesity epidemic is definitely driving the nation's type 2 diabetes epidemic, says a new study by the U.S. Centers for Disease Control and Prevention.
While other factors play some role in the rapidly increasing number of people with diabetes, obesity is the major factor in the trend, said Linda S. Geiss, lead author of the study, published in the May issue of the American Journal of Preventive Medicine.
The study, based on concrete numbers drawn from the entire country, backs up what experts have long believed, said Geiss, a statistician with the CDC's Division of Diabetes Translation.
"Most incidence studies [of diabetes] have been done on samples that aren't representative of the
Geiss and her research team looked at statistics from the National Health Interview Survey, an ongoing nationwide in-person survey of about 40,000 households. They zeroed in on the years 1997 to 2003 to look for trends in the incidence of diagnosed diabetes in adults aged 18 to 79. Each year, about 31,000 adults were asked whether a health professional had told them they had diabetes. Not included was gestational diabetes, a type that occurs during pregnancy.
Participants were asked how old they were when their diabetes was diagnosed. The researchers had access to information about height and weight so they could compute the participants' body mass index (BMI, a ratio of height to weight). A BMI of 25 and above is termed overweight; 30 and higher is considered obese.
Excess weight and inactivity are risk factors for type 2 diabetes, in which the body doesn't properly use the hormone insulin, which is crucial for converting sugars and starches in the blood into fuel for the body.
The incidence of diagnosed diabetes rose 41 percent from 1997 to 2003 among the study participants, Geiss found.
About 20 million Americans have diabetes, although many do not yet know it, according to the American Diabetes Association.
About two-thirds of American adults are now overweight or obese, according to the National Institutes of Health. In 1960, 13 percent of adults were obese, but by 2000, nearly 31 percent were.
Geiss wanted to determine, however, if the rise in diabetes might be due at least partially to better detection methods allowing for earlier diagnosis. "If we were doing a better job, we would be detecting it earlier and when people are healthier."
But from 1997 to 2003, those diagnosed with diabetes were not healthier or younger. Increased detection of diabetes "could be part of the answer," she said, "but not the whole answer. It doesn't seem to be a major factor. Most of the increase in diabetes occurred in those with a BMI of 30 or above. In 2003, 59 percent of the newly diagnosed were at a BMI of 30 or above. Another 30 percent were overweight, with a BMI of 25 to under 30. All together, 89 percent of the [new] cases were either overweight or obese."
The study findings will not surprise experts, said Mary Austin, a diabetes educator and a researcher at Henry Ford Health System in
"These findings are very reflective of what we see around the world,"
Her Advice? Know your risks and do something about them. "If you are not at your ideal body weight and are not active, over time, you have a risk of diabetes,"
The oft-repeated message holds here, she said. Keep your weight at a healthy level and get regular, moderate exercise.
Geiss added: "Recent studies have shown we can prevent diabetes in those with risk factors, just with moderate lifestyle changes. Those include cutting down on daily calories for weight loss, if necessary, and getting activity into each day."
More information
To find out if you are at risk of diabetes, visit the American Diabetes Association.
Chronic fatigue may have genetic basis
By Megan Rauscher
Reuters Health
Thursday, April 20, 2006
Results from the largest study of chronic fatigue syndrome to date suggests that there are specific genes and gene activity patterns that make some people more prone to develop the disorder.
During a telebriefing Thursday, Dr. William C. Reeves, head of chronic fatigue syndrome (CFS) research at the Centers for Disease Control and Prevention in Atlanta, said: "For the first time ever, we have documented that people with CFS have certain genes that are related to those parts of brain activity that mediate the stress response and that they have different gene activity levels."
He explained the gene patterns seen in these people "are related to their body's ability to adapt to challenges and stresses that occur throughout life, such as infections, injury, trauma or adverse events."
By way of background, Reeves noted that CFS was first recognized in the late 1980s and "we are still learning a lot about it." The condition is characterized by medically and psychiatrically unexplained symptoms that include fatigue, problems with sleeping, memory and concentration, and pain.
At least one million Americans have the debilitating disorder, and the costs to society are staggering. "The average family in which someone suffers CFS forgoes about $20,000 a year in lost earnings and wages," Reeves said.
The new findings, published in the medical journal Pharmacogenomics, are based on 227 CFS patients who underwent detailed clinical evaluations and extensive blood testing that included an assessment of genetics and the activity level of 20,000 genes. The objective was to identify factors that could have caused or be related to CFS.
Dr. Julie Gerberding, director of the CDC, said the results of the study are "a very important step forward in the field of chronic fatigue research."
CFS is a controversial topic, with some doctors thinking it is a mental rather than physical condition. Gerberding noted that "this is the first credible evidence of a biological basis for chronic fatigue syndrome. It reflects the remarkable confluence of a number of scientific advances really coming to bear on a problem of great importance to many people around the
Knowing there is a biologic basis for CFS will help researchers identify more effective ways to diagnose the illness and come up with more effective treatments including cognitive behavioral therapy, medications or a combination of both.
Source: Pharmacogenomics, April 2006.
Pituitary Hormone May Be Linked to Osteoporosis
By Amanda Gardner
HealthDay Reporter
HealthDay News
Thursday, April 20, 2006
THURSDAY, April 20 (HealthDay News) -- A hormone produced by the pituitary gland may play a role in bone loss in postmenopausal women, challenging the notion that declining estrogen levels are solely responsible for the problem.
High levels of the hormone, pituitary-derived follicle-stimulating hormone (FSH), caused an increase in bone loss in mice. And mice who lacked either the FSH hormone or its receptor became resistant to bone loss, even if they showed evidence of estrogen deficiency.
The findings open up the possibility that therapies other than estrogen to treat or prevent bone loss may one day be possible. Estrogen-replacement therapy is not an ideal solution because it has been linked to a heightened risk of breast cancer, especially when administered in combination with the hormone progestin.
"In essence, we're revisiting the pathophysiology of bone loss, attributing it not simply to loss of estrogen but to the accompanying elevation of FSH which occurs during menopause," said study author Dr. Mone Zaidi, a professor of medicine and physiology and director of the Mount Sinai Bone Program, at Mount Sinai School of Medicine in New York City. "The importance is that you could actually prevent bone loss without using a load of estrogen."
For now, however, the report, which appears in the April 21 issue of Cell, poses more questions than it answers.
"I personally think this is beautiful work and asks a lot of questions," said Dr. J. Christopher Gallagher, a professor of medicine and endocrinology at Creighton University School of Medicine in
Osteoporosis, a condition in which bones became more fragile and likely to break, affects nearly 45 million women globally, including 8 million in the
So far, the broken balance has been attributed exclusively to loss of estrogen after menopause.
"It has really become virtually gospel that estrogen loss in women after menopause leads to bone loss," Zaidi said.
However, there were some holes in that theory. In some animal studies, taking away estrogen did not always result in bone loss, Zaidi said.
About two years ago, Zaidi's group discovered that thyroid-stimulating hormone, a sister hormone to FSH, affected bone remodeling.
Prior to menopause, FSH's role is to trigger egg development in women and to stimulate production of estrogen by the ovaries. As women get older, however, their estrogen levels decline. At that point, the pituitary gland attempts to restore estrogen levels by releasing more FSH.
"There's a feedback control between estrogen and FSH," Zaidi explained. "As estrogen falls, FSH rises."
In the new study, Zaidi and his colleagues showed that mice lacking FSH or its receptor did not experience bone loss, even if the ovaries were not producing estrogen.
Because this was an animal study, however, more research on humans is necessary.
"The next step would be to have a small molecule or antibody to mop up FSH in circulation and see if bone loss can be prevented," Zaidi said. "If that is the case, we have a new target" for prevention and treatment strategies.
Gallagher added: "It is an interesting clinical question because we've always ignored the height of FSH in postmenopausal women. We're going to need some prospective data, and I don't know of any studies currently looking at that. These are important questions."
More information
The National Osteoporosis Foundation has more on this disease.
Blood tests effective in detecting latent TB: study
Reuters
Thursday, April 20, 2006
Blood tests could be more effective in detecting people with latent tuberculosis than the standard skin test, Italian researchers said on Friday.
Many people with latent TB infection never develop the respiratory disease but detecting cases and providing treatment will be a key to eradicating the illness that kills 2 million people worldwide each year, according to public health experts.
Scientists at the
"To help control and possibly eliminate tuberculosis in low-prevalence areas, a specific and sensitive test for latent infection is needed," said Dr Luca Richeldi, who headed the study, in The Lancet medical journal.
"Two new blood tests ... might be more accurate than the tuberculin skin test."
Tuberculosis is a contagious airborne disease that affects about 9 million people each year. The World Health Organization (WHO) has warned that TB has reached alarming proportions in
A person with tuberculosis can infect others with the TB germs, or bacilli, by coughing, sneezing, talking or spitting.
Every second another person is newly infected with TB bacilli. A person with active TB will infect 10-15 others every year if no treatment is given, according to the WHO.
Countries in sub-Saharan Africa have the highest incidence of the disease while half the world's cases are in
Patients with TB are treated with the DOTS (Directly Observed Treatment, Short-course) program -- an approach adopted by WHO that involves government commitment, patient surveillance and drug treatment.
Certain groups with latent TB including babies, young children, the elderly, people living with HIV and illegal drug users, are more likely to develop active TB and may need treatment.
Richeldi and other scientists who worked on the study said the blood tests could be used either in combination with the skin test or as a substitute to increase detection of latent TB.
"The choice of which diagnostic test to use should depend on the population being tested, the purpose of testing, and resources available," Richeldi added.
Insulin Pump Also Monitors Blood Sugar
HealthDay News
Thursday, April 20, 2006
THURSDAY, April 13 (HealthDay News) -- The U.S. Food and Drug Administration has approved Medtronic's MiniMed Paradigm insulin pump and glucose monitoring system, the first device to both deliver insulin and monitor a user's blood sugar in real time, the company said Thursday.
The device takes blood sugar (glucose) readings every five minutes, displaying up to 288 readings per day, Medtronic said in a statement. It allows users, once sugar levels are confirmed by a standard fingerstick blood test, to take immediate action to improve glucose control.
The glucose sensor is a small electrode that's inserted under the skin. Typically replaced after three days of use, it measures glucose in the fluid contained between the body's cells, Medtronic said.
The insulin pump is a pager-sized device capable of delivering insulin around the clock, much like the human pancreas.
The American Diabetes Association says the disease, affecting nearly 21 million Americans, occurs when the body does not produce or properly use the hormone insulin. Insulin convert sugars, starches and other foods into energy for cells.
More information
Visit the American Diabetes Association to learn more.
Health Tip: Begin an Exercise Program
HealthDay News
Thursday, April 20, 2006
(HealthDay News) -- Most couch potatoes know how important it is to exercise. But getting started may be no walk in the park.
The American Heart Association offers these suggestions for exercise newbies or wannabees:
Wear comfortable, properly fitting shoes and clothing that are appropriate for working out. Start slowly and build up your workout time. Eventually, you should reach 30 minutes of exercise on most (if not all) days of the week. Pick an exercise schedule that works for you, and stick with it so it becomes routine. If more enjoyable, engage in two 15-minute sessions a day instead of one 30-minute session. Be sure to stay hydrated, drinking water before, after, and maybe even during workouts. See what your doctor recommends. Get a group of friends or family members who are willing to work out with you. This will make your workouts more fun and motivate you to continue. Add variety to your workouts. Alternate between walking, biking, swimming, running or any other activities you enjoy. If you miss workouts, don't give up. No matter how long it's been since you've exercised, it's never too late to start over and work your way gradually back to where you were.
HealthDay News
Thursday, April 20, 2006
(HealthDay News) -- If you suffer from heartburn, there are prescription and over-the-counter medications that can help alleviate your symptoms. But how is your heartburn triggered in the first place?
The National Heartburn Alliance recommends dietary changes to lower your risk. Acidic foods and drinks, like coffee, soda or citrus fruit, can aggravate the stomach. So can fattening and spicy foods, as can garlic, onions, pepper, caffeine and alcoholic or carbonated drinks.
Lifestyle changes, such as losing weight or quitting smoking, can reduce bouts of heartburn. Also, avoid lying down or bending over after meals, and try to avoid eating right before bedtime.
Fatal ODs on Rx Meds a Growing Problem
HealthDay News
Thursday, April 20, 2006
THURSDAY, April 20 (HealthDay News) -- The rate of accidental, fatal overdoses involving prescription medications is rising faster than those caused by illegal drugs such as cocaine and heroin, according to a 10-year study from New Mexico.
The majority of prescription drug deaths are caused by opioid pain relievers, such as codeine, morphine and Demerol, the researchers noted.
"The increasing role of opioid painkillers in unintentional drug overdose deaths suggests that overdose prevention efforts would be well targeted at this drug class," lead researcher Mark Mueller, an epidemiologist with the U.S. Centers for Disease Control and Prevention, said in a prepared statement.
Reporting in the May American Journal of Preventive Medicine, Mueller and his colleagues analyzed statewide
In 1994, accidental prescription drug overdoses accounted for 1.9 out of 100,000 deaths. By 2003, that had increased to 5.3 per 100,000 deaths. That's a 179 percent increase, compared to a 121 percent increase in unintentional overdose deaths caused by illegal drugs over the same period.
"While we would all agree on the value of properly prescribed and used opioids, this study illustrates the need to reinforce proper prescribing practices and usage of prescription drugs, particularly opioid painkillers," Mueller said. "It will also be important to find new ways to prevent deaths due to prescription drugs acquired through street diversion."
More information
The Institute for Safe Medication Practices has advice on safe medication use.
Wednesday, April 19, 2006
Cognitive decline in elderly linked to slow gait
Reuters Health
Wednesday, April 19, 2006
Elderly people who retain their mental sharpness are likely to walk at a speedier -- and safer -- rate than those who've suffered a decline in cognitive skills, researchers report.
Dr. Roee Holtzer, of
Gait performance tested without interference was predicted by the subjects' performance on all the mental tests, the team reports in the medical journal Neuropsychology. Only some aspects of mental performance -- memory and what's termed executive control -- predicted gait performance tested with interference.
Gait velocity tested with interference is more representative of walking in public, in which walkers constantly deal with distraction, the investigators note.
They also point out that slow gait is a significant risk factor for falls among the elderly, so the findings may help explain why cognitive problems or dementia are often associated with falls in older adults.
Source: Neuropsychology, March 2006.
Hiccups a possible sign of cancer: study
Reuters
Wednesday, April 19, 2006
Persistent hiccupping in addition to weight-loss and difficulty swallowing could be a warning sign of cancer of the esophagus, an Irish researcher said on Wednesday.
Professor Tom Walsh, of the
"Up to now, hiccups have not been recognized as a possible harbinger of cancer," Walsh told Reuters.
But in a study of 99 patients with the disease he said 27 percent complained of persistent hiccups and six percent said it prompted them to see a doctor.
Hiccups are caused by the involuntary spasm of the diaphragm which causes the vocal cords to close very briefly. Eating too quickly or too much, coughing, laughing and too much alcohol are thought to cause hiccups.
Swallowing and breathing into a paper bag are remedies that are used to cure hiccups.
Walsh believes hiccups in cancer patients could be linked to the phrenic nerve, the motor nerve of the diaphragm.
"Nobody knows why, but there may be the involvement of the vagus nerve or the phrenic nerve," he said.
Nine percent of the patients in the study described hiccupping as the predominant ongoing symptom.
Oesophageal cancer is the sixth most common cancer worldwide with more than 400,000 cases detected each year, according to the International Agency for Research on Cancer in
Most cases are detected when the disease is in an advanced stage. Smoking and alcohol are the most important risk factors.
Steroid Therapy Fails Patients With Deadly Lung Disease
By Ed Edelson
HealthDay Reporter
HealthDay News
Wednesday, April 19, 2006
WEDNESDAY, April 19 (HealthDay News) -- A U.S. government-funded study has dashed hopes that steroid treatment might improve survival of people in the last stages of the often-fatal lung condition called acute respiratory distress syndrome (ARDS).
A trial with 180 people who had ARDS for at least seven days found almost identical death rates -- 28.6 percent for those who did not get steroids, 29.2 percent for those who did. And the death rate was significantly higher when steroids were given to people with ARDS for 14 days or longer.
"The ARDS Clinical Research Network will not recommend that it [steroid therapy] be used," said Andrea Harabin, the U.S. National Heart, Lung, and Blood Institute project officer in charge of the network.
ARDS is a lung condition that develops in patients who are critically ill with other diseases, such as pneumonia or widespread bacterial infections, or who have sustained major injuries. Fluid builds up in the lungs until breathing becomes impossible. There is no specific treatment for the condition, and an estimated 30 percent to 70 percent of ARDS patients die. The federal government estimates that there are 150,000 cases of ARDS in the
The hope was that steroid treatment could help by easing inflammation in the lungs of ARDS patients, Harabin said. "It was important to know whether this drug [methylprednisolone] worked," she said. "The study clearly showed that the effect that might have been suggested by previous, much smaller studies, was not there. At the dose and timing that this study used, steroid treatment would not be recommended."
Harabin added that the implication of the study's results are limited because "we only studied one dose and at one period of ARDS." But no further studies of steroid therapy are planned by the network, which will be looking at alternate treatments, she said.
There still might be a reason to try steroid treatment for some ARDS patients, perhaps when nothing else has helped and death is near, said Dr. Paul N. Lanken, professor of medicine and principal investigator for the ARDS network at the
"My personal belief would be to avoid them," Lanken said. "But if there was a very severe case in a young person who did not have ARDS for two weeks, I would look at the situation to think if there was anything else we could do. Physicians are not comfortable accepting a lethal condition."
The trial was reasonable research to attempt, he said, adding, "We had an open mind -- we weren't sure. We knew there were tradeoffs, but given at the right time, the right dose at the right state of the disease, would the side effects of the drug outweigh the potential benefits?"
The "no" answer that emerged from the study was not definitive, Lanken said. "We got more information for this equation that doctors are using every day to make decisions for their patients," he said, and the study results "are a yellow flag that if a physician does use them [steroids] they should be used cautiously and in selected patients, avoiding the group that had ARDS two weeks or longer."
More information
For more on ARDS and related conditions, visit the ARDS Support Center.
Alzheimer's up on 2004 list of
Reuters
Wednesday, April 19, 2006
Americans are living longer, healthier lives and only the mortality rate from Alzheimer's disease is increasing among the top 10 causes of death, the
Alzheimer's disease moved to seventh place from eighth place among the leading causes of death in 2004, passing influenza and pneumonia, the
"The life expectancy of Americans in 2004 -- 77.9 years -- is the highest it has ever been," the NCHS said in a statement.
"The life expectancy for women in the
This is because there was a 7.3 percent drop in the death rate from influenza and pneumonia, while there was a 1.4 percent increase in the death rate from Alzheimer's.
The NCHS, part of the U.S. Centers for Disease Control and Prevention, reported that 2.39 million Americans died in 2004.
The
The 10 leading causes of death in 2004 were:
§
Heart disease - 654,000 deaths
§
Cancer - 550,000 deaths
§
Stroke - 150,000 deaths
§
Chronic lower respiratory diseases - 123,000
§
Accidents - 108,000
§
Diabetes - 72,800
§
Alzheimer's disease - 65,829
§
Influenza and pneumonia - 61,472
§
Kidney disease - 42,762
§
Septicemia (blood infection) 33,464
By Alan Mozes
HealthDay Reporter
HealthDay News
Wednesday, April 19, 2006
WEDNESDAY, April 19 (HealthDay News) -- A team of American researchers have developed a "risk calculator" that they say is a better tool for predicting a man's odds of developing prostate cancer than prostate-specific antigen (PSA) blood testing alone.
The calculator -- posted online for use by both patients and physicians -- adds age, race, family history of prostate cancer, prior biopsy findings, and digital rectal exam (DRE) results into the mix alongside PSA levels, to assess a man's risk before having a new biopsy.
"PSA is a very important predictor of cancer, but is only one part of the picture of a man's risk of cancer," explained study author Dr. Ian M. Thompson, professor and chairman of the department of urology at the University of Texas Health Science Center in
His team describe the new screen in the April issue of the Journal of the National Cancer Institute.
According to the American Cancer Society (ACS), prostate cancer is the second leading cancer killer for men. An estimated one in six men will receive a prostate cancer diagnosis in their lifetime, and more than 30,000 Americans currently die of the disease each year.
For healthy men over the age of 50, the ACS now recommends an annual PSA blood test, as well as a digital rectal exam (DRE). The organization advises that men at higher risk -- such as blacks and patients with a history of prostate cancer in their family -- begin such testing at age 45.
While 50 percent of older men now undergo routine PSA screenings, Thompson said his prior work suggests PSA results are more useful when taken in context with other factors. Too often, he said, PSA levels are interpreted as black-and-white indicators of either "normal" or "elevated" risk status. The truth is that rising PSA levels reflect a more graduated increase in cancer risk.
Looking for a more accurate method, Thompson and his colleagues collected data from more than 5,500 healthy men over the age of 55 who had participated in a large-scale prostate cancer prevention trial.
For a period of seven years, all the men underwent annual PSA and DRE testing, and well as having at least one prostate biopsy conducted over the study period. By the study's end, nearly 22 percent of the men went on to develop prostate cancer, and 5 percent developed high-grade disease.
At the seven-year mark, the researchers fed a combination of accumulated data -- biopsy findings, patient age, race, family history of prostate cancer, previous biopsy history, along with PSA levels and DRE results -- into their "statistical risk models."
Thompson's team found that a family history of prostate cancer, or an abnormal result from the PSA or DRE test, were all strongly associated with an increased risk for prostate cancer.
Race and age also figured in the equation, with blacks and older men at relatively high risk for prostate cancer.
Having had a prior negative biopsy result was found to be associated with a decreased risk for the disease.
By compiling such patient variables together, the
"This study provides a way to integrate other important risk factors to allow men and their doctors to better understand their risk and make a more intelligent decision whether to proceed with further testing," said Thompson.
But in an accompanying editorial, Dr. H. Ballentine Carter, of the Johns Hopkins School of Medicine, cautioned that the calculator's current design fails to distinguish between slow-growing, cancers and more life-threatening varieties. This, he said, could lead to a rash of unnecessary biopsies.
Robert Smith, director of cancer screening at the American Cancer Society, said the new model has its pros and cons.
"It does not distinguish between significant and not-significant disease, so the calculator provides some help but not enough help," he said. "But it also allows an individual to take their PSA level and actually interpret it in the context of some other information based on the experience of a large number of men, to understand what is the likelihood that they have prostate cancer. So, I think it could actually be useful."
A second study, also published in the April of the same journal, suggests that new prostate cancer treatments currently undergoing clinical trials could be better and more quickly assessed by tracking ongoing changes in a patients' PSA levels, rather than by waiting to tally long-term patient survival.
The team of
They found that a 30 percent drop in PSA levels in the first three months of treatment correlated with a 50 percent drop in their risk of death -- a "surrogate" marker that could be used in placed of the usual endpoint, survival. Use of this marker might mean a treatment's effectiveness could be evaluated much earlier.
The researchers noted that the U.S. Food and Drug Administration currently bases its "endpoint" assessment of a given treatment's success solely on long-term patient survival.
More information
Here's where you can find out more about the Prostate Cancer Risk Calculator.
Hormones boost breast cancer risk for black women
Reuters Health
Wednesday, April 19, 2006
A large new study shows that black women face an increased risk of breast cancer when they take replacement hormones, and that the risk is greater for leaner women.
While previous studies have established a link between the long-term use of hormone therapy and increased breast cancer risk, most of these studies were conducted with white subjects, Dr. Lynn Rosenberg of
They therefore investigated the association between breast cancer and hormone therapy using data from the Black Women's Health Study, which included 32,559 women 40 years of age or older who completed questionnaires between 1995 and 2003.
In the time since then, 615 women developed breast cancer, the team reports in the Archives of Internal Medicine.
Of note, the data were collected before the results of the Women's Health Initiative were published, after which hormone use had dropped sharply.
The greater risk seen among leaner women may have been because heavier women produce more estrogen fat tissue, so they may be less affected by taking estrogens than leaner women, Rosenberg and her team suggest.
Source: Archives of Internal Medicine, April 10, 2006.
Cell-Growth 'Switch' Holds Clues to Cancer
HealthDay News
Wednesday, April 19, 2006
WEDNESDAY, April 19 (HealthDay News) -- A genetic switch involved in animal growth and development also helps normal cells from becoming cancerous, a
Researchers at the
Reporting in the April 18 issue of Current Biology, they studied a tiny roundworm called Caenorhabditis elegans, and found that a tumor suppressor gene called PTEN also functions to keep the animal in a waiting state by blocking cell growth when food is absent.
If the worms hatch from their eggs and are unable to find any food, they can remain in a young state for a long period of time without growing. When they do find food, they start growing and mature into adults. This process is controlled by PTEN. When PTEN is defective, young worms start to mature even when they have no food.
"The attempt of these animals to grow when they should not is not only analogous to the inappropriate growth and proliferation of cells during the formation of tumors in cancer, it also involves the same players," researcher Joel H. Rothman, a professor in the department of molecular, cellular and development biology at UCSB, said in a prepared statement.
He and his team found that PTEN functions with two other proteins (called protein kinases) that are also involved in cancer progression.
"Now that we have information about the switch that keeps animals developmentally arrested, we can readily identify other genes involved in this process," Rothman said.
Those other genes may also be involved in the formation of cancers and could offer new targets for cancer therapy.
More information
The American Cancer Society has more about cancer.
Lower-intensity exercise may melt more pounds
By Amy Norton
Reuters Health
Wednesday, April 19, 2006
A brisk walk through the park might be better than a fast run when it comes to shedding pounds, a small study suggests.
Researchers found that among 14 women who embarked on a three-month exercise regimen, those who worked out at a moderate pace lost more weight than those who exercised more intensively.
But it's not time for runners to start slowing down, according to the study authors. For one, women in the higher-intensity exercise group did retain more muscle mass than those who worked out more moderately.
More importantly, though, there is no such thing as one "magic exercise," said lead study author Dr. Vassilis Mougios of Aristotle University of Thessaloniki in
To get the greatest health and fitness benefits, he told Reuters Health, people should strive for a mix of moderate and vigorous cardiovascular exercise, as well as strength training.
Mougios and his colleagues report their findings in the International Journal of Sports Medicine.
Losing weight basically boils down to burning more calories than you take in. But it hasn't been clear whether the intensity of a regular workout makes a difference in body composition - that is, the proportions of fat and lean tissue.
To study the question, Mougios and his colleagues randomly assigned 14 normal-weight and overweight women to one of two groups: one that exercised on a treadmill at a moderate pace, four times a week; and one that worked out at a more vigorous clip, also four times per week.
The researchers set the duration of the workouts so that women in both groups would burn 370 calories each time.
After three months, exercisers in both groups were slimmer, but the lower-intensity group lost more weight -- about 7 pounds, on average, compared with 4 pounds in the high-intensity group.
Fat-free mass decreased slightly (less than half a pound) in the low-intensity exercisers and increased slightly (about 1 pound) in the high-intensity group.
It's possible, according to Mougios, that women in the high-intensity group shed fewer pounds because they ended up eating more, or were so drained by their regimen that they relaxed more in their leisure time.
In turn, the women may have held on to more muscle simply because they lost less weight. On the other hand, the researchers note, high-intensity exercise may actually spur some growth in muscle fibers.
The bottom line, according to Mougios, is that people should stay active with various forms of exercise. But for those who want to know whether they're working hard or moderately, he said a heart rate monitor or some simple pulse checks during the workout will provide that information.
Source: International Journal of Sports Medicine, March 2006.
Health Tip: What to Expect From Gallbladder Surgery
HealthDay News
Wednesday, April 19, 2006
(HealthDay News) -- The gallbladder collects bile produced by the liver, and releases it into the small intestine. When problems such as gallstones occur, surgery often is the most effective remedy.
If your doctor has recommended surgery, here are a few things pointers, courtesy of the Society of American Gastrointestinal and Endoscopic Surgeons:
You should not eat or drink anything after midnight on the day of your operation. Your doctor may even recommend that you drink only clear liquids for one or several days before surgery. Talk to your doctor about any medications and supplements you are taking. Certain drugs, like aspirin, blood thinners, arthritis medications or vitamin E, should not be taken in the days before surgery. You may experience nausea or vomiting after surgery. Once you are able to eat and drink, you should be able to leave the hospital. Activity levels vary from person to person, but within a week you should resume normal activities and be able to drive, climb stairs and lift light objects. Depending on your job, you should be able to return to work within seven days of surgery.
Teens not learning lesson from mom's skin cancer
By Anne Harding
Reuters Health
Wednesday, April 19, 2006
Teenagers whose mothers have been diagnosed with skin cancer are not much more likely than their peers to protect themselves effectively from the sun, a new study shows.
Having a parent with skin cancer increases a person's own risk of the disease, Alan C. Geller of the Boston University School of Medicine and colleagues note in the medical journal of Pediatrics.
For the more-treatable basal cell and squamous cell cancers, risk is at least doubled, while having a family history of melanoma, the most deadly type of skin cancer, increases risk from two- to eight-fold. This means effective sun protection is even more important for individuals with a family history of skin cancer, Geller and his team write.
To investigate the sun protection practices of children of mothers diagnosed with skin cancer or who had a family history of melanoma, the researchers surveyed 9,943 sons and daughters of women participating in the Nurses Health Study II. The adolescents ranged in age from 12 to 17. The mothers of 463 had been diagnosed with skin cancer, while 783 participants' mothers had a family history of melanoma.
Forty-two percent of adolescents whose mothers had skin cancer used sunscreen, compared to 33% of teens whose mothers had a family history of melanoma and 34% of those whose mother had no personal or family skin cancer history.
But children of mothers with skin cancer were actually slightly more likely than their peers to have gotten three or more sunburns during the past summer -- which could have been because these teens tended to be more fair-skinned, Geller and his colleagues note.
There was no significant difference among the three groups in tanning bed use; about one in ten teens overall reported having used a tanning bed at least once in the past year.
Just one in four of the adolescents surveyed said they thought that untanned skin was the most attractive-looking, and another one in four said it was worth a sunburn to get a tan. These percentages were the same in all three groups.
The findings, Geller told Reuters Health, show that it's essential for parents who have been diagnosed with skin cancer to convey to their children the importance of sun protection. "They need to be aware of the fact that there's risk for their kids and they need to be much more vigilant" about sun protection practices, he said.
Geller points to one "encouraging" finding from the study: children of mothers who had been diagnosed within the past two years were more likely to use sunscreen and less likely to have gotten frequent sunburns or used tanning beds compared to children whose mothers had been diagnosed with the disease more than two years previously.
He said this finding supports the idea that a parent's skin cancer diagnosis represents a "teachable moment" for raising a child's awareness of the importance of sun protection.
"For the offspring of skin cancer patients, this 'moment' needs to be extended and the message needs to be addressed and then readdressed, especially if one is to prevail against the current trend among adolescents to seek out more and more tanning opportunities as they age," Geller and his team conclude.
Source: Pediatrics, April 2006.
Cornea Scratches Don't Need Eye Patches
HealthDay News
Wednesday, April 19, 2006
WEDNESDAY, April 19 (HealthDay News) -- Eye patches aren't necessary in the treatment of simple corneal abrasions, a new review of the data shows. In fact, the use of eye patches initially slows healing and does not reduce pain, the review authors concluded.
"The abrasions on the eye normally don't affect vision too much, so it is pointless rendering a patient acutely monocular [one-eyed] if there is no good reason to do so," researcher Dr. Angus Turner , of the Royal Victorian Eye and Ear Hospital in East Melbourne, Australia, said in a prepared statement.
His team conducted a review of 11 previous studies on the subject, including over 1,000 patients.
The cornea is the clear outer layer of the front of the eye, and corneal abrasions are among the most common kinds of eye injuries. While they're usually quick to heal, they are painful. In the past, nearly all corneal abrasions were treated by placing a patch over the injured eye for a day or two. It was believed that the patch kept out infection and kept the eye and lids still in order to allow the cornea to heal.
Most ophthalmologists no longer use eye patches for minor corneal injuries, but some general practitioners and emergency department doctors may still do so, Turner noted.
The review found that corneal abrasion patients who'd been treated without the use of an eye patch had faster healing times on the first day of treatment and did not report any significant differences in pain levels than patients with patches.
The review appears in The Cochrane Library, published by the Cochrane Collaboration, an international organization that evaluates medical research.
More information
The
Signs of long-term problems seen in teens' dieting
Reuters Health
Wednesday, April 19, 2006
Teenagers who go on diets or take unhealthy measures to lose weight may end up gaining pounds in the long run, according to a new study.
What's more, researchers found, these teens seem likely to get trapped in a pattern of unhealthy eating, extreme weight-loss tactics and, in some cases, overt eating disorders.
Among more than 2,500 teenagers in the study, those who said they were trying to control their weight were three times more likely than their peers to be overweight five years later. They were also at greater risk of having a binge-eating disorder, or to be vomiting or using diet pills, laxatives or diuretics in an effort to lose weight.
The findings, according to the study authors, suggest that dieting and other forms of weight control are either spurring weight gain and eating disorders, or serving as an early warning of problems ahead.
Whatever the case, they say, it seems that when teenagers diet -- even in a healthy way -- it often brings little benefit.
Dr. Dianne Neumark-Sztainer and her colleagues at the
The study included 2,516
The teens were also asked whether they used diet pills, laxatives or diuretics to shed pounds.
Overall, 58 percent of girls and 31 percent of boys reported some form of unhealthy weight-control practice. These teens were more likely to be overweight five years later, even with their current weight taken into account.
Moreover, they were roughly six times more likely to develop a binge-eating disorder, and were at greater risk of using extreme measures to lose weight. Girls who reported unhealthy weight-loss tactics were also more likely to report any form of eating disorder five years later.
And although unhealthy measures were most harmful, healthy dieting was also linked to a higher risk of being overweight or developing a binge-eating problem - at least among girls.
This, Neumark-Sztainer and her colleagues write, suggests the need for a "major shift" in attitudes toward weight control. Many teenagers, they point out, are likely to need help in making lasting, healthy changes in their diets and exercise habits, as opposed to quick fixes.
But most concerning, according to the researchers, are the lasting problems linked to teenagers' weight-control efforts - particularly unhealthy forms.
"Clearly," they write, "dieting is not an innocuous behavior that can be brushed aside as normative for teens."
Source: Journal of the American Dietetic Association, April 2006.
Tuesday, April 18, 2006
Skin cancer epidemic underway in the US
Reuters Health
Tuesday, April 18, 2006
There is an unrecognized epidemic of skin cancer underway in the
One in five Americans will develop skin cancer, and a person's risk of the disease doubles if he or she has had five or more sunburns, according to a report in the April issue of the Mayo Clinic Health Letter.
Basal and squamous cell carcinomas, the most common and treatable types of skin cancers, had long been considered a problem only for people over 50, according to the report. But Mayo Clinic researchers found that the percentage of women under 40 with the more common type, basal cell, tripled between 1976 and 2003, while the rate of squamous cell cancers increased four-fold.
In the same study, the researchers found that just 60% of the cancers they identified occurred on skin frequently exposed to the sun, such as the head and neck, rather than the normal 90%. Most of the remaining cancers were seen on the torso. The researchers suspect this may be due to more widespread use of tanning beds.
Two types of ultraviolet (UV) light are implicated in skin cancers, the article explains. UVA, which penetrates deeper into the skin and impairs its immune defenses, is more responsible for melanoma, the most deadly type of skin cancer. UVB exposure causes sunburn, as well as squamous and basal cell skin cancers.
Tanning beds chiefly release UVA, although some also use UVB. According to the Mayo Clinic report, "occasional yet intense UVA exposure poses a greater risk of melanoma skin cancer than does spending long hours in the sun."
The report offers the following tips for effective sun protection:
§
Apply sunscreen 30 minutes before you are going to be outside, even if the weather is cloudy or hazy.
§
Spend as little time as possible in the direct sun between 10 a.m. and 4 p.m.
§
Use about an ounce of sunscreen -- roughly a shot glass full -- and reapply it every two hours.
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Always wear sunglasses and a broad-brimmed hat, and wear clothing made from tightly woven fabric to protect your skin.
Source: Mayo Clinic Health Letter, April 2006.
Natural Protein Might Ward Off Obesity
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- A natural protein might help the body rid itself of fat while suppressing appetite.
Researchers say the protein, called ciliary neurotrophic factor (CNTF), acts directly with muscles, boosting the body's fat-burning ability as it helps protect against some of the effects of obesity.
"While hormones such as leptin were initially thought to be the cure-all for weight loss, they were later found to be ineffective in obesity due to the presence of proteins which inhibit their ability to stimulate fat metabolism. Fortunately, CNTF's effects on fat burning are maintained," research leader Dr. Greg Steinberg, of the
Reporting in this week's issue of Nature Medicine, his team found that CNTF activates an enzyme called skeletal muscle AMP kinase, which in turns boosts the body's ability to metabolize fat and sugar. The pathways activated by CNTF are similar to those activated by exercise. The findings may help in the development of new ways to reduce the risk of metabolic abnormalities associated with excess weight.
The study was funded by the Heart and Stroke Foundation of Canada, the Canadian Institutes of Health Research (CIHR), and the Canadian Diabetes Association.
Until recently, most obesity research has concentrated on the regulation of appetite by hormones such as leptin.
"Dr. Steinberg's finding is significant because this new pathway that overcomes leptin resistance opens the door to a more promising avenue for the development of a therapeutic anti-obesity agent," Dr. Diane Finegood, scientific director of the CIHR's Institute of Nutrition, Metabolism and Diabetes, said in a prepared statement.
More information
The U.S. Institute of Diabetes and Digestive and Kidney Diseases explains the health risks of being overweight.
Experts Suggest Spacing Pregnancies
By Carla K. Johnson
Associated Press Writer
The Associated Press
Tuesday, April 18, 2006
Women can maximize their chances of having healthy babies by spacing their pregnancies at least 18 months but no more than five years apart, researchers say.
The researchers reached that conclusion after an analysis of 67 international studies involving more than 11 million pregnancies.
The analysis found that spacing babies too close together or too far apart raises the risk of complications such as premature births and low birth weight.
The findings suggest that millions of infant deaths could be avoided worldwide with better family planning, said co-author Dr. Agustin Conde-Agudelo of Santa Fe de Bogota Foundation in
"The financial cost of birth spacing programs is lower than the financial cost of infant deaths, of course," Conde-Agudelo said in an e-mail.
Pregnancy and nursing use up nutrients in a woman's body, he said, and for a woman to get pregnant again before she has a chance to recover nutritionally may mean higher risks for the baby.
As for why long intervals between births cause problems too, he speculated that time could diminish a woman's reproductive capacity and that factors that decrease fertility also could lead to poor fetal development.
The analysis found that for each month under 18 months between pregnancies, the risk of premature birth increased 1.9 percent. For each month longer than 59 months between pregnancies, the chances of premature birth climbed 0.6 percent.
The analysis appears in Wednesday's Journal of the American Medical Association.
Conde-Agudelo said the risks of short and long birth intervals held true for both developing and developed nations, showing up in
The World Health Organization should consider recommending longer intervals between births, said Rachel Royce, an epidemiologist at Research Triangle Institute International in
Dr. Sarah Kilpatrick of the University of Illinois-Chicago, who was not involved in the research, said doctors should educate women about why it is better to space their pregnancies and make sure they have access to contraception.
"The
On the Net:
JAMA: http://jama.ama-assn.org
Health Tip: Get Your Kids to Eat Healthy
HealthDay News
Tuesday, April 18, 2006
(HealthDay News) -- Teaching your young children to eat right is an important way to ensure their health well into adulthood. But convincing them to choose carrots over chips may be easier said than done.
Children learn by watching their parents, so setting a good example of healthy eating is important, the Nemours Foundation says. Children who participate in family meals are more likely to eat more fruits and vegetables, and less likely to snack on unhealthy foods. They are also less likely to indulge in smoking, drug and alcohol abuse.
Make family meals enjoyable for children by allowing them to invite friends to dinner, and encourage them to participate in meal planning. Keep meal-time conversation light and relaxed, and avoid punishments and lectures during dinner.
Choose only healthy foods from the grocery and make those the only options for your children's snacks. Avoid bringing home sugary drinks and high-fat snacks, and keep plenty of fruits, vegetables and whole grains on hand.
Unhappy marriage may harm older adults' health
By Amy Norton
Reuters Health
Tuesday, April 18, 2006
A troubled marriage may speed the decline in health that comes with age, a study has found.
While research shows that married people often enjoy better health than singles do, a number of studies have suggested that an unhappy marriage can take a major health toll. Some, for example, have found a higher rate of heart disease among people who are dissatisfied with their marriage.
This latest study, published in the Journal of Health and Social Behavior, suggests that marital strain may be particularly damaging to older adults' health.
Lead researcher Dr. Debra Umberson said it's the first study she's aware of to look at whether the health effects of marital problems differ depending on age.
Umberson, who chairs the sociology department at the University of Texas-Austin, said there are several reasons that older adults could be more vulnerable to marital woes.
Similar to the case with smoking, she told Reuters Health, chronic stress can have a cumulative effect on health over the years. Add to that the fact that older adults are more susceptible to these effects due to age-related declines in immune function and a higher rate of health problems such as heart disease.
Umberson and her colleagues based their findings on data from a survey of
Study participants answered questions on marital quality -- including whether their spouse made them feel "loved and cared for" and listened to their concerns, and whether they had frequent disagreements and conflicts.
They were also asked to rate their physical health on a range from "poor" to "excellent."
Overall, the study found, men and women who reported more marital strain also reported a steeper decline in their health over time. But when the researchers separated study participants into three age groups - those ages 30, 50 and 70 at the study's start - only the oldest group showed negative health effects.
Similarly, only older adults showed health benefits from a happy marriage.
"Unhappily married individuals have yet another reason to identify marital difficulties and seek to improve marital quality," Umberson and her colleagues conclude. "Their very health may depend on it."
Professional counseling is one of the best options for addressing marital woes, according to Umberson. But, she noted, older adults may be less open to marriage counseling, and they might be more comfortable speaking with someone they trust, such as a minister or pastor.
Source: Journal of Health and Social Behavior, March 2006.
Health Tip: Living With MS
HealthDay News
Tuesday, April 18, 2006
(HealthDay News) -- Multiple sclerosis, a disease that strikes the central nervous system, occurs when the body's own immune system attacks myelin -- the sheath that surrounds nerves.
Symptoms of MS vary from mild to severe, and can include tingling or loss of feeling in some part of the body, fatigue, balance or coordination problems, blurred vision or slurred speech. People diagnosed with MS may experience one, a few, or many symptoms.
There is no cure, the National Multiple Sclerosis Society says, but a variety of drug, exercise and diet remedies can help treat the disease and control symptoms. Physical, occupational and speech therapy also can help people with MS live comfortably and independently, the society says.
Mushrooms Are Unlikely Source of Vitamin D
By Andrew Bridges
Associated Press Writer
The Associated Press
Tuesday, April 18, 2006
Mushrooms may soon emerge from the dark as an unlikely but significant source of vitamin D, the sunshine vitamin that helps keep bones strong and fights disease.
New research, while preliminary, suggests that brief exposure to ultraviolet light can zap even the blandest and whitest farmed mushrooms with a giant serving of the vitamin. The Food and Drug Administration proposed the study, which is being funded by industry.
Exposing growing or just-picked mushrooms to UV light would be cheap and easy to do if it could mean turning the agricultural product into a unique plant source of vitamin D, scientists and growers said. That would be a boon especially for people who don't eat fish or milk, which is today the major fortified source of the important vitamin.
One grower predicted the pilot project, if supported by further research, could give consumers a radically different reason to buy mushrooms, now sought out for being low in fat and calories.
"They eat them for what they don't have, versus what they do have," said Joe Caldwell, vice president of Monterey Mushrooms. The
The ongoing work so far has found that a single serving of white button mushrooms — the most commonly sold mushroom — will contain 869 percent the daily value of vitamin D once exposed to just five minutes of UV light after being harvested . If confirmed, that would be more than what's in two tablespoons of cod liver oil, one of the richest — and most detested — natural sources of the vitamin, according to the National Institutes of Health.
Details were being presented this week at the FDA's annual science forum. The FDA proposed the research, which was funded by the Mushroom Council, as the agency looks for ways to increase the amounts of vitamin D consumed by Americans.
"This could be it," said Robert Beelman, a
Sunshine is a significant source of vitamin D, since natural UV rays trigger vitamin D synthesis in the skin. Mushrooms also synthesize vitamin D, albeit in a different form, through UV exposure. Growers typically raise the mushrooms indoors in the dark, switching on fluorescent lights only at harvest time. That means they now contain negligible amounts of vitamin D.
Research, including new findings also being presented at the conference, consistently has shown that many adult Americans do not spend enough time outside to receive enough UV exposure needed to produce ample vitamin D. The problem is especially acute in winter.
That worries health officials and not only because of rickets, the soft-bone disease linked to vitamin D deficiency that was a scourge in decades past. Vitamin D is increasingly thought to play a role in reducing the risk of osteoporosis, cardiovascular disease and tooth loss, as well as in reducing mortality associated with colon, breast, prostate and other cancers.
Beelman said his research has shown that exposing growing mushrooms to three hours of artificial UV light increases their vitamin D content significantly. That could be easier than exposing fresh-picked mushrooms to light, Beelman said. The only drawback is that the white button mushrooms — like people — tend to darken with increased UV exposure, he added.
On the Net:
Food and Drug Administration: http://www.fda.gov/
Mushroom Council: http://www.mushroomcouncil.org/
Preeclampsia a risk factor for future stroke
Reuters Health
Tuesday, April 18, 2006
Pregnant women who develop preeclampsia -- a condition that includes abnormally high blood pressure -- are known to run the risk of having a stroke during pregnancy, but researchers at the US Centers for Disease Control and Prevention now report that preeclampsia is also a risk factor for stroke in the future.
Dr. David W. Brown and colleagues in
There was a history of preeclampsia in 15 percent of the women with stroke and in 10 percent of controls, the investigators report in the medical journal Stroke.
After taking account of age, race, education and number of pregnancies, women with a history of preeclampsia were 60 percent more likely to have a stroke than those without the pregnancy complication.
While the reason for the increased risk is unknown, the researchers say that the findings indicate that women with preeclampsia should be targeted "for close risk factor monitoring and control beyond the postpartum period" to reduce their risk of having a stroke later on.
Source: Stroke, April 2006.
Education Level Linked to Heart Disease: Study
By Ed Edelson
HealthDay Reporter
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- Fewer years spent in school are associated with the earlier appearance of the first signs of future heart trouble, a long-term study suggests.
There was a direct relationship between level of education and the amount of coronary artery calcium found in the nearly 3,000 study participants, who were followed for 15 years.
The finding appears in the April 19 issue of the Journal of the American Medical Association.
Calcium is important because it indicates the development of artery-blocking plaque deposits that eventually cause atherosclerosis -- sometimes called hardening of the arteries -- and thus is "an indicator of the early phases of coronary disease," said lead study author Lijing L. Yan.
Many studies have shown that poorer, less-educated people have more medical problems, such as heart disease, said Yan, a research assistant professor of preventive medicine at
The researchers used CT scans to measure the amount of calcium in blood vessels of the participants.
They found that individuals who never completed high school were four times more likely to have detectable calcium deposits than those who finished college and had a graduate education. And compared to study participants with a graduate degree, people with just a high school education were twice as likely to have early signs of heart disease.
The study tried to account for factors affecting the development of calcium deposits, such as blood pressure, cholesterol, obesity and physical activity, Yan said. "They do partially explain what we observed," she said, "but they are not the full story. Other factors are involved. Perhaps [study participants without a college degree] have high stress levels, perhaps there are many other factors. We really don't know."
Even when the known risk factors were taken into account, the incidence of calcium was 2.6 times higher for those with the least education compared to those with the most, the study found.
The lesson for doctors is that "they should know the educational level of their patients and be aware of this association," Yan said. "The bigger lesson at the societal level is that we should be doing better for people with low educational levels."
It's a familiar lesson, said Dr. Catarina I. Kiefe, director of the division of preventive medicine at the
"We have known for a long time that a person's socioeconomic status is associated with health," Kiefe said. "The more disadvantaged you are, the less healthy you are. This finding is just an extension of the general rule that the lower on the ladder you are, the worse your health."
More information
For more on atherosclerosis, visit the American Heart Association.
Depression not tied to diabetes control in elderly
By David Douglas
Reuters Health
Tuesday, April 18, 2006
There is no strong relationship between depression in elderly patients with diabetes and the degree to which they control their blood sugar levels, researchers report.
"We often assume that elderly diabetes patients who are depressed will not benefit from clinical intervention programs unless their depression improves," Dr. Paula M. Trief told Reuters Health. "This study suggests that this is not the case; depressed patients can improve and thus should be included."
Trief, of
There was a significant correlation between depression and diabetes control at the beginning of the study. However, depression did not predict a change in blood sugar control in patients, whether they were randomly assigned to the intervention or to usual care.
Thus, the investigators conclude, depression is not a factor in diabetes control, and it should not be used to exclude patients from programs designed to improve how well they manage their condition.
Also worth investigating, said Trief, is "whether depression affects other aspects of a diabetes patient's life; for example, adherence to diet or exercise, and family relationships."
Diabetes Care April 2006.
Blood Sugar Control Boosts Diabetics' Recovery After Surgery
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- Good blood sugar control before surgery reduces the risk of postoperative infections in people with diabetes,
The study included 490 diabetic patients, average age 71, who had major noncardiac surgery. Their hemoglobin (Hb A1c) levels were measured within 180 days before the surgery. Hb A1c reflects the patient's control of blood glucose levels during the previous two to three months. Good blood sugar control was defined as an Hb A1c level of less than 7 percent, the American Diabetes Association target.
Of the patients in the study, 197 (40 percent) had good blood sugar control, report researchers at Yale University School of Medicine. Patients who did not have good blood sugar control had higher rates of postoperative infections, such as pneumonia, wound infection, urinary tract infection and sepsis (systemic blood infection).
Postoperative infections were also more common among patients who were older, had higher scores on physical status tests, had wounds classified as "non-clean" or had operations that took longer.
Writing in the April issue of the Archives of Surgery, the Yale team suggested two reasons why good blood sugar control before surgery might reduce infection risk. One reason: patients with better blood sugar control before surgery are more likely to have lower blood sugar levels after surgery as well, which has been found to reduce the risk of infection.
"The other possibility for decreased postoperative infection with long-term glucose control is the overall improvement in general health and metabolic milieu of the well-controlled diabetic patient," the study authors wrote.
"If the association is confirmed in other studies, strategies to improve glycemic control prior to elective surgery can be employed to decrease infections and improve overall outcomes for diabetic surgical patients," they said.
More information
The American Diabetes Association has more about blood glucose control.
Whites fare poorly with HIV and hepatitis C
By Will Boggs, MD
Reuters Health
Tuesday, April 18, 2006
Liver disease and death rates are worse with hepatitis C virus (HCV) infection on top of HIV infection than with just HIV or HCV, especially among white patients, according to a new report.
"We need to better understand why the co-infected patients do so poorly and the underlying mechanism for apparent racial disparity in their outcome," Dr. Kyong-Mi Chang, told Reuters Health.
"We also need better drugs that directly target HCV," added Chang, from the
Chang's team examined the impact of dual infection and race in 265 veterans with HCV/HIV co-infection, 251 infected with HCV only, and 227 others with HIV only.
Over a three-year period, mortality was significantly greater among HCV/HIV-co-infected patients than among patients mono-infected with either HCV or HIV, the researchers report in the American Journal of Gastroenterology.
Specifically, after taking into account a variety of factors, mono-infected patients were only about one-third as likely to die as dual-infected patients.
During the study period, twice as many white patients died compared to black patients, the report indicates.
Also, the average age at death in white patients (46 years) was significantly younger than that in black patients (52 years).
Since dual-infected patients fare so poorly, Chang said, the team aims to treat them "as much as possible and monitor them closely for liver dysfunction." He said specialists in liver disease and infectious diseases "as well as pharmacists (also social work and mental health support), is needed to optimize therapy for these complex patients."
Source: American Journal of Gastroenterology, April 2006.
Half of Older Diabetics Go Without Key Heart Drugs
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- Just 43 percent of diabetics over the age of 55 receive medications that could help protect their heart and kidneys, even though nearly all of these patients could benefit from such drugs, a new U.S. study finds.
Even among diabetic patients with existing heart and kidney problem -- patients with the most to gain from drugs like ACE inhibitors or ARBs -- the rate of use was just 53 percent, the researchers said.
"These are drugs that we know save lives and save money, and still we're only using them in less than half of the people who could benefit," researcher Dr. Allison Rosen, an assistant professor of internal medicine at the
"It's especially striking that their rate of use isn't much higher in people most likely to gain -- that is, those with multiple clinical indications and risk factors," she said.
The study did not identify the reasons why the use of these drugs is so low, but Rosen said the they may include: poor doctor awareness; cost to patients; and a lack of effective measures to track and encourage the use the drugs.
For their study, Rosen and her colleagues analyzed data from the National Health and Nutrition Examination Survey. They published their findings in the April issue of the Journal of General Internal Medicine.
ACE inhibitors and ARBs have been recommended by
Rosen suggested that diabetes patients should talk to their doctor about whether they should be taking ACE inhibitors or ARBs.
The study was funded by the
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes.
Breast implants don't affect cancer risk: study
By Susan Heavey
Reuters
Tuesday, April 18, 2006
Silicone breast implants do not affect the risk of cancer in women who have cosmetic surgery, according to a company-funded study released on Tuesday that said smoking habits, weight and giving birth had a greater impact.
In one of the longest studies of cosmetic breast implants to date, scientists found women with the devices had an increased risk of lung cancer and a decreased rate of breast cancer compared with the general population, but neither result could be linked to the implants.
"We're not implying implants reduce the risk" of breast cancer, said lead researcher Joseph McLaughlin of the
Higher lung cancer rates were likely due to increased smoking, according to the results published in the April 19 issue of the Journal of the National Cancer Institute. An earlier study found women who had cosmetic implant surgery were 2.8 times more likely to smoke than the general Swedish population, researchers said.
Dow Corning Corporation, once the world's largest maker of silicone gel breast implants before
In 1999, the company filed for bankruptcy and spent $3.2 billion to settle lawsuits from thousands of patients who alleged silicone implants made them sick.
McLaughlin said the devicemaker was not involved in designing the study, collecting data or analyzing results from the study, which began in 1994.
"They had no role beyond the funding," he told Reuters.
His team, which included researchers from Karolinska Institute in
Other Factors
They found 180 total cases of cancer, including skin, ovarian, and brain, among other types that occurred at rates similar to the general population of Swedish women.
Twenty cases of lung cancer were found, compared with an expected 9 cases based on population estimates. Fifty-three cases of breast cancer were reported, compared with an expected 72 cases.
"We do know reproductive and demographic factors do influence (breast cancer) risk," McLaughlin said. "If you're thin -- women who get these implants are typically quite thin -- you have kids early, you have a lot of (kids) ... all those things lower your risk."
The results come as the U.S. Food and Drug Administration considers final approval for silicone breast implants made by two other manufacturers, Mentor Corp. and Inamed Corp., which was acquired by Allergan Inc.
FDA officials have said the products can be widely sold in the
Some women argue that leaking silicone from implants can cause chronic debilitating illnesses. Studies have shown the devices can cause scarring and other minor complications, but most have not linked them to long-term health problems.
McLauglin said his study was part of a series of research Dow began funding in 1994 at his and other institutions. He said his team expects to complete two additional studies on implants and long-term disease within a year.
Elderly Cancer Survivors at Disability Risk
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- Cancer can leaving lingering disability, concludes a new study that finds elderly female cancer survivors less able to perform daily tasks such as housework, preparing meals and climbing stairs.
"These findings support the need for interventions to prevent and reverse functional decline among elderly long-term cancer survivors," a team of
The ability of elderly people to perform physical daily activities is an indicator of their overall health and well-being. The study's findings suggest that there's a need for programs to help elderly cancer survivors regain or maintain physical function.
Researchers examined data from nearly 26,000 women (median age 72) enrolled in the Iowa Women's Health Study who completed a questionnaire about their ability to perform daily functions.
The study found that five-year cancer survivors were more likely to report functional limitations than women who'd never had cancer, including inability to do heavy household work (43 percent vs. 31 percent); inability to walk a half mile (26 percent vs. 19 percent); and inability to walk up and down stairs (9 percent vs. 6 percent).
More information
The U.S. National Cancer Institute has more about life after cancer treatment.
No brain damage from dental fillings, studies show
Reuters
Tuesday, April 18, 2006
Silver dental fillings widely used to fill cavities do not appear to cause brain damage in children even though the mercury in them is a known neurotoxin, according to studies published on Tuesday.
"Dentists and parents I think can be very assured from the results of this study that they can continue to put silver amalgam in children's mouths to fill cavities," said Sonja McKinlay of New England Research Institutes,
That research involved 534
"We found that on IQ, and other aspects of brain function, as well as kidney function, the group that received the mercury-based amalgam was exactly the same as those that received the composite," McKinlay said.
The study said silver-mercury fillings have been used for 150 years and 70 million are put into mouths in the
The New England study, published in the Journal of the American Medical Association and coordinated by Children's Hospital in Boston, said no previous research has been published comparing silver fillings with others to determine possible adverse impacts.
"In this study, there were no statistically significant differences in adverse neuropsychological or renal (kidney) effects observed over the five-year period in children whose caries (cavities) were restored using dental amalgam or composite materials," the study concluded.
In a second study in the same journal, researchers from the
Their study covered 507 children aged 8 to 10 in
While children with silver fillings had higher levels of mercury in their urine, there were no statistically significant differences between the two groups in their scores on tests involving memory, attention or visual motor function.
"These findings ... suggest that amalgam should remain a viable clinical option in dental-restorative treatment," the study concluded.
In an editorial in the same publication commenting on the studies, Herbert Needleman, a physician at the University of Pittsburgh School of Medicine, said further research is needed on whether there are more "subtle effects" from the mercury.
Mediterranean Diet May Help Prevent Alzheimer's
By Ed Edelson
HealthDay Reporter
HealthDay News
Tuesday, April 18, 2006
TUESDAY, April 18 (HealthDay News) -- The heart-healthy benefits of the so-called Mediterranean diet are well known, but new research suggests the eating plan may reduce the risk of Alzheimer's disease, too.
People who carefully followed the Mediterranean diet -- heavy on fish, fruits and vegetables, monounsaturated fats such as those found in olive oil, and low on meat and dairy products -- had a 40 percent lower risk of developing Alzheimer's than those who ate the conventional American diet.
"That is a pretty significant effect," said Dr. Nikolaos Scarmeas, assistant professor of neurology at
While a number of studies have shown that the Mediterranean diet decreases the risk of heart disease, this is the first research to show a benefit in terms of mental function, he said.
The finding appears in the April issue of the Annals of Neurology.
The study involved 2,258
Scarmeas said it's the diet as a whole, not any single element of it, that's responsible for the beneficial effect. And the fact that there is "a combination of many beneficial food items" in the diet makes it hard to determine exactly how the plan works, he added, but there's ample room for speculation.
One possibility is that the Mediterranean diet has the same beneficial effects on blood vessels in the brain as in the heart, reducing the risk of blockage, Scarmeas said. It could also be that the foods in the diet are rich in beneficial antioxidants, or that the diet lowers the incidence of harmful inflammation, he said.
"We tried to single out which of the components of the diet are driving its effect, but none of them is prominently responsible," Scarmeas said. "But, when we put them together, the effect was there."
Dr. Dimitrios Trichopoulos, professor of cancer prevention and epidemiology at the Harvard School of Public Health, who has done similar studies of the benefits of the Mediterranean diet, called the new research "intriguing."
"The authors seem to have done very good work," he said. "They used a diet score we have developed over the years. At face value, I think the study is a good one. This is speculation, but reasonable speculation. One has to do further work to duplicate the finding, but the results are intriguing."
There has been "a general idea" that the incidence of Alzheimer's disease is lower in regions where the Mediterranean diet prevails, Trichopoulos said. "The assumption has always been there, so that fits with this study," he said.
Trichopoulos agreed that the beneficial results "are not the effect of individual components but the entire diet. Small effects have a collective impact."
Trichopoulos said he follows the Mediterranean diet, which, Scarmeas noted, includes "moderate consumption of alcohol, usually in the form of wine during dinner."
More information
The American Heart Association has more details on the Mediterranean diet.
Monday, April 17, 2006
TV time linked to overweight risk for some kids
By Charnicia E. Huggins
Reuters Health
Monday, April 17, 2006
Too much television watching may increase a child's risk of being overweight, according to a study in the Archives of Pediatrics and Adolescent Medicine. However, another study in the same journal found that the association is true only for children of obese parents.
In that study, among children of normal-weight parents, television viewing time did not seem to affect their overweight risk. For children with at least one obese parent, however, the opposite was true.
"You can't think about the impact of television and obesity as uniform for all children," study author Dr. Elizabeth A. Vandewater, of the
"The findings of this study suggest that parental weight status is an important moderator of the relationship between television viewing and child weight status, and that researchers interested in understanding and intervening in childhood obesity would do well to collect information from parents as well as children," Vandewater and her coauthor, Xuan Huang, write.
Their in-home and telephone interviews of 1,483 children aged 6 to 19 years in 2002 revealed that parental obesity was generally associated with an increased overweight risk for all of the children, except 6- to 9-year-old boys.
What's more, for 14- to 19-year-old boys and 10- to 13-year-old girls with at least one obese parent, the risk of overweight increased along with the increasing number of hours spent watching television. No such association was found for their same-age peers with normal weight parents, however.
"Television viewing becomes a real risk in adolescence among kids who are at familial risk of obesity," Vandewater said. Thus, reducing television time to combat a child's overweight risk may only be effective for some youngsters.
In another study published in the same journal, Dr. Julie C. Lumeng, of the
According to parents' reports, more than two-thirds of these children watched television for two or more hours per day. These children were much more likely to be overweight than the 32 percent who watched less than two hours of television daily, as recommended by the American Academy of Pediatrics, the report indicates.
Altogether, nearly 6 percent of the children were overweight at 36 months of age and 10 percent were overweight by 54 months.
Children who were exposed to the television for two or more hours every day, however, were nearly three times more likely to be overweight at 36 months as those who watched less television, Lumeng and her team report.
Noting that "most 3-year-olds don't sit still watching the television for long periods of time," Lumeng told Reuters Health that her study "found that just having the TV on -- even if the child was just in the room playing, but not sitting attentively watching it -- seemed to increase the risk of obesity in the 3-year-old."
And, she added, this finding was true "regardless of if the family is upper income, well-educated, with a stimulating home environment with lots of educational games, toys, and interaction with the children, and (if) the television is 'educational."'
Source: Archives of Pediatrics and Adolescent Medicine, April 2006.
Younger Moms' Kids Get Longevity Edge
By E.J. Mundell
HealthDay Reporter
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- Society's oldest members are most likely to be born to its youngest mothers, new research suggests.
The odds of living to 100 and beyond double when a person is born to a woman under 25 years of age, compared to those people born to older mothers, according to one of the most rigorous studies on the subject yet conducted.
The finding may also help clear up a statistical mystery -- three years ago, the same husband-and-wife team of researchers found that being the first-born child in a family also boosted longevity, although no one knew why.
"It turns out that the whole phenomenon of first-born order and longevity is driven by young maternal age," said study co-author Leonid Gavrilov, a research associate at the Center on Aging at the
In other words, he said, first-born children are simply more likely than their siblings to have been born when mom was in her teens or early 20s.
The study, which was funded by the U.S. National Institute on Aging (NIA) and the Society of Actuaries, was presented recently at the Population Association of America annual meeting, in
As nutrition and health care continue to improve, so too does the number of Americans whose years extend into the triple-digits.
"Certainly there were more [centenarians] in the 2000 census than there were in 1990, and most people think this population will grow," said Georgeanne Patmios, acting chief of the Population and Social Processes Branch of the NIA's Behavioral and Social Research Program.
According to the Census Bureau, there were 37,000 Americans aged 100 years or older in 1990, and by 2000 that population had risen to 55,000. According to experts, women are three to five times more likely to live beyond 100 than men.
But what other factors encourage "extreme" old age? Previous research by Gavrilov and his wife/co-researcher, Natalia Gavrilova, has uncovered some clues. For example, in research published over the past few years, they found that
They also discovered that being the first-born in a family meant a lot, boosting the odds of making it to 100 by nearly 80 percent.
"But nobody knew why that was -- sometimes in research you get answers, but you also get new questions," Gavrilov said.
So, he and his wife set out to solve that puzzle. They selected 198 centenarians from across the
One theory -- that first-born children might have been relatively protected from pediatric illness because they weren't surrounded by disease-bearing siblings in infancy -- didn't pan out. "We found that even at age 75 it still matters that one is first-born," Gavrilov said. "It's a late-life phenomenon."
A second theory -- that first-born kids reaped the benefit of a relatively young, strong and productive father -- also fell flat. "We got the very clear result that the father's age wasn't important," the
That wasn't the case for mothers. In fact, statistical analysis revealed that young maternal age at birth completely accounted for the first-born effect.
"It is very rare in science that you have such clear-cut results. But here, when we saw the results, we went 'Wow,'" Gavrilov said. Overall, children born to an under-25 mother had double the odds of living to 100 and beyond, compared to offspring of women who delivered at a later age.
So, why do young moms tend to bear more long-lived children? "At this point all we have is hypotheses," Gavrilov said. "One is biological -- that maybe the eggs are different in their quality, and the best ones, the most vigorous eggs, go first to fertilization."
He said his wife Natalia came up with a competing theory: That young moms haven't had time to pick up the latent, chronic infections that might in some way impede the long-term health of their offspring. "This might interfere with normal development," Gavrilov said. "So, when the children are born they are superficially healthy but maybe they are not really strong enough to survive to 100."
Patmios said the question of why younger mothers might bear more resilient offspring remains "open, but it's worthy of additional research." She stressed that it has proven extremely tough to get in-depth, reliable data for events that happened over a century ago. "There are a lot of other factors that probably contribute to exceptional longevity which, given the dataset that Dr. Gavrilov has to use, he can't assess," she said.
And what about the longevity of children born to today's moms, who are often postponing first pregnancy to their 30s or even 40s? According to Gavrilov, advances in diet and health care mean American newborns still have a better chance of living out a century than their great-grandparents did.
"The data shows that there is a steady increase in living to age 100, despite the fact that women are tending to postpone their childbearing years," he said.
More information
For more on extreme longevity, visit the U.S. National Institute on Aging.
Obesity Finds Niche in American Marketing
By Deborah Hastings
AP National Writer
The Associated Press
Monday, April 17, 2006
From the cradle to the grave and most points between, obesity has found its niche in American marketing. Make that a wide berth. Baby seats, doorways and caskets are but a few examples from a long list of life's accouterments that are getting much bigger to accommodate much bigger people. There are also vacation resorts for those embarrassed to be seen in a bathing suit.
At Freedom Paradise on
"You should not be embarrassed by how big you are," said William Fabrey, whose online business "Amplestuff" offers larger versions of everyday things from umbrellas to footstools. "You can't just yell at someone and tell them to lose weight. You're already dealing with people who think they have no worth.
"They still have to sit down on a chair that doesn't collapse," he said.
Like others in this small but growing group of businesses, Fabrey started his company after discussions with an overweight friend. "She was a big woman, and she said, 'There's got to be an easier way to get through the day.' "
To make living large a little easier, Fabrey sells lotion applicators and sponges attached to handles — enabling the user to reach all parts of the body; handbooks on hygiene with tips on dealing with odor problems, chafing and irritations caused by skin folds. His business also provides links to physicians and medical services.
"We don't take any position on whether someone should lose weight," Fabrey said. "That's up to the person."
Seemingly every day, another study appears that shows the
As Americans grow in weight, their life expectancy becomes shorter — by as much as five years, according to the latest national statistics — more than the impacts of heart disease and cancer. Obesity is fast approaching tobacco as the No. 1 cause of preventable death.
The price tag to taxpayers, according to the CDC, is a whopping $117 billion a year, a figure that some health experts dispute, claiming the government numbers are based on faulty data. Not disputed, according to obesity specialists, is the amount Americans spend trying to get thinner — $33 billion a year.
U.S. Surgeon General Richard Carmona sounded a dire warning last month, telling university students in
Such pronouncements help fuel criticism that catering to bigger people really means throwing wide the door to death by overeating.
But for those who are overweight, who know full well how it feels to be sneered at, laughed at, pitied and scorned, having a simple tool such as a sponge on a stick, or a sturdy footstool that can bear up to 500 pounds, makes one feel a little more human. And a little less demonized.
Joan Borgos weighed 350 pounds for 28 years, until she had gastric bypass surgery and lost 200 pounds. She began putting out LargeDirectory.com because there was nothing available "that didn't look like a muu muu from Lane Bryant's," she said.
From her home in
Even toddlers have joined the overweight ranks, with car seat manufacturers offering the "Husky," which is 10 pounds heavier and four inches wider than the standard size.
"There are all kinds of theories that abound about why people are getting heavier," said Borgos. "People are more sedentary, people eat more junk food and get less exercise. I don't know what it is.
"But it's a constant level of stress to live as an overweight person. You're always scoping out the environment, looking if you're going to be able to fit. "
Kelly Bliss, a self-described "chubby chick" in suburban
Which means, she says, encouraging overweight clients to exercise as best they can, to eat healthily and to not focus on losing pounds.
"People cannot just stop being fat," she says. "It's prejudice when you say a fat person does not need things to make them comfortable," she says. "People crumble when you given them even more pressure on top of a life that's already not working."
To make caring for the overweight ill easier, and to make patients more comfortable, there also are specialized medical products for an ever-growing clientele.
Treating the obese is called bariatric care, from Greek root meaning weight. Providing it means hospitals are paying for wider beds, wider wheelchairs, wider doorways, longer needles and bigger CT scan machines. As well as larger gowns and extra-sized slippers.
And for the end of life's road, coffin makers have introduced new lines with higher-gauge steel and widths of up to 28 inches, from the standard 24.
In
Free Guidebooks Make for Heart-Healthy
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- Only three percent of American adults follow the "big four" habits to prevent heart disease: Healthy diet, regular physical activity, proper weight, and not smoking, according to a recent national survey.
In order to help people improve their heart health, the U.S. National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, has issued two new guidebooks about the factors that increase heart disease risk or that may contribute to worsening existing heart disease.
"Your Guide to a Healthy Heart" includes a detailed action plan for heart health and "Your Guide to Living Well With Heart Disease" has information to help people with heart disease protect and improve their heart health.
"In the
Here are some tips on how to reduce your heart-disease risk:
Don't smoke. If you do, quit. Smokers are up to six times more likely to suffer a heart attack than non-smokers. Stay trim. Overweight and obesity cause many preventable deaths. Get off the couch. Try to get 30 minutes of moderate-intensity activity on most -- preferably all -- days of the week. Eat right. Stick to a heart-healthy diet that's low in saturated fat, trans fat, and cholesterol. Be sure to include whole grains, vegetables, and fruits in your diet. Know your numbers. Ask your doctor to check your blood pressure, cholesterol (total, HDL, LDL, triglycerides), and blood glucose. Work with your doctor to improve any abnormal numbers.
More information
Here's where you can order the guidebooks.
Women with diabetes breast-feed despite obstacles
Reuters Health
Monday, April 17, 2006
Mothers with type 1 diabetes are just as likely as other women to be able to breast-feed their babies, despite difficulties with blood sugar levels and health problems in their infants, Danish researchers report.
Dr. Elisabeth Mathiesen and colleagues from
More than half of the children had a medical complication when they were born, such as jaundice, infection or breathing difficulties. Nonetheless, most of the women (86 percent) initiated breast-feeding, the team reports in the medical journal Diabetes Care.
By 4 months after delivery, 54 percent were exclusively breast-feeding, 14 percent were partly breast-feeding, and 32 percent were not breast-feeding. These rates were similar to those for women in the general population
Many infants experienced episodes of too-low blood sugar levels, and some required intravenous glucose treatment to correct the condition. However, this was necessary in only 22 percent of the children whose mothers breast-fed exclusively, compared with 40 percent of the others.
Previous experience with breast-feeding and higher educational level were the only independent predictors of exclusive breast-feeding.
Summing up, the researchers conclude, "The majority of the women with type 1 diabetes initiated breast-feeding and the prevalence of breast-feeding at 4 months was comparable to that in the background population" despite high rates of medical complications among the infants.
Source: Diabetes Care, April 2006.
Chronic Stress May Help Cause Depression
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- Is the anxiety that often accompanies chronic depression a cause or effect of the illness?
It's a longstanding question among experts, but new research in mice suggests that chronic stress may be a trigger -- not a symptom of -- depression.
The findings could also help improve treatments for the disorder, says a research team from
It was already known that people with depression tended to have higher levels of the human stress hormone cortisol, but it wasn't clear whether this was a cause or effect of depression. The new mouse study suggests that long-term exposure to cortisol may actually contribute to depression.
For this study, the researchers exposed mice to acute (24 hours) and chronic (17 to 18 days) doses of the rodent stress hormone corticosterone. The hormone was put in the animals' drinking water so that the stress of injections would not cloud the results.
Compared to the mice with short-term exposure, the mice with chronic exposure took much longer to emerge from a small dark compartment into a brightly lit open field. This is a common behavioral test of anxiety in animals. The results suggest that the mice with chronic exposure were more fearful and less willing to explore their new environment.
The researchers also found that mice with chronic exposure showed dulled reactions to being startled, another indication that their nervous system was overwhelmed.
The findings appear in the April issue of the journal Behavioral Neuroscience.
More information
The U.S. National Institute of Mental Health has more about depression.
McDonald's to Tout Healthier Menu Choices
By Dave Carpenter
AP Business Writer
The Associated Press
Monday, April 17, 2006
McDonald's Corp. will promote its healthier menu choices to counter negative publicity expected from a new book co-written by the author of "Fast Food Nation," Chief Executive Jim Skinner said Monday.
While McDonald's maintains that the strategy is not aimed solely at undermining "Chew On This," which is due out next month, Skinner acknowledged that "it's important to ramp this up now" amid heavy criticism of the fast-food industry for its perceived role in increased obesity.
"I wouldn't call it a campaign," he told reporters in a news conference at McDonald's headquarters. "It is a continuous improvement relative to the communication of our story regarding our high-quality food in McDonald's."
The approach signifies a marked departure from the way the world's largest fast-food chain remained mostly quiet after being skewered in both Eric Schlosser's "Fast Food Nation" in 2001 and filmmaker Morgan Spurlock's 2004 documentary, "Super Size Me."
This time, the company is trying to get its side told even before publicity hits for both "Chew On This," which was co-written by Schlosser with Charles Wilson and targets 11- to 15-year-olds, and a film version of "Fast Food Nation" that is due out later this year featuring Patricia Arquette and Ethan Hawke.
McDonald's has been promoting its commitment to balanced, active lifestyles in recent years and adding healthier products, such as entree-sized salads and the option to substitute apple slices and juice for fries and soft drink in Happy Meals.
But Skinner said "we're not doing as good a job as we could, quite frankly," in telling the company's story.
After warning its
According to early reports about the book, it holds fast-food companies responsible for the nation's childhood-obesity epidemic and criticizes them for being low-wage employers.
McDonald's already has been hit by lawsuits accusing it of causing obesity in tens of thousands of children. Courts have dismissed most obesity claims, but an appeals court in
Skinner said the company has to balance efforts to produce healthier food with the fact it is a for-profit restaurant company.
"There is a distinction between what people say they eat, say they want to eat, and what they eat," he told reporters at the start of a daylong session and tour focusing on McDonald's food safety and job opportunities. "It's about choices. It's about opportunities for people to come to McDonald's and get a meal that they feel good about having eaten ... that fits into their lifestyle."
He dismissed the notion that McDonald's is nothing but a minimum-wage employer with dead-end jobs, calling it "a company of opportunity." He said 67,000 McDonald's restaurant managers got their starts working behind the counter, as did 1,200 owners of McDonald's franchised restaurants and 20 members of top management — himself included.
One area where the company remains particularly vulnerable to criticism is the level of harmful trans fatty acids in its fries, which it said earlier this year was higher than previously thought. It's now been almost four years since McDonald's pledged to switch to a new oil that would halve the level of trans fats in the popular product.
Asked about that promise, Skinner said there's still no timetable for when the switch might occur and the company must first get the taste right in ongoing testing.
"We're not there yet," he said. "We believe that we will be. We just don't know exactly when that's going to be. ... But trust me, we are very much focused on this."
McDonald's shares fell 53 cents to close at $34.32 on the New York Stock Exchange.
On the Net:
Fewer Mammograms May Boost Black Women's Breast Cancer Risk
By Steven Reinberg
HealthDay Reporter
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- Less frequent mammograms may explain why black women tend to be diagnosed with more breast cancers at a later stage, and why more die from the disease compared with white women, researchers report.
"African-American women, particularly, are diagnosed with larger, more aggressive tumors than white women," said study lead author Dr. Rebecca Smith-Bindman, an associate professor of radiology at the
According to her team's report, during the 1990s, death rates from breast cancer in the
The likely reason: White women were more likely than black women to be screened every one to two years, the researchers found.
While 72 percent of white women underwent regular screening, just 63 to 68 percent of black, Hispanic, Asian and Native-American women were screened regularly.
Moreover, black, Hispanic and Asian women were more likely than white women to have never had a mammogram. That means many of these women had their first mammogram only after symptoms or a physical examination led to a breast-cancer diagnosis.
The report appears in the April 18 issue of the Annals of Internal Medicine.
In the study, the UCSF team collected data on more than one million women 40 years of age and older who had at least one mammogram between 1996 and 2002. Among these women, 17,558 cases of breast cancer were diagnosed.
The researchers found that 18 percent of white women with breast cancer were inadequately screened before being diagnosed with breast cancer, compared with 34 percent of black, 24 percent of Hispanic and 27 percent of Native-American women.
Although black and Hispanic women had more severe breast cancer, once the women were grouped by their use of mammography, differences in survival disappeared, Smith-Bindman said. "Adequate use of mammography is an ongoing problem," she said. "When women had adequate mammography, all the difference in breast cancer went away."
There is probably a combination of factors that account for the disparity in screening, Smith-Bindman said. "There may be financial and cultural barriers," she said.
One expert thinks there may be a genetic difference between black women and white women that could account for part of the difference in the severity of breast cancer seen in black women.
"When women are equally screened, you no longer see a difference in the size of the tumor or the stage of the tumor between white and African-American women," said Dr. Mary H. Barton, an epidemiologist with the U.S. Agency for Healthcare Research and Quality, and author of an accompanying editorial.
"However, there was one marker of tumor identity that was different between African-American and white women," Barton said. "This means that it may not just be bad medical care and less frequent use of mammography that is the cause that black women die more often from breast cancer than white women. Maybe there is a genetic link."
Barton also thinks efforts are needed to increase screening among black and Hispanic women. Women and their doctors need to be reminded that getting a regular mammogram is vital.
"Let's not just focus on the doctor, let's go to the patients and show how important this is," Barton said. "That will make both of them more likely to ask for it and more likely to follow through,"
More information
For more on breast cancer, head to the U.S. National Cancer Institute.
Assisted reproduction kids do well psychologically
Reuters Health
Monday, April 17, 2006
Children born as a result of assisted reproduction technologies are generally well adjusted, survey results suggest.
However, children who lack a genetic link to one of the parents -- by reason of donor insemination or egg donation -- are unlikely to be told of the circumstances of their birth. On the other hand, most children born by in vitro fertilization (IVF) using egg and sperm from their actual parents are told.
Dr. Susan Golombok, from the University of Cambridge, UK and associates previously reported that when children were approximately 4-1/2 years old, egg donation was associated with greater parental psychological well-being compared with donor insemination, IVF and adoption -- and none of the children exhibited psychological problems.
In the medical journal Fertility and Sterility, the group reports that they re-interviewed the same mother-child pairs when the children reached 12 years of age.
The extensive interviews of the mothers showed that in most cases, parenting skills did not differ significantly among the three groups -- egg donation, donor insemination, or IVF.
However, egg-donation mothers showed significantly lower levels of sensitive responding to their children's anxieties and fears than did donor-insemination mothers. Conversely, donor-insemination mothers tended to be more over-involved with their children than egg-donation mothers.
The authors note that the differences between these two factors were relatively small, suggesting that all the mothers were still functioning well. Otherwise, there appeared to be no significant differences in expressed warmth, supervision, and discipline.
When the children were questioned regarding their social and emotional development (school adjustment, peer relationships, and strengths and difficulties), there were no significant differences among groups -- except that donor-insemination children were more likely than egg-donation children to be bullied.
Golombok's team theorizes that "having a mother who is more likely to be over-involved might render children more vulnerable to negative reactions from their peers."
The researchers found that only four of the 17 egg-donation children and two of the 35 donor-insemination children had been told of their donor origins. In contrast, 26 of the 34 IVF children had been informed.
The investigators suggest that parents who used egg donation or donor insemination don't inform their offspring because they themselves experience more social stigma. These mothers also strongly believe that it would be harmful for their child to learn about their donor origins.
Source: Fertility and Sterility, March 2006.
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- A baseball legend and head and neck cancer survivor is alerting Americans to a free nationwide screening day for oral, head and neck cancers across the
Doctors will screen patients for no charge in honor of Oral, Head and Neck Cancer Awareness Week (April 17-23). The Yul Brynner Head and Neck Cancer Foundation (YBF) is teaming up with baseball great and cancer survivor Brett Butler, as well as MLB.com, the official Web site of Major League Baseball, to urge Americans to get screened for these kinds of malignancies.
"I'm living proof that early diagnosis and treatment can improve your chances of surviving oral, head and neck cancer,"
He was diagnosed with squamous cell cancer of the tonsil in 1996 and was treated with both surgery and radiation. He said early diagnosis and prompt treatment saved his life.
"That's why I'm encouraging everyone who is at risk for this potentially deadly disease, especially tobacco and alcohol users, to take advantage of the free screenings throughout the country on April 21. You owe it to your family and loved ones to get yourself checked," said
"When diagnosed very early, oral and other head and neck cancers are easy to treat and cure," Dr. Terry Day, YBF president, said in a prepared statement. "However, many Americans do not recognize the symptoms of these cancers, which makes screening very important, especially for those who engage in risky behavior such as smoking, use of chewing tobacco and excessive alcohol consumption."
The YBF is sponsoring a Web page on MLB.com that includes a videotaped message from
More information
The U.S. National Cancer Institute has more about head and neck cancer and oral cancer.
Study Finds Activity Key in Weight Gain
Reuters Health
Monday, April 17, 2006
Staying active may be more of a factor in fending off weight gain for adults than cutting calories, according to a new study.
The study on monkeys at the
The most active monkeys gained less weight despite being fed the same high-fat diet, researchers said.
"Considering the fact that 60 percent of adult Americans are overweight or obese, this is a finding that affects a large percentage of the adult population in this country," said Judy Cameron, an
Cameron and her colleagues studied 18 adult female monkeys during a nine-month period. About a year before the study, the ovaries were removed from the animals to simulate menopause in humans. In addition, all of the animals were placed on a high-fat diet, similar to the diet of a middle-aged woman.
Food intake, body weight and body fat were closely tracked. Researchers also tracked the activity levels of the individual monkeys using a small device called an accelerometer, which was worn on a collar.
The results suggest that, while increased food intake has the potential of increasing body weight, it does not appear to be the primary cause of weight gain during the adult years.
"This is especially important to middle-aged Americans who typically witness a jump in weight," Cameron said.
The study was released online this week before publication in the American Journal of Physiology: Regulatory, Integrative and Comparative Physiology.
On the Net:
Evista as good as tamoxifen for breast cancer: study
By Maggie Fox
Health and Science Correspondent
Reuters
Monday, April 17, 2006
The osteoporosis drug Evista works as well as tamoxifen in reducing the risk of breast cancer in high-risk older women, with fewer dangerous side effects, researchers said on Monday.
Both drugs reduce the risk of breast cancer in high-risk women past menopause by about 50 percent, the researchers said.
And the results of the 19,000-woman trial show that Eli Lilly and Co's Evista, known generically as raloxifene, is less likely than tamoxifen to cause certain types of blood clots, cataracts and uterine cancer, as well as more minor side effects such as hot flashes.
"It is clear that raloxifene is the winner of this trial," Dr. Norman Wolmark, a researcher at the University of Pittsburgh Medical Center who led the trial, told reporters in a telephone briefing.
Tamoxifen, sold as a generic and by AstraZeneca Plc under the brand name Nolvadex, has long been prescribed to treat and prevent breast cancer.
Lilly said it would seek U.S. Food and Drug Administration approval to market Evista to prevent breast cancer. But doctors are free to prescribe the drug in any way they see fit.
Researchers said the findings should reassure women who know they have a high risk of breast cancer but who were afraid to take tamoxifen because of its widely known side effects.
"This is good news for women," said Dr. Leslie Ford of the National Cancer Institute.
Evista does not carry several of tamoxifen's most serious risks, the trial showed. Women who got Evista had 36 percent fewer uterine cancers and 29 percent fewer blood clots than women who took tamoxifen. Rates of stroke and heart attack were similar in both groups.
"Each has estrogen-like effects in some tissues and anti-estrogen effects in other tissues," Vogel said. Estrogen is linked to most breast cancer cases.
There will still be reason for many women to take tamoxifen, the researchers stressed. Evista has not been tested in women who have not yet passed menopause, for instance.
"Tamoxifen will remain the drug of choice for reducing breast cancer risk in pre-menopausal women," Vogel said.
Oddly, the women given Evista had a higher number of pre-cancerous lesions. The researchers said they were not sure why.
"As a result, the outcome of the study is not as clear cut as we might have hoped for," the American Cancer Society said in a statement.
"For now it will be very important for women with an increased risk of breast cancer to make an informed decision with the advice of their physician," the group said. "It is also important to note that while both drugs can prevent many breast cancers, neither has been shown to reduce the risk of death due to the disease."
Among the 9,745 women in the raloxifene group, 167 developed invasive breast cancer, compared to 163 of 9,726 women in the tamoxifen group.
The researchers estimated that 500,000
The drug had sales of $1.04 billion last year.
"This study is a positive for them, but it's kind of a non-event in terms of the share price. ... The market is saying show me something new," said Doug Christopher, an analyst at Crowell Weedon.
Lilly's shares fell 49 cents to close at $53.01 on the New York Stock Exchange.
The researchers estimated that 9 million to 10 million
Breast cancer is the second leading cause of cancer death among
(Additional reporting by Deena Beasley in
Melanoma That Recurs More Prevalent Than Thought
By Amanda Gardner
HealthDay Reporter
HealthDay News
Monday, April 17, 2006
MONDAY, April 17 (HealthDay News) -- Recurrent melanoma is more common than previously thought, with nearly 15 percent of people diagnosed with the potentially fatal skin cancer at risk of a second diagnosis within two years, a new study found.
About 6 percent of patients will develop a second melanoma within one year of the initial diagnosis, while 8 percent will be diagnosed with a second malignancy within two years, according to the researchers from
This rate is more frequent than previously thought and points to the importance of surveillance and skin screenings, according to the study in the April issue of Archives of Dermatology.
"This is not surprising, but it gives us another stimulus to be very vigilant about picking up second and third melanomas," said Dr. Vijay Trisal, assistant professor of surgical oncology at City of Hope Cancer Center, in
Dr. Keyvan Nouri, director of Mohs and dermatologic surgery and associate professor of dermatology at the University of Miami Miller School of Medicine, added, "I don't think it [the new study] is going to affect the way doctors practice, but it's more data that says there's a real risk of recurrent melanomas."
Melanoma is a particularly virulent form of skin cancer. It begins in cells known as melanocytes, the pigment-producing cells that give skin its color, but can spread quickly and unpredictably to other organs of the body.
An estimated 62,000 Americans are diagnosed with melanoma each year, according to the American Cancer Society, and nearly 8,000 people die from the disease annually.
According to the new study, previous studies have put melanoma recurrence at less than 4 percent within one year.
The current study included 354
Six percent of the participants developed an additional melanoma within one year of the first diagnosis, while 8 percent developed an additional melanoma within two years.
Roughly two-thirds of those who developed additional malignancies and 37 percent of those who did not had at least one atypical mole, which is a risk factor for additional melanomas. Someone with three or more atypical moles had four times the risk of developing an additional tumor. Atypical moles have at least three of the following features -- a diameter larger than 5 millimeters; redness; an irregular or ill-defined border; a variety of colors or a portion that is flat, the researchers said.
In one-third of the patients who developed another melanoma within two years, the subsequent melanoma was deeper than the first.
The study found little relationship between risk and benign moles, eye and hair color, or length of sun exposure. There was, however, a surprising inverse relationship between blistering sunburn and melanoma -- those with a history of sunburn were less likely to develop a second melanoma than those without, the researchers wrote. But this finding "must be viewed cautiously," the researchers said. It's possible that people who are predisposed to multiple melanomas may be less vulnerable to sunburn than those who get only one melanoma, or there may be a separate reason for the finding, the researchers said.
Another study in the same issue of the journal reported that nearly half of high schools surveyed in the
The ultraviolet (UV) radiation used in tanning parlors is a known carcinogen. The authors of the study, led by Dr. Scott Freeman, of the
The increasing incidence of melanoma in the
For individuals who have been diagnosed with melanoma, Trisal suggested surveillance every six months from a dermatologist. People who have been diagnosed with a second melanoma should consider getting checked every four months.
Nouri said, "Depending on the thickness of the melanoma, they should be seen every two to six months for the first two to three years to make sure there is no recurrence."
More information
The American Academy of Dermatology has information on melanoma and also offers free national screenings.
Sunday, April 16, 2006
Warmer Weather Brings Wheezing, Sneezing
HealthDay News
Sunday, April 16, 2006
SUNDAY, April 16 (HealthDay News) -- April showers bring -- the beginning of another allergic asthma season, experts say.
"Allergic asthma is the most common form of asthma," Dr. Sheldon L. Spector, chairman of the American Academy of Allergy, Asthma, and Immunology's asthma diagnosis committee, said in a prepared statement. "Asthma is considered allergic when symptoms become more intense, perhaps resulting in an asthma attack, when the individual is exposed to allergens to which their immune system is sensitive."
An estimated 20 percent of Americans struggle with allergic asthma; about 60 percent of asthma attacks are caused by allergens, including pollen, animal dander, dust mites, mold, cockroaches and forest-fire smoke, according to the AAAAI.
Allergic and non-allergic asthma have similar symptoms: Coughing, wheezing, shortness of breath or rapid breathing, and chest tightness.
The AAAAI offers the following tips on how to reduce asthma attacks caused by allergens:
Watch for ozone alerts, which will help keep you aware of the potential triggers for the day. Keep your outdoor activities to a minimum when temperatures are especially high. Take your asthma medications as prescribed in the recommended doses. Do not take more medication to ease severe symptoms without first consulting your doctor. Use an air conditioner in your home and car to keep air clean, cool and dry. Don't stand directly behind cars with their engines on. Exhaust fumes can trigger an asthma attack.
More information
To learn more, visit the American Academy of Allergy, Asthma, and Immunology.
By Kathleen Doheny
HealthDay Reporter
HealthDay News
Sunday, April 16, 2006
SUNDAY, April 16 (HealthDay News) -- Scott Peres, a 42-year-old sales representative from
His acupuncturist, Shellie Goldstein, who practices in
At the end of his fourth facial acupuncture session, Peres was increasingly pleased with the results. "My crow's feet have definitely softened out, and it definitely makes the color of my skin look better," he said, adding that a friend even asked if he'd got a "filler" to plump up his face.
While the extent of the trend is hard to gauge because exact numbers are tough to come by, it's clear that facial acupuncture is gaining fans, particularly among aging Baby Boomers looking to roll back the clock. But there are other forces driving demand, including consumers who are tired of getting repeat Botox injections or are wary of the procedure. So, business-savvy acupuncturists are marketing their alternative approach as a holistic solution.
Just like traditional acupuncture, the practitioner inserts small needles into "pressure points" in the face, boosting, advocates say, blood flow to the area, producing tighter muscles and a more youthful appearance.
No one seems to know how many licensed acupuncturists in the
And at the American Association of Oriental Medicine's annual meeting last year, the two workshops on facial acupuncture were standing-room-only, said Rebekah Christensen, a spokeswoman for the
The real boom began, Goldstein said, after media reports two years ago noted that many
Goldstein has trademarked the name of her technique, Acufacial, which, she said, is good for the "marionette lines" around the sides of the mouth that appear when you smile, the nose-to-lip wrinkles called nasolabial lines and the frown lines between the eyebrows, among other areas.
"It's good for all of those," she said.
Facial acupuncture "is as effective as Botox for fine lines, almost as effective with deeper wrinkles, and without paralyzing the muscles," Goldstein said.
Facial acupuncture tends to cost more and demand more of a time investment than Botox, however.
Typical
For Botox injections, the average physician's fee is $376 -- but is often higher in metropolitan areas -- according to the American Society of Plastic Surgeons, and the procedure is repeated every three months.
Cosmetic surgeons don't dismiss the idea that facial acupuncture works, but for now they say published scientific evidence is lacking.
One cosmetic surgeon who's keeping an open mind is Dr. Laurie A. Casas, an associate professor of surgery at
"I never, ever dismiss any modality that has been around that many thousands of years," said Casas, referring to the practice of acupuncture.
But, she added, "I think it is critical that this group of very fine practitioners do some studies and then show us" it works.
While some studies have been published suggesting that facial acupuncture works, Casas said what's needed is a good scientific study, one in which acupuncture is performed on one side of the face and Botox, or no procedure, on the other side. Then, photo documentation could show the effects of each treatment or non-treatment.
"They [acupuncturists] need to prove acupuncture is cost-effective as an alternative to standard methods to reduce the signs of facial aging," she said.
More information
To find an acupuncturist, visit the National Certification Commission for Acupuncture and Oriental Medicine.
Saturday, April 15, 2006
Experts Push for Rosacea Awareness
HealthDay News
Saturday, April 15, 2006
SATURDAY, April 15 (HealthDay News) -- April is Rosacea Awareness Month, and experts want to alert people to the signs of this facial skin disorder affecting an estimated 14 million Americans.
"Rosacea is frustrating and baffling for so many people because its conspicuous signs and symptoms may not only come and go unexpectedly, but they can affect various individuals in ways few might imagine," Dr. Richard Odom, a professor of dermatology at the
"Unfortunately, without treatment rosacea tends to become progressively worse -- and can have a substantial impact both physically and on people's emotional, social and professional lives," Odom said.
Rosacea usually first appears between the ages of 30 and 60 and often resembles a sunburn or blush on the cheeks, nose, chin or forehead. It happens again and again, becoming ruddier and lasting longer each time. If the condition isn't treated, bumps and pimples can develop and grow more extensive over time. Burning, itching and stinging are common. Blood vessels can become visible in the face.
In severe cases, the nose may become enlarged from the development of excess tissue. The eyes are also affected in about 60 percent of people with rosacea. This can lead to vision problems.
"The good news is that, while rosacea cannot be cured, it can be effectively controlled with medical therapy and lifestyle changes," Odom said.
More information
The
More Doctors Shunning Cumbersome Casts
By Lindsey Tanner
AP Medical Writer
The Associated Press
Saturday, April 15, 2006
The black Velcro bandage strapped on 3-year-old Ben Crotty's left arm looks like a Rollerblader's wrist guard, but it's really a mini medical milestone.
It's today's answer to the cast.
Once almost a childhood rite of passage, plaster or fiberglass casts were the method of choice for fixing broken bones. But now, doctors around the world are increasingly shunning cumbersome casts in favor of more cutting-edge options for both kids and adults: splints, special boots, metal plates, rods and screws.
For Ben Crotty's broken wrist, it was a removable splint.
The trend is most common among adults, who often develop swelling and pain and sometimes permanent stiffness. "We often refer to this as 'cast disease.' I say, 'Good riddance!'" said Dr. John Fernandez, an orthopedic surgeon at
Support for the modern technique on kids was bolstered by a Canadian study last month in the journal Pediatrics. It showed that in children aged 6 to 15 with wrist fractures like Ben's, those who wore removable splints for three weeks had better physical function during treatment and afterward than those treated with plaster casts.
The splinted kids also escaped cast-related problems: Four youngsters sought emergency room treatment for wet casts and one for removing a pencil placed under the cast.
As an ER doctor at
Casts that aren't waterproof can get moldy, and Crotty said he's "seen maggots crawling out of casts" that kids got wet.
So when Ben's doctor offered a splint as an alternative, his dad readily accepted.
"This is nice because he can take a bath and we just take it off," Crotty said.
Ben broke his wrist in mid-March when he tumbled down the family's stairs.
"I fell down and I hurt myself, and I cried and I cried and I cried," Ben explained.
Some physicians still hesitate to put splints on young children, fearing they will remove them at will.
Ben said he didn't like his splint "because I can't play with two hands," but his mother, Sheeba, said he balked whenever she wanted to remove it because he remembered his doctor's admonition.
Ben's splint was removed for good on April 7, three weeks after his injury.
Advances in splints have revolutionized treatment of wrist fractures in the past few years, Fernandez said.
"Splints now are custom-molded to the body with thermoplastic material allowing a custom fit to immobilize and support without the constriction of the cast," Fernandez said. "These are not the 'off-the-rack' splints you buy at the pharmacy," he said. They're "more like a custom-tailored suit."
For some kids, though, casts are still cooler.
Sarah Bond, 11, a suburban
"It's fun to have a cast because your friends get to sign it," Bond said.
"The cool factor is much bigger in kids, and the look on their faces when you say they don't need a cast is pretty bad," said Dr. Matthew Bueche, a pediatrician at
Dr. Stuart Hirsch, an orthopedic surgeon in
Other cast alternatives include "cast boots," which look and feel like wearing ski boots and are used to treat some foot and ankle fractures. They're removable for bathing and easier to walk in than old-fashioned "walking casts," said Dr. Cynthia LaBella, medical director at the Institute for Sports Medicine at Chicago's Children's Memorial Hospital.
And like splints, they're adjustable. A drawback with casts is that as the confined limb loses muscle mass, the cast loosens and rubs, causing pain and often requiring doctors to replace it. Cast removal, generally with noisy, vibrating medical saws, can be frightening for children.
Adjustable devices can be tightened as needed, LaBella said.
In the past five years or so, better alloy metals and advances in design and technology have made use of pins, rods and special metal plates that "lock" onto bone fragments commonplace in treating adult fractures.
Some of those newer devices require surgery to implant them next to broken bones, but they're far better than casts at realigning bones into a normal position, said Dr. Matthew Jimenez of the Illinois Bone and Joint Institute in
For some fractures, that means starting to use the injured limb within a few weeks rather than a few months of immobilization in a cast, he said.
These devices are most appropriate for adults, whose bone growth plates have closed, Jimenez said.
But pins and locked plates sometimes are used for school-age children with broken thigh bones who used to be treated with three weeks of traction and then a cast for a month or two, said Dr. John Flynn of The Children's
Patients and their parents have higher expectations these days and often won't accept "anything short of perfect," said Flynn. "They want a bone to be put back straight."