Personal Health
Joel P. Rutkowski, Ph.D., Editor
July 8, 2006
- Vegetables, antioxidants may lower lymphoma risk
- Slight mutation found in bird flu virus
- Insulin may up blood pressure in type 2 diabetics
- Could a Low-Carb Diet Slow Alzheimer's?
- Low birth weight kids prone to gain fat early
- Heart Differences May Explain Young Athletes' Deaths Despite CPR
- Heartburn common in Western countries
- Health Tip: Food Sensitivities in Infants
- Blood Pressure Woes Start Earlier Than You Think
- UV irradiation in the home improves kids' asthma
- Low-carb diet benefits obese type 2 diabetics
- Epilepsy does not appear to increase cancer risk
- Obese kids suffer more disabling headaches
- Americans visit doctor, hospital more often: study
- New imaging technology improves cancer detection
- Omega-3 fatty acids may help kids with depression
- US group cautions against laser therapy for smokers
- Vitamins' use in stopping cancer debated
- Some hospitals cut back on use of stents
- Parents' attitude impacts kids' diabetes control
- Condoms proven to protect against virus
- AEDs may not save athletes in cardiac arrest
- Health Tip: Heat Stroke? Get Help!
- More women than men hospitalized for asthma
- Migraines More Common in Overweight Kids
- More men than women get best care for heart attack
- Human 'Mad Cow' Could Cause Eventual Epidemic
- Soy component linked to heart health benefits
- Researchers Reverse Parkinson's Symptoms in Animals
- Cadmium linked to breast cancer
- Older Transfused Blood May Raise Risks After Surgery
- Magnetic device may prevent migraine
- Protein May Fight Lung Cancers
- Early screening spots vision problems in infants
- Cigarette Smoke Makes Allergy Symptoms Worse
- New imaging technology improves cancer detection
- Potassium-enriched salt may cut heart risks
- Health Tip: Eaten Bad Food?
- Being fired from work could be fatal: study
- Health Tip: Swimmer's Ear Not Just From Pools
- Drug, blood provide clues to healthy aging
- Health Tip: Kids Need to Behave Around Dogs
- Heart recommendations emphasize calories, exercise
- Cherry Juice May Ease Muscle Pain
- Heart risks similar for blacks and whites
- Heart Drugs May Help Shield Brain Cells From Stroke
- Painkillers may pose risk after heart attack
- Older Women Not Getting Needed Mammograms
- Whole grain-rich diet may reduce gum disease risk
- Treatment Order Won't Affect Aggressive Breast Cancer Survival
- Parental smoking still a threat to kids' lungs
- Most Lung Disease Patients Don't Get 'Ideal' Care
- Lower is better for diabetics' bad cholesterol
- Pricey Heart Procedure Best for Younger Patients
- Kids with type 1 diabetes often depressed
- New Type 2 Diabetes Cases Have Doubled in 30 Years
- Heart Association urges trans fats limit
- Peanut Allergy Incidents Waning, But Still a Problem
- Teen obesity linked to heart abnormalities
- Patients help fight cancer after death
- Vegetables may help arteries stay clear
- Health Tip: Too Much Caffeine?
- New breast cancer gene raises risk in Europeans
- Engineered Cells Could Control Irregular Heartbeat
- Melanoma deadlier for blacks, Hispanics: study
- NSAIDs Pose Death Risk for Heart-Attack Patients
- What You Should Know About Complementary and Alternative Medicine
- Cousins at risk of cancer give up stomachs
- Medical home concept catching on in U.S.
- Simple Steps Bring Sweeter Breath
Vegetables, antioxidants may lower lymphoma risk
By Amy Norton
Reuters Health
Friday, June 23, 2006
Eating plenty of leafy greens, broccoli and Brussels sprouts may help ward off the blood cancer non-Hodgkin's lymphoma, research findings suggest.
In a study of more than 800
In particular, leafy greens like spinach and kale, and cruciferous vegetables like broccoli, Brussels sprouts and cauliflower, seemed to be protective.
Similarly, the study found, two nutrients found in green vegetables -- lutein and zeaxanthin -- were related to a lower NHL risk. The same was true of zinc, a mineral obtained through meat, nuts and beans.
The "working hypothesis" is that the antioxidant activity of these vegetables and nutrients explains the connection, said study co-author Dr. James R. Cerhan of the Mayo Clinic College of Medicine in
NHL begins in the lymphatic system, a component of the immune system that carries disease-fighting white blood cells called lymphocytes. The cancer arises when these cells become abnormal and begin to divide uncontrollably.
Antioxidants help protect cells from such damage by neutralizing molecules called reactive oxygen species. These substances are byproducts of normal body processes, as well as environmental exposures like cigarette smoke, and in excess they can damage body tissue and lead to disease.
The new findings, published in the American Journal of Clinical Nutrition, suggest "yet another benefit" of eating your vegetables, Cerhan told Reuters Health.
Vegetables and fruits are probably the best way to get antioxidants, he said, because these foods have a host of other nutrients that may all work together to bestow health benefits.
The study included 466 adults with NHL who were enrolled in a national cancer registry, along with 391 cancer-free adults who were matched to patients by age, race and sex. Both groups answered questions about their diet and other health and lifestyle factors.
In general, those who ate more than 20 servings of vegetables a week had a 42 percent lower risk of NHL than those who ate eight weekly servings or fewer. When the researchers looked at specific nutrients, lutein and zeaxanthin stood out; people with the highest intakes were about half as likely as those with the lowest to develop NHL.
This makes sense, Cerhan noted, given that the major vegetable sources of these antioxidants, including spinach, kale and broccoli, also seemed particularly protective against the cancer.
Zinc, a mineral important to immune function, was also linked to a lower lymphoma risk. But Cerhan said this has not been seen in previous studies, and more research is needed to know what to make of it.
Source: American Journal of Clinical Nutrition, June 2006.
Slight mutation found in bird flu virus
By Margie Mason
AP Medical Writer
The Associated Press Writer
Friday, June 23, 2006
The World Health Organization has detailed the first evidence that a person likely caught the bird flu virus from a human, then passed a slightly mutated version to another person. But experts said Friday the genetic change does not increase the threat of a pandemic.
The investigation said the mutation of the H5N1 strain of the virus occurred in a 10-year-old Indonesian boy who was part of the largest cluster ever reported. The index case is believed to have been infected by poultry. She then likely passed it to the boy and five other blood relatives. The boy is then thought to have infected his father, whose samples showed the same mutation, according to the report obtained by The Associated Press.
Only one infected family member survived.
"It stopped. It was dead end at that point," said Tim Uyeki, an epidemiologist from the U.S. Centers for Disease Control and Prevention.
Uyeki, who was part of the investigating team, stressed that viruses are always slightly changing, and there was no reason for this mutation to raise alarm because the virus has not developed the ability to spread easily among people.
U.N. bird flu chief David Nabarro said the findings nevertheless emphasized the importance of continuous monitoring of the H5N1 virus in both humans and poultry.
"We were fortunate in that the change that took place did not result in sustained human-to-human transmission," he said by telephone Friday. "This is a vivid reminder of the need to keep a very close watch on what the virus is doing."
Experts fear the H5N1 virus could eventually mutate into a highly contagious form that spreads easily among people, potentially sparking a global pandemic. The current virus remains hard for people to catch, and most human cases have been traced to contact with sick birds. Scientists believe limited human-to-human transmission has occurred in a handful of other clusters, all of which involved very close contact.
The WHO report was distributed during a three-day meeting in
Keiji Fukuda, WHO's coordinator for the Global Influenza Program in
"What we're really looking for is the kind of human-to-human transmission which can cause large neighborhood outbreaks and big community outbreaks," he said. The virus in
William Schaffner, a bird flu expert at the
Schaffner said it is remarkable that scientists were able to discover a mutation that occurred in a remote village. That's the result of intense surveillance linked with "21st-century laboratory virology," he said.
At the end of the meeting Friday,
"Human cases and clusters are expected to continue to occur in
The virus has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003.
WHO and others continue to investigate a report that a
Eight
On Friday, journal editors said a man claiming to be the lead author called to say he had not asked for the report to be pulled and that he stood by its claims. The journal alerted reporters and asked the scientist to send a letter signed by all the researchers affirming the report.
Associated Press reporter Zakki Hakim in
Insulin may up blood pressure in type 2 diabetics
Reuters Health
Friday, June 23, 2006
Some people with type 2 diabetes need to take insulin, and this seems to heighten their risk of developing high blood pressure, according to a
Type 2 diabetes is caused not by a lack of production of insulin in the pancreas, but by the body's resistance to its glucose regulating action. Nevertheless, some people with the condition may need to take extra insulin to overcome this resistance.
Using national health insurance records, Dr. Chin-Hsiao Tseng from the
The likelihood that they would have high blood pressure increased with the duration of insulin use, the team reports in the Archives of Internal Medicine.
Compared with those who didn't use insulin, the chances of developing high blood pressure were 14 percent higher in those who used insulin for less than 5 years. The risk was increased to 35 percent with 5 to 9 years of insulin use, and to 46 percent after 10 years or more.
The reason for this could be that people taking insulin "may be repetitively exposed to high concentrations of insulin," Tseng explains. "This excess of insulin may exert detrimental effects on the vascular system, leading to elevated blood pressure."
Source: Archives of Internal Medicine, June 12, 2006.
Could a Low-Carb Diet Slow Alzheimer's?
HealthDay Reporter
Friday, June 23, 2006
FRIDAY, June 23 (HealthDay News) -- A low-calorie diet, particularly one that's low in carbohydrates, may reduce or even reverse the symptoms of Alzheimer's disease, a new study in mice suggests.
Researchers at Mount Sinai School of Medicine in
"Both clinical and epidemiological evidence suggests that modification of lifestyle factors such as nutrition may prove crucial to Alzheimer's disease management," study author Dr. Giulio Maria Pasinetti, director of the Neuroinflammation Research Center at Mount Sinai, said in a prepared statement.
"This research, however, is the first to show a connection between Alzheimer's disease neuropathy by defining mechanistic pathways in the brain and scrutinizing biochemical functions," he said. "We hope these findings further unlock the mystery of Alzheimer's and bring hope to the millions of Americans suffering from this disease."
Alzheimer's disease is characterized by the buildup of plaque in the brain, caused by increased amounts of beta-amyloid peptides. These peptides stimulate a protein, called SIRT1, which affects aging.
In their study, the
The results, which appear in the July issue of the Journal of Biological Chemistry, showed that the restricted diet did, in fact, reduce peptides in the brain, while a diet high in saturated fat appeared to cause higher concentrations of peptides.
More information
The Alzheimer's Association has more information on Alzheimer's disease.
Low birth weight kids prone to gain fat early
Reuters Health
Friday, June 23, 2006
Children who are born small show "catch-up" weight gain up to 2 years of age, then exhibit a "dramatic transition" to having more body and belly fat, European researchers report.
This tendency is accompanied by a risk of developing resistance to the effects of the blood sugar regulating hormone insulin by age 4, suggesting an increased likelihood of diabetes down the road.
"Understanding the mechanisms underlying this predisposition to adverse future health could lead to specific preventive interventions during early childhood," Dr. Lourdes Ibanez of the Hospital Sant Joan de Deu at the
While low birth weight followed by rapid catch-up weight gain has been linked to an increased risk of diabetes and heart disease, the researchers note, the timing of this risk-boosting weight gain has not been clear.
To investigate, the researchers followed 29 small-for-gestational-age children and 22 children of normal birth weight, evaluating their body composition and insulin sensitivity at ages 2, 3 and 4 years.
The body composition of the two groups was identical at age 2, the researchers report, but between age 2 and 4 increases in body fat and abdominal fat were "strikingly higher" in the low birth weight kids.
Further analysis found weight gain in the first 2 years of life was strongly associated with the amount of total and belly fat gained up to age 4.
The low birth weight children also showed a shift from insulin sensitivity to resistance.
Preventing excessive weight gain in infancy could reduce the risk of diabetes, heart disease and obesity in low birth weight children, the researchers note, while a better understanding of how this weight gain contributes to disease risk could help in the development of more specific prevention strategies.
However, the researchers add, "future intervention studies are needed before translating such observations into public health messages."
Source: Journal of Clinical Endocrinology & Metabolism, June 2006.
Heart Differences May Explain Young Athletes' Deaths Despite CPR
By Kathleen Doheny
HealthDay Reporter
HealthDay Reporter
Friday, June 23, 2006
FRIDAY, June 23 (HealthDay News) -- Experts say differences in the heart's structure may explain the finding that most young athletes who suffer cardiac arrest die -- even after excellent attempts at resuscitation have been made.
Researchers reported earlier this week that measures that have proven tried and true for older people, such as cardiopulmonary resuscitation (CPR) may not always work with younger athletes.
The study, reported in the July issue of Heart Rhythm, found that eight of nine college athletes who suffered sudden cardiac arrest did not survive, despite optimal efforts to save them.
The reason, according to researchers at the
"One of our hypotheses to explain why success rates are lower than expected is that resuscitating athletes with structural heart disease may be more difficult than resuscitating a structurally normal heart," explained lead researcher Dr. Jonathan A. Drezner, an assistant professor of family medicine.
For older victims of sudden cardiac arrest, the underlying cause is typically hardening of the arteries (atherosclerosis) and coronary artery disease.
"In young athletes, the main cause is usually a structural abnormality, with the most common cause of sudden cardiac death in young athletes hypertrophic cardiomyopathy, an enlarged and abnormal heart muscle," said Drezner, who is also associate director of the Sports Medicine Fellowship at the university.
The researchers evaluated nine cases of sudden cardiac arrest occurring in nine college athletes between 1999 and 2005. All but one died.
All the athletes suffered a "witnessed collapse," meaning bystanders were there and able to respond. In all case, the victims received CPR and/or use of an automated external defibrillator (AED), a device to restore heart rhythm to normal. These procedures were carried out either by emergency medical responders or athletic trainers. In seven cases, a shock was administered with the AED -- on average just 3.1 minutes after the cardiac arrest.
But only one of the players survived.
Four played basketball, two football, two lacrosse and one was a swimmer. All were male. The survivor played basketball.
"It's still surprising, given the young age," said Drezner of the fact that all but one died.
On further evaluation, the underlying cause of the sudden cardiac death was found to be hypertrophic cardiomyopathy (enlarged heart) in five students and heart attack in one. Two died from "commotio cordis" -- cardiac arrest caused by a blow or trauma occurring just as the heart is preparing to pump. This sudden trauma disrupts the heart's vital electrical system.
The use of AEDs outside of the hospital has helped save lives in recent years, experts say. The devices, found in casinos, airports, on airlines and in public buildings, have resulted in survival rates of 36 percent to 52 percent among the general population, Drezner noted.
Another expert, Dr. Mark Link, an associate professor of medicine at
Link, who is also director of the Center for the Evaluation of Athletes at Tufts, called the results of the
While the findings are worrisome, Drezner and Link urged parents and athletes to put the findings in perspective and said officials should consider the study a reminder to focus on emergency plans. "It's an unusual event that a young athlete dies suddenly," Link said. About 75 to 150 young athletes per year experience sudden cardiac arrest in the
"The emphasis is certainly not to be critical of the responders," Drezner said, noting that they all did a great job. "It could be that, in young athletes, the window [to save them] is short."
To reduce risk, young athletes should undergo a comprehensive history and physical before participating in sports, Drezner said. It should be done by a physician who is familiar with screening for athletic physicals. Any child or young adult with symptoms of heart problems, such as fainting while exercising or experiencing chest pain, should have a comprehensive cardiac exam, he said.
However, he acknowledged that, just as happens in the old, cardiac arrest can occur in the young with no warning. With that in mind, Drezner said, schools should review their plans for emergency protocols and be sure good procedures are in place.
More information
To learn more about high school emergency protocols, visit the National Athletic Trainers' Association.
Heartburn common in Western countries
Reuters Health
Friday, June 23, 2006
Heartburn, resulting from gastro-esophageal reflux disease (GERD) in which stomach acid seeps into the esophagus causing burning and pain in the chest, is a common malady in Western populations, much more so than in other parts of the world, according to report in The Lancet this week.
Two doctors who reviewed 31 published studies reporting on the prevalence of heartburn symptoms estimate that 25 percent of people in Western countries suffer from heartburn at least once a month, 12 percent at least once per week, and 5 percent suffer daily with symptoms of heartburn.
In contrast, in east Asian countries, only 11 percent of people suffer heartburn at least once per month, 4 percent weekly, and 2 percent report daily symptoms of heartburn.
"There is a paucity of information about the prevalence of heartburn in other geographical regions, but symptoms of GERD are uncommon in non-Western populations," note Dr. Nicholas J. Talley from the Mayo Clinic in
The exact cause of heartburn remains unknown but genetic factors are thought to be involved. Obesity and lifestyle factors, such as eating certain foods, drinking alcohol and smoking also appear to increase the risk that a person will develop GERD.
Some studies have shown that losing weight and elevating the head of the bed at night may relieve heartburn caused by GERD, although it's less clear whether avoiding spicy foods, carbonated beverages, coffee or that late night meal, which are often recommended, will relieve GERD-associated heartburn.
"Unfortunately, most patients do not respond to lifestyle advice and require further therapy," Talley and Moayyedi note. Their options, at the moment, include, medications that suppress acid, such as proton pump inhibitors, endoscopic therapy, and anti-reflux surgery.
Drug therapy looks to be "better than placebo," Talley and Moayyedi report, although "most patients need long-term treatment because the disease usually relapses."
Endoscopic therapy to treat GERD may entail the use of suturing devices, the application of radiofrequency energy to the lower esophagus, or the injection of bulking agents. The authors say these approaches are of "great interest," but so far their value is uncertain.
Surgery seems to work as well as proton pump inhibitor therapy "although there is a low operative mortality and morbidity," the authors note.
GERD is also a costly problem for Western societies. In the
Source: The Lancet, June 24, 2006.
Health Tip: Food Sensitivities in Infants
HealthDay Reporter
Friday, June 23, 2006
(HealthDay News) -- Because some infants have sensitivities or allergies to certain foods, the Children's Hospital in Richmond, Va., suggests you choose single-ingredient infant cereals and plain fruits and vegetables until you know what your child can tolerate.
And introduce new foods one at a time and wait three to five days in between each new food.
Food sensitivities can manifest themselves in several ways. Your child may develop a rash, wheezing, diarrhea or vomiting.
But before you blame food for your infant's ailments, have your pediatrician rule out other possible causes.
Blood Pressure Woes Start Earlier Than You Think
By Dennis Thompson
HealthDay Reporter
HealthDay Reporter
Friday, June 23, 2006
FRIDAY, June 23 (HealthDay News) -- Until recently, doctors treating high blood pressure limited their concern to blood pressure that exceeded a reading of 140 systolic (the upper number) and 90 diastolic (the lower number).
About two-thirds of Americans over age 65 have this level of high blood pressure, according to federal health statistics.
But now medical experts say the damage done by elevated blood pressure starts at levels much lower than that, when people are experiencing a less severe condition known as "prehypertension." That's the term given to blood pressure ranging from 120/80 to 139/89, higher than normal but not within the traditional danger zone.
"There's always been this ambiguity about this blood pressure that's not normal, but not high blood pressure either," said Dr. Adnan I. Qureshi, director of the cerebrovascular program in the
Blood pressure is the force exerted by blood against the walls of arteries. High blood pressure is dangerous because it makes the heart exert itself too hard and contributes to atherosclerosis, or hardening of the arteries, according to the National Institutes of Health.
High blood pressure, also known as hypertension, increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. It also can result in other conditions, such as congestive heart failure, kidney disease and blindness.
Nearly one of every three American adults, some 65 million people, has high blood pressure. People tend to develop high blood pressure as they get older, with middle-aged Americans facing a 90 percent chance of having it during their lives.
African-Americans are at greater risk of developing high blood pressure and have been shown to get it earlier in life and more often than whites. Others at risk for developing high blood pressure are people who are overweight, those with a family history of hypertension and those with prehypertension.
Recent studies have shown that people with prehypertension are three times more likely to have a heart attack and 1.7 times more likely to develop heart disease. An estimated 59 million Americans have prehypertension.
It's important to detect and treat high blood pressure early, to limit the condition's effects on the body, said Dr. Jeffrey Cutler, a senior advisor for the National Heart, Lung, and Blood Institute.
"Over the years, the higher pressure damages and aggravates diseases of the arteries," Cutler said.
Luckily, blood pressure is a condition that receives regular medical attention. "When you go see a doctor for anything, you get your blood pressure checked," Cutler said.
He recommended that people not rely on automatic blood-pressure machines, like those found in drug stores or supermarkets. "Those cuffs are not well-maintained or very accurate, and we discourage dependence on them for reassurance that your blood pressure's OK," Cutler said.
Once you've got high blood pressure, or prehypertension, a range of treatments are available.
Lifestyle changes are the first line of defense -- keeping your weight down, exercising regularly, reducing salt in your diet, cutting down on drinking, quitting smoking, and following a healthy eating plan that emphasizes fruits, vegetables and low-fat dairy foods.
But that only goes so far, Cutler said.
"Studies have shown that the majority of patients will need some medication," he said. "Some well-motivated people can get there with lifestyle changes, but not many."
The problem with prehypertension is that it falls within a gray area where medicine will not necessarily help, Qureshi said.
"With hypertension, we know that medication may be beneficial. With prehypertension, we don't know that yet," he said.
"It's still an evolving body of knowledge," Qureshi added. "We know prehypertension needs to be addressed, but we don't know what to do with these patients, and there are so many of them that we can't ignore the problem. Whatever we come up with will have true public impact."
For now, doctors are recommending that prehypertensive patients follow the same lifestyle changes as people will full-blown high blood pressure, Qureshi said.
"The real message for the public is that if you are prehypertensive, do not ignore it," he said. "You do have something to worry about."
More information
To learn more about prehypertension, visit the National Heart, Lung, and Blood Institute.
UV irradiation in the home improves kids' asthma
Reuters Health
Friday, June 23, 2006
The use of centrally installed ultraviolet (UV) irradiation units in the homes of asthmatic children who are sensitized to mold can improve their symptoms, according to a new report.
The idea is that UV light kills off circulating microbial agents that can trigger asthma.
The study is one of only a few to look at the health benefits of UV air disinfection systems, Dr. Jonathan A. Bernstein, from the University of Cincinnati in Ohio, and colleagues note in the May issue of the Journal of Asthma. Also, many of the previous studies have focused on the use of these systems in an office environment, not at home.
In a 28-week 'crossover' trial, the researchers assessed respiratory symptoms in 19 children with asthma first while UV irradiation units were running in the home central ventilation system and then when dummy units were installed, or vice versa.
UV irradiation was delivered by the CREON2000 Photonic Air Disinfection system, which can operate continuously due to the presence of a pre-filter system that prevents dust from accumulating on the UV lamps.
Compared with the placebo situation, the use of the UV irradiation system was associated with a significant improvement in the children's peak expiratory flow rate, the report indicates.
In addition, the system seemed to improve asthma symptoms and reduce asthma medication usage by 51 percent, compared to 13 percent with placebo.
A larger study "to validate the clinical health effects of UV irradiation as a primary indoor environmental intervention for allergic asthma" is necessary to confirm the present findings, the researchers conclude.
Source: Journal of Asthma, May 2006.
Low-carb diet benefits obese type 2 diabetics
By Megan Rauscher
Reuters Health
Friday, June 23, 2006
In motivated people who are overweight and have type 2 diabetes, a low-carbohydrate diet with some caloric restriction has lasting benefits on body weight and blood sugar control, Swedish researchers report.
Dr. Jorgen Vesti Nielsen and Dr. Eva A. Joensson from Blekingesjukhuset, Karlshamn, previously reported that 16 obese patients with type 2 diabetes who followed a low carbohydrate diet achieved significantly better diabetes control and body weight over 6 months than did 15 patients who followed their usual diet.
Follow-up data at 22 months for the low-carbohydrate group now show "stable improvement" of body weight and glucose control, the investigators report in the journal Nutrition and Metabolism. (The publication is open access, available subscription-free at http://www.nutritionandmetabolism.com/home).
At the start of the study, the average body weight of the participants was 100.6 kg in the low-carbohydrate group. At 6 months, they were down to 89.2 kg, and by 22 months they were at 92.0 kg.
Moreover, hemoglobin A1c, an indicator of ongoing blood glucose control, dropped from 8.0 percent in the low-carbohydrate group to 7.0 percent after a year, and at 22 months it was still down, at 6.9 percent.
The low-carbohydrate and high-carbohydrate diet contained about the same amount of calories (1800 kcal for men and 1600 kcal for women), but the proportions of carbohydrates, protein, and fat were different: 20 percent, 30 percent, and 50 percent, respectively, for the low-carb diet versus 55-60 percent, 15 percent, and 25-30 percent, respectively, for the higher-carb control diet.
In comments to Reuters Health, Nielsen said: "There is no such thing as one diet that all patients should adapt to. Some prefer to eat as they are used to and treat the blood glucose with medications. Others are willing to make quite substantial changes in their lives in order to get healthier (and in some cases to get cured of their diabetes)."
When it comes to diet and diabetes, Nielsen acknowledges that "we know very little and patients should be informed about our lack of knowledge so they can make their own choices. And then they should get our full support in whatever they chose."
Source: Nutrition and Metabolism 2006.
Epilepsy does not appear to increase cancer risk
Reuters Health
Friday, June 23, 2006
Contrary to earlier suspicions, epilepsy is not associated with an increased risk of cancer, researchers report.
"Epilepsy and long-term use of anti-epileptic drugs have been suggested to be associated with an increased risk of cancer," Dr. Cecilia Adelow of the
They investigated this notion by comparing people with various types of cancer to other similar but healthy people.
Specifically, the researcher identified 52,861 cases of blood cancers (leukemia, lymphoma, myeloma) and pancreatic cancer in the Swedish Cancer Registry from 1987 to 1999. A total of 137,485 controls were randomly selected from the Swedish Population Registry. The team linked cases and controls to the Swedish Hospital Discharge Registry to identify those who had been diagnosed with epilepsy.
A diagnosis of epilepsy 2 years or more before a cancer diagnosis was not associated with an increased risk of any of the types of cancer studied. This lack of association was also seen when an epilepsy diagnosis preceded a cancer diagnosis by more than 10 years.
"Although we have studied the association between a prior diagnosis of epilepsy and the risk of cancer, our negative findings also suggest that there is no major increase in risk with long-term use of...antiepileptic drugs regarding the types of cancer studied," Adelow's team points out.
While no evidence was found that epilepsy increases the risk of cancer, the investigators recommend that additional studies be performed to confirm these results.
Source: Journal of Neurology, Neurosurgery and Psychiatry, June 2006.
Obese kids suffer more disabling headaches
By Anne Harding
Reuters Health
Friday, June 23, 2006
Children who have migraines are more likely to be overweight than the general population, while overweight kids suffer more disabling migraines than their normal-weight peers, a new study shows.
"If you have two unhealthy conditions, migraine and obesity, you are even more disabled than if you'd had either one," Dr. Andrew D. Hershey of Cincinnati Children's Hospital Medical Center, the study's lead author, told Reuters Health. He reported the findings June 22 at the American Headache Society's annual meeting in
Past research has linked obesity to headache and migraine in adults. To investigate if such a connection exists in children and teens, Hershey and his colleagues looked at 440 migraine patients between the ages of 3 and 18 treated at seven specialty headache centers.
While 15.5 percent of the general population of children is obese, 21.1 percent of the headache patients met the criteria for obesity, the researchers found.
In people under 18, obesity is defined as a BMI in the 95th percentile for a person's age group, meaning it is higher than that of 95 percent of his or her peers. A BMI in the 85th to 95th percentile puts a young person at risk of obesity, while healthy BMI is between the 6th and 85th percentiles.
Using a six-item questionnaire known as the PedMIDAS, Hershey and his team evaluated how disabled the patients were by their headaches. The obese kids' average scores were 41.9 and at-risk individuals scored 42.9, compared to 33.8 for the group as a whole.
About 10 percent of kids between the ages of 5 to 15 have migraines, Hershey noted. Before adolescence, boys are more likely to have migraines, but about 40 percent outgrow them as they reach adolescence. Girls' migraine risk rises as they enter puberty, and among adults, women are three times more likely than men to have migraines.
"Obesity probably contributes to the more frequent migraines, meaning if you're obese you're less likely to do the healthy habits we talk about -- which is eating healthy, exercise and getting good sleep," Hershey noted. Obesity and migraine can also be a vicious circle, he noted, with headaches making it more difficult for a child to be active.
He and his colleagues are currently following the patients in the study to see if losing weight will reduce the severity of their headaches.
Americans visit doctor, hospital more often: study
Reuters Health
Friday, June 23, 2006
Americans are seeking medical care in greater numbers than ever before with the number of visits growing at three times the rate of population growth, according to government statistics published on Friday.
People made more than 1 billion visits in 2004 to doctors' offices, emergency rooms and hospital outpatient departments, according to the report from the
This is an increase of 31 percent from 10 years before, while population rose only 11 percent during the same time, according to the center, part of the U.S. Centers for Disease Control and Prevention.
Nearly half of the 1.1 billion visits were to primary-care doctors in office-based practices. Another 18 percent were to medical specialists and 16 percent to surgical specialists. Ten percent of visits were to emergency departments.
Medicaid patients, those with no health insurance and charity cases used hospitals more, and waiting times at emergency rooms, which by federal law must take in everyone who comes, increased significantly, the report found.
"The amount of time a patient waits before seeing a physician in the emergency department increased from 38 minutes in 1997 to 47 minutes in 2004," the CDC said in a statement.
Last week the
"There was no change in the average time -- about 16 minutes -- a patient spends face-to-face with a doctor in an office visit," the report said.
The most common diagnosis was high blood pressure, seen in 42 million visits, the CDC said.
Diagnoses of diabetes rose by 117 percent and diagnoses of spinal disorders rose by 94 percent, according to the statistical survey, which did not examine reasons for the changes.
New imaging technology improves cancer detection
By Jon Hurdle
Reuters Health
Friday, June 23, 2006
New imaging technology that combines the power of CAT scans with the finesse of a PET scan can catch cancer and other diseases earlier, potentially boosting survival rates and cutting costs, researchers said on Wednesday.
The two types of scan are commonly used separately but the team at the
The CAT, or computer assisted tomography, scan uses a special barrage of X-rays to see through tissue while the PET, or positron emission tomography, scan can detect the kinds of metabolic changes associated with tumor growth.
"We can use this PET/CAT to check for early indications of cancer or to see if the cancer has spread," said Dr. Laurie Loevner, a neuroradiologist at the Hospital of the
Once a patient has been injected with a radioactive isotope, the new technology allows doctors to measure to within half a billionth of a second the time difference in the detection of two gamma rays coming from the isotope. That allows for more accurate identification of the site of a lesion and a better image of any possible tumor.
At a news conference, Loevner cited the example of a patient who previously had cancer but was not clinically suspected of having a recurrence, and had only very mild symptoms of continuing illness. The new technology discovered that the patient's cancer had indeed come back.
The technology is particularly valuable for obese patients -- a growing sector of the population -- whose body size makes detection and diagnosis of tumors difficult. Although mostly used with cancer patients, it also has applications in the fields of cardiology and neurology, doctors said.
The technology has been in experimental use at the Hospital of the
Launched this month by maker Philips Medical Systems, a unit of Philips Electronics NV ,it is now also in use at
Each unit costs about $2 million, a price that is expected to come down as its use spreads, said Dr. Joel Karp, a professor of radiology. He said the technology has the potential to reduce medical costs by eliminating the need for exploratory surgery or other treatment that turns out to be unnecessary.
Thursday, June 22, 2006
Omega-3 fatty acids may help kids with depression
Reuters Health
Thursday, June 22, 2006
Treatment with omega-3 fatty acids, the type found in fish oils, appears to benefit children suffering from clinical depression, according to pilot study conducted in
The results of some studies in adults with major depressive disorder have suggested that omega-3 fatty acids may be an effective add-on therapy. However, the effects of this supplement in children with the disorder are unknown, researchers explain in the American Journal of Psychiatry.
Dr. R. H. Belmaker, of
Standardized depression scores were used to assess the children at the start of the study and throughout the 16-week trial.
Twenty children who remained in the study for at least 1 month were included in the analysis.
Seven out of 10 children in the active treatment group and none of the children in the placebo group had a reduction in depression scores of more than 50 percent. Four children in the omega-3 group achieved remission.
No clinically relevant side effects were reported, the researchers say.
The omega-3 fatty acid supplement used in the study was "a combination of eicosapentaenoic acid and docosahexaenoic acid that is commonly available as an over-the-counter preparation," the researchers note.
Belmaker and colleagues conclude that the effects of omega-3 fatty acids are "highly significant." This is the first such study, they believe, that has been conducted in children.
Source: American Journal of Psychiatry, June 2006.
US group cautions against laser therapy for smokers
By Susan Heavey
Reuters
Thursday, June 22, 2006
Pain-zapping lasers are not approved to help smokers kick their habit, but at least five companies are illegally promoting them, a consumer group said on Thursday in a petition asking
Also known as laser acupuncture, the therapy aims low doses of power -- less than the wattage of a typical light bulb -- at certain points on the body.
The U.S. Food and Drug Administration has cleared the procedure to temporarily relieve aches and pains, but several companies advertise the service as an aid to stop smoking, Public Citizen said in a petition to the agency.
Under FDA rules, companies cannot make any claims about a product or its use until they submit data and win agency approval.
Freedom Laser Therapy Inc., the Anne Penman Laser Therapy clinics, New Beginnings Laser Therapy, Laser Concept, and the
Of the five, Freedom Laser Therapy has promoted itself the most prominently through videos and media interviews, Public Citizen said.
"The company often claims to be able to rid a client of tobacco addiction in 'just one treatment,' and often touts a success rate of 85 percent," the group said in a statement.
On its Web site, the California- and Michigan-based company said: "Laser therapy treatment works to stimulate the release of endorphins in a healthy way, mimicking similar endorphin rush caused by nicotine. The laser helps to balance the body without harmful effects."
The other company sites also promote lasers for smoking cessation.
Low-watt lasers can be used in the
Two of the companies said they were conducting clinical trials through Atlanta-based Sterling Investigational Review Board, which did not return a call seeking comment.
"We're saying that low-level lasers help to mitigate nicotine withdrawal symptoms. We're not saying you're going to get off smoking," said Craig Nabat, who owns Freedom Laser Therapy and tests the lasers under
Nabat, who charges between $299 and $349, said he changed his Web site on Thursday to clearly state that therapy is part of a trial.
Geoff Mann, owner of
The three other companies did not return calls.
Public Citizen's petition calls on the FDA to take aggressive action to protect consumers. Agency representatives could not be reached.
"This is an expensive 'experiment' for the typical smoker who is looking to end his (or) her addiction," the group said.
Their money would be better spent on nicotine-replacement therapy, counseling and other proven treatments, it added.
Vitamins' use in stopping cancer debated
By Mike Stobbe
Associated Press Writer
The Associated Press Writer
Thursday, June 22, 2006
Your parents may still tell you to take your vitamins, but a cancer doctor might be less enthusiastic. A recent study that found calcium and vitamin D supplements don't reduce the odds of developing breast cancer is the latest to deflate the cancer-prevention claims of some vitamin proponents.
A federal science panel last month had concluded there is no evidence for recommending certain vitamin supplements for cancer prevention. Even the Council for Responsible Nutrition, a supplement trade association, won't say vitamins prevent cancer.
"There is no vitamin or mineral supplement proven to reduce the risk of cancer," said Eric Jacobs, a senior epidemiologist and vitamin specialist with the American Cancer Society.
However, many doctors continue to recommend daily multivitamins for general health. And some experts say certain supplements may yet prove to be a help in the fight against cancer — once scientists can work out the right amounts and better ways to study their effects.
"I do think there is a fundamental issue of finding the optimal dose of essential nutrients," said Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard School of Public Health.
Experts say more research is needed.
"More than half of Americans are taking dietary supplements — mostly multivitamins — but scientists aren't certain about their benefit," said Dr. J. Michael McGinnis, who chaired the National Institutes of Health panel that critiqued supplemental vitamins.
"For something used so widely, at such expense, among Americans, there is simply a need for much better information," he said.
Scientists once suspected vitamin E and beta-carotene prevented lung cancer after a study showed people who took supplements appeared to have lower cancer incidence.
But a larger, more scientifically rigorous study found 50 milligrams a day of alpha-tocopherol, a form of vitamin E, had no effect on lung cancer incidence. And 20 milligrams of beta-carotene, a precursor of vitamin A, actually increased lung cancer incidence in smokers by 18 percent. Health officials now warn smokers not to take beta-carotene supplements.
Studies also have found that beta-carotene has no impact on the incidence of lung cancer in non-smokers, or prostate or breast cancer. And research has found vitamin B2 and niacin had no impact on the occurrence of cancers, and selenium did not decrease skin cancer in people with a history of that disease.
More recently, a study published in April in the Journal of the National Cancer Institute concluded that a low-dose vitamin A derivative did not prevent head and neck tumors. Earlier research had suggested that higher doses of the derivative cut occurrence of subsequent tumors. But those higher doses caused severe cracking of the lips, eyelid inflammation and other problems, researchers said.
A study of about 36,000 post-menopausal women released this month found calcium and vitamin D supplements didn't cut the odds of developing breast cancer.
Willett, the Harvard expert, faulted the study led by Dr. Rowan Chlebowski of Harbor-UCLA Medical Center in Los Angeles and said a different dose of vitamin D may be needed to show an effect. He also said it's possible vitamins and supplements reduce cancer risk at one stage of life, but not another, as a previous Canadian study suggested.
Much of the research into potential cancer-fighting powers of vitamins and other supplements have been observational studies, said Andrew Shao, the Council for Responsible Nutrition's vice president for scientific and regulatory affairs.
But the gold standard is large, case-controlled trials involving elaborate precautions to isolate cause and effect and prevent biased results. Such studies are expensive and take many years to complete.
Also, if dosage is a key and researchers select the wrong dosage, such a study may find no benefit but miss that the vitamins reduce cancer risks at a different dose, he said.
Shao and others say there have been promising results regarding selenium's value against cancers other than skin cancer, and that continued work on folate and vitamins D and E also seems rewarding.
Meanwhile, patients are making their own decisions.
Lisa McRae, a 39-year-old real estate agent in suburban
She and her mother read dozens of books discussing the value of diet and nutrients in combating chronic diseases. Staff at a hospital referred her to an acupuncturist, who recommended a Chinese herbal mix and seven other supplements.
McRae believes they can help her fight cancer, both now in the future.
"I think more people need to realize there are several ways to combat this disease," she said.
Some hospitals cut back on use of stents
The Associated Press Writer
Thursday, June 22, 2006
Some cardiac centers are decreasing their use of the drug-coated stents used to prop open the arteries of heart patients because of rising concerns about potentially deadly blood clots, according to a published newspaper report.
Hospitals aren't drastically curbing the use of the stents, and there no indication yet of an overall decline in sales, The Wall Street Journal reported. But the some leading hospitals say they are substituting uncoated, bare metal stents in some patients.
The reported reduction in use comes as new research raises questions about long-term risks for patients who already have the drug-coated stents, including a Swiss study that found more heart attacks and deaths per 100 patients with drug-coated stents than with the uncoated, bare-metal ones. The heart attacks and deaths were mostly attributed to blood clots.
The stents won federal approval in the 1990s and have been used by millions of heart patients.
Stents are designed to keep arteries open after they are cleared of fatty deposits, preventing a future heart attack or more risky bypass surgery. The drug coating aims to combat the growth of scar tissue that can gradually narrow the artery again. The problem rarely leads to death, but can cause chest pain and force a patient to get the area opened up again — a process called "revascularization."
Drug-coated stents saw $5.3 billion in sales last year in a field dominated by Natick-based Boston Scientific and Johnson & Johnson. The drug-coated stents are far more profitable than bare metal stents, selling for $2,300 each, compared to $700 for the bare metal model.
Shares of Boston Scientific dropped to a 52-week low in trading Thursday on the New York Stock Exchange after the report, to $18.06, but rebounded by mid-afternoon to $18.48, down 3.3 percent. Johnson & Johnson shares were off 1.2 percent to $61.05 in trading on the exchange.
The Journal reported use of drug-coated stents is down about 5 percent in the past few months at
At the
Cedars-Sinai Medical Center in Los Angeles has doubled its use of bare-metal stents in the first four months of this year, compared with the last six months of 2005 (14 percent of all stents, from 7 percent), the Journal reported.
Charles Rudnick, a Boston Scientific spokesman, told the Associated Press in an interview that studies and real-world experience have proven the drug coated stents are safe and effective. The hospitals in the article who've moved away from drug-coated stents don't reflect a broader trend, he said.
"There was a few of them, a cross section perhaps, but we have not seen the trend they were discussing in our numbers for the bare metal stents," he said.
According to the Journal, some doctors are concerned about a phenomenon called late-stent thrombosis, which is the formation of a blood clot inside a stent months, or even years, after the procedure. It leads to death about half the time, according to one study.
Some cardiologists say increasing numbers of patients are coming into emergency rooms with the problem, though the problem was rarely seen before drug-coated stents came on the market. The concern is that the drug coating prevents healing around the stent, leaving an area akin to an open wound that attracts blood clots.
The Swiss study cited by the Journal was presented at a large cardiology meeting in March. It indicated five revascularizations were prevented for every 100 patients receiving a drug-coated stent, but at the cost of 3.3 additional heart attacks or deaths.
Rudnick said the Swiss study was a small, single center trial, compared to the company's larger, multi-center trials which show no difference in problems with patients with either type of stent. He said the company has not found any class of patients that benefit more from a bare metal stent, compared to drug-coated stent.
He said the company makes that information available to doctors, but respects whatever decisions they make.
"It's not ours to question a doctor's decision if they think one stent is better than another for the treatment of their patient," he said. "That's their decision, we support it."
Parents' attitude impacts kids' diabetes control
Reuters Health
Thursday, June 22, 2006
Diabetic school-age children whose parents perceive them as quite capable of keeping on top of their disease actually have poorer control of blood sugar than kids whose parents are less confident in their children's ability, a survey suggests.
"Some parents may perceive their children to be competent enough to manage their diabetes, and give them more responsibility for monitoring and treatment, when they are not yet fully prepared," warn doctors from the
Dr. H. M. Pattison, from Aston University in Birmingham, and associates asked 51 parents, mostly mothers, of children 6 to 12 years of age with insulin-dependent diabetes to rate their child's competence and their own competence in managing the disease. The investigators compared these ratings with the children's average annual hemoglobin A1c level -- a measure of glucose control.
They report in the Archives of Disease in Childhood that higher levels of confidence and "self-efficacy" among parents were not associated with better blood sugar control "as anticipated."
On the contrary, children of parents who perceived them as more competent to self-manage their disease, and who perceived diabetes as less serious, had poorer control of their blood sugar.
Having confidence in one's ability to manage a disease is a positive health belief in many ways, but in this case it may have "counterproductive effects" on blood sugar control, the authors note.
Diabetes has a major impact on family life, and higher levels of confidence in managing it may be one way that families cope with the disease and try to minimize the effect it has on the family, "even at the expense of good glycemic control," Pattison and colleagues warn.
Source: Archives of Disease in Childhood, June 2006.
Condoms proven to protect against virus
By Linda A. Johnson
Associated Press Writer
The Associated Press Writer
Thursday, June 22, 2006
For the first time, scientists have proof that condoms offer women impressive protection against the virus that causes cervical cancer.
A three-year study of female college students — all virgins at the start — found that women whose partners always wore a condom during sex were 70 percent less likely to become infected with the human papilloma virus, or HPV, than those whose partners used protection less than 5 percent of the time.
"That's pretty awesome. There aren't too many times when you can have an intervention that would offer so much protection," said Dr. Patricia Kloser, an infectious-disease specialist at
Condoms have been shown convincingly to prevent pregnancy and AIDS. But conservatives who want to see abstinence taught in schools have long argued that condoms do not protect well against diseases such as HPV, because men can spread the virus to women from sores on their genitals outside the area covered by a condom.
However, the researchers at the
Human papilloma virus — which can cause cervical cancer, genital warts and vaginal, vulvar, anal and penile cancers — is the most common sexually transmitted disease, infecting about 80 percent of young women within five years of becoming sexually active. An estimated 630 million people worldwide are infected.
The virus is spread during sex from contact with the sores, or lesions, that develop around infected cells.
Often, the virus is killed by the immune system, but in some people HPV can take hold and cause lesions that can turn cancerous years later. Cervical cancer strikes about 10,520 American women and kills about 3,500 each year. Worldwide, about 500,000 women develop cervical cancer and nearly 300,000 die from it every year.
In the HPV study, published in Thursday's New England Journal of Medicine, none of the women who reported that their partners always used condoms developed lesions during the three-year period. Fourteen women whose partners used condoms less regularly got lesions.
Twelve of the 42 women who said their partners always used condoms became infected. Rachel Winer, a researcher in the university's epidemiology department, said it could be that the couples did not use the condoms correctly or had some sexual contact before putting on a condom.
Recent medical advances might someday render the condom debate moot: Earlier this month, the government approved the first vaccine against HPV, and public health officials are urging that girls be routinely vaccinated before they become sexually active.
The study comes as the Food and Drug Administration is revising rules for the claims that manufacturers can make on how well condoms prevent sexually transmitted diseases.
Packages now must state: "If used properly, latex condoms will help to reduce the risk of transmission of HIV infection (AIDS) and many other sexually transmitted diseases." But revisions were ordered by Congress in 2000 amid pressure from conservative groups demanding "medically accurate" claims as to condoms' effectiveness.
Safe-sex advocates warn that changing the wording would undermine public confidence in, and use of, condoms.
At the time, there was solid evidence only on how well condoms prevent pregnancy, HIV and, in men, gonorrhea. Recent research has produced strong evidence condoms protect well against gonorrhea, chlamydia and herpes in both men and women, said Dr. Ward Cates Jr., president of the Institute for Family Health at Family Health International. This study adds HPV to that list, he said.
"This will help clinicians to counsel their patients about the effectiveness of condoms to reduce another of the sexually transmitted infections — if condoms are used consistently and correctly," Cates said.
The researchers invited 24,000 female students ages 18 to 22 at the
Winer said previous HPV studies either showed no protection from condoms or were inconclusive. This one included only virgins and collected more details, and the computer diaries helped women be more honest about condom use than those in studies where people are interviewed about their sexual behavior, she said.
"This is about as ideal a study as you can get," said Dr. Tom Fitch, a
Nevertheless, Fitch noted that some consistent condom users still were infected with HPV. Fitch and Kloser also suggested that the results in the real world — say, among poor, inner-city women — might be different from those with college women.
Fitch said several studies have shown that at most, 50 percent of people reported using a condom every time they had sex.
On the Net: http://www.nejm.org
Centers for Disease Control and Prevention: http://www.cdc.gov/nchstp/od/latex.htm
American Social Health Association: http://www.ashastd.org
AEDs may not save athletes in cardiac arrest
By Megan Rauscher
Reuters Health
Thursday, June 22, 2006
It seems that college athletes who suffer sudden cardiac arrest during play often do not survive, despite appropriate and timely resuscitation efforts, investigators report.
The finding comes from a detailed analysis of nine intercollegiate athletes who suffered sudden cardiac arrest between 1999 and 2005, and it raises questions about the usefulness of automated external defibrillators (AEDs) in these circumstances.
All nine sudden cardiac arrests were witnessed and bystanders were able to respond immediately, so that all received immediate CPR. Prompt defibrillation with an AED was applied by a trainer in five cases and by arriving emergency medical services personnel in four cases. Nonetheless, only one of the nine athletes survived, report Dr. Jonathan A. Drezner and Dr. Kenneth J. Rogers in the journal Heart Rhythm.
"The apparent lower survival rate in young athletes with sudden cardiac arrest is both surprising and alarming," Drezner, associate director of the sports medicine fellowship in the department of family medicine at the
The findings "raise concerns regarding the effectiveness of early defibrillation in young athletes," he added.
"The lower survival rate may be due to the presence of structural heart disease in the majority of young athletes with sudden cardiac arrest that may be more resistant to defibrillation," Drezner explained.
For example, in five of the eight athletes who did not survive, the underlying cause of sudden cardiac death was an abnormally enlarged heart, called hypertrophic cardiomyopathy. In two cases, the cause of sudden cardiac death was blunt trauma to the chest triggering a chaotic heartbeat, a condition termed called commotio cordis. One athlete died of a heart attack.
In the sole surviving athlete, no structural heart defect or disease was detected. In this case, doctors failed to identify a precise cause of sudden cardiac arrest.
These results, Drezner said, reinforce the need for further research on sudden cardiac arrest in young athletes and the effect of early defibrillation in those with structural heart disease. "Clearly, we need to understand this better," he said.
Source: Heart Rhythm, July 2006.
Health Tip: Heat Stroke? Get Help!
HealthDay Reporter
Thursday, June 22, 2006
(HealthDay News) -- Heat stroke occurs when the body is not able to cool itself to a safe temperature. It usually happens when a person is exposed for too long to the sun, without proper shade, cooling and hydration.
The very young and the very old are most sensitive to heat and most likely to develop heat stroke, as are people who work outside and those taking certain medications, the University of Maryland Medical Center says.
Heat stroke is typically characterized by flushed, hot and dry skin. Other symptoms can include dizziness, headache, confusion, fatigue, seizure, and loss of consciousness.
Someone with heat stroke should receive professional medical attention. A heat stroke victim should be brought inside out of the sun and cooled down immediately. The skin should be wiped down with cool water and fanned to bring the body temperature down. Ice packs should be applied to the groin and armpits, and the patient should rest in a cool place with the feet slightly elevated.
Doctors often treat heat stroke victims with intravenous fluids. Bed rest is usually recommended.
More women than men hospitalized for asthma
Reuters Health
Thursday, June 22, 2006
Women are significantly more likely than men to go to the emergency department because of asthma-related symptoms and to be admitted to the hospital, a Canadian study shows.
It's not that women have more severe asthma, the researchers say. Rather, it seems that women perceive their asthma symptoms as worse than men do. Sex bias on the part of healthcare professionals may also factor in to the higher admission rates for an asthma attack among women.
To investigate sex differences in hospital admission rates for asthma, Dr. Akerke Baibergenova from
Women not only made up the majority of all emergency visits (62.2 percent), they also accounted for a greater percentage of hospitalizations (7.4 percent versus 4.5 percent for men), the researchers report in the Annals of Allergy, Asthma and Immunology.
These differences could not be explained on the basis of asthma rates or severity in men and women. Even women with low asthma severity scores were still more likely to be hospitalized than men with moderate scores, Baibergenova's team reports.
"Although more research on the mechanisms behind this phenomenon is needed, educational interventions that focus on female asthmatic patients may be an efficient way of decreasing the number of hospitalizations and thus reducing the overall financial burden of asthma on the health care system," they conclude.
Source: Annals of Allergy, Asthma and Immunology, May 2006.
Migraines More Common in Overweight Kids
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- Children who suffer from migraine headaches are 36 percent more likely to be overweight, according to a new
Researchers were not surprised by the findings, as previous studies have linked obesity to migraine headaches in adults as well.
"The numbers tell us that being overweight may contribute to kids having more headaches, most often migraines," Dr. Andrew D. Hershey, director of the Headache Center and a pediatric neurologist at Cincinnati Children's Hospital Medical Center, said in a prepared statement. "There are likely a number of causes, including poorer general health, body stress, lack of exercise and nutrition. It may not be that being overweight directly causes migraine, but that the reasons for being overweight cause these children to have worsening headaches."
Researchers evaluated 440 children between the ages of 3 to 18 who visited one of seven pediatric headache centers. Of the entire population, just over 91 percent were diagnosed with migraine headaches and close to 9 percent had other types of headaches. While 15.5 percent of
Severity of headaches was also examined and calculated on a scale where a score of between 30 and 50 signified moderate disability due to headache. Children who were overweight had an average score of 41.9, those at risk of being overweight a score of 42.9, and children of normal weight a score of 28.7.
Results of the study were to be presented at this week's annual meeting of the American Headache Society, in
"Obesity is a state of chronic, low-degree systemic inflammation," study author Dr. Marcelo E. Bigal, director of research at the New England Center for Headache in Stamford, Conn., said in a prepared statement. "Most of the inflammatory markers that are elevated in obese people also play a role in the inflammation of blood vessels in the brain that occurs during migraine attacks. Being a pro-inflammatory state, obesity may increase the chances of migraine attacks in people who are biologically predisposed to suffer from migraines."
More information
The National Migraine Association has more information on migraine headaches.
More men than women get best care for heart attack
Reuters Health
Thursday, June 22, 2006
An initiative by the American College of Cardiology has increased the number of heart attack patients who get guidelines-based care, but women are still less likely to benefit than men, researchers report.
The Guidelines Applied in Practice (GAP) program aimed to raise the quality of care for men and women who survived a heart attack. A major component of the effort was a "discharge document" that outlined best treatment options.
"The GAP program and its associated discharge document were important in increasing the rates of evidence-based care," senior investigator Dr. Kim A. Eagle told Reuters Health.
Eagle, of the
The study, in the Archives of Internal Medicine, shows that "the GAP discharge tool was independently associated with a substantial reduction in mortality after discharge at 1 year in women." Nevertheless, women were still significantly more likely to die than men.
The investigators found that 27.9% of women received a discharge document compared with 33.96% of men, a statistically significant difference. "Greater use of the GAP discharge tool in women might narrow the post-(heart attack) gender mortality gap," the team concludes
Dr. Philip Greenland of
Source: Archives of Internal Medicine, June 12, 2006.
Human 'Mad Cow' Could Cause Eventual Epidemic
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- Variant Creutzfeldt-Jakob disease, or vCJD, the human form of "mad cow disease," has a long incubation period and could cause an eventual epidemic, researchers report.
Reporting in the June 24 issue of the Lancet, they looked at a similar disease -- linked to cannibalism -- to better understand the impact such an epidemic might have.
Mad cow disease, or bovine spongiform encephalopathy (BSE), is caused by misfolded brain proteins called prions, which cows contract through contaminated feed. Humans can catch the human form the disease, vCJD, by eating contaminated beef. So far, the fatal degenerative illness has infected about 160 people in the
Now, researchers at University College London have determined, through the study of a similar disease, that BSE has an incubation period of more than 50 years before it actively becomes vCJD.
Patients in
Kuru occurs in
Eleven participants in the kuru study had minimum incubation periods of between 34 and 41 years, the researchers calculated. They could more accurately calculate the date of infection for men, and estimated an incubation period of between 39 and 56 years, with the potential for even seven years longer.
The researchers also noted a genetic variation in some kuru patients that has been known to promote long incubation periods.
John Collinge, one of the researchers, wrote in a prepared statement that the current small cohort of vCJD patients "could represent a distinct genetic subpopulation with unusually short incubation periods for BSE," suggesting that many more vCJD patients who caught the disease via contaminated beef could emerge in the coming decades.
"A human BSE epidemic may be multiphasic, and recent estimates of the size of the vCJD epidemic based on uniform genetic susceptibility could be substantial underestimations," Collinge said.
More information
The
Soy component linked to heart health benefits
Reuters Health
Thursday, June 22, 2006
A specific estrogen-like compound, daidzein, appears to be responsible for the healthy effects of soy on cholesterol levels in women, a new study shows.
Women with high levels of daidzein in their blood had lower levels of triglycerides, higher levels of HDL-C or "good" cholesterol, and healthier ratios of total to good cholesterol levels, Dr. C. Noel Bairey Merz of
The researchers note in The Journal of Clinical Endocrinology & Metabolism that female monkeys fed a soy-rich diet show healthy changes in blood fat levels, the researchers note, but evidence of the effects of soy on cholesterol in humans has been mixed.
To investigate, the team checked blood levels of daidzein and genistein, another plant estrogen, in a group of 483 women at risk of heart disease who were participating in the Women's Ischemia Syndrome Evaluation study. About 80 percent of the women were postmenopausal.
The researchers found no association between genistein and blood fat levels. But higher blood levels of daidzein were tied to lower triglyceride levels and higher good cholesterol levels.
The effect of daidzein was strongest for women with low estrogen levels, who also showed reductions in LDL-C or "bad" cholesterol, as well as lower total cholesterol levels, suggesting that the soy component may act like the real hormone in the body to help in restoring healthier blood fat levels, the researchers suggest.
While the findings must be confirmed by additional research, they provide evidence that daidzein is responsible for soy's beneficial effects on blood lipid levels, Merz and colleagues write.
"These and prior studies suggest that cardiovascular risk reduction strategies in women should consider dietary intake of food products, such as soy, which elevate blood daidzein levels, consistent with recent recommendations," they conclude.
Source: Journal of Clinical Endocrinology & Metabolism, June 2006.
Researchers Reverse Parkinson's Symptoms in Animals
By Ed Edelson
HealthDay Reporter
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- Focusing on a protein that mysteriously accumulates in the brains of people with Parkinson's disease, researchers have discovered a biological pathway that might some day lead to better treatments for the neurological condition.
Clumps of the protein, called alpha-synuclein, "are hallmarks of Parkinson's disease," said Aaron Gitler, a postdoctoral researcher in the laboratory of Susan Lindquist at the Whitehead Institute in
They started with the simplest of organisms -- yeast cells -- using an array engineered by the Harvard Institute of Proteonomics. The researchers infected those cells with alpha-synuclein. They reasoned that if they identified genes whose over-expression rescued a cell, that would tell them something about how alpha-synuclein sickened a cell in the first place.
Most of the genes they identified were involved in the production and folding of cellular proteins into the proper shape and the fine-tuning of those proteins. Then, working with researchers at the
The next step was to find a gene that increased production of this key transport protein, to see if that would save the cells.
"We were surprised that when we tested this gene in higher animals -- fruit flies, worms, rat cells -- remarkably we could reverse Parkinson's symptoms in higher animals," Gitler said. "There are obvious implications for drug targets and the basic mechanism of how the disease occurs."
The scientists tried several ways of increasing production of the transport protein. In every case, the nerve cells were restored to health, Gitler said.
The study findings appear in the June 23 issue of the journal Science.
"The long-term goal is to find a drug target," said Cole M. Haynes, who took part in the research at the
The progress made thus far is just a beginning, Gitler added. "We hope that in the long run we can get a very good understanding of this and other cellular defects," he said. "Knowing these details will allow us and others to design therapies for Parkinson's disease and other disease."
In a statement, Lindquist said, "We hoped that we could use these simple model organisms to study something as deeply complex as neurodegenerative disease. Most people thought we were crazy. But we now not only have made progress in understanding this dreadful disease, but we have a new platform for screening pharmaceuticals."
Dr. Michael S. Okun, medical director of the National Parkinson Foundation and co-director of the
"The information from this study will be potentially useful to investigators around the world interested in why brain cells die in Parkinson's disease, and the results will hopefully be applied to more complex research model systems," Okun said.
Parkinson's disease is a brain disorder that occurs when certain nerve cells in the brain die or become impaired. Symptoms can include tremors, slowness of movement, stiffness, trouble with balance, muffled speech and depression.
An estimated 1.5 million Americans have the disease, with 60,000 new cases diagnosed annually. The condition typically develops after age 65, according to the National Parkinson Foundation.
More information
The full facts about Parkinson's disease are available from the National Library of Medicine.
Cadmium linked to breast cancer
By Anthony J. Brown, MD
Reuters Health
Thursday, June 22, 2006
Women with the highest levels of cadmium in their urine have more than a two-fold higher risk of breast cancer than women with the lowest levels, according to a new study. However, further studies are needed to determine if these elevated levels are a cause or effect of breast cancer.
Although cadmium, a heavy metal, has been classified as a probable cancer-causing substance by the US Environmental Protection Agency, until now no human studies have investigated its link with breast cancer, Dr. Jane A. McElroy told Reuters Health.
The findings from "animal studies have supported an association, and cadmium has been found in breast tissue," noted the researcher, from the University of Wisconsin Comprehensive Cancer Center in
McElroy and her team compared urinary levels of cadmium in 246 breast cancer patients and in 254 age-matched controls. The subjects were contacted by telephone to determine the presence of known breast cancer risk factors.
In the study, reported in the Journal of the National Cancer Institute, women with cadmium levels above a certain cut-off were 2.29-times more likely to have breast cancer than those with lower levels. This held true after accounting for established risk factors.
Exactly how cadmium might cause breast cancer is unclear, but there is evidence that it mimics the effects of estrogen. "It actually competes with estrogen for the alpha receptor site," McElroy said.
McElroy believes that if the current findings are replicated in a larger study and cadmium's role is confirmed, it could lead to tighter restrictions on how the heavy metal is disposed of in the environment.
Source: Journal of the National Cancer Institute, June 21, 2006.
Older Transfused Blood May Raise Risks After Surgery
By E.J. Mundell
HealthDay Reporter
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- When it comes to blood transfused during surgery into very sick heart patients, newer may be better, researchers report.
"High-risk patients who received older blood were more likely to die after cardiac surgery," said lead investigator Dr. Elliot Bennett-Guerrero, director of perioperative clinical research at the
Specifically, repeat bypass patients who received the "freshest" blood during their operation (stored for one to 19 days) had a 4 percent in-hospital death rate, compared to a 25 percent rate in similar patients receiving the "oldest" blood (stored for 31 to 42 days). U.S. Food and Drug Administration regulations prohibit the use of blood stored for more than 42 days.
The study authors and others stressed that blood transfusion is often absolutely necessary to save lives. They also noted that for healthier patients requiring fewer units of blood, any increase in risk from receiving older blood would probably be minimal.
The study appears in the July issue of Analgesia & Anesthesia.
Each year, Americans receive more than 12 million units of potentially life-saving blood, with more than 2 million units used in cardiovascular surgeries, according to data included in the study.
Whether or not the amount of time blood has spent in storage can affect the recipient's health "has been an age-old question in transfusion medicine," Bennett-Guerrero said.
In the new study, the Duke team took a retrospective look at the medical files of 321 patients who underwent repeat, open-heart surgeries for either coronary artery bypass or valve replacement between 1995 and 2001. The patients received a relatively large amount of donated blood -- an average of 5 units -- during these procedures.
The researchers tracked the patients' incidence of in-hospital and long-term mortality, as well as post-surgical complications such as kidney failure. They compared the rate of those types of outcomes to the number of units and age of the blood each patient received.
In-hospital death rates rose along with the age of blood received, the study found, as did hospital length-of-stay -- an average of 3.5 days for those receiving freshest blood vs. seven days for those getting older units.
Patients who received older blood also had higher rates of death in the eight years after their surgery, the researchers noted. According to Bennett-Guerrero, that's probably due to the long-term consequences of complications sustained just after surgery (for example, kidney failure) that may have been triggered -- at least in part -- by the use of older transfused blood.
Why might blood stored closer to the 42-day maximum be less healthy than "younger" blood?
"One of the theories is that as red blood cells age during storage, they become stiffer," Bennett-Guerrero said. "There's lots of evidence that these stiffer red blood cells may not deliver oxygen as efficiently. Or, they may even clot up or get stuck in organs and cause those organs to become damaged."
One blood expert called the study "commendable" but urged caution in interpreting the results.
"This paper is provocative, but it's a retrospective study with lots of confounding factors," said Dr. Richard Benjamin, chief medical officer of the American Red Cross. "We need to do a randomized, prospective trial to see if what we think we are seeing here is real."
Benjamin noted that the study focused on the very sickest type of patients, whose surgeries required very large amount of blood. The average "low-risk" patient might require just one or two units, he said.
"Remember, the more blood that you get, the more likely you are to get at least one old unit," Benjamin said. He added that the patients in the Duke study were already fragile; it's likely that healthier individuals wouldn't be at any significant risk from receiving a unit of older blood. "The danger [to that group] is infinitesimally small," Benjamin said.
And he said that, until supplies of donated blood increase, the only alternative is for patients is to receive "no blood at all."
"Our difficulty at the Red Cross is that we'd love to give everyone fresh blood -- there's no question about that," Benjamin said. "But we can't because there just isn't enough of it. So, we have to keep it on the shelf for a while. If we restricted its use to fresh blood only, a lot of people wouldn't get transfused, and they'd die."
Bennett-Guerrero agreed that a larger, prospective trial is needed, and said his team is applying for a U.S. National Institutes of Health grant to conduct just such a trial. If the results of that trial are similar to those found in the retrospective study, they may point to a need for more selective rationing of fresher blood to specific patients on a case-by-case basis, he said.
Bennett-Guerrero also seconded the notion that older, sicker patients may be at highest risk from receiving older blood.
"If you look at patients who are doing really well, maybe at lower risk for surgical procedures, my guess is that in that setting, it doesn't matter whether they even receive the blood or not, or whether the blood is older," he said. "But if you take someone who is 80 years old with complex heart surgery, who's already at high risk of developing complications, it may be a factor that puts them over the edge."
More information
Find out how you can donate blood at the American Red Cross.
Magnetic device may prevent migraine
By Karla Gale
Reuters Health
Thursday, June 22, 2006
A device that delivers magnetic pulses through the skull to the brain may become a migraine sufferer's best friend, new research indicates.
Transcranial magnetic stimulation, or TMS as the technique is called, prevents or reduces the severity of migraines, according to preliminary studies reported Thursday at the annual meeting of the American Headache Society in
"Migraine starts because of neuronal hyperexcitability, during which patients see flickering lights or other manifestations of an aura. The hyperexcitability phase is followed by fatigue and depression of neurons, which spreads throughout the brain, and the result is a pounding headache," Dr. Yousef Mohammad said in a teleconference.
"We hypothesized that if we could interrupt this cortical spreading depression by administration of TMS, we could abort the headache," he continued.
His group conducted a 3-month study that included eight migraine-with-aura patients. They were instructed to use a portable device, which they held to the back of their head to deliver two TMS pulses 30 seconds apart as soon as they experienced an aura.
Mohammad, a neurologist at
The subjects experienced a total of 31 migraines during the study, and for 81 percent of these episodes the patients reported that they were headache-free within 2 hours of using the device.
They also rated their response to the treatment as very good or excellent for 55 percent of the attacks. In about three-quarters of the headaches, TMS eliminated nausea and sensitivity to noise and light.
Mohammad's team went on to conduct a controlled trial with 42 migraine patients who were randomly to TMS treatment or inactive placebo treatment.
The TMS group had either no pain or only mild pain 2 hours after treatment in 69 percent of headache episodes, whereas the placebo group experienced similar relief for 48 percent of episodes.
Following TMS, work functioning was improved for 86 percent of headache episodes, versus 56 percent of the episodes in the placebo group.
"Our overall impression was that TMS was much better than placebo," Mohammad said.
In neither of the studies were any adverse side effects tied to TMS.
Mohammad and his associates have begun a large, randomized clinical trial that will include patients with migraine with or without aura to validate these early findings.
Protein May Fight Lung Cancers
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- A naturally occurring protein called HLJ1 may slow down or even stop the progression of tumors in non-small-cell lung cancer, a new study finds.
Non-small-cell lung cancers comprise about 85 percent of lung malignancies, according to the American Cancer Society.
The new study included 71 patients diagnosed with non-small-cell lung cancer. Researchers at
They found that when HLJ1 was increased or eliminated in lung cancer cells, differences emerged in terms of tumor proliferation.
If the cell received increased exposure to the protein, the tumor experienced a decrease in cell division, as well as slower movement to other cells. This suggests that the protein may be a natural tumor-suppressor, the team concluded in the June 21 issue of the Journal of the National Cancer Institute. In some cases, HLJ1 appeared to prevent the cancer cells from reproducing at all, they said.
The researchers also noted that in 55 of the patients studied, the cancer cells contained far lower concentrations of HLJ1 than non-cancerous cells. Patients whose tumors were exposed to high concentrations of HLJ1 maintained higher survival rates and lower rates of cancer reappearance.
"These findings may identify a subgroup of non-small-cell lung cancer patients who may benefit from adjuvant therapy and facilitate the design of individualized therapies for lung cancer," the study authors wrote in a prepared statement.
In a related editorial, Adriana Albini and Ulrich Pfeffer of the National Cancer Research Institute in Genova, Italy, said the finding "will further stimulate scrutiny of the (proteins in the same family as HLJ1) and put cancer invasion, angiogenesis, and metastasis back on the list of functions inhibited by oncosuppressor genes in lung and perhaps other organs."
More information
The U.S. National Cancer Institute has more information on non-small-cell lung cancer.
Early screening spots vision problems in infants
By Charnicia Huggins
Reuters Health
Thursday, June 22, 2006
One out of every 20 infants may be at risk for abnormal vision, according to the American Optometric Association's InfantSEE program.
The findings, presented Thursday during the association's annual meeting in
"It is very important that (parents) think about having an eye doctor involved in their baby's life ... as a complement to wellness check-ups," Dr. Scott Jens told Reuters Health. Jens is chair of the AOA's InfantSEE Committee and a private practice optometrist.
To date, nearly 50,000 babies have been screened by optometrists via the InfantSEE program, a partnership between the American Optometric Association and The Vision Care
Previous researchers have reported that 1 in 25 children will develop strabismus, which increases their risk for amblyopia, or lazy eye, and that 1 in 30 children will be affected by amblyopia, which is one of the most common causes of vision loss among individuals under age 45.
Studies have shown that preventive screenings may reduce the occurrence of such vision problems. One example comes from the
The current review of 5,000 assessments conducted via InfantSEE further confirms the need for such screenings.
Participating optometrists found that one in 20 infants were at risk for an abnormal prescription status, such as evidence of nearsightedness or farsightedness. In addition, 1 in 14 babies had risk factors that generated overall concern among optometrists, who required these infants to be followed closely through their early stages of life or referred them to a specialist.
Overall, the assessments suggest that some of the infants may need glasses by the time they enter kindergarten or even earlier, according to Jens.
Optometrists measure the prescription status of adults by having them view letters through various lenses and then deciding which lens provides the best clarity. For babies, however, the process is very different.
"Babies don't necessarily know what they see," Jens said. He and his colleagues therefore use specialized tests and instruments, such as a retinoscope, which measures how light bounces out of the eye, to determine babies' prescription status.
Without such specialized screenings, which are performed specifically by eyecare professionals - optometrists and ophthalmologists - and not by family physicians, most prescription-related issues are not caught until years later, Jens said, particularly if the infant's vision problems do not affect crawling or walking.
The InfantSEE program is not geared toward providing treatment to infants, however. Instead, the program aims to find at-risk infants, "those kids that will need that intervention by age 5," Jens said.
To learn more about the InfantSEE program, or to find a participating optometrist in your area, visit www.infantsee.org or call 1-888-396-eyes.
Cigarette Smoke Makes Allergy Symptoms Worse
HealthDay Reporter
Thursday, June 22, 2006
THURSDAY, June 22 (HealthDay News) -- People allergic to typical triggers such as ragweed may be especially bothered by cigarette smoke, a new study says.
Researchers at the
After the rinsing, patients were exposed to either secondhand cigarette smoke or smoke-free air, and their nasal passages were then rinsed and studied again. The process was repeated with exposure to ragweed and uncontaminated air, and fluids were again examined.
At the four-day point, levels of IgE had risen 16.6 times higher in patients exposed to ragweed plus cigarette smoke, as compared to those only exposed to ragweed and clean air. Histamine levels were also 3.3 times higher in participants who breathed the ragweed and smoke.
The results suggest that people with allergies are especially affected by cigarette smoke and should avoid smoking, the research team said. They should also reduce their exposure to secondhand smoke.
More information
The Asthma and Allergy Foundation has more information on allergies and smoking.
New imaging technology improves cancer detection
By Jon Hurdle
Reuters
Thursday, June 22, 2006
New imaging technology that combines the power of CAT scans with the finesse of a PET scan can catch cancer and other diseases earlier, potentially boosting survival rates and cutting costs, researchers said on Wednesday.
The two types of scan are commonly used separately but the team at the
The CAT, or computer assisted tomography, scan uses a special barrage of X-rays to see through tissue while the PET, or positron emission tomography, scan can detect the kinds of metabolic changes associated with tumor growth.
"We can use this PET/CAT to check for early indications of cancer or to see if the cancer has spread," said Dr. Laurie Loevner, a neuroradiologist at the Hospital of the
Once a patient has been injected with a radioactive isotope, the new technology allows doctors to measure to within half a billionth of a second the time difference in the detection of two gamma rays coming from the isotope. That allows for more accurate identification of the site of a lesion and a better image of any possible tumor.
At a news conference, Loevner cited the example of a patient who previously had cancer but was not clinically suspected of having a recurrence, and had only very mild symptoms of continuing illness. The new technology discovered that the patient's cancer had indeed come back.
The technology is particularly valuable for obese patients -- a growing sector of the population -- whose body size makes detection and diagnosis of tumors difficult. Although mostly used with cancer patients, it also has applications in the fields of cardiology and neurology, doctors said.
The technology has been in experimental use at the Hospital of the
Launched this month by maker Philips Medical Systems, a unit of Philips Electronics NV ,it is now also in use at Montefiore Medical Center in New York, and the University Hospital of Cleveland, Ohio, as well as in Europe and Japan.
Each unit costs about $2 million, a price that is expected to come down as its use spreads, said Dr. Joel Karp, a professor of radiology. He said the technology has the potential to reduce medical costs by eliminating the need for exploratory surgery or other treatment that turns out to be unnecessary.
Wednesday, June 21, 2006
Potassium-enriched salt may cut heart risks
By Amy Norton
Reuters Health
Wednesday, June 21, 2006
Replacing regular salt with a potassium-fortified alternative may help lower older adults' risk of dying from cardiovascular disease, new research suggests.
In a study of nearly 2,000 elderly Taiwanese men, researchers found that those given a potassium-enriched salt substitute were 40 percent less likely to die of heart disease or stroke over the next two to three years.
The salt alternative, which was half sodium chloride, half potassium chloride, helped the men make a moderate cut in their sodium intake and a substantial increase in their potassium consumption.
This potassium boost may have been largely responsible for the lower risk of cardiovascular death, the researchers conclude in the American Journal of Clinical Nutrition.
Like sodium, potassium is an electrolyte needed for maintaining the body's fluid balance. It's also involved in proper nerve and muscle control, as well as blood pressure regulation. A number of studies have suggested that diets high in potassium -- from foods like raisins, bananas, melon, beans and potatoes -- may help maintain a healthy blood pressure.
The new findings suggest the mineral may also help lower the risk of dying from heart disease or stroke -- possibly by protecting blood vessel function, according to study co-author Dr. Wen-Harn Pan, a researcher at the
While the study looked at a potassium-enriched salt, Pan told Reuters Health she suspects that a diet high in potassium-rich fruits and vegetables could be even more beneficial.
The study included 1,981 elderly men who were residents of a veterans' retirement home. Half of the men were randomly assigned to eat meals prepared with the potassium-enriched salt, while the rest had meals made with regular salt.
Over the next 30 months, the researchers found, men given the salt alternative were 40 percent less likely to die of cardiovascular disease.
The findings are in line with general nutrition advice for controlling blood pressure and lowering heart risks: eat more fresh fruits and vegetables, beans and low-fat dairy, while limiting salty processed foods.
An advantage of whole-food sources of potassium is that they contain other nutrients important to overall health, Pan noted. Still, potassium-enriched salt offers a "convenient and fast way" to alter the diet's sodium-potassium ratio, she added.
It is possible, however, for the body's potassium levels to get too high, particularly in older people who have kidney dysfunction or are taking certain medications -- including blood pressure drugs called ACE inhibitors.
Older adults should check with their doctors before using potassium-enriched salt substitutes or potassium supplements.
Source: American Journal of Clinical Nutrition, June 2006.
HealthDay Reporter
Wednesday, June 21, 2006
(HealthDay News) -- Food poisoning often occurs after eating a meal in a large, social setting like a picnic, cookout or cafeteria. According to the U.S. National Library of Medicine, foods in these settings are often prepared early and can be left unrefrigerated for long periods, allowing bacteria to form on the food.
Food poisoning symptoms typically begin within two to six hours after eating contaminated food. Signs of food poisoning are most often vomiting, fever, chills, headache, bloody diarrhea, weakness, and severe abdominal cramps.
Treatment from a doctor is rarely necessary, unless dehydration occurs, says the NLM. To prevent dehydration, drink plenty of fluids, but avoid milk or drinks with caffeine. You should also avoid solid foods while severely nauseated. Antibiotics usually aren't needed.
Being fired from work could be fatal: study
Reuters
Wednesday, June 21, 2006
Being fired is not just bad news, it could be fatal -- especially if the individual is middle aged, according to a study published on Wednesday.
Among a sample of 4,301 people aged between 51 and 61, the study found the incidence of heart attack and stroke among those who had lost their jobs was more than double that in those still working.
"For many individuals, late career job loss is an exceptionally stressful experience with the potential for provoking numerous undesirable outcomes including cardiovascular and cerebrovascular events (heart attacks and strokes)," the researchers wrote in the journal Occupational and Environmental Medicine.
"Based on our results, the true costs of unemployment exceed the obvious economic costs and include substantial health consequences as well," wrote the team led by William Gallo of Yale School of Medicine.
Health Tip: Swimmer's Ear Not Just From Pools
HealthDay Reporter
Wednesday, June 21, 2006
(HealthDay News) -- Swimmer's ear is an infection in the ear canal triggered by excess moisture. Water can gather in the ear after swimming, but it can also come from taking a bath or shower.
While water itself can cause the deterioration of tissue that leads to the infection, there are other factors that can cause damage, the Nemours Foundation says. These factors include scratching the ear canal, rough scrubbing with a Q-tip inside the ear, and inserting sharp objects in the ear canal.
Symptoms of otitis externa, as swimmer's ear is also called, include pain or itching inside the ear, swelling, discharge from the ear, and pain when chewing. Oral antibiotics or antibiotic eardrops are typically used to clear the infection. An over-the-counter pain reliever can help alleviate discomfort.
To prevent the infection in people who are prone to them, the foundation recommends using over-the-counter eardrops of a dilute solution of acetic acid or alcohol after swimming, long showers, or baths.
A shower cap or swimmer's ear plugs can protect the ear canals from getting too wet in the first place.
Drug, blood provide clues to healthy aging
By Maggie Fox
Health and Science Correspondent
Reuters
Wednesday, June 21, 2006
An experimental drug designed to kick-start growth hormones in humans shows signs of helping the elderly age without becoming too frail, researchers reported on Wednesday, while another team found clues to healthy longevity in the blood of 100-year-old women.
The reports, presented to a meeting of the International Congress of Neuroendocrinology, gave a snapshot of some of the progress in the growing field of aging research.
By 2010, census experts predict more than 40 million people will be over age 60 in the
"Some people age quite successfully and can live to very old ages with relatively little impairment, and other people do not age as successfully, and the question is why," Robert Gibbs of the University of Pittsburgh School of Pharmacy told a news conference.
Dr. George Merriam of the University of Washington/VA Puget Sound Health Care System and colleagues tested Pfizer's experimental drug capromorelin in 395 men and women aged 65 to 84. All were frail in some way, having fallen or lost grip strength or having slowed down in walking.
Capromorelin is a growth hormone stimulator. It causes the body to secrete human growth hormone in a way seen at puberty and in young adulthood.
In young adults, those pulses of growth hormone are associated with a buildup of lean muscle mass and strength, and elderly people have much lower levels of the hormone -- and less lean muscle mass.
Patients who got the drug gained an average of 3 pounds (1.4 kg) in lean muscle mass after six months, and also were better able to walk a straight line -- a test of balance, strength and coordination.
A year later, they also showed an improvement in stair climbing, Merriam told the meeting at the
He said Merck and Co. was working on a similar drug.
Staying Independent
"Drugs in this category have the promise of improving physical function ... thereby prolonging older people's ability to continue to live independently," Merriam told reporters.
It would not be easy to license such a drug, he cautioned.
"It is very difficult to get a drug for normal aging on the market, because the FDA (the U.S. Food and Drug Administration) does not consider aging to be a disease and sets the bar extremely high," Merriam said.
A study by Polish researchers suggested other routes of research.
Dr. Agnieszka Baranowska-Bik and colleagues at the
The women aged over 100 had measurably higher levels in their blood of adiponectin, a protein produced by fat tissue, Baranowska-Bik told the meeting.
"We found that our centenarian women were healthier than other elderly women," she told the news conference. They had lower cholesterol and better control of blood sugar -- a measure of tendency to diabetes, she said.
They were also healthier than the much younger but overweight women.
It is not clear if the women's adiponectin was a cause or effect of healthier lifestyle. The protein counteracts inflammation, which is linked with disease, helps keep vessels clear of fatty deposits and plays an important role in metabolism.
Tuesday, June 20, 2006
Health Tip: Kids Need to Behave Around Dogs
HealthDay Reporter
Tuesday, June 20, 2006
(HealthDay News) -- Although often labeled man's best friend, a dog's instinct may tell him to bite to protect himself around those he doesn't know -- especially excitable children.
Here are a few tips from the U.S. Centers for Disease Control and Prevention on how to keep your children from provoking dogs:
Stay away from dogs you don't know. Children should never run up to pet a strange dog, no matter how friendly it looks. Never approach any dog -- even a dog you know -- who is eating, sleeping, or with its puppies. Do not run and scream around a dog. Be still if an unfamiliar dog approaches you, and let it sniff you and see you before you try to walk away. If a child is playing with a dog, make sure an adult is around to supervise.
Heart recommendations emphasize calories, exercise
Reuters Health
Tuesday, June 20, 2006
The American Heart Association on Monday released new lifestyle recommendations that urge Americans to cut calories and artery-clogging fats, and to replace "screen time" with exercise.
The advice differs from the AHA's previous recommendations, issued in 2000, in several ways. The group now urges Americans to cut their intake of cholesterol-raising saturated fat and trans fats even further, but eschews the old advice to limit total fat intake to less than 30 percent of daily calories as a way to lose weight.
Instead, the new recommendations emphasize the importance of eating nutritious foods and balancing calories taken in with calories burned.
To reach that goal, the AHA says, adults and children need to eat more lower-calorie, nutrient-rich foods -- including fruits and vegetables, whole grains, beans, low-fat dairy and fish. They also need to spend less time in front of the TV or computer to make room for at least 30 minutes of exercise a day.
Recognizing that weight-loss diets so often fail in the long run, the group is urging people to follow a healthy diet and lifestyle that at least prevents further weight gain.
Quitting or never starting to smoke is also vital to heart health, the AHA says, while certain dietary supplements -- namely, fish oil and plant sterols -- may be helpful for people with elevated cholesterol or triglycerides.
"The key message of the recommendations is to focus on long-term, permanent changes in how we eat and live," Dr. Alice H. Lichtenstein, chair of the AHA nutrition committee that wrote the new guidance, said in a statement.
The recommendations, published online by the AHA journal Circulation, now call on Americans to get less than 7 percent of their calories from saturated fat, down from the previous 10 percent recommendation. And for the first time, there's a specific cap on trans fat intake -- less than 1 percent.
Both saturated and trans fats can raise levels of "bad" LDL cholesterol, and thereby contribute to heart disease. Saturated fat comes mainly from animal products, and the AHA urges Americans to choose lean cuts of meat or opt for fish or vegetarian meat substitutes.
Trans fats are found in many commercially baked and fried foods, including crackers, cookies, pastries, French fries and breads.
Gone from the AHA recommendations, however, is the advice to limit total fat intake as a way to lose weight. Instead, the group advises people to cut calories by limiting their portion sizes and choosing lower-calorie foods like fruits, vegetables and fiber-rich grains.
Given the potential heart benefits of fish oils, the AHA also says people should strive for at least two weekly servings of fatty fish, such as salmon and tuna.
The group also calls on food manufacturers and restaurants to cut down on sugar, salt and portion sizes, and on local governments to encourage exercise by providing more sidewalks, parks and other safe areas for people to walk and bike.
Source: Circulation, online June 19, 2006.
Cherry Juice May Ease Muscle Pain
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) -- Drinking cherry juice after exercise may reduce muscle strain-linked pain, according to the results of a small industry-funded study.
Researchers at the
Exercises consisted of arm muscles that were flexed and tensed 20 times in only one arm. After two weeks, the process was repeated, with participants who previously drank cherry juice -- which contained the juice from about 50-60 cherries -- switching to the other drink mixture and vice-versa. The arm muscle exercised was also switched.
The participants were asked to identify the pain and soreness in their muscles on scale of one to 10, and the researchers also analyzed muscle strength and range of motion.
Participants who drank the other juice mixture experienced a 22 percent loss in muscle strength, while those who drank the cherry juice mixture only lost 4 percent of their muscle strength. Their reported pain rating was also much lower, at 2.4 percent compared to 3.2 percent for those who drank the other juice. After 96 hours, the cherry-juice drinkers even gained some muscle strength.
Results of the study, which was funded by Cherrypharm Inc., of
More information
The Mayo Clinic has more about muscle soreness.
Heart risks similar for blacks and whites
Reuters Health
Tuesday, June 20, 2006
When it comes to the likelihood of dying from cardiovascular disease (CVD), the factors that increase that risk are similar for blacks and whites -- although small differences exist -- according to a new report.
"To our knowledge, this is the first black-white comparison study conducted exclusively in an employed population," note Dr. Mercedes R. Carnethon and colleagues from
"By studying an employed cohort, we were able to better account for socioeconomic differences between race groups compared with previous studies," the researchers explain.
Their analysis involved 3741 black and 33,246 white men and women who were enrolled in the Chicago Heart Association Detection Project in Industry study. The subjects were between 18 and 64 years of age and had not had a heart attack when they joined the study in 1967-1973.
They were followed through 2002. A total of 107 black women, 1586 white women, 177 black men, and 2866 white men died from cardiovascular causes during follow-up.
In general, the magnitude of the association between CVD death and traditional risk factors, such as smoking and diabetes, was comparable for the two racial groups.
Notable exceptions included a higher risk of CVD death with increasing blood pressure for white women compared with black women, and with high cholesterol in white men but not black men.
"This investigation provides evidence that the association between traditional risk factors and CVD mortality is generally similar in black and white men and women," the researchers conclude.
Source: Archives of Internal Medicine, June 12, 2006.
Heart Drugs May Help Shield Brain Cells From Stroke
By Randy Dotinga
HealthDay Reporter
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) -- New laboratory research suggests that digoxin and digitoxin, two widely used heart drugs, could protect the brain from damage during a stroke.
The findings are preliminary, and scientists have only tested the drugs on the brain cells of rats. However, confirming the drugs' effects in human trials could lead to a powerful new weapon against stroke, the researchers said.
Despite billions of dollars spent on research, "not a single stroke drug has come out that protects neurons from the damage caused by stroke. There's this amazingly huge need for a protective drug," noted senior researcher Donald Lo, director of the Center for Drug Discovery at
According to the American Heart Association, more than 700,000 Americans are diagnosed with stroke each year, with stroke rehabilitation costs topping $50 billion annually.
In search of a new stroke treatment, Lo and colleagues tested thousands of existing drugs by injecting them into dishes containing slices of rat brains. Because scientists can simulate the effects of stroke in brain cells, they can save money by not having to test the drugs on live rats.
Nearly all the drugs tested failed to prevent neurons from dying. But a chemical found in digoxin and digitoxin worked, according to the study, which is published in this week's issue of the Proceedings of the National Academy of Sciences.
The chemical, known as neriifolin, protected the cells of the brain slices from damage for six hours or more, the researchers reported. The chemical -- one of a class of molecules called cardiac glycosides -- also appeared to prevent brain damage in live rats.
Currently, no drug has been shown to directly protect sensitive neurons during a stroke, said Lo, who is also an associate professor of neurobiology at Duke. One commonly well-known stroke drug, tissue plasminogen activator, or tPA, is a "clot buster" that breaks open blockages in blood vessels. But tPA only works if given within a few hours after a stroke.
Digoxin is a common heart drug used to treat heart failure and atrial fibrillation, a kind of irregular heartbeat. Digitoxin is also used to treat heart problems, but it's used less now than in the past, Lo said.
"The most exciting outcome would be if digoxin itself could be used in treatment of stroke," Lo said. "But there are a lot more studies that need to be done before that is tested in humans."
Another expert agreed that a pinch of caution is warranted.
"Lots of agents have been found useful as neuroprotectants in mice and rats and did not pan out to work in people for various reasons," said Dr. Rafael H. Llinas, medical director of neurology at
Still, it's possible that a treatment might be able to protect the brain from the effects of a stroke, or "at least prolong the period when the brain is able to tolerate not getting enough oxygen, blood and energy," he said.
Llinas noted, for example, that some people survive being trapped under the ice in a frozen lake for a significant period of time. "Then, when they are removed and resuscitated, they are neurologically intact."
Currently, he said, researchers are trying to develop a treatment that both protects the brain, perhaps by slowing its function, but doesn't put the heart in danger.
More information
Learn more about stroke from the American Stroke Association.
Painkillers may pose risk after heart attack
Reuters Health
Tuesday, June 20, 2006
Among people who have survived a heart attack, taking certain types of painkillers is associated with an increased risk of a repeat heart attack or death, investigators in
The elevated risks apply not only to COX-2 inhibitors (which include drugs like Vioxx) but also so-called nonselective nonsteroidal anti-inflammatory agents (NSAIDs) like ibuprofen or diclofenac.
"Patients who have already suffered a heart attack appear be more vulnerable to the harmful effect of these medications," said Dr. Gunnar H. Gislason said in press release from the American Heart Association.
Gislason, from the
They then mined the Danish Registry of Medicinal Product Statistics for information regarding prescriptions of NSAIDs as well as selective COX-2 inhibitors, their dosages, and how long they were prescribed.
During follow-up, 9773 of the patients had another heart attack and 16,561 died, the team reports in the American Heart Association's journal Circulation.
Taking a low dose of a COX-2 inhibitor was tied to an approximate doubling of the risk of dying and about a 50 percent increase in the chances of having another heart attack. At higher doses, mortality risk was increased five-fold.
With high daily doses of NSAIDs, the likelihood of dying was doubled or quadrupled depending on the specific drug, and the risk of another heart attack went up 22 to 89 percent.
Given the results from this and other studies, Gislason's team writes, "COX-2 inhibitors and nonselective NSAIDS should be used with particular caution in patients with a prior (heart attack)."
Source: Circulation, online June 19, 2006.
Older Women Not Getting Needed Mammograms
By Amanda Gardner
HealthDay Reporter
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) -- Older American women are not getting as many mammograms as they say -- or think -- they are, new research finds. The study also found that black, Asian-American and Hispanic women are receiving even fewer screenings than white women.
While experts say it's no surprise that women remember having more mammograms than they actually do, the findings do have troubling policy implications.
"When we are making policy decisions [on breast-cancer screening], simply asking people is not enough," said Dr. Christopher Kagay, lead author of the study and a radiology resident at
Annual mammograms to detect possible tumors are recommended for women aged 40 and over. Breast cancer is the second leading cancer killer among women in the
Overall, breast-cancer screening rates have risen over the past 15 years, but they have dipped during the last five.
For the new study, which appears in the August issue of the American Journal of Preventive Medicine, the investigators analyzed Medicare claims data on 146,669 women in 11 metropolitan areas around the country. These statistics were then compared with what the women themselves had reported.
Seventy percent to 80 percent of women aged 65 to 69 reported getting at least one mammogram every two years. But the data showed that only 61.1 percent of the women actually received regular screening, with the lowest rates among black, Asian-American and Hispanic women.
Overall, the biennial screening rate in 2000-2001 was 50.6 percent for non-Hispanic white women, 40.5 percent for black women, 34.7 percent for Asian-American women, 36.3 percent for Hispanic women and only 12.5 percent for Native-American women.
According to Dr. Alan Astrow, director of hematology/oncology at Maimonides Medical Center in New York City, it's not unusual for patients to think they are taking better care of themselves than they actually are, whether it's pills, screening or other procedures. One possible limitation of this study, he added, is that the researchers can't be sure that the Medicare claims data and the ensuing analysis tell the full story.
But for Kagay, the results point up the need to keep hammering home awareness and education messages regarding breast-cancer screening.
"The data is important for people who are basically interested in asking, 'Are we meeting our goals for getting elderly women screened?' And that can range from an individual doctor evaluating his own practice patterns to a policy maker trying to allocate money for public-health resources," Kagay said.
More information
For more on breast cancer, head to the American Cancer Society.
Whole grain-rich diet may reduce gum disease risk
By Charnicia E. Huggins
Reuters Health
Tuesday, June 20, 2006
Eating lots of whole grains may do more than lower a person's risk of developing diabetes or heart disease, as has been previously reported. New study findings suggest a diet rich in whole grains may lower the likelihood of developing periodontitis, or gum disease, as well.
"A diet that is beneficial for general health is also good for oral health," study co-author Dr. Anwar T. Merchant, of
Diabetes and high levels of blood sugar are known to increase a person's risk and severity of periodontitis, while whole grains and fiber have been shown to improve ability to process blood sugar. Yet, whether whole grain consumption is associated with a lower risk of periodontitis had not previously been studied.
To investigate, Merchant and colleagues followed over 34,000 men from the Health Professionals Follow-Up study, gathering information about the men's diet every four years via a food-frequency questionnaire. None of the study participants, who were aged 40-75 years at the start of the study, had a history of periodontitis, heart attack, high cholesterol or diabetes.
Over a 14-year period, 1,897 men were diagnosed with periodontitis, or inflammation of the gums that also involves bone.
Those who reported eating the most brown rice, dark breads, popcorn and other whole grains (about three servings per day) were 23 percent less likely to develop periodontitis than those who reported eating less than one daily serving of whole grains, Merchant and colleagues report in this month's American Journal of Clinical Nutrition.
In other findings, men who reported eating more whole grains were older, more physically active, less likely to smoke, and of lower weight for their height than those who reported the lowest whole grain consumption. They also reported eating more fruits, vegetables and nuts than their counterparts, study findings indicate. After taking all these factors into consideration, however, higher consumption of whole grains was still associated with a lower risk of periodontitis, the report indicates.
According to Merchant, "the likely mechanism is as follows: Whole grain intake improves glucose metabolism, resulting in lower levels of blood glucose. Lower blood glucose levels are reported to reduce the risk of periodontitis in diabetics. Lower blood glucose levels -- resulting from consuming whole grains -- may reduce the risk of periodontitis in non-diabetics as well."
The findings suggest that, without consuming more calories, three or four servings of whole grains -- equal to three or four slices of whole wheat bread, for example -- "may be optimal to reduce periodontitis risk," Merchant told Reuters Health.
Source: American Journal of Clinical Nutrition, June 2006.
Treatment Order Won't Affect Aggressive Breast Cancer Survival
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) -- Switching the order in which treatments were administered did not improve survival for patients with aggressive inflammatory breast cancer, a new study found.
Inflammatory breast cancer affects about 2.5 in every 100,000 women and is characterized by rapid tumor growth and earlier metastasis (spread). Doctors treating this cancer often combine surgery, chemotherapy, radiation and hormone therapy to battle the disease.
Recent studies have suggested that the order in which these therapies are given might impact patient survival.
In this study, researchers at the Mayo Clinic studied the medical records of 128 patients with inflammatory breast cancer treated at the clinic between 1985 and 2003. Average patient age was 53, and 57 percent of women studied were post-menopausal. The study excluded any women whose cancer had metastasized at the time of their first visit to the clinic.
Chemotherapy was the first line of treatment in 83 percent of the patients, while surgery was performed first on another 17 percent.
Within five years of treatment, survival rates were 42 percent, with 21 percent surviving with no signs of cancer.
After all factors were considered and calculated, the researchers did not find a greater likelihood of survival by having either surgery or chemotherapy as an initial treatment.
"Although the combined-modality regimen clearly provides the best outcome for patients with inflammatory breast cancer, further research is necessary to delineate subsets of patients who may benefit from alterations in the approach to improve survival from this aggressive disease," the researchers said in a prepared statement.
The findings appear in the June issue of Archives of Surgery.
More information
To read more about inflammatory breast cancer, head to the Inflammatory Breast Cancer Association.
Parental smoking still a threat to kids' lungs
By Anne Harding
Reuters Health
Tuesday, June 20, 2006
A new international study of more than 20,000 children confirms that exposure to cigarette smoke before and after birth impairs their lung function, and that parental smoking remains a serious public health issue.
The effects of smoking during pregnancy last up to age 12, while exposure to cigarette smoking after birth further worsens lung function, Dr. Manfred A. Neuberger of the
It is difficult to tell, Neuberger noted, whether the impairment of lung function resulting from prenatal and early life exposure is permanent, given that many individuals with parents and siblings who smoke will have started smoking themselves by their teen years.
The researchers analyzed results from a subset of children who had participated in the Pollution and the Young Study, including a total of 22,712 children from eight countries. The findings appear in the American Journal of Respiratory and Critical Care Medicine.
Children whose mothers smoked during pregnancy were 31 percent to 40 percent more likely to have poor lung function than children born to non-smokers, the researchers found. Early-life exposure independently increased risk of poor lung function to a lesser degree, by 24 percent to 27 percent.
Sixty percent of the children in the study had been exposed to cigarette smoke before birth or in early life, the researchers found. "Considering the high number of exposed children, this indicates that both environmental tobacco smoke exposure and smoking during pregnancy remain a severe public health problem," Neuberger and his team conclude.
The findings are a "stark reminder" that legal efforts to reduce exposure to cigarette smoke in workplaces aren't protecting the group of people at greatest risk from passive smoking, young children, Drs. Mark D. Eisner of the University of California, San Francisco and Francesco Forastiere of the Rome E Health Authority in Italy write in an editorial accompanying the study.
"Children are primarily exposed to tobacco smoke in the home, where legal restrictions do not apply," they note.
Source: American Journal of Respiratory and Critical Care Medicine, June 2006.
Most Lung Disease Patients Don't Get 'Ideal' Care
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) --
COPD includes serious, sometimes fatal, respiratory illnesses such as chronic bronchitis and emphysema.
According to guidelines from the
The study in the June 20 Annals of Internal Medicine found that of almost 70,000 hospitalized patients with COPD, only one-third received that level of ideal care.
Researchers noted a drastic difference in level of care at each of the hospitals studied. At some hospitals, fewer than 10 percent of patients were given ideal care, while more than 60 percent of patients at other hospitals received ideal care.
The study indicates the need for higher utilization of recommended tests and treatments for patients with COPD and eliminating unnecessary ones. This would improve the level of care across health care institutions, the authors noted.
More information
For more on COPD, head to the American Lung Association.
Lower is better for diabetics' bad cholesterol
Reuters Health
Tuesday, June 20, 2006
Lowering LDL ("bad") cholesterol levels substantially below currently recommended levels significantly reduces the chances that people with diabetes and heart disease will suffer a stroke or heart attack, researchers report.
Previously, a study showed that intensive cholesterol-lowering using the statin drug Lipitor at 80 milligrams per day rather than at 10 milligrams per day increased clinical benefits for patients with stable coronary disease, Dr. James Shepherd of the Royal Infirmary,
For the current analysis, the researchers looked at a subgroup of 1500 patients from this study who also had diabetes to see if they too benefited from a higher statin dose.
The subjects already had LDL cholesterol levels below 130 before starting the trial. Recently, the target LDL for such patients has been set at less than 100, the researchers explain.
They found that, after nearly five years, the average LDL cholesterol level was 99 in the low-dose group and 77 in the high-dose group.
Major cardiovascular events -- that is, death, stroke, heart attack or cardiac arrest -- occurred in 135 (17.9 percent) of the low-dose group and 103 (13.8 percent) of the high-dose group, amounting to a 25 percent reduction.
Pending a definitive clinical trial, the investigators conclude that the use of high-dose statins may be appropriate for patients with heart disease and diabetes, regardless of factors such as age and blood sugar control.
Source: Diabetes Care, June 2006.
Pricey Heart Procedure Best for Younger Patients
HealthDay Reporter
Tuesday, June 20, 2006
TUESDAY, June 20 (HealthDay News) -- A treatment known as "left atrial catheter ablation" (LACA) that regulates irregular heartbeats may be a great benefit to some patients -- but at a high price, new research shows.
LACA is an effective treatment for atrial fibrillation, according to researchers at the University of Michigan Cardiovascular Center and the VA Ann Arbor Healthcare System. The procedure sends radiofrequency energy to stabilize the heartbeat, stopping the electrical circuits that cause the heart to beat irregularly.
The team calculated LACA's effectiveness using an advanced computer model. They concluded that the treatment was most successful and cost effective in patients around 55 years old who are at a high risk for stroke.
"Before LACA is more generally adopted as a treatment option, it's important to ask from a societal perspective if it's cost effective, and under what conditions," study author Dr. Paul Chan, a fellow in cardiovascular medicine at the
The computer model calculated outcomes by accounting for anticipated life expectancy, cost of the procedure and potential complications, lifetime cost of drugs to treat the condition, drugs patients should be taking, potential care-giving costs, and estimated stroke risk.
Reporting in the Journal of the
The researchers estimated the cost would total $28,700 per quality-adjusted life year in 55-year-old patients with additional risk factors for stroke beyond atrial fibrillation, meaning it was a cost-effective intervention in this group.
However, in the same group of patients aged 65 years old, the cost totaled $51,800.
According to Chan, "LACA doesn't have to have as big an impact on stroke risk to be cost effective for younger patients, because the benefits appreciate over their lifetime."
More information
For more on atrial fibrillation, head to the American Heart Association.
Monday, June 19, 2006
Kids with type 1 diabetes often depressed
Reuters Health
Monday, June 19, 2006
Symptom of depression are common among children and adolescents with type 1 diabetes, according to researchers from
Dr. Lori M. B. Laffel and colleagues conducted a study with 145 such youngsters, who had had diabetes for an average of eight years, and their parents.
The researchers used a 27-item self-report questionnaire to assess depressive symptoms, which was completed by the children as well as by the parents with regard to their children.
The investigators also used other questionnaires to measure family conflict specifically related to diabetes management, to assess emotional responses to the children's high and low blood glucose values, and to determine the parents' perceived burden related to diabetes care.
As reported in the medical journal Diabetes Care, Laffel's team found that 15.2 percent of the young diabetics had symptoms of depression, which was also tied to poorer control of blood sugar levels.
Higher levels of diabetes-specific family conflict, whether reported by parents or children, were associated with higher depression scores, say the researchers.
They suggest that doctors should pay close attention to the emotional state of children with diabetes, as well as their family situation, to promote optimal diabetes management for these children.
Source: Diabetes Care, June 2006.
New Type 2 Diabetes Cases Have Doubled in 30 Years
By Steven Reinberg
HealthDay Reporter
HealthDay Reporter
Monday, June 19, 2006
MONDAY, June 19 (HealthDay News) -- The number of new cases of type 2 diabetes among middle-aged Americans has doubled over the past 30 years, researchers report.
"There has been tremendous concern, but probably not enough concern, about the emerging epidemic of diabetes," said Dr. Robert Rizza, a professor of medicine at the Mayo Clinic and president of the American Diabetes Association. "It doesn't take long to be doubling before the numbers are simply too great to be even conceived of."
"We've got to stop this, and, of course, it's obesity which is driving it," Rizza added. "This is a biologic weapon which has been unleashed on our population -- its name is diabetes."
Experts agree that the great increase in obesity over the same time frame appears to be responsible for the growing incidence of diabetes. An estimated two-thirds of adult Americans are now overweight or obese.
"These [diabetes numbers] warrant monitoring, especially if we continue to see increases in the trends of obesity," said study lead author Dr. Caroline S. Fox, a medical officer at the National Heart, Lung, and Blood Institute's Framingham Heart Study.
The study findings appear in the June 19 issue of the journal Circulation.
In type 2 diabetes, the body either doesn't produce enough insulin -- the hormone that converts blood sugar to energy for cells -- or the cells ignore the insulin. Left untreated, the disease can produce complications such as heart disease, blindness, nerve and kidney damage.
In their study, Fox and her colleagues collected data on 3,104 men and women, ages 40 to 55, who participated in the Framingham Offspring study. All participants were diabetes-free at the start of the study, and they received a routine physical examination during the 1970s, the 1980s, and the 1990s. They were also followed for eight years to track new cases of diabetes.
The researchers found that the odds of developing type 2 diabetes increased 40 percent from the 1970s to the '80s, and doubled between the '70s and '90s. The data revealed that among women, there was an 84 percent increase in the incidence of type 2 diabetes in the '90s, compared with the '70s. In men, the incidence of type 2 diabetes more than doubled in the '90s compared with the '70s.
This trend must be reversed to avoid serious repercussions for the
"It requires a concerted effort by our health-care system, by our government, by all parts of society to realize that this epidemic is endangering not only all the people alive, but our children and our children's children," Rizza said. "Our health-care system and our nation's economy cannot tolerate one in three people having diabetes."
One expert thinks the only way to correct the problem is by making a total lifestyle change.
"This epidemic results, almost entirely, from obesity and sedentary behavior," said Cathy Nonas, director of the obesity and diabetes program at North General Hospital, in New York City, and a spokeswoman for the American Dietetic Association.
"The more sedentary we are, the fatter we get, the more insulin resistance we get, the more at risk we are for type 2 diabetes," Nonas said. "We have to maintain healthier weights. We have to be active."
More information
To learn more, visit the American Diabetes Association.
Heart Association urges trans fats limit
By Marilynn Marchione
AP Medical Writer
The Associated Press Writer
Monday, June 19, 2006
The American Heart Association has become the first big health group to urge a specific limit on trans fats in the diet — less than 1 percent of total calories — in new guidelines released Monday.
Also for the first time, the organization's dietary guidelines include lifestyle recommendations, including an emphasis on getting exercise and not smoking.
A panel of specialists in nutrition and heart disease reviewed more than 90 studies to update the dietary advice the association released in 2000. The guidelines are for healthy Americans ages 2 and older.
Rather than slavishly counting calories and grams of fat, people should try something simpler: getting in the habit of cooking with healthier oils, and balancing calories consumed with calories burned through exercise, said Alice Lichtenstein, a
Trans fats, or trans fatty acids such as partially hydrogenated oils, are in many cookies, crackers, breads, cakes, French fries and other fried foods. They contribute to heart disease risk by raising LDL, or the bad cholesterol.
Avoiding them and keeping a healthy diet is challenging while eating out as much as Americans do, panel members noted.
Last week, a consumer group sued KFC to try to get the company to stop frying its chicken in trans fats, and other fast-food chains have been pressured to lower such fats as well.
"Total fat reduction alone is not the only answer. It is important what kind of fat you eat," said Linda Van Horn, a
Among the panel's other recommendations:
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Limiting saturated fats to no more than 7 percent of daily calories, down from the 10 percent formerly recommended and the 11 percent most Americans consume. Saturated fats are in meat and dairy products, and in coconut and palm oil.
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Getting at least half an hour of exercise a day.
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Eating fruits and vegetables (not fruit juices) that are deep in color, such as spinach, carrots, peaches and berries.
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Choosing whole-grain, high-fiber foods.
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Eating fish, especially oily fish like salmon and trout, at least twice a week. (Children and pregnant women should follow federal guidelines for avoiding mercury in fish.)
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Choosing lean meats and trying vegetable alternatives.
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Consuming fat-free and 1 percent fat milk and other dairy products.
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Minimizing calories from beverages and avoiding ones with added sugars.
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Adding little or no salt to foods.
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Drinking alcohol in moderation.
The guidelines were published in the association's journal Circulation. For a free brochure, visit http://www.americanheart.org or call 1-800-AHA-USA1.
Peanut Allergy Incidents Waning, But Still a Problem
HealthDay Reporter
Monday, June 19, 2006
MONDAY, June 19 (HealthDay News) -- The number of people with peanut allergy unwittingly eating peanut-laced products is going down, but more public education is still needed.
So concluded a team of researchers at McGill University Health Centre in
Reporting their findings online in the Journal of Allergy and Clinical Immunology, the researchers studied 252 Canadian children, ages 4-17, with diagnosed peanut allergies. The subjects answered a series of survey questions, including questions about any recent incidences of accidental peanut ingestion.
Of the 252 children studied, 29 said they had accidentally consumed peanuts a total of 35 times over 244 patient years. That translates to a little more than a 14 percent incidence rate per year -- a big drop from the 50 percent incidence rate published in the same journal in 1989, and a 55 percent rate found in a British study published in 2005.
Twelve of the 35 allergic reactions occurred when a food was clearly marked as containing peanuts, while 22 occurred when foods with undetected peanuts were consumed. Since
Children and parents need better education on preventing these reactions by learning how to look for peanut content in foods, the researchers concluded. They also recommended stricter regulations on food manufacturers and food labeling.
More information
Visit the Food Allergy and Anaphylaxis Network has more information about peanut allergies.
Teen obesity linked to heart abnormalities
By Will Boggs, MD
Reuters Health
Monday, June 19, 2006
Obesity in adolescence is associated with reduced heart function and excessive cardiac mass, according to a new study.
"Many of these kids will become hypertensive and the association of obesity with hypertension might be devastating," Dr. Giovanni de Simone from "Federico II" University Hospital School of Medicine,
The researcher and his colleagues in
Of the 460 participants, 113 were overweight and 223 were obese. Also, 110 had high-normal blood pressure and 27 had high blood pressure. Ten were diagnosed with diabetes, the team reports in the Journal of the
The size of the left ventricle, the main pumping chamber of the heart, was enlarged in the obese and overweight adolescents compared to the normal-weight adolescents, the findings indicate, and one third of the obese teenagers were classified as having an actual medical condition called left ventricular hypertrophy.
"Early intervention during childhood and adolescence to reduce the prevalence of obesity and prevent the transition from overweight to overt obesity might represent a crucial step," the investigators say, in order to avert the development of heart disease.
"Obesity has been recognized as an important risk factor that contributes to the development of many different disease states worldwide," write Dr. Stephan von Haehling from Imperial College School of Medicine,
"For young people with...established risk factors for future cardiovascular illness (like hypertension, hyperlipidemia or diabetes), it seems very likely that obesity confers a somewhat higher risk for death compared to people with normal weight," the editorialists conclude.
Source: Journal of the
Patients help fight cancer after death
By Lauran Neergaard
AP Medical Writer
The Associated Press Writer
Monday, June 19, 2006
Pancreatic cancer killed William Schunk. Now scientists are using his body to fight back. Within about an hour of his death, researchers at the University of Nebraska Medical Center began collecting the
"It probably should be called 'rapid organ donation,'" says Dr. Aaron Sasson, a pancreatic cancer surgeon who volunteers his time to help perform the autopsies. "These patients are really donating their bodies and organs to science."
Organs in the chest and abdomen are meticulously photographed, sliced and flash-frozen before genetic evidence starts to degrade. So are samples of skin, muscle, nerves, lymph nodes, blood and urine.
This tissue — 16,000 samples collected from Schunk and 10 others so far — holds vital clues to what causes pancreatic cancer, and what makes it march so aggressively through the body.
A fast autopsy is the only way to get at those clues. Pancreatic cancer is grimly different from breast cancer, for example, where surgically removed tumors are plentiful for research that can lead to new treatments.
Pancreatic cancer seldom is discovered in time to even attempt surgery. Not only is that devastating news for patients, it means frustration in the quest to improve the disease's bleak outcome.
"There isn't any tissue available, ever, for the researchers to study," says cancer professor Michael A. Hollingsworth, who runs
"Patients and their families are amazing, that they realize the importance of trying to do this," adds Christine Iacobuzio-Donahue, a pathologist at
Some 33,700 Americans will be diagnosed with pancreatic cancer this year, and 32,300 will die.
There is no early-detection test; early symptoms are vague complaints like indigestion. By the time the classic jaundice, or yellowing skin, and itching appears, the cancer usually has spread. Once that happens, patients typically have only months left to live.
Lack of early diagnosis explains only part of pancreatic cancer's lethality. Overall, less than 5 percent of patients live five years. But even when patients are caught early enough for the arduous surgery — removing parts of the pancreas, stomach, intestines and other organs — just 16 percent will survive that long.
Rapid autopsies have been used in other diseases, such as Alzheimer's and prostate cancer. But the Nebraska and Hopkins programs are generating intense new interest — because they answer an urgent call from a 2001 National Cancer Institute review for tissue banks to help overcome a dearth of research into pancreatic cancer.
One of the biggest questions: Why do some patients die with huge pancreatic tumors while others have tiny ones that prove equally as lethal by seeding themselves throughout the body?
At
The autopsy costs families nothing and doesn't interfere with normal funeral arrangements. Still, recruiting participants is a balancing act. Doctors don't want to deprive patients of hope, and gently broach the program for those who accept that they're terminally ill.
Schunk, a retired Air Force lieutenant colonel, had what Sasson calls a typical reaction. "He just said, 'If they can take anything that will help them identify a way to find this sooner, then I am 100 percent for it,'" recalls his daughter, Karen Sater.
Ardith Hopp of
"I'm not afraid of dying. It's going to happen to everybody," says Hopp, 62. "If there's something there they can use, I'm not going to need it anymore."
Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in
On the Net:
Info on pancreatic cancer resources: http://www.pancan.org
Vegetables may help arteries stay clear
By Amy Norton
Reuters Health
Monday, June 19, 2006
A healthy dose of vegetables every day may help keep the heart arteries clear, a study in mice suggests. Researchers found that lab mice given a diet full of broccoli, carrots, green beans, corn and peas developed far less artery narrowing than those reared on a veggie-free diet.
For humans, the findings offer more support for the advice health experts and mothers have long given: eat your vegetables.
Discounting French fries, most Americans aren't adequately heeding that advice, noted the study's lead author, Dr. Michael R. Adams of Wake Forest University School of Medicine in
The new research, he explained in an interview, adds to what's known about the health benefits of vegetables by showing that they may thwart the progression of atherosclerosis, a hardening and narrowing of arteries that can lead to heart disease and stroke.
Some studies have found that people who eat more vegetables tend to have fewer heart attacks, but studies such as those are not definitive. The current study, published in the Journal of Nutrition, appears to be the first to look at whether vegetable consumption can interfere with the process of atherosclerosis.
Adams and his colleagues studied mice that were genetically altered and bred to quickly develop the artery-clogging plaques that mark atherosclerosis. Starting at 6 weeks of age, half of the mice went on the veggie-rich diet -- with 30 percent of calories coming from freeze-dried vegetables -- while the other half followed a vegetable-free regimen.
Sixteen weeks later, the researchers found, the extent of atherosclerosis was 38 percent less in the vegetable-fed mice.
The animals also had somewhat lower cholesterol and much lower levels of a protein involved in inflammation -- which may help explain the clearer arteries, according to
Chronic inflammation in the blood vessels is believed to contribute to atherosclerosis, and research shows that plant compounds called polyphenols have both anti-inflammatory and antioxidant powers. Vegetables are also rich in vitamins that act as antioxidants, which means they neutralize cell-damaging molecules called oxygen free radicals.
The study focused on broccoli, green beans, peas, corn and carrots in part because they are among the most commonly consumed vegetables in the
General Mills Co., maker of the Green Giant brand of canned and frozen vegetables, funded the study.
Source: Journal of Nutrition, July/August 2006.
Health Tip: Too Much Caffeine?
HealthDay Reporter
Monday, June 19, 2006
(HealthDay News) -- Caffeine is found in everything from morning coffee or tea to lunchtime sodas and afternoon chocolate snacks. It's also found in certain pain medicines, including those taken for headaches.
According to the U.S. National Library of Medicine, caffeine stimulates the central nervous system. It can make you feel more alert, although some people may be particularly sensitive. A caffeine overdose can be caused by taking medications that contain the chemical, combined with too much in your diet.
Side effects from too much caffeine may include headaches, anxiety, nausea, vomiting, rapid heartbeat, irritability, shaking and high blood sugar. Some people may even have abdominal bleeding and diarrhea, the NLM says.
New breast cancer gene raises risk in Europeans
By Maggie Fox
Health and Science Correspondent
Reuters
Monday, June 19, 2006
Researchers have found another breast cancer gene that can greatly raise the risk of the disease in women of European heritage, according to a report published on Monday.
They said the gene worked in tandem with the well-known BRCA1 and BRCA2 genes to raise the risk of breast cancer by as much as 80 percent.
The team, at
The new gene is called BARD1, Decode's team reports in the online journal Public Library of Science Medicine.
"The BARD1 variant works together with the BRCA2 mutation in
And women with the BARD1 variant who develop breast cancer are more likely to have tumors in both breasts, Stefansson said.
Breast cancer is known to run in families and has a genetic component, although most cases occur in people with no family history of the disease. Several genes are known to be involved, including the BRCA1 and BRCA2 genes, p53 and others.
The known BRCA1 and BRCA2 mutations only account for about 3 percent of all cases of the disease.
The Decode team is trying to find other genes that work with these genes.
They found 1,090 women in
A certain BARD1 mutation was found in 5.4 percent of breast cancer patients and 3.1 percent of women who did not have breast cancer -- an 80 percent increase in risk, the researchers said.
Simply having the BARD1 mutation was not especially dangerous to a woman, but women who had it and a specific mutation on BRCA2 had a "dramatic" risk of breast cancer, the researchers found.
It may be worth developing a test for that particular combination, the researchers and the company said.
This BARD1 mutation has been found in Italian and Finnish families with a history of breast and ovarian cancer.
It has not been found in people of Chinese, Japanese, African-American and Yoruban descent, the researchers added.
"Therefore, the variant may be restricted to individuals with European ancestry and could contribute to the higher load of breast cancer seen in this group. However, other BARD1 variants have been discovered in African-American and Japanese individuals. The contribution of these variants to the risk of disease is still uncertain," they wrote.
Breast cancer is the second leading cause of cancer deaths among women after lung cancer, affecting 1.2 million women globally and killing more than 400,000 every year, according to the International Agency for Research on Cancer .
Engineered Cells Could Control Irregular Heartbeat
By Ed Edelson
HealthDay Reporter
HealthDay Reporter
Monday, June 19, 2006
MONDAY, June 19 (HealthDay News) -- A tissue-engineered implant could someday take the place of implanted pacemakers in children with life-threatening heart blocks, researchers report.
A heart block occurs when the electrical signals that keep the heart beating normally cannot pass from the atria, the heart's upper chambers, to its lower ventricles. When the AV node -- the point through which the signals pass -- does not function, heart blocks can occur. Right now, a pacemaker is the only effective treatment for the condition.
"Young children not infrequently suffer heart block when they undergo major surgery," noted co-researcher Dr. Edward P. Walsh, chief of the cardiac electrophysiology division at Children's Hospital Boston. "They often need to have their chests opened when they have problems."
Reporting in the June 19 online edition of the American Journal of Pathology, Walsh's team said it engineered skeletal muscles in a way that could eliminate the need for pacemakers. The technique has worked well in early animal tests, the researchers said.
"The idea was that rather than using a pacemaker, we could create an electrical conduit to connect the atria and ventricles," Douglas Cowan, a cell biologist at the hospital and leader of the research program, said in a statement.
Cowan's attempt to create a more natural solution for the AV node problem began with rat studies in which he extracted early stage muscle cells called myoblasts.
Those cells were placed on a flexible scaffold made of collagen, a fibrous material found in bone and cartilage. That three-dimensional structure was then implanted into the rats' hearts.
The cells distributed themselves evenly and became oriented in the same direction. Laboratory tests showed that this newly engineered tissue would start beating when stimulated electrically. When the tissue was implanted between the right atrium and right ventricle of the rats, it soon established an "electrical pathway" in one-third of the animals. That pathway remained active over the rats' three-year life span.
The researchers now are planning trials involving larger animals whose cardiac systems more resemble those of humans, Walsh said.
One major advantage of the proposed method is that it would use cells from the patient's own body, he said, eliminating the possibility of rejection by the immune system.
Other researchers are creating new AV nodes in different ways. Several groups are trying to transform embryonic stem cells into heart cells that would transmit the essential electrical signals.
Progress on that line of research has been slower than hoped, Walsh said, "but that approach has not been given up on."
"We have no idea whether this will work or not in these patients, but someone has to look for an alternative," he said.
Total heart block occurs in about one of every 22,000 births. Causes include congenital heart disease, an injury or scar tissue from heart surgery, or as a side effect of medications. While pacemakers work well for adults, the devices carry a greater risk of heart perforation and clot formation in children. In addition, pacemakers typically last just three to five years in children, and the leads must be replaced frequently, which means repeat operations, the researchers said.
More information
For more on heart block, head to the American Heart Association.
Melanoma deadlier for blacks, Hispanics: study
Reuters
Monday, June 19, 2006
Melanoma can be especially deadly for blacks and Hispanics because they tend to get diagnosed later than whites whose fairer skin makes them more susceptible to the skin cancer, a study said on Monday.
An improvement in the survival rate of whites with melanoma has not been matched among populations with darker skin tones who contract the cancer, which can spread to other parts of the body more readily than other skin cancers.
In a look at 1,690 melanoma cases among residents of the
Delay in diagnosis allows the disease to progress and may contribute to the lower survival rates among blacks and Hispanics, the study said. Whites' survival rates have climbed to 92 percent in recent years from 68 percent in the 1970s, while blacks have a 78 percent survival rate.
"Evidence suggests that secondary prevention efforts such as skin cancer examination are suboptimal in Hispanic and black populations," the report said.
Overall, the incidence of melanoma is increasing 2.4 percent annually, according to the study published in this month's issue of the Archives of Dermatology. The disease strikes 21 out of 100,000 whites, 4 out of 100,000 Hispanics and 1 out of 100,000 blacks.
NSAIDs Pose Death Risk for Heart-Attack Patients
By Amanda Gardner
HealthDay Reporter
HealthDay Reporter
Monday, June 19, 2006
MONDAY, June 19 (HealthDay News) -- People who have survived a first heart attack have a higher risk of dying or having a second heart attack if they are taking non-steroidal anti-inflammatory drugs (NSAIDs), including the newer class called cox-2 inhibitors.
The research detailing these findings appears in the June 20 issue of the journal Circulation, and was first presented at the 2005 meeting of the American Heart Association. The results of the two studies are almost the same, although the latest study shows an even higher correlation between NSAID use and a second heart attack.
"The evidence is accumulating, and it seems that patients who have already had a heart attack are at even more risk than we thought before, and we are talking about short-term treatment," said study lead author Dr. Gunnar H. Gislason, senior resident at
Dr. Mark Fendrick, professor of internal medicine at the University of Michigan School of Medicine and professor of health management and policy at the university's School of Public Health, added, "This is yet another study adding to the mountain of evidence suggesting that we should be very careful about the use of cox-2 drugs, specifically, and possibly all additional NSAIDs for patients at risk for cardiovascular adverse events."
NSAIDs are pain relievers, including aspirin, ibuprofen and naproxen, that carry a risk of gastrointestinal bleeding. Cox-2 inhibitors are a specific type of NSAID that do not carry that risk.
Cox-2 inhibitors and NSAIDs have been caught in a prolonged furor since September 2004, when the cox-2 Vioxx was withdrawn from the market due to concerns about cardiovascular safety. Similar concerns were raised about Bextra, another cox-2, then Celebrex, and then naproxen, a traditional NSAID. Bextra was later withdrawn from the market.
A number of studies continue to look at the different risks and benefits of the drugs. This new research is the first to look at patients who took NSAIDs after suffering their first heart attack.
The study authors looked at all patients in
Patients who had survived a first heart attack and were taking any NSAID were more likely to die than those who had survived one heart attack and were not taking NSAIDs. Death rates were highest among those taking cox-2 drugs and high doses of traditional NSAIDs.
Compared to patients not taking any of these drugs, the risk of death was two to three times higher for patients taking low-dose (25 milligrams or less a day) of Vioxx (rofecoxib) or 200 milligrams or less a day of Celebrex (celecoxib).
The risk of death was five times higher for patients taking high-dose Vioxx (more than 25 milligrams a day); almost five times as high among those taking more than 200 milligrams of Celebrex; more than four times higher for those on high-dose diclofenac (more than 100 milligrams daily); and more than two times greater for those taking high-dose ibuprofen (more than 1,200 milligrams daily).
Taking NSAIDs for only short periods of time was enough to show a detrimental effect, the study found.
Although aspirin was not evaluated in the study, the authors presumed that more than 90 percent of people being analyzed were probably taking this drug. Aspirin has a proven beneficial effect in preventing heart attacks.
More and more studies, most of them observational, are showing that NSAIDs have this deleterious effect. A large, randomized, controlled trial has yet to be completed, however, although one sponsored by Pfizer and conducted by the Cleveland Clinic will soon be under way.
So what should consumers do?
"Physicians and patients at risk should think thrice, not twice, before using NSAIDs," Fendrick said. "If someone with a cardiovascular risk absolutely needs NSAIDs, given the available evidence, I would suggest taking naproxen with a proton pump inhibitor" to counteract the gastrointestinal effects.
Gislason added: "Our recommendation is that patients should at least consult their physician if they are taking any of those drugs, and our recommendation would be that if they can't be without them, they should stick with low doses of the traditional NSAIDs and probably avoid the new cox-2 inhibitors."
More information
The American Heart Association has a statement on pain medications.
Sunday, June 18, 2006
What You Should Know About Complementary and Alternative Medicine
By Karen Pallarito
HealthDay Reporter
HealthDay Reporter
Sunday, June 18, 2006
SUNDAY, June 18 (HealthDay News) -- If you've ever taken herbal products, seen a chiropractor or tried megavitamin therapy, you've ventured outside the boundaries of conventional medicine.
There's a term for those therapies -- "complementary and alternative medicine," or
The list of
There are also important distinctions between complementary and alternative medicine. Complementary medicine is something that is used in conjunction with conventional medicine, while alternative medicine is used in place of conventional treatment.
"You can have conventional cancer therapy along with, say, some music therapy or something that's soothing but relatively innocuous. It isn't going to affect your conventional treatment," explained Jackie Wootton, president of the Alternative Medicine Foundation in
"On the other hand," she added, "alternative medicine, such as coffee enemas, can be used as an alternative to conventional treatment."
In the
According to the survey, prayer is the most commonly used
About one-fifth of people surveyed used natural products, such as Echinacea, ginseng, ginkgo biloba, garlic supplements and glucosamine.
Recognizing CAM's possible potential to prevent disease and promote wellness, some health care providers practice what is known as "integrative medicine," which combines conventional treatment with
But if, like many Americans, you see a conventional physician and use complementary or alternative medicine on the side, play it safe and tell your doctor what you are doing.
People shouldn't be afraid to broach the subject, Wootton urged. Physicians are much more accepting of
Experts say one reason to share this information is the pittance of scientific evidence demonstrating the results of various therapeutic combinations.
"We know very little about the herb-drug interactions or the herb-herb interactions or vitamin-drug interactions," said Fredi Kronenberg, director of the Richard and
You want your doctor to be in the loop because a particular supplement you are taking may interact either positively or negatively with a drug you are taking.
"It could interact negatively if you're taking a blood thinner and now you're taking a supplement that's a blood thinner, and now you get too much of a good thing," Kronenberg explained.
On the other hand, she added, "You could have a supplement that synergizes the effect of a drug -- that makes a drug work better -- and therefore you might need less of that drug."
Conventional doctors may not be
More information
The National Center for Complementary and Alternative Medicine has developed a tip sheet for people who are considering using CAM.
By Alicia Chang and Malcolm Ritter
AP Science Writers
The Associated Press Writer
Sunday, June 18, 2006
Mike Slabaugh doesn't have a stomach. Neither do his 10 cousins. Growing up, they watched helplessly as a rare hereditary stomach cancer killed their grandmother and some of their parents, aunts and uncles.
Determined to outsmart the cancer, they turned to genetic testing. Upon learning they had inherited Grandmother Golda Bradfield's flawed gene, these were their options:
Risk the odds that they might not develop cancer, with a 70 percent chance they would; or have their stomachs removed. The latter would mean a challenging life of eating very little, very often.
All the cousins chose the life-changing operation. Doctors say they're the largest family to have preventive surgery to protect themselves from hereditary stomach cancer.
"We're not only surviving, we're thriving," said Slabaugh 16 months after his operation at
Advances in genetic testing are increasingly giving families with bad genes a chance to see the future, sometimes with the hope of pre-emptive action. People have had stomachs, breasts, ovaries, colons or thyroid glands removed when genetic tests showed they carried a defective gene that gave them a high risk of cancer.
But what about people whose families don't have these rare, but powerful genetic defects? Experts say that someday, doctors may do DNA tests as routinely as they check cholesterol levels now, spotting disease risks that can be lowered. That day isn't here yet, but progress is being made.
"We do not yet have a general DNA test that fits into that category, but we're headed for it at a pretty good clip," said Dr. Francis Collins, head of the National Human Genome Research Institute.
By 2010, there might be several such tests, along with recommendations to help high-risk people avoid certain diseases, he said. (In fact, newborns are routinely tested now for some genetic conditions, but those tests generally focus on substances in the blood rather than DNA.)
To come up with a useful DNA mass-screening test, it's not enough to identify a particular gene variant that raises the risk of a disease, experts said. There are other questions:
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Are there enough potential cases in the general population to make mass screening worthwhile?
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Is there good evidence that screening would improve health?
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Is the risk of disease high enough to make the test result useful?
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How useful is the test in various ethnic groups?
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Is there a way to lower the disease risk?
For now, "mass screening with DNA testing isn't quite ready for prime time," said Dr. Ned Calonge, head of the U.S. Preventive Services Task Force, which recommends steps people can take to prevent disease.
The task force recently recommended against routinely testing women for harmful mutations in BRCA genes. Those mutations raise the risk of breast and ovarian cancer. But it endorsed such testing for women whose family histories show certain suggestive patterns of cancer — a situation like stomach cancer in the Bradfield family.
Slabaugh, who lives in
They gambled, went to shows and dined in the City of
"Rather than live in fear, they tackled their genetic destiny head-on," said Dr. David Huntsman of the
About 22,000 Americans will be diagnosed with stomach cancer this year and half will die, according to the American Cancer Society. But the form that runs in the Bradfield family called hereditary diffuse gastric cancer is extremely rare with about 100 families diagnosed worldwide.
The CDH1 gene mutation was first discovered in 1998 in a large
It killed Golda Bradfield in 1960. She passed the faulty gene to seven of her children. Six died of the disease in their 40s and 50s.
The 18 grandchildren learned of the defective gene after one of them, David Allen, died of stomach cancer in 2003. His doctor had sent a blood sample to Huntsman's lab, which confirmed the genetic mutation.
Soon after, the remaining 17 got tested. Eleven who had the bad gene had surgery.
Slabaugh, haunted by his mother's death since his teen years, didn't hesitate to have the operation. He and five other cousins had it done at Stanford. The other family members had surgery closer to home.
"I wake up every morning and think, 'This is a free day. I get a bonus today,'" said the 52-year-old marketing executive.
During surgery, doctors removed the entire stomach and surrounding lymph nodes and attached the bottom of the esophagus to the intestine to create a pouch. Without a stomach, patients typically lose significant weight and must eat smaller meals more often. They can still digest food through the small intestine.
Insurance paid for part or all of the procedure, which cost between $65,000 to $85,000.
While the stomachs of all six Stanford patients looked normal before surgery, a study of the tissue revealed early tumor growths, said Dr. Jeff Norton, the surgeon.
The long-term effects of stomach removal surgery are still unclear. Researchers around the world are following families with hereditary stomach cancer to find out how the procedure affects quality of life.
It took about a year for Linda Bradfield, a 55-year-old merchandising coordinator from
"Life is pretty good without a stomach," she said.
Before Diane Sindt and her two older sisters had their stomachs taken out, they ate their "last supper" during Thanksgiving. True to their sisterly bond, they scheduled their operations at Stanford on consecutive days in December 2004.
The upside is that Sindt dropped from a size 12 to a 2, since the surgery. But she has trouble keeping down certain foods like ice cream and tends to shed weight easily if she over-exercises. To overcome it, Sindt sticks with meat and has replaced running with "power walking."
"It's definitely a new normal for us," said the 51-year-old real estate broker from the
Unlike his other cousins, Bill Bradfield of
But after watching his other cousins slowly regain parts of their former lives, Bradfield went ahead with the operation at the University of Texas M.D. Anderson Cancer Center in March, becoming the last in the family to give up his stomach.
"We're all going to die of something," he said, "but I know I won't die of stomach cancer."
AP Science Writer Alicia Chang reported from
On the Net:
American Cancer Society: http://www.cancer.org
Saturday, June 17, 2006
Medical home concept catching on in U.S.
By Holly Ramer
Associated Press Writer
The Associated Press Writer
Saturday, June 17, 2006
The frustration used to start on the phone.
Every time Donna Dunlop called her daughter's pediatrician, she started from scratch, describing the girl's complex history of seizures and other neurological problems to someone in a remote office who had never heard of her.
Specialists arrived at appointments clutching Elena Spahr's medical history — a stack of bulging folders well over a foot high — yet failing to grasp the bigger picture. An oblivious X-ray technician once asked her mother, "Can you just have her stand over here?"
"The kid's in a wheelchair and completely unable to do that," Dunlop said. "It seems small, and yet I can't tell you how hard it is when no one has been clued into the reality that child faces."
Several years later, Elena, 9, still has no diagnosis, can't talk or walk and relies on her parents for all her basic needs. But her parents now can rely on her pediatrician's office to help them connect the complicated dots between specialists, schools and various support networks.
"It was a pretty typical medical practice then," she said. "Now, it really is a medical home."
The term "medical home" describes not just a physical place, but the people who provide care and how they do it. In an ideal medical home, patients and parents feel respected. Staffers take a proactive, team approach to helping families coordinate information from multiple providers and direct them to other resources in the community.
In the words of the
It sounds like common sense, but it's not common practice, said Dr. Joseph Hagan, co-chairman of the academy's
"The idea of a medical home is maybe not one-stop shopping on-site, but one place or group of people you can count on to help you address whatever the medical issue is," said Hagan, a pediatrician in Burlington, Vt.
Though the academy coined the term "medical home" in the 1960s, and formally defined it in 1992, the concept didn't start catching on until the academy adopted it as its standard of care in 2002. Since then, certifying organizations for family physicians and internists have embraced the model.
The U.S. Maternal Child and Health Bureau has made the medical home part of its national agenda for states, and ensuring that every child with special health care needs has a medical home is one of six top objectives for states under the president's New Freedom Initiative.
"The medical home is the brand name for 21st century primary health care," said Dr. Carl Cooley. "It's no longer a decision to become a medical home. You are a medical home, and it's a question of how good of a medical home do you want to become?"
Cooley is co-director of the Center for Medical Home Improvement in
The first step is setting up a team of providers, staff and parents, and assessing the practice's strengths and weaknesses. Next comes identifying children who would benefit most from the approach and interviewing their families. The eventual result is an individualized plan for each patient so that anyone he or she sees has the same information and is working toward the same goals.
For Dunlop, that means her calls go directly to a nurse familiar with her daughter's condition. Every provider Elena sees has an electronic copy of her medical records and care plan. And her pediatrician is the "central point person" who helps bring together everything they learn from other doctors.
"She's sort of like the universal translator. We can go to her and say, 'OK, we've heard this here and that there.' She doesn't always have the answers, but sometimes what she has done is called the docs and talked to them in doc language, or she helps us sort through what we already know."
Dr. Greg Prazer, who oversees medical home improvement efforts at Exeter Pediatric Associates, said the biggest shift is the much larger role for parents in their children's care. That starts with parents putting their main concerns in writing.
"Physicians always have a huge agenda for what they want to talk about," he said. "It's important for parents to set the agenda."
His team is working to improve communication among schools, families, health care providers and other agencies.
"This has absolutely changed how I feel about practicing," he said. "Working with the parent partners has really rejuvenated me."
The Center for Medical Home Improvement is studying whether medical homes lead to better results and save money. The results aren't in yet, but smaller studies have demonstrated reductions in emergency visits, unplanned hospital stays and dependence on specialty care, Cooley said.
He is encouraged that Medicare is developing reimbursement codes for care coordination for the elderly.
"What Medicare adopts tends to be adopted by Medicaid, and eventually by private payers," Cooley said, "so I think we're on the threshold of seeing care coordination as a reimbursable service."
On the Net:
http://www.medicalhomeimprovement.org/
Simple Steps Bring Sweeter Breath
HealthDay Reporter
Sunday, June 18, 2006
SUNDAY, June 18 (HealthDay News) -- Some simple measures can help put a muzzle on bad breath, according to an article in the June issue of the Mayo Clinic Health Letter.
Bad breath can be caused by food particles in the mouth, dry mouth, or a health problem. Mayo experts offer these tips to help prevent it:
Brush your teeth or use mouthwash after you eat. Brushing is the more effective of the two. If you use mouthwash, make sure you swish it around in your mouth for 30 seconds before you spit it out. Floss your teeth at least once a day in order to remove decaying food. When brushing your teeth, brush the back of your tongue, too, or scrape it with a tongue scraper, available at pharmacies. Drink water to keep your mouth moist. When your mouth gets dry, there isn't enough saliva to wash away dead cells. You can also chew sugarless gum or suck on sugarless hard candy to help stimulate saliva production. Don't eat foods -- such as onions and garlic -- that encourage bad breath. These foods contain oils that are transferred to the lungs and exhaled. If you have dentures, clean them daily to get rid of food particles and bacteria. If these simple measures don't improve your bad breath, see your doctor or dentist. Persistent bad breath may be a sign of periodontal disease, an abscessed tooth, infection, chronic sinusitis, postnasal drip, chronic bronchitis, certain kinds of esophageal problems, and other health conditions.
More information
The American Dental Association has more about bad breath.