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Friday, June 24, 2011

Heart risks lower in men who get enough vitamin D

By Amy Norton

Reuters Health

Friday, June 24, 2011

NEW YORK (Reuters Health) – Men who consume the recommended amount of vitamin D are somewhat less likely to suffer a heart attack or stroke than those who get little of the vitamin in their diets, a large U.S. study suggests.

Following nearly 119,000 adults for two decades, researchers found that men who got at least 600 international units (IU) of vitamin D each day -- the current recommended amount -- were 16 percent less likely to develop heart problems or a stroke, versus men who got less than 100 IU per day.

There was no such pattern among women, however, the researchers report in the American Journal of Clinical Nutrition.

The authors say the findings do not prove that vitamin D, itself, deserves the credit for the lower risks seen in men. So they should not start downing supplements for the sake of their hearts.

"The evidence is not strong enough yet to make solid recommendations," said lead researcher Dr. Qi Sun, a research associate at the Harvard School of Public Health.

On the other hand, the apparent benefits were linked to vitamin D intakes near what's already recommended: Last year, the Institute of Medicine (IOM), a scientific advisory panel to the U.S. government, bumped up the recommended dose to 600 IU for most people. Adults older than 70 were told to get 800 IU.

So these latest findings may encourage more people to meet those guidelines, Sun said.

But as far as whether vitamin D cuts heart disease and stroke risk, the jury is still out.

Sun said that more answers should come from an ongoing clinical trial that is looking at whether a high dose of vitamin D (2,000 IU per day) can cut the risk of heart disease, stroke and other chronic diseases.

Clinical trials, wherein people are randomly assigned to a treatment or a placebo, are considered the "gold standard" of medical evidence.

So far, there have been few such randomized clinical trials testing vitamin D's health effects.

A flurry of studies in recent years has linked higher vitamin D intake to lower risks of everything from diabetes, to severe asthma, heart disease, certain cancers and depression.

The problem with those studies is that were "observational" -- researchers looked at people's vitamin D intake, or their blood levels of the vitamin, and whether they developed a given health condition. Those kinds of studies cannot prove cause-and-effect.

The current study was also observational, based on data from two long-term projects that have followed two large groups of U.S. health professionals since the 1980s.

Out of 45,000 men, there were about 5,000 new cases of cardiovascular disease over the study period. These were defined by an incident of heart attack, stroke, or death attributed to cardiovascular disease.

After accounting for a range of factors -- like age, weight, exercise levels and other diet habits, such as fat intake - Sun's team found that men who got at least 600 IU of vitamin D from food and supplements had a 16 percent lower risk of heart attack and stroke compared to men who got less than 100 IU of vitamin D per day.

For women, though, there was no correlation between vitamin D intake and cardiovascular health.

It's not clear why that is, Sun said. One possibility is that women may have less active vitamin D circulating in the blood; vitamin D is stored in fat, and women typically have a higher percentage of body fat than men do.

But more research is needed, Sun said, to know whether real biological differences underlie the current findings.

In theory, vitamin D could help ward off heart disease and stroke; lab research suggests that it may help maintain healthy blood vessel function and blood pressure levels, reduce inflammation in the blood vessels, and aid blood sugar control.

But until clinical trials help show whether vitamin D works, Sun advised people to stick with the tried-and-true ways of protecting their hearts: maintaining a healthy weight, getting regular exercise, eating a well-balanced diet and not smoking.

"There are many established ways to lower your cardiovascular disease risk," Sun said. "People can focus on those measures."

As for vitamin D, the sun is the major natural source, since sunlight triggers vitamin D synthesis in the body. Food sources are relatively few and include fatty fish like salmon and mackerel, and fortified dairy products and cereals.

Source: http://bit.ly/irO9Xe

American Journal of Clinical Nutrition, online June 8, 2011.

Adolescents' Dieting and Disordered Eating Behaviors Continue Into Young Adulthood, Study Finds

ScienceDaily

Friday, June 24, 2011

ScienceDaily (June 24, 2011) — Adolescents who diet and develop disordered eating behaviors (unhealthy and extreme weight control behaviors and binge eating) carry these unhealthy practices into young adulthood and beyond, according to a study conducted by University of Minnesota researchers and published in the July 2011 issue of the Journal of the American Dietetic Association.

"The findings from the current study argue for early and ongoing efforts aimed at the prevention, early identification, and treatment of disordered eating behaviors in young people," commented lead investigator. Dianne Neumark-Sztainer, PhD, MPH, RD, Professor, Division of Epidemiology & Community Health, School of Public Health, University of Minnesota. "Within clinical practices, dietitians and other health care providers should be asking about the use of these behaviors prior to adolescence, throughout adolescence, and into young adulthood. Given the growing concern about obesity, it is important to let young people know that dieting and disordered eating behaviors can be counterproductive to weight management. Young people concerned about their weight should be provided with support for healthful eating and physical activity behaviors that can be implemented on a long-term basis, and should be steered away from the use of unhealthy weight control practices."

Using data from Project EAT-III (Eating and Activity in Teens and Young Adults), a 10-year longitudinal study aimed at examining eating, activity, and weight-related variables among young people, investigators from the Division of Epidemiology & Community Health, School of Public Health and the Department of Pediatrics, University of Minnesota, examined the records for 1,030 young men and 1,257 young women. One third of participants (29.9%) were in early adolescence (mean age = 12.8 years) at the beginning of the study and were in early young adulthood (mean age = 23.2 years) at the 10-year follow-up. Two thirds of participants (70.1%) were in middle adolescence (mean age = 15.9 years) at the beginning and were in middle young adulthood (mean age = 26.2 years) after 10 years.

Subjects were asked about dieting, extreme weight control behaviors such as fasting, using food substitutes and skipping meals, and binge eating with loss of control. Additional socioeconomic, gender, age, and race/ethnicity data was also collected.

About half of the females reported dieting in the past year compared to about a fourth of the males. The prevalence of dieting remained fairly constant from adolescence through young adulthood for females in both age groups. Among males, the prevalence of dieting stayed constant over time in the younger age cohort, but significantly increased in the older cohort as they progressed from middle adolescence to middle young adulthood (21.9% to 27.9%). In the younger females, unhealthy weight control behaviors remained constant from early adolescence to early young adulthood. Among older females, unhealthy weight control behaviors showed a statistically significant decrease from middle adolescence to middle young adulthood, but still remained very high (60.7% to 54.4%). Approximately one-third of males reported unhealthy weight control behaviors, and the prevalence remained fairly constant over the study period in both age cohorts.

For extreme weight control behaviors, significant increases from adolescence to young adulthood were found in females for both age cohorts and for the older cohort of males. Among females, the use of extreme weight control behaviors increased from 8.4% to 20.4% between early adolescence and early young adulthood and from 12.6% to 20.6% between middle adolescence and middle young adulthood. For the older males, extreme weight control behaviors increased from 2.1% in middle adolescence to 7.3% in middle young adulthood.

These behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors 10 years later. Tracking was particularly consistent for the older females and males transitioning from middle adolescence to middle young adulthood. The tracking of these potentially harmful behaviors suggests that their use is not just "a phase" that adolescents go through, but instead indicates that early use of dieting and disordered eating behaviors may set the stage for continued use of these behaviors later on.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Elsevier Health Sciences, via EurekAlert!, a service of AAAS.

Journal Reference:

Dianne Neumark-Sztainer, Melanie Wall, Nicole I. Larson, Marla E. Eisenberg, Katie Loth. Dieting and Disordered Eating Behaviors from Adolescence to Young Adulthood: Findings from a 10-Year Longitudinal Study. Journal of the American Dietetic Association, 2011; 111 (7): 1004-1011 DOI: 10.1016/j.jada.2011.04.012

Drug Use May Play Role in 25% of Driver Deaths, Study Finds

HealthDay News

Friday, June 24, 2011

FRIDAY, June 24 (HealthDay News) -- Among U.S. drivers who died in a car crash, about one in four tested positive for drugs, a new study has found.

Most commonly, the drivers were found to have been using marijuana and stimulants such as cocaine and amphetamines, and each of these drugs accounted for one-quarter of the positive tests, according to the report published in the July issue of the Journal of Studies on Alcohol and Drugs.

For their study, the researchers analyzed federal government drug test information from 44,000 drivers who died between 1998 and 2009.

It's not certain that the drugs used by the drivers were directly responsible for the fatal crashes, the researchers said. For example, some people who use illegal drugs may simply be reckless drivers, they explained.

But they noted that a recent government study found that 14 percent of U.S. drivers who were randomly pulled over tested positive for drugs. The fact that the rate of drug use was 11 percent higher among drivers in fatal crashes does suggest that drug use contributes to road deaths.

"The suspicion is there, because when you look at drivers who've been in fatal crashes, the percentage using drugs is a good deal higher," study co-author Robert B. Voas, of the Pacific Institute for Research and Evaluation in Calverton, Md., said in a journal news release.

However, when a driver is drinking alcohol in addition to taking drugs, the booze is usually the main impairment to driving, the study authors noted.

"Alcohol is still the largest contributor to fatal crashes," study lead author Eduardo Romano said in the news release. "Don't drink or don't consume drugs when you're going to drive," Romano added.

More information

The U.S. National Institute on Drug Abuse has more about drugged driving.

Prenatal folic acid doesn't boost sons' fertility

By Allison Bond

Reuters Health

Friday, June 24, 2011

NEW YORK (Reuters Health) – Young men whose mothers took folic acid supplements while pregnant did not grow up to produce healthier sperm, a small Danish study has found.

The research, published in the journal Fertility and Sterility, was the first to compare the quality of sperm from sons of mothers-to-be who took folic acid with sperm from men whose mothers did not take the B vitamin.

Because B vitamins are important to many processes in the body, and folic acid (vitamin B9) is critical to fetal development, the Danish team wanted to see if a mother's intake would affect her son's later reproductive health.

Because the study was small, however, other researchers say they view the results with caution.

Dr. Elizabeth Ginsburg, an obstetrician-gynecologist at Brigham and Women's Hospital in Boston who was not involved in the study, called the evidence "skimpy."

"I wouldn't be comfortable telling somebody that folic acid would have no effect on their subsequent sons' sperm function," she said.

The study's authors were unavailable for comment.

Their results were based on sperm samples collected in 2004 from the sons of Danish women enrolled in a study on reproductive health between 1984 and 1987 while they were pregnant.

Among a total of 347 young men, the number, mobility, and shape of sperm cells -- factors that help clinicians assess a man's fertility -- did not significantly vary, regardless of whether or not a man's mother had taken folic acid while pregnant.

For example, men whose mothers took folic acid during pregnancy had an average sperm count of 114 million per sample; among men whose mothers didn't take the B vitamin, that number was 110 million.

Both figures are well above the 40 million sperm count considered the minimum for normal fertility by the World Health Organization.

Previous studies have explored the effects of folic acid on sperm quality when taken by men during adulthood, but the results have proven ambiguous.

"There are no conclusive studies that show folic acid changes the quality of semen either way," said Dr. Irene Su, an assistant professor of reproductive endocrinology and fertility at the University of California, San Diego.

Although folic acid might not have an effect, there are other ways men can boost the quality of their sperm.

"There is growing evidence to suggest antioxidants are beneficial for men's fertility," said Dr. James Smith, director of the Male Reproductive Health Center at the University of California, San Francisco.

Eating antioxidant-rich foods, such as kale and blueberries, or taking an antioxidant supplement are simple ways to boost intake.

In addition, men should avoid activities that expose the groin to excessive heat, since this can make them less fertile, noted Ginsburg. When it comes to this area of the body, she said, "anything that increases the temperature can decrease fertility, including bicycling and spending time in a hot tub."

Regardless of folic acid's role in male fertility, it plays a key role in normal fetal development and will remain an important part of doctors' recommendations to women who are pregnant or may become pregnant, said Su.

The U.S. Centers for Disease Control and Prevention recommend that women of childbearing age get at least 400 micrograms of folic acid daily.

Because folic acid is so important for the development of the fetus, said Su, "it won't change what we (as doctors) do: recommend every pregnant woman take folic acid supplements every day."

Source: http://bit.ly/klJctS

Fertility and Sterility, online June 10, 2011.

Snacking Totals a Quarter of Daily Calories for Many

HealthDay News

Friday, June 24, 2011

FRIDAY, June 24 (HealthDay News) -- Snacking accounts for 25 percent of the calories consumed by Americans each day and beverages account for half of those snacking calories, a new study indicates.

Since the 1970s, snacking has grown to become a "fourth meal" that averages 580 calories per day, said Richard D. Mattes, a professor of foods and nutrition at Purdue University, in West Lafayette, Ind.

Because many Americans don't think about calories in beverages, they're less likely to take those calories into account, he noted.

The study also found that secondary eating (consumption while doing another activity) increased from 15 minutes per day in 2006 to nearly 30 minutes in 2008, and secondary drinking rose from 45 minutes to 85 minutes per day.

During that same period, the time spent eating primary meals (breakfast, lunch and dinner) remained steady at 70 minutes.

The study was presented recently at the annual meeting of the Institute of Food Technologists in New Orleans.

More information

The American Academy of Family Physicians explains how to make healthy food choices.

Amylin study shows insignificant heart rhythm link

By Deena Beasley

Reuters

Friday, June 24, 2011

SAN DIEGO (Reuters) – Analysis of an earlier trial found a "clinically insignificant" link between changes in heart rhythms and use of Bydureon, a long-acting diabetes drug being developed by Amylin Pharmaceuticals, Eli Lilly and Alkermes.

Amylin also said an earlier version of the drug, Byetta, was associated with a lower risk of heart failure and its shares rose nearly 6 percent.

Last October, U.S. regulators asked for more data on potential heart risks before approving the experimental medicine as a treatment for Type 2 diabetes.

Another trial is under way specifically to measure the drug's effect on the QT interval, the time the heart's electrical system takes to recharge after each beat.

Amylin has not said when those results are expected, but the company does plan to resubmit Bydureon to the Food and Drug Administration in the second half of this year, said Chris Weyer, the company's research and development head.

Meanwhile, data presented here this weekend at a meeting of the American Diabetes Association showed no significant correlation between changes in the heart-rate adjusted QT interval and treatment with Bydureon for 148 patients in an earlier trial, called Duration-1.

Amylin called the link in the earlier trial "clinically insignificant." It said that after 14 weeks the change was 1.7 milliseconds, rising to 3 milliseconds after 30 weeks of treatment with Bydureon, which is given once a week by injection.

The company also said there was no link between change in the QT interval and blood-stream levels of the drug or kidney function.

Bydureon is a longer-acting version of Byetta, known generically as exenatide, which is also sold by Lilly and Amylin. Both drugs belong to a relatively new GLP-1 class of drugs that stimulate insulin release when glucose levels become too high.

Amylin said a retrospective analysis of more than 778,000 patients found that, across all therapies, patients receiving Byetta were 54 percent less likely to develop heart failure than patients not receiving the drug.

More than 220 million people worldwide suffer from diabetes, including nearly 26 million Americans. They run a high risk of heart disease, stroke, kidney failure, blindness and limb loss.

Earlier this week, European health regulators approved Bydureon as a treatment for Type 2 diabetes.

It competes with Novo Nordisk's Victoza, a GLP-1 agonist which is injected daily. Results from a study earlier this year showed Bydureon did not control blood sugar as well as Victoza.

Amylin, Lilly and Alkermes are also studying a once-monthly suspension formulation of exenatide.

The companies said that a Phase 2 trial found that after 20 weeks, patients receiving once-monthly exenatide improved A1C levels (a measure of average blood sugar over three months) by 1.3 percentage points for the 5 mg and 8mg dose and 1.5 percentage points for the 11 mg dose.

Fifty percent of those treated with the 50 mg dose, 57 percent treated with the 8 mg dose and 70 percent treated with the 11 mg dose achieved target glucose levels.

Amylin said the results were comparable to those seen in patients treated with Bydureon.

The most common side effects associated with the once-monthly drug were headache and nausea.

Amylin's Weyer said the results were "very reassuring" but would not comment on when or if the company would conduct a pivotal trial of the once-monthly formulation.

Lilly and Amylin are fighting a legal battle over marketing of another drug, Tradjenta, or linaglipton, that was developed by Lilly and German drugmaker Boehringer Ingelheim.

Bydureon sales for Amylin are expected to reach $1.1 billion a year by 2015, according to analysts polled by Thomson Pharma.

Amylin shares rose 5.6 percent to $12.50 in after hours trading, from their closing price on Friday of $11.83 on the Nasdaq.

(Reporting by Deena Beasley, editing by Matthew Lewis and Sofina Mirza-Reid)

More Autism Diagnoses in High-Tech Areas, Study Finds

By Jenifer Goodwin
HealthDay Reporter

HealthDay News

Friday, June 24, 2011

FRIDAY, June 24 (HealthDay News) -- Autism experts have long noted that they meet a lot of engineers and computer programmers who have autistic children compared to, say, salespeople. A new study suggests there may be merit to those observations.

Researchers from Cambridge University in England found that nearly three times as many children were diagnosed with an autism spectrum disorder in a region of the Netherlands known as a center of high-tech industry than in two other regions with fewer high-tech jobs.

The possible explanation: Autism is highly heritable -- meaning, it runs in families -- and has a strong genetic component related to a trait called "systemizing," which is a skill for analyzing how systems work and creating them. Workers in high-tech industries -- engineering and computing, for example -- tend to excel at systemizing.

"The theory is that people with autism may have a relative strength in systemizing, or the drive to analyze how systems work, how systems behave, how you can control them and build new ones," said study co-author Rosa Hoekstra, a visiting scientist with the Autism Research Center at Cambridge and an assistant professor of psychology at the Open University in Milton Keynes, England. "In the engineer or physicist or mathematician, these traits are advantageous, but it might cause difficulties in the children and show up as a clinical diagnosis of autism."

Some parents of autistic children have personality traits that are similar to those of autistic people, though not to the degree that they would be considered autistic, she added.

"They can function in society, but they have some personality or cognitive characteristics that are consistent with autism, such as a real preference for routines, or some social difficulties," Hoekstra said.

The study, published June 17 online in the Journal of Autism and Developmental Disorders, has implications for the distribution of services to autistic children, the authors said.

For the study, researchers asked schools in three regions of the Netherlands -- Eindhoven, Haarlem and Utrecht -- for statistics on children with an autism spectrum disorder. Children with autism often struggle with communication and social interactions, exhibit repetitive behaviors and have strong but narrow interests.

All three regions are similar in population size and socioeconomics, but Eindhoven is the Netherland's information technology hub. It's home to Eindhoven University of Technology, the High Tech Campus Eindhoven, and several technology companies, including Philips, ASML, IBM and ATOS Origin.

About 30 percent of jobs in Eindhoven are in technology or ICT compared to 16 percent in Haarlem and 17 percent in Utrecht.

The schools provided diagnostic information on more than 62,500 children. About 2.3 percent (or 229 for every 10,000) children in Eindhoven had autism, almost three times as many as in Haarlem (84 per 10,000) and four times as many as in Utrecht (57 per 10,000).

The rate in the United States is estimated to be about 1 percent.

Dr. Gary Goldstein, president and CEO of the Kennedy Krieger Institute in Baltimore, said the findings mirror his experiences with parents of autistic children. "I haven't met that many high-end people in sales with children with autism, but I met all these very successful people in the backroom processing the data," he said.

And while a doubling or a tripling of the risk is "enormous" in statistical terms, parents should also rest assured that it still means the vast majority of children -- 98 percent -- born to engineers or high-tech types will not have autism.

Researchers acknowledged their study had limitations, including the possibility that parents in the high-tech region were more attuned to the signs of autism and that the kids were more likely to be diagnosed, and that they relied on numbers from the schools but were unable to examine the kids themselves.

They are planning a follow-up study to test for other factors that might explain their finding.

Prior research has found that the mothers of children with autism are more likely to work in highly technical occupations, that autism is more common among the siblings of mathematics students, and that autism is more common among children who have fathers or grandfathers who worked as engineers, according to background information in the study.

"This suggests some link between a talent for systemizing and autism," Hoekstra said.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on autism.

Thursday, June 23, 2011

New Biomarker May Help With Early Diagnosis of Alzheimer's Disease

ScienceDaily

Thursday, June 23, 2011

ScienceDaily (June 23, 2011) — A new biomarker may help identify which people with mild memory deficits will go on to develop Alzheimer's disease, according to a new study published in the June 22, 2011, online issue of Neurologyฎ, the medical journal of the American Academy of Neurology. The biomarker may be more accurate than the currently established biomarkers.

"Being able to identify who will develop Alzheimer's disease very early in the process will be crucial in the future," said study author Robert Perneczky, MD, of the Technical University Munich in Germany. "Once we have treatments that could prevent Alzheimer's disease, we could begin to treat very early and hopefully prevent the loss of memory and thinking skills that occurs with this devastating disease."

The study involved 58 people with slight memory problems, or mild cognitive impairment (MCI). Up to 15 percent of people with mild cognitive impairment develop Alzheimer's disease each year.

A sample of cerebrospinal fluid of the participants was taken at the beginning of the study through a lumbar puncture, or spinal tap. The concentrations in the cerebrospinal fluid of several proteins that are associated with Alzheimer's disease were measured.

The participants were followed for nearly three years on average. At that point, 21 people had developed Alzheimer's disease, 27 still had mild cognitive impairment and eight people had reverted back to their normal cognitive health. Two people had developed frontotemporal dementia, and their results were not included in the analysis.

Researchers found that the people who developed Alzheimer's disease had significantly higher levels of a protein called soluble amyloid precursor protein beta (sAPPβ) in their spinal fluid than those who did not develop Alzheimer's disease. Those who developed Alzheimer's disease had an average of 1,200 nanograms per milliliter, compared to 932 for those who did not develop the disease.

The researchers found that the best predictor of whether someone would develop Alzheimer's disease was a combination of sAPPβ, the tau protein (an established marker of brain cell damage) and the age of the individual. When these factors were combined, the results were roughly 80 percent accurate in predicting whether the disease would develop.

The protein amyloid beta1-42, or Aβ1-42, which has previously been considered a biomarker for Alzheimer's disease, was not a predictive factor in this study.

"These results suggest that sAPPβ as a biomarker may be useful and superior to the established marker Aβ1-42 in the early diagnosis of Alzheimer's disease," Perneczky said.

"One possible explanation is that Aβ1-42 measures events further downstream from the initial steps that lead to the production of the amyloid plaques that accumulate in the brains of people with Alzheimer's disease. sAPPβ is a measure of the first critical step in that process and may therefore provide more accurate information on the core pathological events."

The study was supported by the League of Friends of the Technical University Munich and the Commission for Clinical Research of the Rechts der Isar Munich Hospital.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Academy of Neurology.

No sign scans after testicle cancer cause new tumors

By Alison McCook

Reuters Health

Thursday, June 23, 2011

NEW YORK (Reuters Health) – Follow-up scans after treatment for testicular cancer don't appear to put men at higher risk of new tumors, researchers have found.

Men usually get regular computerized tomography (CT) scans to check if their testicular cancer has returned following treatment, but some worry that the associated radiation could be dangerous.

But that did not seem to be the case in the new study, published in the Journal of Clinical Oncology.

Overall, 14 percent of some 2,500 men who received multiple follow-up scans developed new tumors in the scanned area over the decade following their diagnosis. And those who received the most radiation were at no higher risk.

"Even with those incredibly high doses of diagnostic radiation, we did not identify any association between this exposure and an increased risk of cancers," study author Dr. Carl van Walraven at the Ottawa Health Research Institute told Reuters Health.

"To us, it's reassuring," he added, given the fact that more and more people get CT scans, which may increase cancer risks slightly although they are designed to look for disease.

Research has also found that people who get radiation treatment for other cancers are at increased risk for second tumors. For instance, men who receive such therapy for prostate cancer more often develop bladder and rectal cancers.

However, in radiation therapy the dose is typically higher than what people receive during diagnostic scans, explained van Walraven. And previous studies that have looked at the relationship between radiation from diagnostic scans and risk of second cancers have used different methods, making overall conclusions difficult, he added.

"The literature is very unclear whether there is an association between diagnostic radiation exposure and cancer."

Still, half of the men included in van Walraven's study received more radiation than many Japanese atomic bomb survivors, who were at increased cancer risk.

The difference, he suggested, may be how the radiation is delivered. Atomic bomb survivors received a massive dose at one time, while men who get several diagnostic scans stretch out their exposure over several years, which could be less dangerous.

It's possible that these smaller doses, stretched over time, "are small enough that the body can take care of them," said van Walraven. But more research is needed. "We don't know whether or not that's true. But we thought that may be one way to explain our data."

During the study, half of the men received at least 10 CT scans of their abdomen and pelvis within five years of their diagnosis. But only 14 developed tumors in that region during the study period.

One concern with the findings, however, is that the researchers didn't follow the men very long, said Dr. David Brenner, a radiation expert at Columbia University Medical Center in New York, who was not involved in the new work.

On average, the men were only 35 when diagnosed with testicular cancer, and half were tracked for 11 years or less. Yet most radiation-induced cancers in young men "will actually appear 10 to 40 years post-radiation," said Brenner.

So with such a short follow-up, the study will only capture a small fraction of the total cancers that the radiation will induce, he said.

These results "don't really tell us anything about the lifetime cancer risks associated with CT scans," said Brenner.

"I would hope the authors will be continue to study this population over a further 10 to 20 years," he added. "The results should be very informative."

Source: http://bit.ly/kP0FPD

Journal of Clinical Oncology, online June 20, 2011.

Contaminated Cocaine Triggers Decaying, Dying Skin

ScienceDaily

Thursday, June 23, 2011

ScienceDaily (June 23, 2011) — If the obvious reasons for avoiding recreational drug use aren't off-putting enough, physicians have yet another detrimental consequence to add to the list -- crusty, purplish areas of dead skin that are extremely painful and can open the door to nasty infections.

The condition is called purpura. Typical causes include a range of rare disorders, but it is also associated with the use of cocaine. Not just any cocaine, though: Physicians, researchers and health officials believe cocaine contaminated with a de-worming drug commonly used by veterinarians is the culprit. The drug, called levamisole, was found in 30 percent of confiscated cocaine in 2008 and 70 percent in 2009, according to the U.S. Drug Enforcement Administration.

In the Journal of the American Academy of Dermatology, physicians highlight six new and very similar patient cases of purpura, mostly on and around the ears, following cocaine use. The cases -- four seen in Rochester, N.Y., and two in Los Angeles -- closely resemble two additional cases in San Francisco that were reported previously in the journal. In each case an extensive battery of blood tests ruled out the usual causes of purpura.

The cases were reported by the University of Rochester Medical Center and the University of California, Los Angeles.

Because testing for traces of levamisole in the blood is complex and unreliable, researchers cannot say for sure that it is the direct cause of purpura in these instances. But, due to the striking similarity of these cases, and the presence of another condition caused by levamisole called agranulocytosis -- low blood counts that up the risk of infection -- in the majority of the patients, doctors say there is strong reason to suspect the drug and to focus greater attention on what could become a widespread health concern.

"We believe these cases of skin reactions and illnesses linked to contaminated cocaine are just the tip of the iceberg in a looming public health problem posed by levamisole," said the study authors.

According to Mary Gail Mercurio, M.D., an author and associate professor in the Department of Dermatology at the University of Rochester Medical Center, "When we first started seeing these patients they all had a similar clinical picture, but they were really an enigma because they weren't falling into any other pattern we'd seen before. When a colleague at the National Institutes of Health mentioned levamisole contamination, we did toxicity screens and lo-and-behold, all the patients came up positive for cocaine. We had our diagnosis."

Drug enforcement officials have detected levamisole -- which was once used to treat colon cancer -- in cocaine since 2003, but have watched it increase rapidly in recent years. The Drug Enforcement Administration says that the drug, which is inexpensive, is used more and more as a diluting agent in order to stretch supplies. Study authors report that levamisole is known to increase dopamine, a neurotransmitter that helps control the brain's reward and pleasure centers, causing experts to believe it is also added to cocaine to further enhance or prolong the user's high.

Researchers don't know how levamisole causes purpura, which occurs when vessels become plugged and blood can't flow to the skin, leading to skin death and the resulting purplish, crusty appearance. Cocaine alone constricts blood vessels, which is probably the first step, but how levamisole contributes is not yet understood, Mercurio said.

Both smoking and snorting tainted cocaine can lead to purpura and both men and women can be affected. Treatment options include steroids to prevent inflammation, but stopping the exposure to cocaine is the best medicine: Mercurio and the other study authors observed that once patients stopped using cocaine, the purpura and low blood counts improved.

"We've seen a lot of cases in Rochester alone, so it is important to alert the gatekeepers of medicine, the primary care physicians who are in the trenches every day, of this diagnosis," said Mercurio. "This is one of those entities that with familiarity and recognition can go a long way in helping physicians to quickly make a diagnosis and intervene without embarking on an elaborate workup where nothing will pan out."

In addition to Mercurio, Catherine Chung, M.D., a resident in the Department of Dermatology at the Medical Center, also contributed to the research. Ghinwa K. Dumyati, M.D., associate professor in the Department of Medicine, identified two of the four patients from Rochester, and these patients were recently discussed in the internal medicine literature. From the University of California Los Angeles, Paul C. Tumeh, M.D., Ron Birnbaum, M.D., Belinda H. Tan, M.D., Ph.D., Linda Sharp, M.D., Erin McCoy, M.D., and Noah Craft, M.D., Ph.D., also participated.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Rochester Medical Center.

Less Invasive Colon Surgery Results in Fewer Blood Clots: Study

By Steven Reinberg
HealthDay Reporter

HealthDay News

Thursday, June 23, 2011

THURSDAY, June 23 (HealthDay News) -- Minimally invasive colon surgery reduces the risk of blood clots in the deep veins compared with traditional surgery, University of California, Irvine, researchers report.

Deep vein blood clots, called venous thromboembolism (VTE), occur in about a quarter of patients who have colorectal surgery, the researchers said. The benefits of less invasive laparoscopic surgery also include faster recovery time and a smaller scar, but these advantages may not be enough to bring about a widespread switch from traditional surgery.

"From the cancer perspective, this does not appear to be a game changer," said Dr. Durado Brooks, director of colorectal cancer at the American Cancer Society.

Brooks said that among cancer patients in the study, no significant difference in the risk of VTE was found between the two procedures.

"In addition, cancer had been viewed as a contraindication for laparoscopic surgery," Brooks said. "There needs to be a more focused study looking [exclusively] at the cancer population before anyone would promote laparoscopic surgery as the way to go for cancer patients."

The report was published in the June issue of the Archives of Surgery.

For the study, a team led by Dr. Brian Buchberg used information from the U.S. National Inpatient Sample database to look for the risk of deep vein blood clots among 149,304 patients who had colon surgery from 2002 through 2006. Of these patients, 5.3 percent had laparoscopic surgery.

Buchberg's group found such clots occurred in 1.4 percent of the patients -- 65 laparoscopy patients and 2,036 who had traditional surgery.

The risk of clots was almost twice as high among patients undergoing traditional surgery as for the laparoscopy patients, the researchers said.

With both types of surgery, they found that cancer, obesity and congestive heart failure were significant risk factors for clotting.

Brooks thinks it's worthwhile for patients to ask their doctor if laparoscopic surgery is an option, but he added that it's not advisable for all patients.

"The main issue with cancer is you want to make sure you get adequate cancer control," Brooks said. "You can't just look at whether you get an individual out of the hospital sooner."

Also, you can't look at the likelihood of having a deep vein clot, he said. "You have to look at whether you are impacting their five-year survival favorably or unfavorably with laparoscopic surgery," Brooks added.

More information

For more information on colon cancer, visit the American Cancer Society.

TV and soda: small habits cause weight creep

By Julie Steenhuysen

Reuters

Thursday, June 23, 2011

CHICAGO (Reuters) – Just a few bad habits -- watching TV, eating potato chips, having a sugary soda at lunch or staying up too late at night -- can add up to a steady creep of pounds over the years, U.S. researchers said on Wednesday.

While most studies on diet focus on changes needed to help obese people lose weight, the study by the Harvard team showed tiny changes in diet and lifestyle can make a big impact.

The study focuses on specific lifestyle choices -- foods, activity, sleep habits -- that slowly pack on the pounds. The researchers stressed that the quality of food choices, and not just calories, are key to maintaining a healthy weight.

"These small choices add up," said Dr. Dariush Mozaffarian of the Harvard School of Public Health and Brigham and Women's Hospital, whose study appears in the New England Journal of Medicine.

"Because the weight gain is so gradual and occurs over many years, it has been difficult for scientists and for individuals themselves to understand the specific factors that may be responsible," Mozaffarian, who led the effort, said in a statement.

To get at this, the team analyzed data on 120,877 U.S. women and men from three large studies of health professionals that tracked changes in lifestyle factors and weight every four years over a 20-year period.

All study participants were normal-weight and healthy when they started. Over time, they gained an average of 3.35 pounds (1.59 kg) during each 4-year period for a total average weight gain of 16.8 pounds (7.6 kg) at the end of the 20-year study.

Foods that added most to weight gain over a four-year period included daily consumption of potato chips (1.69 lbs or 0.76 kg), potatoes (1.28 lbs or 0.58 kg), sugar-sweetened beverages (1 lb or 0.45 kg), unprocessed red meats (0.95 lbs or 0.43 kg) and processed meats (0.93 lbs or 0.42 kg).

More than a third of adults and nearly 17 percent of children in the United States are obese, increasing their chances of developing health problems including type 2 diabetes, heart disease, high blood pressure, fatty liver disease and some cancers.

Obesity-related diseases account for nearly 10 percent of U.S. medical spending, or an estimated $147 billion a year.

Food That Should Be Called Bad

Mozaffarian said understanding ways to keep people from becoming obese may be more effective than getting people to lose weight as U.S. policymakers attempt to turn the tide.

Those in the study who lost or maintained their weight over time tended to eat minimally processed foods.

"Fruits, vegetables, whole grains and nuts -- if you increase their intake, you had relative weight loss, presumably because you are replacing other foods in the diet," Mozaffarian said.

The study contradicts the notion that all foods are good for you in moderation.

"The idea that there are no 'good' or 'bad' foods is a myth that needs to be debunked," said Frank Hu of Harvard, who worked on the research.

Mozaffarian said different foods have a different effect on the body. "You can't just say a calorie is a calorie. It doesn't address your feelings of fullness, your blood glucose levels, your blood insulin levels and the other biological responses in your body," he said.

In the study, dietary changes appeared to have the biggest impact on weight gain over time, but other lifestyle changes also were a factor.

For example, watching one hour of TV per day added 0.31 pounds (0.14 kg) over a four-year period.

Sleep also played a role. People in the study who got between six and eight hours of sleep were less likely to gain weight over the study period. But people who got less than six hours or more than eight hours tended to gain weight.

And when people increased their physical activity, they tended to gain less weight during the study period.

Source:  http://bit.ly/myrd12

New England Journal of Medicine, June 23, 2011.

Long-Term Inhaled Corticosteroid Use Increases Fracture Risk in Lung Disease Patients, Study Finds

ScienceDaily

Thursday, June 23, 2011

ScienceDaily (June 23, 2011) — Patients with chronic obstructive pulmonary disease (COPD) who use inhaled corticosteroids to improve breathing for more than six months have a 27 percent increased risk of bone fractures, new Johns Hopkins-led research suggests.

Because the research subjects were mostly men age 60 and older, the findings raise perhaps more troubling questions about the medication's effects on women with COPD, a group already at a significantly higher risk than men for fractures.

"There are millions of COPD patients who use long-term inhaled corticosteroids in the United States and millions more across the world," says Sonal Singh, M.D., M.P.H., an assistant professor of general internal medicine at the Johns Hopkins University School of Medicine and the senior author of the study published online in the journal Thorax. "The number of people who are getting fractures because of these medications is quite large."

The inhaled corticosteroids evaluated were fluticasone, sold in combination with salmeterol as Advair, and budesonide, sold in combination with formoterol as Symbicort. Although applied through the mouth, the body absorbs corticosteroids, which have long been linked to a decline in bone density. Until now, no reliable association had been found to fractures in patients with COPD, Singh says.

Singh and his colleagues reviewed and analyzed two different sets of research studies comparing inhaled corticosteroids to a placebo in COPD patients. One study looked at 16 long-term double-blind randomized controlled trials with more than 17,500 participants; the other examined seven observational studies with 69,000 participants. In both, the researchers found a significantly increased risk of fractures for those using inhaled corticosteroids. The observational studies also found evidence of dose-response that fracture risk increased as steroid dosage increased.

Recent research has linked other popular medications to increased fracture risk, notably proton-pump inhibitors given for heartburn and some diabetes drugs, such as rosiglitazone (Avandia) and pioglitazone (Actos).

Inhaled corticosteroids are used to reduce the frequency of hospitalizations in patients with moderate to severe COPD. "Patients need to know about this risk along with the benefits of these inhaled medications," Singh says. "People who continue to use inhaled corticosteroids should pay attention to bone health and consider the lowest possible dose for the shortest possible time. The risks may be somewhat mitigated with bone-building drugs."

Patients with COPD, the researchers note, are already at a high risk of osteoporosis and fractures, which may stem from nutritional deficiencies or previous corticosteroid use. At larger doses, adverse effects of inhaled corticosteroids may come close to that of oral steroids, which are well known to increase bone loss and decrease bone formation.

Singh says he would like the U.S. Food and Drug Administration to look into the issues discovered in this research by his team and his colleagues from the University of East Anglia in the United Kingdom and the University of Louisville in the United States.

Although many asthma patients also take inhaled corticosteroids, Singh says his research does not apply to that mostly younger cohort since they were not included in the study.

Singh says he is most concerned about those who were not the focus of this study: women.

"It was surprising to find an increased risk of fractures in this study where two-thirds of the participants were men over the age of 60," Singh says. "It really makes us wonder what is happening to women with COPD who use inhalers, because older women are already at a much higher fracture risk than men."

This study was supported by the National Institutes of Health's National Center for Research Resources and the NIH's Roadmap for Medical Research.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Johns Hopkins Medical Institutions.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Y. K. Loke, R. Cavallazzi, S. Singh. Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax, 2011; DOI: 10.1136/thx.2011.160028

Report: Fight fat even in toddlers, preschoolers

By Lauran Neergaard

AP Medical Writer

The Associated Press

Thursday, June 23, 2011

WASHINGTON – A food pyramid just for the under-2 set? Contrary to popular belief, children don't usually outgrow their baby fat — and a new report urges steps to help prevent babies, toddlers and preschoolers from getting too pudgy too soon.

That's a growing problem: Already, one in five preschoolers — 2- to 5-year-olds — is overweight or obese.

Topping the list of proposed changes: better guidelines to help parents and caregivers know just how much toddlers should eat as they move from baby food to bigger-kid fare. And making sure preschoolers get at least 15 minutes of physical activity for every hour they spend in child care.

Thursday's recommendations, from the Institute of Medicine, aren't about putting the very young on diets. But those early pounds can lead to lasting bad effects on their health as children grow, says the report.

"It's a huge opportunity to instill good habits at a time when you don't have to change old ones," said Leann Birch, director of Pennsylvania State University's Center for Childhood Obesity Research, who chaired the IOM panel.

Consider: Babies drink milk until they're full and then turn away. But children as young as 2 or 3 are sensitive to portion size, important in not inadvertently training them to overeat.

"If you give them larger portions, they eat more," Birch explained.

Pediatricians generally give pretty explicit directions on how to feed babies. And the nation's dietary guidelines include a special section for preschoolers, including information that a portion size generally is about 1 tablespoon of each food type per year of age.

But overall, those national guidelines are aimed at ages 2 and older — though surveys show even very young children eat too few of the fruits and vegetables they need. So the institute called on the government to create consumer-friendly dietary guidelines for birth to age 2.

That would capture the "dramatic dietary transition that occurs, from consuming one single food to, by the time they're 2, ordering up things from McDonald's and, we hope, having also learned to eat a lot of healthy foods," Birch said.

That will be part of the discussion during the next dietary guidelines update in 2015, said Robert Post, deputy director of the Agriculture Department's Center for Nutrition Policy and Promotion, which oversees that process. But developing guidelines for these younger children is complex because their nutrition needs are based in part on developmental stage, he cautioned.

Of course, parents have the biggest influence over whether healthy eating and being active become a child's norm.

But the report makes the case that children's habits are influenced by far more than their parents — and thus it's time to expand obesity prevention to more of the other places youngsters spend time. For example, nearly three-fourths of children ages 2 to 5 spend at least part of their day in some form of child care.

Among the recommendations:

  • Day care and preschool operators should be trained in proper physical activity for young children, provide at least 15 minutes of it per hour, and avoid withholding physical activity as a punishment.
  • Child care regulations should limit how long toddlers and preschoolers sit or stand still to no more than 30 minutes at a time — and limit holding babies in swings, bouncy seats or other equipment while they're awake.
  • Day care and preschools should practice what's called responsive feeding: providing age-appropriate portion sizes, teaching children to serve themselves properly, requiring adults to sit with and eat the same foods as the children and following babies' cues as to when they've had enough.
  • Breastfed infants are less likely to become obese later in childhood, so doctors and hospitals should encourage breastfeeding and limit formula samples aimed at new moms.
  • At checkups, doctors should consider the parents' weight in assessing which children are at risk of later obesity, and then alert parents early that preventive steps are needed. About 10 percent of infants and toddlers already weigh too much for their length.
  • To increase healthful eating among the poorest children, the government should take steps to get more families who are eligible for federal nutrition-assistance programs to sign up.

Large Numbers of Birth Defects Seen Near Mountaintop Mining Operations

ScienceDaily

Thursday, June 23, 2011

ScienceDaily (June 23, 2011) — Birth defects are significantly more common in areas of mountaintop coal mining and are on the rise as the practice becomes more common, according to a study by researchers at Washington State University and West Virginia University.

The researchers, led by Melissa Ahern, health economist and associate professor in WSU's College of Pharmacy, found 235 birth defects per 10,000 births where mountaintop mining is most common in four central Appalachian states. That's nearly twice the rate of 144 defects per 10,000 in non-mining areas.

Previous studies have found low birth weights and increased levels of adult disease and death in coal mining areas. This study offers one of the first indications that health problems are disproportionately concentrated specifically in mountaintop mining areas.

The findings "contribute to the growing evidence that mountaintop mining is done at substantial expense to the environment, to local economies and to human health," the authors conclude in the current issue of the peer-reviewed journal Environmental Research.

The study is based on an analysis of more than 1.8 million birth records between 1996 and 2003. It compared the incidence of birth defects in mountaintop mining areas, other mining areas and areas without mining.

Mountaintop mining involves using explosives to remove ridges and deposit the rock and soil in nearby valleys. More than 2,700 mountain ridges, as well as thousands of rivers, have been destroyed or altered by the technique in portions of eastern Kentucky, eastern Tennessee, southern West Virginia, and southwestern Virginia. Peer-reviewed research has documented elevated levels of pollutants in these areas, including mercury, lead, and arsenic.

Driven by an increased demand for the fuel, including cleaner low-sulfur coal, this type of mining increased 250 percent between 1985 and 2005.

The study found counties in and near mountaintop mining areas had higher rates of birth defects for five out of six types of birth defects, including circulatory/respiratory , central nervous system, musculoskeletal, gastrointestinal, and urogenital defects. These defect rates became more pronounced in the more recent period studied, 2000-2003, suggesting the health effects of mountaintop mining-related air and water contamination may be cumulative.

Residents of the region tend to have less education, less prenatal care, more smoking and more alcohol use during pregnancy. But after controlling for socioeconomic and behavioral risks, the researchers still found residents in mountaintop mining areas had significantly higher rates of birth defects.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Washington State University. The original article was written by Eric Sorensen, WSU science writer.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Melissa M. Ahern, Michael Hendryx, Jamison Conley, Evan Fedorko, Alan Ducatman, Keith J. Zullig. The association between mountaintop mining and birth defects among live births in central Appalachia, 1996–2003. Environmental Research, 2011; DOI: 10.1016/j.envres.2011.05.019 

Wednesday, June 22, 2011

Could a Dangerous Fungus Lurk in Your Dishwasher?

By Alan Mozes
HealthDay Reporter

HealthDay News

Wednesday, June 22, 2011

WEDNESDAY, June 22 (HealthDay News) -- Can a dishwasher be both an excellent cleaning machine and an agent for infectious disease? Possibly, according to a new study.

The concern stems from an analysis of 189 household dishwashers in 101 cities around the world. Sample swabs taken from the rubber seals around the dishwasher doors revealed that more than six in 10 dishwashers (62 percent) contain some form of fungi, said the study team from the University of Ljubljana in Slovenia.

What's more, 56 percent of the dishwashers -- installed in homes in Europe, North and South America, Israel, Africa, Asia, and Australia -- contained at least one of two different species of black yeast.

Slow-growing forms of black yeast -- such as Exophiala dermatitidis and E. phaeomuriformis -- can cause "systemic disease in humans," the authors reported. Black yeast, they added, was the type of fungi most frequently detected.

"The bottom line is that this pathogenic black yeast species occurs rarely in nature, but in very high numbers in the dishwashers," said study co-author Nina Gunde-Cimerman, from the biology department of the University of Ljubljana.

But do dishwasher pathogens threaten the well-being of healthy people?

"No," concur a pair of American researchers who did not participate in the investigation.

"Frankly, this is of little or no medical importance," said Dr. Henry F. Chambers, chief of infectious diseases at San Francisco General Hospital. "Now I don't dispute that they found these organisms. But I'm not surprised at all. These are hardy organisms. You go in your shower and you will find microorganisms in your shower. Behind your toilet as well.

"We shouldn't overestimate the importance of these organisms relative to what is already in or on your body," Chambers added. "There are by some accounts 10 times more microorganism cells on or in your body than there are your own cells of your own body. That amounts to thousands of billions. And secondly, nothing they found is able to cause disease in people who are not extremely immunocompromised."

Dr. Philip Tierno, director of clinical microbiology and immunology at New York University Langone Medical Center, echoed Chambers' sentiments.

"We're exposed to large amounts of fungi in everyday life," he observed. "When you consume any kind of dairy product you're likely to come into contact with fungi. There are more fungi -- that is, a mold fungus with spores -- in an ounce or two of cheese than you're likely to get from exposure to a dishwasher. And, in any case, 99 percent of the organisms that we come into contact with on a daily basis are totally innocuous."

The study authors, however, are concerned about that other one percent. More research is needed, they said, to determine whether E. dermatitidis in appliances can cause humans harm.

Writing in the current issue of Fungal Biology, the authors said that the presence of black yeast and similar organisms within the "extreme environment" of a dishwasher was "remarkable," given their harsh exposure to high heat and substantial amounts of detergents, alkaline and salt.

"With the new eco regimes that we all use nowadays (meaning lower temperatures, milder detergents), they thrive," Gunde-Cimerman said. "Not much" can be done to combat it, she added.

The presence of these fungi raise concerns about other humid indoor environments and water-retaining appliances, the authors said. They noted that continuous exposure to moisture, high acid content, high temperatures, and residual organic matter (in particular, food) are features that dishwashers share in common with bathrooms, sinks, kitchens, and coffee makers.

Black yeast and similar organisms are "opportunistic invaders," the scientists added. This means that individuals with a compromised immune system are particularly vulnerable.

The authors said that black yeast has been found to colonize the lungs of cystic fibrosis patients. Similarly, white yeast (also detected in dishwashers in the study) is a familiar problem in hospital settings, where it can form a slimy coating around prosthetics, catheters, and tubing.

Even in extremely immunocompromised people exposed to black yeast and similar organisms, however, "we're talking about very rare infections," Chambers said.

More information

For more on infection control, visit the U.S. National Institutes of Health.

More evidence air pollution may be a heart risk

Reuters Health

Wednesday, June 22, 2011

NEW YORK (Reuters Health) – Day-to-day spikes in air pollution seem to be followed by an uptick in hospital admissions for heart attack, a new study in Italy finds.

The findings, reported in the American Journal of Epidemiology, add to evidence that high-pollution days may trigger heart attacks in some people.

And, like other studies, the new one suggests that the elderly and people with existing heart or lung disease are most vulnerable.

Already, the American Heart Association (AHA) recommends that people with heart disease and others at risk -- including the elderly and people with diabetes or high blood pressure -- try to steer clear of congested roadways and spend less time outside on days when air quality is poorer.

The evidence of harm is strongest against pollutants known as fine particulate matter.

Fine particulate matter is released into the air when wood or fossil fuels are burned, so car exhaust, home heating and industrial sources like power plants all contribute.

The particles are small enough that they can be inhaled deeply into the lungs, and researchers suspect they may trigger heart attacks in vulnerable people by causing inflammation in the blood vessels and irritating the nerves of the lungs.

For the new study, researchers led by Dr. Alessandro Barchielli, of the Regional Health Service of Tuscany, looked at data on 11,450 hospitalizations for heart attack between 2002 and 2005.

They used local air-quality monitors to see how those hospitalizations correlated with changes in air pollution levels.

Overall, the study found that for each fine-particle increase of 10 micrograms per cubic meter of air, heart attack hospitalizations inched up 0.01 percent over the next two days.

There was a similar pattern when the researchers looked at two other traffic pollutants: carbon monoxide and nitrogen dioxide.

The link between pollution spikes and heart attack was strongest among people age 75 or older, and for those with the lung diseases emphysema or chronic bronchitis, and people with high blood pressure.

The findings alone do not prove that air pollution, itself, triggers heart attacks.

But they do add to other studies that have found a similar association, according to Barchielli's team.

They are also in line with what the AHA and other groups recommend for people vulnerable to heart problems: pay attention to air quality and, whenever possible, limit time outdoors on high-pollution days.

In the U.S., where heart attacks kill 425,000 people yearly, local news outlets generally provide daily air-quality indices; they are also available on the government website AIRNow, at http://www.airnow.gov.

Source: http://bit.ly/jBAdxJ

American Journal of Epidemiology, July 2011.

Clues to Alzheimer's May Reside in Spinal Fluid

HealthDay News

Wednesday, June 22, 2011

WEDNESDAY, June 22 (HealthDay News) -- The spinal fluid of people with mild memory problems may help identify those who will later develop Alzheimer's disease, according to new research.

In the study, researchers collected samples of cerebrospinal fluid from 58 people with mild memory (cognitive) impairment and analyzed the samples for concentrations of several proteins associated with Alzheimer's disease. After an average follow-up of three years, 21 people had developed Alzheimer's, 27 still had mild cognitive impairment, and 8 had reverted back to their normal cognitive health.

Two of the participants developed a type of dementia other than Alzheimer's and weren't included in the final results.

The spinal fluid of people who developed Alzheimer's disease had significantly higher levels of a protein called soluble amyloid precursor protein beta (sAPPβ) than the spinal fluid of those who didn't develop the brain disorder -- an average of 1,200 versus 932 nanograms per milliliter.

Predicting participants' risk of Alzheimer's was 80 percent accurate when three factors were combined -- sAPPβ, a person's age, and a known marker of brain cell damage called tau protein.

A protein called amyloid beta1-42 (Aβ1-42), previously considered a so-called "biomarker" for Alzheimer's, was not a predictive factor, according to the German researchers.

The study is published in the June 22 online edition of the journal Neurology. As many as 15 percent of people with mild memory problems develop Alzheimer's disease each year, the researchers said.

"These results suggest that sAPPβ as a biomarker [indicator] may be useful and superior to the established marker Aβ1-42 in the early diagnosis of Alzheimer's disease," study author Dr. Robert Perneczky, of the Technical University Munich, said in a journal news release.

"One possible explanation is that Aβ1-42 measures events further downstream from the initial steps that lead to the production of the amyloid plaques that accumulate in the brains of people with Alzheimer's disease," he explained.

Perneczky said that sAPPβ is a measure of the first critical step in the development of Alzheimer's and may "provide more accurate information on the core pathological events."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about Alzheimer's disease.

B vitamins in pregnancy not tied to baby's asthma

By Eric Schultz

Reuters Health

Wednesday, June 22, 2011

NEW YORK (Reuters Health) – Taking folic acid during pregnancy doesn't seem to raise the baby's risk of getting asthma, according to a Dutch study that eases earlier concerns.

In 2009, two research teams reported that folic acid, a B vitamin recommended during pregnancy, might be linked to allergic diseases like asthma or wheezing in the kid.

But expecting moms can breathe easy. According to Dr. Monique Mommers of Maastricht University, the new study did not find "any meaningful association between folic acid supplement use during pregnancy and (allergic diseases) in the offspring."

Getting enough folic acid around the time of conception helps lower the risk of certain birth defects, including spina bifida, a paralyzing malformation of the spine.

Experts advise women to take 400 micrograms of folic acid per day shortly before conceiving and in the first trimester of pregnancy, a critical window of time when neural tube defects take shape.

The Dutch researchers tracked folic acid use among more than 2,600 pregnant women and followed the health of their children for seven years.

Then they tested the kids' lung function and recorded how many developed diseases caused by allergic reactions, including asthma and eczema.

Overall, nearly seven percent of the children developed asthma, regardless of whether their mothers had taken folic acid or not.

The kids' lung function was also similar in the two groups, as was the number of allergic reactions.

According to allergy specialist Dr. Rachel Miller of Columbia University Medical Center, the results "do not suggest any changes in current practices."

Still, Dr. Tsunenobu Tamura, a nutrition expert at the University of Alabama at Birmingham, cautioned that the findings don't prove that folic acid has no side effects. For instance, it's important to monitor long-term outcomes like cancer, he said.

"This type of study should have been done even before the folic acid fortification program was initiated in the United States," he told Reuters Health.

Source: http://bit.ly/lCXMJH

Pediatrics, online June 20, 2011.

Early Chemical Exposures May Affect Breast Health: Report

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Wednesday, June 22, 2011

WEDNESDAY, June 23 (HealthDay News) -- Exposure to common chemicals during critical periods of breast development may affect breast growth, the ability to breast-feed and breast cancer risk, a new report contends.

Some of these chemicals are found in ordinary household products such as certain types of plastic water bottles, canned foods and laundry detergents, the researchers noted.

With this in mind, the study authors called for chemical test guidelines for industry requiring that scientists test the chemicals' effects on early mammary gland development.

Scientists from the U.S. National Institutes for Environmental Health Sciences, the Environmental Protection Agency and the Silent Spring Institute collaborated on the report, published online June 22 in the journal Environmental Health Perspectives.

"If we try to figure out what causes breast cancer, we have to look at the breast when we do the chemical safety tests," said Ruthann Rudel, research director at Silent Spring.

Currently, protocols for testing don't require looking at mammary tissues, Rudel said, so it is rarely done. "We could be missing a lot," she said.

Experts believe these early disturbances in mammary glands due to chemical exposure may boost the risk of harmful effects later in life. These could include impaired lactation (secretion of breast milk), abnormal breast growth in men and breast cancer.

One impetus for the study, in fact, was an increase in early breast development in girls, which is linked to an increased risk of breast cancer.

The report also noted that although experts recommend that all infants be breast-fed exclusively for six months, some 3 million to 6 million women in the United States are unable to produce milk or have difficulty breast-feeding each year.

The scientists interviewed 18 experts, reviewed research and discussed the issue at a workshop in late 2009. They are submitting a request to the Paris-based Organisation for Economic Co-Operation and Development (OECD), asking it to add mammary tissue testing to its guidelines.

The international organization develops guidelines for testing of chemicals for safety, human health effects and environmental effects. "It's a call for government agencies that develop policy to make sure mammary gland assessment is required," Rudel said.

Industry representatives said they welcomed the review.

"This workshop, which provided a forum for scientific discussion, did not produce data or outcomes relevant to consumers, and thus comments from the meeting should not cause undue concern," said Kathryn St. John, spokeswoman for the American Chemistry Council. "Based on their review of animal studies conducted by the participating scientists, the group considered ways to change chemicals safety testing, and discussed the relevance of potential scientific outcomes to human health."

According to Rudel, the three main findings of the review were:

Rodents are a reasonable test models and should be used to test for dangers to humans.

The breast can be more sensitive to the chemical exposure than other tissues, and in some cases the male mammary tissue was most sensitive.

Chemical exposure to the developing mammary gland can alter susceptibility to cancer-causing agents.

In the report, the experts concluded that early life environmental exposures can alter milk gland development, disrupt the secretion of breast milk, and increase susceptibility to breast cancer. "Assessment of mammary gland development should be incorporated in chemical test guidelines and risk assessment," they added.

Among the chemicals known to affect breast development and cancer susceptibility in animal studies, according to the report, are pesticides such as atrazine, used in agriculture; dioxins, an industrial pollutant found in some fatty foods; bisphenol A (BPA), found in some water bottles and canned foods; polybrominated diphenyl ether (PBDE) flame retardants, and nonylphenol (a breakdown product found in certain laundry detergents).

While efforts are being made to curb some of these chemical exposures, the experts said required testing is crucial. Rudel speculated that women with genetic predispositions to breast cancer might be at higher risk from these exposures.

The study authors declared no financial conflicts of interest.

The review is "raising a necessary red flag," said Olga Naidenko, a senior scientist at the Environmental Working Group, an advocacy organization in Washington, D.C. She reviewed the report but was not involved in it.

Naidenko agreed that there has been a gap in studying the effect of chemical exposure on the mammary gland. "For many chemicals, researchers have not looked at it."

Meanwhile, she said, while some exposures are difficult to avoid, there are steps to take to minimize exposure.

Avoiding the plastic BPA in bottles (which some manufacturers have discontinued using) is one step. Buying organic produce whenever possible may also help consumers avoid the pesticide atrazine.

Avoiding canned foods (which can also have BPA in the liners) and the chemical DEHP by focusing on a fresh food diet can also reduce the levels of those chemicals in the body, according to the Silent Spring Institute.

More information

To reduce your exposure to harmful chemicals, visit the Silent Spring Institute.

Tuesday, June 21, 2011 

Resveratrol Studies Confirms Potential Health Boost

ScienceDaily

Tuesday, June 21, 2011

ScienceDaily (June 21, 2011) — A University of Florida review of research finds the polyphenol compound known as resveratrol found in red wine, grapes and other fruits may not prevent old age, but it might make it more tolerable. News stories have long touted resveratrol as a cure for various diseases and a preventative against aging.

"We're all looking for an anti-aging cure in a pill, but it doesn't exist. But what does exist shows promise of lessening many of the scourges and infirmities of old age," said UF exercise psychologist Heather Hausenblas, one of the researchers involved in the study.

A comprehensive review of human clinical research on resveratrol has found it has "anti-aging, anti-carcinogenic, anti-inflammatory and antioxidant properties," but more research of its benefits is needed, she said.

The study, which appeared online this week in Molecular Nutrition and Food Research, examined results gleaned from thousands of laboratory studies with enzymes, cultured cells and laboratory animals. It was conducted by Hausenblas and fellow researchers James Smoliga of Marywood University and Joseph Baur of the University of Pennsylvania School of Medicine. Their review aimed to examine the current state of knowledge of the effects of resveratrol on humans and to use this information to guide much needed future human clinical trials.

Despite numerous clinical studies on resveratrol's tonic effects on animals, there is little evidence that it benefits human health. That's because "there haven't been many studies on humans," Hausenblas said.

However, she points out, for years many scientists have thought that a link between resveratrol and human health exists. The French people, for example, enjoy low levels of cardiovascular disease, even though their diets are rich in saturated fats and oils. Some researchers think the reason for this paradox lies in France's national drink -- red wine, which is the most important dietary source of resveratrol. The UF review, said Hausenblas, shows that the resveratrol has considerable potential to improve health and prevent chronic disease in humans. However, further research examining the long-term health effects of resveratrol is much needed.

Exactly how resveratrol works isn't yet fully understood. Correlating factors such as metabolism, the chemical interplay of molecules, genetics, exercise, age, dosage, and many others all play a role.

Among resveratrol's most intriguing aspects is how it functions as an antioxidant. Oxidation is a natural chemical process in living tissues that results in a transfer of electrons. When this happens, groups of atoms are formed called "free radicals" that can cause cell damage which in turn provides a pathway for diseases. Antioxidants, however, suppress free radicals. "It's not so easy to say resveratrol is the main factor," Hausenblas said. "It's one piece of the overall puzzle that reduces the free radicals."

The UF study also reveals that resveratrol's contribution to good health promises to be widespread. Various clinical trials, for example, indicate that this polyphenol -- an antibiotic substance produced by plants as a defense against microorganisms -- prevents the growth of some cancers in mice, inhibits enzymes that cause inflammation, shrinks tumors and increases blood flow, thus reducing cardiovascular diseases. In many cases, it also extends the life of obese animals. Some evidence also shows that resveratrol could one day be used to help regulate insulin sensitivity in diabetic patients.

Hausenblas and her colleagues think research that explores resveratrol's potential to alleviate human infirmities will become increasingly more important as the nation's 76 million baby boomers undergo the aging process. One trial under way at UF's College of Medicine in the Institute on Aging examines the effect resveratrol may have on the physical and cognitive skills on older people.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

James M. Smoliga, Joseph A. Baur, Heather A. Hausenblas. Resveratrol and health - A comprehensive review of human clinical trials. Molecular Nutrition & Food Research, 2011; DOI: 10.1002/mnfr.201100143 

High-dose statins raise risk of diabetes: study

By Julie Steenhuysen

Reuters

Tuesday, June 21, 2011

CHICAGO (Reuters) – Taking a high-dose statin to lower cholesterol may increase risk of developing diabetes by as much as 12 percent, but the heart benefits of statins still outweigh the risks, new research shows.

Statins such as Pfizer's Lipitor are the world's best-selling drugs. They work by lowering levels of low-density lipoprotein, or LDL, the so-called "bad" cholesterol.

Doctors say the new research made public on Tuesday should not prompt any patients to stop taking statins, but patients on high doses of statins should get screened regularly for diabetes.

The findings on two of the biggest-selling statins may lead doctors to choose Lipitor when high doses are needed versus the less expensive, generic version of Merck & Co's Zocor.

While both drugs raise the risk of diabetes, high-dose Lipitor worked far better than generic Zocor at cutting heart risks, the team said.

Study after study has shown that taking statins can lower the risk of heart attacks and strokes, but some studies have suggested that the drugs may raise the risk of diabetes.

To see if dose is a factor, researchers from St George's, University of London and the University of Glasgow analyzed data from five different studies involving 32,752 patients who were treated with high and moderate doses of statins.

Over a five-year period, 2,749 participants, or 8.4 percent, developed diabetes, and 6,684 participants, or 20 percent, had a major heart problem.

"Overall, we found that high doses were associated with a 12 percent increased risk of diabetes compared with standard doses," Professor Kausik Ray of St George's said in an e-mail.

He said for every 498 patients treated there was one extra case of diabetes. But use of high-dose statins reduced risk of heart attacks, strokes, and the need for artery-clearing angioplasty by 16 percent.

For every 155 people treated, one of these heart problems was prevented, the team reported in the Journal of the American Medical Association on Tuesday.

"Nobody should stop taking their prescribed statins because of the evidence shown in this research," Professor Peter Weissberg of the British Heart Foundation, who was not involved with the study, said in a statement.

"Statins play a vital role in protecting the hearts of many, many people and the benefits still far outweigh any risks associated with diabetes," he said.

Lipitor Better Than Generic Zocor

"Patients who need high doses of statins are at very high risk of heart attacks and strokes. They should not come off these drugs, but simply be monitored more closely." Ray said.

The team also compared rates of heart problems in people who took high doses of Zocor, available widely as the generic simvastatin and less costly than brand-name Lipitor.

Lipitor, or atorvastatin, had global sales last year of nearly $11 billion and is expected to lose U.S. patent protection at the end of November.

The risk of developing diabetes proved to be the same with both drugs. But high-dose Lipitor cut the risk of heart attacks and strokes by 22 percent, compared with a 5 percent reduction in heart risk among those who took simvastatin, Ray said.

He said the study shows high-dose simvastatin is not the best option.

"The net benefit of simvastatin is clearly very low and patients on simvastatin 80 mg should be moved to atorvastatin 80 mg instead," Ray said. "I don't think we can wait for loss of (Lipitor's) patent to stop using simvastatin 80 mg," Ray said in an email.

Currently, the National Institute for Health and Clinical Excellence, Britain's health cost watchdog, recommends an 80 mg dose of simvastatin because it is the least costly option for patients with heart disease.

U.S. health regulators earlier this month recommended limiting the 80 mg dose of simvastatin because it increases the risk of muscle damage.

An estimated 2.1 million patients in the United States were prescribed a product containing 80 mg of simvastatin in 2010, according to the U.S. Food and Drug Administration.

(Editing by Michele Gershberg and Jackie Frank) 

Diabetic Kidney Disease Rising in the U.S.

HealthDay News

Tuesday, June 21, 2011

TUESDAY, June 21 (HealthDay News) -- The frequency of diabetic kidney disease has increased in line with rising rates of diabetes in the United States over the past two decades, a new study finds.

About 40 percent of people with diabetes develop diabetic kidney disease (DKD), which is a leading cause of chronic kidney disease and accounts for nearly half of all new cases of kidney failure in the United States, according to background information in the study in the June 22/29 issue of the Journal of the American Medical Association.

The researchers analyzed national data from the past two decades, and found that the prevalence of DKD in the U.S. population was 2.2 percent in 1988-94, 2.8 percent in 1999-2004 and 3.3 percent in 2005-08.

The demographically adjusted increase in DKD prevalence was 18 percent from 1988-94 to 1999-2004 and 34 percent from 1988-94 to 2005-08.

The estimated number of people with DKD in the United States at any given point in time increased from 3.9 million during 1988-94 to 5.5 million during 1999-2004 to 6.9 million during 2005-08.

The researchers also found that the prevalence of impaired glomerular filtration rate (a measure of kidney function) among people with diabetes increased from 14.9 percent in 1988-94 to 17.7 percent in 2005-08.

"In conclusion, DKD has become more prevalent in the U.S. population over the last two decades and will likely contribute increasingly to health-care costs and mortality," wrote Dr. Ian H. de Boer, of the University of Washington, Seattle, and colleagues.

Increasing use of medications to lower glucose levels and blood pressure haven't seemed to prevent diabetic kidney disease from increasing, he added.

More information

The National Kidney Foundation has more about diabetes and kidney disease. 

Smoking in pregnancy cuts child's good cholesterol

By Kate Kelland

Reuters

Tuesday, June 21, 2011

LONDON (Reuters) – Mothers who smoke while pregnant are causing changes to their unborn babies that can lead them to have less of a type of cholesterol known to protect against heart disease, scientists said on Tuesday.

In a study in the European Heart Journal, Australian researchers found that by the age of eight, children born to mothers who smoked in pregnancy had lower levels of HDL cholesterol, at around 1.3 millimoles per liter (mmol/L), than those born to mothers who hadn't smoked, with about 1.5 mmol/L.

High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol and is known to play an important role in protecting against atherosclerosis, where fatty materials collect along the walls of arteries, thickening and eventually blocking them, leading to heart problems and heart attacks.

"Our results suggest that maternal smoking 'imprints' an unhealthy set of characteristics on children while they are developing in the womb, which may well predispose them to later heart attack and stroke," said David Celermajer, a professor of cardiology at the University of Sydney.

"This imprinting seems to last for at least eight years and probably a lot longer," he said, adding that the heart disease risk for smokers' children could be 10 to 15 percent higher.

Smoking during and after pregnancy is already known to be linked to a wide range of childhood health problems, including behavioral and neurocognitive problems and sudden infant death.

Yet the prevalence of smoking while pregnant is still high, at around 15 percent in many Western countries, the researchers said. And until now scientists were not clear how prenatal exposure to cigarette smoke might affect future heart risks.

Celermajer's team analyzed data from 405 healthy eight year olds, born between 1997 and 1999, who had been enrolled before birth into a randomized controlled trial that was investigating asthma and allergic diseases.

The researchers collected data before and after the children were born, including information on mothers' smoking habits before and after pregnancy, exposure to passive smoke, and data on height, weight, waist measurement and blood pressure.

They used ultrasound scans to measure the arterial wall thickness and, in 328 children who agreed, they took blood to measure lipoprotein levels.

Although there was no effect on the thickness of the children's arterial walls, Celermajer's team found there was an effect on levels of HDL cholesterol.

He suggested that lower HDL levels at this age might have a serious health impact in later life, since the children will probably continue to have low levels as they grow up.

"Cholesterol levels tend to track from childhood to adulthood, and studies have shown that for every 0.025mmol/L increase in HDL levels, there is an approximately 2.0 to 3.0 percent reduction in the risk of coronary heart disease," he said in a statement about his research.

"If we extrapolate this, we can suggest that the difference between children of smoking mothers versus non-smoking mothers might result in a 10 to 15 percent higher risk."

(Editing by Paul Casciato)

Blueberries Help Lab Rats Build Strong Bones

ScienceDaily

Tuesday, June 21, 2011

ScienceDaily (June 21, 2011) — Compounds in blueberries might turn out to have a powerful effect on formation of strong, healthy bones, if results from studies with laboratory rats turn out to hold true for humans.

Jin-Ran Chen and his colleagues are exploring this idea in research funded by the U.S. Department of Agriculture (USDA) at the Arkansas Children's Nutrition Center (ACNC) in Little Rock. Chen is a principal investigator and lead scientist at the center's Skeletal Development Laboratory, and an assistant professor in the department of pediatrics at the University of Arkansas for Medical Sciences, also in Little Rock.

Chen specializes in research on how what we eat during infancy, childhood and early adulthood affects growth and development of bones and the risk of developing osteoporosis or other degenerative bone diseases in later years.

Chen's studies with young, rapidly growing laboratory rats suggest that polyphenols, the compounds that give blueberries their blue, purple, and red coloration, might aid in building strong bones. The work has paved the way for new research that might reveal whether blueberries could be used in the future in treatments to boost development of bone mass and to help prevent osteoporosis.

Published in the Journal of Bone and Mineral Research in 2010, the investigation showed that animals fed rations that contained 10 percent freeze-dried blueberry powder had significantly more bone mass than their counterparts whose rations were blueberry-free.

When the researchers exposed laboratory cultures of bone-forming cells (osteoblasts) to blood (serum) from the animals, the scientists found that serum from the blueberry-fed rats was associated with an increase in development of osteoblasts into mature, functional bone cells.

Serum in the blueberry-fed rats was high in phenolic acids, derived from the color-impacting polyphenols. The research suggests that the phenolic acids may have had bone-building effects in the rats. Studies are needed to determine whether these benefits occur in humans, Chen noted.

Chen's research also suggests that the phenolic acids stimulated bone building via a pathway that may involve, for example, two genes, TCF and LEF, and a protein, beta-catenin. Beta-catenin is responsible for prompting osteoblasts to become mature and functional, while TCF and LEF are responsible for promoting synthesis of beta-catenin.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Jin-Ran Chen, Oxana P Lazarenko, Xianli Wu, Jie Kang, Michael L Blackburn, Kartik Shankar, Thomas M Badger, Martin JJ Ronis. Dietary-induced serum phenolic acids promote bone growth via p38 MAPK/β-catenin canonical Wnt signaling. Journal of Bone and Mineral Research, 2010; 25 (11): 2399 DOI: 10.1002/jbmr.137

Monday, June 20, 2011

'My Dishwasher Is Trying to Kill Me': New Research Finds Harmful Fungal Pathogens Living in Dishwasher Seals

ScienceDaily

Monday, June 20, 2011

ScienceDaily (June 20, 2011) — A potentially pathogenic fungus has found a home living in extreme conditions in some of the most common household appliances, researchers have found. A new paper published in the British Mycological Society journal, Fungal Biology, published by Elsevier, shows that these sites make perfect habitats for extremotolerant fungi (which includes black yeasts). Some of these are potentially dangerous to human health.

Modern living comes with an increasing need for electrical household equipment such as dishwashers, washing machines and coffee machines. A characteristic of these appliances is a moist and hot environment. In the case of dishwashers, high temperatures between 60บ to 80บC are intermittently produced and aggressive detergents and high concentrations of salt are used in each washing cycle.

The article focuses on the occurrence of potentially pathogenic fungal flora located in dishwashers, over a sample of private homes from 101 cities on 6 continents. 62% of the dishwashers contained fungi on the rubber band in door, 56% of which accommodated the polyextremotolerant black yeasts Exophiala dermatitidis and E. phaeomuriformis. Both Exophiala species showed remarkable tolerance to heat, high salt concentrations, aggressive detergents, and to both acid and alkaline water. This is a combination of extreme properties not previously observed in fungi.

Exophiala dermatitidis is rarely isolated from nature, but is frequently encountered as an agent of human disease, both in compromised and healthy people. It is also known to be involved in pulmonary colonization of patients with cystic fibrosis, and also occasionally causes fatal infections in healthy humans. The invasion of black yeasts into our homes represents a potential health risk.

The discovery of this widespread presence of extremophilic fungi in some of our common household appliances suggests that these organisms have embarked on an extraordinary evolutionary process that could pose a significant risk to human health in the future.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

P. Zalar, M. Novak, G.S. de Hoog, N. Gunde-Cimerman. Dishwashers – A man-made ecological niche accommodating human opportunistic fungal pathogens. Fungal Biology, 2011; DOI: 10.1016/j.funbio.2011.04.007

Study says 1 in 13 US children have food allergy

By Lindsey Tanner

AP Medical Writer

The Associated Press

Monday, June 20, 2011

CHICAGO – Food allergies affect about one in 13 U.S. children, double the latest government estimate, a new study suggests.

The researchers say about 40 percent of them have severe reactions — a finding they hope will erase misconceptions that food allergies are just like hay fever and other seasonal allergies that are troublesome but not dangerous.

Overall, 8 percent of the children studied had food allergies; peanuts and milk were the most common sources. That translates to nearly 6 million U.S. children.

The most recent government estimate, from the Centers for Disease Control and Prevention, was based on in-home interviews and found that about 3 million children were affected, or about 4 percent. Other estimates based on different methods have ranged from 2 percent to 8 percent.

The new study, funded by an advocacy group, is based on online interviews with parents of kids younger than age 18 and involved 40,104 children. Research firm Knowledge Networks conducted the survey. Families were recruited through random telephone dialing.

Results were released online Monday in Pediatrics.

The findings suggest that food allergies affect two kids per classroom, said lead author Dr. Ruchi Gupta, a pediatrician and researcher with Chicago's Children's Memorial Hospital.

Dr. Calman Prussin, an investigator with the National Institute of Allergy and Infectious Diseases, said the study "confirms that food allergy is a substantial public health problem."

Prussin said differences in estimates are due to different survey methods and definitions of what constitutes a food allergy. He said the only way to know for sure how many kids are affected would be lab tests on scores of children, which isn't practical.

Because the new figure is within the range of previous estimates, he said the study doesn't mean prevalence has increased, although experts generally believe allergies including those to food are on the rise, Prussin noted.

He said some people mistake food intolerances for food allergies. For instance, many people are lactose intolerant, meaning they can't properly digest milk. That can cause bloating and digestive problems, but not an allergic reaction.

Typical signs of a true food allergy include skin rashes, wheezing, tightness in the throat or difficulty breathing.

The new survey asked parents whether their children had those symptoms — a big strength of the study, Prussin said.

Many children outgrow allergies to some foods, including eggs and wheat, but they're less likely to outgrow allergies to peanuts and other nuts.

The study was funded by the Food Allergy Initiative, a nonprofit advocacy group founded by parents of children with allergies.

Mary Jane Marchisotto, the group's executive director, said the study "paints a more comprehensive picture" of food allergies, and should help raise awareness.

The group, funded privately but without industry money, is working with the CDC on national guidelines on how to manage food allergies in schools, she said.

Online:

Pediatrics: http://www.pediatrics.org

Food Allergy Initiative: http://www.faiusa.org

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

No vitamin D screening in pregnancy: committee

By Alison McCook

Reuters Health

Monday, June 20, 2011

NEW YORK (Reuters Health) – Most pregnant women do not need to be screened for vitamin D deficiency, nor given additional supplements, according to an official statement issued by the American College of Obstetricians and Gynecologists.

Vitamin D provided by the mother's body helps build a baby's bones and teeth before it's born. Vitamin D is manufactured in the skin in response to sunlight and occurs naturally in some foods, as well as being added to others such as milk.

Pregnant women do not generally have tests to check their vitamin D levels. But many are asking if they should, or whether they should take supplements, said Dr. George Macones, chair of ACOG's committee on obstetric practice. "And for the most part, the answer is no."

Macones and his colleagues came to that conclusion after reviewing available evidence about the value of screening for low vitamin D levels in every woman who's pregnant - and finding a lack of data to prove a benefit to mother or baby.

Performing an additional blood test that has no benefit would be a waste of healthcare resources, said Macones. "If there isn't a reason to do it, you're just wasting money and time."

The only pregnant women who might benefit from a blood test for vitamin D deficiency - and it's not clear even for them -- are those who are at high risk for the problem in the first place due to certain diseases or other circumstances.

Last November, the Institute of Medicine said the highest amount of vitamin D women could safely take during pregnancy or breastfeeding was 4000 international units (IU) per day. For the average pregnant woman, the Institute recommends 600 IU of vitamin D daily. Most prenatal vitamins contain 400 IU, according to the ACOG report.

In an interview with Reuters Health, Macones explained that women can obtain extra amounts through sunlight and eating fish, as well as through milk and juices that have been specially fortified with vitamin D.

"I have no problem with women deciding to drink some extra fortified milk, or fortified juices," he said. And if a woman asked if she could take a supplement with modest amounts of vitamin D, "I would be okay with that," Macones added. "I just wouldn't routinely recommend it."

Although experts suspect that relatively high levels of vitamin D are safe in pregnancy, there could be some risks to supplements that researchers haven't uncovered yet, Macones said. "We think it's safe, but sometimes unexpected things turn up."

Still, a study last year by researchers in the United States suggested that pregnant women should dramatically increase their intake of vitamin D, in the form of supplements, to as much as 4000 IUs per day. The authors said there is little danger at that level. A review of previous studies published earlier this year concluded that many women have low blood levels of vitamin D early in pregnancy, but it's unclear whether a deficiency stunts fetal growth or causes other pregnancy-related complications.

To date, researchers have not published a randomized controlled study of the effects of vitamin D on pregnancy. That type of trial yields the most reliable results.

Given the lack of conclusive evidence, the ACOG committee did not recommend that pregnant women be screened routinely for vitamin D deficiency and take supplements. Its report appeared online June 20th in ACOG's monthly medical journal, Obstetrics & Gynecology.

Dr. Carol Wagner at the Medical University of South Carolina told Reuters Health that the committee's conclusions are "sound based on the information published," but she and her colleagues recently conducted a randomized controlled study of 350 pregnant women who received either 400, 2000, or 4000 IUs of vitamin D per day. The results, which may be published in a few weeks, showed that 4000 IUs was the "optimal dose" to help pregnant women produce the active, hormonal form of vitamin D, Wagner said.

But does that lower mom's or baby's risk for problems before or after delivery? The answer is clear yet.

For now, as Wagner said in an email, "According to the IOM and the Endocrine Society, up to 4000 IU per day is safe during pregnancy; any dose above that should be taken in consultation with the patient's physician."

Source: http://bit.ly/kbnKlF

Obstetrics & Gynecology, July 2011.

Study: Docs overtesting for cervical cancer virus

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, June 20, 2011

WASHINGTON – Too many doctors are testing the wrong women, or using the wrong test, for a virus that causes cervical cancer.

The days of one-size-fits-all screening for cervical cancer are long gone. How often to get a Pap smear — and whether to be tested for the cancer-causing HPV virus at the same time — now depend on your age and other circumstances.

But a government study reports Monday that a surprising number of doctors and clinics aren't following guidelines from major medical groups on how to perform HPV checks, suggesting a lot of women are getting unnecessary tests.

That wastes money and could harm women who wind up getting extra medical care they didn't need, says Dr. Mona Saraiya of the Centers for Disease Control and Prevention, who led the research.

Even she wasn't protected from the confusion. Saraiya was stunned to get a bill showing that her own doctor had ordered testing for HPV strains not connected to cervical cancer.

The findings, reported in the journal Obstetrics & Gynecology, show women have to be savvy to ensure they're getting the right checkups — enough, but not too much.

"It's extremely discouraging," says Debbie Saslow, gynecologic cancer director at the American Cancer Society, who's had to argue with her doctor against testing too often. "We have not been able to get that message across."

Cervical cancer grows so slowly that Pap smears — which examine cells scraped from the cervix — usually find it in time to treat, or even to prevent when precancerous cells are spotted and removed.

For decades, Paps were the only way to screen for cervical cancer. Now doctors know that certain strains of HPV, the human papillomavirus, cause most cervical cancer. HPV testing isn't a replacement for the Pap. But it can provide extra information to help determine if a woman is at higher or lower risk and thus guide her ongoing care — if it's used correctly.

The new CDC study, part of a national survey of medical practices that included 600 providers of cervical cancer screening, examined how doctors are using it.

The study found 60 percent of doctors and clinics say they give a routine Pap-plus-HPV test to women who are too young for that combination. Guidelines stress that so-called co-testing is only for women 30 and older. If both tests are negative, they can wait three years before their next screening.

Why the age limit? Saslow says HPV is nearly as common as the common cold, especially in younger women — but their bodies usually clear the infection on their own and only a years-long infection is risky. Learning that a 20-something has HPV increases the odds of more invasive testing that in turn can leave her cervix less able to handle pregnancy later in life. Younger women are supposed to get HPV testing only if a Pap signals a possible problem and doctors really need the extra information.

Then there's the question of which test to use. Only a few so-called high-risk strains of HPV cause cervical cancer, the strains doctors are supposed to test for. Before scientists understood the different HPV types, a test already was on the market that detects strains that can cause genital warts, not cervical cancer. The CDC's Saraiya says there's no reason to use that old test because learning you have a probably transient warts-causing strain doesn't alter your care.

Yet her study found 28 percent of doctors and clinics say they order tests for both the cancer-causing and warts-causing strains, regardless of patient age. The study couldn't tell why, although Saraiya says some doctors don't know there's a difference and some order forms for the lab tests don't differentiate.

An HPV test costs $80 to $100, on top of a $40 Pap. Saraiya says labs can bill for two HPV tests when doctors order testing for both kinds of strains.

So what does a woman need to know before her next checkup? The CDC has developed a consumer-friendly brochure to help women understand their options for cervical cancer screening: http://tinyurl.com/6g8de6v

And guidelines from the American College of Obstetricians and Gynecologists recommend that:

Routine Paps start at age 21.

Most women in their 20s get a Pap every two years.

Women 30 and older wait three years between screenings if they've had a negative Pap and negative HPV test, or three consecutive clear Paps.

If a Pap is inconclusive at any age, HPV testing may help rule out who needs further examination and who can just repeat a Pap in a year.

Anyone who's been vaccinated against HPV, a relatively new vaccine, still must follow Pap screening guidelines for their age group.

Higher-risk women, such as those with HIV or previous cervical abnormalities, need more frequent screening.

Editor’s Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Fat Substitutes Linked to Weight Gain: Rats On High-Fat Diet Gained More Weight After Eating Low-Calorie Potato Chips Made With Fat Substitutes

ScienceDaily

Monday, June 20, 2011

ScienceDaily (June 20, 2011) — Synthetic fat substitutes used in low-calorie potato chips and other foods could backfire and contribute to weight gain and obesity, according to a study published by the American Psychological Association.

The study, by researchers at Purdue University, challenges the conventional wisdom that foods made with fat substitutes help with weight loss. "Our research showed that fat substitutes can interfere with the body's ability to regulate food intake, which can lead to inefficient use of calories and weight gain," said Susan E. Swithers, PhD, the lead researcher and a Purdue psychology professor. The study was published online in the APA journal Behavioral Neuroscience.

The study used laboratory rats that were fed either a high-fat or low-fat diet of chow. Half of the rats in each group also were fed potato chips that are high in fat and calories. The remaining rats in each group were fed high-calorie chips on some days and low-calorie chips on other days. The low-calorie chips are made with olestra, a synthetic fat substitute that has zero calories and passes through the body undigested.

For rats on the high-fat diet, the group that ate both types of potato chips consumed more food, gained more weight and developed more fatty tissue than the rats that ate only the high-calorie chips. The fat rats also didn't lose the extra weight even after the potato chips were removed from their diet. "Based on this data, a diet that is low in fat and calories might be a better strategy for weight loss than using fat substitutes," Swithers said. However, she warned that it can be difficult to extrapolate laboratory findings about rats to people, even though their biological responses to food are similar. The study was conducted by Swithers along with Purdue psychology professor Terry L. Davidson, PhD, and former Purdue undergraduate student Sean Ogden.

Why would a fat substitute confuse the body? Food with a sweet or fatty taste usually indicates a large number of calories, and the taste triggers various responses by the body, including salivation, hormonal secretions and metabolic reactions. Fat substitutes can interfere with that relationship when the body expects to receive a large burst of calories but is fooled by a fat substitute.

There is some good news if a diet is naturally low in fat. The rats that were fed a low-fat diet didn't experience significant weight gain from either type of potato chips. However, when those same rats were switched to a high-fat diet, the rats that had eaten both types of potato chips ate more food and gained more weight and body fat than the rats that had eaten only the high-calorie chips.

Swithers and Davidson have reported similar findings in previous rat studies that showed saccharin and other artificial sweeteners also can promote weight gain and increased body fat. The use of artificial sweeteners and fat substitutes has increased dramatically over the past 30 years, mirroring the increase in obesity in America. Dieters have turned to these artificial means to lower calories while still eating foods that taste sweet or fatty. So what is a dieter supposed to do to drop a size?

"Unfortunately, there is no silver bullet," Swithers said. "Eating food which is naturally low in fat and calories may be a better route than relying on fat substitutes or artificial sweeteners." 

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Susan E. Swithers, Sean B. Ogden and Terry L. Davidson. Fat Substitutes Promote Weight Gain in Rats Consuming High-Fat Diets. Behavioral Neuroscience, 2011; 125 (4)

Obesity and lack of exercise linked to chronic pain

By Eric Schultz

Reuters Health

Monday, June 20, 2011

NEW YORK (Reuters Health) – It may not be surprising, but people who exercise at least one hour per week have a lower risk of troublesome back, neck, and shoulder pain, a new study shows.

The new evidence supports the possibility that obesity and physical inactivity play a role in a person's risk of developing chronic pain in those areas, said study co-author Dr. Paul Mork, of Norwegian University of Science and Technology in an email to Reuters Health.

Mork and colleagues followed more than 30,000 adults who participated in a large Norwegian health study. They recorded participants' body mass index (BMI) - a measure of weight related to height - at the start of the study, as well as how often they exercised, and then tracked them over the next 11 years.

The authors divided the participants into four categories based on how often they exercised, and four categories based on their BMI. They also looked at how many people in each category developed chronic neck, shoulder, and lower back pain.

Overall, 1 of every 10 people in the study developed lower back pain, and nearly 2 of every 10 developed shoulder or neck pain.

After taking into account participants' age, BMI, whether or not they smoked, and whether they did manual labor at work,

the research team found that men who were exercising 2 hours or more per week at the start of the study were 25 percent less likely to have lower back pain 11 years later, and 20 percent less like to have neck or shoulder pain, compared men who didn't exercise at all. And women who exercised at least 2 hours per week were 8 percent less likely to develop lower back pain than women who were inactive, and 9 percent less likely to develop neck and shoulder pain.

Weight, not surprisingly, also affected the risk of chronic pain later on. Obese men were almost 21 percent more likely to develop chronic lower back pain than men of normal weight, and 22 percent more likely to develop neck or shoulder pain. Obese women were also 21 percent more likely to develop lower back pain than women of normal weight, and 19 percent more likely to develop neck and shoulder pain.

Based on the results, Mork believes that even moderate physical exercise - just one hour or more per week - "can, to some extent, compensate for the adverse effect of being overweight and obese on future risk of chronic pain."

"Chronic neck and back pain are important to public health due to their substantial influence on quality of life, disability, and health care resources," Dr. Adam Goode from Duke University in Durham, North Carolina told Reuters Health by email. Goode, a physical therapist, was not involved in the study by Mork's group.

Back in the mid-1990s, a study from the Netherlands estimated that low back pain cost that country nearly 2 percent of its gross national product. In their new paper Mork and colleagues write that "just a small reduction in the incidence of chronic lower back pain would have a profound economic impact."

Because of the way it was designed, the Norwegian study can't prove that lack of exercise and being overweight actually caused people's chronic pain, or that regular exercise and a more healthy weight prevented it. It could be that the people who did or didn't have chronic pain are different in ways the study did not measure.

However, given the known benefits of exercise and maintaining a healthy weight, Mork believes that "community based measures aimed at reducing the incidence of chronic pain...should aim at promoting regular physical exercise and the maintenance of normal body weight."

Source: http://bit.ly/jaoix5 , online June 11, 2011

Millions Don't Get Meds for Serious Artery Disease: Study

By Randy Dotinga

HealthDay News

Monday, June 20, 2011

MONDAY, June 20 (HealthDay News) -- Millions of Americans suffer from a condition known as peripheral artery disease but aren't receiving medical treatment, putting them at risk of potentially fatal heart problems, a new study finds.

Those who had the condition but didn't take medications were more likely to die of all causes during the period studied, although it's not clear how the disease specifically affected their health, the researchers noted.

The findings, released online June 20 in advance of publication in an upcoming print issue of the journal Circulation, reinforce the belief that peripheral artery disease, or PAD, is an early warning sign of possible clogged vessels elsewhere in the body, said study lead author Dr. Reena L. Pande, a cardiologist and associate professor at Harvard Medical School.

"We think of it as a manifestation of a whole-body problem," she said. "What happens in the legs can happen in other parts of the body, like the heart and the brain even."

Atherosclerosis -- or blockages in the arteries in the legs caused by plaque -- is the source of PAD. Physicians have long known about the condition, but it's only begun to receive much attention in the last couple of decades, Pande said.

People with the condition may experience cramping in the hips, thighs or calves, pain and burning sensations in the legs, ulcers and even amputation. But in many cases, no symptoms occur.

A simple test of the blood pressure in the arm and the ankle can detect the condition, and there's debate about whether the test should be routine, said Pande, who is also an associate physician at Brigham and Women's Hospital in Boston.

In the new study, funded in part by federal grants, Pande and colleagues analyzed statistics from a national survey of 7,458 people aged 40 and older. The participants were tracked from 1999 through 2004.

The researchers found that about 6 percent of the participants suffered from peripheral artery disease, translating to about 7 million adults in the United States. Of those, 25, 36 and 31 percent, respectively, took high blood pressure medication, aspirin or cholesterol drugs.

Those who took two or more of the drugs were 65 percent less likely to die of all causes during the seven years of the study, Pande said. However, she said the percentages of people who died in each group -- those who took two or more drugs and those who didn't -- weren't available.

The research "raises the question of whether we should be looking for these people to get them on the appropriate treatments," Pande said. "We don't have any studies that tell us that if we find them and treat them, they'll have a lowered risk of dying. But it makes us wonder if we should try to find these individuals with a simple screening test."

The screening test is inexpensive and can be conducted by health care professionals other than doctors, she said. As for cost, at least one of the medications in question -- aspirin -- is very inexpensive.

Dr. Jeffrey W. Olin, a vascular medicine specialist at Mount Sinai School of Medicine in New York City, said the study provides more evidence that doctors should take peripheral artery disease seriously and treat it. In many cases, he said, doctors don't prescribe medications even when they know a patient has the condition.

"We've been working on this for 15 years, trying to get health care providers to be aware of the fact that people with peripheral artery disease don't die because of their legs," he said. "They die because they have heart attacks and strokes."

More information

For more about peripheral artery disease, visit the U.S. National Library of Medicine.

Diagnosed Autism Is More Common in an IT-Rich Region, Study Finds

ScienceDaily

Monday, June 20, 2011

ScienceDaily (June 20, 2011) — A new study from Cambridge University has for the first time found that autism diagnoses are more common in an information technology-rich region.

The Medical Research Council (MRC) funded study, published June 20 in the Journal of Autism and Developmental Disorders, has important implications for service provision in different regions and for the 'hyper-systemizing' theory of autism.

Professor Simon Baron-Cohen, Director of the Autism Research Centre (ARC) at the University of Cambridge, led the study (which was conducted in the Netherlands) with Dr Rosa Hoekstra, a Dutch autism researcher based at ARC and The Open University.

The researchers predicted that autism spectrum conditions (ASC) would be more common in populations enriched for 'systemizing', which is the drive to analyse how systems work, and to predict, control and build systems. These skills are required in disciplines such as engineering, physics, computing and mathematics.

The team had previously discovered evidence for a familial association between a talent for systemizing and autism in that fathers and grandfathers of children with ASC are over-represented in the field of engineering. The team had also previously found that mathematicians more often have a sibling with ASC, and students in the natural and technological sciences, including mathematics, show a higher number of autistic traits.

The researchers tested for differences in the prevalence of ASC in school-aged children in three geographical regions in the Netherlands: Eindhoven, Haarlem, and Utrecht-city. The region Eindhoven was selected because it is rich in information-technology (IT) having the Eindhoven University of Technology there, as well as the High Tech Campus Eindhoven, where IT and technology companies such as Philips, ASML, IBM and ATOS Origin are based. (The Philips factory has been in Eindhoven since 1891. Since then, the region has attracted businesses in IT and technology.)

The growth of the High Tech Campus Eindhoven has led to Eindhoven becoming a major technology and industrial hub: 30% of jobs in Eindhoven are now in technology or ICT, in Haarlem and Utrecht this is respectively 16 and 17%.

The two control regions were selected because they have similar size populations and a similar socioeconomic class. Schools in each region were asked to provide the number of children enrolled, the number having a clinical diagnosis of ASC and/or two control neurodevelopmental conditions (dyspraxia and ADHD). The participating schools in the three regions provided diagnostic information on a total of 62,505 children. The researchers found school-reported prevalence estimates of ASC in Eindhoven was 229 per 10,000, significantly higher than in Haarlem (84 per 10,000) and Utrecht (57 per 10,000), whilst the prevalence for the control conditions were similar in all regions.

Simon Baron-Cohen commented: "These results are in line with the idea that in regions where parents gravitate towards jobs that involve strong 'systemizing', such as the IT sector, there will be a higher rate of autism among their children, because the genes for autism may be expressed in first degree relatives as a talent in systemizing. The results also have implications for explaining how genes for autism may have persisted in the population gene pool, as some of these genes appear linked to adaptive, advantageous traits."

Rosa Hoekstra added: "We need to conduct a follow-up study to validate the diagnoses and to test the alternative explanations for the elevated rate of autism in Eindhoven, including the possibility that children with autism may more often remain undetected in the two other regions. These results are important findings in the field of autism epidemiology, since they suggest regional variation in autism prevalence. In our follow-up study we plan to study the causes of this variation in more detail. This will help local authorities plan services appropriately for the number of children with autism."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Martine T. Roelfsema, Rosa A. Hoekstra, Carrie Allison, Sally Wheelwright, Carol Brayne, Fiona E. Matthews, Simon Baron-Cohen. Are Autism Spectrum Conditions More Prevalent in an Information-Technology Region? A School-Based Study of Three Regions in the Netherlands. Journal of Autism and Developmental Disorders, 2011; DOI: 10.1007/s10803-011-1302-1