While chewing gum may help you feel better when you're stressed, don't overdo it, advises the University of Texas Southwestern Medical Center at Dallas.
When you're stressed, you may be prone to chewing more vigorously, which can strain your jaw.
Chewing too hard can cause fatigue and soreness in the jaw. It can also trigger a condition called TMJ, affecting the temporomandibular joint. The condition can causes pain in the head and the neck, and difficulty in opening and closing the jaw.
If you have any of these symptoms, give your jaw a rest and stop chewing gum for a few days. If symptoms don't subside, see a doctor.
Thursday, August 23, 2007
Health Tip: While Chewing Gum May Relieve Stress
Health Tip: Before a Colonoscopy
A colonoscopy -- used to detect colon cancer and other potential problems -- involves use of a long, flexible tube with a camera that takes images of the colon. Before having a colonoscopy, you should follow certain do's and don'ts to ensure an accurate procedure. This list is provided by the U.S. National Digestive Diseases Information Clearinghouse:
- Avoid all solid foods and any beverages with food coloring for one to three days before a colonoscopy.
- You may eat fat-free bouillon or broth soups, or gelatin.
- You may drink water, strained fruit juice, plain coffee, plain tea or diet soda (no food coloring).
- As certain medications may affect your results, tell your doctor if you are taking aspirin, arthritis medications, blood thinners, medications for diabetes, or any vitamins containing iron.
Tuesday, August 21, 2007
Health Tip: Keep Bugs at Bay
Insect bites can itch, cause pain, and be quite uncomfortable. While they can't always be prevented, there are ways to reduce your chances of being bitten. Here are suggestions to help prevent insect bites, courtesy of the U.S. National Library of Medicine:
- Don't poke, pick up or otherwise provoke insects.
- Be cautious around nests and hives, and avoid sudden or rapid movement.
- Avoid heavy perfumes, and clothing that has a floral pattern.
- Wear protective clothing that covers the skin, and apply insect repellent when you're outside.
- Pay attention when eating outside, especially when drinking sugary beverages or sitting near garbage cans.
- People with known allergies to bites or stings should carry an emergency epinephrine kit.
Health Tip: Treating Acne Scars
While there is no perfect treatment to eliminate all acne scars, there are remedies that can significantly reduce their appearance. The Nemours Foundations offers this list of potential options :
- Laser resurfacing, which removes the top layer of damaged skin.
- Dermabrasion, which wears down the skin, fostering a new, smoother layer of skin as it heals.
- Fractional laser therapy, which affects deeper layers of skin without damaging the top layer.
- A chemical peel.
- Injections or surgery.
Health Tip: Why Are My Eyes Red?
Eye redness occurs when blood vessels on the surface of the eye become dilated. Here are some common causes of red eyes, courtesy of the U.S. National Library of Medicine:
- Straining the eyes.
- Persistent or severe coughing.
- An eye infection.
- A cold or allergy.
- Damage to the eye.
- Acute glaucoma.
- Scratches on the cornea, commonly caused by wearing contact lenses too long, or sand or dust in the eyes.
- Bleeding problems, often caused by taking blood-thinning drugs.
Health Care : Antioxidant Supplements May Raise Women's Skin Cancer Risk
Taking antioxidant supplements won't protect against skin cancer and may actually boost the risk, at least in women, according to a new French study. "Taking into consideration our results, we are particularly concerned by the use of long-term supplementation, notably in sun-seekers and people wanting to look tanned [using beta-carotene]," said researcher Dr. Serge Hercberg, professor of nutrition at the Medical University of Paris.
The new findings come on the heels of a study, published in mid-August in the Archives of Internal Medicine, that found that antioxidants don't prevent heart disease risk in high-risk women. In the new French study, published in the September issue of The Journal of Nutrition, Hercberg's team looked at the effects of antioxidant doses on skin cancer. The research was conducted as part of a larger study that looked at the effects of antioxidants on cancer and ischemic heart disease.
Antioxidant nutrients are thought to reduce disease risk by cutting down on the unhealthy effects of "free radical" molecules that damage cells.
The researchers assigned almost 7,900 women and more than 5,100 men to take either an oral daily capsule of antioxidant or a placebo that looked the same. The antioxidants included 120 milligrams of vitamin C, 30 milligrams of vitamin E, 6 milligrams of beta-carotene, 100 milligrams of selenium and 20 milligrams of zinc.
"They are not high doses," Hercberg said. "They are at a level below a lot of pills you can find to buy over the counter."
The men and women were followed for about 7.5 years. In that time, 157 cases of any form of skin cancers were reported, including 25 melanomas, the most deadly form.
The team found that, in women, the incidence of all types of skin cancer combined was actually higher in the antioxidant group, and so was their incidence of melanoma.
But the incidence of non-melanoma skin cancers, when evaluated separately, did not differ between the antioxidant and placebo groups in men or women. In men, there was no difference in any form of skin cancer (including melanoma) between the two groups.
In the antioxidant group, 51 women developed skin cancer, while 30 in the placebo group did. Among the men, 43 in the placebo group and 33 in the antioxidant group got skin cancers.
As for melanoma, the incidence did not differ significantly between the men's treatment group -- 6 in the placebo group and 3 in the antioxidant group got it. But 3 women on placebo and 13 on antioxidants got melanoma -- a significant difference, the researchers said.
Antioxidant studies have yielded mixed results, Hercberg stressed. For example, in previous studies, researchers saw a higher risk of lung cancer in heavy smokers who regularly took high doses of beta-carotene.
Studies have suggested that antioxidant supplements might protect against prostate cancer incidence in men with low blood levels of prostate specific antigen (PSA), Hercberg said. But research has also suggested that the nutrients might increase prostate cancer risk in men with a high PSA. PSA levels are a marker for pre-existing prostate cancer risk.
That could also be happening in the women who got more skin cancers after taking antioxidants, he theorized. If their skin cancer had already been developing, taking an antioxidant might not help, Hercberg speculated.
While the study is interesting, further research is needed to confirm it, said Dr. Ariel Ostad, a spokesman for the Skin Cancer Foundation and a New York City dermatologist not involved in the study.
He said the study did have one serious limitation. "It does not take into account sunscreen use," he said. If the participants tended not to use sunscreen, that could have affected the results.
Meanwhile, Ostad added, taking care in the sun is important, and "sunscreens are by far the most powerful" weapon to prevent skin cancers.
source : news.yahoo.com
Cancer survival rate up in Europe
Cancer survival has improved across Europe, with eastern European nations beginning to close the gap with western neighbours, according to a study covering the decade up to 2002, released Tuesday. The study, published in the British journal The Lancet, showed a clear link between high rates of survival and the amount spent on health, but pointed out that Britain lagged well behind other countries with similar national health budgets.
An accompanying editorial in the influential journal called for a "fundamental reassessment" of Britain's cancer policy in light of the fact that survival rates were comparable to eastern European countries that spent two-thirds less. "So has the cancer plan worked? The short answer is seemingly no," it concluded, suggesting that the National Health Service should be "divorced from political control and short-term political gains."
The 23-country study, the largest of its kind, said that the survival rate for the most common cancers -- colorectal, lung, breast and prostate -- and for ovarian cancer was highest in Nordic countries, with the exception of Denmark, and in central Europe.
It was somewhat lower in southern Europe, including Spain and Italy, lower still in Britain and Ireland, and lowest in eastern Europe.
Poland and the Czech Republic, however, showed sharp improvement across most major cancers in the period studied, suggesting that eastern European countries were closing the health gap.
From 1991 to 2002, survival rates in eastern Europe improved from 30.3 to 44.7 percent for colorectal cancer, from 60.0 to 73.9 percent for breast cancer, and from 39.5 to 68.0 percent for prostate cancer.
For patients diagnosed in 2000-2002, survival for patients across Europe with tumours was significantly lower than in the United States: 47.3 percent for men and 55.8 for women, compared to 66.3 and 62.9 percent respectively, the study noted.
The journal called for the development of a "pan-European cancer plan" to promote modern diagnostic and treatment facilities.
It noted in particular that Britain should emphasize earlier diagnosis of the disease.
source : news.yahoo.com
Health Care : Egypt death sparks debate on female circumcision
It was a routine procedure undertaken by thousands of Egyptian girls every year, but something went wrong and Budour Ahmed Shaker died while having her genitals cut in a rite known locally as "purification." The death of the 11-year-old schoolgirl at a private clinic in the Egyptian village Mughagha in June prompted the government to outlaw the custom of female genital mutilation, which is so widespread in Egypt that 95 percent of the country's women are estimated to have undergone the procedure.
But the ban may be hard to enforce and activists fear the practice may go underground as the vast majority of Egyptian families still view circumcision as necessary to protect girls' chastity. Most girls are cut by the time they reach puberty. Even in Mughagha, a village of low rise houses hemming the Nile, many women and girls say they want the procedure to be allowed but under more stringent medical supervision.
"If a girl is not purified, she will just go hook up with men. This protects women's honor. Otherwise it will become just like America here and girls will go with guys," said Asma Said, a 16-year-old secondary school student.
"Those who say it doesn't happen are lying 100 percent. There is not one person here not circumcised, and it will continue."
She like many of the schoolgirls in Maghagha who spoke to Reuters said they supported the practice, even if they were frightened of having it done.
The only girl who spoke against the practice was shouted down by her classmates until she conceded that genital cutting was a necessity.
"No one can get married without it," said the girl.
Another classmate, 15-year-old Nesma Radi, chimed in: "Egypt lives in peace and security because there is circumcision."
Egypt imposed a complete ban on female genital cutting -- also known as female genital mutilation or circumcision -- in June after Shaker died of an excessive dose of anesthesia while being cut at a private clinic in Maghagha.
Egypt's state-appointed Grand Mufti, the government's official arbiter of Islamic law, decreed in June that female genital cutting was forbidden by Islam, in his strongest statement yet against the practice.
In Egypt, the cutting is done on both Muslim and Christian girls and typically involves excising the clitoris and sometimes other female genitalia, often by a doctor. Side effects include hemorrhage, shock and sexual dysfunction.
Outside of Egypt and Sudan to the south, the practice is extremely rare elsewhere in most of the Arab world but is common in Eritrea, Ethiopia and Somalia.
More than 95 percent of Egyptian women had been circumcised, with the highest levels in poor families living in rural areas of the Nile valley in southern Egypt, according to an Egyptian Demographic and Health Survey conducted in 2005.
source : news.yahoo.com
Health Tip: Children Who Play Sports
Scholastic sports are a great way for children to get exercise and stay healthy. But young athletes also are at greater risk of injury to their growing bodies. Here are potential risks to keep in mind when your child is playing a sport, courtesy of the American Academy of Orthopaedic Surgeons:
- Growing bones, muscles, ligaments and tendons are more susceptible to injury than those of adults.
- Growth plates leave weak areas exposed that can cause long-term damage.
- Children in the same age group may vary greatly in size and ability, which can lead to injuries in contact sports.
- Competitive children may try to push themselves to play longer and harder than their bodies can physically handle.
source : news.yahoo.com Read More..
Health Care : Study finds virus contributes to obesity
In the buffet of reasons for why Americans are getting fatter, researchers are piling more evidence on the plate for one still-controversial cause: a virus. New research announced Monday found that when human stem cells — the blank slate of the cell world — were exposed to a common virus they turned into fat cells. They didn't just change, they stored fat, too.
While this may be a guilt-free explanation for putting on pounds, it doesn't explain all or even most of America's growing obesity problem. But it adds to other recent evidence that blames expanding waistlines on more than just super-sized appetites and underused muscles. For several years, researchers have looked at a possible link between obesity and this common virus, called adenovirus-36, from a family of viruses that cause colds and pinkeye in people. They had already found that a higher percentage of fat people had been infected with the virus than nonfat people. They had exposed animals to the virus and got them to fatten up and even found a a gene in the virus that causes animals to get obese.
But ethical restraints kept researchers from exposing people to the virus to see what happens. So they did what would be considered the next best thing, said Nikhil Dhurandhar, who headed the research at the Pennington Biomedical Research Center in the Louisiana State University system.
They took fat tissue from people who had liposuction, removed adult stem cells from the tissue and exposed the cells to the virus in the lab. Adult stem cells can regenerate and turn into different types of specialized cells to help the body heal itself.
More than half the stem cells exposed to the virus turned into fat cells and accumulated fats, while only a small percentage of the non-exposed stem cells did the same, said researcher Dr. Magdalena Pasarica, who presented the results Monday at the American Chemical Society's annual meeting in Boston.
"It's the first time we see an effect in human cells," Pasarica said in a phone interview.
If a viral cause of obesity can be confirmed, a vaccine could be developed, maybe within five to 10 years, to prevent the virus from making some people fat, Dhurandhar said. However, it wouldn't help people already obese, he said.
Outside experts are intrigued but worry about people blaming all obesity on viruses, when this may be just one of many causes. It doesn't mean it's OK to overeat, blame a bug or wait for some kind of antivirus medicine, they said.
"The cause for obesity in everyone is the same," said Dr. Samuel Klein, director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis. "You eat more calories than you burn up; You can't get away from that basic law of physics."
But there are many causes that trigger overeating and extra storage of fat in the body, including the virus, Klein said. However, he said he considers the virus only a small factor, easily outweighed by genetics and even childhood eating habits.
Dhurandhar said some of his earlier research found that 30 percent of obese Americans had developed antibodies to the virus, showing they had been exposed to it at some point. But for non-obese people, only 11 percent had antibodies, he said.
That means for some people it is not their fault they are fat, Dhurandhar said.
But Klein said that's not completely right.
"We don't want obese people to feel that it's all their fault because it is not all their fault ... but clearly the buck finally lies with the person," Klein said.
source : news.yahoo.com
Health Care : Too fat? Common virus may be to blame
A common virus caused human adult stem cells to turn into fat cells and could explain why some people become obese, U.S. researchers said on Monday. The research builds on prior studies of adenovirus-36 -- a common cause of respiratory and eye infections -- and it may lead to an obesity vaccine, they said.
"We're not talking about preventing all types of obesity, but if it is caused by this virus in humans, we want a vaccine to prevent this," said Nikhil Dhurandhar, an associate professor at Pennington Biomedical Research Center at Louisiana State University System. The virus adenovirus-36 or Ad-36, caused animals to pack on the pounds in lab experiments. "These animals accumulated a lot of fat," Dhurandhar said in a telephone interview.
Dhurandhar also has shown that obese people were three times more likely to have been infected with Ad-36 than thin people in a large study of humans.
Now, researchers in Dhurandhar's lab have shown that exposure to the virus caused adult human stem cells to turn into fat-storing cells.
Dr. Magdalena Pasarica, who led the study, obtained adult stem cells from fat tissue of people who had undergone liposuction. Stem cells are a type of master cell that exist in an immature form and give rise to more specialized cells.
Half of the stem cells were exposed to the virus Ad-36. After a week, most of the infected stem cells developed into fat cells, while the uninfected cells were unchanged.
Pasarica presented her findings at a meeting of the American Chemical Society in Boston.
"The virus appears to change their commitment to a fat storing cell," Dhurandhar said, adding that Ad-36 is just one of 10 pathogens linked to obesity and that more may be out there.
He acknowledged that some people might find it hard to believe that a virus could be responsible for obesity.
"Certainly overeating has something to do with gaining weight. No doubt about that. But that is not the whole truth," Dhurandhar said. "There are multiple causes of obesity. They range from simple overeating to genes to metabolism and perhaps viruses and infections."
Long term, he said he hoped to develop a vaccine and perhaps treatments for the virus. But first, he and colleagues need to better understand the role of Ad-36 in human obesity, he said.
Globally, around 400 million people are obese, including 20 million children under age 5, according to the World Health Organization.
source : news.yahoo.com
Health Care : Obesity predicts prostate cancer recurrence
Obese men have an increased risk of prostate cancer recurrence and death after they have completed radiation therapy, according to results of a study published in the medical journal BJU International. Obesity is known to predict prostate cancer progression in men who undergo radical prostatectomy, or complete surgical removal of the prostate gland, Dr. David Palma and colleagues from the British Columbia Cancer Agency, Vancouver, Canada, pointed out.
The researchers therefore examined whether obesity is associated with outcome for patients who undergo external beam radiation therapy for prostate cancer. Of 706 patients treated with radiation from 1994 through 2000, 195 were normal weight, 358 were overweight, and 153 were obese. There were no significant differences among the three groups in Gleason score (aggressiveness of the tumor); prostate-specific antigen (PSA) score (a prostate tumor marker) before treatment began; or cancer stage (how far the cancer has spread).
Blood levels of the male hormone testosterone were lower in obese men than in overweight and normal-weight men.
There were a total of 292 treatment failures detected by laboratory tests. The average times to relapse for normal-weight, overweight, and obese men were 93 months, 88 months, and 84 months, respectively.
The average times to prostate cancer death were 11.1 years for normal and overweight men, and 10.6 years for obese men, a statistically significant difference. The results of further analysis revealed a trend toward decreased overall survival by weight group.
"A number of explanations have been postulated to account for more aggressive prostate cancer in obese men," Palma and colleagues note. "Possible mechanisms include dietary factors, and alterations in hormonal levels, such as estrogens, androgens, leptin, and IGF-1, although definitive mechanisms have not been elucidated."
source : news.yahoo.com
Monday, August 20, 2007
Health Tips : Tea for tumors.
Research shows one kind of tea can be up to 100 times more potent at blocking growth of cancer cells than another. While all tea (green, oolong or black) contains antioxidant compounds called catechins that protect against cancer (especially of the lung, breast, colon, stomach and skin) by neutralizing free radicals, green tea contains about 7 times more catechins than black tea. Green tea also has unique catechins that block an enzyme involved in breast, prostate and colon cancers. Green tea is 10 to 100 times stronger than black tea in blocking the growth of cancer cells. Catechins also prevent heart disease and stroke, primarily by defending against the harmful effects of artery-clogging LDL cholesterol.
Health Tip: Facts About Febrile Seizures
When a child has a seizure that's related to a fever, it's called a febrile seizure. Here are some facts for parents on febrile seizures, courtesy of the American Academy of Family Physicians:
- While febrile seizures can be very frightening to watch, they are rarely harmful to children.
- Febrile seizures do not cause brain damage, and will not cause your child to swallow his or her tongue.
- Febrile seizures -- even repeated ones -- do not mean your child has epilepsy.
- These seizures typically last only a few minutes (rarely more than 10) and will subside on their own. Contact your doctor if the seizure lasts longer than 10 minutes.
- If your child has had one febrile seizure, the chances of her having another one are between 25 percent and 30 percent. Most children do not have multiple febrile seizures.
- Your child should be checked by your family doctor after a seizure to be sure that a fever was the only cause.
Health Tip: Talking to Your Doctor About How to Lose Weight
It may seem intimidating to approach your doctor for advice about how to lose weight. Here are some pointers to get you started, courtesy of the American Academy of Family Physicians:
- Ask your doctor for any available pamphlets or brochures about weight loss, diet and exercise.
- Have your doctor measure your body mass index and waist circumference, and talk about your results and what they mean to your health.
- Talk to your doctor about your exercise regimen and diet, and what changes you can make to help you to lose weight.
- Consider how much change and effort you are willing to make before you talk to your doctor.
- Ask if there are any specialists who can help you, such as dieticians, nutritionists or physical trainers.
Zero trans fat doesn't always mean zero
Stroll the aisles of any grocery store and you're sure to spot labels declaring "zero grams trans fat" on the front of snack foods, cookies and crackers. But does zero really mean there's NO artery-clogging fat inside?
Maybe, maybe not.
Federal regulations allow food labels to say there's zero grams of trans fat as long as there's less than half a gram per serving. And many packages contain more than what's considered one serving.
"The problem is that often people eat a lot more than one serving," said Dr. Dariush Mozaffarian of Harvard School of Public Health. "In fact, many people eat two to three servings at a time."
Those small amounts of trans fat can add up, said Michael Jacobson of the consumer advocacy Center for Science in the Public Interest. To find out if there might be some trans fat, he said shoppers can check the list of ingredients to see if partially hydrogenated oil — the primary source of trans fat — is included.
"When it says zero grams, that means something different from no trans fat," said Jacobson. His group has urged the government to bar food producers from using any partially hydrogenated oils at all.
The Food and Drug Administration began forcing food companies to list the amount of trans fat on nutrition labels of packaged foods in January 2006. That led many companies to switch to alternative fats.
Trans fat occurs naturally in some dairy and meat products, but the main source is partially hydrogenated oils, formed when hydrogen is added to liquid vegetable oils to harden them.
Consumer groups and health officials have campaigned to get rid of trans fat because it contributes to heart disease by raising levels of LDL or bad cholesterol while lowering HDL or good cholesterol. Fast-food restaurants are switching to trans fat-free oils and New York City and Philadelphia are forcing restaurants to phase out their use of trans fat.
The American Heart Association recommends that people limit trans fats to less than 2 grams per day.
Julie Moss of the FDA's Office of Nutrition, Labeling and Dietary Supplements, said the half-gram threshold for labeling was adopted because it is difficult to measure trans fat at low levels and the same half-gram limit is used for listing saturated fat. She said the FDA would soon be doing consumer research on trans fat labeling, including whether a footnote such as "Keep your intake of trans fat as low as possible" should be added to food labels.
Robert Earl of the Grocery Manufacturers Association said any trans fat in products labeled zero trans fat is likely to be far less than the half-gram threshold. For example, he said, a little partially hydrogenated oil might be used to help seasoning stick.
"I think the industry has been extremely responsive. Most of them were ahead of the curve to either remove or reduce trans fat in most food products," he said.
Earl said shoppers should be looking at the entire food label.
Jacobson is also concerned that people are focusing too much on the trans fat content alone, and not considering other ingredients such as saturated fat, which also raises the risk of heart disease.
"The bigger problem is foods that have no labels at all," Mozaffarian said, citing food served not only at restaurants, but at bakeries, cafeterias and schools.
New York resident Diana Fiorini said she's just recently started paying attention to labels. Holding a box of microwave popcorn at a Manhattan store, she scanned the label and was happy to see that it listed zero grams trans fat.
"I look at the labels. It's still hard to stop yourself when you know you should," she said.
source : news.yahoo.com
Deer hunting may put men's hearts at risk
Deer hunting could be a dangerous endeavor for men with heart disease or risk factors for it, research findings suggest. In a study of 25 middle-aged male deer hunters, researchers found that the activities inherent to hunting -- like walking over rough terrain, shooting an animal and dragging its carcass -- sent the men's heart rates up significantly.
In some cases, this led to potentially dangerous heart-rhythm disturbances, or diminished oxygen supply to the heart. Of the 25 hunters, 17 had established coronary heart disease, while the rest had risk factors such as being overweight, smoking or having high blood pressure or cholesterol.
The findings suggest that for men like these, hunting could boost the risk of heart attack or cardiac arrest.
Susan Haapaniemi and colleagues at William Beaumont Hospital in Royal Oaks, Michigan, report the findings in the American Journal of Cardiology.
For the study, the researchers outfitted each man with a portable monitor that continuously recorded his heart's electrical activity during a day of deer hunting. For comparison, the men also had their hearts monitored as they exercised on a treadmill on a separate day.
In general, the researchers found, deer hunting put the men's hearts under more strain than the treadmill did. Ten men exceeded the maximum heart rate they logged on the treadmill, and several showed potentially dangerous heart responses to hunting that they did not show during the treadmill test.
Three men had signs of impeded blood flow to the heart during hunting, but not on the treadmill. Similarly, three of the men with heart disease had heart-rhythm abnormalities while hunting that did not show up on the treadmill test.
The combination of physical exertion, adrenaline rush and the stress of rough terrain and cold weather may explain the "excessive cardiac demands" seen with hunting, according to Haapaniemi's team.
What's more, they point out, most of the men in the study were taking part in an exercise program to treat their heart disease, or were regularly physically active. Hunting could be an even greater strain on the heart in men who are usually sedentary, the researchers note.
source : news.yahoo.com
Breast cancer vaccine looks safe, study shows
A vaccine designed to treat breast cancer appeared to be safe in women with advanced disease and showed signs of actually slowing down tumors, U.S. researchers reported on Friday. Dendreon Corporation, maker of the Provenge prostate cancer vaccine, calls the new vaccine Neuvenge. It targets a type of breast cancer called her2/neu-positive breast cancer, which affects between 20 percent and 30 percent of breast cancer patients.
Like Provenge, Neuvenge is made using immune cells from the cancer patient, so it is a tailor-made vaccine.
Dr. John Park of the University of California, San Francisco and colleagues tested it in 18 women with advanced her2/neu-positive breast cancer, whose cancer had spread despite treatment.
Writing in the Journal of Clinical Oncology, the researchers said the vaccine did not cause any serious side effects and appeared to help at least one patient.
"We saw a partial response, meaning a reduction in the size of tumor area in one patient that was certainly attributable to the treatment," Park said in a telephone interview.
In three other women, their cancer appeared to stabilize for as long as a year, something that could have been due to treatment, Park said.
Park said the effects justify moving from the Phase 1 safety trial to a Phase 2 trial, which would be designed to show the treatment actually helps patients. But that may not happen for a while, he said.
source : news.yahoo.com
Coloring Compound in Fruits, Veggies May Cut Colon Cancer Risk
Compounds called anthocyanins, which give color to most red, purple and blue fruits and vegetables, may help protect against colon cancer, an Ohio State University study says. In laboratory tests on rats and on human colon cancer cells, the researchers found that anthocyanins can significantly slow the growth of colon cancer cells. The team also found that, in some cases, slightly altering the structure of anthocyanin molecules boosted their anti-cancer properties.
The findings, presented Sunday at the American Chemical Society's annual meeting in Boston, may help advance knowledge about what gives fruits and vegetables their cancer-fighting properties which, in turn, could eventually lead to the development of new cancer treatments.
"These foods contain many compounds, and we're just starting to figure out what they are and which ones provide the best health benefits," lead author Monica Giusti, an assistant professor of food science at the university, said in a prepared statement.
She did not recommend certain kinds fruits or vegetables over others, and noted that much more research needs to be conducted on anthocyanins. Currently, she and her colleagues are examining how anthocyanins interact with other compounds in foods to determine if these interactions affect the health benefits of the foods or of anthocyanin itself.
source : news.yahoo.com
Doctor's advice may boost car seat use
While a doctor's advice can encourage people to use car seats for children younger than four, there is less data on the effectiveness of counseling on motor vehicle restraint use for older kids and adults, according to a new study. And there's no evidence that doctors can help prevent alcohol-related car crashes by warning patients about the risks of drunk driving, the study team found.
Motor vehicle accidents are the leading killer of people between 3 and 33 years of age in the US, the researchers note in their study, which was commissioned by the US Preventive Services Task Force (USPSTF). In 1996, the USPSTF issued a recommendation urging primary care doctors to counsel their patients about using seatbelts, booster seats and car seats to help prevent car crash injuries.
Dr. Selvi B. Williams of the Kaiser Permanente Center for Health Research in Portland, Oregon and colleagues reviewed all available studies to see whether this counseling had any independent effect on increasing proper restraint use, and also to determine if counseling on the risks of drinking and driving was effective.
Eighty percent of adults use seatbelts, while car seat use is 90 percent and use of booster seats is rising, the USPSTF notes in a statement accompanying the study, but proper use of car seats and booster seats remains low.
In their review, Williams and colleagues found that interventions that included demonstrations of proper restraint use were more effective than counseling alone, as were approaches that included distributing free or reduced-price car safety seats.
Among parents of children younger than 4, counseling did indeed increase correct use of car safety seats in the short term. The researchers found just two studies on the effect of counseling 4- to 8-year-olds on booster seat use, and just three studies of counseling older kids, teens and adults on proper seatbelt use. There were no studies at all on the effectiveness of counseling on alcohol-related driving.
Based on other research on drunk driving, the researchers say, "Screening all patients for alcohol misuse and then intervening with risky and harmful users (instead of counseling all primary care patients about reducing alcohol-related driving) may be the best evidence-based approach that is currently available for primary care clinicians."
In order to ensure widespread and appropriate use of motor vehicle restraints by adults and children, the USPSTF concludes, a multi-pronged approach including legislation, counseling, community-based efforts, and enforcement is necessary.
source : news.yahoo.com
Friday, August 17, 2007
Health Tip: Who's at Greater Risk for Heat-Related Illness
Health Tip
Heat-related illness occurs when the body can't cool itself during extremely hot and humid conditions. According to the U.S. Centers for Disease Control and Prevention, certain people are at greater risk, including:- Infants and young children up to 4 years of age.
- People aged 65 and older.
- People who are significantly overweight or obese.
- People who overexert themselves or don't drink enough fluids.
- People with high blood pressure, heart disease, and those who take certain medications for depression, insomnia or poor circulation.
Health Tip: Symptoms of Bone Spurs
- "Pins and needles" sensation in the hands or feet.
- Dull pain in the neck or lower back while standing or walking.
- Lack of coordination in a part of the body.
- Muscle weakness, spasms or cramps.
- Numbness.
- Pain that radiates through the thighs, buttocks or shoulders.
- Headaches.
Health Care : Menopause hard on couple's sex lives
Sexual Health Care
When a woman enters menopause, her sex life and that of her partner may suffer, according to a survey in which more than half of the women reported a decrease in sex drive and in the amount of sex they were having since entering menopause. Overall, 46 percent of menopausal women surveyed reported having sex less than once per month and most women felt that this was hurting their relationship."Menopausal women are having less sex and it's impacting our relationships," Karen Giblin noted in a telephone interview with Reuters Health. "Frankly, through the Red Hot Mamas menopause education programs, I have heard that a lot of women would rather go shoe shopping than have sex, and that concerns me."
The survey, including more than 1,000 women, 35 years or older, who were just beginning, just ending, or in the middle of menopause, was conducted between June 20 and July 2, 2007.
"We are the baby-boom generation who is now entering menopause; we are the women who lived through the sexual revolution in the 60s and now we are having our own sexual revolution, of a different kind," said Giblin, the founder of the Red Hot Mamas organization (www.redhotmamas.org), which commissioned the Sex and Menopause Survey. The survey was sponsored by Duramed Pharmaceuticals and conducted by Harris Interactive.
Four hundred sixty nine of these women -- about 44 percent -- reported suffering from vaginal symptoms such as vaginal atrophy (vaginal narrowing or shrinkage), which can cause vaginal dryness and painful sex.
Eighty-eight percent of women experiencing vaginal atrophy said it was causing them problems and 47 percent said that they have avoided, made an excuse, or stopped having sex altogether because of physical discomfort during intercourse.
Vaginal dryness, in particular, plagued more than half of menopausal women surveyed and this resulted in two thirds of them having less sex. "Seventy percent of the women did not know that therapies are available to relieve vaginal dryness," Giblin noted.
"There are over-the-counter products to combat dryness and your physician has a treasure chest of prescription medications to relieve vaginal dryness," she added.
Giblin believes men need menopause education just as much as women. "It's not only important that a woman have a thorough understanding of the menopause process." Men should also because the symptoms of menopause "can be very hard on relationships," Giblin said.
"If a partner sees a decrease in sex with their partner, often times the partner becomes resentful and feels that the woman has lost interest and it isn't necessarily true," Giblin said. "It's very critical for women and their significant other to stay really connected during menopause."
source : news.yahoo.com
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Health Care : Obesity Heightens Kidney Disease Risks
Chronic kidney disease patients who are also obese are much more likely than normal-weight patients to have a condition called hyperparathyroidism, which raises their risk of heart problems and death, U.S. researchers say. Hyperparathyroidism involves elevated levels of parathyroid hormone (PTH). Normally, parathyroid hormone plays an important role in maintaining normal bone structure. Elevated levels of the hormone can lead to bone abnormalities and increased risk of cardiovascular disease and death. Decreased kidney function is the main cause of hyperparathyroidism in chronic kidney disease patients.
This study of 496 patients with moderate to severe chronic kidney disease who were not yet on dialysis showed a significant association between obesity and hyperparathyroidism. As body mass increased, so did PTH levels, the researchers said.
"We knew that in people with normal kidney function obesity leads to impairment in vitamin D metabolism and elevated PTH levels, but this phenomenon was never studied in patients with chronic kidney disease," lead author Dr. Csaba P. Kovesdy, of Salem VA Medical Center in Salem, Va., said in a prepared statement.
"Since both obesity and hyperparathyroidism are very complex problems in chronic kidney disease, establishing an association between the two is important because of potential prognostic and therapeutic implications," Kovesdy said.
The study is published in the September issue of the Clinical Journal of the American Society of Nephrology.
source : news.yahoo.com
Health Care : Obese people tend to pick overweight mates
A new UK study provides additional evidence that heavy people are more likely to choose other overweight individuals as mates. This phenomenon is known as "assortative mating" - when men and women tend to select partners according to nonrandom attributes such as height, religion, age and smoking habits.
Researchers have suggested that assortative mating by obesity could increase the already high prevalence of obesity by helping to pass on genes promoting excess weight to the next generation. To date, all studies investigating assortative mating for obesity have used body mass index or skin fold thickness to measure obesity, and many have not accounted for other potential contributing factors, Dr. John R. Speakman of the Rowett Research Institute in Aberdeen, Scotland and colleagues note.
Rowett and his team used a technique called dual-energy X-ray absorptiometry (DXA) to get a more precise picture of levels of body fat in their study participants, which included 42 couples. They used statistical techniques to measure and account for the effects of age, the postal code area where people had grown up, and the amount of time they had been in a relationship.
The researchers found that assortative mating for body composition had indeed occurred, with heavier people winding up with heavier mates. It's not clear why this happens, Speakman and his team note; leaner individuals may choose one another first, they suggest, leaving overweight people a more limited mate pool to pick from.
Aside from the underlying reason, they add, the fact that people are becoming overweight and obese at earlier ages than ever before could be making assortative mating for obesity even more common, because it is "allowing singles in their late teens and early twenties to more easily distinguish partners with obese and lean phenotypes."
source : news.yahoo.com
Health Care : Obesity may not bring on migraine
Obese middle-age and older women appear no more likely to report migraine than their non-obese counterparts, a new study suggests. Some previous studies have suggested that there is a relationship between obesity and migraine, while others have found no connection.
To further investigate, Dr. Peter Mattsson, of the department of Neuroscience and Neurology at University Hospital in Uppsala, Sweden enrolled 684 women, age 40 to 74 years, who were attending a mammography screening clinic between November 1997 and October 1998. Mattsson looked for an association between migraine and body mass index, a ratio of height to weight commonly used to determine if an individual is over- or underweight. His findings are reported in the medical journal Cephalalgia.
Overall, 19 percent of the women reported active migraine -- one or more migraine attacks during the previous year. Another 14 percent had inactive migraine -- previous migraine but not within the past year. Just over 19 percent of the study population was obese.
Mattsson found no association between active migraine or inactive migraine and obesity in this population of women. Thirty-two percent of the obese women had active migraine and 38 percent of the non-obese women had active migraine, a difference that was not statistically significant. Similar findings were obtained for inactive migraine.
He also found significant relationship between migraine characteristics -- frequency, intensity, and duration - and obesity in the study participants.
Mattsson notes that one recent population-based study, using interviews conducted by non-medical personnel and self-reports of physical characteristics, found an increased risk of migraine among obese and morbidly obese individuals compared with those of normal weight.
By contrast, Mattsson based his conclusions on data from interviews conducted by neurologists and actual body weight and height measurements. He found "no evidence in this study that obesity affects the prevalence of migraine among middle-aged and older women."
"If there are true associations between obesity and features of migraine such as frequency, these are likely to be small, and cannot be reliably studied in small or moderately sized community samples," Mattsson concludes.
source : news.yahoo.com
Thursday, August 16, 2007
Health Tip: Living With Bipolar Disorder
Bipolar disorder, also called manic-depressive illness, is characterized by extreme mood swings.
The American Academy of Family Physicians offers these suggestions to help you cope with bipolar disorder:
- Find out as much as you can about the disorder -- ask your doctor for good references and resources.
- Maintain a regular routine of sleeping and waking times, mealtimes and exercise.
- Continue to take your medications prescribed by your doctor.
- Avoid caffeine and alcohol, and don't take over-the-counter cold, allergy or cough medicines.
- Try to reduce stress.
- Monitor your moods, and tell your doctor when you start to notice significant changes.
Health Tip: Warning Signs of Dehydration
Dehydration, is meaning lacking of body fluids ( what is functioning assists body organ activity because secretory dilution amounts too many for one entering dilution amounts.Dehydration occurs when the body doesn't have enough fluids, either because it's lost too many fluids, a person hasn't drunk enough fluids, or both.
The U.S. National Library of Medicine lists these common warning signs of significant dehydration:
- Not being able to urinate, or urinating very little.
- Urine that is very concentrated and dark yellow in color.
- Not being able to produce tears.
- Sunken eyes.
- In infants, the soft spot on the head is significantly sunken.
- Lethargy, dizziness or lightheadedness.
Healthy Lifestyle Key To Cancer Prevention
While the number of deaths from cancer have been declining, many malignancies could be prevented by exercising, eating right, maintaining a healthy weight and not smoking, a new federal report finds. The President's Cancer Panel issues a report every year that focuses on one aspect of what is happening in the United States in terms of cancer.
This year's effort "centers on lifestyle changes, and two issues that are actually quite different," said panel member Margaret L. Kripke, executive vice president and chief academic officer at the University of Texas M. D. Anderson Cancer Center, in Houston. One issue is nutrition, exercise and the fight against obesity, and the other is the battle to cut tobacco use, Kripke said.
"We tried to think of what would have the biggest impact on reducing cancer mortality," she said. "If you consider that 15 to 20 percent of cancer deaths are related to obesity and another 30 percent of cancer deaths are due to tobacco use, that's 50 percent of all people with cancer."
And quitting smoking and avoiding obesity are things that people can do themselves, Kripke noted. But, as she and other experts know, it's not easy to get people to make the lifestyle changes they should.
"The most serious lack, in terms of what we know, is what motivates people to live a healthier lifestyle," she said.
The experts call for a move toward a "culture of wellness" in the United States. This culture would embrace healthy living as a goal and promote a healthy lifestyle as a way of achieving wellness.
Despite progress in diagnosis and treatment, cancer continues to account for more than a half million deaths each year in the United States, with almost 1.5 million new cases diagnosed annually. Two-thirds of these deaths, and many thousands of new cases, could be avoided through lifestyle changes, according to the report.
Tobacco is the leading cause of lung cancer, but it's also responsible for most cancers of the larynx, oral cavity and pharynx, esophagus and bladder. In addition, it is a cause of kidney, pancreatic, cervical and stomach cancers, along with acute myeloid leukemia. "We really need to get rid of tobacco," Kripke said.
Obesity has been linked to a variety of cancers, including colon, breast, kidney, ovarian and pancreatic cancer. "There are very definitive studies showing that moderate exercise reduces your risk of breast cancer and colon cancer," Kripke said.
In addition, living a healthy lifestyle lowers a person's risk of cancer recurrence and improves outcomes after cancer, Kripke said.
The causes of the obesity epidemic in the United States are complex, Kripke said. The epidemic started in the 1970s about the time that food makers started using high fructose corn syrup as an additive. In addition, portion sizes in restaurants increased as schools cut back on exercise programs.
The obesity problem has grown steadily over the past 30 years. "I don't think there is going to be a quick fix," she said.
One recommendation the panel made in the report is to have subsidies for corn farmers curtailed. "There doesn't seem to be coordination between agricultural subsidies and public health policy for diet and nutrition," Kripke said.
"Subsidies for corn make corn syrup very cheap and it's not nutritionally what you want in all of your foods," Kripke said. "It might make more sense to make agricultural subsidies for fruits and vegetables that would be more healthy for the population."
Although the White House doesn't usually comment on the report, Kripke hopes that it will spur government officials to develop programs that help people make necessary lifestyle changes.
One expert agreed that societal changes are to blame for ever-heavier Americans.
"Obesity has been brought about by changes in our environment, not by any increase in the number of susceptible people," said Eugenia Calle, director of Analytic Epidemiology at the American Cancer Society.
Calle argues that while once fats and sugars were relatively expensive, they are now cheap. "It used to be impossible to buy a great deal of calories for $2.99, and now it is possible to buy one day's allotment of calories for less than $10," she said. "So now calorie-dense foods are cheap."
In contrast, fruits and vegetables are more expensive than they used to be, Calle said. "So, it becomes economically more difficult to make good food choices, especially if you don't have a lot of income," she said. In addition, people have become more sedentary, she added.
"The best idea in the report is implementing a culture of wellness in the U.S., so that the social and cultural norm is one of health," Calle said.
source : news.yahoo.com
Cancer panel attacks U.S. food subsidies
A new presidential report on cancer takes on not only tobacco companies but the food industry while calling on the federal government to "cease being a purveyor of unhealthy foods" and switch to policies that encourage Americans to eat vegetables and exercise. The report, issued on Thursday, also urged changes in public and private insurance policies to encourage doctors to spend more time counseling patients on how to stay healthy by eating right, exercising and avoiding tobacco.
Federal, state, and local policies have actually made healthful foods more expensive and less available, have limited physical education in schools and created an environment that discourages physical activity, the report said.
"Ineffective policies, in conjunction with limited regulation of sales and marketing in the food and beverage industry, have spawned a culture that struggles to make healthy choices -- a culture in dire need of change," said the report.
Margaret Kripke of the University of Texas M.D. Anderson cancer center, a member of the President's Cancer Panel, said in a telephone interview, "What became clear to me is that we simply don't have the political will to protect the public health."
Several reports have shown that a third of all cancers are caused by tobacco use, and another one-third by obesity and inactivity.
"This country must not ignore its moral obligation to protect the health of all Americans. We can and must empower individuals to make healthy choices through appropriate policy and legislation, and the panel urges you to use the power of your office toward this life-saving goal," the panel, chaired by Howard University's Dr. LaSalle Leffall, wrote in a letter to Bush.
PURVEYOR OF UNHEALTHY FOODS
The report recommended much stricter control of the tobacco industry and urged Congress to authorize the U.S. Food and Drug Administration to regulate tobacco.
"The report also supports increasing the federal cigarette tax, which is currently 39 cents per pack," American Cancer Society Chief Executive Officer John Seffrin said in a statement.
"The panel's recommendation runs counter to the president's public opposition to a tobacco tax increase."
The federal government also should "require the elimination of unhealthy foods from school breakfast and lunch programs" and "must cease being a purveyor of unhealthy foods that lead to disease and increased health care costs," the report said.
This includes regulation of food advertising and changing agricultural support policies, it said.
"We heavily subsidize the growth of foods (e.g., corn, soy) that in their processed forms (e.g., high fructose corn syrup, hydrogenated corn and soybean oils, grain-fed cattle) are known contributors to obesity and associated chronic diseases, including cancer," the report reads.
"The people who are doing the U.S. agricultural subsidies need to connect their subsidies with the policy on public health and I don't think that has been done," Kripke said.
Yet fresh fruits and vegetables are not subsidized in the same way. "And physical education classes in school have almost disappeared," Kripke said.
source : news.yahoo.com
Indian flooding sparks new worries about polio
India will make "extraordinary efforts" to immunize children against polio in its eastern state of Bihar, fearing disruption by massive flooding may make them more vulnerable to the crippling disease, officials said on Thursday. The country of 1.1 billion people has the world's highest number of polio cases, with 139 being reported in 2007 out of a global total of 345. Defeating the paralyzing disease in India is seen as key in the global war against the virus.
In Bihar, where 20 cases of the virulent Type 1 polio were reported this year, nearly 15 million people -- including millions of children -- have been affected in what officials say are the worst monsoon floods in memory in some areas.
The WHO said with thousands of marooned or homeless children living in crowded makeshift camps in the state of 90 million people -- often in extremely unhygienic conditions -- the transmission of the virus could become easier.
"In flood-hit areas, populations mix in unusual fashion which facilitates transmission of the polio virus," said Hamid Jafari, head of WHO's polio project in India.
"There are operational challenges in reaching children in flood-hit areas and going house-to-house to vaccinate them," he said, adding that campaigns were under way in areas health workers could access.
Officials were planning to deploy boats in some areas where there was no let-up in flooding.
Polio is transmitted through the fecal-oral route in unhygienic conditions. It enters the intestine and multiplies there if food is eaten with unwashed hands.
Impoverished Bihar has the second highest number of polio cases after the most populous state of Uttar Pradesh. Most of Bihar's cases were reported from districts hit by flooding.
A spike in cases in 2006 in India -- mostly in these two states -- sparked global concern as the Indian strain of the virus reinfected several other countries.
Indian Health Secretary Naresh Dayal told Reuters that the government planned polio immunization rounds in Bihar in the coming weeks as a major national round had to be cancelled on August 5 in several districts due to widespread inundation.
India says it has beaten back the Type 1 virus in the western parts of Uttar Pradesh -- the world's most affected region -- for the first time, with no cases reported this year.
Officials said they did not want the progress in Uttar Pradesh undermined by gaps in Bihar due to the flooding.
"Diarrhea and intestinal infections that follow flooding compromises the efficacy of the polio vaccine," Jafari said. "We must make extraordinary efforts to plug the gap."
source : news.yahoo.com
Kenya slashes malaria child mortality by 44 percent
Kenya has cut malaria deaths among children under five by 44 percent on 2002 levels thanks largely to the increased use of insecticide treated nets (INTs), the government said Thursday. The health ministry said the distribution of 13.4 million INTs over the past five years among children and pregnant women had helped curtail infections, a key success against a disease threatening 40 percent of the world's population.
"Childhood deaths have been reduced by 44 percent in high-risk districts, in-patient malaria cases and deaths are falling (and) there are reduced cases at the community level," it said in a statement.
"For every 1,000 treated nets used, seven children who might have died of malaria are saved."
Malaria kills 34,000 children under the age of five each year in Kenya, and threatens the lives of more than 25 million of its population of 34 million people, the ministry said.
Children sleeping under ITNs in malaria risk areas are 44 percent less likely to die than those who are not, according to a survey carried out in four districts representing varied transmission patterns.
The government has distributed 12 million doses of artemisinin-based therapy (ACT), the latest surefire anti-malaria drug cocktail to replace the mono-therapies that had developed resistance.
In addition, some 824,600 houses in 16 epidemic-prone districts underwent indoor spraying this year.
Health Minister Charity Ngilu said the government would boost distribution of free treated nets -- a policy backed by the World Health Organisation -- to keep away mosquitoes at night when they are active.
"The impact we have seen and the lessons we have learnt through massively distributing INTs, rather than selectively marketing and selling them, will not only benefit Kenya's children but all Africa's children," she said.
The WHO launched a global programme in 1955 to eradicate the disease that has frustrated attempts to create a vaccine.
Using dichloro-diphenyl-trichloroethane (DDT), a powerful insecticide, and the drug chroloquine, it managed to eradicated the disease in the West by the 1960s.
But the programme never got off the ground in the humid and low-lying tropics in sub-Saharan Africa where the disease persisted.
By 1969, the programme collapsed as financing withered in the face of rising poverty, political unheavals and surging opposition to the use of DDT.
Malaria affects more than a billion people worldwide and kills a million -- mainly under age five -- every year, the vast majority in sub-Saharan Africa.
source : news.yahoo.com
Few obese adults get treatment plan from docs
Few obese adults receive a formal weight-management plan from their doctors, despite the proven health benefits of even modest weight loss, a new study suggests. The researchers reviewed the medical records of 9827 patients seen at the Mayo Clinic in Rochester, Minnesota, between November 2004 and October 2005. A total of 2543 of these patients were obese.
Principal investigator Dr. Warren G. Thompson, and his colleagues, found that only 505, or about one in five obese patients had their condition formally documented. However, patients who did have a formal diagnosis of obesity were 2.5 times more likely to be given a plan of treatment, such as diet changes and exercise goals.
Obese patients who were older or male were less likely to have their condition documented, whereas patients who were morbidly obese, had diabetes mellitus, or obstructive sleep apnea, were more likely to be formally diagnosed, according to the study published in the Mayo Clinic Proceedings journal.
Better management of obesity could have a "huge public health impact," according to Thompson and his group. Even a modest weight loss, they point out, can help control a range of chronic health problems, such as high blood pressure, type 2 diabetes and high cholesterol.
It's possible, Thompson told Reuters Health, that when doctors think about obesity as a medical problem that can be diagnosed, they are apt to discuss ways to manage the problem.
Not surprisingly, he noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.
Thompson also suggests that people who are significantly overweight and have yet to get advice from their doctors should consider broaching the topic themselves.
source : news.yahoo.com
Indian flooding sparks new worries about polio
India will make "extraordinary efforts" to immunize children against polio in its eastern state of Bihar, fearing disruption by massive flooding may make them more vulnerable to the crippling disease, officials said on Thursday. The country of 1.1 billion people has the world's highest number of polio cases, with 139 being reported in 2007 out of a global total of 345. Defeating the paralyzing disease in India is seen as key in the global war against the virus.
In Bihar, where 20 cases of the virulent Type 1 polio were reported this year, nearly 15 million people -- including millions of children -- have been affected in what officials say are the worst monsoon floods in memory in some areas. The WHO said with thousands of marooned or homeless children living in crowded makeshift camps in the state of 90 million people -- often in extremely unhygienic conditions -- the transmission of the virus could become easier.
"In flood-hit areas, populations mix in unusual fashion which facilitates transmission of the polio virus," said Hamid Jafari, head of WHO's polio project in India.
"There are operational challenges in reaching children in flood-hit areas and going house-to-house to vaccinate them," he said, adding that campaigns were under way in areas health workers could access.
Officials were planning to deploy boats in some areas where there was no let-up in flooding.
Polio is transmitted through the fecal-oral route in unhygienic conditions. It enters the intestine and multiplies there if food is eaten with unwashed hands.
Impoverished Bihar has the second highest number of polio cases after the most populous state of Uttar Pradesh. Most of Bihar's cases were reported from districts hit by flooding.
A spike in cases in 2006 in India -- mostly in these two states -- sparked global concern as the Indian strain of the virus reinfected several other countries.
Indian Health Secretary Naresh Dayal told Reuters that the government planned polio immunization rounds in Bihar in the coming weeks as a major national round had to be cancelled on August 5 in several districts due to widespread inundation.
India says it has beaten back the Type 1 virus in the western parts of Uttar Pradesh -- the world's most affected region -- for the first time, with no cases reported this year.
Officials said they did not want the progress in Uttar Pradesh undermined by gaps in Bihar due to the flooding.
"Diarrhea and intestinal infections that follow flooding compromises the efficacy of the polio vaccine," Jafari said. "We must make extraordinary efforts to plug the gap."
source : news.yahoo.com
Nursing Home Residents at Highest Heatstroke Risk
Heatstroke may be most lethal for people who live in nursing homes or take medication to lower their blood pressure, a French study finds. Heatstroke, which results from exposure to high temperatures, is "defined by an elevated core body temperature above 40 degrees Celsius (104 degrees Fahrenheit), associated with central nervous system abnormalities," the study authors wrote.
They looked at the survival rates and outcomes of 83 heatstroke patients hospitalized in the city of Lyon during a severe heat wave that struck Europe in 2003. Estimates of the death toll ranged from 22,000 to more than 70,000 people.
Of the 83 patients in the study, 58 percent died within 28 days after being admitted to hospital. The patients who died:
- more often came from an institution for the elderly (24 of 48 who died vs. 7 of 35 survivors);
- were more likely to have used blood-pressure lowering drugs long-term (33 of 48 who died vs. 13 of 35 survivors);
- had a higher average body temperature when they were admitted to hospital (41.3 degrees C/106.3 degrees F compared with 40.7 degrees C/105.3 degrees F among survivors);
- had more respiratory, cardiovascular or kidney dysfunctions than survivors;
- were more likely to be in a coma when they arrived at the hospital (81 percent of those who died vs. 23 percent of survivors), or to have anuria, the inability to form urine (19 of those who died vs. zero of survivors).
The study was published online Aug. 13 in the journal Archives of Internal Medicine and was expected to be published in a later print issue.
A second study, also published by the journal, found that being confined to bed, not leaving home daily, or being unable to care for oneself were associated with death from heatstroke.
For this study, Saudi Arabian researchers analyzed six previous studies that examined a total of 1,065 heat-related deaths.
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Cell Therapeutics to buy cancer drug
Biotech firm Cell Therapeutics Inc. on Thursday will announce plans to pay Biogen Idec Inc. up to $30 million for a lymphoma cancer treatment. Seattle-based Cell Therapeutics will take over sales, marketing and development of Zevalin in the U.S., while Bayer Schering will continue to sell the drug outside the country. Zevalin posted sales of $15.4 million in the U.S. last year as a treatment for patients with relapsed non-Hodgkin's lymphoma.
Cell Therapeutics management hopes to expand the drug's use to serve an initial treatment for non-Hodgkin's lymphoma.
"We see potential for substantial revenue growth for this product," Cell Therapeutics Chief Executive James Bianco said in a statement.
Upon terms of the agreement, Cell Therapeutics will pay Biogen $10 million in cash and up to $20 million in milestone payments when the product receives approval for an additional use. The company plans to hold a news conference Thursday morning to provide details.
Shares of Cell Therapeutics fell 12 cents, or 3.3 percent, to $3.47 on Wednesday.
source : news.yahoo.com
Tuesday, August 14, 2007
Placebo effect seen in kids during allergy testing
A "placebo effect" can cause a diverse array of symptoms in children when undergoing food allergy testing, according to the results of a study published in the current issue of Allergy. One of these effects is that some patients believe they have had an allergic reaction when they have actually received with the placebo. This reaction is sometimes referred to as a "nocebo" effect. The more conventional placebo reaction is an improvement of symptoms after receiving an inactive substance rather than the real medicine.
"To date, the occurrence and diagnostic significance of placebo events have not extensively been documented," Dr. B. J. Vlieg-Boerstra and colleagues from the University of Groningen, the Netherlands point out. To investigate, Vlieg-Boerstra's group conducted a double-blind, placebo-controlled food "challenge," in which a patient is exposed a substance that he is likely to be allergic to. A double-blind study is when the doctor and the patients do not know which is the placebo and which is the real medicine.
The researchers examined the occurrence and features of placebo reactions after 132 challenges in 105 children (average age 5.3 years) who were suspected of having an allergy to cow's milk, egg, peanut, hazelnut or soy. Challenges with a placebo or food were performed on different days with at least a 2-week interval in between.
A total of 17 (12.9 percent) false-positive reactions to the placebo occurred in 17 different children, meaning the children developed food allergy symptoms after being exposed to the placebo. Most of these symptoms (65 percent) were objective, such as rash, hives diarrhea and vomiting. The other symptoms were subjective -- reported by the child but couldn't really be verified.
The researchers conclude that doctors should be aware that some reactions to food allergy challenges may be false-positive, and that these sensitivity tests will need to be repeated.
source : news.yahoo.com
Estrogen loss contributes to obesity, high BP
The loss of estrogen that accompanies menopause contributes to the development of obesity and high blood pressure (hypertension), according to studies conducted in female rats. Estrogen is known to protect women against heart disease. When women reach menopause, their estrogen levels drop dramatically and they lose this protection and often put on weight Dr. Lourdes A. Fortepiani of the University of Texas Health Science Center at San Antonio, reported. The findings were reported by Dr. Fortepiani and her colleague Dr. Huimin Zhang at an American Physiological Society-sponsored meeting held in Austin.
The researchers showed that in older female rats, free of heart disease, estrogen deficiency appears to trigger the development of high blood pressure and obesity.
Rats that had their ovaries removed, thereby depleting their estrogen levels, had significantly higher blood pressure and gained twice as much weight as "control" rats with intact ovaries.
"The increase in blood pressure seems to be related to the increase in body weight," Fortepiani told Reuters Health.
Rats that had their ovaries removed also showed 70-percent higher levels of the fat hormone leptin and 35 percent higher blood sugar levels.
However, treating these "ovariectomized" rats with estrogen abolished these effects. "When you treat with estrogen, the animals don't gain that much weight and their blood pressure goes down," Fortepiani said.
Moreover, female rats without ovaries that receive estrogen replacement therapy do not experience any of these adverse hormonal and metabolic effects, she said.
While acknowledging the controversy surrounding hormone therapy, these findings may open up new therapeutic approaches for postmenopausal hypertension, Fortepiani added.
(source : news.yahoo.com)
Monday, August 13, 2007
Fertility drugs don't raise breast cancer risk
Drugs used to treat female infertility do not appear to be associated with an increased risk of breast cancer, according to a new report. Based on these findings and others, "infertile women should not worry about breast cancer," Dr. Allan Jensen from the Danish Cancer Society, Copenhagen, told Reuters Health.
Jensen and his associates evaluated the effects of different types of fertility drugs on the risk of breast cancer, after taking account of reproductive factors that are known to affect the risk, in a study involving more than 54,000 women with infertility problems. Out of that whole group, 331 women developed breast cancer after an average of 14 years, the investigators report in the journal Cancer Epidemiology, Biomarkers, and Prevention.
After adjustment, the researchers found that clomiphene and four synthetic hormones used to boost fertility did not significantly affect the risk of breast cancer.
The use of progesterone was associated with an increased risk of subsequent breast cancer, the investigators say, but this increased risk was based on only eight cases.
"The progesterone results are limited by a low number of cases," Jensen said. "We will therefore increase the follow-up period in order to collect more cases. Also, as progesterone is mainly used for IVF patients, we will go into more details with this subgroup."
In any case, he added, "we are talking about small increased relative risks, and therefore the absolute risk will still be low."
source : news.yahoo.com
MRI Beats Mammograms at Spotting Early Breast Cancer
MRI appears to be better than mammograms at finding breast cancer before it spreads, German researchers report. However, despite the technology's advantages, its cost and a lack of people skilled at reading breast MRIs means it won't replace mammograms any time soon, experts say.
"MRI is more powerful and accurate for diagnosing pre-invasive breast cancer called ductal carcinoma in situ (DCIS)," concluded lead research Dr. Christiane Kuhl, from the Department of Radiology at the University of Bonn. Her team published its findings in the Aug. 11 issue of The Lancet.
Most breast cancers arise from cells that build up in the inner lining of the milk duct, Kuhl explained. As long as this cancer is confined to the duct, it is considered benign and does not spread. "If you identify breast cancer at this stage and remove it, the patient is healed -- always," she said. "Avoiding invasive breast cancer is even better than early diagnosis."
In the study, Kuhl and colleagues collected data on more than 7,300 women over five years. In addition to mammograms, the women were also given MRIs. The researchers wanted to see if MRIs could detect DCIS.
They found that among the 167 women who had a DCIS, 92 percent were found by MRI compared with 56 percent found by mammography.
Moreover, of the 89 women diagnosed with "high grade" DCIS -- the ones most likely to develop into cancer -- 98 percent were found by MRI, compared with 52 percent found by mammography. In addition, 48 percent were missed by mammography but found by MRI alone.
High-grade DCIS almost always becomes invasive and does so after a short time, Kuhl explained. "When it becomes invasive, it is biologically aggressive -- that means it kills," she said.
In contrast, low-grade DCIS usually remains within the duct and poses no threat. In fact, women can have low-grade DCIS for a lifetime with no ill effects, Kuhl said.
Also, MRI was not associated with many false positive findings. The positive predictive value of both methods was similar -- 55 percent for mammography and 59 percent for MRI, the researchers reported.
There's one big downside, however: MRI is very expensive compared with mammography. "Also, MRI is more difficult to read, and you have to use different criteria to diagnose DCIS than for invasive breast cancer," Kuhl said.
Since MRI is used less often than mammography "the number of radiologists who are experienced in interpreting breast MRIs is far smaller than the number of radiologists who are able to accurately interpret a mammogram," further limiting its use, the German researcher said.
And more studies that compare MRI with mammography are needed before MRI can be recommended as the best way to diagnose DCIS, she added. "This is the beginning of the death of mammography, but that is going to be a long death," Kuhl predicted.
One expert wasn't surprised by the findings.
"This study shows that MRI is definitely better than mammography for detecting DCIS," said Dr. Kristin Byrne, chief of breast imaging at Lenox Hill Hospital in New York City. "We have known that MRI is better for detecting cancer, but there has been a debate whether MRI was best for detecting DCIS," she said.
The enhanced ability to find DCIS using MRI is due to better quality images and improved ability in reading the MRI, Byrne said. "We are now detecting much more DCIS than what is seen on the mammogram," she said.
The American Cancer Society does recommend that women who are at high risk for breast cancer get an MRI in addition to their yearly mammogram, Byrne noted.
Still, it will take a long time before breast MRI replaces mammograms, she said, for the reasons Kuhl laid out.
Another expert agreed that a larger study is needed before MRI can become the preferred breast cancer screening method.
"We don't know yet how much MRI screening will add and at what price this comes, economically and psychologically, [because of the] emotional burden due to increased absolute amount of unnecessary recalls," said Dutch radiologist Ritse M. Mann, of Radboud University Nijmegen Medical Centre in Nijmegen.
But Mann, the co-author of an accompanying journal editorial, said that "MRI can no longer be regarded as [just] an adjunct to mammography, even though this needs considerable funding."
"MRI screening will detect malignancies more often and earlier and will increase breast cancer survival. Therefore, it is time to start a large multicenter trial on MRI screening for breast cancer in the general population," Mann said.
source : news.yahoo.com
Extreme Heat Hits Elderly Harder
A combination of age-linked factors helps explain why older adults and the elderly are at higher risk on very hot days, experts say. Due to age-related physical changes, older adults can't cool down as well as younger adults, says the American Geriatric Society's Foundation for Health in Aging. Older people may not feel as hot when temperatures are dangerously high, and they are also less likely to feel thirsty, even when they're almost dehydrated, the experts say.
These and other factors mean that extreme heat can lead to serious health problems and increased risk of death for older adults. Each year in the United States, about 200 people die of health problems caused by high heat and humidity. Most of the victims are age 50 or older.
The foundation also noted that heart disease, diabetes and certain other diseases that are common in older adults can make it more difficult to cope with high heat and humidity. The same goes for a number of drugs, including water pills, allergy and sinus medications, and medicines for depression and nerve problems.
When the temperature reaches 90 degrees F, family and caregivers should check on older adults, said the foundation, which also offered hot weather safety tips for older adults:
source : news.yahoo.com
Last Flu Season Was Mild, But Child Deaths Worrying
Although the 2006-07 flu season was comparatively mild in the United States, it still claimed the lives of 68 children, and experts say more must be done to reduce the death toll. They're especially concerned about the steady rise in a potentially lethal combination of infection with flu and drug-resistant staphylococcus, or "staph."
"While waiting to see what this year will bring, we should all plan to roll our sleeves up and get vaccinated and in no way let our guard down," said Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center. In a report released Thursday by the U.S. Centers for Disease Control and Prevention, experts said the 2006-07 flu season peaked in mid-February. And there were actually fewer pediatric deaths and fewer children hospitalized with influenza than in the past three flu seasons, according to the CDC.
But, among the 68 children whose deaths were associated with flu from Oct. 1, 2006, to May 19, 2007, 21 had influenza plus Stapholococcus aureus ("staph") that was resistant to a leading antibiotic, methicillin, according to the report in the Aug. 10 issue of the CDC's Morbidity and Mortality Weekly Report.
In comparison, only one child died from flu coupled with S. aureus infection in 2004 through 2005, and three died during the 2005-06 season, the CDC said.
"We are looking into the number of deaths of children combined with staff bacterial infection," said Dr. Joe Bresee, CDC's chief of the Epidemiology and Prevention Branch in the Influenza Division. "From our perspective, it looks like it has increased."
Bresee said the CDC isn't sure if the number of deaths is actually rising, or the increase is due to better reporting. "The actual risk to kids from this is not known, but it is concerning," he said.
Bresee thinks that increasing the number of young children who get flu shots is key to reducing the problem. "They would be less likely to get influenza and, therefore, less likely to get co-infections with S. aureus," he said.
Despite the troubling news that such dual infections may be on the rise, the past season's flu statistics were relatively positive, Katz said.
"Data from the last flu season provide mostly good news," he said. "The number of cases was never unusually high. The strains were mostly of the expected varieties, and vaccine composition was just right. The death toll from complications of influenza was a bit lower than average."
The reasons for the milder flu season aren't clear, said Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine. "It could be increased surveillance and improved care and more awareness of what influenza can do," he said. "It may also be a less virulent strain of the virus."
Katz noted that, even in a good year, the average number of deaths from flu in the United States totals about 30,000, mostly among the elderly.
During the 2006-07 flu season, the influenza A (H1) virus was most common in the United States, but the A (H3) virus was found to be more common late in the season, according to the CDC.
For the 2007-08 vaccine, the U.S. Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee has recommended that the trivalent flu vaccine contain A/Solomon Islands/3/2006-like (H1N1), A/Wisconsin/67/2005-like (H3N2), and B/Malaysia/2506/2004-like viruses, the CDC reported.
The influenza A (H3N2) and influenza B components remain the same for the new vaccine. These recommendations were based on antigenic analyses of recently isolated influenza viruses, epidemiologic data, vaccination studies in humans, and the availability of vaccine strains and reagents, the CDC said.
Last season, around the world, influenza A (H1), A (H3), and B viruses were most common. In Africa, small amounts of influenza A and B were seen. In Europe and Asia, influenza A (H3) virus was most common, but low levels of A (H1) were seen. Influenza B viruses were seen at lower levels in Asia and Europe but were most common in some countries, according to the CDC.
The best way to protect yourself from flu is to get vaccinated, experts said. "We had a good flu year. But that was last year," Katz noted.
In terms of the H5N1 bird flu virus, from December 2003 to mid-July 2007, 319 cases of bird flu in humans were reported to the World Health Organization. Among these cases, 60 percent (192) were fatal. To date, no human cases of bird flu have been reported in the United States.
All human cases were reported from Asia (Azerbaijan, Cambodia, China, Indonesia, Iraq, Laos, Thailand, Turkey, and Vietnam) and Africa (Djibouti, Egypt, and Nigeria).
But, "the threat of an avian flu pandemic still looms," Katz said. "To date, deaths from avian flu have been few, and limited to Asia. But no one knows for sure when that might change."
Siegel, author of Bird Flu: Everything You Need to Know About the Next Pandemic, noted that although H5N1 has a high mortality rate, "we see year after year that it is confined to birds. There is no indication that it is about to become a massive human problem. There is no indication that it is on the verge of transforming."
source : news.yahoo.com
Egypt to strengthen penalties against female circumcision
A law to strengthen penalties against female circumcision will be put to parliament when it reconvenes in autumn, a health ministry spokesman said on Sunday, after a teenage girl died during an illegal operation to mutilate her genitalia. Spokesman Abdel Rahmane Shahine told AFP that a group of doctors and parliamentarians are working on the text which will be presented to parliament when it meets again in November.
"The proposed law is aimed at strengthening penalties" for the practice, he said, without elaborating. Those currently in place, he added, are "not proportional to the seriousness of the crime." People found guilty of carrying out female circumcision currently risk up to three years in prison.
The health ministry will also allocate a further one million euros (1.365 million dollars) in the fight to stamp out the practice, Shahine added.
Newspapers on Saturday reported that Karima Rahim Massud, 13, died as the result of problems with the anasthaesia in the Nile Delta village of Gharbiya.
In June, following the death of 12-year-old Bedur Ahmed Shaker, Health Minister Hatem al-Gabali issued a decree banning every doctor and member of the medical profession from performing the procedure.
Female genital mutilation, also known as female circumcision, is a practice that dates back to pharaonic times in Egypt. It is common in a band that stretches from Senegal in West Africa to Somalia on the east coast, and from Egypt in the north to Tanzania in the south.
The practice, which affects both Muslim and Christian women in Egypt, was banned in 1997 but doctors were allowed to operate "in exceptional cases."
Female circumcision can cause death through haemorraging and later complications during childbirth. It also carries risks of infection, urinary tract problems and mental trauma.
Religious leaders, usually silent on taboos relating to female sexuality, have also started to speak out against the practice, which many Egyptians believe is a duty under Islam and Christianity.
After the death of Shaker, chief mufti Ali Gomaa declared female circumcision forbidden under Islam.
Mohammed Sayyed Tantawi, the sheikh of Al-Azhar university, the top Sunni Muslim authority, and Coptic Patriarch Chenouda III also declared it had "no foundation in the religious texts" of either Islam or Christianity.
source : news.yahoo.com
Italian town to pay residents to shed flab
Overweight residents of an Italian town will be paid to lose weight, the mayor said on Monday. Men living in the northwestern Italian town of Varallo will receive 50 euros ($70) for losing 4 kg (9 pounds) in a month, Mayor Gianluca Buonanno said. Women will get the same amount for shedding 3 kg (7 pounds).
If they can keep the weight off for 5 months, they will get another 200 euros ($280), he told Reuters. "Lots of people are saying, 'I really need to lose some weight but it's really tough.' So I thought, why don't we go on a group diet?" said Buonanno, who said he was about 6 kg (13 pounds) overweight.
The town of 7,500 people started the campaign on Friday and some residents have already signed up, he said.
Around 35 percent of Italians are overweight or obese, according to European Union figures, with waistlines expanding as the country's healthy Mediterranean diet has given way to processed foods rich in fat, sugar and salt.
source : news.yahoo.com
Obesity-Linked Woes Boost Kids' Lifetime Heart Risk
Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals. Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.
Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats). "I wasn't exactly shocked, but this is the first time we have shown that children who have this constellation of factors known as metabolic syndrome are at an increased risk for cardiovascular disease in their adult years," said study lead author John A. Morrison, a research professor of pediatrics who also works in the division of cardiology at Cincinnati Children's Hospital Medical Center in Ohio.
The findings are published in the August issue of Pediatrics.
According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.
Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.
To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.
The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.
Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.
The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.
Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.
Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.
In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.
Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.
Morrison and his colleagues said their findings should help doctors and parents identify young patients who are at an increased risk for serious adult illness. They could also point the way toward ways to reduce that risk.
"So, there's some good news here," said Morrison. "Pediatric weight is not destiny. If you're obese as a child, you can do something to lose the pounds. And you must do something to lose the pounds, if you want to reduce risk."
Dr. Brenda Kohn, an associate professor of pediatrics at the New York University School of Medicine, added that proactive parental and physician intervention is critical to help children avoid behaviors that keep the syndrome going.
"The treatment has to be started in childhood, in adolescence," she advised. "Eating patterns, activity patterns, all start in infancy. Good habits have to start early."
"So, it's very, very important that a child is raised in an environment where physical exercise is encouraged on a routine basis and eating patterns are geared to healthy eating decisions," added Kohn, who is also a medical advisory board member with the Juvenile Diabetes Foundation. "Children should be monitored at least once yearly by a physician in order to ensure that all these goals are being met," she said.
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Obese elementary schoolchildren miss a couple more school days on average than their normal-weight classmates, according to a study that says being fat is a better predictor for absenteeism than any other factor. Researchers said their results suggest that childhood obesity, in addition to serious medical issues, can lead to a plethora of additional problems down the road.
"It's clear in all the literature that the more days of school you miss, it really sets you up for such negative outcomes: drugs and AIDS and (teen) pregnancy," said Andrew B. Geier, a doctoral candidate at the University of Pennsylvania and lead author of the study released Friday. He said the findings should serve as a clarion call to school officials.
"At this early age to show that already they're missing school, and missing school is such a major setup for big-time problems, that's something school policy people have to know," Geier said.
The researchers from Penn and Temple University looked at 1,069 fourth- to sixth-graders for one academic year in nine Philadelphia schools, where teachers took attendance each morning. Based on body mass index, a standard measure of height and weight, each child was classified as underweight, normal weight, overweight or obese.
Of 180 school days, researchers found that on average the normal weight students missed 10.1 days, overweight kids missed 10.9 days and obese children missed 12.2 days. For reasons that aren't clear, underweight children had the fewest absences — 7.5 on average.
In decades of research about student performance, race, socioeconomic status, age and gender have been tagged as the top predictors for absenteeism. The new study, in the latest issue of the journal Obesity, concludes that weight tops them all, Geier said.
The study didn't explore why the children missed school. Researchers theorize it's got less to do with medical issues — many children at this young age haven't yet developed major obesity-linked maladies — and more to do with the stigma of being fat.
"They're missing school because they don't want to be bullied and called names," Geier said.
Researchers tried to make the test group as homogeneous as possible by picking schools that were among the city's poorest, with the assumption that education and income levels would be fairly even.
Nationally, obesity rates have nearly quintupled among 6- to 11-year-olds and tripled among teens and children ages 2 to 5 since the 1970s, according to the Centers for Disease Control and Prevention. Obesity can lead to diabetes, high blood pressure and cholesterol, sleep apnea and orthopedic problems.
The study adds to growing research into non-medical complications of being fat, including data suggesting that obese adults miss more workdays and go to college less frequently than people of normal weight, Geier said.
"This is exactly the kind of study that will get the attention of policy makers," said Jim Bogden, healthy eating project coordinator for the National Association of State Boards of Education. "The correlation with absenteeism is very powerful."
He likened the results to studies linking academic achievement to participation in school breakfast programs — research that prompted lots of schools to start offering such programs. In this case, changes could include anything from improving nutrition education and cafeteria offerings to getting parents to serve healthy meals at home.
"Those of us working in school health do all we can to publicize this information, and it seems to be starting to sink in," Bogden said.
source : news.yahoo.com
Friday, August 10, 2007
New vaccine may beat bird flu before it starts
Researchers studying bird flu viruses said on Thursday they may have come up with a way to vaccinate people before a feared influenza pandemic. Experts have long said there is no way to vaccinate people against a new strain of influenza until that strain evolves. That could mean months or even years of disease and death before a vaccination campaign began.
But a team at the National Institute of Allergy and Infectious Diseases in Maryland and the Emory University School of Medicine in Atlanta said they may have found a short-cut. The vaccine might protect people against the mutation that would change the H5N1 avian flu virus from a germ affecting mostly birds to one that infects people easily, the NIAID's Dr. Gary Nabel and colleagues report in Friday's issue of the journal Science.
"If we can define what changes need to be made to make that jump then we can target the immune system to that spot on the virus," Nabel said in a telephone interview.
"It gives us a chance to develop vaccines or monoclonal antibodies ... to really work in a preemptive way to be prepared."
Monoclonal antibodies, often used against cancer, are engineered immune system proteins that specifically attack proteins on a tumor or, in this case, on the flu virus.
"While nobody knows if and when H5N1 will jump from birds to humans, they have come up with a way to anticipate how that jump might occur and ways to respond to it," National Institutes of Health Director Dr. Elias Zerhouni said in a statement.
source : news.yahoo.com
Health Care : Age-related illness may lead to self-neglect
Elderly people who display "self-neglect" behavior often suffer from common age-related ailments like depression, heart problems, and dementia, a new study shows. "These disorders render the senior unable to perform the tasks necessary for daily living" such as eating and bathing, Dr. Carmel Bitondo Dyer, a researcher from the University of Texas Health Science Center, Houston, told Reuters Health.
Some elderly persons who neglect themselves simply lack access to support services, whereas others either refuse help, or when provided access to services cannot complete the tasks necessary to obtain these services, Dyer and colleagues note in the September issue of the American Journal of Public Health. The researchers sought to identify factors associated with self-neglect by studying 538 people who were referred to an adult protective service agency because they weren't taking care of themselves. Their average age was 75.6 years and 70 percent were women.
The team found that two-thirds of these subjects had physical problems that prevented them from functioning normally, half scored poorly on mental health tests, and virtually all of them (95 percent) had inadequate social support networks.
Patients in the study had a range of illnesses, yet 46 percent were not on any medication. For example, 52 percent had high blood pressure but only 24 percent were taking blood pressure-lowering medication; and 25 percent had diabetes yet only 15 percent were taking an anti-diabetes medication. Other common disorders, which often went untreated, were arthritis, stroke, dementia and depression.
Self-neglect is a very common problem among the aged, Dyer and colleagues note in their report.
"We have a theory," she told Reuters Health, "that if social or medical support is not available or declined by these elders, they may manifest self-neglecting behaviors, such as living in very dirty homes or suffering the consequences of otherwise treatable diseases like hypertension or diabetes."
"Lack of family or social support was the most common finding in this study, which supports our theory," she added.
source : news.yahoo.com
Health Care : Flu killed 68 children this season
Influenza killed at least 68 children in America during the latest flu season and a third of them had a worrying new complication, U.S. health officials said on Thursday. The 2006-2007 annual flu season never reached epidemic stage, but doctors should keep a lookout for such dangerous cases in children, the Centers for Disease Control and Prevention said.
The CDC issued an alert in May for deaths of children who were infected with both flu and a bacteria called Staphylococcus aureus, or staph. It said 21 of the children who died also had such infections, some of them resistant to antibiotics. "Only one pediatric death with influenza and S. aureus coinfection had been reported during 2004-05, and three had been reported during the 2005-06 season," the CDC report said.
Staph and other bacterial infections can complicate flu and make the disease more likely to kill and the number of antibiotic-resistant staph infections is on the rise.
More than 90 percent of the children who died in the latest season had not been vaccinated against flu, the CDC said. Flu vaccination is recommended for children aged 6 months to 5 years old, for anyone with chronic conditions such as asthma, and for people aged over 64.
Seasonal flu kills an estimated 36,000 people a year in the United States, most of them elderly. Last year 41 children who died from flu were reported to the CDC, although the agency stresses that reporting is not routine yet and it is misleading to compare deaths from one season to another.
The CDC is still trying to build an accurate picture of an average flu season in the United States but it is difficult because doctors do not often even test patients for respiratory diseases, much less report them to the federal government.
But because health experts suspect a pandemic -- a serious global epidemic -- of influenza is potentially imminent, the CDC is struggling to gather as much information as possible about flu now.
source : news.yahoo.com
China targets toy and drug manufacturers
China has banned two factories from exporting toys after a high-profile recall of Mattel products including Big Bird and Elmo because of fears about lead in paint. It has also put on trial five drug company managers accused of killing patients with a tainted medicine, exposing corruption and lax safety that have alarmed consumers worldwide.
China has been struggling to convince the world its products are safe after a series of scandals over tainted pet food, drugs, tires, toys and toothpaste. China stripped export licenses from Hansheng Wooden Products Factory and Lida Toy Company, both based in the booming southern province of Guangdong, the General Administration of Quality Supervision, Inspection and Quarantine watchdog said on its Web site on Thursday.
Lead is toxic and can pose serious health risk to young children who often put objects in their mouths.
Hansheng, based in Dongguan, was the producer of 1.5 million wooden vehicles, buildings and other train-set toys sold in the United States from January 2005 through June 2007, and then voluntarily recalled by U.S. toymaker RC2 Corp., an Illinois-based company that imports the popular "Thomas & Friends" toys.
About 1.5 million preschool toys made by Lida Toy, a Foshan-based contract manufacturer for Mattel Inc.'s Fisher-Price unit, were recalled across the globe by the U.S. company last week.
Mattel said the toys, which include popular characters such as Elmo, Cookie Monster and Dora, could have contained excessive amounts of lead in their surface paint.
The Chinese watchdog said the problem was with Lida's paint supplier, which had provided "fake lead-free" paint for use in production.
It ordered the companies to "correct" their problems, and said police were investigating.
But it defended the made-in-China brand and said the overwhelming majority of toys met American standards. Of about 300,000 batches for export, the U.S. Consumer Product Safety Commission had only made about 29 recalls, it said.
It added that importers and "brand" companies also had a "very big responsibility" and that it hoped that "foreign toy brands further improve product design and supervision and control to prevent loopholes in toy quality and safety."
The general manager of the Qiqihar No. 2 Pharmaceutical Company, Yin Jiade, and four other employees are accused of killing patients by using a cheap, fatal substitute ingredient in a drug to treat gall bladder, liver and gastric disorders, the China News Service reported on Thursday.
The tainted medicine killed 13 patients in the southern city of Guangzhou, where the trial began on Wednesday. The same Chinese-made chemical has been linked to dozens of deaths in Panama, where it was used in a cough syrup.
Testimony from the defendants has highlighted abuses that have alarmed domestic and foreign consumers and prompted China to execute the former head of its food and drug watchdog, Zheng Xiaoyu, for taking bribes and dereliction of duty in July.
Most of the staff of the company laboratory had no knowledge of chemistry or any training, lab director Chen Guifen was quoted as saying.
The victims died last year after receiving injections of tainted Armillarisni A, made by the Qiqihar No. 2 which is based in the country's northeast.
More than 5 million doses of drugs made by the company had been recalled nationwide since the scam was exposed in May 2006, state newspapers said.
source : news.yahoo.com
Health Care : Panel worried about baby bottle chemical
A chemical used in plastic baby bottles and other products may affect unborn babies and young children and more study on its safety is needed, a U.S. panel of experts said on Wednesday. The National Toxicology Program Center for the Evaluation of Risks to Human Reproduction convened an expert panel on the effects of bisphenol A, used in clear plastic polycarbonate bottles. Its report will be available later this year, the NTP said.
It said the panel of experts "expressed negligible concern that exposure to Bisphenol A in utero produces birth defects and malformations." But for pregnant women and fetuses, the committee expressed some concern that exposure to Bisphenol A in utero causes neural and behavioral effects. The NTP, part of the National Institute of Environmental Health Sciences, said people can be exposed to the chemical by direct contact or via food or drink that has been in contact with a material containing bisphenol A.
Environmental groups have for years been complaining about the safety of plastic toys, baby bottles and other products containing bisphenol A and pother chemicals known as phthalates.
"(The Center) selected this chemical for evaluation because of (1) high production volume, (2) widespread human exposure, (3) evidence of reproductive toxicity in laboratory animal studies, and (4) public concern," the NTP said in a statement.
Polycarbonate plastics are used in food and drink packaging and resins are used to coat metal products such as food cans, bottle tops, and water supply pipes.
The Juvenile Products Manufacturers Association, which represents the leading manufacturers of baby bottles in the United States, said the panel's brief statement suggested the bottles are safe.
"The Panel's conclusions today reaffirm the safety of plastic baby bottles," said JPMA President Robert Waller.
"These findings validate the Food and Drug Administration's conclusions and the conclusions of governments and independent scientists worldwide that polycarbonate plastic baby bottles are safe."
source : news.yahoo.com
Health Care "Fat" hormone sheds new light on obesity
The hormone that tells us we are full also regulates our desire for certain foods, researchers said on Thursday, in a finding that sheds light on why people gain weight and could lead to new treatments for obesity. The study showed that patients with a rare genetic disorder who lacked the hormone called leptin ate less after receiving injections of the hormone, said I.S. Farooqi, a researcher at Cambridge University who led the study.
Previous research has shown the hormone does not help people with normal leptin levels lose weight, but scientists still do not completely understand how it works, Farooqi said. "By studying patients who have no leptin and then treating them with leptin, we can tell what it is doing," Farooqi said in a telephone interview. "It gives a clear look at how leptin operates in the brain."
In the study, published in the journal Science, researchers searched for "circuits" in the brain that signal when a person is hungry or full and found that they were linked to areas involved in determining the enjoyment of food. To see how the hormone worked, the researchers showed the patients pictures of different types of food, ranging from tasty fare like chocolate cake and pizza to blander choices such as cauliflower and broccoli.
The patients with the genetic disorder -- of which there are about a dozen known cases in the world -- liked all types of food, ate excessively and were obese, the researchers said.
Using magnetic resonance imaging technology, the researchers tracked the patients' brain activity as they responded to the pictures and pinpointed several key areas that play an important role when it comes to a desire for food.
After the patients received leptin injections, the areas that had previously shown activity all the time at the sight of food were only active if the people had not eaten the night before, which was a normal response, Farooqi said.
It showed desire for food is driven by biology -- not greed -- which causes overeating and obesity, Farooqi said.
Knowing how leptin, which is produced by fat cells, triggers different parts of the brain could lead to new drugs that target obesity and help dangerously overweight people take pounds off.
"If you find those molecules that leptin triggers then you can manipulate or target them with drugs to treat obesity," Farooqi said. "The first step is to work out what leptin does and how it does it."
source : news.yahoo.com
Thursday, August 9, 2007
Health Tip: Risk Factors for Prostate Cancer
Prostate cancer is one of the most common cancers that affect men. While most cases aren't fatal, it is important to understand the risk factors for the disease to help recognize symptoms and begin treatment early.
The U.S. National Cancer Institute lists these potential risk factors for prostate cancer:
- Aging.
- High levels of testosterone.
- A high-fat diet, which may increase the risk. (A low-fat diet rich in fruits and vegetables may help the risk.)
- Blacks are at much greater risk of prostate cancer, whites are at intermediate risk, and Japanese have the lowest average risk.
China targets toy and drug manufacturers
China has banned two factories from exporting toys after a high-profile recall of Mattel products including Big Bird and Elmo because of fears about lead in paint. It has also put on trial five drug company managers accused of killing patients with a tainted medicine, exposing corruption and lax safety that have alarmed consumers worldwide. China has been struggling to convince the world its products are safe after a series of scandals over tainted pet food, drugs, tires, toys and toothpaste.
China stripped export licenses from Hansheng Wooden Products Factory and Lida Toy Company, both based in the booming southern province of Guangdong, the General Administration of Quality Supervision, Inspection and Quarantine watchdog said on its Web site on Thursday.
Lead is toxic and can pose serious health risk to young children who often put objects in their mouths.
Hansheng, based in Dongguan, was the producer of 1.5 million wooden vehicles, buildings and other train-set toys sold in the United States from January 2005 through June 2007, and then voluntarily recalled by U.S. toymaker RC2 Corp., an Illinois-based company that imports the popular "Thomas & Friends" toys.
About 1.5 million preschool toys made by Lida Toy, a Foshan-based contract manufacturer for Mattel Inc.'s Fisher-Price unit, were recalled across the globe by the U.S. company last week.
Mattel said the toys, which include popular characters such as Elmo, Cookie Monster and Dora, could have contained excessive amounts of lead in their surface paint.
The Chinese watchdog said the problem was with Lida's paint supplier, which had provided "fake lead-free" paint for use in production.
It ordered the companies to "correct" their problems, and said police were investigating.
But it defended the made-in-China brand and said the overwhelming majority of toys met American standards. Of about 300,000 batches for export, the U.S. Consumer Product Safety Commission had only made about 29 recalls, it said.
It added that importers and "brand" companies also had a "very big responsibility" and that it hoped that "foreign toy brands further improve product design and supervision and control to prevent loopholes in toy quality and safety."
The general manager of the Qiqihar No. 2 Pharmaceutical Company, Yin Jiade, and four other employees are accused of killing patients by using a cheap, fatal substitute ingredient in a drug to treat gall bladder, liver and gastric disorders, the China News Service reported on Thursday.
The tainted medicine killed 13 patients in the southern city of Guangzhou, where the trial began on Wednesday. The same Chinese-made chemical has been linked to dozens of deaths in Panama, where it was used in a cough syrup.
Testimony from the defendants has highlighted abuses that have alarmed domestic and foreign consumers and prompted China to execute the former head of its food and drug watchdog, Zheng Xiaoyu, for taking bribes and dereliction of duty in July.
Most of the staff of the company laboratory had no knowledge of chemistry or any training, lab director Chen Guifen was quoted as saying.
The victims died last year after receiving injections of tainted Armillarisni A, made by the Qiqihar No. 2 which is based in the country's northeast.
More than 5 million doses of drugs made by the company had been recalled nationwide since the scam was exposed in May 2006, state newspapers said
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Panel worried about baby bottle chemical
A chemical used in plastic baby bottles and other products may affect unborn babies and young children and more study on its safety is needed, a U.S. panel of experts said on Wednesday. The National Toxicology Program Center for the Evaluation of Risks to Human Reproduction convened an expert panel on the effects of bisphenol A, used in clear plastic polycarbonate bottles. Its report will be available later this year, the NTP said.
It said the panel of experts "expressed negligible concern that exposure to Bisphenol A in utero produces birth defects and malformations." But for pregnant women and fetuses, the committee expressed some concern that exposure to Bisphenol A in utero causes neural and behavioral effects.The NTP, part of the National Institute of Environmental Health Sciences, said people can be exposed to the chemical by direct contact or via food or drink that has been in contact with a material containing bisphenol A.
Environmental groups have for years been complaining about the safety of plastic toys, baby bottles and other products containing bisphenol A and pother chemicals known as phthalates.
"(The Center) selected this chemical for evaluation because of (1) high production volume, (2) widespread human exposure, (3) evidence of reproductive toxicity in laboratory animal studies, and (4) public concern," the NTP said in a statement.
Polycarbonate plastics are used in food and drink packaging and resins are used to coat metal products such as food cans, bottle tops, and water supply pipes.
The Juvenile Products Manufacturers Association, which represents the leading manufacturers of baby bottles in the United States, said the panel's brief statement suggested the bottles are safe.
"The Panel's conclusions today reaffirm the safety of plastic baby bottles," said JPMA President Robert Waller.
"These findings validate the Food and Drug Administration's conclusions and the conclusions of governments and independent scientists worldwide that polycarbonate plastic baby bottles are safe."
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Low-Cal Sweets Might Still Make Kids Obese
Diet foods and drinks meant to help children control their weight may actually spur overeating and obesity, Canadian researchers say. The study found that animals learn to associate the taste of food with the amount of caloric energy it provides. The researchers speculate that children who eat low-calorie versions of foods that normally have a high calorie content may develop distorted connections between taste and calorie content, resulting in overeating as the children grow up.
"The use of diet food and drinks from an early age into adulthood may induce overeating and gradual weight gain through the taste conditioning process that we have described," lead author and sociologist Dr. David Pierce, of the University of Alberta, said in a prepared statement. In a series of experiments published Aug. 8 in the journal Obesity, the researchers found that young rats started to overeat when they received low-calorie food and drink. Adolescent rats did not overeat when given low-calorie items.
This may be because, unlike the younger rats, the adolescent rats didn't rely on taste-related cues to assess the caloric energy content of their food, the researchers said.
"Based on what we've learned, it is better for children to eat healthy, well-balanced diets with sufficient calories for their daily activities rather than low-calorie snacks or meals," Pierce said.
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Wednesday, August 8, 2007
Red Meat, Dairy Nutrient May Raise Colon Cancer Risk
New research suggests that a nutrient in red meat, poultry and dairy products may contribute to the development of intestinal polyps, which can lead to colon cancer. The study, which involved women only, was preliminary, and no one is yet suggesting a change in diet as a result. However, the research into the nutrient, called choline, could ultimately lead to new dietary recommendations, said Eunyoung Cho, an epidemiologist at Brigham and Women's Hospital in Boston.
"There may be some impact," Cho said. "But this is one study, and it's hard to make any conclusion based on this study." The role played by choline, a nutrient required by the body, has been unclear. Some researchers had thought it might provide protection against colon cancer, which kills an estimated 52,000 people in the United States each year, according to the American Cancer Society. The disease is the second biggest cancer killer in the United States after lung cancer.
In the new study, Cho and colleagues looked at nurses enrolled in a large study. They found more than 39,000 women who were free of colon cancer and then underwent at least one endoscopic examination between 1984 and 2002. Polyps -- benign growths that can lead to colon cancer -- were found in more than 2,400 of the women.
Women who ate the most choline in their food were 1.45 times more likely to have polyps, the team reported in the Aug. 7 online issue of the Journal of the National Cancer Institute.
Having more polyps doesn't necessarily mean more cancer, and future research will explore whether those who ate the most choline actually developed tumors, Cho said. Studies also need to look into the impact of choline on men.
Why might choline contribute to polyps, and possibly colon cancer, in the first place? The nutrient is a major component of the membranes of cells, Cho said, "and the tumor cell may need choline."
Currently, health officials recommend that people prevent colon cancer by eating a lot of fiber along with fruits and vegetables. Red meat, meanwhile, is thought to increase risk.
That dietary advice isn't likely to change even if choline turns out to be a possible villain, said Regina Ziegler, a senior investigator with the National Cancer Institute, who co-wrote a commentary accompanying the new study. "What they're finding is consistent" with the recommendations, she said.
As for now, "people shouldn't run out and start either taking more choline or less choline," she said.
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Check-ups, immunizations urged for pre-teens
By scheduling a well-child visit for their 11- or 12-year-old, parents can help protect their pre-teen's health into the turbulent teen years and beyond, according to the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). At this visit, kids can be immunized or re-vaccinated against whooping cough, meningitis and other serious infectious diseases. It's also an opportunity for parent, child and doctor to discuss health concerns that become increasingly important in adolescence, such as growth, nutrition and obesity; peer pressure, substance use and sex; and more, Dr. Anne Schuchat, the director of the CDC's National Center for Immunization and Respiratory Diseases, told Reuters Health.
Currently, just 9 percent of pediatrician visits by 11- to 12-year-olds are for preventive care, Schuchat notes; the rest are for illness and injury. This means many parents and their pre-teens are missing an opportunity to update immunizations and address key health issues.
With this in mind, the CDC and the AAP have launched their first-ever Preteen Vaccine campaign to increase awareness of three new vaccines now routinely recommended for 11- and 12-year olds. They include Tdap, a tetanus, diphtheria and pertussis (whooping cough) booster, and MCV4, which helps prevent meningitis, both introduced in 2005; and the cervical cancer-preventing human papilloma virus (HPV) vaccine for girls, which became available last year.
"Most parents know about vaccines for babies," Schuchat noted. "A lot of parents think that immunization ends at the beginning of elementary school, but that's just not true."
Immunity to some infectious diseases, such as whooping cough, begins to fade in the pre-teen years, she explained, making boosters particularly important. Moreover, in adolescence, kids become increasingly vulnerable to meningococcal meningitis, an infection of the membranes surrounding the brain and spinal cord that can lead to permanent disability or even death. "It's a very tragic disease and now it can be prevented through the vaccine," Schuchat said.
While some parents may question giving girls a vaccine against a sexually transmitted virus at such a young age, this is actually the best time for them to be immunized against HPV, she added. Preteens have a stronger antibody response to the shot than young adults, Schuchat explained, and giving the vaccine -- which requires a series of three injections -- so early ensures that a girl is well protected years before sexual activity begins.
The cost of the shots shouldn't worry, Schuchat noted. Health insurers typically cover immunizations recommended by the CDC, and the CDC's Vaccinations for Children program will pay for immunizations for uninsured kids, she added, as long as a child's pediatrician is participating in the program, and most do.
Another key issue for pre-teens is obesity, Schuchat noted. At this age, boys and girls are growing so quickly that they, and their parents, may not know if they are overweight or obese, and checking in with their pediatrician will give them a chance to talk about nutrition and exercise.
Finally, the pre-teen well-child visit is generally the first time that a pediatrician will speak to the child privately, which can help build a relationship that makes it possible for the child to address sensitive issues with his or her doctor down the road.
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Calcium supplements ward of pregnancy complication
Pregnant women who take calcium supplements reduce their risk of developing preeclampsia, sometimes called toxemia of pregnancy, according to a new study. However, calcium supplementation has no effect on the risk of preterm birth or stillbirth. Dr. G. J. Hofmeyr, of the University of the Witwatersrand/University of Fort Hare, East London, South Africa, and colleagues conducted a systematic review of 12 clinical trials, involving over 15,500 women, that compared at least 1 gram of calcium daily during pregnancy with an inactive "placebo" supplement.
Most of the women were at low risk for pregnancy complications, but they had low levels of calcium in their diet. Compared with placebo, calcium supplementation was associated with less high blood pressure and less preeclampsia, the investigators report in the British Journal of Obstetrics and Gynecology.No overall effect was seen on the risk of preterm birth or stillbirth or infant death before hospital discharge.
"Calcium supplementation during pregnancy for women with deficient dietary calcium intake offers modest benefit for individual women," Hofmeyr's team concludes.
"However, a public health policy of calcium supplementation during pregnancy is unlikely to have a major impact on the incidence of pre-eclampsia," they continue, because in those communities where dietary calcium is inadequate, high-risk women "often attend antenatal clinics late in pregnancy or not at all and so would not benefit from strategies directed at those attending for antenatal care."
The researchers therefore suggest "that future research be directed towards evaluation of improving calcium intake at a population level, for example by food fortification, rather than at an individual level."
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Some children shut out from vaccines
For children whose health insurance doesn't cover newly recommended shots, it's better to have no insurance at all, a new study suggests. Free vaccines are available to children who are uninsured or qualify for public insurance. But many states can't afford to help children with inadequate private insurance that doesn't cover new, expensive shots and even some older shots, the study found. That puts more than a million children at risk, researchers said.
Illinois, for example, doesn't provide vaccines against chickenpox, pneumonia, hepatitis A, human papillomavirus and rotavirus to children with insufficient private insurance. Parents would have to pay $400 out of pocket for those vaccines. "Health insurance plans are not necessarily keeping up with the new vaccines, posing significant ethical dilemmas to public health clinics," said the study's lead author Dr. Grace Lee of Harvard Medical School.
The study of the nation's patchwork system of paying for immunizations appears in Wednesday's Journal of the American Medical Association.
Childhood shots have become a $1 billion-a-year endeavor for government since the discovery of polio vaccine 55 years ago. The per-child cost grew more than sevenfold from $155 in 1995 to $900 for boys and $1,200 for girls this year. Costs in the private sector are higher.
Lee and her colleagues surveyed states to find out which shots they provide and to whom. Program managers from 48 states responded. Lee wouldn't say which states participated because researchers promised anonymity.
Sixteen of the states require health insurers to cover all recommended vaccines.
About 55 million employees and their dependents get coverage through self-insured companies that are exempt from state mandates. Those people are the most likely to be underinsured for vaccines, said vaccine policy expert Dr. Matthew Davis of the University of Michigan.
According to the research, 17 states reported they were unable to give a vaccine for meningitis to children with inadequate private insurance, even if they were seen in public health clinics. And eight states don't give pneumococcal shots to underinsured infants and toddlers.
A handful of states don't provide shots for chickenpox and hepatitis A to the underinsured. Two states don't provide Tdap, the combined booster shot for tetanus, diphtheria and pertussis (whooping cough) for 11- to 12-year-olds.
More than 1 million insured children are unable to get the meningococcal vaccine leaving them vulnerable to potentially deadly infection, the researchers estimated.
The survey did not ask about two vaccines recommended last year: an oral vaccine for infants against rotavirus, a common cause of childhood diarrhea and vomiting, and a vaccine for girls against human papillomavirus, which can cause cervical cancer.
Workers covered by plans marketed by Aetna and other insurance companies generally are covered for childhood vaccines, although they may have to pay co-payments or satisfy deductibles, said Mohit Ghose, a spokesman for America's Health Insurance Plans.
As costs rise, it may be necessary to decide at a national level which vaccines are most important, Davis said. He was not involved in the new study, but wrote an accompanying editorial in the journal.
Officials at the U.S. Centers for Disease Control and Prevention oppose prioritizing vaccines and instead favor better coverage by insurers and more government funding as a safety net, said CDC immunizations director Dr. Lance Rodewald.
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Metabolic syndrome in kids ups adult heart risk
Adults who had so-called metabolic syndrome when they were children have a substantially increased risk of having heart disease in their 30s, researchers report. The metabolic syndrome is a cluster of risk factors -- such as high blood pressure, obesity and high blood sugar levels -- that together increase the likelihood of developing heart problems or diabetes.
Individual components of metabolic syndrome are known to track from childhood into adulthood, but the association between metabolic syndrome in childhood and cardiovascular risk later in life has not been established, Dr. John A. Morrison and his associates explain in the medical journal Pediatrics. The researchers analyzed data, collected between 1973 and 1976, on levels of blood glucose, triglycerides, "good" cholesterol, body weight, and blood pressure in 771 children aged 5 to 19 years.
Thirty-one of these kids had at least three abnormal factors and were classified as having metabolic syndrome, Morrison, at Children's Hospital Medical Center in Cincinnati, Ohio, and colleagues report.
The original group was followed-up between 22 and 31 years later. Twenty-one of the 31 subjects with metabolic syndrome as children had the condition in adulthood.
In the entire adult group, there were 17 cases of cardiovascular disease; six of these occurred in the group that had childhood metabolic syndrome -- a rate almost 15 times higher than among subjects without metabolic syndrome as children.
Increases in weight were the main factor driving in the development of metabolic syndrome, Morrison's team found. The findings, they stress, "underscore the importance of weight management in early and middle adult years."
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Many Kids With Private Insurance Missing Vaccinations
Thanks to an increasingly complex coverage system, many U.S. kids who are privately insured are actually having more trouble getting recommended vaccines than kids who have no insurance at all, experts say. Gaps in coverage for an expanding repertoire of recommended shots are leaving many "underinsured" kids falling through the cracks, they said. Filling those gaps could remedy the situation, however.
"Until we can ensure that such enhancements are made, we need to be able to support the public sector safety net so these children have some place to go, because right now, they have nowhere to go," said lead researcher Dr. Grace M. Lee, assistant professor of ambulatory care and prevention and pediatrics at Harvard Medical School, Children's Hospital Boston and Harvard Pilgrim Health Care. "Our study highlights the need to enhance immunization benefits among insured children, making sure the appropriate requirements or incentives for employers and insurers are in place to make sure vaccines are covered," said Lee, whose team published its findings in the Aug. 8 issue of the Journal of the American Medical Association.
"Vaccines are our strongest prevention tool, and they're not being utilized as well as they could be," added Dr. Ciro Sumaya, founding dean of the Texas A&M Health Science Center School of Rural Public Health. "This has implications for the individual as well as for the population as a whole," said Sumaya, who is also a member of the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP).
The problems reflect an impossibly complex system for patients, parents, practitioners, payers and policy makers, the experts said.
For one thing, the number of new vaccines recommended for children and adolescents has almost doubled over the past five years.
Then, there's the cost. "The HPV vaccine alone is $150 a dose at three doses," Lee said. "In the past, it was less than $100 to give all the vaccines" a child needed, Lee added.
The new or expanded recommendations for meningococcal conjugate, tetanus-diphtheria-acellular pertussis (Tdap), hepatitis A, influenza, rotavirus, and human papillomavirus vaccines (HPV) have resulted in a 7.5-fold increase in the cost to fully vaccinate a child in the public sector -- from $155 in 1995 to $1,170 in 2007.
"As one learns more about vaccines, there are more complexities in the timing, the age levels, can you give it with other vaccines," Sumaya said. "Thirty years ago, all the vaccine recommendations were on one sheet of paper. Now, it takes several sheets of paper, with a lot of individual notes and exceptions."
Children who are uninsured, Medicaid-eligible or of American Indian/Alaska Native origin can get all the vaccinations recommended by the ACIP through the federal Vaccines for Children (VFC) program.
On the other hand, children with private health insurance often have plans that don't cover all the recommended vaccines, or the vaccine may be covered but not its administration.
In 2000, an estimated 14 percent of children aged 0 to 17 were underinsured in the United States, according to background information in the study. These children may be referred to public health clinics, but now, it seems, those clinics are no longer able to provide the needed vaccines.
"We had been hearing reports from state policy makers and clinicians about a lack of adequate funding to give vaccines to all children who needed them," Lee explained.
In the 2006 study, her group interviewed the program managers for state immunization programs in 48 states.
For vaccines given in the private sector, 46 percent of states did not provide publicly purchased chicken pox vaccine, and 70 percent did not provide publicly purchased meningococcal conjugate vaccine to underinsured children.
For vaccines given in the public sector, 17 percent of states were unable to provide publicly purchased pneumococcal conjugate vaccine, and 40 percent were unable to provide publicly purchased meningococcal conjugate vaccine to underinsured children.
Pneumococcal conjugate and meningococcal vaccines are among the newest vaccines, which tended to exhibit more disparities in delivery.
Due to limited financing for new vaccines, 10 states restricted access to publicly purchased new vaccines for underinsured children between 2004 and early 2006.
If 14 percent of children are assumed to be uninsured in the United States, then an estimated 2.3 million children aren't able to receive state-purchased meningococcal conjugate vaccine in the private sector, and 1.2 million children are unable to receive the vaccine in the public sector, the researchers said.
The problem is only likely to get worse, experts said, as the proportion of children with inadequate insurance policies grows.
"We had assumed that all children with health insurance had access to vaccines, but this group didn't have access," Lee said. "This is really concerning, because we see public health clinics as safety nets for vulnerable children. But program managers are forced to turn away underinsured kids, and this is creating ethical dilemmas."
"We need to be able to find or increase sources of funding for vaccine purchase for underinsured kids," she continued.
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Maternal Obesity Heightens Risk of Birth Defects
Women who were obese before they became pregnant had a higher risk of having babies with certain birth defects, including missing limbs, malformed hearts and underdeveloped spinal cords, a new study found. But the researchers cautioned that overweight women planning to get pregnant should try to lose weight sensibly and carefully.
"We would advise women who are obese to try to maintain a healthy weight, engage in moderate exercise and follow a healthy daily diet," said study lead author Kim Waller, associate professor of epidemiology at the University of Texas at Houston's School of Public Health. "Multivitamins both before and after a woman becomes pregnant are very important." In particular, women are advised to take 400 micrograms of folic acid daily both before pregnancy and during pregnancy. A multivitamin will usually satisfy this recommendation.
And women should not try fad diets.
"We don't want women who are thinking of becoming pregnant or who are pregnant to rush out and go on a crash diet," Waller cautioned. "If you become pregnant, then, sure, maybe try to lose some weight, but do so very, very carefully and maintain a healthy diet while you're doing so."
"You have to be of a healthy weight not only for yourself but also for a healthy pregnancy," added Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "You want to try to get down to a healthy weight before you even get pregnant in the first place. Pregnancy is not the time to do a crash diet to try to lose weight."
In 2003 and 2004, 51 percent of U.S. women aged 20 to 39 were overweight or obese, putting them at increased risk for chronic diseases, infertility, irregular menstruation and pregnancy complications, according to background information in the study.
Previous research had shown a strong association between pre-pregnancy body mass index (BMI, a ratio of weight to height) and the risk for certain birth defects, particularly anencephaly -- a defect in the closure of the neural tube, which forms the brain and spinal cord of the embryo -- and spina bifida. The link between overweight and obesity and other birth defects has been less clear.
According to the U.S. Agency for Healthcare Research and Quality, as many as one in 33 babies born in the United States has a birth defect. For the new study, the largest of its kind, Waller and her colleagues interviewed 10,249 women in eight states whose babies had been born with birth defects between 1997 and 2002. Information on the women came from the National Birth Defects Prevention Study.
These women were then compared to 4,065 women who had given birth to babies without birth defects during the same time period. Sixteen birth defects were studied. Of those, mothers of babies with the following seven birth defects were more likely to have been obese than mothers of infants without birth defects:
- Spina bifida, or the incomplete development of the brain, spinal cord and/or meninges (the protective covering around the brain and spinal cord). This is the most common neural tube defect in the United States and affects up to 2,000 of the more than 4 million babies born annually, according to the National Institutes of Health.
- Heart defects.
- Anorectal atresia, or malformation of the anal opening.
- Hypospadias, or an abnormally placed urethral opening in males -- on the underside instead of the end of the penis.
- Limb reduction defects, such as small or missing toes, fingers, arms or legs.
- Diaphragmatic hernia, an opening in the diaphragm that allows abdominal organs to move into the chest cavity. This may also cause lungs to be underdeveloped.
- Omphalocele, when the intestines or other abdominal organs protrude through the navel.
The findings are published in the August issue of Archives of Pediatrics & Adolescent Medicine.
It's not clear why the association between pre-pregnancy obesity and birth defects exists.
"We know that obese women have a higher risk of certain defects, but we don't know if obesity is the direct cause," Waller said. "There could be other explanations, such as different types of diet, different ways of dieting when they're dieting. We were not able to exclude women with diabetes, and that is a very strong risk factor for birth defects, so we think there may be undiagnosed cases of diabetes remaining with the study."
Future research will look at dieting techniques and the risk of birth defects, as well as any links between over-the-counter diuretics and appetite suppressants and birth defects.
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Tuesday, August 7, 2007
Energy drinks' caffeine in line with coffee
Despite such speedy-sounding names as "Full Throttle," "Amp" and "Rush," energy drinks pack a punch that is generally no stronger than coffee, according to a report released on Monday. A comparison of 12 popular energy drinks, published in the September issue of Consumer Reports, found that the caffeine in 8 ounces of various brands ranged from 50-145 milligrams (mg), though most were in the 75- to 80-mg range.
Results were rounded to the nearest 5 mg. By comparison, the caffeine in an 8-oz cup of brewed coffee can range from 65-120 mg, with an average of 85 mg, according to the National Coffee Association. The least-caffeinated energy drink Consumer Reports tested was the fruit punch-flavored offering by Target Corp.'s private label Archer Farms, with 50 mg. At the high end was the lemon-lime flavored Celsius with 145 mg.
Market-leading Red Bull had 80 mg of caffeine. Sobe No Fear, owned by PepsiCo Inc., had 85 mg of caffeine. Amp had 75 mg of caffeine, while Rush and Coca-Cola Co.'s Full Throttle both had 80 mg.
Jamie Kopf Hirsh, associate editor at Consumer Reports and the report's author, said it was "good news" that energy drinks were not much more caffeinated than coffee, but said consumers should still be cautious.
Even though 8 ounces is the standard serving size for measuring, most containers have more than that, and most consumers drink more than that.
"You don't have to be alarmed by this, you just have to account for it in your daily caffeine intake," Hirsh said, adding that energy drinks, with their graphic video-game-like logos that appeal to young men, could be "coffee for the new generation."
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Coffee may slow memory declines in women
Drinking more than three cups of coffee a day helped protect older women against some age-related memory decline, French researchers said on Monday, giving women more reason to love the world's most popular stimulant. Men did not enjoy the same benefit, they said. "The more coffee one drank, the better the effects seemed to be on (women's) memory functioning in particular," said Karen Ritchie at the French National Institute of Medical Research, whose work appears in the journal Neurology.
The researchers followed more than 7,000 men and women in three French cities, checking their health and mental function and asking them about their current and past eating and drinking habits, their friends, and their daily activities. They used this information to sort out the specific role caffeine played in these women's lives.
They found that women who drank more than three cups of coffee per day, or its caffeine equivalent in tea, retained more of their verbal and -- to a lesser extent -- visual memories over four years.
These women had a 33 percent lower odds of having verbal memory declines and 18 percent lower odds of having visual and spatial memory declines, compared to women who drank one cup or fewer per day.
The effect also depended on age, with women over 80 reaping more benefits from these beverages than those who were 10 to 15 years younger, Ritchie's team wrote. It was unclear whether current or former coffee consumption made the difference.
Some studies in mice have suggested that caffeine might block the buildup of proteins that lead to mental decline.
Ritchie is not sure why only women benefited in her study.
"Our best guess is that women don't metabolize coffee in the same way (as men)," she said in a telephone interview.
Ritchie plans to follow the women longer to see if caffeine delays the onset of dementia -- the mental confusion that signals Alzheimer's disease and other brain disorders.
She said people should weigh any brain gains derived from caffeine against other effects of the stimulant, including raised blood pressure.
The average American drinks one to two cups of coffee a day, according to the National Coffee Association.
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Stomach meds tied to mental slowing in seniors
Taking certain types of medication to deal with heartburn and excess stomach acid may increase the risk of cognitive impairment in the elderly, according to a new report. The drugs in question -- called histamine-2 receptor antagonists or H2As -- include popular medicines such as Zantac and Pepcid. Previous reports have yielded conflicting results regarding the effect of H2As on cognition. Recent studies have generally supported an adverse effect, but did not reach definitive conclusions.
In their study in the Journal of the American Geriatric Society, Dr. Malaz Boustani, from Indiana University in Indianapolis, and colleagues used a standard screening test to assess cognitive impairment in 1558 African Americans, 65 years and older, who had normal mental abilities at the outset of the study. During follow-up, 275 subjects (17.7 percent) showed signs of diminished cognitive capacity, the report indicates. After accounting for age, education level and medical history, treatment with H2As more than doubled the likelihood of developing cognitive impairment.
"This study suggests that long-term use of H2As is associated with cognitive impairment in elderly African Americans," Dr. Boustani's team concludes. "Because a significant number of Americans are exposed to H2As every year, with approximately 16 million prescriptions in 2005, the association between H2As and cognitive impairment merits further study."
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Dengue kills nearly 100 children in Myanmar
Dengue fever has killed nearly 100 children in military-run Myanmar in the first seven months of the year, a senior health official said Tuesday, amid fears of a possible epidemic in Southeast Asia. As of July 31, a total of 8,000 cases of dengue were recorded in children age 14 and under, 98 of them fatal, the health ministry's deputy director Kyaw Nyunt Sein told AFP.
"In July alone, 32 children were killed out of 3,000 cases. This July has been the deadliest month," he said, adding that most of the victims were under the age of five. Last year, a total of 130 children died out of some 11,000 cases recorded, he said.
Dengue fever is a flu-like illness spread by the bite of an infected mosquito. Unlike the mosquitoes that cause malaria, those carrying dengue bite during the day. The disease is especially dangerous in children and the elderly, who have little resistance and often die of internal bleeding.
It normally takes its greatest toll in Myanmar in the rainy season, which begins in June. The country does not track adult cases of the disease, Kyaw Nyunt Sein said.
The World Health Organisation (WHO) has expressed concerns that Asia could see a dengue epidemic this year on a par with that of 1998, when nearly 1,500 people died.
More than 1,100 people have been killed by dengue fever in Indonesia alone this year.
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Health Tip: Adjusting to a Move
Changing homes can be a stressful ordeal, particularly for young children and even toddlers. The Nemours Foundation offers these suggestions to help young children cope with the stress of a move:
- While explaining details of the move, keep it clear and simple.
- Tell them a story about the move, and use their toys to act it out.
- Let them help pack up their toys, and make sure they understand that the toys will be at the new home, too.
- If you can, take your child to visit the new home several times, and try taking toys over each time you go.
- Try to keep your child's bedroom furniture the same.
- Just before and after the move, don't try to make any other changes in your child's life, like toilet training or moving to a bed from a crib.
- Have your child stay with a babysitter while the furniture and belongings are moved to the new home.
Farms Shield Kids From Bowel Disease
Children regularly exposed to farm life as babies are about half as likely as other kids to develop inflammatory bowel diseases such as ulcerative colitis or Crohn's disease, German researchers report. The findings, published in the August issue of Pediatrics, fall into line with what experts in inflammatory bowel diseases (IBDs), allergy and asthma call the "hygiene hypothesis."
That theory "refers to the observation that children living in environments with lower levels of microbial exposure seem to be at higher risk for the development of allergies," explained the study's lead researcher, Katja Radon, of Ludwig-Maximilians-University in Munich. Crohn's and ulcerative colitis are autoimmune illnesses, where the body's immune system mistakenly attacks its own tissues. It is possible that this dysfunction may originate, at least in part, in how immune responses develop very early in life, said Dr. Joel Rosh, director of pediatric gastroenterology at Goryeb Children's Hospital, part of the Atlantic Health System in Morristown, N.J.
He pointed out that while rates of IBDs are holding steady in the developing world, they are rising sharply in more affluent nations.
"It's something that we are doing to ourselves," Rosh said.
"The thinking is that if your immune system isn't appropriately challenged at the appropriate time in life, then it might do some wacky things," Rosh added. In other words, a too-clean environment -- while healthy in some ways -- might be less than ideal when it comes to immune-linked illness, experts say.
The German study is one of the first to compare inflammatory bowel disease rates against infant exposures to farm animals and farm life. The German team questioned the parents of more than 2,200 6- to-18-year-old children. More than 300 of the children had ulcerative colitis, another 444 had Crohn's, and almost 1,500 were free of either illness.
Kids with either Crohn's or ulcerative colitis "were less likely to have lived in rural environments and were less likely to have farm contact in the first year of life, before the disease had developed," Radon noted.
In contrast, children who had spent regular amounts of time visiting or living on farms during their first year of life were 50 percent less likely to develop Crohn's as they got older and 60 percent less prone to ulcerative colitis, compared to youngsters who had not had that experience.
Early exposure to cattle, especially, appeared to help keep the diseases at bay, cutting the odds of Crohn's by 60 percent and colitis by 70 percent, the study authors said.
Cattle appeared to have a more potent effect on IBD risk than exposure to household pets, the study found. Household cat and dog exposure has been the focus of much study and debate among allergists and immunologists.
In this study, regular exposure in infancy to cats reduced Crohn's risk by just 20 percent, a statistic the researchers described as only of "borderline significance." Cat exposure was somewhat more useful against colitis, with rates dropping by 50 percent compared to unexposed children.
The cat-cattle discrepancy didn't come as a big surprise to Rosh.
"It seems that it's not so much animals, per se, as it is which animals," he said. "So, the domesticated cat that stays in the corner cleaning himself all day may not be 'dirty enough' to save you."
Radon agreed. "It has also been shown for allergies that farm animal contact is more efficient [in reducing risk] than pet contact. Therefore, it is not surprising that we see the same for inflammatory bowel disease," she said. "The reason might be that the level of exposure to bacteria and fungi in the farm environment is much higher than if you have a cat or dog at home."
Rosh has his own theories as to where the protective element might lie. "They sanitize it in the article, but they do say it can't be a clean animal -- it's got to be livestock. It's got to be something in that environment, and I would say, it's not in the air so much, as in the poop," he said.
So, does all this mean that modern-day babies need to get "back to the land"?
Perhaps not, according to the experts.
"You can't make the leap to say that to protect our children against autoimmune disease, we need to take them to farms, because we don't know yet what the [protective] exposure is," said Dr. Peter Mannon, head of the Clinical Inflammatory Bowel Diseases Research Unit at the U.S. National Institute of Allergy and Infectious Diseases.
"Are you supposed to be exposed to hay? To a particular type of vermin? The rats in barns? It's very hard to know," he said. While there's no reason not to bring infants to more pastoral settings, "I would not guarantee that it is going to add any protection," Mannon said.
Radon agreed that "at the moment, we cannot give direct advice to parents" since the study showed no cause-and-effect relationship, only an association.
And she pointed out that society's obsession with cleanliness does have its rewards. "We should not forget that an improved level of hygiene has relevantly contributed to today's health in industrialized countries," she said.
For his part, Rosh said there might be some virtue in letting kids get a little dirty -- a prescription most youngsters should have no problem with.
"I don't mean that we all have to eat dirt, but if we could isolate what is in it that is good, maybe we'd have a good [IBD] treatment," he said. "These various areas of research are going to unlock the secrets that we need to cure these diseases."
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Maturity Brings Richer Memories
While children and adults are similar when it comes to basic memory formation, adults create richer, more detailed contextual memories. That's the conclusion of a new Massachusetts Institute of Technology study that included 49 people, ages 8 to 24.
The researchers said adults form richer memories because they have a more developed prefrontal cortex (PFC), an area of the brain associated with higher-order thinking, planning and reasoning. "Activation in the PFC follows an upward slope with age in contextual memories. The older the subjects, the more powerful the activation in that area," senior author John Gabrieli, of MIT's McGovern Institute for Brain Research, department of brain and cognitive sciences, said in a prepared statement.
"This makes sense, because there's been a convergence of evidence that the PFC develops later than other brain regions, both functionally and structurally... But this is the first study that asks how this area matures and contributes to learning," Gabrieli said.
For this study, participants did memory exercises while their brain activity was recorded using functional magnetic resonance imaging. The researchers said their findings offer new information about how children learn.
The study was published in the Aug. 5 online edition of the journal Nature Neuroscience.
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Mom's obesity linked with birth defects
Women who are obese before pregnancy face a higher risk of having babies with a variety of birth defects than women with a healthy weight, a new study suggests. The results involving nearly 15,000 women from eight states found abnormalities of the spine, heart, arms, legs and abdomen, building on previous research that showed heart and spine defects. The greatest risk was for spina bifida.
"Obese women should not be overly alarmed by these findings because their absolute risk of having a child with a birth defect is low, and the cause of the majority of birth defects is unknown," said University of Texas researcher Kim Waller, the study's lead author. Still, the results underline yet another reason for women to maintain a healthy weight, Waller said.
The findings suggest that about 4 percent of women who are obese before pregnancy will have babies with major birth defects, versus 3 percent for healthy-weight women, Waller said.
Obese women faced double the risk of having babies with spina bifida than women of healthy weight. With spina bifida, the most common disabling birth defect in the United States, the spinal column fails to close properly. That often leads to leg paralysis, learning difficulties and other serious problems.
Very heavy women also were 60 percent more likely to have babies born with a rare defect in which abdominal organs protrude through the belly button; 40 percent more likely to have heart defects; 36 percent more likely to have shortened arms or legs; and at least 20 percent more likely to have any of several gastrointestinal deformities.
The study was released Monday in the August edition of Archives of Pediatrics & Adolescent Medicine. It was funded by the federal Centers for Disease Control and Prevention.
"This is probably an under-recognized finding which I suspect will be corroborated by other research in the future and something we will need to talk to our patients about," said Dr. Alan Peaceman, a high-risk pregnancy specialist and professor at Northwestern University.
Dr. Michael Katz, acting medical director for the March of Dimes, said, "It's important because if it is true," it suggests that rising obesity rates might be triggering increases in birth defects.
The research is part of the National Birth Defects Prevention Study, involving women who were pregnant between October 1997 and December 2002.
Participants included 10,249 women whose babies were born with at least one birth defect. They were compared with 4,065 women with healthy babies.
Women were asked what their height and weight had been just before they got pregnant. Based on those responses, the researchers calculated that 2,312 women were obese pre-pregnancy.
Reasons for the potential link between obesity and birth defects are unclear, Waller said. It's possible that some women had undiagnosed diabetes, which also is linked to birth defects, she said.
While the study didn't examine weight during pregnancy, it's also possible that some women tried potentially dangerous weight-loss techniques right before conception or during early pregnancy, when most birth defects occur, the researcher said.
She urged obese pregnant women, however, not to try diet pills, fasting or other aggressive methods which also might contribute to risks for birth defects.
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Obesity before pregnancy ups risk of birth defects
There's an increased risk of birth defects among babies born to women who are obese before becoming pregnant, according to a new study. To look into this issue, Dr. D. Kim Waller and colleagues used information from the ongoing National Birth Defects Prevention Study, a multi-site, population-based study of more than 30 different categories of structural birth defects.
Waller, at the University of Texas in Houston, and associates pulled data for births between 1997 and 2002 on over 10,000 babies born with birth defects and compared them with some 4000 normal babies. The team found that maternal obesity more than doubled the likelihood that the baby would have spina bifida. Other increased risks linked to the mother's pre-pregnancy obesity were defects involving the heart, anus, penis, limbs, diaphragm and navel, the researchers report in the Archives of Pediatrics and Adolescent Medicine.
For mothers who were overweight but not classified as obese, there was also a significant, but smaller, association with some of these defects.
Among underweight women, the only defect linked to their weight was a slightly increased risk of cleft lip.
Waller and colleagues conclude: "Our study supports previous evidence as well as provides new evidence for the associations between maternal obesity and particular categories of birth defects."
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Monday, August 6, 2007
Two-Drug Combo Tough on Kidney Cancer
Kidney cancer might have met its match in a new combination of cancer drugs, a new study shows. Used together, interferon alpha, a drug that boosts the body's ability to fight off tumors and infections, and sorafenib, a drug that cuts off a tumor's blood supply, led to significant tumor shrinkage in 33 percent of patients in a U.S. pilot study.
"We found that by combining a drug that enlists the immune system's help in combating cancer with one that cuts off a tumor's blood supply, we could substantially increase patients' response rates to treatment," lead investigator Dr. Jared Gollob, of the Duke Comprehensive Cancer Center in Durham, N.C., said in a prepared statement. Used alone, each drug is only successful in fighting 5 percent to 10 percent of tumors. But the new study finds that the combination works much better. Sorafenib is sold under the brand name Nexavar. The drugs had an additional benefit, the researchers said, in that the combo therapy doubled the time before tumors began to grow again. According to Gollob, most tumors begin growing again after about five or six months when treated by either drug alone.
Reporting in the Aug. 1 issue of the Journal of Clinical Oncology, Gollob and his research team gave 40 study patients sorafenib in pill form twice daily and interferon alpha injections three time a week for eight weeks. If the patient's tumor had not grown or had shrunk after eight weeks, they repeated the cycle after a two-week break until the tumors disappeared or the cancer got worse. The researchers monitored the tumors using computerized-tomography (CT) scans.
The approach completely destroyed tumors in two of the 40 patients.
Researchers plan to begin a multi-site clinical trial that will analyze the impact of giving patients increasing doses of sorafenib alone after their tumors have shrunk as much as possible on the combination treatment.
According to the U.S. National Cancer Institute, about 51,000 people suffer from kidney cancer every year, and almost 13,000 will die from the disease. The majority of patients are men over the age of 45. The cancer is especially deadly, because it very rarely causes symptoms until it has reached an advanced stage. By the time kidney cancer rates stage IV status, it has spread to other organs such as lungs, liver and bones. People are given six months to two years to live once they reach stage IV, and only about 10 percent are alive five years after diagnosis.
The Duke team noted that one of the biggest challenges facing doctors and patients with kidney cancer is the cancer's resistance to chemotherapy, radiation and other common cancer-fighting tools.
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Loss of key genetic shield aggravates lung cancer
Flaws in a key gene called LKB1 help lung cancers develop swiftly into dangerous, metastasising tumours, a paper released on Sunday by the British journal Nature says. LKB1 has previously been identified as helping the body to suppress cancer.
Mutations that disabled this gene were found in patients with Peutz-Jeghers syndrome, which boosts the risk of cancer, and in human lung cancers classified as squamous carcinomas.
The telltale variants could help predict how cancer will develop in a patient and also open up pathways for new drugs, according to the study, led by by Kwok-Kin Wong of the Dana Farber Cancer Institute in Boston, Massachusetts.
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Eye Health Group Backs Kids' Sight-Saving Bills
Many children's vision problems can be treated successfully if they're detected early, says Prevent Blindness America. The vision health organization has declared August Children's Eye Health and Safety Month as part of its effort to educate the public about the importance of quality eye care for children.
About two out of three children in the United States don't receive critical eye services before the age of 6, and that increases their risk of suffering vision loss, according to Prevent Blindness America. If children don't receive a certified vision screening or eye exam, serious vision problems may go undetected. Children should have their vision checked at infancy, 6 months, 3 years, and 5 years, with follow-ups as needed, recommends Prevent Blindness America. Vision plays an important role in learning, and eye disorders can have a serious impact on a child's school performance.
In an effort to improve access to proper eye care, Prevent Blindness America and other vision health groups developed the "Vision Care for Kids Act of 2007," which would provide funding for eye exams and follow-up care for qualified children. Bills were introduced in the U.S. Senate and the House of Representatives earlier this year, and Prevent Blindness America and its partners hope the legislation will be passed within the next few weeks.
"We already know that one in 20 preschool children have a vision problem. What we need to do now is to develop programs to provide children in need with the professional eye care they deserve," Daniel D. Garrett, senior vice president of Prevent Blindness America, said in a prepared statement. "We ask everyone to contact their representative and urge their support for vision services."
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Child Maltreatment Rises in Homes of Soldiers Sent to War
A U.S. Army-sponsored study finds that children of enlisted soldiers are more likely to be abused or neglected when a parent is deployed to a combat zone. The findings point to the need for more support services at home, the study authors said. "The practical implication is that child maltreatment incidents are much more likely to occur during soldier deployments than during other times, and this really underlines the necessity of formal and informal support for parents who are going through this," said Deborah A. Gibbs, lead author of the study and a senior analyst with the Children and Families Program at RTI International in Research Triangle Park, N.C. "Our findings really put a number on the extent of the problem and suggest the areas in which supports are most necessary."
The study is published in the Aug. 1 issue of the Journal of the American Medical Association, a theme issue on violence and human rights. U.S. Army support of the study should give the issue of child abuse in general even more of a spotlight, experts said.
"The fact that the military is taking an interest is going to be helpful for the whole nation," said Dr. Rachel Bramson, associate professor of family and community medicine with the Texas A&M Health Science Center College of Medicine and the Scott & White Clinic in College Station, Texas. "A lot of times if you have an organization of complexity with the degree of resources and the appropriate interest in their employee and family health, then you can bring about greater social change," she added.
U.S. Army spokesman Lt. Col. Ben Clark is deputy director of family programs, Family Advocacy Program, Army Family and Morale, Welfare and Recreation Command. Responding to the study, he said, "What they [the researchers] see is pretty consistent with what we see. We see an increase of neglect cases when we have large deployments. We're getting resources to help with that."
Deployment of a parent results in added stress, particularly to the parent left behind. Stress, in turn, is thought to play a role in child maltreatment, including neglect, physical abuse, emotional abuse and sexual abuse.
In 2004, there were more than 1.1 million American military families with children younger than 18.
Although there is not a long history of research in this field, previous studies have found that children of parents in the U.S. military serving in Iraq and elsewhere have higher blood pressure, heart rates and stress levels than other youngsters, and that children from military families are twice as likely to die from severe abuse as other children are.
Gibbs and her colleagues looked at confirmed incidents of child maltreatment by a parent in 1,771 families of enlisted U.S. Army soldiers who had been deployed to combat at least once between September 2001 and December 2004.
In total, 1,858 parents in these families had maltreated their children. The overall rate of child maltreatment was 42 percent higher during the times when the soldier-parents were deployed, compared to when they weren't deployed.
Moderate or severe maltreatment was 61 percent higher during deployment periods as compared to non-deployment periods.
While rates of child neglect were nearly double during deployment, the rate of physical abuse was less.
The rate of maltreatment by female civilian spouses was more than triple during times of deployment. Male civilians had a higher rate of maltreatment during these periods, but not significantly so, the study found.
The rate of child neglect by civilian female spouses was nearly four times the rate at other times.
"When people are stressed, there's a much higher likelihood of abuse. It's true of any situation," Bramson said. "Also, most abusers were themselves abused. The key is preventing abuse, so you don't raise kids who are going to go on to be abusers. Luckily, there's more interest in trying to create community interventions. One of the major things is awareness, and that's why I'm excited about this coming from the military. That's going to get some attention."
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Fatter Australians cause hazard for mortuaries
More than two-thirds of Australians living outside major cities are overweight or obese, and extremely obese corpses are creating a safety hazard at mortuaries, according to two studies released on Sunday. Nearly three quarters of men and 64 percent of women were overweight in a study of people in rural areas. Just 30 percent of those studied recorded a healthy weight, said research published in the Medical Journal of Australia.
"Urgent action is required at the highest level to change unhealthy lifestyle habits by improving diet, increasing physical activity and making our environments supportive of these objectives," wrote the lead researcher, Professor Edward Janus. The figures were much higher than for the general population, where statistics show about 3.2 million of Australia's 21 million people are obese.
Meanwhile, pathologists are calling for new "heavy-duty" autopsy facilities to cope with obese corpses that are difficult to move and dangerously heavy for standard-size trolleys and lifting hoists.
The bodies presented "major logistical problems" and "significant occupational health and safety issues," according to a separate study, which found the number of obese and morbidly obese bodies had doubled in the past 20 years.
Specially designed mortuaries would soon be required if the nation failed to curb its fat epidemic, providing "larger storage and dissection rooms, and more robust equipment," said Professor Roger Byard, a pathologist at the University of Adelaide.
"Failure to provide these might compromise the post-mortem evaluation of markedly obese individuals, in addition to potentially jeopardizing the health of mortuary staff."
In the past year, there have also been requests for larger crematorium furnaces, bigger grave plots as well as super-sized ambulances, wheelchairs and hospital beds.
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Saturday, August 4, 2007
Hostility Puts Men's Hearts at Risk
Ten years of frequent hostility and depression may harm men's immune systems and put them at risk for heart disease, a U.S. study found. These negative emotional states may also hike men's risks for related disorders such as type 2 diabetes and high blood pressure, according to research in the August issue of Brain, Behavior, and Immunity. Angry men are more likely to have increased levels of C3, an immune system protein associated with chronic inflammation, say the researchers from Duke University.
"Hostile, depressed and angry people see the world around them in a different way, and sometimes they see it as them against the world," study co-author Edward Suarez said in a prepared statement. "That kind of lifestyle often leads to greater stress and possibly changes in the way the body functions that could lead to disease."
Other research has shown a relationship between elevated levels of C3 and chronic diseases such as heart disease and diabetes.
The Duke team studied 313 male Vietnam veterans over a 10-year period. The men were part of a larger study on the effects of the wartime defoliant Agent Orange. All of the men underwent standard psychological testing to assess hostility, depression and anger. The researchers also tested the men's blood on three occasions between 1992 and 2002.
The researchers looked for changes in levels of C3 and C4, immune system proteins that are markers of inflammation, the body's response to injury or infection.
Men whose psychological screening showed the highest level of hostility, depressive symptoms and anger had a 7.1 percent increase in C3 levels, the investigators found, while men with low scores on the test showed no change in C3 or C4 over the decade. Levels of C4 did not change for either group.
The relationship between the psychological scores and C3 levels remained true even when the researchers looked for the possible effects of other risk factors. Smoking, age, race, alcohol use, body mass index and Agent Orange exposure had no influence on C3 levels.
The researchers noted that while the study does not point to psychological therapy as a means of preventing inflammation, finding ways to reduce anger and hostility couldn't hurt.
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Vinegar is mighty weapon in fight against cervical cancer
A cheap and simple screening test using the key ingredient in vinegar could help slash incidence of cervical cancer in poor countries, according to a trial conducted in India which is reported in Saturday's Lancet. The method entails making a visual inspection of the cervix, using a speculum (a tool to dilate the vaginal walls), a bright halogen lamp and a solution of three- to five-percent acetic acid.
The solution is applied to the cervix, and suspect tissue shows up as whitish lesions. Healthy tissue shows no colour change. Doctors led by Rengaswamy Sankaranarayanan of the International Agency for Research on Cancer (IARC) in Lyon, France, tested the method on 31,000 women aged 30-59 in the district of Dindigul, in the southern state of Tamil Nadu. A total of 3,088 women were screened as positive, and were given further examination or a pap smear.
This turned up 1,874 cases of precancerous lesions, 72 percent of whom received treatment.
Over six years, the group recorded a total of 167 cases of cervical cancer and 83 deaths from this disease.
The investigators recruited a "control" group of 31,000 women, who were not screened.
Comparing the two groups, women who had been screened were 25 percent less likely to develop cervical cancer and 35 percent less likely to die from it.
Combined with "good training and sustained quality assurance," the technique is an excellent preventative tool for developing countries, believes Sankaranarayanan.
The vinegar test was pioneered by doctors from Johns Hopkins University in Baltimore, Maryland, who assessed it for safety and effectiveness among 10,000 women in Zimbabwe in 1999. The new trial takes this process a major step further.
There were 493,000 new cases of cervical cancer and 273,000 deaths from the disease in 2002, according to IARC figures quoted in The Lancet paper.
Once the cancer, initiated by the human papilloma virus, spreads beyond the cervix, the chances of survival fall, which means it is vital to spot tumorous cells in the earliest possible stage.
But in poor countries, the pap smear, as well as the newly-introduced cervical cancer vaccine, are often too expensive or unavailable.
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Tumor-Zapping Technique Fights Kidney Cancer
A heat-based technique called "CT-guided radiofrequency ablation" was almost 100 percent successful in destroying small malignant kidney tumors in a study of more than 100 patients, new research shows. Radiofrequency ablation has been used successful in liver tumors since the early 1990s. A needle-like treatment probe, guided by computer tomography (CT), is inserted into the tumor where it emits a high-frequency alternating current. The current heats the tumor tissue and destroys it. Radiofrequency ablation is an outpatient procedure in which the patient is sedated but conscious, and a local anesthetic is used at the puncture site.
The technique targeted tumors ranging in size from 0.6 centimeters to 8.8 centimeters in size. A total of 125 tumors in 104 patients were treated between 2000 and 2006. Of the 95 tumors that were smaller than 3.7 cm, all were completely eradicated by a single treatment, the researchers reported in the August issue of the American Journal of Roentgenology.
Seven of the remaining tumors were eradicated after a second treatment, the team added, for a total 93 percent success rate for all 125 tumors. The tumors were still gone 14 months after treatment. Of the 104 patients in the study, 101 went home the same day.
"This is the largest treatment group to date of patients with biopsy-proven renal malignancies," lead author Dr. Ronald J. Zagoria, of Wake Forest University Baptist Medical Center in Wnston-Salem, N.C., said in a prepared statement. "The results, a high cure rate and low complication rate, establish that at institutions with experience doing this procedure, this is an alternative method for treating small renal malignancies in patients who are not good surgical candidates," he said.
His team noted that the technique is best used for small tumors. Although it can be effective in larger tumors, there is always the risk of incomplete destruction. Further, tumors located near the middle of the kidney pose a particular challenge, because they are close to large blood vessels or the ureter, the tubes that transport urine from the kidney to the bladder.
Zagoria's group cautioned that surgery is still the preferred method of fighting kidney cancer in patients who are young, healthy and have two kidneys because there is no data available for long-term follow-up on the effects of radiofrequency ablation.
There are more than 51,000 new cases of kidney cancer every year in the United States and 12,000 deaths from the disease, according to the U.S. National Cancer Institute.
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Smoking tied to serious pregnancy condition
Smoking during pregnancy is associated with an increased risk of placental abruption, a potentially life-threatening condition for both the mother and fetus, according to a report in the American Journal of Epidemiology.With placental abruption, the placenta detaches from the uterus wall prior to birth, resulting in severe bleeding. Depending on the degree of detachment, up to 40 percent of affected infants die.
Dr. Cande V. Ananth, from the Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Dr. Sven Cnattingius, from the Karolinska Institute in Stockholm, investigated whether the effect of maternal smoking on abruption risk is restricted to the pregnancy during which the mother smokes or whether subsequent pregnancies may be affected as well. According to the findings, smoking during pregnancy raised the risk of abruption during that pregnancy but seemed to have little impact on the risk in future pregnancies.
Regardless of smoking status, having one abruption greatly increased the risk of another abruption. In women with a prior abruption, the likelihood of having another was increased 5.3-fold for nonsmokers and 10.9-fold for smokers compared with women with no history of abruption.
These findings further reinforce the message that women should reduce smoking during pregnancy, Ananth told Reuters Health.
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Fat-burning defect in liver may cause obesity
Rats with a genetic predisposition to burn fat more slowly tend to put on weight more readily than rodents bred to resist becoming obese, a new study shows. The findings could help explain why some people get fat more readily than others, Dr. Mark I. Friedman of the Monell Chemical Senses Center in Philadelphia, one of the study's authors, told Reuters Health.
Just like the animals in the study, he explained, it may be harder for obesity-prone people to use energy from the fats they eat -- as well as to burn fat from their own bodies -- forcing them to overeat to get enough energy. Essentially, Friedman said, "they overeat because they're getting fat." Previous studies in people have found that individuals who burn fat slowly are more likely to subsequently gain weight, Friedman and his colleague Dr. Hong Ji note in the current issue of the journal Metabolism: Clinical and Experimental. To determine if impaired fat oxidation might be involved in the development of obesity, the researchers fed a low-fat diet to rats bred to either be susceptible or resistant to obesity, and then switched them to a high-fat diet.
No weight difference developed between the two groups of rats while they were eating a low-fat diet, the researchers found. However, the obesity-prone rats showed a 35-percent lower rate of fatty acid oxidation. And after the animals were switched to a higher fat diet, the obesity-prone rats gained 36 percent more weight than the obesity-resistant rats, even though they consumed just 14 percent more calories.
The obesity-prone rats also showed reduced expression of genes involved in transporting fatty acids to the liver cells and burning them to make energy.
The findings imply that impairment of fatty acid oxidation may contribute to obesity in humans, Ji and Friedman conclude.
While fat metabolism may be at fault, Friedman added, people who want to control their weight should be paying attention to carbs, too. "As far as diet recommendations go, I personally would not pin it all on the fat. I would say that it really depends on a mix of fat and carbohydrates."
Friedman and his colleagues are now looking into the enzymes involved in fatty acid oxidation and how their function might be altered in obesity-prone rats, which could provide an approach to treating or preventing obesity in humans.
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Friday, August 3, 2007
Health care : Moms too quick to reach for baby bottle
Nearly three-quarters of new mothers in the United States are breast-feeding their babies, but they are quitting too soon and resorting to infant formula too often, federal health officials said Thursday. A government survey found that only about 30 percent of new moms are feeding their babies breast milk alone three months after birth. At six months, only 11 percent are breast-feeding exclusively.
Formula isn't as good at protecting babies against diseases, eczema and childhood obesity. Ideally, nearly all mothers should breast-feed their babies for six months or more, said Dr. David Paige, a Johns Hopkins University reproductive health expert.
But many do not because of their jobs, the inconvenience, and perhaps because of convincing advertising for baby formula. What's wrong with giving a baby a bottle every once in a while? Not much, except it can begin a pattern as a child sucks at the breast less, causing less stimulation needed to produce milk, Paige said.
"It creates a downward spiral," he said, adding that often, a woman then moves away from breast-feeding altogether.
The annual random-digit-dial survey by the Centers for Disease Control and Prevention showed that the percentage of women who start breast-feeding rose slightly from 2000 to 2004, from 71 percent to 74 percent. That's a new high, CDC officials said, and is based on nearly 17,000 responses.
A previous survey suggested a higher percentage breast-fed exclusively — 39 percent at three months and 14 percent at six months. However, researchers think there may have been confusion in that earlier survey that led to the higher percentage.
The new results are being called the best national data to date on "exclusive breast-feeding," in which mothers give their infants nothing but breast milk except for vitamin drops.
The CDC study found that rates of exclusive breast-feeding were lowest among black women and among those who are unmarried, poor, rural, younger than 20, and have a high school education or less. Those findings are consistent with earlier studies.
This year, the government announced goals for 2010: getting 60 percent of women to breast-feed exclusively for the first three months and 25 percent through six months.
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Health Care : U.S. breast-feeding rates rise to record high
The percentage of U.S. mothers who breast-feed their babies has reached the highest level on record amid mounting evidence that it provides many health benefits to the child, U.S. officials said on Thursday. The Centers for Disease Control and Prevention said 74 percent of American women who gave birth in 2004 breast-fed their babies for at least some period of time, continuing an upward trend since the early 1990s.
"We've made quite a bit of progress," CDC epidemiologist Dr. Celeste Philip, lead author of a CDC report on breast-feeding, said in a telephone interview. Breast-feeding rates just about reached the government's target of 75 percent, the report showed. But many women did not stick exclusively to breast-feeding in the first months after birth as recommended by experts, turning instead to baby formula, the report showed.
The American Academy of Pediatrics recommends that women who do not have health problems exclusively breast-feed their infants for at least the first six months, with breast-feeding continuing at least through the first year as other foods are introduced. The CDC backs these recommendations, Philip said.
The CDC report found that among infants born in 2004, the rate of exclusive breast-feeding through the first three months after birth was 31 percent, shy of the government's goal of 60 percent, and through six months was 11 percent, below the government target of 25 percent.
The report detailed racial and socioeconomic disparities among women who provide their babies exclusively breast milk in these first months, with black, teen-age, rural, less-educated, lower-income and unmarried mothers less likely to do so.
PROGRESS SINCE THE 1970s
Philip said she hoped the new statistics will prompt doctors to renew efforts to persuade mothers to breast-feed their babies. She said the CDC is working with hospitals to encourage support of breast-feeding in the days after birth.
The 2004 breast-feeding rate of 74 percent was the highest since such statistics were first kept for U.S. women in the 1950s, Philip said. The lowest rate on record was in 1971, when only 25 percent of mothers breast-fed their infants amid major cultural shifts occurring in the country.
By 1982, the rate had jumped to 62 percent. But it declined again through the 1980s and slumped to 52 percent in 1990 before increasing to 71 percent in 2000 and continuing to rise into this decade, the CDC said.
The CDC noted that breast-feeding is associated with decreased risk for many diseases and conditions, including ear infections, respiratory tract infections, sudden infant death syndrome, obesity, eczema and diarrhea.
It also is associated with health benefits to women, CDC said, including decreased risk for the most common form of diabetes, ovarian cancer and breast cancer. "Something I think a lot of people may not realize is that there are benefits to the mother as well as the child," Philip said.
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Health Care : Sexual abstinence programmes in US fail
Programmes to encourage sexual abstinence, which American conservatives see as a keystone of efforts to prevent HIV infection, fail just as much in the United States as they do in developing countries, a new study says. Researchers reporting in Saturday's British Medical Journal (BMJ) say an overview of 13 published investigations into abstinence programmes, conducted among nearly 16,000 American youngsters, found no evidence that the schemes work.
The study covered research into the performance of so-called "abstinence only" programmes. These are schemes that encourage teenagers to delay their sexual debut and not have multiple partners after they begin sexual activity. There is no promotion of condoms or other methods of safer sex or contraception.
In contrast, "abstinence plus" programmes are those that promote abstinence but also safer sex.
"No (abstinence only) programme affected incidence of unprotected vaginal sex, number of partners, condom use or sexual initiation," says the paper, written by a trio of researchers at the University of Oxford's Centre for Evidence-based Intervention, England.
Indeed, one of the 13 trials found evidence that youngsters who had been encouraged to be abstinent had a higher rate of sexually-transmitted infections, intercourse and unwanted pregnancy than their counterparts.
This finding was not borne out by data from the 12 other trials, though.
The authors admit that their review had limitations. It did not address oral or anal sex or same-sex behaviour, and the data in the 13 trials was self-reported, which is prone to bias. Nor did any trial specifically assess incidence of the human immunodeficiency virus (HIV).
Despite these weaknesses, they say, the clear picture is that abstinence-only programmes in the United States have made no headway on reducing HIV risk compared with safe-sex programmes -- or even no programmes at all.
Previous reviews about abstinence-only programmes in developing countries have come to the same conclusion.
At present, 33 percent of funds that are allocated for HIV prevention under President George W. Bush's campaign to fight AIDS in Africa and the Caribbean are used for abstinence-only programmes.
In addition, the US House of Representatives has approved funding of 141 million dollars (103 million euros) in fiscal 2008 for "Community-Based Abstinence Education", or CBAE, to US youth. Funding in 2007 was 109 million dollars.
CBAE programmes encourage abstinence from sexual activity outside marriage and describe it as the only certain way to avoid unwanted pregnancies and sexually transmitted diseases.
Abstinence programmes incense many AIDS campaigners, who contend that these initiatives do not work, are often driven by political or religious agendas and drain money from more effective HIV prevention schemes.
source : news.yahoo.com
Health Care : Basic cervical cancer test may help in poor regions
A simple method to screen for cancer of the cervix could help reduce the number of cases of the disease in developing countries where it is often the most common form of cancer for women, researchers said on Thursday. Writing in the Lancet medical journal, the researchers tracked the effectiveness of an inexpensive screening method involving acetic acid, which is a chemical compound in vinegar, and a bright halogen lamp to detect signs pointing to the development of cervical cancer.
Researchers led by Dr. Rengaswamy Sankaranarayanan of the International Agency for Research on Cancer in Lyon, France, used the method to screen tens of thousands of apparently healthy women aged 30 to 59 in the Dindigul district of India for cervical cancer. The women who got the screening method turned out to be 25 percent less likely to develop cervical cancer and 35 percent less likely to die from the disease compared with women who did not have the benefit of the screening method. The researchers reported their results after seven years of study rather than the planned 10 years because the benefit was better than expected.
According to 2002 figures cited by the researchers, cervical cancer is the most common cancer among women in many developing countries, where 85 percent of the estimated 493,000 new cases and 273,000 deaths worldwide occurred.
Cervical cancer is caused by types of a virus called human papillomaviruses, or HPV, that spread through sexual contact. The cervix is the lower part of the uterus.
The development of cervical cancer is slow and its precancerous condition is readily treatable, but only if discovered through screening. Women in many poor nations may not have access to screening. The disease is far less common in many developed countries because of routine use of Pap smears to screen for it.
source : news.yahoo.com
Health care : Coffee May Lower Liver Cancer Risk
People who drink coffee are 41 percent less likely to develop liver cancer compared with folks who don't indulge in the brew, Italian researchers report. "Moreover, the apparent favorable effect of coffee drinking was found both in studies from southern Europe, where coffee is widely consumed, and from Japan, where coffee consumption is less frequent, and in subjects with chronic liver diseases," the researchers wrote in the August issue of Hepatology.
One expert said it's too early to laud coffee as an anti-cancer agent, however. "I don't doubt that the association is true, but it is hard to know the cause," said Dr. Alfred I. Neugut, a professor of medicine and epidemiology at Columbia University College of Physicians and Surgeons and co-director of cancer prevention at New York Presbyterian Hospital in New York City. He was not involved in the study.
Without evidence of a real biological mechanism, the finding could be just a statistical artifact, Neugut said. "What's missing from the study is biological plausibility, so one has to have a degree of skepticism," Neugut said.
However, the findings aren't unique: In February, researchers at Japan's National Cancer Center tracked more than 90,000 older adults for 10 years and found that liver cancer rates fell by half in daily coffee drinkers, compared to people who did not consume the drink. That study was published in the Journal of the National Cancer Institute
More than 17,500 new cases of liver or bile duct cancer are diagnosed each year in the United States, according to the American Cancer Society.
In the new study, a team led by Dr. Francesca Bravi, of the Istituto di Ricerche Farmacologiche Mario Negri in Milan, reviewed 10 published studies on liver cancer that included information on how much coffee the patients drank.
They found a 41 percent reduction in the risk for liver cancer among coffee drinkers compared with those who never drank coffee.
Animal and laboratory studies have suggested that certain compounds in coffee may block enzymes involved in cancer detoxification, the Italian team noted. In addition, caffeine has been shown to have favorable effects on liver enzymes, they said, and coffee has also been linked to a lower risk of liver disease and cirrhosis, which can lead to liver cancer.
"Despite the consistency of these results, it is difficult to derive a causal inference on the basis of the observational studies alone," the authors noted.
"The results from this meta-analysis provide quantitative evidence of an inverse relation between coffee drinking and liver cancer," the Italian group concluded. "The interpretation of this association remains, however, unclear and the consequent inference on causality and worldwide public health implications is still open for discussion."
source : news.yahoo.com
Health Care : For Chinese children lead can be inescapable
Parents around the world may have been shocked this week when 1.5 million Chinese-made Fisher-Price toys were recalled because of excessive lead content, but for mums and dads in China lead poisoning is just a fact of life. Mattel Inc.'s worldwide recall of dozens of products is the latest in a deluge of safety scares that have rattled international consumer confidence in Chinese-made goods.
High levels of lead from toys, water pipes and industry can cause behavioral problems and slow learning among children. But if Beijing was worried about Chinese children being affected, that was not reflected in state-run media on Friday, which were silent about Mattel's recall.
And it was business as usual in the toy section of Beijing's Tianyi department store.
"I do not worry so much, if the toy looks fun for my child, it is okay. My child is already so big, he is not going to put the toy in his mouth," said a Mrs. Zhang, who was buying toys for her four-year-old son.
Indeed, for many parents, lead competes with many other toxins in the heavily polluted country as a source of anxiety.
"There are just too many things to worry about," said Li Huijing, mother of a five-year-old girl. "There are some things I just try not to think about. I try to pay more for good toys."
HOUSE PAINT, OLD PIPES
China has responded to rising consumer expectations by setting stricter standards for lead in toys, most recently introducing new labeling rules. But imposing those standards on the country's vast and fragmented toy sector is difficult.
China makes 75 percent of the world's toys, according to the national chamber of light industry, and many of the thousands of producers are small and resistant to regulation.
They make cheap plastic, metal and wooden toys that -- if regular news reports are a guide -- often have a lead content well above government-set limits.
A 2005 report in a Beijing newspaper cited estimates that 60 percent of Chinese-made toys used paint with lead above internationally accepted limits.
The China Toy Association would not answer questions about the problem.
"The worry isn't big toy makers that also export their products. The worry is small factories," said Feng Guoqiang, a childhood development specialist at Peking University's Health Science Centre.
"It's a matter of money and choice. Some parents can't afford better, so they buy the cheapest on the stall."
Feng said that toys are not the biggest threat. China has phased out leaded petrol, but house paint, old pipes and buildings and belching factories are still big sources of lead.
A study of Chinese cities in 2004 found that 10.5 percent of children had lead levels in their blood of at least 100 microgram's per liter -- a level considered unhealthy by the World Health Organization.
"For us, the problem is the factories. What they make is less important," said Feng.
source : news.yahoo.com
Thursday, August 2, 2007
Health Care : Hormones Might Help Treat Colon Cancer
Hormone deficiency is a prime cause of colon cancer, which means that it may be possible to treat the disease with hormone replacement therapy, a new study suggests.
In experiments with mice, a team at the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, focused on GCC (guanylyl cyclase C), a protein receptor on the surface of intestinal epithelial cells. They looked specifically at two hormones, guanylin and uroguanylin, which regulate the growth of intestinal epithelial cells. Reporting in the Aug. 1 issue of Gastroenterology, the researchers found that GCC helped suppress colon tumor formation in mice.
Study author Dr. Scott Waldman, professor and chair of pharmacology and experimental therapeutics at Jefferson Medical College, noted that early in colon cancer development, the hormones guanylin and uroguanylin are "lost" and not expressed. This disrupts the activity of GCC.
The study finding "converts colon cancer from a genetic disease, which is the way we've all thought about it, to a disease of hormone insufficiency," Waldman said in a prepared statement.
"Not only does this give a new paradigm in how we think about the disease, but it give us a new paradigm for treating the disease -- that is, by hormone replacement therapy," he said.
source : news.yahoo.com
Health Care : Canada cancer vaccination launched in controversy
Canada's biggest province will begin vaccinating Grade 8 girls against cervical cancer this fall, the Ontario government said on Thursday, but some medical experts say the campaign is premature and could lead to more unsafe sex. The Ontario provincial government will offer the vaccine against human papilloma virus (HPV), a cause of cervical cancer, on a voluntary basis to 84,000 school girls aged 13 and 14.
The assumption is that age group has not yet been exposed to the viruses that cause the sexually-transmitted disease. "We're providing this vaccine to women at a young age so we can help prevent the spread of HPV and save lives," Ontario Premier Dalton McGuinty said in a statement.
About 400 Canadian women die from cervical cancer every year, 140 of them in Ontario. It is the second most common cancer in women aged 20 to 44, after breast cancer.
But the vaccine launch was clouded by concerns by some doctors who said more independent study is needed on the effectiveness of the Gardasil vaccine and on the implications for teenage sexual behavior.
In a commentary published online in the Canadian Medical Association Journal on Wednesday, a group of experts pointed out that the reported vaccine trials of Gardasil, manufactured by Merck Frosst Canada, have been funded wholly, or in part, by the manufacturer.
"A careful review of the literature ... reveals a sufficient number of unanswered questions to lead us to conclude that a universal immunization program aimed at girls and women in Canada is, at this time, premature and could possibly have unintended negative consequences for individuals and for society as a whole," said Abby Lippman, an epidemiologist at McGill University in Montreal and lead author of the commentary.
Lippman said there is no urgency for a massive vaccination in Canada, where deaths from cervical cancer have been declining. More needs to be known about the vaccine, including the duration of immunological protection it provides and whether factors such as smoking or poor health influence its effectiveness, she said.
Without a public education campaign, misunderstandings about the vaccine could lead teenagers to practice unsafe sex, Lippman says.
"Might misunderstandings about what the vaccine does and does not do lead to reductions in safer sex practices and Pap screening rates? These are among the questions raised ... and they remain pertinent and unanswered," the article said.
The vaccine program is funded by the federal government and will eventually be implemented by all the provinces, which make their own rules about how to administer it.
The government approved the vaccine in July 2006 to protect against two types of HPV that are responsible for about 70 percent of cervical cancer cases in Canada.
source : news.yahoo.com
Health Care : Medicare plan increases use of costly drugs
New prescription drug coverage in the federal Medicare insurance plan for the elderly drove a boost in use of pricey brand-name drugs such as statins and ulcer medications, an analysis released on Tuesday said. Medicare, available to 43 million elderly and disabled Americans, began to pay for prescription drugs in 2006, the biggest shift in its four-decade history. As a result, more than half of the Medicare population now gets drug coverage through a private plan run by companies such as Humana Inc. or UnitedHealth Group.
The so-called Medicare Part D program boosted sales of cholesterol-lowering statins by 7 percent, and ulcer- and heartburn-treating proton pump inhibitors by 5 percent, the report by pharmaceutical industry consultancy IMS Health said. These first few years of Medicare Part D will be "golden years for enrollees and branded pharmaceutical companies alike," the report said.
Drugmakers strongly backed the 2003 law creating the drug program and are turning out to be, as expected, big financial winners. Private health insurers that largely run the plans were supposed to keep a lid on costs, but spent the first year focusing on enrolling patients, one report author said.
"The first year was about enrollment. To be very blunt, the second year will be about making money," for the plans, Michel Denarie, senior principal at IMS said.
The report forecast "bumps in the road," for both enrollees and drugmakers going forward, as insurers clamp down on brand-drug usage and force more costs onto patients.
About 486 million prescriptions, or 15 percent of all retail prescriptions filled in 2006, came from Part D beneficiaries. These were not all new prescriptions, however, because a sizable amount of people had another form of health insurance the year earlier.
Of the 24 million people in some private Part D plan, 58 percent had some form of private insurance beforehand, although it may have been limited. Another 24 percent of the Part D participants had some coverage under Medicaid, the government health plan for the poor.
Part D drove higher demand for proton pump inhibitors, primarily AstraZeneca Plc's Nexium and prescription forms of Prilosec, because seniors found it cheaper than available alternatives over-the-counter.
Medicare patients in most drug categories were more likely to fill prescriptions, possibly due to the hurdles they had to clear to get into the program, further boosting demand, the report said.
Some drug classes suffered, including a 9 percent drop in schizophrenia drugs such as Eli Lilly and Co.'s Zyprexa. That may be due to confusion in the way the program switched patients on Medicaid to Medicare, Denarie said.
Indicating that insurers will put pressure on seniors to cut costs going forward, there has been increased use in 2007 of pravastatin, the generic of Bristol-Myers Squibb Co.'s Pravachol, Denarie said.
source : news.yahoo.com
Health Care : Medicare plan boosts statins, ulcer drugs
New prescription drug coverage in the federal Medicare insurance plan for the elderly drove a boost in use of pricey brand-name drugs such as statins and ulcer medications, an analysis released on Tuesday said. Medicare, available to 43 million elderly and disabled Americans, began to pay for prescription drugs in 2006, the biggest shift in its four-decade history. As a result, more than half of the Medicare population now gets drug coverage through a private plan run by companies such as Humana Inc. or UnitedHealth Group.
The so-called Medicare Part D program boosted sales of cholesterol-lowering statins by 7 percent, and ulcer- and heartburn-treating proton pump inhibitors by 5 percent, the report by pharmaceutical industry consultancy IMS Health said.
These first few years of Medicare Part D will be "golden years for enrollees and branded pharmaceutical companies alike," the report said.
Drugmakers strongly backed the 2003 law creating the drug program and are turning out to be, as expected, big financial winners. Private health insurers that largely run the plans were supposed to keep a lid on costs, but spent the first year focusing on enrolling patients, one report author said.
"The first year was about enrollment. To be very blunt, the second year will be about making money," for the plans, Michel Denarie, senior principal at IMS said.
The report forecast "bumps in the road," for both enrollees and drugmakers going forward, as insurers clamp down on brand-drug usage and force more costs onto patients.
About 486 million prescriptions, or 15 percent of all retail prescriptions filled in 2006, came from Part D beneficiaries. These were not all new prescriptions, however, because a sizable amount of people had another form of health insurance the year earlier.
Of the 24 million people in some private Part D plan, 58 percent had some form of private insurance beforehand, although it may have been limited. Another 24 percent of the Part D participants had some coverage under Medicaid, the government health plan for the poor.
Part D drove higher demand for proton pump inhibitors, primarily AstraZeneca Plc's Nexium and prescription forms of Prilosec, because seniors found it cheaper than available alternatives over-the-counter.
Medicare patients in most drug categories were more likely to fill prescriptions, possibly due to the hurdles they had to clear to get into the program, further boosting demand, the report said.
Some drug classes suffered, including a 9 percent drop in schizophrenia drugs such as Eli Lilly and Co.'s Zyprexa. That may be due to confusion in the way the program switched patients on Medicaid to Medicare, Denarie said.
Indicating that insurers will put pressure on seniors to cut costs going forward, there has been increased use in 2007 of pravasatain, the generic of Bristol-Myers Squibb Co.'s Pravachol, Denarie said.
source : news.yahoo.com
Health Care : Most Sleepless Kids Prescribed Drugs
More than 80 percent of American children who visit a doctor for help combating sleep problems are given some form of prescription medication, new research has found, despite the fact that no sleeping pills are currently approved for use in kids. "The concern with sleep medications is that we don't know how much to use and how long to use these drugs for children," explained study co-author Milap C. Nahata. "This is because many drugs used for pediatric care in general -- including sleep medications -- have been well-studied and approved by the FDA but have not been studied for effectiveness and safety among children."
Nahata is a professor of pediatrics and internal medicine and a division chair at the Ohio State University College of Pharmacy in Columbus. His team's study is being published in the Aug. 1 issue of Sleep. The new findings complement a 2004 National Sleep Foundation poll that revealed that sleep difficulties are extremely widespread among the young.
That survey found that 60 percent of American boys and girls under the age of 11 experience some kind of trouble getting shut-eye at least a few nights a week, while nearly three-quarters of parents indicated that they would like to alter something about their child's sleep behavior.
Nahata and his colleagues noted that, in the United States, about 75 percent of all prescription drugs are not labeled for pediatric use, and not a single insomnia drug is indicated for use among young patients.
In their study, the authors analyzed data collected between 1993 and 2004 by the National Ambulatory Medical Care Survey.
The researchers focused on information concerning survey patients 17 or younger with sleep difficulties who sought care as outpatients.
During that 12-year period, approximately 18.6 million visits were registered by children seeking help with a sleep disturbance. The largest slice -- 36 percent -- involved kids six to 12 years of age. Adolescents (aged 13-17) accounted for another third of the patient pool.
Just over a third of the patients were seen by pediatricians, while under a quarter sought care from psychiatrists. Another 13 percent visited family practice doctors.
In terms of therapies prescribed, the researchers found that 7 percent of the patients were recommended diet and nutritional counseling, while 22 percent were offered behavioral therapy. Mental health and stress management treatment was offered to 17 percent of patients.
By contrast, 81 percent of the children and teens were prescribed some sort of medication for their sleep issues.
Specifically, about a third were prescribed antihistamines, about a quarter were offered alpha-2 agonists, 15 percent were offered benzodiazepines, and 6 percent received prescriptions for antidepressants. A combined regimen of medication plus behavioral therapy was prescribed in just under a fifth of cases.
Patients who sought care from a psychiatrist were more than three times as likely to be prescribed a drug for their sleep trouble than those who visited a general practice physician.
The study did not explore how often the young patients actually filled their prescriptions, or why doctors so readily turned to pharmaceutical solutions to pediatric sleep woes.
Nahata emphasized, however, that his study simply tracked the types of sleep medicines being prescribed for children and the frequency of their usage -- it was not an attempt to gauge the appropriateness of any particular therapy. He believes further research is needed to explore such issues.
"And I'll say that, legally, I'm glad physicians can prescribe these drugs off-label for children when they need to," he added. "Because sometimes they can help. But the point is that, when these drugs are utilized for pediatric care, we need to exercise caution."
But Dr. Gregg Jacobs, an insomnia specialist with the Sleep Disorders Center at the University of Massachusetts Medical School in Worcester, Mass., said prescribing drugs often sidesteps the underlying causes of sleep trouble.
"Children are in the golden years of sleep," he observed. "It's not normal for them to have sleep problems. So, if they do, then you know something's wrong. And medicating the child doesn't get to the heart of the problem. It's more important to figure out what's going on. Is it stress, caffeine, a problem in the home environment?"
Jacobs added that, despite heavy marketing by drug companies designed to convince patients and physicians that prescription sleep aids are an easy and cheap solution, he believes that such therapies are only "marginally effective," regardless of the patient's age.
"And there are many side effects among adults that may be even more serious among children," he cautioned. "Patients may develop tolerance or dependence on these medications, and they often cause daytime sedation and sometimes amnesia. And probably the biggest shocking thing is that regular nightly use of sleeping pills is associated with an increased mortality rate among adults. This is shown in a dozen studies."
"Besides which, behavioral methods of treatment are extremely effective," added Jacobs. "So, why would you want to risk giving this medication to children, when they're probably not very effective and would be masking the real problem in any case? Sleeping pills should be a last resort."
source : news.yahoo.com
Health Care : CDC's 'Preteen Vaccine' Campaign Aimed at Parents
U.S. health officials are urging parents to make sure their 11- and 12-year-old children are vaccinated against meningitis, tetanus, diphtheria, whooping cough, and cervical cancer, in a new campaign launched Wednesday. Experts at the U.S. Centers for Disease Control and Prevention (CDC) say the Preteen Vaccine campaign informs parents, caregivers, family doctors, and pediatricians about new CDC vaccination recommendations for children ages 11 and 12.
The CDC recommends MCV4, which protects against meningitis and its complications and Tdap, a booster against tetanus, diphtheria and pertussis (whooping cough). In addition, girls should receive the human papilloma virus (HPV) vaccine, which protects against the most common types of cervical cancer, the CDC said.
"Many parents do not realize that some childhood vaccines, such as those for tetanus and whooping cough, wear off over time and, as they get older, young people are at risk of exposure to different diseases at school, camp or in other new situations," Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said in a prepared statement.
The launch of the Preteen Vaccine campaign coincides with National Immunization Awareness Month in August. The American Academy of Pediatrics (AAP), a partner with the CDC in the Preteen Vaccine campaign, says that parents should also schedule a routine checkup for children ages 11 and 12.
"The preteen checkup is an important time to make sure children are also caught up on important childhood immunizations such as chickenpox, hepatitis B and measles-mumps-rubella (MMR). Depending on their health and medical history, some preteens may require additional vaccines," AAP President-Elect Dr. Renee Jenkins said in a prepared statement.
source : news.yahoo.com
Mild cognitive deficits seen after heart surgery
Children who undergo surgery to correct congenital heart defects may experience mild learning difficulties when they enter elementary school, according to study findings published in the Journal of Pediatrics. As advances have been made in the surgical treatment of children with congenital heart disease, developmental outcomes have become the major focus of research, note Dr. Marijke Miatton and colleagues from Ghent University, Belgium.
In their study, the researchers examined 43 children who had congenital heart disease and were an average of nine years old, who were matched to 43 healthy children. An abbreviated intelligence scale (Wechsler Intelligence Scale for Children) and a developmental neuropsychological assessment battery were used to evaluate the children.
The intelligence scale included two verbal subtests and two performance subtests; and the developmental battery tested neuropsychological development in five functional areas.
Compared with the healthy children, the children with congenital heart disease had statistically significant lower IQ scores -- 107.0 vs 95.6, respectively. They also scored significantly lower on the Picture Completion and Vocabulary sections of the Wechsler scale.
Miatton's team observed that on the developmental battery the children with congenital heart disease had lower scores in the cognitive areas of Sensorimotor Functioning, Language, Attention and Executive Functioning, and Memory. Children with congenital heart disease also showed more impulsive behavior than the healthy children.
Summing up the results, the researchers conclude that between 6 and 12 years after surgery, children with congenital heart disease have primarily mild motor deficits and subtle difficulties with language tasks. The areas of attention, memory and executive functioning (the ability to absorb, interpret and make decisions based on information provided) also appear to be involved, but to a lesser degree.
Miatton and colleagues point out that this information may lead to learning programs that are tailored to the needs of these children that will significantly improve their outcomes.
source : news.yahoo.com
Kids often get unapproved drugs for sleep problems
Doctors commonly prescribe drugs to children and teens with sleep difficulties that are not approved for use by patients in these age groups, a new study shows. Eighty-one percent of physician visits for sleep problems by children and teens ended in a prescription for some type of medication, most commonly a drowsiness-promoting antihistamine or a sedative, Dr. Sasko D. Stojanovski of The Ohio State University College of Pharmacy in Columbus and colleagues found.
There is currently no Food and Drug Administration-approved medication for treating insomnia in children, the researchers point out. The reasons that these drugs are prescribed, along with strategies to minimize the use of unapproved drugs in this population need to be examined, the researchers report in the medical journal Sleep.
To better understand how frequently children are prescribed drugs for their sleep problems, Stojanovski and his colleagues looked at data collected between 1993 and 2004 from the National Ambulatory Medical Care Survey on patients ages 17 or younger, which included roughly 18.6 million physician visits. School-aged children between 6 and 12 years old represented the greatest proportion of these visits.
Doctors recommended diet and nutritional approaches (for example, limiting caffeine in food and beverages) for 7 percent of patients. Psychotherapy was recommended for 12 percent, and mental health and stress management therapy for 17 percent.
However, as mentioned, 81 percent of the young patients were offered a prescription for medication. This included an antihistamine, such as hydroxyzine, in 33 percent; sedative drugs, known as alpha-2 agonists, in 26 percent; benzodiazepines, such as Valium or Ativan, in 15 percent; antidepressants in 6 percent, and non-benzodiazepines in 1 percent. Nineteen percent of the patients were given a combination of drugs.
Psychiatrists were 3.6 times as likely as other doctors to prescribe a medication for sleep problems, while pediatricians were about twice as likely as other physicians to do so.
The researchers point out that their study was unable to investigate whether children were taking over-the-counter sleep-inducing drugs or herbal medicines.
"The findings of this study suggest that physicians frequently prescribed medications for sleep difficulties in children in U.S. outpatient settings," they conclude. "Of particular concern is the prescribing of many unapproved medications for this population."
source : news.yahoo.com
Kids often get unapproved drugs for sleep problems
Doctors commonly prescribe drugs to children and teens with sleep difficulties that are not approved for use by patients in these age groups, a new study shows. Eighty-one percent of physician visits for sleep problems by children and teens ended in a prescription for some type of medication, most commonly a drowsiness-promoting antihistamine or a sedative, Dr. Sasko D. Stojanovski of The Ohio State University College of Pharmacy in Columbus and colleagues found.
There is currently no Food and Drug Administration-approved medication for treating insomnia in children, the researchers point out. The reasons that these drugs are prescribed, along with strategies to minimize the use of unapproved drugs in this population need to be examined, the researchers report in the medical journal Sleep.
To better understand how frequently children are prescribed drugs for their sleep problems, Stojanovski and his colleagues looked at data collected between 1993 and 2004 from the National Ambulatory Medical Care Survey on patients ages 17 or younger, which included roughly 18.6 million physician visits. School-aged children between 6 and 12 years old represented the greatest proportion of these visits.
Doctors recommended diet and nutritional approaches (for example, limiting caffeine in food and beverages) for 7 percent of patients. Psychotherapy was recommended for 12 percent, and mental health and stress management therapy for 17 percent.
However, as mentioned, 81 percent of the young patients were offered a prescription for medication. This included an antihistamine, such as hydroxyzine, in 33 percent; sedative drugs, known as alpha-2 agonists, in 26 percent; benzodiazepines, such as Valium or Ativan, in 15 percent; antidepressants in 6 percent, and non-benzodiazepines in 1 percent. Nineteen percent of the patients were given a combination of drugs.
Psychiatrists were 3.6 times as likely as other doctors to prescribe a medication for sleep problems, while pediatricians were about twice as likely as other physicians to do so.
The researchers point out that their study was unable to investigate whether children were taking over-the-counter sleep-inducing drugs or herbal medicines.
"The findings of this study suggest that physicians frequently prescribed medications for sleep difficulties in children in U.S. outpatient settings," they conclude. "Of particular concern is the prescribing of many unapproved medications for this population."
source : news.yahoo.com
India monitors four children after bird flu outbreak
India monitors four children after bird flu outbreak
Health officials in India were monitoring four children suffering from fever on Wednesday after they had contact with dead or sick poultry in Manipur state, where authorities are fighting a bird flu outbreak in fowl. The children have been restricted to their homes and are being visited twice a day by medical professionals, said Vineet Chawdhry, joint secretary in the ministry of health."We are being extra careful," Chawdhry said, adding that throat swabs and blood samples taken from the children had been sent to a federal laboratory, where tests for the H5N1 strain of bird flu will be carried out. The children live within a 5-km (3-mile) radius of a small poultry farm where more than 130 chickens died last month from the H5N1 virus.
Health officials have checked more than 235,000 people around the affected farm since the weekend for flu symptoms, while veterinary workers have culled a similar number of birds in the remote northeastern state.
India had two major flare-ups of bird flu in its western region last year.
Manipur neighbors Myanmar, which has battled several outbreaks of bird flu in chickens this year, including one reported last week.
Globally, at least 192 people have died due to bird flu out of 319 cases since 2003, the World Health Organization says.
The H5N1 strain remains mainly a bird virus but experts fear it may mutate into a form that passes easily between humans, triggering an influenza epidemic in which millions could die.
source : news.yahoo.com
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Health Care : Dietary carbs linked to vision loss
The carbohydrates present in a diet can influence the risk of age-related macular degeneration (AMD), the most common cause of vision loss in older adults, according to a report in the American Journal of Clinical Nutrition. "AMD appears to share several carbohydrate-related mechanisms and risk factors with diabetes-related diseases, including (eye) and cardiovascular disease," write Dr. Allen Taylor, of Tufts University, Boston, and colleagues. "However, to date, only one small study has addressed this issue."
To investigate further, the researchers conducted a study of 4,099 participants, aged 55 to 80 years, in the Age-Related Eye Disease Study. The team classified a total of 8,125 eyes into one of five AMD groups based on the severity of the disease and other factors.
Regular consumption of a diet with a high-glycemic index - a diet containing carbs that quickly raise blood sugar levels -- significantly increased the risk of AMD relative to regular consumption of a diet with a low-glycemic index. The researchers calculate that 20 percent of AMD cases could have been prevented if subjects had consumed diets with a low-glycemic index.
source : news.yahoo.com
Health Care : Overweight women at risk of pregnancy complications
Health Care : Overweight women at risk of pregnancy complications
The heavier a woman is before pregnancy, the greater her risk of a range of pregnancy complications, a large study suggests. Using data from more than 24,000 UK women who gave birth between 1976 and 2005, researchers found that the risk of problems, such as high blood pressure, pre-eclampsia and premature delivery climbed in tandem with a woman's pre-pregnancy weight.
The findings, published in the online journal BMC Public Health, add to evidence that obesity is a risk for mothers and newborns. They also support the belief that all pregnancies in obese women should be considered "high risk," and managed accordingly, conclude the study authors, led by Dr. Sohinee Bhattacharya of Aberdeen Maternity Hospital.
The researchers found that compared with normal-weight women, obese women were 50 percent more likely to have post-delivery bleeding and twice as likely to deliver prematurely. They were also more likely to need an emergency C-section or to have labor induced.
Morbidly obese women had the highest risk of suffering pre-eclampsia, a potentially serious pregnancy complication marked by a sudden rise in blood pressure and kidney abnormalities.
In contrast, the study found that women who were underweight before pregnancy tended to have the lowest risk of all these complications. They were, however, more likely than normal-weight women to have an underweight newborn.
The results add to growing evidence of the importance of a mother's weight in pregnancy outcomes, according to Bhattacharya's team.
"The evidence for obesity as an important complication in pregnancy is mounting," the researchers write, it is time for physicians to be aware of these findings and start using them in their practice.
Besides good prenatal care, they note, this means counseling overweight women to lose weight before they become pregnant.
source : news.yahoo.com
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