The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
March 20, 2006


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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Brain Chemistry May Spur Unhealthy Behaviors
  2. Alternative medicine common in kids; docs unaware
  3. Lifting Weights Keeps Overweight at Bay
  4. Grape Juice Good for Aging Brain
  5. Diabetes May Roll Back Victories Over Heart Disease
  6. Health Tip: A Broken Heart Can Make You Sick
  7. Stress may raise women's BV risk
  8. Hard Marriages Can Harden Arteries
  9. Efforts to curb diabetes reduce incontinence rates
  10. Combat Stress Boosts Heart Disease Risk
  11. Acupuncture shown to relieve migraines: study
  12. Noni Juice Might Lower Smokers' Cholesterol
  13. Yeast treatment may affect warfarin therapy
  14. Vascular Abnormalities in Brain Linked to Shorter Life Span
  15. Cognitive decline predicted by brain scans
  16. Hispanics Benefit from Cholesterol-Lowering Statins
  17. Breathing training can help heart failure patients
  18. Pesticide Risk to Babies Underestimated: Study
  19. Whirlpool baths: enter at your own risk
  20. Health Tip: Some Pregnant Women at Higher Risk of Gestational Diabetes
  21. Eat more whole grains to lower diabetes, heart risk
  22. Lifestyle affects the brain as well as the heart
  23. Study confirms oral contraceptive-migraine link
  24. Poverty, not race, lowers prostate cancer survival
  25. Blood Protein Could Signal Lung Disease Risk
  26. Study Casts Doubt on Glycemic Index
  27. Age Influences Visual Perception
  28. Coma may be self-induced by teens with diabetes
  29. Health Tip: Valerian as Sleep Aid
  30. Family docs fine for breast cancer follow-up
  31. Antibiotic Can Cause Life-Threatening Blood Sugar Problems for Older Patients
  32. Vitamin D plus calcium curbs falls in older women
  33. Radiowave Technique Steadies Abnormal Heartbeats
  34. Childhood depression tied to adult asthma, obesity
  35. Obese People Might Be More Sensitive to Pain
  36. Chemotherapy treatment suggested for bird flu patients
  37. Gingko Biloba May Help Fight Cancer
  38. Soy benefits heart health in healthy young men
  39. Health Tip: Prevent Osteoporosis
  40. Natural painkillers linked to high blood pressure
  41. Benign Breast Findings Can Still Pose Dangers
  42. Mild thyroid disease not tied to heart problems
  43. Strong Immune System May Protect Women From Loneliness-Linked lllness
  44. Stem cells fail to help heart attack damage: study
  45. Want to live longer? Think positive thoughts
  46. Rheumatoid Arthritis Drugs Won't Boost Lymphoma Risk
  47. Cocoa consumers have lower disease risk: study
  48. Arthritic Knees May Begin With Cartilage Loss
  49. Infections linked to women's heart bypass deaths
  50. Eye Damage Might Not Signal Child Abuse
  51. Breast cancer risk tied to HRT evident across race
  52. Surgeon's skill affects prostate cancer relapse
  53. Alternative Remedies Fail Government Tests
  54. Governors Urge Change in Eating Culture
  55. Watch Out for Winter Health Woes

 

 

 Friday, March 3, 2006

 

Brain Chemistry May Spur Unhealthy Behaviors

 

HealthDay News

Friday, March 3, 2006

FRIDAY, March 3 (HealthDay News) -- Could sluggish brain chemicals cause people to make the poor lifestyle choices that boost their risk for heart disease?

That's the question raised by a new study that looks at links between neurochemistry and human behavior.

Research conducted at the University of Pittsburgh suggests that an underactive brain serotonin system may help drive people to smoke, eat poorly and stay sedentary -- all behaviors that lead to early hardening of the arteries (atherosclerosis).

Serotonin, a chemical that carries messages between neurons in the brain, is believed to play an important role in regulating mood, appetite and blood pressure. This is the first study to suggest an association between the serotonin system and atherosclerosis. The findings could lead to new approaches for preventing heart disease and stroke, the researchers said.

"Many of the known risk factors for heart disease and stroke -- high blood pressure and cholesterol, obesity, diabetes, smoking and lack of exercise -- can, to some extent, be controlled by our lifestyle choices," Dr. Matthew F. Muldoon, an associate professor of medicine, said in a prepared statement.

"Until now, no one had studied the possibility that brain abnormalities could explain why some people make these poor lifestyle choices and have multiple risk factors for heart disease,'" he said.

Muldoon and his colleagues studied 244 people, aged 30 to 55, and found that those with low levels of serotonin system activity were more likely to have thickening of the carotid artery than those with higher levels of serotonin activity.

The findings were presented Friday at the American Psychosomatic Society meeting, in Denver.

"If, through further studies, we can establish that risk factors for heart disease and stroke are, in part, controlled by the serotonin systems in the brain, it could open a whole new avenue for preventing heart disease and stroke," Muldoon said.

In previous research, he and his colleagues found that people who are overweight, get little exercise, have high blood pressure, blood sugar, and cholesterol had low serotonin activity levels.

More information

The U.S. National Heart, Lung, and Blood Institute has more about atherosclerosis.


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Alternative medicine common in kids; docs unaware

 

Reuters Health

Friday, March 3, 2006

In places as far apart as Wales and Australia, about half of the children seen at pediatric hospitals are using complementary and alternative medicine (CAM), investigators report.

In a second study, British researchers found that children with chronic diseases were three times more likely to use CAM than healthy children.

In both studies, reported in the Archives of Disease in Childhood, the researchers found that parents and their children were unlikely to discuss CAM use with their doctors.

Although the number of people using complementary or alternative remedies has been increasing with time, there have been no studies of CAM use by youngsters, note Dr. Colin V. E. Powell, from University Hospital of Wales in Cardiff and his associates.

To find out more, the team interviewed approximately 500 children and their parents attending a major specialist hospital in Cardiff, Wales and in Melbourne, Australia.

CAM was used by 41 percent of patients in Cardiff and 51 percent in Melbourne.

Powell's group observed that Cardiff patients were less likely to use specific medicinal CAM, such as vitamins and minerals, herbs, or naturopathy, as well as non-medicinal CAM, such as chiropractic and therapeutic massage.

Only about one third of patients or their parents reported CAM use to their doctors. "The poor communication highlights the importance of local policy development," the authors say, to promote a dialogue about alternative medicine between patients and their health care providers.

For the second article, Dr. l. J. McCann from University College London and Dr. S. J. Newell from St. James's University Hospital in Leeds interviewed parents of 25 children with cerebral palsy, 25 with inflammatory bowel disease, 25 with cancer, and 25 healthy "controls" regarding CAM use.

They found that children with chronic illnesses were significantly more likely to use CAM than their healthy counterparts -- 40 percent versus 12 percent. The sick children were also more likely to use complementary medications (21 percent versus 4 percent) -- primarily Echinacea, and herbal and Chinese remedies.

The investigators also observed that 55 percent of parents whose children were using CAM had not discussed the issue with their doctor.

McCann and Newell suggest that doctors gain a working knowledge of complementary and alternative medicine, so they can discuss it with their patients.

Editorialist Dr. E. Ernst from the Universities of Exeter & Plymouth, UK, points out that although alternative therapy may be harmless, bad advise from a homeopath or naturopath, such as recommending against immunizations, "would almost inevitably cause serious harm."

Ernst agrees that clinicians need up-to-date knowledge about which CAMs work, which do not and which may be harmful.

Source: Archives of Disease in Childhood, February 2006.

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Lifting Weights Keeps Overweight at Bay

 

HealthDay News

Friday, March 3, 2006

FRIDAY, March 3 (HealthDay News) -- Lifting weights twice a week can help women prevent "middle-aged spread" and keep their hearts healthy, a new study shows.

"On average, women in the middle years of their lives gain one to two pounds a year, and most of this is assumed to be fat," study author Kathryn H. Schmitz, an assistant professor at the University of Pennsylvania's Center for Clinical Epidemiology and Biostatistics, said in a prepared statement.

"This study shows that strength training can prevent increases in body fat percentage and attenuate increases in the fat depot most closely associated with heart disease. While an annual weight gain of one to two pounds doesn't sound like much, over 10 to 20 years the gain is significant," Schmitz said.

The study included 164 overweight and obese women, aged 24 to 44, divided into two groups. One group took part in a 16-week program of supervised strength training classes, which were followed up with booster sessions four times a year for two years.

The other group of women received a brochure that recommended they get 30 minutes to an hour of exercise most days of the week.

Both groups were told not to change their diets in ways that might lead to weight changes during the study.

By the end of two years, the women in the weight-training group showed an average 3.7 percent decrease in body fat, while the women in the brochure group showed no change in body fat. The study also found that weight training reduced intra-abdominal fat, which is associated with heart disease and metabolic disturbances.

The findings were presented Friday at the American Heart Association's annual conference on Cardiovascular Disease Epidemiology and Prevention, in Phoenix.

Schmitz said that weight training is a fairly time-efficient way to prevent these small annual increases in weight that may increase the risk of heart disease and diabetes.

More information

The American Academy of Family Physicians has more about heart disease and women.

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Grape Juice Good for Aging Brain

 

HealthDay News

Friday, March 3, 2006

FRIDAY, March 3 (HealthDay News) -- Antioxidant-rich concord grape juice may help keep aging brains limber, a study with rats suggests.

The study -- partly funded by grape juice maker Welch Foods Inc. -- included mature rats nearing the end of their expected life spans. Researchers put the rodents through a series of tests designed to measure their short-term memory and neuro-motor skills.

"Concord grape juice appeared to enhance the cognitive and some motor skills in the test animals. In many of the tests we saw significant improvements or trends toward improvement," lead researcher James Joseph, chief of the neurosciences laboratory at the U.S. Department of Agriculture Nutrition Research Center on Aging at Tufts University, said in a prepared statement.

"As our population ages, we are continually looking for ways to maintain our mental and physical skills," Joseph noted.

"While these laboratory animal studies are certainly preliminary and much more work needs to be done, we know that consuming high levels of natural dietary antioxidants is a good thing from a number of perspectives. And it appears that drinking Concord grape juice has the potential to help retard the mental and physical declines of aging."

The findings appear in the March issue of the journal Nutrition.

More information

The American Heart Association has more about antioxidants.

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Diabetes May Roll Back Victories Over Heart Disease

 

HealthDay News

Friday, March 3, 2006

FRIDAY, March 3 (HealthDay News) -- Gains in reducing deaths due to heart disease could be wiped out by the ongoing upsurge in diabetes, U.S. researchers report.

"Over the past 30 years, the U.S. has achieved dramatic reductions in illness and deaths from coronary artery disease," study lead author Dr. Jing Fang, formerly of the Albert Einstein College of Medicine in New York City and now at the U.S. Centers for Disease Control and Prevention, said in a prepared statement. "But if this upsurge in diabetes-associated deaths and illnesses continues, it may put an end to the progress we've made in combating illness and death from coronary artery disease."

Fang's team analyzed New York City death records for people 35 and older from 1989 to 1991 and from 1999 to 2001. In the decade that elapsed between these two periods, death rates due to stroke, cancer and all other diseases declined. The exception was the diabetes death rate, which increased by 61 percent.

Over that decade, the percentage of heart attacks among people with diabetes increased from 21 percent to 36 percent. The total number of diabetics who had a heart attack more than doubled -- from 2,951 to 6,048. While there was an overall decline among the general population in days spent in a hospital due to heart attack, diabetics showed an increase of 51 percent.

The findings appear in the February issue of the journal Diabetes.

"Diabetes has reached epidemic proportions in the U.S. and the leading cause of death among people with diabetes is coronary heart disease," senior author Dr. Michael Alderman, professor of epidemiology and population health at Einstein, said in a prepared statement.

"We expected to see an increase in hospitalizations due to heart attacks among diabetics, but we were surprised by the magnitude of the increase and the sharply rising trend indicated by these findings," Alderman said.

More information 

The American Diabetes Association has more about diabetes.

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Health Tip: A Broken Heart Can Make You Sick

 

HealthDay News

Friday, March 3, 2006

(HealthDay News) -- The sudden shock of losing a loved one, a failed romance, even losing a job, can all trigger a series of symptoms that mimic a serious heart attack, researchers at Johns Hopkins University say.

That's because sudden emotional stress can cause adrenalin to spike and stun the heart, causing severe heart muscle weakness.

Doctors call the condition stress cardiomyopathy, but it's often described to patients as "broken heart syndrome."

The good news? It's usually treatable, and it rarely causes permanent damage.

But check with your doctor immediately if you think you're having a heart attack, just to make sure.

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Stress may raise women's BV risk

 

By Karla Gale

Reuters Health

Friday, March 3, 2006

Increases in psychosocial stress seem to increase a woman's odd of having, or developing, a vaginal infection termed bacterial vaginosis (BV), researchers report.

"Bacterial vaginosis is a common condition that is not well understood in terms of how women get it and what degree of harm it causes, or even how you can prevent whatever harm it may be causing," Dr. Mark A. Klebanoff told Reuters Health.

There is evidence, added the researcher from the National Institute of Child Health and Human Development in Bethesda, Maryland, that BV increases the risks of HIV infection, post-operative infection, and premature delivery among women who are pregnant.

However, it is hard to eradicate and often recurs.

To gain a better understanding of the disease, Klebanoff and his associates recruited 3614 women, between the ages of 15 to 44, who were not pregnant or on long-term antibiotic therapy and had a normal immune system.

According to the team's report in the American Journal of Obstetrics and Gynecology, the subjects underwent pelvic examinations quarterly for 1 year. The investigators found that the likelihood of having BV was associated with age, race, income, frequency of douching, frequency of vaginal intercourse, number of recent sex partners, and the use of hormonal contraceptives.

The investigators evaluated the subjects' psychosocial stress over the preceding 30 days at each examination using.

They also found that stress was linked to BV, with each 1-point increase on the Perceived Stress Scale (range 1.00 to 5.00) associated with a 1.15-fold greater risk of being positive for BV.

"The magnitude of the effect is relatively small, but one that is large enough to be meaningful," co-researcher Dr. Tonja R. Nansel, also with the NICHHD, told Reuters Health.

Stress may have immune-altering effects that affect the risk of vaginosis, Klebanoff said, adding that "there is plausible speculation that chronic stress is associated with some local immune defects," but further documentation will be required.

He noted that the study is ongoing and the researchers are still collecting a wide range of data, including hygiene habits, sex behaviors, as well smoking, alcohol and drug use, "to get a better handle on what factors are associated with BV, and to see which ones might be amenable to treatment."

Source: American Journal of Obstetrics and Gynecology, February 2006.

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Hard Marriages Can Harden Arteries

By Meryl Hyman Harris
HealthDay Reporter

HealthDay News

Friday, March 3, 2006 

FRIDAY, March 3 (HealthDay News) -- Matters of the heart do, in fact, affect the heart.

A new study shows that hardening of the coronary arteries is more likely in wives when their husbands express hostility during marital arguments, and more common in husbands when either he or his spouse acts in a controlling manner.

"Women pay more attention to that friendliness vs. hostility quality, and are more concerned when it's out of line than are men. Men are more interested in issues of control in their lives," explained study author Tim Smith, who is to present the findings Friday at the American Psychosomatic Society meeting in Denver, a conference that deals with the influence of psychological factors on physical health. Smith is a professor of psychology at the University of Utah.

Some 150 healthy married couples, mostly in their 60s, were recruited through newspaper ads and a polling firm, paid $150 to participate, and received a free CT scan to look for calcification in the arteries that supply the heart muscle.

Each couple was told to pick a topic that was a sore subject in their marriage. They were videotaped sitting in comfortable chairs facing each other as they talked about their problems -- money, in-laws, children and so forth.

Graduate students then coded the conversation indicating the extent to which the conversation was friendly vs. hostile, and submissive vs. dominant.

For example, comments like, "You can be so stupid sometimes," or "You're too negative all the time," were coded as hostile and dominant. A warm, submissive comment would be, "Oh that's a good idea, let's do it."

Even while being taped, the couples engaged in some "quite pointed" arguments, said Smith. "Behaving in this way in this six-minute sample is also associated with couples telling us that this happens a lot for them," he said. Some couples were so hostile researchers suggested they go to counseling.

Two days after their discussion, each couple underwent a CT scan of the chest at the University of Utah's Center for Advanced Medical Technologies. Doctors used a standard scale to score each person's level of coronary artery calcification.

"We went looking for the fact that different aspects of the marriage might be important to men's and women's heart health, and I was pleasantly surprised that it was so clear," Smith said.

The researchers factored out traditional risks such as weight and cholesterol levels, and personality indicators that are known to trigger disease. The results said "something about the quality of their relationships," Smith said.

The notion that the tenor of a marriage affects one's health did not come as a surprise to Matthew Silvan, a psychoanalyst and director of Psychocutaneous Medicine at St. Luke's Roosevelt Hospital's department of dermatology in New York City. He specializes in psychology's role in skin diseases.

"The link between the mind and body is something I believe in strongly, and see all the time," he said. While studies such as this one need to be looked at carefully and in general need more supporting data, Silvan said he wasn't surprised men and women react physically to their marriages in different ways.

"For a long time people thought of the mind and body as separate," he said. "And more and more they see they aren't separate. The two mutually influence each other, and the more we study disease the more we have a comprehensive approach to illness."

The idea, said Smith, is to do the smart, healthy things. The most important factors for heart health are diet and exercise, and avoiding tobacco. But, he said, people have to pay attention to their relationships, too.

More information

For more on the impact of stress on health, visit the National Mental Health Association.

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Efforts to curb diabetes reduce incontinence rates

Reuters Health

Friday, March 3, 2006

In overweight, pre-diabetic women, intensive lifestyle intervention to prevent diabetes also results in a lower risk of urinary incontinence, a new study shows.

"Less-frequent urinary incontinence may be a powerful motivator for women to choose lifestyle modification to prevent diabetes, " Dr. Jeanette S. Brown and colleagues point out.

Type 2 diabetes increases the risk of urinary incontinence for women by 50 to 70 percent, the team from the Diabetes Prevention Program Research Group at George Washington University in Rockville, Maryland, explains in the medical journal Diabetes Care.

While weight loss is known to reduce incontinence, the researchers add, there is some evidence that exercise can increase it.

Brown's group investigated the effects of diet and exercise, compared to drug treatment with metformin only or inactive "placebo" treatment, on incontinence risk among 1957 overweight women at high risk for diabetes.

During the trial, which lasted about 3 years, women in the intensive lifestyle group lost an average of 3.4 kilograms, compared with 1.5 kg for those on metformin and a gain of 0.5 kg in the placebo group.

The percentage who developed diabetes in the three groups was 14.9 percent, 23.9 percent, and 30.9 percent, respectively.

At the close of the study, 38.3 percent of the women in the lifestyle intervention group had incontinence, compared to 48.1 percent of women on metformin and 45.7 percent of those on placebo.

Most of the difference in rates of incontinence was attributable to weight loss, the researchers conclude. They recommend that health care providers get out the message that "weight loss and lifestyle intervention may lower the risk of urinary incontinence."

Source: Diabetes Care, February 2006.


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Combat Stress Boosts Heart Disease Risk

 

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Friday, March 3, 2006 

FRIDAY, March 3 (HealthDay News) -- Military veterans exposed to combat have a higher long-term risk of heart attacks and strokes than either non-vets or vets not exposed to combat, researchers report.

"Their risk of heart disease is predicted to be higher," said study author Anna Johnson, a doctoral candidate at the University of North Carolina, Chapel Hill.

Johnson found that, compared to non-veterans, combat veterans' 10-year risk of heart disease is more than 3 percentage points higher.

She presented the findings Friday at the American Heart Association (AHA) annual conference on Cardiovascular Disease, Epidemiology and Prevention, in Phoenix.

In the study, Johnson and her colleagues followed nearly 5,000 men, including veterans who saw combat, veterans who didn't, and non-veterans who served as controls. "They came in for visits every few years," she said, "with about four visits each since the 1980s."

Researchers looked at measures such as blood pressure, smoking, cholesterol levels and other factors to predict their heart disease risk over the next decade. The men started the study between 1987 and 1989, and the last follow-up questionnaires were conducted in 2001 and 2002.

Johnson's team found that the mean predicted 10-year risk of heart disease risk was 10.2 percent for the non-veterans, 11.5 percent for the veterans not exposed to combat and 13.3 percent for those exposed to combat.

While others have studied veterans and their risk of combat, she said "nobody has looked at predicted risk." And many previous studies did not separate subjects who were in combat from those who were not, she said.

The follow-up time is also longer than in most studies, Johnson noted. "Other studies have looked at shorter-term risk and found limited evidence for a higher risk of cardiovascular events."

"I was surprised there was such marked effects," she said.

Deciphering how combat boosts heart risk is beyond the scope of her study, Johnson said. "Is it behavioral? Are they all smoking and not exercising? Is it psychological? I don't know the underlying mechanisms."

In a previous study, which Johnson presented last year at another AHA conference, she found that veterans of World War II, Korea and Vietnam who had seen combat were 60 percent more likely to be heavy drinkers than those who had not, and four times as likely to be problem drinkers than those who hadn't been in the armed forces at all.

She also found that combat vets were 20 percent more likely to be heavy smokers than vets who hadn't seen combat, and nearly two times as likely to smoke heavily compared with non-vets.

Joseph Boscarino, a Vietnam veteran and senior investigator for the Giesinger Clinic in Danville, Pa., has researched combat exposure and post-traumatic stress disorder (PTSD) for 30 years. He said this new study "adds to the growing literature that combat is related" to heart disease.

But he added an interesting observation, based on his research. "We found combat by itself is not significant when you control for PTSD."

PTSD is a psychiatric condition triggered by a life-threatening event such as military combat, disaster or serious accident. People with PTSD often suffer from nightmares, flashbacks and other persistent reminders of a past traumatic event.

In other words, Boscarino said, "combat by itself doesn't make you more at risk for heart disease, it is whether you develop PTSD. It appears that PTSD is a good predictor of heart disease risk."

More information

For more on stress and heart disease, head to the American Heart Association.


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Thursday, March 2, 2006

 

Acupuncture shown to relieve migraines: study

 

Reuters

Thursday, March 2, 2006

Acupuncture, one of the most popular complementary treatments, works as well as standard drugs for migraines, German researchers said on Thursday.

They compared the effects of real and fake acupuncture with drug treatments for migraine and found all equally effective.

"The main finding is that Chinese acupuncture is as effective as drug treatment for the prophylaxis of migraine," said Hans-Christoph Diener, a neurologist at the University of Duisburg-Essen in Germany.

"Secondly, sham acupuncture is as effective as traditional Chinese acupuncture," he told Reuters.

All of the more than 900 patients who had been randomly selected to receive Chinese acupuncture, sham acupuncture or drugs reported similar improvements and reductions in the number of migraine-free days.

"This tells us that Chinese acupuncture is not a very specific treatment," said Diener.

Traditional Chinese acupuncture involves inserting fine needles at specific energy meridians of the body to reduce pain. In the so-called sham procedure the needles were put in places that were not traditional acupuncture points.

The ancient Chinese therapy has been shown to relieve nausea, stress, arthritis pain in the knee and pelvic pain during pregnancy.

"What we showed is that acupuncture is effective but we need more research to find out the biological effect behind it," added Diener, who reported his findings in The Lancet Neurology journal.

Migraine affects about 15 percent of people in Britain alone. Symptoms can include intense throbbing on one side of the head, distorted vision, nausea or vomiting and raised sensitivity to light, sounds and smells.

An attack can last up to three days and prevent the sufferer from carrying out normal, everyday activities. Although anyone can get a migraine, it is most common between the ages of 20 and 50 and most sufferers are women.

Over-the-counter and prescription drugs can help to relieve the pain and reduce inflammation. Many patients also try other therapies such as acupressure, homeopathy, osteopathy and physiotherapy.

"The most important result is that all three treatments were effective and that improvement in the number of migraine days was closely similar in all treatment groups," Diener said in the study.

"The decision whether acupuncture should be used in migraine prevention remains with the treating physician," he added.

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Noni Juice Might Lower Smokers' Cholesterol

 

By E.J. Mundell
HealthDay Reporter

HealthDay News

Thursday, March 2, 2006

THURSDAY, March 2 (HealthDay News) -- Claims that it can ward off any number of ailments have helped boost annual sales of Tahitian noni juice into the billions, and now a new study suggests the drink may, in fact, help lower cholesterol.

But skeptics note that the small study -- like most others looking at the product -- was funded by the maker of the juice, and they are calling for a larger, independent clinical trial.

The findings were to be presented Thursday at the American Heart Association (AHA) annual conference on Cardiovascular Disease Epidemiology and Prevention, in Phoenix.

"Are the findings a reason for people to drink noni juice? I don't think that there is an answer to that," said Dr. Stephen Barrett, a retired psychiatrist and founder of Quackwatch, which has investigated the unfounded claims of noni juice distributors in the past.

While not dismissing the idea that the juice, made from the bumpy fruit of the Polynesian noni plant, might have some heart-healthy effects, Barrett added, "You'd want to have someone who's independent, at some point, do the study."

The study's lead researcher, Dr. Mian-Ying Wang of the University of Illinois College of Medicine, defended her team's work. She pointed out that the study was a double-blinded, placebo-controlled effort that met the standards of the college's Institutional Review Board.

Wang drinks noni juice daily. She claims it helps her feel more energized and concentrate better, and has even thickened her hair. "I do recommend it," she said, "and several of my coworkers drink noni juice for their cholesterol -- it controls it very well."

Noni juice does have an ancient history among the peoples of the South Pacific, where Wang said, "it has been used for over 2,000 years as a traditional medicine." She said her previous research has found the juice does contain a very high level of disease-fighting antioxidants.

However, the bitter-tasting beverage has had a more checkered history in the United States, with some distributors having claimed it cured everything from arthritis to cancer to AIDS. In 1998, unsubstantiated claims led attorney generals in Arizona, California, New Jersey and Texas to levy a $100,000 fine against one major noni juice maker, Utah-based Morinda Inc., ordering it to cease making such claims.

Morinda owns Tahitian Noni International (TNI), which funded Wang's study. However, according to the company's Web site, the company now claims only that the juice is "rich in antioxidants that promote wellness." They go on to say that "TNI and its distributors do not claim that noni cures cancer or any other ailments." In a statement, TNI said its global sales had reached $3 billion by 2005.

In the Illinois study, Wang's team compared blood levels of total cholesterol and triglycerides (fats) in 132 smokers. Twenty-six of the participants drank a harmless placebo mixture while 106 drank one ounce to four ounces daily of TNI's brand of noni juice (mixed with grape and blueberry juice for palatability).

Wang said the study focused on smokers because their cholesterol levels tend to be higher than those of nonsmokers, and they are at higher risk for heart disease.

At the end of the month-long study, noni drinkers saw their total cholesterol drop from an average of 235.2 mg/dL to 190.2 mg/dL, while their triglycerides declined from 242.5 mg/dL to 193.5 mg/dL.

Although the data was not included in the heart association meeting data, Wang said levels of LDL "bad" cholesterol showed a "trend toward decreasing" in noni drinkers, while levels of HDL "good" cholesterol rose 17 percent to 20 percent.

However, not everyone was impressed with the findings. Dr. Jeffrey Galpin is an assistant clinical professor of medicine at the University of Southern California in Los Angeles who has investigated claims made by noni juice distributors in the past.

Like Barrett, he said that the remedy "may well have benefits, but somebody -- and not the company -- is going to have to do studies that are well-controlled with no conflict of interest."

He also pointed to one small, independent study that found that overindulgence in the juice could actually be dangerous. "A couple of people used this juice for a few months and drank a ton of it -- one of them ended up needing a liver transplant and the other had some kind of related hepatitis," he said.

He and Barrett also noted that the four-week study says little about the juice's ability to benefit users over the long term.

Then there's the juice's expense.

"If there are antioxidants in noni juice, prove to me that it's worth $35 for 24 ounces -- instead of just eating some [antioxidant-rich] blueberries," Galpin said.

Barrett agreed, noting that drinking three to four ounces of noni juice a day would cost consumers the same as taking a prescription statin medication, "which we know works." Beyond that, Barrett said, "we know that if you simply eat a healthy low-fat diet, your cholesterol level drops really fast."

Galpin also questioned the AHA's decision to promote the small, company-funded study in its press kit for this week's meeting. "That shocked me," he said.

But Dr. Barbara Howard, vice chairwoman of the AHA's Nutrition, Physical Activity and Metabolism Council, defended the association's choice. "There's a huge focus on these kinds of supplements nowadays, and the AHA has made it clear that these are all basically unproven and need a lot more research," she said. "This [choice] doesn't in any way reflect our judgment of the quality of the study."

According to Wang, skeptics may soon get what they wish for, anyway.

"Based on this data," she said, "I'm going to submit a [proposal for a] bigger clinical trial to the AHA, to try and get funding." At the same time, the U.S. National Center for Complementary and Alternative Medicine is currently recruiting participants for its own federally funded, phase 1 clinical trial focused on the juice's effectiveness against cancer.

More information

For more on herbals and dietary supplements, head to the U.S. National Center for Complementary and Alternative Medicine..


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Yeast treatment may affect warfarin therapy

 

Reuters Health

Thursday, March 2, 2006

For women taking warfarin to prevent blood clots, a single dose of fluconazole to treat a vaginal yeast infection can lead to an increased risk of bleeding, findings from a small study suggest.

The time taken for blood to clot -- the so-called prothrombin time -- should therefore be carefully monitored in this scenario, and a change in warfarin dose may be needed, the author advises.

Fluconazole (brand name, Diflucan) is a common treatment for vaginal candidiasis, and is known to interact with a number of drugs, including warfarin -- which can give rise to serious bleeding complications -- according to the report in the medical journal Obstetrics and Gynecology.

While a few studies have looked at the effect of several days of fluconazole therapy on bleeding risk in warfarin users, until now none had looked at the impact of a single dose.

The study involved six women who had been on warfarin therapy for at least 6 months and had no dose changes in the last 4 weeks. Prothrombin time and other blood-clotting measurements were taken at the start of the study and then repeated 2, 5, and 8 days after the participants took one 150-milligram dose of fluconazole.

Prothrombin times increased by 11 percent, 34 percent and 2 percent at each time point, respectively, Dr. Mark A. Turrentine, from the Kelsey-Seybold Clinic in Houston, found.

Following the fluconazole dose, three of the women required a decrease in warfarin dose.

Because the difference between a dangerous dose and an effective dose of warfarin is so narrow, and given the "individual sensitivity demonstrated by a portion of the population, some alteration of the dose of warfarin may be necessary when patients are given even a single dose of fluconazole," Turrentine concludes.

Source: Obstetrics and Gynecology, February 2006.

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Vascular Abnormalities in Brain Linked to Shorter Life Span

 

By Amanda Gardner
HealthDay Reporter

HealthDay News

Thursday, March 2, 2006

 THURSDAY, March 2 (HealthDay News) -- Large amounts of white matter in the brain, along with enlarged open areas filled with spinal fluid, appear to be linked to cardiovascular disease and shorter life spans for the elderly.

The findings raise the possibility that controlling blood pressure may need to take a greater role in the fight against cardiovascular disease and early mortality.

"It suggests that very tight control of blood pressure throughout life is a major determinant of longevity," said study author Dr. Lewis Kuller, a professor of epidemiology at the University of Pittsburgh's Graduate School of Public Health.

"We need to be more aggressive about treatment," added Dr. Jesse Weinberger, director of the neurovascular lab at Mount Sinai School of Medicine in New York City. The findings also fit nicely with existing information about how blood pressure affects different systems in the body, he added.

The research was presented Thursday at the American Heart Association's annual conference on Cardiovascular Disease Epidemiology and Prevention, in Phoenix.

"White matter" are the nerve fibers that carry messages from neurons, or the brain's nerve cells, to the rest of the body. The fluid-filled open areas in the brain are called ventricles. As a person ages, neurons are lost while ventricles get bigger.

Kuller and his colleagues had earlier shown that blood pressure and vascular disease are associated with dementia. Other researchers have shown that kidney function is a predictor of mortality and of heart attack and stroke. Experts have since been playing with the idea that damage to the small vessels in the kidney and brain as a result of high blood pressure are responsible for these connections.

The new study is part of the Cardiovascular Health Study, sponsored by the National Institutes of Health, which is looking at the factors relevant to cardiovascular disease.

More than 3,200 people, average age 75 at the time, underwent magnetic resonance imaging of the brain. They were subsequently followed for 12 years, the longest such follow-up ever. Sixty percent of the participants were women and 14.5 percent were black (who have a higher incidence of high blood pressure).

Each brain was given a "white matter grade" (WMG) from one to nine, and a ventricular grade (VG). During the 12 years of follow-up, mortality rose with increasing grades.

Women on the younger end of the spectrum (ages 65 to 74) who had a WMG of less than two had an overall death rate of 12.2 per 1,000, vs. 57.9 per 1,000 for those with a WMG greater than five.

Overall, participants who scored below the average on both scales had a 57 percent lower risk of death, compared to participants who scored above the average.

The white matter and ventricle scores also predicted the presence of cardiovascular disease.

The average survival of a 75-year-old participant with below-average scores and no cardiovascular disease was estimated to be almost 18 years, vs. 11.9 years for those with white matter grades and ventricular grades above the average plus early cardiovascular disease.

"It was an independent predictor of longevity," Kuller said.

While the findings do point to the need for more stringent blood pressure control and possibly for limiting dietary salt intake, more studies need to be done, he added.

"We need focusing on individuals at a younger age to see if we can prevent progression of cardiovascular disease," Kuller said. "We think a lot of disease and disability might be prevented by aggressive treatment of vascular disease. This is potentially preventable."

More information

The National Heart, Lung, and Blood Institute has more on lowering your blood pressure.


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Cognitive decline predicted by brain scans

 

By David Douglas

Reuters Health

Thursday, March 2, 2006

 Among normal, health elderly people, brain imaging can spot changes that suggest an impending decline in cognitive function, California-based researchers report.

This is important, lead investigator Dr. William Jagust told Reuters Health, because effective treatments for Alzheimer's disease might be developed in the relatively near future.

"If such treatments are to be effective," he pointed out, "we will have to apply them to individuals in the earliest possible stage of the disease -- preferably even before symptoms are present -- in order to have maximal benefit, since once symptoms appear the brain has already suffered considerable damage."

Jagust, at the University of California, Berkeley, and colleagues performed brain scans in 60 cognitively normal men and women with an average age of 69.5 years. The subjects were participants in the Sacramento Area Latino Study on Aging (SALSA) and most were Mexican-American.

They were followed for almost 4 years, and about once a year underwent testing to assess global cognition and memory.

Six of the subjects developed dementia or cognitive impairment, according to the team's report published in the Annals of Neurology. Examination of scans showed that areas of lower glucose metabolism in upper and side regions of the brain were strongly linked to a faster decline in mental performance.

The anatomical location of the findings, the researchers conclude, "suggests detection of preclinical Alzheimer's disease pathology."

When and if treatments for Alzheimer's disease become available, Jagust added, "studies like ours, which aim to detect signs of the disease in normal older people, could have clinical applications."

Source: Annals of Neurology, February 8, 2006.

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Hispanics Benefit from Cholesterol-Lowering Statins

 

HealthDay News

Thursday, March 2, 2006

THURSDAY, March 2 (HealthDay News) -- Two kinds of cholesterol-lowering statin drugs -- Crestor and Lipitor -- may reduce important heart disease risk factors in Hispanic Americans, new research shows.

The findings were presented Thursday at the American Heart Association's annual conference on Cardiovascular Disease Epidemiology and Prevention, in Phoenix. The study was funded by AstraZeneca, the maker of Crestor.

The study included 635 volunteers, whose blood levels of C-reactive protein (CRP) and LDL "bad" cholesterol were measured before and after treatment. CRP is a marker of inflammation, and high levels of CRP correlate with increased risk of coronary heart disease.

All the volunteers had LDL levels of 130 milligrams per deciliter at the start of the study, which put them at high risk for having a coronary event within the next 10 years.

The volunteers were divided into four groups. One group received 10 milligrams of Lipitor, made by Pfizer Inc., daily for six weeks; a second group received 20 milligrams of Lipitor; the third group received 10 milligrams of Crestor; and the fourth group received 20 milligrams of Crestor.

"LDL levels fell significantly in all four statin-treatment groups after six weeks. Crestor, at both doses, reduced LDL significantly more than Lipitor did at the same dose. Both the drugs had similar effects on the participants' CRP levels," study author Dr. Ramon Luis Lloret, cardiologist and president of the Cardiovascular Center of South Florida, said in a prepared statement.

The average overall CRP level among the participants was 2.5 mg/L at the start of the study. More than half of them had CRP levels higher than 2 mg/L, putting them at much greater risk for coronary disease than people with CRP levels lower than 2 mg/L.

Participants taking 10 milligrams a day of Crestor had an average CRP reduction of 18.8 percent, compared with 16.8 percent for those taking the same dose of Lipitor. In the 20-milligram groups, the average CPR reduction was 26.7 percent for Crestor after six weeks, compared with 23.8 percent for Lipitor.

CRP reductions were greatest among patients who had CPR levels higher than 2mg/L at the start of the study.

The drugs were well-tolerated, and there were no serious side effects such as muscle or kidney problems sometimes seen in patients taking statins, Lloret said.

"Despite Hispanics being the fastest- growing minority in the United States, there are relatively little data in large-scale studies about treating cardiovascular risk factors in this population. The findings were important because Hispanics are under-diagnosed and under-treated for heart disease," he said.

More information

The U.S. National Heart, Lung, and Blood Institute has more about statins.


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Breathing training can help heart failure patients

 

Reuters Health

Thursday, March 2, 2006

People with heart failure and difficulty breathing may benefit considerably from using a device to train the muscles involved in breathing, Brazilian researchers report.

The Threshold Inspiratory Muscle Trainer (Healthscan Products, Inc.) applies a load while subjects breathe in, thus training the muscles to become stronger.

Dr. Jorge P. Ribeiro of Hospital de Clinicas de Porto Allegre and colleagues randomly assigned 32 patients to either a 12-week home-based program using the device with an inspiratory load maintained at 30 percent of maximal inspiratory pressure, or to a placebo program in which the participants had no inspiratory load.

Muscle training resulted in a 115 percent improvement in maximal inspiratory pressure, and a 17 percent increase in peak oxygen uptake.

Also in a test measuring how far the subjects were able to walk in 6 minutes, the distance increased from an average of 449 meters to 550 meters, the investigators report in the Journal of the American College of Cardiology.

Active treatment patients also experienced an increase in quality-of-life scores.

The researchers point out that although the training was not continued beyond 12 weeks, part of the effect on maximal inspiratory pressure and on quality of life was still maintained after a year.

"Together with the observations from other small trials," Dr. Ribeiro told Reuters Health, "our data indicate that inspiratory muscle training is a safe intervention that can be considered for the management of patients with chronic heart failure, particularly those with weakness in inspiratory muscles."

Given these findings, the team also concludes that it may be worth screening heart failure patients for breathing muscle weakness.

Source: Journal of the American College of Cardiology, February 21, 2006.

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Pesticide Risk to Babies Underestimated: Study

 

HealthDay News

Thursday, March 2, 2006

THURSDAY, March 2 (HealthDay News) -- Newborns have far greater variability in susceptibility to pesticides than previously believed, U.S. researchers report. They found that some newborns may be 26 to 50 times more susceptible to certain organophosphate pesticides than other newborns, and 65 to 130 times more sensitive than some adults.

The study "raises the question of whether current standards for safe levels of pesticide exposure are sufficiently protective of a vulnerable population," co-lead author Nina Holland, a University of California, Berkeley adjunct professor of environmental health sciences, said in a prepared statement.

"Based on our study, I feel that more research is urgently needed to establish whether the standards need to be re-evaluated," Holland said.

The study appears in the March 2 issue of the journal Pharmacogenetics and Genomics.

Along with researchers at the University of Washington, Holland's team studied 130 Hispanic women and their newborns living in California's Salinas Valley, an agricultural area where almost 200,000 pounds of the organophosphate pesticides diazinon and chlorpyrifos are used each year.

Current U.S. Environmental Protection Agency (EPA) guidelines for pesticides require an tenfold extra safety factor to protect children compared with adults if there are gaps in information about the children's susceptibility. The EPA can select a lower safety factor if the agency believes there's enough available information.

"People have this remarkable difference in enzymes that defend their health from pesticide exposure," Holland said. "In developing regulatory standards for safe levels of exposure, we need to protect the most sensitive in a population, particularly because children and unborn fetuses are involved."

More information

The EPA has more about pesticides and health.


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Whirlpool baths: enter at your own risk

 

By Megan Rauscher

Reuters Health

Thursday, March 2, 2006

Better think twice before soothing those aching muscles in a whirlpool bath or hot tub. A new study shows that whirlpool bathtubs can be a breeding ground for a host of disease-causing bacteria.

Dr. Rita B. Moyes a microbiologist at Texas A & M University tested 43 water samples from both private and public whirlpool bathtubs. "Every tub tested had some kind of microbial growth," she told Reuters Health.

"And I was just getting the few organisms I was testing for, so it is probably just the tip of the iceberg as far as what is really present. Also, I did no viral testing," Moyes emphasized.

In 95 percent of the tubs, bacteria derived from feces were present, while 81 percent had fungi and 34 percent contained potentially deadly staphylococcus bacteria.

Moyes explained that a teaspoon of normal tap water contains about 138 bacteria and many samples are bacteria-free. A teaspoon of whirlpool tub water, on the other hand, contains an average of more than 2 million bacteria.

The interior pipes of whirlpool baths that are not filtered or chemically treated, and non-maintained hot tubs, are prime areas for potentially infectious microbes to congregate and grow, Moyes noted. These organisms often form a biofilm - a community of organisms, which work together and are more resistant to cleaners.

When the jets are switched on, the bacteria-packed water gets blown into the tub. "Due to the movement of the water, an aerosol is created that carries these organisms down into your lungs or other orifices - something that doesn't happen in a regular tub," Moyes explained.

The bacteria found in whirlpool baths can lead to a number of diseases, including urinary tract infections, skin infections, and pneumonia.

So who is most at risk? "Of course the young and the old and the immunocompromised should not be exposed, including breathing in the aerosol from outside the tub," Moyes said.

"A chemically maintained hot tub should not be a problem to a healthy person but if you are having recurring infections, consider the tub as a potential source," she added. Moyes' research is published in an online journal called PM Engineer.

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Health Tip: Some Pregnant Women at Higher Risk of Gestational Diabetes

 

HealthDay News

Thursday, March 2, 2006

(HealthDay News) -- Gestational diabetes is diabetes that is found for the first time when a woman is pregnant.

Diabetes means that a woman's blood sugar is too high, a condition that isn't good for her or her baby, according to the National Diabetes Information Clearinghouse.

Of every 100 pregnant women, three to eight develop gestational diabetes.

Women are at higher risk if they are overweight or have a family history of diabetes.

If a woman is at higher risk, it's recommended that she be checked for the condition during one of her first prenatal visits.

If she is found to have gestational diabetes, doctors will recommend exercise and changes in diet, and in some cases, will prescribe insulin.

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Eat more whole grains to lower diabetes, heart risk

 

By Charnicia Huggins

Reuters Health

Thursday, March 2, 2006

 A diet high in whole grains may lower a person's likelihood of developing diabetes and heart disease, new study findings show.

Among more than 900 healthy men and women, those who reported consuming the most whole grains had lower levels of cholesterol and various markers of heart disease and better-controlled blood sugar.

"This suggests that people with a high whole-grain intake may have lower risks of diabetes and ischemic heart disease," study author Majken Karoline Jensen, of Aarhus University Hospital in Denmark, told Reuters Health.

Jensen and colleagues found that healthy men and women who reported the highest intake of whole grains had levels of homocysteine, a blood protein that has been tied to heart disease and stroke, that were 17 percent lower than those who reported consuming the least amount of whole grains.

Apart from the better cholesterol and blood sugar levels, levels of insulin and C-peptide, a marker of insulin production, were also 14 percent lower in the high whole-grain consumers, the researchers report in the American Journal of Clinical Nutrition.

Furthermore, concentrations of leptin, a hormone that generally reflects body fat levels, were 11 percent lower among the whole-grain eaters than among their counterparts.

"Together with a growing body of evidence on the effects of refined carbohydrates versus whole grains, our study suggests that replacing refined grain products with whole grain products may be beneficial in terms of lowering cholesterol levels and maintaining a constant blood sugar," Jensen told Reuters Health.

Source: American Journal of Clinical Nutrition, February 2006.

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Lifestyle affects the brain as well as the heart

 

By Amy Norton

Reuters Health

Thursday, March 2, 2006

There is growing evidence that what's good for the heart is also a boon for the aging brain, according to a new research review.

In a survey of 26 large studies of older adults, an expert panel found that certain heart-health factors -- like high blood pressure, diabetes and exercise habits -- appeared key to study participants' cognitive function as well.

Cognitive function refers to a person's ability to learn, reason and remember, for example, and these skills commonly decline with age. In some cases, the decline is part of a process leading to Alzheimer's disease or other forms of dementia.

But a growing number of studies are finding that controllable lifestyle factors such as exercise and intellectual and social engagement throughout life seem to alter a person's risk of cognitive decline and dementia.

Going out for a daily walk might not prevent Alzheimer's, but it might help delay its onset, according to Dr. Hugh C. Hendrie of the Indiana University Center for Aging Research in Indianapolis.

Hendrie headed the committee that conducted the research review, which is published in the Alzheimer's Association journal Alzheimer's & Dementia.

The review included 96 analyses of 26 North American and European studies that followed large groups of older adults over time, charting both cognitive and emotional health.

What emerged was an unexpected level of consistency regarding some risk factors, according to Hendrie.

"It did surprise us a little that there's some consensus developing," he told Reuters Health.

Among the consistent findings were the associations between high blood pressure and poorer cognitive function and between regular exercise and sharper cognitive skills. A number of studies have also implicated diabetes and excess weight in contributing to age-related cognitive decline.

The reasons for all these associations are not completely clear, Hendrie said, but damage to blood vessels -- either to large vessels from a major injury like a stroke, or to smaller vessels from the long-term build-up of plaques -- may offer one explanation.

So the same things recommended for heart health -- including moderate exercise, a healthy diet, and preventing or controlling conditions like high blood pressure and diabetes -- may protect mental health as well, according to Hendrie and his colleagues.

Regarding exercise, animal research suggests it may even have direct protective effects on brain cells, Hendrie pointed out. "It does look like exercise is important," he said.

Though it's not clear how much exercise is necessary, moderate activity like walking is a good idea for overall health -- and, Hendrie noted, "it's never too late for older people to start."

Mental exercise may also be key, a number of studies show. Older adults who stay intellectually stimulated through reading or other hobbies may slow the onset of cognitive decline, and the same may be true of people who stay socially active.

"The things that are likely to be good for your overall health anyway," Hendrie said, "may also be good for your brain health."

Source: Alzheimer's & Dementia, February 21, 2006.

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Study confirms oral contraceptive-migraine link

 

By Anne Harding

Reuters Health

Thursday, March 2, 2006

Women who take oral contraceptives have increased chances of suffering from both migraines and non-migraine headaches, a large new population-based study shows.

Some women have migraines during menstruation, when levels of estrogen drop, Dr. Karen Aegidius of the Norwegian National Headache Center in Trondheim, the study's lead author, told Reuters Health.

These women also are more likely to have migraines while taking oral contraceptives, she added, explaining that these pills can boost estrogen levels up to four-fold above normal, resulting in a particularly steep estrogen drop-off with menstruation.

Aegidius and her colleagues studied data from 13,944 women included in the Nord-Trondelag Health Study in Norway who responded to questions on both oral contraceptive use and headaches.

Migraines were 40 percent more common among women taking oral contraceptives, the researchers report in the medical journal Neurology, and non-migraine headaches were 20 percent more common.

However, the team could find no link between the amount of hormones contained in the pills and headache risk.

Physicians whose patients suffer headaches while on the pill could prescribe an estrogen patch to be used two to three days before menstruation, Aegidius suggested, so that estrogen levels wouldn't drop so steeply.

Another possibility, she added, is for women to stay on estrogen for three consecutive months, so they experience headaches just four times a year rather than every month.

Finally, she pointed out that the fall in estrogen with Mircette, an oral contraceptive available in the US but not Europe, is gradual rather than immediate, which could reduce headache risk.

Source: Neurology, February 14, 2006.

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Wednesday, March 1, 2006

 

Poverty, not race, lowers prostate cancer survival

 

Reuters Health

Wednesday, March 1, 2006

The racial gap seen in the outcome of prostate cancer among older men is primarily due to differences in socioeconomic status, according to the results of a large community-based study.

The exception is Hispanic men, who have the highest rates of survival, but a socioeconomic status on par with African American men.

"Lower socioeconomic status appeared to be one of the major barriers to achieving comparable outcomes for men with prostate carcinoma," Dr. Xianglin L. Du, from the University of Texas School of Public Health in Houston, and colleagues report in the medical journal Cancer.

The findings are based on analysis of data from 61,228 men, 65 years of age or older, who were diagnosed with prostate cancer between 1992 and 1999. The subjects were from 11 US geographic areas and were followed for up to 11 years.

After factoring in age, other illnesses, tumor grade, and treatment, men in with the lowest socioeconomic status were 31 percent more likely to die than those at the highest socioeconomic level, the report indicates.

The "marginally significant" survival advantage for white men compared with African American men disappeared after adjusting for socioeconomic factors, the researchers note. By contrast, Hispanic men continued to have a lower risk of death than the other groups after adjusting for these factors.

The exact reason for this "Hispanic Paradox," as it has come to be called, is unclear, Du's team notes. It could be related to the "healthy immigrant theory" and may reflect strong social support. Still, the number of Hispanics in the study was relatively small, which may have led to "unstable results," they point out.

"These findings have important public health implications if we are to achieve the goals of Healthy People 2010, one of which is to eliminate health disparities among different segments of the population," the researchers conclude.

Source: Cancer, March 15, 2006.

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Blood Protein Could Signal Lung Disease Risk

HealthDay News

Wednesday, March 1, 2006

WEDNESDAY, March 1 (HealthDay News) -- C-reactive protein (CRP), a blood marker for inflammation typically used to identify cardiovascular risk, might also help spot people with abnormal precancerous lesions in the lung, Canadian researchers report.

Researchers measured CRP, lung function and other inflammatory markers in 65 people with "bronchial dysplasia" -- at least one site of abnormal lung cell activity, measured at greater than 1.2 millimeters in size.

When the patients were assessed again six months later, 32 had bronchial lesions that had progressed to a more abnormal state, greatly raising cancer risk.

What's more, the team also found that "the odds of developing progressive disease were 9.6-fold higher in the group that had CRP greater than 0.5 mg per liter compared with the group less than this threshold," Dr. Stephen Lam, of the Lung Tumor Group, British Columbia Cancer Agency, at the University of British Columbia, said in a prepared statement.

"These data are consistent with the prevailing hypothesis that squamous cell carcinoma arises from preinvasive lesions in stepwise fashion, which is called the sequential theory of cancer development. This hypothesis is supported by animal experiments mimicking human carcinogenesis," Lam said.

He said the findings from this study may eventually help in the design of chemopreventive and early-detection studies, by identifying people at high risk for non-small cell lung cancer.

More information

The U.S. National Cancer Institute has more about lung cancer screening.

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Study Casts Doubt on Glycemic Index

 

By John C. Drake

Associated Press Writer

The Associated Press

Wednesday, March 1, 2006

Diets that distinguish between "good carbs" and "bad carbs," are not an effective way of controlling blood sugar levels, a new study suggests.

Although made popular by the South Beach Diet and others, the glycemic index has never been fully embraced by most dietitians and remains a point of debate among scientists.

Now, diabetes researcher Elizabeth Mayer-Davis of the University of South Carolina says the use of the index should be ended altogether in favor of more traditional methods of losing weight and reducing the risk of diabetes — eating less and exercising more.

"The glycemic index is sufficiently flawed as an index that it is not helpful for scientists or people trying to create a healthy diet," Mayer-Davis said.

The glycemic index is a 100-point scale, with white bread at 100 points, that measures how quickly carbohydrates enter the bloodstream as sugar.

According to index supporters, people should avoid high-glycemic foods such as white bread and potatoes because they will quickly raise a person's blood-sugar level. Meanwhile, low-glycemic foods such as carrots and apples are absorbed more slowly, making a person feel full longer and reducing cravings, which helps with weight loss.

Promoters of the diet also say that eating low-glycemic foods will result in less fluctuation in their blood sugar levels.

Both the Atkins and South Beach diets have raised interest in the theory, and an entire series, "The Glucose Revolution," guides consumers through a diet based on it.

Beth Kunkel, a professor of food science and human nutrition at Clemson University and president of the South Carolina Dietetic Association, said that while there is debate among dietitians about its validity, it would be a mistake to reject the concept altogether. Kunkel was not involved in the University of South Carolina study.

"To just reject it out of hand and quit working on it would be a mistake," Kunkel said. "I just think we're five to 10 years away from really understanding it from a research viewpoint."

Previous studies have shown conflicting results. One small study showed that people on a low-glycemic diet were less hungry later in the day than a group fed a high-glycemic diet. Another study, involving 39 overweight people, showed that those on a low-glycemic diet lowered their risk of heart disease. Both studies were conducted by Dr. David Ludwig of Boston's Children's Hospital.

However, American Heart Association officials have disputed the significance of those findings.

The new study, published in the February issue of the British Journal of Nutrition, relied on food questionnaires from more than 1,000 people over five years and assessed their consumption of high- and low-glycemic foods. Researchers tested their blood sugar levels twice during the study period and found no significant correlation between the glycemic index of foods and the blood-sugar levels of participants.

Mayer-Davis said that researchers should develop a new measure of how different carbohydrates can affect health. She said a better index would be based on the physical characteristics of foods, such as fat content and calories, because numerous factors influence a food's effect on blood-sugar levels.

On the Net:

University of South Carolina's Arnold School of Public Health: http://www.sph.sc.edu

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Age Influences Visual Perception

 

HealthDay News

Wednesday, March 1, 2006

WEDNESDAY, March 1 (HealthDay News) -- When it comes to how the brain processes visual information, age matters, a new study suggests.

Duke University researchers used brain imaging technologies to study the brains of two groups of volunteers -- aged 19 to 28 and 60 to 82 -- while they performed vision-related tasks.

Younger people tended to use "bottom-up" areas of the brain involved in processing the visual features of a scene, the researchers report in the March 1 online edition of the Neurobiology of Aging. This area is the occipital region, located in lower back of the brain.

In contrast, older adults made more use of "top-down" areas located in the front and upper back areas of the brain. These "parietal" areas control higher functions such as speech, thought and planning for the future.

For their study, the researchers used functional magnetic resonance imaging (fMRI) to study the volunteers' gray brain matter and another technology, diffusion tensor imaging (DTI), to study their white matter. Gray matter is responsible for information processing and white matter enables transmission of information between different areas of the brain.

The study found that white matter appeared to play a role in which areas of the brain are activated during vision tasks. It also found that age-related decline in white matter was more pronounced in frontal areas of the brain.

"It appears that age-related cognitive changes are the result of combined influences on the gray matter and the white matter," study author David Madden, a behavioral psychologist and researcher on aging, said in a prepared statement.

"We need further studies to better understand how all these different factors relate to each other, and which changes in cognition result from normal aging or something else," he said.

More information

The American Academy of Family Physicians has more about aging and the brain.

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Coma may be self-induced by teens with diabetes

 

Reuters Health

Wednesday, March 1, 2006

Among people with diabetes, there's a danger that too much insulin can lower blood sugar levels too far, which can lead to coma in severe cases. While this is nearly always an accidental mishap, in rare instances it may be intentional.

Recurrent episodes of so-called hypoglycemic coma among teens may be a red flag for deliberate self-administration of large doses of insulin, French investigators report.

Dr. Pierre Bougneres and colleagues at Saint Vincent de Paul Hospital in Paris investigated 322 cases of recurring hypoglycemic coma since 1990 in 149 adolescents with type 1 diabetes.

According to the team's report in the medical journal Diabetes Care, 19 patients had a very unusual frequency of coma. Sixteen of these patients (15 girls and 1 boy), at the time of the event or over the next several years, admitted to surreptitious self-administration of insulin.

Seven of these young people admitted to using insulin to deliberately induce coma, in one case to attempt suicide. Five of the patients had significant familial difficulties, including incest, hidden abortion, and alcoholism.

Another five teens injected secretive doses of insulin, apparently in response to strong parental pressure to bring down blood sugar levels because of unreasonable fears of future blindness.

The remaining four patients used secret injections to mask periods in which they had skipped their usual injections.

Bougneres' team advises doctors that "all children with more than two repeated comas within a 3-month period should immediately be hospitalized to allow in-depth discussions with physicians, nurses, and psychiatrists after the physician has made clear that secret self-administration of insulin is suspected."

Source: Diabetes Care, February 2006.

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Health Tip: Valerian as Sleep Aid

 

HealthDay News

Wednesday, March 1, 2006

(HealthDay News) -- Valerian, an herb native to Europe and Asia and introduced in the United States, is often marketed as a natural sleep aid.

But clinical research has yet to prove that the herb actually works in inducing sleep, the U.S. National Institutes of Health's Office of Dietary Supplements says.

"Although the results of some studies suggest that valerian may be useful for insomnia and other sleep disorders, results of other studies do not," the agency says. "Overall, the evidence from these trials for the sleep-promoting effects of valerian is inconclusive."

Women who are pregnant and children under age 3 should not take supplements containing the herb, since its side effects have not completely been evaluated on these groups, the agency says.

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Family docs fine for breast cancer follow-up

 

By Will Boggs, MD

Reuters Health

Wednesday, March 1, 2006

 Women who have been treated for early-stage breast cancer can safely rely on their family physicians for their follow-up care, according to a new report.

"I think the most important message is that patients should be told frankly about what the limitations and potential benefits of follow-up are," Dr. Eva Grunfeld from Dalhousie University, Halifax, Nova Scotia, told Reuters Health.

"They should be informed that follow-up can be provided by their family physician so that they can make an informed choice about their follow-up arrangements," she explained.

Grunfeld and her colleagues conducted a 5-year controlled trial of routine follow-up care, provided either by family physicians or cancer specialists, for 969 breast cancer patients from six regional cancer centers in Ontario.

Serious clinical events proved to be extremely rare, with only 35 occurring during follow-up, the investigators report in the Journal of Clinical Oncology. The frequency of these events was similar in patients followed by their family physician or by a specialist. The quality of life was also similar in the two study groups.

In preliminary studies that preceded this clinical trial, Grunfeld said, "patients indicated that they would prefer to stay with the cancer specialist until the end of the first year. That is why the study was designed to enroll patients at 12 months." Women also indicated that they would want reassurance of access to specialist care should they need it.

"Our plans are now to test an intervention which can facilitate the transfer of care," she continued.

"The intervention consists of several components," Grunfeld explained, "including guidelines for the family physicians, guidelines on follow-up for the patient, a patient care plan which includes recommendations for referral back to the oncologist ... and a supportive care resource kit."

Source: Journal of Clinical Oncology, February 20, 2006.

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Antibiotic Can Cause Life-Threatening Blood Sugar Problems for Older Patients

 

By Steven Reinberg
HealthDay Reporter

HealthDay News

Wednesday, March 1, 2006

 WEDNESDAY, March 1 (HealthDay News) -- Antibiotics can be lifesaving medicines that fight bacterial infection, but the antibiotic Tequin can cause changes in blood sugar levels that can be life-threatening to older patients in particular, a new study finds.

The Canadian research, which will appear in the March 30 issue of The New England Journal of Medicine, is being released Wednesday because of last month's warning about Tequin (gatifloxacin) from the drug's maker, Bristol-Myers Squibb. The Feb. 16 advisory was issued at the request of the U.S. Food and Drug Administration (FDA).

The warning, added to the drug's label and sent to doctors, notes serious cases of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) in patients receiving the drug. The antibiotic commonly is used to treat pneumonia, bronchitis, gonorrhea and infections of the urinary tract, kidneys and skin.

Since 1999, when Tequin was approved by the FDA, there have been cases of life-threatening events in patients treated with the drug. Although most of these were reversible, a few were fatal.

The new warning strengthens the existing warning about low blood sugar and high blood sugar, adds a contraindication for use of the drug with diabetics, and includes information about other risk factors for developing low blood sugar and high blood sugar.

However, Laura Y. Park-Wyllie, from the Institute for Clinical Evaluative Sciences at St. Michael's Hospital in Toronto, and lead author of the new study, doesn't think the warning is strong enough.

"We have a drug here that is commonly used and is associated with a potentially life-threatening medical problem," Park-Wyllie said. "Really, what it comes down to is that we have a number of antibiotics that treat the same infections and don't cause the same problems."

"Doctors should think twice and consider whether this is the antibiotic they want to use, given the many other antibiotics which don't have the same problems," Park-Wyllie said. "If it were me, I wouldn't want to take it or have a family member take it. There are other alternatives that are safer to take."

In the study, Park-Wyllie's team compared cases of high and low blood sugar among older patients taking Tequin and other antibiotics. The researchers identified 788 patients treated for low blood sugar within 30 days of antibiotic therapy.

Compared with other antibiotics, Tequin was associated with an increased risk of low blood sugar. "There was a four times greater risk of developing low blood sugar with Tequin than with any other antibiotic," Park-Wyllie said.

They also identified 470 patients treated for high blood sugar within 30 days after antibiotic therapy. Again, Tequin was significantly associated with the condition compared with other antibiotics. "There was an almost 17 times greater risk with Tequin compared with other antibiotics," she noted.

"It didn't seem to matter whether or not people had diabetes or not," Park-Wyllie said. "So, both people with and without diabetes seemed to be at risk for developing these blood sugar problems."

"This is different from the warning that went out, which focuses on diabetes only," Park-Wyllie said.

One expert agreed that Tequin should be avoided.

"The warnings are not effective, including the letter I received, in preventing errors in prescribing in situations like this," said Dr. Jerry H. Gurwitz, executive director of the Meyers Primary Care Institute at the University of Massachusetts.

Gurwitz, author of an editorial that accompanies the study, doesn't think there is any need for Tequin.

"There are alternatives to this drug," he said. "Those alternatives are probably safer, less costly and equally effective," he said. "Under circumstances like this, you wonder does a drug like this really need to be available? Who in the world needs this drug and all the risks associated with it?"

Despite this latest finding, Bristol-Myers Squibb stands behind the drug and the new warning label. "The study is consistent with the label change," said Bristol-Myers Squibb spokesman Eric Miller.

More information

The American Academy of Family Physicians can tell you more about antibiotics.

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Vitamin D plus calcium curbs falls in older women

 

Reuters Health

Wednesday, March 1, 2006

Long-term dietary supplementation with vitamin D and calcium significantly reduces the risk of falling among older women, according to the results of a new study.

Dr. Heike A. Bischoff-Ferrari, at the University Hospital Zurich, Switzerland, and colleagues assigned 199 men and 246 women to take either vitamin D and calcium daily or placebo.

The subjects were at least 65 years of age (average, about 71 years) and lived at home.

During follow-up over 3 years, 49 percent of the men and 55 percent of the women experienced falls, according to results published in the Archives of Internal Medicine. Of the 231 total falls, 107 occurred in the vitamin D-calcium group and 124 occurred in the placebo group.

On analysis of the data, the researchers found vitamin D-calcium supplementation, compared with placebo, was not associated with an overall lower risk of falling in the total group of subjects.

However, among women, vitamin D and calcium did significantly reduce the risk of falls by 46 percent. No significant reduction was seen in men.

One explanation may be that "ambulatory women have lower muscle strength and an increased susceptibility to falls than ambulatory men," Bischoff-Ferrari and colleagues suggest. "Only among less active men who stayed on treatment could a possible benefit not be excluded," they note. "However, this result was not significant."

Source: Archives of Internal Medicine, February 27, 2006.

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Radiowave Technique Steadies Abnormal Heartbeats

 

By Ed Edelson
HealthDay Reporter

HealthDay News

Wednesday, March 1, 2006

 WEDNESDAY, March 1 (HealthDay News) -- Generating intense radio waves to kill tiny areas of flawed heart tissue can bring permanent relief to people who have suffered for years from atrial fibrillation, the most common form of abnormal heart rhythm, a new American-Italian study finds.

Some 2.3 million Americans live with atrial fibrillation, in which the normal pattern of electrical impulses that cause the heart to beat regularly are disturbed in the atria, the upper chambers of the heart. Many can be helped by medications or an electric shock treatment called cardioversion, but others cannot. Atrial fibrillation increases heart attack risk in several ways, most notably by encouraging the formation of blood clots.

The new research included 146 people with chronic atrial fibrillation who were treated at the University of Michigan in Ann Arbor and the San Raffaele Hospital in Milan. Half got standard treatment, while 77 got standard treatment and catheter ablation, in which a circle of cells around the source of the abnormal heartbeats is killed by radio waves emitted by a catheter threaded into the heart.

A year after the treatment, 55 of the patients who had catheter ablation were free of their irregular heartbeats, reported a steep drop in symptoms, and stopped taking medications (although 26 of them required a second ablation). In contrast, 53 of the people in the other group had catheter ablation in the following year, and only three of those who did not get the therapy regained normal heart rhythm.

"Catheter ablation has been available for 20 years or so for other arrhythmias [abnormal heartbeats]," said study author Dr. Hakan Oral, an associate professor of medicine at the University of Michigan Medical School. "Atrial fibrillation is much more complex than other arrhythmias. Much progress has been made in recent years in using this for atrial fibrillation, and this study is reflection of those prior advances."

The finding is reported in the March 2 issue of the New England Journal of Medicine.

An accompanying editorial, however, warns against speedy adoption of catheter ablation for atrial fibrillation.

The impressive results were reported by physicians who are highly skilled in the technique, and "it might not be ready for the doctor on the corner," said Dr. Kenneth A. Ellenbogen, a professor of medicine at the Virginia Commonwealth University School of medicine, and co-author of the editorial.

"The physicians in the study were very experienced with the technique," Ellenbogen added. "It's possible that this technique will prove to be very successful, and that is what the study begins to show. But like any new technology, it needs to be studied in the hands of people who are not yet masters of it."

The new study also included a relatively small number of patients, Ellenbogen noted. "It needs to be studied in larger groups of patients and tested against other competing techniques," he said.

However, the technique is not all that difficult to learn, Oral said. "It is doable by most people and the learning curve is steep," he said. "It can be learned in a short time."

Meanwhile, he and his colleagues are planning studies to improve the effectiveness of the procedure. "We are exploring different mechanisms and devices," Oral said.

The primary targets of catheter ablation will be people whose atrial fibrillation has not been controlled by medication, cardioversion or other treatments, he said. Another group that might want to undergo the procedure are patients who are young and are not willing to take medications for the rest of their lives, Oral said.

More information

Catheter ablation is explained by the U.S. Food and Drug Administration.


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Childhood depression tied to adult asthma, obesity

 

By Amy Norton

Reuters Health

Wednesday, March 1, 2006

 Young adults with asthma appear to be at greater risk of becoming obese later in life -- and childhood depression may play a role in the connection, according to researchers.

Their study of nearly 600 men and women found that those who had asthma symptoms at the age of 20 were three times more likely than their non-asthmatic peers to become obese by age 40. Also, depression during childhood or adolescence appeared to be a common factor.

All of this suggests that early depression may somehow contribute to the development of both asthma and excessive weight gain, according to Dr. Gregor Hasler of the University Hospital Zurich in Switzerland.

Hasler and his colleagues report the findings in the current issue of the International Journal of Obesity.

A number of studies have suggested that obesity raises the risk of developing asthma, but some researchers have argued that this is not necessarily a one-way relationship. The current findings support this idea by showing that "asthma also may precede obesity," Hasler told Reuters Health.

And, in fact, the study found no evidence that obesity in young adulthood increased the risk of developing asthma later on. This was an unexpected finding, Hasler said, given that past studies have pointed to obesity as a risk factor for asthma.

Exactly why asthma may contribute to excessive weight gain is not clear. Some asthma medications may cause people to put on extra pounds, the researchers note, but the study lacked detailed information on any treatments asthmatic participants were taking.

People with asthma may also be less likely to exercise -- though study participants' activity levels, reported at two separate times in their 20s, did not explain the connection between asthma and later obesity.

On the other hand, a history of depressive symptoms during childhood or adolescence did explain a large share of the asthma-obesity relationship, the researchers found.

It's not yet known why the three are linked. One possibility, Hasler speculated, is that early depression is a marker of a stressful family life.

"Since psychological stress early in life is a risk factor for the development of both obesity and asthma," he said, "it may explain why asthma and obesity co-occur in an individual more frequently than expected by chance."

It's also possible that certain genes affect the risks of early depression, asthma and obesity alike, according to the researcher.

For instance, Hasler explained, all three disorders are marked by widespread inflammation in the body, a product of immune system activity. So some genes that help regulate this inflammatory process may also contribute to depression, asthma and obesity.

Most likely, Hasler said, some combination of genes and environment explains the connections between early depression and later asthma and weight gain. He and his colleagues call for more research to unravel the relationships among the three.

Source: International Journal of Obesity, February 21, 2006.

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Obese People Might Be More Sensitive to Pain

By Steven Reinberg
HealthDay Reporter

HealthDay News

Wednesday, March 1, 2006

 WEDNESDAY, March 1 (HealthDay News) -- Obese people may be more sensitive to pain than people who aren't overweight, a new study suggests.

Researchers gauged reaction to pain among 62 older adults who had osteoarthritis of the knee, a disease that affects more than 20 million people in the United States. The study participants -- one-third of whom were obese -- were given a mild electrical shock on the left ankle that caused sensations of tingling and mild pain in the lower leg. This was done before and after the participants took a 45-minute, coping-skills session that included progressive muscle-relaxation exercises.

The researchers wanted to see if coping-skills training would help people with osteoarthritis to better cope with the pain caused by the disease.

But the scientists were especially interested in determining how the obese group responded to pain. A small number of studies have looked at pain sensitivity among obese people, but they have produced conflicting results.

The researchers found that obese individuals had a greater physical response to the electrical stimulation than non-obese people. They based their findings by measuring the reflex of the lower leg muscles; this indicated that the obese individuals had a lower tolerance for pain, even though they said that they felt no more pain than non-obese people.

The findings are to be presented Saturday at the American Psychosomatic Society annual meeting, in Denver.

"For subjective indicators of pain, obese people indicated similar levels of pain to non-obese people," said study author Charles Emery, a professor of psychology at Ohio State University. "But when we looked at objective indicators, we found that the obese group had a lower threshold for pain."

Emery believes that obese people may have more experience with pain because of their weight. "They may be used to some degree of pain," he said.

But obese people appear to experience greater pain than non-obese people, Emery added. "It is important to look at both objective indicators of pain, as well as subjective indicators," he said. "We need to keep in mind that the subjective rating may not be reflective of physiological processes that are going on."

One expert found the study results compatible with what is known about how people experience pain.

"These results do not surprise me at all," said Dr. Doris K. Cope, director of the Pain Medicine Division at the University of Pittsburgh.

Pain is not only a physiological stimulus-response, but the psychological interpretation of that stimulus providing a total experience of pain, Cope said. "Psychological studies of the obese demonstrate personality differences between obese and non-obese subjects, so it would not surprise me if these patients also experience pain differently as well," she said.

More information

The American Society of Anesthesiologists can tell you more about managing pain.


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Chemotherapy treatment suggested for bird flu patients

 

By Patricia Reaney

Reuters

Wednesday, March 1, 2006

 A chemotherapy treatment given to patients with an immune system disorder may work for human avian influenza, but it has not been tested in patients, researchers said on Thursday.

Dr Jan-Inge Henter of the Karolinska Hospital in Stockholm said at the moment it was a theory.

But he and colleagues in Hong Kong believe chemotherapy treatment could work because of the similarities between human infection with H5N1 bird flu and an illness known as haemophagocytic lymphohistiocytosis (HLH).

"Since the mortality from H5N1 infection is high, and since there is concern that the virus could cause a pandemic, novel treatments for human beings are warranted," Henter said in his hypothesis, published online by The Lancet medical journal.

The H5N1 bird flu virus, which has spread from Asia to birds in Europe, the Middle East and Africa, has killed 94 people since 2003. Global health experts fear the virus could mutate into a pandemic strain capable of killing millions of people.

Henter said human infection with H5N1 produces similar symptoms to people suffering from HLH, an illness that produces too many white blood cells which can accumulate in healthy tissue and cause organ damage and death.

HLH can be inherited or can develop after a severe infection by a virus such as Epstein-Barr.

Children with the inherited form of HLH usually died until Henter and other scientists developed the chemotherapy treatment in 1994. Henter said the treatment had reduced deaths in children and had produced similar results in people with the secondary form of disorder.

"Now we know that HLH also occurs in patients with avian flu," Henter explained in an interview.

"There are clinical similarities and similarities at autopsy. So why shouldn't one use a treatment that has been successful in other forms of HLH induced by viruses?" he asked.

The chemotherapy drug etoposide, which helps to kill excess immune cells, is the basis for the treatment for HLH which the scientists believe should be tested on patients with the H5N1 virus.

The treatment is usually given for 8 weeks. Henter said there is risk involved in the treatment but it has improved survival in patients. Side effects can include low blood count and moderate nausea.

"I think it is reasonable to consider this in the medical community. It is reasonable to discuss whether one could initiate a clinical study," said Henter.

He added that he would welcome the World Health Organization to consider a platform for doing clinical trails of the treatment for human cases of bird flu.

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Gingko Biloba May Help Fight Cancer

HealthDay News

Wednesday, March 1, 2006

WEDNESDAY, March 1 (HealthDay News) -- Studies in mice suggest the popular herbal remedy Gingko biloba might help fight human brain and breast tumors.

Mice treated with an extract of Gingko biloba leaves both before and after being implanted with human breast or brain tumors had decreased expression of a cell receptor -- peripheral-type benzodiazepine receptor (PBR) -- associated with invasive cancer, say researchers at Georgetown University Medical Center, in Washington, D.C.

This drop in PBR expression slowed the growth of breast tumors by 80 percent in treated vs. untreated mice. The effect lasted for as long as the mice received the Gingko biloba extract, the researchers added. Decreased expression of PBR also reduced the size of the brain tumors, but only temporarily so, and to a lesser degree.

"It is very encouraging that Gingko biloba appeared to reduce the aggressiveness of these cancers, because it suggests that the leaves could be useful in some early-stage diseases to prevent them from becoming invasive, or spreading," study senior author Vassilios Papadopoulos, director of the Biomedical Graduate Research Organization and associate vice president of Georgetown University Medical Center, said in a prepared statement.

"But I must stress that this is a study in mice, and so we cannot say what anticancer effects, if any, Gingko biloba might offer humans," he added.

The findings appear in the January-February issue of Anticancer Research.

More information

The U.S. National Center for Complementary and Alternative Medicine has more about Gingko biloba.

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Tuesday, February 28, 2006

 

Soy benefits heart health in healthy young men

 

By Clementine Wallace

Reuters Health

Tuesday, February 28, 2006

Soy proteins modulate the ratio of different lipids in the blood, in a way that should reduce the risk of cardiovascular diseases, in healthy subjects, according Canadian researchers.

Diet is one channel through which blood lipid levels can be modified. Lately, soy has received special attention, in particular soy proteins and soy "isoflavones" -- estrogen-like plant compounds whose effects are still controversial -- according to lead author Alison Duncan, from the University of Guelph in Ontario, Canada.

"There is evidence to suggest that soy reduces lipid levels in various samples of humans, but it hasn't really been looked at in people that are healthy," Duncan told Reuters Health. She and her colleagues aimed to assess the effect of soy protein with varying amounts of isoflavones in healthy young men.

As described in the American Journal of Clinical Nutrition, the study included 35 healthy men about 28 years old, who took three different supplements for periods of eight weeks: "regular" milk proteins, soy proteins with low isoflavone content, and soy with high isoflavone content.

The different supplements were given in a random order, each separated by a one-month break, to insure the sequence didn't influence the findings, according to Duncan.

The researchers collected blood samples to measure levels of different lipids.

Ratios of total cholesterol to HDL ("good") cholesterol and LDL ("bad") cholesterol to HDL were significantly lower with both soy supplements, compared to the regular milk protein. "Isoflavone doesn't seem to influence the outcomes," Duncan explained, "but our results confirmed that soy proteins reduce lipid levels, even in healthy individuals."

Levels of other blood lipids were also modified in a favorable way in this group of young subjects. "It's never too early to start to try to prevent cardiovascular diseases," Duncan concluded.

Source: American Journal of Clinical Nutrition, February 28, 2006.

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Health Tip: Prevent Osteoporosis

 

HealthDay News

Tuesday, February 28, 2006

(HealthDay News) -- Forty-four million Americans are at risk of contracting osteoporosis, a disease of low bone mass that can lead to breaks and fractures.

One of every two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetimes, according to the U.S. National Institutes of Health (NIH).

In women, bone loss is related to a drop in production of the female hormone estrogen after menopause. Small, thin-boned women are most likely to develop osteoporosis.

But women aren't the only ones at risk. More than 2 million American men have the disease, the NIH says, and millions more are at risk.

The best way to help prevent osteoporosis is to get enough dietary calcium. Good sources include milk, cheese, salmon and leafy green vegetables like spinach.

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Natural painkillers linked to high blood pressure

 

By Megan Rauscher

Reuters Health

Tuesday, February 28, 2006

 Opioid hormones, which are naturally produced by the body to reduce pain, may be involved in changes in both pain sensitivity and blood pressure among people with early-stage hypertension.

"Persons with hypertension have reduced pain sensitivity," Dr. James A. McCubbin told Reuters Health. "This pattern also emerges in young people at risk for hypertension, suggesting that altered pain sensitivity may have a role in the early development of this disease," he added.

However, the exact relationship between pain perception and altered blood pressure control is not clear, McCubbin, from Clemson University in South Carolina, and his colleagues note in the medical journal Psychosomatic Medicine.

McCubbin's team examined the effects of natural opioids, such as endorphins and enkephalins, on pain perception and blood pressure in 125 young adults with mildly elevated blood pressure. On separate occasions, subjects were given the opioid blocker, naltrexone, or placebo 60 minutes before their pain threshold was tested by immersing their dominant hand in ice water for two minutes or as long as they could bear.

The results, report the researchers, support the idea that blood pressure goes up as pain sensitivity goes down -- whether or not natural opioids are blocked. This indicates that both opioid and non-opioid analgesic mechanisms are linked to blood pressure.

Additionally, McCubbin's team observed that subjects with high-normal blood pressure have diminished sensitivity to pain, which is reversed by opioid blockade. "This indicates a greater degree of opioid analgesic tone in young persons at risk for hypertension," they point out.

Summing up, McCubbin and colleagues say evidence from this study, as well as several others, suggests that natural opioid pain-lowering mechanisms "are deranged in the early stages of hypertension" and might be a cause of increased blood pressure.

"Better understanding of the effects of opioid hormones on pain sensitivity and blood pressure may lead to novel prevention and treatment strategies for hypertension and related cardiovascular diseases," McCubbin said.

Source: Psychosomatic Medicine, January/February 2006.  

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Benign Breast Findings Can Still Pose Dangers

HealthDay News

Tuesday, February 28, 2006

TUESDAY, Feb. 28 (HealthDay News) -- Breast lesions often deemed benign following a needle biopsy can still harbor adjacent cancers and should be removed anyway, U.S. researchers conclude.

"Our study shows that all papillary lesions of the breast should be surgically excised to avoid missing a cancer," study lead author Dr. Cecilia L. Mercado, an assistant professor of radiology at New York University Medical Center, said in a prepared statement.

Papillary lesions, which account for 1 percent to 3 percent of all lesions sampled by core needle biopsies, are benign growths in the duct of the breast. Current treatment for these lesions includes radiographic follow-up and surgical removal, depending on a doctor's recommendation.

While these lesions may be diagnosed as benign, they can harbor adjacent atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) -- cancerous cells confined to the lining of the milk ducts. Left untreated, both these conditions put a woman at increased risk for future cancer.

For this study, the researchers analyzed the imaging and histologic outcomes of 42 patients diagnosed with benign papillary lesions after core needle biopsy. Doctors performed 43 biopsies on the 42 patients. Of the 43 biopsies, 36 (84 percent) of the lesions were surgically removed and seven (16 percent) received long-term imaging follow-up.

As a result of surgical removal of the lesion and laboratory follow-up, the diagnoses of nine of the 42 patients (21.4 percent) were upgraded to ADH or DCIS. That percentage is much higher than reported in previous research.

"This is one of the largest series and shows statistically significant findings. The results of our study revealed a considerable upgrade to either ADH or DCIS at core needle biopsy," Mercado said. "Therefore, all benign papillary lesions of the breast should be surgically excised, since a considerable number of atypical lesions and malignant lesions could be missed."

The study appears in the March issue of Radiology.

More information

The American Cancer Society has more about benign breast lesions.

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Mild thyroid disease not tied to heart problems

Reuters Health

Tuesday, February 28, 2006

Mild disease of the thyroid gland, a hormone-secreting organ in the neck, does not generally cause heart problems or stroke, new research shows. The one exception is a slightly overactive thyroid gland, which may raise the risk of atrial fibrillation, a common heart-rhythm disturbance in which the upper chambers beat erratically.

The findings are based on a study of 3233 older adults who had thyroid function testing performed between 1989 and 1990 and then were followed through June 2002 for heart problems and stroke. All of the subjects were 65 years of age or older when the study started.

Dr. Anne R. Cappola, from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues report their findings in this week's Journal of the American Medical Association.

In terms of thyroid function, 82 percent of subjects were normal, 15 percent were mildly underactive, 1.5 percent were moderately underactive, and 1.5 percent were mildly overactive.

Compared with individuals with normal thyroid function, subjects with mildly overactive glands were nearly twice as likely to develop atrial fibrillation during follow-up. By contrast, the other types of thyroid disease did not predispose to any heart problems or stroke.

"Our analyses do not support screening older individuals for thyroid disease to prevent heart disease and stroke," the investigators conclude.

Source: Journal of the American Medical Association, March 1, 2006.

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Strong Immune System May Protect Women From Loneliness-Linked lllness

The Associated Press

Tuesday, February 28, 2006

TUESDAY, Feb. 28 (HealthDay News) -- A stronger immune system may help explain why women are less likely to become ill in the face of isolation and loneliness than men, research in mice suggests.

This more robust immune response in females may be related to the demands of motherhood, the U.S. researchers speculated.

According to a team from the University of Chicago and the University of Wisconsin, female rats that were socially isolated for three months and then subjected to 30 minutes of acute physical stress had a "staggeringly stronger" inflammatory immune response than male rats subjected to the same conditions.

The 30 minutes of stress involved being placed in a restraint tube that simulated a collapsed burrow. About two weeks after that stressful experience, both the female and male rats were injected with a substance meant to challenge their inflammatory immune response, which responds to bacteria, viruses and parasites.

The female rats has a much faster healing response than male rats following the injections, the researchers said.

They believe the findings add to a growing body of knowledge about male/female health disparities and may help explain why socially isolated men are more vulnerable to disease and death than socially isolated women.

Inflammatory response is an important immune response involved in heart disease, infectious disease, cancer and other kinds of health problems.

The study appears in the February issue of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.

More information

The U.S. National Institutes of Health has more about stress and disease.

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Stem cells fail to help heart attack damage: study

Reuters

Tuesday, February 28, 2006

An experimental therapy using the body's bone marrow stem cells to repair damage done to cardiac tissue and blood vessels in a heart attack does not appear to work, German researchers reported on Tuesday.

The study from Technische Universitat in Munich involved a growth protein called granulocyte colony-stimulating factor, which brings the body's bone marrow stem cells into play.

The authors said there is increasing evidence that stem cells can contribute to regeneration of cardiac tissue and the development of new blood vessels following a heart attack.

But a study involving 114 heart attack victims found that the stem cell stimulating substance had "no influence" on the size of the area of damage to the heart, how well the heart pumped or on keeping blood vessels from narrowing again.

The patients in the study were given either the substance or an inert placebo for five days following a heart attack.

The study was published in this week's Journal of the American Medical Association along with an editorial from Robert Kloner, a physician at the University of Southern California in Los Angeles, who said the therapy in question remains experimental and has "yet to be proven in large, long-term multicenter trials ... ."

While some may be disappointed with the German study, he said, "this investigation is one of the first, controlled, larger, and more carefully designed studies to assess the effect of an attempt to recruit stem cells" for heart attack repair.

"Additional large, carefully designed trials are needed to assess the true potential (or possibly lack of potential) of stem cell therapy," he added.

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Monday, February 27, 2006

 

Want to live longer? Think positive thoughts

 

Reuters

Monday, February 27, 2006

Optimism is good for the heart, a study said on Monday.

The most optimistic among a group of 545 Dutch men age 64 to 84 had a roughly 50 percent lower risk of cardiovascular death over 15 years of follow-up, according to the study published in the Archives of Internal Medicine.

Previous research has suggested being optimistic boosts overall physical health and lowers the risk of death from all causes. A positive attitude also has been shown to help patients who suffer from heart disease caused by narrowed arteries.

The new study measured participants' level of optimism about their lives by having them respond to statements such as "I do not look forward to what lies ahead for me in the years to come" and "My days seem to be passing by slowly," or "I am still full of plans."

"Optimism can be estimated easily and is stable over long periods," though it does tend to decrease with age, said lead researcher Erik Giltay of the Institute of Mental Health in Deft, the Netherlands.

On a scale of zero to three, with three being most optimistic, the average scores in the study fell from 1.5 in 1985 to 1.3 in 2000.

Higher scores were associated with being younger, being better educated, living with others, having better health, and doing more physical activity.

"It is yet to be established whether interventions aimed at improving an older individual's level of optimism may reduce the risk of cardiovascular mortality," he added.

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Rheumatoid Arthritis Drugs Won't Boost Lymphoma Risk

 

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Monday, February 27, 2006

 MONDAY, Feb. 27 (HealthDay News) -- Experts have long known that rheumatoid arthritis boosts the risk for lymphoma, but the reason for this connection has remained unclear.

Now, Swedish research suggests it isn't due to the treatments for the disease, as some had feared.

Instead, chronic inflammation linked to illness appears to be the culprit, with cancer risk rising as the arthritis worsens. According to experts, this means that drugs that keep rheumatoid inflammation to a minimum may be crucial in curbing both the arthritis and its associated lymphoma risk.

"What this study is showing is, not only is there not a cause-effect relationship with treatment [and lymphomas], but the cause and effect is really with the severity of the disease," said Dr. Hayes Wilson, national medical advisor for the Arthritis Foundation and chief of rheumatology at Piedmont Hospital in Atlanta.

He was not involved in the study, which appears in the March issue of Arthritis & Rheumatism.

Rheumatoid arthritis is a chronic disease, marked by inflammation of the lining of the joints. Over time, the disease can cause long-term joint damage, chronic pain, immobility and disability. About 2 million Americans have rheumatoid arthritis, according to the Arthritis Foundation. A variety of medications are used to treat the disease, including nonsteroidal anti-inflammatory drugs (NSAIDs), other analgesic drugs, prednisone, disease-modifying anti-rheumatic drugs and newer "biologic-response modifiers," which directly modify the immune system.

"The major concern and the common interpretation of earlier reports and studies have been that the drugs used to treat rheumatoid arthritis also leads to increased lymphoma risk," explained study co-author Dr. Eva Baecklund, of University Hospital in Uppsala.

However, "reading the existing medical literature critically, I would say that results have been conflicting," Baecklund said, adding that no specific drug has ever been linked to increased lymphoma risk.

In their study, Baecklund's team evaluated the records of nearly 75,000 rheumatoid arthritis patients, zeroing in on 378 patients who also developed lymphoma. They then compared those patients to 378 healthy controls.

The researchers assessed whether arthritis patients had low-, medium- or high-activity disease, based on how long they had had the illness and how swollen or tender their joints were. Then they looked at the type of drug the patient was on.

The results: Those with medium disease activity had an eightfold rise in their risk for lymphoma, compared with those with low activity. Those with high activity disease had a 70-fold increase. The risk of lymphoma also rose as the severity of the joint damage in hands, knees and feet increased in the last year before the lymphoma was diagnosed.

More than 70 percent of the rheumatoid arthritis patients studied had taken anti-rheumatic drugs (DMARDS), including the drug methotrexate (Trexall, Rheumatrex) , which had been linked by one French study to increased risk of lymphomas. However, in this study, none of the DMARDS were linked with an increase in lymphoma risk, nor were the nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin or steroids. In fact, the researchers noted that patients who received corticosteroid injections in their inflamed joints were at particularly low lymphoma risk, suggesting the drugs might help protect against the cancer.

"This is good news for the majority of rheumatoid arthritis patients without very severe disease," Baecklund said. "And it is not so bad news for those with severe disease either, as the results suggest treatment may decrease the risk also in patients with severe disease. It should hopefully support patients with arthritis to seek medical care as early as possible and use anti-rheumatic treatment."

"This study confirms our suspicions," said Wilson. "The worse your disease, the worse your complications and associated diseases."

"We feel probably the best thing to do is aggressively treat the disease and its inflammation," he said. "By treating the disease and the inflammation, we will decrease complications and other associated diseases. If anything, we should be treating the inflammation more aggressively, not less."

More information

To learn more about rheumatoid arthritis, visit the Arthritis Foundation.


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Cocoa consumers have lower disease risk: study

 

Reuters

Monday, February 27, 2006

Men who consumed the most cocoa had a 50 percent lower risk of dying from disease compared to those who did not eat cocoa, Dutch researchers said on Monday.

Cocoa is known to lower blood pressure, though previous studies have disagreed about whether it staves off heart disease over the long-term particularly since it is contained in foods high in fat, sugar and calories.

The new study in Archives of Internal Medicine concluded that it was not lower blood pressure that corresponded to the finding of a lower overall risk of death -- although the biggest cocoa consumers did have lower blood pressure and fewer cases of fatal heart disease than non-cocoa eaters.

Instead, the report credited antioxidants and flavanols found in cocoa with boosting the functioning of cells that line blood vessels and for lessening the risks from cholesterol and other chemicals that can cause heart attacks, cancer and lung diseases. Flavanols are a class of healthy flavonoids that are found in many vegetables, green tea and red wine.

The 15-year study of 470 elderly men aged 65 to 84 in Zutphen, the Netherlands, found one-third did not eat any cocoa, while the median intake was 4.2 grams per day among the third who consumed the most cocoa. From 1985 to 2000, 314 of the men died, and the biggest cocoa eaters were at half the risk of dying compared to men who did not eat it.

The report's author, Brian Buijsse of the National Institute for Public Health and the Environment in Bilthoven, said drawing conclusions for the broader population would require more study of cocoa's impact on health.

"Before we can say cocoa can save your life, a larger study would need to be done," agreed Dr. Nieca Goldberg, a cardiologists at Lenox Hill Hospital in New York who did not participate in the research. "This study is not generalizable to the public because it was done in men over the age of 65 years."

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Arthritic Knees May Begin With Cartilage Loss

 

HealthDay News

Monday, February 27, 2006

MONDAY, Feb. 27 (HealthDay News) -- Damage to a pair of key knee structures called meniscus is associated with advanced cartilage loss in early knee osteoarthritis, Boston researchers report.

Each knee is supported and protected by a pair of C-shaped meniscus that provide load bearing and shock absorption functions, along with stability enhancement.

The onset of knee osteoarthritis is fairly common after surgical removal of all or part of a torn meniscus (meniscectomy), but little is known about the impact of meniscal damage and abnormalities on cartilage loss in knees of people predisposed to osteoarthritis, noted researchers from Boston University School of Medicine.

This study included 257 people with knee osteoarthtritis who had MRI imaging of their most severely affected knee at the start of the study, and then again at 15 and 30 months into the study. The researchers used the MRI images to measure the position of the meniscus and to evaluate the severity of meniscal damage.

Of the MRI-assessed knees, 29 percent had a previous injury, 27 percent had a previous surgery, and 5 percent had a previous meniscectomy.

As expected, the researchers found a strong association between meniscal malposition and meniscal damage. There was also a strong association between meniscal tears and cartilage loss. In addition, the study found that reductions in coverage and height of the meniscus -- caused by partial dislocation of the meniscus -- increased the risk of cartilage loss.

The findings appear in the March issue of Arthritis & Rheumatism.

This study did not implicate meniscus damage as a cause of osteoarthritis and did not distinguish the type of meniscal tear that may be linked to cartilage loss. However, the researchers said the findings highlight the importance of a strong, whole meniscus in protecting the knee from rapid damage in the early stages of disease, and perhaps lessening the need for replacement surgery.

"At present, efforts are being made to preserve a damaged meniscus rather than remove it, and an industry of meniscal replacement is developing," the authors wrote. "Our study points to the need for critical, prospective evaluation of these new therapeutic options."

More information

The American Medical Association has more about knee osteoarthritis.


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Infections linked to women's heart bypass deaths

 

Reuters

Monday, February 27, 2006

Infections, including those acquired in hospitals, may help explain why women die more frequently than men after heart bypass surgery, according to a study published on Monday.

Why women are more prone to such infections than men is not clear, said the report from the University of Michigan, nor is the reason for the higher death toll, although the body's systemic inflammatory response to infection has been linked to heart attack and death in other research.

The study, published in the Archives of Internal Medicine, was based on medical records from 9,218 Michigan residents who had bypass surgery, all of them aged 65 or older.

Investigators found that 16 percent of the women had an infection compared to 9 percent of men. Urinary, digestive, respiratory and skin infections were all more common in women than men.

"Overall, we found that women's increased risk of mortality after coronary artery bypass surgery may be due to differences in infection," said lead author Mary Rogers. "We suspect that there may be a systemic, or body-wide, response to infection, making infection at any site a concern in elderly patients."

The study also found that when men did get infections they were more likely to die of them than infected women.

"This finding was a surprise since, overall, women had greater mortality," said Rogers. "But when we looked closer, we found that there were two underlying relationships here: A greater prevalence of infection in women, and a higher mortality once infected for men."

"Women tend to live with their disease; men die of it," she said, but the overall higher death rate in women can be traced to the fact that infections were more common among women in the study.

The study did not determine whether the infections were present before surgery or were hospital-acquired, though the report said the latter is more likely since people with known infections are not good surgical candidates.

The researchers suggested that older bypass patients in the hospital should get up and start walking after surgery because staying in bed may encourage respiratory infections.

Frequent hand-washing by patients and hospital staff is also a good idea, they said, and patients might also consider asking friends and family members who have colds to send their wishes by phone instead of visiting.

Current U.S. national guidelines for bypass surgery call for patients to receive antibiotics an hour before their operation begins and to stay on them for at least a day afterward, the report said.

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Eye Damage Might Not Signal Child Abuse

 

HealthDay News

Monday, February 27, 2006

MONDAY, Feb. 27 (HealthDay News) -- Doctors have long looked upon hemorrhage in a child's retina as potential evidence of child abuse. But a new study suggests this strategy may be flawed.

"Contrary to what many doctors have been taught, we found that number and location of hemorrhages of the eye's retina aren't always proof of child abuse," forensic pathologist Dr. Patrick Lantz, of Wake Forest University Baptist Medical Center in Winston-Salem, N.C., said in a prepared statement.

His team was schedule to present their findings over the weekend at the annual meeting of the American Academy of Forensic Sciences meeting in Seattle.

"Retinal hemorrhages occur more often than most doctors think and are associated with a wide variety of conditions," Lantz noted.

The retina is the light-sensitive nerve tissue at the back of the eye. Hemorrhages occur when tiny blood vessels on the surface of the retina rupture.

Lantz found that about 16 percent of the 700 people of all ages he examined during autopsy had hemorrhages of the retina. These hemorrhages were found in people who died from ruptured aneurysms, falls, car crashes, gunshot wounds, meningitis and drug overdose.

He detected retinal hemorrhages in 30 children under age 14, but only six of those cases were associated with child abuse.

"Our research shows that you see the hemorrhages in a lot of different situations. Retinal hemorrhages occur in child abuse, but they don't always mean a child was abused," Lantz said.

"Unfortunately, many pathologists, pediatricians and ophthalmologists have been taught that retinal hemorrhages are diagnostic of child abuse unless the child was involved in a high-speed car crash or fell more than two stories," he added.

More information

The U.S. National Library of Medicine has information about shaken baby syndrome.


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Breast cancer risk tied to HRT evident across race

 

Reuters Health

Monday, February 27, 2006

Postmenopausal hormone therapy with estrogen or estrogen-progestin is associated with an increase in breast cancer risk across ethnic groups, new research indicates.

Previous studies have indicated that menopausal estrogen-progestin therapy increases the risk of breast cancer, but it is unclear whether this association varies by specific prognostic factors and ethnicity.

"Findings from our study are consistent with previous literature of an association between hormone therapy use in breast cancer, in particular, an increase in risk associated with current estrogen-progestin therapy use," Dr. Malcolm Pike from the University of Southern California, Los Angeles, and colleagues write in the International Journal of Cancer.

Moreover, "our study provides some of the first results comparing breast cancer risk among different ethnic groups in relation to hormone therapy use. The results suggest that risk among women of other races is similar to the risk previously reported among Whites," they note.

Their findings are based on data from the Multiethnic Cohort Study of more than 55,000 women to investigate the relationship between menopausal hormone therapy use and breast cancer risk.

Current use of estrogen-progestin increased the risk of breast cancer an estimated 29 percent per 5 years of use, the authors report. Current use of estrogen was associated with a 10 percent increased risk of breast cancer per 5 years of use.

The increased risk associated with current estrogen-progestin use was observed in all ethnic groups, the results indicate, but the increased risk associated with current estrogen use was not apparent among African-American women.

Past estrogen-progestin use was associated with a significant increase in breast cancer risk only among African-American women, the researchers note. Past estrogen use was not associated with a significant increase in breast cancer risk in any ethnic group.

The breast-cancer risks associated with current estrogen-progestin and estrogen use were greater for women with body mass indices below 25, the report indicates, but increased risk was also noted in women with higher BMIs.

Estrogen-progestin use was associated with a clear increase in risk for advanced disease, the investigators say, and both estrogen-progestin use and estrogen use were significantly associated with estrogen receptor-positive tumors.

Source: International Journal of Cancer, March 1, 2006.

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Surgeon's skill affects prostate cancer relapse

 

By Megan Rauscher

Reuters Health

Monday, February 27, 2006

 Prostate cancer recurrence after surgery to remove the prostate is not only influenced by features of the tumor but also by the skill or level of experience of the surgeon, according to a study presented at a medical conference in California.

"The study suggests that in surgery for prostate cancer, surgeons with more experience who've done at least 250 cases in their lifetime are more likely to get rid of the cancer permanently," Dr. Peter Scardino of Memorial Sloan Kettering Cancer Center in New York told Reuters Health.

"That is, the chances of curing a patient's cancer increase measurable until a surgeon has done more than 250 cases or so."

Patients faced with a surgical procedure should not be shy about asking their surgeon about their level of experience, Scardino said.

The findings, reported at the 2006 Prostate Cancer Symposium in San Francisco, are based on 7535 men who had their prostates removed -- a procedure called radical prostatectomy -- by one of 65 surgeons at four institutions between 1987 and 2003. After an average follow-up of 50 months, 1,281 patients (17 percent) experienced a recurrence of prostate cancer as indicated by a rising PSA level.

The rate of recurrence was associated with several tumor characteristics such as higher stage, grade, degree of tumor invasiveness, PSA level, and the extent of cancer cells left around the tumor site after surgery.

However, after taking these tumor characteristics into account, the rate of recurrence was also independently associated with the surgeon's expertise -- that is, the cumulative number of surgeries he or she had performed.

"The learning curve looks like it continues to rise up to 250 procedures," Scardino said. "But the emphasis," he cautioned, "should not be on the exact number but on the principle that the more the surgeon has done the better."

This principle, Scardino said, fits well with several studies that have looked at things like complications of surgery and it also fits with studies of surgery for cancer in other organs.

Scardino also noted that there is growing emphasis on laparoscopic and robotic-assisted laparoscopic surgery, and while his team didn't specifically look at this, he's confident that the same principle applies. "There is probably a similar learning curve with these new procedures, although we won't know how steep that learning curve is for another few years," he said.

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Sunday, February 26, 2006

 

Alternative Remedies Fail Government Tests

 

By Lindsey Tanner

AP Medical Writer

The Associated Press

Sunday, February 26, 2006

For years, millions of Americans have spent billions of dollars on alternative remedies with unproven effects. Now, rigorous science is starting to test those treatments and mostly finds them lacking.

Last week, major government-funded research indicated that two wildly popular arthritis pills, glucosamine and chondroitin, did no better than dummy pills at relieving mild arthritis pain.

Earlier this month a study revealed negative results for saw palmetto to treat prostate problems; last July, ditto for echinacea and the common cold. Those followed similar disappointments for St. John's wort to treat major depression, and powdered shark cartilage for some cancers.

Yet despite the U.S. government's multimillion-dollar investment to scientifically scrutinize a little regulated $20 billion-a-year industry, the big question is, do the results really matter when so many consumers swear by these remedies?

"I'll wrestle anybody who says it's no good," Carl Haupt, 79, says of glucosamine and chondroitin, pills he credits with helping him resume mountain hiking, a hobby he quit seven years ago because of arthritis pain.

Haupt spends about $25 monthly on the pills. Debilitating pain returned when he quit taking them once, and he said the government's results won't change his mind.

"I wouldn't quit taking it again. I learned my lesson," Haupt said.

Even the researchers themselves, funded by the National Institutes of Health, say their results don't necessarily mean consumers are pouring their money down the drain.

"If someone tells me this is working for them, I'm not going to tell them not to take it," said Dr. Thomas Schnitzer, a Northwestern University arthritis specialist and co-author of the glucosamine/chondroitin study.

That's partly because the three most recent studies found no real harm; also, in some cases, the results are not completely clear-cut.

For example, while most people taking the arthritis pills in the study got no significant benefit, the pills did appear to help those with more severe pain. And critics of the echinacea study say different doses might have found a benefit in fighting colds.

Also, studying these herbs and extracts is far more challenging than researching prescription drugs, which are subject to Food and Drug Administration scrutiny. Alternative health products with the same name can have vastly different ingredients and potencies, and research results from one may not apply to others, said Gail Mahady, a botanicals researcher at the University of Illinois at Chicago. She was not involved in the federal studies.

But another important factor is what scientists call the placebo effect — meaning that just thinking you're taking something useful can make you think there's a benefit.

Imaging tests have shown changes in the brains of placebo users, suggesting that the effect is not just "in your mind," it's also in the brain, said Dr. Stephen Straus, director of NIH's National Center for Complementary and Alternative Medicine.

"Their wishful thinking that they're going to get better is harnessing the body's own mechanism for relieving pain," said Straus, whose agency was formed seven years ago to stringently test non-conventional remedies.

The placebo effect was huge in patients unknowingly taking dummy pills in the arthritis study and could have overshadowed any potential benefit from the real pills.

But it's also likely that the placebo effect contributes to benefits that many people say they get from alternative remedies, and it's something doctors shouldn't dismiss, said Dr. Anthony Miksanek, a family physician in rural southern Illinois who has many arthritis patients on glucosamine and chondroitin.

"My thought is if you give somebody a pill and say this may help you," that might be the spark they need to "get out and do more things, walk more," or get more exercise, all of which can help relieve arthritis pain, said Miksanek, of Benton, Ill.

"Maybe it's a message of hope ... and the brain kind of takes that and runs with it," he said.

Milly Navarro, a 33-year-old public relations specialist in Dallas, said she doesn't care if the placebo effect explains why echinacea keeps her from getting colds — she'll keep taking it anyway.

"I know the mind is a powerful thing and even if it's that that does the trick, whatever it is, it works for me," Navarro said.

Barrie Cassileth, an alternative medicine researcher at Memorial Sloan-Kettering Cancer Center in New York, said some products, including echinacea and St. John's wort, can interfere with conventional medicine and should not be considered harmless.

But others, including saw palmetto, are cheaper and have fewer side effects than prescription medicine. "If the results that people swear by work by placebo, who cares?" she asks.

Some data suggest that more than one-third of Americans use alternative medicine, and many remedies are even more popular abroad. It's too soon to know if this month's studies have changed any habits, but anecdotal evidence suggests all five products studied remain popular.

Ben Pratt, a spokesman for the General Nutrition Centers, a national chain of stores that sell nutritional supplements, said sales of echinacea remain strong and were not affected by last summer's negative study.

Some consumers use alternative medicine because of safety concerns about prescription drugs, including reports of heart problems that doomed the once-popular arthritis drug Vioxx. Others mistrust the medical establishment because it bombards them with contradictory studies.

"You can just wait long enough and someone else will have an opposite opinion," said Richard Peterson, 62, a Baltimore property manager who says he won't stop taking glucosamine.

But even if some consumers ignore the results, the rigorous government studies are extremely useful for doctors seeking to rely on more than word of mouth, said Miksanek, the family physician in Benton, Ill.

"We are very much relying now on evidence-based medicine," said Miksanek. "We're trying to get away from things like Doc Welby saying, 'I've used snake oil for years and it's the greatest thing around.'"

Miksanek said now he can tell patients with minor arthritis pain that the pills may not work for everybody while offering more hopeful advice to patients with more severe pain.

Straus, of the NIH's alternative medicine center, says his agency is committed to continuing research on supplements. The center's research budget has steadily grown to $107.7 million for fiscal year 2005.

"I think that consumers should pay attention," Straus said, "understanding that a single study may not provide the final answer."

On the Net:

NCCAM: http://www.nccam.nih.gov

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Saturday, February 25, 2006

 

Governors Urge Change in Eating Culture

 

By Robert Tanner

AP National Writer

The Associated Press

Saturday, February 25, 2006

 Greasy food. Sugary drinks. And exercise? The tolls from today's temptations, from sweet soft drinks popular with school kids to drive-through lunches eaten behind the wheel, are well-known: obesity, diabetes, heart attacks. Governors say states can guide people to healthier choices — and that they must to cut rising health care costs.

Mike Huckabee of Arkansas is leading the way among the dozens of governors gathered here Saturday for their annual meeting, with a zeal that comes from knowing the costs up close, both personal and financial. Four years ago, his doctor diagnosed him with type 2 diabetes and said he was sure to die an early death. The then 290-pound Huckabee said: "Can we rewrite the last chapter of this book?"

He went on to do just that, changing his eating habits — "anything fried" — starting an exercise regimen, and dropping 110 pounds. Next week, the Republican who jokes about running for the presidency runs another marathon, his third, back in Little Rock.

On a personal level, it means he's rewritten his future. But for Huckabee, along with many governors who've joined with his initiative, the aim is much broader — to change the nation's focus from treating disease to preventing it, and so doing to save lives and get control of soaring health care costs. That in turn would free state governments, workers and private business to spend their money on other demands.

"Every single one of our states is being confronted with an extraordinary crisis, as well as an epidemic ... of overeating, underexercising and smoking," Huckabee told a crowd of governors, health officials and experts, and lobbyists. "The fact is 2,000 Americans will die today, and tomorrow, and the day after that. They'll die not because of some calamity. They'll die because of cultural and lifestyle choices that we can really work on."

The toll is 700,000 a year from chronic diseases. And the cost is $117 billion a year to the economy.

It's time to change the nation's culture, Huckabee said, in the same way that the nation changed its thinking on littering, drinking and driving, smoking and driving without a seatbelt.

States can be key movers, governors said. Among some of the programs already operating:

• Enroll overweight recipients of Medicaid, the government health care program for the poor, into Weight Watchers at a discounted rate, as Tennessee has done.

• Provide fresh, local produce at discounted costs to thousands of rural residents, as a Hawaiian health clinic in Oahu has done with federal and state support.

• Boost physical education programs at public schools with specific guidelines and policy changes, as encouraged by a Michigan program.

"Health care has to be about keeping people healthy. Not just helping them after they've become sick," said Michael Leavitt, secretary of the federal Department of Health and Human Services.

Dr. David Katz, director of the Prevention Research Center at Yale University's School of Medicine, drew the timeline that's seen the rise in obesity in adults and children, and the rise of type 2 diabetes among children and youths — a disease that almost never used to appear among children.

"What was a disease of overweight, sedentary adults has migrated down the age curve and is now routine in kids under the age of 10. This has happened on your watch, this has happened on my watch. We must share in the shame," Katz said.

The cause is simple — humans adapated and evolved to do hard physical exercise with relatively few calories, but modern life offers the exact opposite, with every convenience from cars to escalators, and all-you-can-eat buffets.

Katz likened modern American man to polar bears living in a desert, with all the health damage that would bring.

He dismissed the occasional study that questioned the rise in obesity, and said the evidence is overwhelming. "This is not a crisis of cosmetics. This is a bonafide health crisis," he said.

The first two days of the governors' gathering — before they begin policy discussions with President Bush and Cabinet officials on Monday — focuses on different programs in place, ways to get the public engaged and how states can go further. On the last day, governors will hear from former President Bill Clinton, who has joined Huckabee in his effort to focus on improving health.

"This more than a call to action, it's a call to innovation," Huckabee said. The impact will affect much more than state government, but private business, too. "There isn't a CEO in America who doesn't get it. ... You don't shift a culture immediately. But we have to turn this battleship around."

National Governors Association: http:http://www.nga.org


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Watch Out for Winter Health Woes

 

HealthDay News

Saturday, February 25, 2006

SATURDAY, Feb. 25 (HealthDay News) -- Winter can be wonderful, but it also poses hazards, especially for older adults.

The American Geriatric Society's Foundation for Health in Aging offers some winter safety tips for older adults and their caregivers.

Older adults have a slower metabolism, which means they produce less body heat -- rendering them more vulnerable to hypothermia. Hypothermia's symptoms include shivering; cold skin that is pale or ashy; feeling tired and weak; problems walking; and slowed breathing or heart rate.

In extremely cold temperatures, elderly individuals should try to stay indoors and keep rooms heated to at about 65 degrees F, keep dry, and wear two or three thin layers of loose-fitting clothing and a hat, gloves, coat, boots and scarf when outdoors.

People with heart disease and other circulation problems are also more prone to frostbite. Signs of this problem include numbness; pale or grayish-yellow skin; or skin that is hard or waxy to the touch. To prevent frostbite, keep all body parts covered and protected from the cold. If your skin begins to ache or turn red or dark, go indoors immediately.

Ice and snow increase the risk of falls, which can be especially dangerous to older persons whose bones are more fragile. Reduce the risk of falls by carefully shoveling steps and walkways to your home. But shoveling has its own risks for injury: talk to your doctor about whether it's safe to shovel. It might be a good idea to hire someone to do this for you.

Wear boots with non-skid soles and, if you use a cane, replace the rubber tip before it's worn smooth, the experts advised.

More information

The U.S. National Institute on Aging has more about cold weather and older adults.


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