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High Natural Estrogen Might Raise Women’s Stroke Risk

2011-06-21T05:46:00.000-07:00

WEDNESDAY, March 10 (HealthDay News) — Higher levels of naturally occurring estrogen are tied to a rising risk of stroke in postmenopausal women who aren’t on hormone therapy, a new study finds.

U.S. researchers analyzed medical histories and blood samples from more than 9,700 generally healthy postmenopausal white women recruited for an osteoporosis study in the late 1980s. None of the women were on hormone therapy.

During eight years of follow-up, 247 of the women suffered a first stroke. Those women were compared with 243 women who did not have a stroke.

The researchers found that women with the highest levels of estradiol (the most potent naturally occurring estrogen) were 2.3 times more likely to suffer a stroke than those with the lowest levels.

“These results raise the possibility that estradiol levels might be a decision-making tool for health care providers and their female patients when discussing stroke and weighing the option of estrogen therapy,” study leader Jennifer Lee, an endocrinologist and epidemiologist at the University of California, Davis Health System, said in a news release.

The researchers also found that women with waist sizes larger than 34 inches had higher estradiol levels and greater stroke risk than those with smaller waist sizes.

“In women with waist girths greater than 34 inches, high estradiol levels conferred a six-fold greater stroke risk over low levels,” Lee said. “This might be because fat around the midsection is a source of naturally occurring estrogen. Reducing waist size would be a good defense against future stroke.”

The study appears in a recent issue of the Archives of Neurology.

More information

The National Stroke Association has more about women and stroke.

— Robert Preidt

SOURCE: University of California, Davis Health System, news release, March 8, 2010

Last Updated: March 10, 2010

Copyright © 2010 HealthDay. All rights reserved.

Chocolate May Make Some Strokes Less Likely

2011-06-21T05:44:00.001-07:00

WEDNESDAY, March 3 (HealthDay News) — In news that’s sure to delight chocolate lovers, a Harvard study finds that a couple of squares of dark chocolate a day might reduce the risk of a hemorrhagic stroke, by 52 percent.

Unfortunately for chocolate fans, though, the same research also found that chocolate does not appear to have a protective benefit for the most common type of stroke.

People who have a stroke have either an ischemic or a hemorrhagic stroke. An ischemic stroke occurs when a blood vessel that supplies blood to the brain becomes blocked, either partially or completely. This type of stroke accounts for about 80 percent of all strokes,
according to the U.S. National Institute of Neurological Disorders and Stroke. Hemorrhagic strokes, which occur when a blood vessel in the brain bursts and bleeds into the brain, make up about 20 percent of all strokes.

“There are several possible mechanisms, but the effect of rich cocoa on cardiovascular health seems to be through its effect on blood pressure, and the capacity to improve the flexibility of the blood vessels,” said study author Dr. Martin Lajous, a doctoral candidate at the Harvard School of Public Health in Boston.

“In the context of an appropriate intake, eating small amounts of cocoa could be beneficial,” Lajous said. “There are several possible mechanisms, but the effect of rich cocoa on cardiovascular health seems to be through its effect on blood pressure, and the capacity to improve the flexibility of the blood vessels.”

But Lajous added that “it’s difficult to understand why it appears to just benefit hemorrhagic stroke.”

The findings were to be presented Wednesday at the American Heart Association’s conference on cardiovascular disease epidemiology and prevention in San Francisco.

The benefit attributed to cocoa stems from substances it contains known as flavonoids, which are believed to help protect against certain cardiovascular disease risk factors, such as blood pressure and blood clotting.

In the study, the researchers reviewed data from 4,369 middle-age French women, none of whom had any evidence of heart disease at the start of the study in 1993. The women’s average body-mass index was 23, a number that’s considered normal weight.

When the study began, the women provided a detailed account of the foods they’d eaten over a 24-hour period. The researchers calculated the cocoa intake by looking for seven foods in particular: plain chocolate bars, candy bars, chocolate drinks, chocolate mousse, chocolate-filled croissant, cookies with chocolate and cakes containing chocolate.

In the next 12 years, 493 of the women were diagnosed with some type of cardiovascular disease: 200 had heart attacks and 293 had a stroke. Of the strokes, 189 were ischemic and 91 were hemorrhagic.

After adjusting the data to account for known cardiovascular disease risk factors — such as smoking, physical activity, weight, blood pressure and cholesterol levels and diabetes — the researchers found no statistically significant association in the risk for cardiovascular disease between the highest levels of cocoa consumption and the lowest.

However, when they broke down the data by type of stroke, they found a statistically significant reduction for women who’d had hemorrhagic strokes and had consumed the most chocolate. In women who ate more than 9 grams of chocolate daily, the risk for hemorrhagic stroke was 52 percent lower than it was for those who consumed less than 0.1 grams of chocolate a day.

Lajous said that 9 grams is about two or three squares of chocolate, and he noted that the French women in the study usually consumed dark chocolate, containing about 35 percent cocoa.

“Our results are intriguing, but need to be confirmed in other studies,” he said.

And not everyone is on board with the concept.

“It would be great if chocolate really worked to prevent heart disease and stroke, but I think it’s wishful thinking,” said Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at the New York University Langone Medical Center in New York City. “Although the idea that flavonols — the bitter part of the chocolate — can help your cardiovascular health may have some merit, there’s no strong scientific proof.”

Also, he’s puzzled by the study’s finding that cocoa might protect against one type of stroke but not the other. “It’s hard to understand why there’s no benefit for heart disease and ischemic stroke,” Siller said. “Anything that helps stroke should help both types.”

People who add such things as chocolate or red wine to their diet with the hope of helping to prevent heart disease, he said, also need to be aware that they’re taking in additional calories. “If you start adding weight, you may give yourself additional risk factors for stroke and heart disease,” Siller said.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.

By Serena Gordon
HealthDay Reporter

SOURCES: Martin Lajous, M.D., doctoral candidate, Harvard School of Public Health, Boston; Keith Siller, M.D., medical director, Comprehensive Stroke Care Center, New York University Langone Medical Center, New York City; March 3, 2010, presentation, American Heart Association’s Cardiovascular Disease Epidemiology and Prevention Annual Conference, San Francisco

Last Updated: March 04, 2010

Copyright © 2010 HealthDay. All rights reserved.

Study Unravels Link Between Stress and Chronic Health Issuest

2011-06-21T05:43:00.000-07:00

WEDNESDAY, Feb. 23 (HealthDay News) — People’s emotional response to challenges may affect how their body reacts to stress, according to a new study.

To reach that conclusion, researchers from the University of Pittsburgh had individuals make a speech in a laboratory in front of a video camera and a panel of judges. The participants’ physical responses were monitored during the speech, and they were later asked about the emotions they felt while delivering the speech.

Those who reported high levels of anger and anxiety after their speech had greater increases in a marker of inflammation called interleukin-6, compared with those who remained relatively calm.

The findings may explain why some people with high levels of stress experience chronic health problems, the researchers said.

The study is published in the February issue of the journal Brain, Behavior, and Immunity.

“Our results raise the possibility that individuals who become angry or anxious when confronting relatively minor challenges in their lives are prone to increases in inflammation,” Anna Marsland, an associate professor of psychology and nursing and the study’s lead author, said in a journal news release.

“Over time, this may render these emotionally reactive individuals more vulnerable to inflammatory diseases, such as cardiovascular disease,” she noted.

More information

The American Heart Association has more about stress and how to manage it.

– Robert Preidt

SOURCE: Brain, Behavior, and Immunity, news release, Feb. 17, 2011

Last Updated: Feb. 23, 2011

Copyright © 2011 HealthDay. All rights reserved.

Stress Fractures Hitting High School Athletes

2011-06-21T05:41:00.000-07:00

By Alan Mozes
HealthDay Reporter

TUESDAY, Feb. 15 (HealthDay News) — Stress fractures linked to overuse may be more common than thought among high school athletes, especially among those who participate in running-related sports, a new study finds.

“The risk is that we’re often dealing with very dedicated athletes who are constantly trying to perfect their performance, and sometimes they overdo it,” said Dr. Letha Y. Griffin, an Atlanta-based team orthopedist at Georgia State University and a staff physician with Peachtree Orthopeadic Clinic. Griffin was not involved with the study.

Stress fractures occur when bones face repetitive strain over a long period of time, especially when bones are not given time to heal.

The new study found that risk factors for stress fractures injuries vary by gender, with young female athletes having a heightened risk for fracture at a younger age and lower body mass than male students.

Still, “our study is suggestive that this is a big problem for all student athletes,” said study author Dr. Andrew D. Goodwillie, chief orthopedic resident with the Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey in New Brunswick, N.J.

“The fact that we picked up so many stress fractures in such a short amount of time, and that we’re finding that there are clear risk associations to the type of training regimens and dietary habits of the student athletes who are experiencing them, indicates that we’re really just hitting the tip of the iceberg in terms of this issue,” he said.

Goodwillie is slated to present the findings on Tuesday at the annual meeting of the American Academy of Orthopaedic Surgeons in San Diego.

Between 2007 and 2010, Goodwillie and his team tracked the frequency and nature of stress fractures among student athletes enrolled at 57 participating high schools.

At each school, athletic trainers were asked to fill out information forms outlining each young athlete’s sport history, skill level, training intensity, dietary routine and fracture details.

Among the 230 fractures in evidence among 189 athletes (74 boys, 115 girls), the tibia (shinbone) was the most likely to be affected, making up nearly half of all cases. Nearly 20 percent of cases involved the metatarsal bones of the feet, while the fibula (smaller bone behind tibia) was affected in 10 percent of fractures, followed by fractures to the pelvic bone, hind foot and femur (thighbone) .

More than half (53 percent) of the fractures were experienced by varsity athletes, the researchers noted.

Among male athletes, track was the biggest culprit, accounting for more than a quarter of fractures. This was followed by football (23 percent), and cross-country (19 percent).

Among female athletes, track was also the number one source for fractures (28 percent), trailed by cross-country (23 percent).

Gender differences emerged. Boys tended to get injured at a slighter older age than girls, and at a higher body-mass index, the study found. And while boys undertook more intense weight-lifting routines, they also tended to sleep more than their female counterparts, giving bones more time to heal.

“Although there hasn’t been anything out there before that specifically looked at athletes under the age of 18, these findings definitely go along with the adult data we have,” Goodwillie noted. “Basically, the fractures we see are related to running sports like cross-country, track and field, basketball and soccer, in both males and females. You don’t see it in sports such as wrestling and swimming, the non-impact type sports.”

According to Griffin, “the general message here is that fractures can occur with frequency in all high school athletes.”

She believes that “the focus should be on helping kids think about what they need to do to be the best at their sport and perform maximally, rather than by warning them that they might get a stress fracture. Because frankly, young people are never going to think that it’s going to happen to them.”

“So, first I would tell them that if they don’t get enough rest they won’t get the time at night to repair the tissue damage that occurs during the day,” Griffin advised. “And they need to do that to be good at their sport, and also not to be injured.”

“They also need to eat properly,” she added. “You can’t run a car on no gas. Specifically, I would tell them that they need calcium, because they’re building up bone density during the teenage years, up until the age of 25. Drink skim milk if you’re worried about calories. And they need sunshine, so they can get vitamin D [made when sunlight hits the skin] to incorporate into the bones.”

“Basically,” said Griffin, “many of the good things that momma always told you are key, if you really want to be good at your sport and stay healthy.”

More information

For more on stress fractures and high school athletes, visit the American Academy of Orthopaedic Surgeons.

SOURCES: Andrew D. Goodwillie, M.D., chief orthopedic resident, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, N.J.; Letha Y. Griffin, M.D, Ph.D., team orthopedist, Georgia State University, and staff physician, Peachtree Orthopaedic Clinic, Atlanta; Feb. 15, 2011, presentation, American Academy of Orthopaedic Surgeons Meeting, San Diego

Last Updated: Feb. 15, 2011

Copyright © 2011 HealthDay. All rights reserved.

Smoke-Free Laws Moving Ahead in U.S.

2011-06-21T05:39:00.000-07:00

THURSDAY, April 21 (HealthDay News) — Smoking bans in workplaces, restaurants and bars across the United States are now in place in half the states, and all such venues across the country could be smoke-free by 2020, government researchers reported Thursday.

Indoor areas of worksites, restaurants and bars are major sources of secondhand smoke, and approximately 88 million nonsmoking Americans 3 and older are still exposed to it each year, said the researchers at the U.S. Centers for Disease Control and Prevention.

In a detailed report using 10 years of data on state smoking restrictions from the CDCs State Tobacco Activities Tracking and Evaluation System database, the researchers found that:

    25 states and the District of Columbia have enacted comprehensive smoke-free laws in workplaces, restaurants and bars. The move began with Delaware in 2002, New York in 2003, Massachusetts in 2004, and Rhode Island and Washington in 2005. In 2006 and 2007, Arizona, Colorado, D.C., Hawaii, New Jersey, Minnesota, New Mexico and Ohio enacted laws; Illinois, Iowa, Kansas, Maryland, Maine, Michigan, Montana, Nebraska, Oregon, South Dakota, Utah, Vermont and Wisconsin acted in 2008- 2010.
    Ten states have laws that ban smoking in at least one or two of the three venues.
    Eight states have less-restrictive smoking laws, which allow smoking in designated areas or in areas with separate ventilation.
    Seven states still have no smoking restrictions for any of the three venues: Indiana, Kentucky, Mississippi, South Carolina, Texas, West Virginia and Wyoming.

The study appears in the April 22 issue of the CDC’s Morbidity and Mortality Weekly Report.

“Eliminating smoking from worksites, restaurants and bars is a low-cost, high-impact strategy that will protect nonsmokers and allow them to live healthier, longer, more productive lives while lowering health care costs associated with secondhand smoke,” CDC director Dr. Thomas R. Frieden said in an agency news release. “While there has been a lot of progress over the past decade, far too many Americans continue to be exposed to secondhand smoke at their workplaces, increasing their risk of cancer and heart attacks.”

“Secondhand smoke is responsible for 46,000 heart disease deaths and 3,400 lung cancer deaths among nonsmokers each year,” Ursula Bauer, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion, added in the news release. “Completely prohibiting smoking in all public places and workplaces is the only way to fully protect nonsmokers from secondhand smoke exposure.”

The 2010 Surgeon General’s report reiterated that any exposure to tobacco smoke — including secondhand smoke — can cause damage to the body’s organs and DNA, the CDC news release said.

More information

The U.S. Environmental Protection Agency has more about the health effects of secondhand smoke.

— Robert Preidt

SOURCE: U.S. Centers for Disease Control and Prevention, news release, April 21, 2011; CDC’s Morbidity and Mortality Weekly Report, April 22, 2011

Last Updated: April 21, 2011

Copyright © 2011 HealthDay. All rights reserved.

For Nonsmokers, Healthy Living Cuts Death Rate in Half: Study

2011-06-21T05:38:00.000-07:00

TUESDAY, April 19 (HealthDay News) — A healthy lifestyle nearly halves nonsmokers’ risk of death from cancer, cardiovascular disease and other causes, a new study finds.

Most lifestyle guidelines for reducing the risk of illness and death warn against smoking or other types of tobacco use. But about 80 percent of Americans are never or former smokers, so the authors of this study wanted to assess the impact of healthy living recommendations other than tobacco avoidance.

They looked at diet and lifestyle questionnaires filled out in 1992 and 1993 by almost 112,000 non-smoking women and men in the Cancer Prevention Study. The participants were scored based on their adherence to American Cancer Society prevention guidelines regarding body mass index, physical activity, diet and alcohol consumption.

After 14 years of follow-up, participants who were highly compliant with the recommendations had a 42 percent lower risk of death vs. those who were the least compliant. Among those with higher compliance scores, the risk of cardiovascular-related death was 58 percent lower for women and 48 percent lower for men, and the risk of cancer death was 24 percent lower in women and 30 percent lower in men.

The findings were similar for both never and former smokers.

The study appears online in the journal Cancer Biomarkers, Epidemiology, and Prevention.

More information

The American Academy of Family Physicians offers tips for maintaining your health.

— Robert Preidt

SOURCE: American Cancer Society, news release, April 14, 2011

Last Updated: April 19, 2011

Copyright © 2011 HealthDay. All rights reserved.

Tossing and Turning May Fuel Marital Discord

2011-06-15T08:00:00.000-07:00

By Ella Quittner

MONDAY, June 13, 2011 (Health.com) — The snooze button on your alarm clock may not be the only casualty of a sleepless night.

A new study of married couples suggests that when wives have trouble falling asleep, the quality of their relationship with their husband suffers. The longer it took women to drift off, the study found, the more likely both partners were to report negative interactions with their spouse—such as feeling ignored or criticized—the following day.

The same wasn’t true for the men, however. The researchers found no relationship between the amount of time it took a husband to fall asleep and the couple’s interactions the following day. So why didn’t the husbands’ sleep affect next-day interactions, too?

“There is some evidence to show that women tend to be more communicative and expressive in relationships and men may be more repressive,” says the lead researcher, Wendy Troxel, PhD, an assistant professor of psychiatry and psychology at the University of Pittsburgh. “After a bad night of sleep, women may be more likely to express irritability or frustration, whereas men might be more likely to withhold that.”

Research on sleep problems such as insomnia has tended to focus on the individual who is directly affected, Troxel and her colleagues note. But, they add, their findings suggest that sleep problems should perhaps be viewed—and treated—in a broader context that takes into account the patient’s relationships and social interactions.

“Sleep doesn’t occur in a vacuum,” says Lauren Hale, PhD, a sleep expert and associate professor of preventive medicine at Stony Brook University, in New York. “It’s embedded in the social world, and particularly relevant to one’s romantic relationships.”

Hale, who was not involved in the new study but has researched the effect of social factors on sleep, says that the person you share your bed with each night can have a significant influence on your own sleep quality. “It may not be simply your own choices that affect your sleep,” she says. “If your partner snores or gets into bed two hours later than you and wakes you up, that will affect your sleep.”

Troxel presented preliminary results from the study at an annual meeting of the Associated Professional Sleep Societies in Minneapolis on Monday. Unlike studies published in medical journals, the findings have not been thoroughly vetted by other experts

Sleep-Deprived People May Crave High-Calorie Foods

2011-06-15T07:58:00.000-07:00

By Denise Mann
HealthDay Reporter

MONDAY, June 13 (HealthDay News) — People who are sleepy by day may be unable to resist calorie-laden comfort foods, new research shows.

The findings, slated for presentation Monday at a meeting of the Associated Professional Sleep Societies in Minneapolis, Minn., add to a growing body of research linking lack of sleep to weight gain and obesity.

In the new study of 12 adults aged 19 to 45, people who were sleepy during the daytime showed decreased activation in the part of their brain that inhibits
behavior (prefrontal cortex) when they were shown photos of high-calorie foods such as hamburgers, French fries, pizza, cakes and ice cream, compared with images of low-calorie, healthier foods.

“When you are sleepy, there’s a good chance that you won’t be able to control how much you eat,” said lead study author William Killgore, an assistant professor of psychology at Harvard Medical School and McLean Hospital in Belmont, Mass. “You may be drawn to unhealthy foods because you are not putting the brakes on as well as you would be if you were well-rested.”

Researchers looked at activity in the brain’s prefrontal cortex via functional MRI (fMRI) scans. Daytime sleepiness was measured using a standardized scale that looks at how often a person dozes off during certain situations such as reading or watching TV.

None of the individuals in the new study had sleep disorders; all participants fell within a normal range of sleepiness. The sleepier they were within this range, however, the less their brain responded when looking at images of fattening foods.

The sleepiest people in the study were also more likely to say they were hungrier than their less-sleepy counterparts.

“Not getting enough sleep is taking its toll on us,” Killgore said.

Now, Killgore and colleagues plan to expand the study and see if the results hold up in larger numbers of people. He also wants to determine how sleepiness affects exercise habits.

This study provides another piece of the sleep-weight puzzle, said Dr. Shelby Freedman Harris, director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center in the Bronx, N.Y.

“We already know that when you don’t sleep enough, it affects your hormone levels, and now we see how sleepiness can affect your ability to resist high-fat foods,” she said.

Studies have shown that inadequate sleep leads to an increase in the hormone ghrelin, which tells you when to eat, and decreases in the hormone leptin, which tells you to stop eating, Harris said.

With insufficient sleep, “you have less leptin and more ghrelin, which tells you to keep on eating , and your prefrontal cortex isn’t working as well and can’t stop you from overeating,” she said.

“Get more sleep,” she advised. “Try to go to bed an hour earlier each night, limit caffeine and alcohol, and try to exercise five to six hours before bed,” she said. “Sleep is like a dimmer switch; you have to wind down first.”

Dr. Louis Aronne, director of the Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City, says the findings make sense.

“When you don’t get enough sleep, the important hormones change in a direction that would tend to cause weight gain, and this finding shows how it is expressed behaviorally,” he said. High calorie, fattening foods provide a sudden, but not sustainable, burst of energy, which is why sleepy people are drawn to them, he explained.

“It is harder to stick with a plan when you don’t get enough sleep,” he said. Some patients can’t comply with the diet, but as soon we fix the sleep, they are able to do well, he said.

Because the study is slated to be presented in a meeting, the findings should be considered preliminary until published in a peer-reviewed journal.

More information

For more on sleep, head to the National Sleep Foundation.

SOURCES: William Killgore, Ph.D.,
assistant professor of psychology, Harvard Medical School and McLean Hospital, Belmont, Mass.; Shelby Freedman Harris, Psy.D., director, Behavioral Sleep Medicine Program, Sleep-Wake Disorders Center, Montefiore Medical Center, Bronx, N.Y.; Louis Aronne, M.D., director, Comprehensive Weight Control Program, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, N.Y.; Associated Professional Sleep Societies meeting, Minneapolis, Minn., June 13, 2011

Last Updated: June 13, 2011

Copyright © 2011 HealthDay. All rights reserved.

Study Singles Out Beachgoers’ Skin Cancer Risk

2011-06-15T07:57:00.000-07:00

MONDAY, Nov. 17 (HealthDay News) — That basic rule, “know thyself,” can help prevent a pleasant seaside vacation from turning into a skin cancer risk, Australian dermatologists report.

A detailed study of 88 Hawaii vacationers identified three groups of people with distinct characteristics and sun protection behaviors, according to a report in the December issue of Archives of Dermatology by researchers at the University of Queensland:

    Those people in class 1 (“unconcerned and at low risk”) were at least risk of skin cancer, intended to tan, and used the least amount of sun protection.

    Those in class 2 (“tan seekers”) had the second highest risk of skin cancer, had the highest proportion of women, became sunburned easily, intended to tan, had used tanning beds in past 30 days, and had the highest proportion of sunscreen coverage and the least clothing coverage.
    Those in class 3 (“concerned and protected”) had the highest skin cancer risk, the highest proportion of clothing coverage and shade use, and were more likely to be Hawaii residents.

“Specific strategies should target the subsets of the beach-going population (particularly those in group 2 — the tan seekers) that intend to tan and sunburn repeatedly, taking into account their relevant personal attributes and behavior patterns,” the researchers wrote.

A targeted message is needed for that group, said Dr. Susan Weinkle, assistant clinical professor of dermatology at the University of South Florida and a member of the Skin Cancer Foundation.

“These vacationers are at high risk of skin cancer, and we are not getting the message across,” Weinkle said. “People like me who live right on the beach use more sun-protective clothing and don’t go to the beach with the primary goal of getting a tan. People who are on vacation often end up with sunburn.”

Vacationers should know that “you can get out on the beach, you just have to do protective things — sit in the shade when you have lunch, wear sun-protective clothing and a hat when you are taking a walk on the beach,” she said.

The Australian classification system is useful because, “if you want to intervene in a setting where you see people tanning, it is important to know their different reasons for being exposed to the sun,” said Sherry L. Pagoto, assistant professor of medicine at the University of Massachusetts Medical School, and co-author of an accompanying editorial in the journal.

Pagoto and her colleagues did a similar study of beachgoers several years age, she said, which found that “the largest class of people are very motivated to be tanned.”

“They are well aware of the risk of skin cancer — both their actual risk and perception of risk is somewhat elevated. But they don’t use sunscreen to an adequate level,” Pagoto said

“A great challenge” in skin cancer prevention is that “people really want to be tanned,” she said. “It is a conundrum, how to get people not to want to be tanned.”

Given that feeling, “the only way to get them out of the sun is to use alternatives and understand what it is about being tanned that makes them feel good,” Pagoto said.

Skin cancer prevention measures should include not only education, but also “a change of the environment around beaches,” said Vilma Cokkinides, strategic director of risk factor surveillance for the American Cancer Society.

“We need more shade and to make point-of-source information available, if people forget their sunscreen, for example,” Cokkinides said. “Also, we need signage around beaches telling people to be aware of the hours of greatest risk. I haven’t been to any beach that I recall and seen anything of that sort available.”

There is no registry of skin cancer cases, but more than a million are estimated to occur in the United States each year, she said.

More information

The various kinds of skin cancer and measures to reduce the risk are described by the Skin Cancer Foundation.

SOURCES: Susan Weinkle, M.D., assistant clinical professor of dermatology, University of South Florida, Tampa; Sherry L. Pagoto, Ph.D., assistant professor of medicine, University of Masachusetts Medical School, Worcester; Vilma Cokkinides, Ph.D., strategic director, risk factor surveillance, American Cancer Society, Atlanta; December 2008, Archives of Dermatology

By Ed Edelson
HealthDay Reporter

Last Updated: Nov. 17, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Safe in the Sun: How to Stay Cancer-Free

2011-06-15T07:54:00.000-07:00

Experts say skin cancer is largely preventable if people take a few simple precautions. But David J. Leffell, MD, a professor of dermatology and surgery at the Yale School of Medicine and author of Total Skin: The Definitive Guide to Whole Skin Care for Life, says he’s actually treating more, not fewer, cases of the illness. “I see young women with skin cancer who never would have had it in the past. And almost everyone in this group has used a tanning parlor.” A recent survey found that one in five people ages 18 to 29 have used tanning beds; the numbers do go down as people get older—but not by much. Needless to say, one of Dr. Leffell’s top tips for prevention is to avoid tanning booths. What other things can you do to protect yourself from skin cancer? Here, six ways to be sun-safe.

Watch the clock. Stay out of the sun between the peak hours of 10 a.m. and 4 p.m.

Pick a smarter sunblock. Stick with an SPF of 15 or higher, and make sure the label says it blocks UVA and UVB radiation—both can damage skin in different ways. Virtually all reputable sunblocks guard against UVB rays, and those with avobenzone (Parsol 1789) or oxybenzone reflect UVA rays too. Chemical-free sunscreens with titanium dioxide or zinc oxide block both. Apply a palmful about 30 minutes before heading out, and reapply every two hours and after swimming.

Wear your protection. Sporting-goods stores are now stocking stylish sun-protective clothing for the beach (or anywhere). And while you’re out shopping, don’t forget to pick up a pair of sunglasses; your eyes can get sunburned, too.

Sport a reminder. Try the new sun-sensitive wristbands from SpaFinder ($5) that turn from white to purple when exposed to UVA rays. Proceeds are used for skin-cancer research and awareness campaigns.

Drink more coffee. One caffeinated cup may lower your risk of nonmelanoma cancer by 5%—and the more you drink, the more benefits you may get, according to a large study from Wayne State University in Detroit. (Caffeine may help eliminate skin cells with sun-damaged DNA, preventing their ability to replicate.) You don’t like coffee? Any caffeinated beverage could help. But remember: Caffeine is no substitute for covering up, wearing sunblock, or avoiding the beach at midday.

Check your skin … and get help. Once-a-year self-checks are recommended, at a minimum. Have your partner look at areas you can’t see—that boosts your chances of early detection. And don’t forget to check your palms, the soles of your feet, and your scalp. If anything looks unusual, head to the doc pronto. Can’t get an appointment? Dr. Leffell suggests telling the receptionist that you think you have signs of melanoma. Annual derm appointments may be worthwhile too.
Back to “Stay Safe in the Sun” Intro

By Linda Formichelli
(PHOTO: 123RF)

Skin Cancer Foes Declare May 27 ‘Don’t Fry Day’

2011-06-15T07:51:00.000-07:00

WEDNESDAY, May 25 (HealthDay News) — This Friday, the start of the Memorial Day weekend, is also “Don’t Fry Day,” a time for skin-safety experts to remind Americans about the hazards of overexposure to sunlight.

Melanoma, the potentially deadly form of skin cancer, is the most common cancer among young adults in their late 20s, according to the U.S. Environmental Protection Agency (EPA) and the National Council on Skin Cancer Prevention, which joined forces to provide life-saving tips on sun safety. The main cause of skin cancer: overexposure to harmful ultraviolet (UV) rays.

“Many people still do not realize that unprotected sun exposure can lead to skin cancer and other health problems,” said Gina McCarthy, assistant administrator for EPA’s Office of Air and Radiation, in an agency news release. “Simple steps, such as using sunscreen, putting on sunglasses or wearing a hat, can protect us and our families, while still enjoying the great outdoors.”

Skin cancer, the most common type of cancer in the United States, affects more than 2 million Americans each year — more than breast, prostate, lung and colon cancers combined, the EPA said. Every hour, one American dies from skin cancer, the agency noted.

Although UV rays are dangerous year-round, the risks are greatest in the summer months when people spend more time outside, McCarthy said.

To limit exposure to harmful UV rays, experts suggest you:

    Cover up. One of the most effective ways to reduce exposure to the sun’s harmful rays is to wear a shirt, hat, sunglasses and SPF 15+ sunscreen.
    Find a shady spot. It’s best to stay out of direct sunlight during the peak hours of 10 a.m. to 4 p.m.
    Be aware of the UV index. Before engaging in outdoor activities, check the UV index to identify the most risky times for overexposure to the sun.

More information

The American Cancer Society offers additional tips on sun safety.

– Mary Elizabeth Dallas

SOURCE: U.S. Environmental Protection Agency, news release, May 23, 2011

Last Updated: May 25, 2011

Copyright © 2011 HealthDay. All rights reserved.

Survey Shows Dangers of Tanning Not Hitting Home

2011-06-15T07:49:00.000-07:00

TUESDAY, May 3 (HealthDay News) — Although studies have shown that indoor tanning raises your risk of the deadly skin cancer melanoma by a staggering 75 percent, a new survey reveals that young women continue to use tanning beds at an alarming rate.

In the past year, 32 percent of the 3,800 young women questioned in the American Academy of Dermatology survey said they had visited a tanning salon. In fact, 25 percent of those who tanned admitted to soaking up ultraviolet (UV) rays from indoor beds at least once a week, on average. Moreover, 81 percent of the respondents also tanned outdoors, either frequently or occasionally.

Young women were the most at risk, according to the survey. Specifically, 18- to 22-year-olds were almost twice as likely as 14- to 17-year-olds to have use a tanning bed.

“Exposure to UV radiation is the leading risk factor for skin cancer, yet — despite this knowledge — droves of teens and young women are flocking to tanning bed facilities and beaches or pools to tan every year,” academy president and dermatologist Dr. Ronald L. Moy said in a news release from the academy.

“The challenge is that teens have access to indoor tanning salons on almost every corner. A recent survey of 116 U.S. cities found an average of 42 tanning salons per city, which means tanning salons are more prevalent than Starbucks or McDonald’s. We are very concerned that this tanning behavior will lead to a continued increase in the incidence of skin cancer in young people and, ultimately, more untimely deaths from this devastating disease,” Moy added.

Melanoma rates have been increasing for the past three decades, particularly among young, white women, the academy noted. If trends continue, one in five Americans will develop skin cancer during their lifetime. The disturbing numbers prompted the U.S. Department of Health and Human Services and the World Health Organization’s International Agency of Research on Cancer panel to declare UV radiation from both the sun and artificial light sources as a known carcinogen.

“Our survey underscores the importance of educating young women about the very real risks of tanning, as melanoma — the deadliest form of skin cancer — is increasing faster in females 15 to 29 years old than in males of the same age group,” said Moy. “In my practice, I have had patients — young women with a history of using tanning beds — who have died from melanoma.”

More information

The Skin Cancer Foundation has more on the dangers of tanning.

– Mary Beth Dallas

SOURCE: American Academy of Dermatology, news release, May 2, 2011

Last Updated: May 03, 2011

Copyright © 2011 HealthDay. All rights reserved.

Infectious Disease Experts Call for More Focus on Hepatitis C

2011-06-15T07:48:00.000-07:00

TUESDAY, Feb. 1 (HealthDay News) — Among injection drug users, new cases of HIV infection have declined dramatically in the past two decades, but the number of new infections from the hepatitis C virus have dropped only a small amount, a new study reports.

The findings suggest that efforts — such as needle exchange programs and substance abuse treatment — to prevent blood-borne transmission of infectious diseases have been successful against HIV but more needs to be done to reduce the transmission of hepatitis C virus (HCV), according to the study’s leader, Shruti H. Mehta of the Johns Hopkins School of Public Health.

The researchers noted that HCV is nearly 10 times more transmissible by sharing needles than HIV. Sharing a needle just once can be enough to transmit HCV.

The study, which looked at infection rates among injection drug users in Baltimore over a 20-year span, found dramatic decreases in new HIV infections: from 5.5 cases per 100 person years in 1988-1989 to two per 100 in 1994-1995, and to zero cases in 1998 and 2005-2008.

Reductions in new HCV infections were not as dramatic: from 22 cases per 100 person years in 1988-1989 to 17.2 per 100 in 1994-1995, to 17.9 in 1998 and to 7.8 in 2005-2008.

Overall, new cases of HCV appeared to decrease only among younger injection drug users who had recently starting using the drugs, the study found.

The results were released online Jan. 31 in advance of publication in the March 1 print issue of the Journal of Infectious Diseases.

The results suggest that “current prevention efforts delay but do not prevent HCV at the population level and will need to be further intensified to reduce risk of HCV infection to the level of HIV,” the researchers wrote.

They called for expansion of efforts on both the prevention and the treatment fronts to reduce the reservoir of HCV-infected injection drug users.

More information

The American Academy of Family Physicians has more about hepatitis C.

– Robert Preidt

SOURCE: Journal of Infectious Diseases, news release, Jan. 31, 2011

Last Updated: Feb. 01, 2011

Copyright © 2011 HealthDay. All rights reserved.

More Screenings May Explain Higher Chlamydia Rates Among Minorities

2011-06-15T07:46:00.000-07:00

WEDNESDAY, Jan. 26 (HealthDay News) — Screening rates for the sexually transmitted disease chlamydia are significantly higher in the United States among young black and Hispanic women than among young white women, which might explain why black and Hispanic women have higher reported rates of the disease, a new study suggests.

Researchers who analyzed data from more than 40,000 visits to health-care facilities found that young Hispanic women were 9.7 times more likely to be screened for chlamydia than young white women. The screening rate was 2.7 times greater for young black women.

The investigators also found that:

Women with public health insurance were more likely to have chlamydia testing than were those with private insurance.
A medical history was more important than race, ethnicity or insurance status in terms of differences in chlamydia screening.
Young women with a previous sexually transmitted disease were more likely to be screened for chlamydia, regardless of race or ethnicity.
After a pregnancy, young Hispanic women were 24 times more likely and young black women were four times more likely than young white women to be screened for chlamydia.

The study was published online Jan. 24 in Pediatrics.

“For some common conditions like breast cancer, white women are more likely to receive a screening test like mammography,” the study’s first author, Dr. Sarah E. Wiehe, an assistant professor of pediatrics at the Indiana University School of Medicine, said in a university news release. “For chlamydia infections — which are highly stigmatized STDs — white women are less likely, while minority women are more likely, to receive screening,” she noted.

“This may mean that providers make judgments about a woman’s likelihood of infection based on her race or ethnicity,” Wiehe added. “Yet in an asymptomatic condition like chlamydia, all sexually active young women should be screened.”

She said that pediatricians, internists, family doctors and gynecologists must be encouraged to conduct chlamydia screening for all sexually active young women under their care.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about chlamydia.

– Robert Preidt

SOURCE: Indiana University School of Medicine, news release, Jan. 24, 2011

Last Updated: Jan. 26, 2011

Copyright © 2011 HealthDay. All rights reserved.

Testosterone Gets Bad Rap: Study

2011-06-15T07:44:00.000-07:00

TUESDAY, Dec. 8 (HealthDay News) — People associate testosterone with aggressiveness, but the male sex hormone actually encourages a sense of fair play, a new study finds.

Testosterone does not cause aggression, said lead researcher Michael Naef, of the department of economics at Royal Holloway, University of London. But it does lead to “status-seeking behavior — or trying to secure one’s own status,” he said.Such status-seeking behavior can include aggression, as well as other behaviors appropriate to particular situations, the researchers said.

But they also found that people’s preconceptions about testosterone, rather than the hormone itself, may cause them to behave anti-socially and unfairly.

For the study, Naef’s team randomly assigned 121 women to receive testosterone or a placebo. The women then participated in an experiment where they were asked to distribute money.

The money could be distributed fairly or unfairly, and participants could accept or reject an offer. The fairer the offer, the more likely it was accepted. If no agreement could be reached, no one earned any money.

Women given testosterone made fairer offers than those who received the placebo, the researchers found.

However, women who were told they had received testosterone were more aggressive, whether they had actually received the hormone or not, the study authors noted. These women continually made unfair offers.

Naef said the effects seen in the women would be similar in men. “The effects of testosterone are very similar in men and women,” he explained.

“We asked our subjects how testosterone changed their behavior, and they were all wrong. Most of them say it makes you aggressive and anti-social,” said Naef. “It’s more complicated.”

The myth about testosterone appears to induce aggression, Naef stated. “People who believe they are given testosterone behave much more aggressively and anti-socially, compared with people who think they received placebo,” he said.

Also, the interplay between testosterone and the environment influences testosterone’s effect, he added. In the environment of the bargaining experiment, testosterone caused pro-social behavior, Naef said.

“But in a more hostile situation like a prison, testosterone may cause aggressive behavior, because by being aggressive in a prison you may secure your status or achieve a high status,” he said.

The report is published in the Dec. 8 online edition of Nature.

Another expert, George Wilson, an associate professor of sociology at the University of Miami, said the study “speaks to the dual role that biology and the environment play in structuring behavior, although biology appears to work in a way that is unexpected.”

Wilson added: “We are complex animals, we are symbolic animals — we are not led around purely by biology.”

Challenges to status can be a powerful cultural force, Wilson stated. “They act in our conscious and preconscious in ways we are not always aware,” he said. “We are status-seeking creatures.”

Aggression is largely a male behavior in our society, which may explain how testosterone, the primary male sex hormone, became synonymous with aggression, Wilson noted.

“People will orient their behavior along the line of a cultural myth,” he said. “It really speaks to the powerful socio-cultural forces in our society.”

More information

For more information on testosterone, visit the U.S. National Library of Medicine.

By Steven Reinberg
HealthDay Reporter

SOURCES: Michael Naef, experimental economics laboratory, department of economics, Royal Holloway, University of London, England; George Wilson, Ph.D., associate professor of sociology, University of Miami; Dec. 8, 2009, Nature, online

Last Updated: Dec. 08, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

‘Bonding Gene’ Could Help Men Stay Married

2011-06-15T07:43:00.000-07:00

MONDAY, Sept. 1 (HealthDay News) — Whether a man has one type of gene versus another could help decide whether he’s good “husband material,” a new study suggests.

A study of Swedish twin brothers found that differences in a gene modulating the hormone vasopressin were strongly tied to how well each man fared in marriage.

“Our main finding was an association between a variant of the vasopressin receptor 1a gene and how strong bonds men reported they had to their partners,”
said lead researcher Hasse Walum, of the department of medical epidemiology and biostatistics at the Karolinska Institute in Stockholm. “Men carrying this variant scored on average lower on a scale measuring the strength of the bond compared to men not carrying this variant.”

Women married to men carrying the “poorer bonding” form of the gene also reported “lower scores on levels of marital quality than women married to men not carrying this variant,” Walum noted.

His team published its findings in this week’s issue of the Proceedings of the National Academies of Science.

Walum’s team first got interested in the role of vasopressin and bonding among males when studying a rodent, the vole. “Studies in voles have shown that the hormone vasopressin is released in the brain of males during mating,” Walum explained.

Vasopressin activates the brain’s reward system, and “you could say that mating-induced vasopressin release motivates male voles to interact with females they have mated with,” Walum said. “This is not a sexual motivation, but rather a sort of prolonged social motivation.” In other words, the more vasopressin in the brain, the more male voles want to stick around and mingle with the female after copulation is through. This effect “is more pronounced in the monogamous voles,” Walum noted.

But voles and humans are very different species, so would the same effect hold true for men?

To find out, the Swedish team zeroed in the vasopressin 1a gene, which is shared by both species. Variations in this gene strongly influence vasopressin activity in the male vole, so Walum wondered if it might do the same for men.

To find out, his team looked for variants of the vasopressin 1a gene among 552 pairs of male twins enrolled in Sweden’s ongoing Twin and Offspring Study. All of the men were currently in a relationship that had lasted at least five years, although about 18 percent of the men remained unmarried. The men were subjected to psychological tests assessing their ability to bond and commit, and the researchers also interviewed the men’s spouses when possible.

They found that men with a certain variant, known as an allele, of the vasopressin 1a gene, called 334, tended to score especially low on a standard psychological test called the Partner Bonding Scale. They were also less likely to be married than men carrying another form of the gene. And carrying two copies of the 334 allele doubled the odds that the men had undergone some sort of marital crisis (for example, the threat of divorce) over the past year.

All of these findings “make sense,” said Dr. John Lucas, a clinical associate professor of psychiatry at Weill Cornell Medical College in New York City. He said it’s well known that genes help drive much of human behavior, including mate bonding.

But the vasopressin 1a gene is likely not the only factor influencing a man’s ability to form true and lasting bonds, he added.

“It’s unlikely to be a single gene [at work] — it’s likely to be multiple genes that are expressed incompletely and interact with the environment,” said Lucas, who is also a psychiatrist at New York Presbyterian Hospital/Weill Cornell Medical Center. He pointed out that what psychologists call “temperament” — the individual palette of emotions and behaviors that even babies display — is probably “hard-wired” by our genetics. “But temperament, through training and experience, becomes personality,” Lucas said. “And personality is a complicated situation, of course, and it involves the ability to commit.”

So, it’s too early for men to blame their inability to commit on a single gene, although Lucas guesses it’s an excuse that’s “certainly going to be used.”

For his part, Walum agreed that men and their spouses shouldn’t read too much into the finding.

“Taken together, the effect of the gene variant that we have studied on human pair-bonding behavior is rather small, and it can not, with any real accuracy, be used to predict how someone will behave in a future relationship,” he said.

Walum also noted that the finding would probably not be applicable to women, since vasopressin appears to be tied to social bonding in males, but not females.

In a related study, also in the same issue of the journal, researchers at the Pacific Health Research Institute in Honolulu said they’ve identified a gene strongly linked to extended health and life span in humans. The FOXO3A gene, involved in insulin signaling, is just the second gene ever found that is closely tied to longevity, the researchers said. In their study of Japanese-American men, those who lived to an average age of 98 had a specific variant of FOXO3A compared to men who died at younger ages, the team said.

More information

There’s more on genes and behavior at Stanford University.

SOURCES: Hasse Walum, department of medical epidemiology and biostatistics, Karolinska Institute, Stockholm, Sweden; John Lucas, M.D., clinical assistant professor, psychiatry, Weill Cornell Medical College, and psychiatrist, New York Presbyterian Hospital/Weill Cornell Medical Center, New York City; Sept.1-5, 2008, Proceedings of the National Academy of Sciences

By E.J. Mundell
HealthDay Reporter

Last Updated: Sept. 01, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Study Suggests Rheumatoid Arthritis Linked to Heart Attack Risk

2011-06-08T04:17:00.000-07:00

THURSDAY, Dec. 9 (HealthDay News) — One year after a person is diagnosed with rheumatoid arthritis they are at a 60 percent increased risk of heart attack compared to people without the disease, a new study suggests.

The study included almost 7,500 patients who were diagnosed with rheumatoid arthritis, a chronic autoimmune disease marked by painful inflammation of the lining of the joints, and more than 37,000 people without the disease. The study was conducted between between 1995 and 2006; median follow-up was just over four years with a maximum follow-up of 12 years.

According to the Swedish researchers, the risk of heart attack rose 60 percent one to four years after the rheumatoid arthritis diagnosis, compared to people without the condition, and remained at the same level for five to 12 years after diagnosis. The risk of any type of ischemic (blocked blood flow) heart disease increased 50 percent one to four years after a rheumatoid arthritis diagnosis compared to those without the condition, and it remained at that level five to 12 years after diagnosis.

The study appears in the December issue of the Journal of Internal Medicine.

“Our findings emphasize the importance of monitoring a patient’s heart risk from the moment they are diagnosed with rheumatoid arthritis, as the risk rises rapidly in the first few years,” lead author Marie Holmqvist, of the Karolinska Institute in Stockholm, said in a journal news release.

She added that it “is also very clear that more research is needed to determine the mechanisms that link these two health conditions.”

More information

The American Academy of Family Physicians has more about rheumatoid arthritis.

— Robert Preidt

SOURCE: Journal of Internal Medicine, news release, Dec. 6, 2010

Last Updated: Dec. 09, 2010

Copyright © 2010 HealthDay. All rights reserved.

Better Outcomes Seen With Early Rheumatoid Arthritis Diagnosis

2011-06-08T04:15:00.000-07:00

TUESDAY, Nov. 30 (HealthDay News) — Early assessment of rheumatoid arthritis can reduce the amount of joint damage and improve the likelihood of disease remission without having to take disease-modifying antirheumatic drugs, known as DMARDs, new research indicates.

Although DMARDs are considered effective in treating rheumatoid arthritis, especially when other treatments don’t work, they have been linked to uncommon but serious side effects.

The study included 1,674 patients with rheumatoid arthritis, or RA, who were followed-up for six years after diagnosis. The median time from the onset of symptoms until a patient was assessed by a rheumatologist was 13.7 weeks.

Patients who were seen by a rheumatologist 12 or more weeks after RA symptoms began had a joint destruction rate 1.3 times higher than patients assessed within 12 weeks. A delay in assessment and treatment was also associated with a 1.87 times greater risk of not achieving a remission free of DMARD drugs.

The study is published in the December issue of the journal Arthritis & Rheumatism.

“Early treatment intervention dramatically improves clinical outcomes in patients with RA,” Dr. Michael van der Linden, of the Leiden University Medical Center, said in a news release from the journal’s publisher. “Our study presents the first evidence that RA patients who have a delay longer than 12 weeks between first symptoms and visiting a rheumatologist have a higher rate of joint destruction and lower chance of achieving a sustained DMARD-free remission.”

The findings “highlight the importance of reducing the delay in assessment by a rheumatologist and further studies could test whether accelerated treatment leads to improved disease outcomes in RA,” van der Linden concluded.

More information

The American Academy of Family Physicians has more about rheumatoid arthritis.

– Robert Preidt

SOURCE: Arthritis & Rheumatism, news release, Nov. 23, 2010

Last Updated: Nov. 30, 2010

Copyright © 2010 HealthDay. All rights reserved.

Cost of Psoriasis Drugs Rising Faster Than Others

2011-06-08T04:14:00.000-07:00

MONDAY, Jan. 18 (HealthDay News) — The cost of treating psoriasis is rising faster than inflation, says a U.S. study, which also found that newer, biologically-derived treatments cost more than traditional systemic therapies.

The researchers created a cost model to analyze the total cost of systemic therapy for psoriasis, a chronic autoimmune skin disease that affects 4.5 million to 7.5 million Americans and costs the nation’s health-care industry more than $3 billion a year.

The cost for each type of systemic therapy (such as oral medications) was calculated by using the average wholesale price of each drug plus the cost of office visits, laboratory tests and monitoring.

“Current total and annual costs for systemic psoriasis therapies ranged from $1,197 (methotraxate [a traditional systemic therapy]) to $27,577 (alefacept [a biologic], two 12-week courses),” wrote Dr. Vivianne Beyer of St. Vincent Hospital in Indianapolis and Dr. Stephen E. Wolverton of the Indiana University School of Medicine.

Costs for phototherapy (exposure to ultraviolet light) ranged from $3,083 to $7,288, and costs for biologics ranged from $18,384 to $27,577.

“Trends in the average wholesale price of brand-name psoriasis therapies from 2000 through 2008 demonstrate an average increase of 66 percent,” they wrote. “Thus, costs of several brand-name psoriasis drugs greatly outpaced the rate of inflation for all items and all prescription drugs.”

During this time, the urban Consumer Price Index for all items increased 25.8 percent and 30.1 percent for all prescription drugs.

The study is in the January issue of the Archives of Dermatology.

“Although the tendency of psoriasis drug costs to outpace the Consumer Price Index-Urban rate is shared by both traditional and biologic therapies, traditional therapies remain much more affordable than biologic therapies,” the researchers wrote. “When considering the expense of biologic therapies, even relatively small increases in price become significant, such as the 14-percent increase during an eight-year period seen with infliximib.”

More information

The American Academy of Family Physicians has more about psoriasis.

— Robert Preidt

SOURCE: JAMA/Archives journals, news release, Jan. 18, 2010

Last Updated: Jan. 18, 2010

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Newer Drug More Effective in Psoriasis Treatment

2011-06-08T04:12:00.001-07:00

WEDNESDAY, Jan. 13 (HealthDay News) — The estimated 7.5 million Americans suffering from psoriasis often have to tolerate long-term treatment that may be only moderately effective.

Now, a new drug called ustekinumab (Stelara) appears to be more effective than the old standby, etanercept (Enbrel), according to the results of a head-to-head comparison sponsored by the maker of Stelara.

“Ustekinumab is a more effective and faster acting therapy for psoriasis than the current biologic market leader for this condition,”
said lead researcher Dr. Christopher E.M. Griffiths, a professor of dermatology at the University of Manchester in England.

Enbrel and Stelara are biologic agents, which work by blocking proteins produced in the body. Enbrel blocks tumor necrosis factor alpha, while Stelara inhibits interleukin-12 and interleukin-23.

This is the first head-to-head trial of two biologic therapies for psoriasis, Griffiths noted. Psoriasis is a chronic, autoimmune disease that appears on the skin.

The report is published in the Jan. 14 issue of the New England Journal of Medicine. Centocor Research and Development sponsored the study.

For the study, Griffiths and colleagues randomly assigned 903 patients with moderate-to-severe psoriasis to two different doses of Stelara injected 30 days apart or to high-dose Enbrel injections twice a week for 12 weeks.

After 12 weeks of treatment, 67.5 percent of the patients receiving 45 milligrams of Stelara had a 75 percent improvement in their condition, according to the psoriasis area-and-severity index, as did 73.8 percent of those receiving 90 milligrams of Stelara.

Only 56.8 percent of those receiving Enbrel showed a similar improvement, the researchers found.

In addition, based on doctors’ assessments, 65.1 percent and 70.6 percent of patients receiving the low and high dose of Stelara had little or no signs of psoriasis, compared with 49 percent of the patients receiving Enbrel, the team reported.

Moreover, among the patients who did not respond to Enbrel, 48.9 percent had at least a 75 percent improvement 12 weeks after switching to Stelara.

These results show that “the optimal approach to treating psoriasis may be via the targeting of the chemical messengers interleukin-12 and interleukin-23 as exemplified by ustekinumab as opposed to the chemical messenger tumor necrosis factor alpha targeted by etanercept,” Griffiths said.

Dr. Paolo Romanelli, an associate professor of dermatology at the University of Miami Miller School of Medicine, wasn’t totally surprised by the results. “These findings are exciting and a little bit expected,” he said.

Stelara was approved in October, so not many patients are receiving it yet, he noted. A main benefit of Stelara is the need for fewer injections, Romanelli said.

Romanelli advises patients receiving Enbrel to stay on the drug if they are doing well. For those who do not respond to Enbrel, there is “incredible hope to have a new medication that may help them,” he added.

Patients who don’t respond to Enbrel may respond to Stelara, the study found. The safety of the two biologics appeared similar, Griffiths said.

Common side effects included local reactions at the injection site, headache and back pain.

Before the creation of these biologics, psoriasis treatment focused on reducing inflammation with drugs such as methotrexate and cyclosporine.

Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression, according to the National Psoriasis Foundation.

More information

To learn more about psoriasis, visit the U.S. National Institutes of Health.

By Steven Reinberg
HealthDay Reporter
SOURCES: Christopher E.M. Griffiths, M.D., professor of dermatology, University of Manchester, England; Paolo Romanelli, M.D., associate professor of dermatology, University of Miami Miller School of Medicine, Fla.; Jan. 14, 2010, New England Journal of Medicine

Last Updated: Jan. 13, 2010

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Exercise May Prevent Prostate Cancer: Study

2011-06-08T04:11:00.000-07:00

FRIDAY, Sept. 25 (HealthDay News) — Regular exercise may help protect men from prostate cancer, says a new study.

U.S. researchers looked at 190 men who had a prostate biopsy and found that those who were moderately active — anything equivalent to walking at a moderate pace for several hours a week — were significantly less likely to be diagnosed with prostate cancer.

The study also found that exercise was associated with less aggressive disease in men who did develop prostate cancer.

“As the amount of exercise increased, the risk of cancer decreased,” lead author Dr. Jodi Antonelli, a urology resident at Duke University Medical Center, said in a news release.

The results, published Sept. 22 online in the Journal of Urology, contribute to the ongoing debate about how exercise affects prostate cancer risk, said study senior author Dr. Stephen Freedland, a urologist at Duke and the Durham Veterans Affairs Hospital.

“There have been dozens of studies about the value of exercise in lowering risk of prostate cancer, and some of them quite large, but the bottom line is that they’ve left us with mixed signals,” Freedland said in the news release.

The majority (58 percent) of the men in this study were sedentary, which means they exercised less than the equivalent of one hour per week of easy walking.

More information

The U.S. National Cancer Institute has more about prostate cancer.

— Robert Preidt

SOURCE: Duke Medicine, news release, Sept. 22, 2009

Last Updated: Sept. 25, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Virus May Drive Some Prostate Cancers

2011-06-08T04:10:00.000-07:00

TUESDAY, Sept. 8 (HealthDay News) — A new study tightens the suspected link between a virus and prostate cancer, and raises the possibility that infection with the virus could be an indicator of aggressive tumors that require swift treatment.

“We’re not making any causal association at this moment,” stressed Dr. Ila R. Singh, an associate professor of pathology at the University of Utah, lead author of a report on the virus, known as xenotropic murine leukemia virus-related virus (XMRV).

“There probably are multiple causes of prostate cancer, but for the first time we have analyzed prostate cancer and normal prostate tissue and found cancers are much more likely to have [the virus],” Singh said.

The research is published in this week’s issue of Proceedings of the National Academy of Sciences.

A link between XMRV and prostate cancer was first reported two years ago by researchers at the Cleveland Clinic and the University of California, San Francisco. They found the virus in cells around tumors.

The new study, involving more than 300 prostate cancer specimens, found that 27 percent of them carried the virus.

“It was also more likely to be present in more aggressive tumors,” Singh said. “We found it in 20 percent of the least aggressive tumors and over 45 percent of the most aggressive tumors.”

So, a test for presence of XMRV could be at least a partial solution to the major problem facing doctors who treat prostate cancer: distinguishing the minority of virulent, life-threatening cancers from the majority of tumors which grow so slowly that “watchful waiting” may be enough.

Prostate cancers now are diagnosed by a test for prostate-specific antigen (PSA), a protein produced by the gland. However, PSA tests cannot single out aggressive cancers, and there is a major debate on whether widespread use of these tests leads to overdiagnosis and overtreatment.

“I don’t know yet if this is the better test, but it might be linked to more aggressive prostate cancers,” Singh speculated.

Robert A. Silverman, a professor of cancer biology at the Cleveland Clinic, was one of the researchers who first reported the association of XMRV with prostate cancer. He called the new study “very exciting.”

“Finding it in cancer cells makes it easier to reconcile with the idea of a cancer-causing virus than in our prior study,” Silverman said. “The prior study found the virus in cells surrounding the cancer. We can’t say with certainty that XMRV is a cause of cancer, but it still is a candidate for a cancer-causing virus.”

Even if causation is not proved, “XMRV could be a marker for aggressive tumors,” Silverman said.

His group has continued research on the virus, one of which indicates that human semen promotes the activity of XMRV, Silverman said.

The new study also overturns a previously reported association between XMRV infection and a genetic variation carried by a small percentage of men. “We don’t find any such association,” Singh said. So, the new research appears to expands the population at risk from the virus to all men — whether they carry the genetic variant or not.

Singh and her colleagues are expanding their research on XMRV. “We don’t know if women have the virus, and we are looking at cervical cells from Pap smears,” she said. “We are looking at seminal fluid from men and also at tissues other than the prostate. We have two large series of autopsies of male and female organs. We are also looking for antibodies to the virus in serum as a way to detect infection.”

More information

Find out more about prostate cancer at the U.S. National Cancer Institute.

By Ed Edelson
HealthDay Reporter

SURCES: Ila R. Singh, M.D., Ph.D, associate professor, pathology, University of Utah, Salt Lake City; Robert A. Silverman, Ph.D, professor, cancer biology, Cleveland Clinic; Sept. 7, 2009, Proceedings of the National Academy of Sciences, online

Last Updated: Sept. 08, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Moms Who Have Twins May Live Longer: Study

2011-06-08T04:08:00.001-07:00

WEDNESDAY, May 11 (HealthDay News) — Naturally conceiving and giving birth to twins may be a sign of good health, new research suggests.

The study found that among women who were born in Utah in the 1800s, those who gave birth to twins tended to live longer than the mothers of singletons.

University of Utah researchers analyzed records on nearly 59,000 non-polygamous women in the Utah Population Database who were born between
1807 and 1899 and lived to at least age 50. Of those women, about 4,600 gave birth to twins.

Among women born before 1870, mothers who had twins had a 7.6 percent lower yearly risk of dying after age 50 than mothers who had one baby at a time. Among women born between 1870 and 1899, the risk was 3.3 percent lower for moms who had twins, although that was not statistically significant.

The study also found that mothers of twins had more children than normal, had a shorter interval between births, and were older when they had their last child.

“The prevailing view is that the burden of childbearing on women is heavier when bearing twins,” senior author and demographer Ken R. Smith, a professor of family and consumer studies, said in a university news release. “But we found the opposite: women who naturally bear twins in fact live longer and are actually more fertile.”

The finding that mothers of twins tend to live longer does not mean that having twins is healthy for women, Smith explained.

Indeed, the study did not look at women who died in childbirth or before menopause, but only those who reached at least age 50.

But the findings suggest that healthier women are more likely to have twins.

The study is published in the May 11 online edition of the journal Proceedings of the Royal Society B.

“This study has been able to identify — and it’s a fairly novel result — another important factor that contributes to health and longevity in later years, namely, that women bearing twins appear to be healthier,” Smith said. “That innate healthiness is contributing to their ability to have twins, and it is also contributing to their longevity.”

Smith directs the University of Utah’s Pedigree and Population Resource, which maintains and manages the Utah Population Database.

More information

The American Congress of Obstetricians and Gynecologists has more about twins.

– Robert Preidt

SOURCE: University of Utah, news release, May 10, 2011

Last Updated: May 11, 2011

Copyright © 2011 HealthDay. All rights reserved.

Vitamin D May Prevent Serious Respiratory Disease in Newborns

2011-06-08T04:07:00.000-07:00

By Steven Reinberg
HealthDay Reporter

TUESDAY, May 10 (HealthDay News) — Vitamin D supplements for pregnant women may help prevent a respiratory disease called RSV that can lead to pneumonia and other potentially life-threatening illnesses in newborns, Dutch researchers report.

Respiratory syncytial virus (RSV) is the most common cause of pneumonia and inflammation of the lower airways (bronchiolitis) in infants in the
United States, according to the U.S. Centers for Disease Control and Prevention. While most children recover, many are hospitalized and develop respiratory problems that persist well into childhood.

“We have no treatment for RSV. The only thing we can do is try to prevent the disease,” said lead researcher Dr. Louis Bont, from the department of pediatric infectious diseases at Wilhelmina Children’s Hospital and University Medical Center in Utrecht.

One way to prevent RSV is for pregnant women to take supplemental vitamin D, he said. “In fact, there are guidelines that prescribe that,” he added.

“If pregnant women do not take vitamin D supplements, they have low vitamin D levels in the umbilical cord blood and then the children have a severely increased risk of RSV,” Bont said.

“Intake of vitamin D during late stage of pregnancy is vital to prevent RSV, and probably other respiratory diseases as well,” he concluded.

RSV infects about 5 million children in the United States each year. But if women took vitamin D supplements during pregnancy, about 20 percent of those infections in newborns might be prevented, Bont said. “That would be in the magnitude of 1 million cases per year,” he said.

Vitamin D has many important functions, Bont explained, noting that “it shapes and matures the immune system.” In addition, the vitamin plays a role in helping the respiratory system develop, he added.

The report was published in the May 9 online edition of Pediatrics.

For the study, Bont’s team measured the amount of vitamin D in the umbilical cord blood of 156 newborns in the Netherlands.

The researchers found 54 percent of these newborns had insufficient levels of vitamin D. Among these infants, 18 (12 percent) developed RSV in the first year of life.

In fact, infants with low levels of vitamin D were six times more likely to develop RSV, compared with infants who had the highest levels, Bont’s group found.

Among the women in the study, only 46 percent said they took supplements containing vitamin D while they were pregnant, the researchers noted.

Bont thinks all pregnant women should be taking vitamin D supplements. In general, they should be getting 400 to 1,000 International Units (IU) a day, he said.

In the study, Bont and other researchers explained that some pregnant women might need up to 4,000 IU a day to achieve the best outcome for their infants. (Experts who make up the U.S. Food and Nutrition Board recommend that pregnant women get at least 600 IU of vitamin D daily and note that they can safely take up to 4,000 IU a day, according to the U.S. Office of Dietary Supplements.)

The cost of prenatal vitamins, which contain vitamin D, is about $9 a month.

What the researchers have shown in this study is an association between vitamin D and preventing RSV. To establish a cause-and-effect relationship, Bont said that randomized trials are needed.

Dr. Andrew Colin, director of the division of pediatric pulmonology at the University of Miami Miller School of Medicine, said this finding could “save the world a humongous amount of money.”

Colin noted the recognition of the link between low vitamin D levels and lung diseases has been growing over the years. This is particularly true for asthma. In fact, the increase in the number of asthma cases can, in part, be attributed to low vitamin D levels, he said.

“RSV is a worldwide scourge,” Colin said. “Probably the most significant lung disease of infancy is RSV. The bad news about this disease is that quite a few infants who have had RSV infection will develop an asthma-like disease, which can affect their entire childhood,” he added.

Colin thinks vitamin D may very well prevent RSV. “If, indeed, boosting the vitamin D in the mothers is going to end up with high vitamin D in babies [and] is going to make a difference, I think it’s huge,” he said.

This concept needs to be tested, Colin said, but added that he thinks it is fine for pregnant women to take supplemental vitamin D now. “I can’t see the downside,” he said.

More information

For more information on respiratory syncytial virus (RSV), visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Louis Bont, M.D., Ph.D., department of pediatric infectious diseases, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands; Andrew Colin, M.D., professor and director, division of pediatric pulmonology, University of Miami Miller School of Medicine; May 9, 2011, Pediatrics, online

Last Updated: May 10, 2011

Copyright © 2011 HealthDay. All rights reserved.

Diabetes Linked to Depression During and After Pregnancy

2011-06-06T05:43:00.000-07:00

TUESDAY, Feb. 24 (HealthDay News) — Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder, a new study found.

And, it didn’t matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes, the study found.

“Those with diabetes have nearly twice the risk of depression during pregnancy and post-partum,” said the study’s lead author, Katy Backes Kozhimannil, a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston.

And, Kozhimannil added, women who’d never been depressed before appeared to be at risk, too. “One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery,” she said.

Results of the study were published in the Feb. 25 issue of the Journal of the American Medical Association.

Although the study didn’t look at potential reasons for this association, Kozhimannil said there are biological changes that occur with diabetes that might increase the risk of depression. She also said the stress of managing a chronic illness might contribute to the risk of depression.

Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child’s development.

Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby. Previous studies have linked diabetes to an increased risk of depression in general, according to the study authors.

To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.

From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who’d never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.

“Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period,” said Kozhimannil. “Both diabetes and depression in the post-partum period are treatable.”

Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?

“A new diagnosis may be overwhelming for a lot of women,” he said.

Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. “Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis,” he said.

Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.

Welch recommended that no matter what your income, if you’re expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you’re not alone with the baby day after day, he said.

“Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it’s an overwhelming situation. You’re fatigued from the new baby and have the stress of managing diabetes,” he said.

More information

To learn more about pregnancy and depression, including symptoms of depression to watch for, visit the U.S. National Women’s Health Information Center.

SOURCES: Katy Backes Kozhimannil, M.P.A., research fellow, department of ambulatory care and prevention, and doctoral candidate, Harvard Medical School, Boston; Robert Welch, M.D., chairman, obstetrics and gynecology, Providence Hospital, Southfield, Mich.; Feb. 25, 2009, Journal of the American Medical Association

By Serena Gordon
HealthDay Reporter

Last Updated: Feb. 24, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Caring Counseling May Ease Postpartum Depression

2011-06-06T05:42:00.000-07:00

FRIDAY, Jan. 16 (HealthDay News) — Either in person or over the phone, women struggling with postpartum depression can be treated effectively by professionals or mothers who have gone through the same thing, two studies find.

Both reports, published in the Jan. 16 online edition of BMJ, find that talk therapy and caring communication can help new mothers deal with their depression without the need for antidepressants.

“Approximately 13 percent of women will experience postpartum depression,”
said Cindy-Lee Dennis, an associate professor at the University of Toronto and lead researcher on one of the studies. “There are significant consequences of this condition for the mother, the infant and the family.”

Once a woman has had postpartum depression, she is more likely to have future bouts of depression, Dennis said, and that puts infants and children at risk for cognitive, behavioral and social problems.

“For the family, often you see with postpartum depression [that] the partner can also experience depression,” she said. “We know that this leads to marital conflict and potentially divorce.”

People need to understand what the signs and symptoms of postpartum depression are and seek help, Dennis said.

Jane Morrell, research leader at the University of Huddersfield in the U.K. and an author of the other study, agreed.

“Women need to be encouraged not to bottle up their feelings and talk to other people, including their partners and health-care professionals,” she said.

Morrell and her colleagues randomly assigned 418 mothers with postpartum depression to have one-hour weekly visits for up to eight weeks from a health-care worker who delivered counseling, cognitive behavioral therapy (sometimes called talk therapy) or traditional postnatal care.

The researchers found that at six months and 12 months, mothers who had received counseling or therapy had greater reductions in depression than did mothers who had received usual care.

In fact, mothers who were depressed at six weeks were 40 percent less likely to be depressed at six months if they had gotten counseling or therapy, the researchers found.

Morrell’s team also found that this method of dealing with depression was cost-effective. “There is no stronger evidence of an intervention to help women who have depression postnatally,” she said.

In the other report, Dennis’s group studied the benefit of telephone support to prevent postpartum depression in high-risk women.

In this case, 701 women who were at high risk of postpartum depression were randomly assigned to standard postnatal care or to standard care plus telephone support from women who had experienced postpartum depression themselves.

The researchers found that women who received peer support were 50 percent less likely to develop postpartum depression 12 weeks after giving birth than were women who didn’t get the support. In addition, more than 80 percent of the women who got telephone support said they would recommend this type of support to a friend.

For any new mother with symptoms of depression, “providing her with telephone-based support from another mother who has experienced postpartum depression and has recovered, and has been trained, might be able to prevent the development of postpartum depression,” Dennis said.

William S. Meyer, an associate clinical professor in the departments of psychiatry and obstetrics/gynecology at Duke University Medical Center, said that both reports highlight what people who work with women suffering postpartum depression see.

“These papers provide further support for what those of us who work in the field learn every single day,” Meyer said. “The support of new mothers is the single best deterrent of postpartum depression.”

Study upon study demonstrates that the most severe risk factor for postpartum depression is the mother who does not feel supported, Meyer said. “Is it any wonder then that providing support from mothers, even fairly minimal support, even by modestly trained lay people, would not mitigate the incidence and severity of depression in the postpartum period?” he asked.

But Dr. Kimberly Yonkers, an associate professor of psychiatry at Yale University School of Medicine and an expert in treating postpartum depression, said that for many women with severe depression, these treatments aren’t enough.

“Modest forms of psychotherapy are helpful for mild to modest forms of depression,” Yonkers said. “These therapies can be administered by trained paraprofessionals or lay personnel. These interventions decrease the burden of depressive symptoms in postpartum women.”

“But there are still substantial numbers of women who seem to require stepped-up treatment,” she said.

More information

For more on postpartum depression, visit the National Women’s Health Information Center.

SOURCES: Jane Morrell, Ph.D., research leader, University of Huddersfield, U.K.; Cindy-Lee Dennis, Ph.D., associate professor, nursing and psychiatry, University of Toronto; William S. Meyer, M.S.W., associate clinical professor, departments of psychiatry and obstetrics/gynecology, Duke University Medical Center, Durham, N.C.; Kimberly Yonkers, M.D., associate professor, psychiatry, Yale University School of Medicine, New Haven, Conn.; Jan. 16, 2009, BMJ, online

By Steven Reinberg
HealthDay Reporter

Last Updated: Jan. 16, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Stopping Antidepressants Boosts Risk of PMS Relapse

2011-06-06T05:40:00.000-07:00

MONDAY, May 4 (HealthDay News) — Relapse is common among women with severe premenstrual syndrome (PMS) who stop taking the antidepressant sertraline to treat their symptoms, a new study concludes.

It included 174 women with PMS or the most severe form of PMS — premenstrual dysphoric disorder (PMDD). The women were randomly assigned to take sertraline for four months and then switch to placebo for 14 months or to take sertraline for 12 months and a placebo for six months.

Of the 174 patients, 125 (72 percent) showed improvement following treatment with sertraline, most within the first four months. Relapse (a return to the level of symptoms experienced before treatment) occurred in 41 percent of women in the 12-month treatment group (median time to relapse, eight months) and in 60 percent of women in the four-month treatment group (median time to relapse, four months).

“Patients with severe symptoms at baseline were more likely to experience relapse compared with patients in the lower symptom severity group and were more likely to experience relapse with short-term treatment,” wrote Ellen W. Freeman and colleagues at the University of Pennsylvania School of Medicine in Philadelphia. “Duration of treatment did not affect relapse in patients in the lower symptom severity group.”

The study found that the 41 women (24 percent) who experienced remission (reduction of PMS symptoms to normal post-menstrual level) after four months of treatment with sertraline were least likely to experience relapse after they stopped taking the drug.

“How long medication should be continued after achieving a satisfactory response and the risk of relapse after discontinuing treatment are important concerns for women and clinicians, given the possible adverse effects and cost of drugs vs. the benefit of medication that improves symptoms, functioning and quality of life,” the study authors wrote.

“These findings suggest that the severity of symptoms at baseline and symptom remission with treatment should be considered in determining the duration of treatment,” they concluded.

The study appears in the May issue of the Archives of General Psychiatry.

More information

The U.S. National Women’s Health Information Center has more about PMS.

— Robert Preidt

SOURCE: JAMA/Archives journals, news release, May 4, 2009

Last Updated: May 04, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Possible Cause of Postpartum Depression Pinpointed

2011-06-06T05:37:00.000-07:00

WEDNESDAY, July 30 (HealthDay News) — Researchers have uncovered a potential cause for postpartum depression, at least in mice.

According to the study, from assistant researcher Jamie Maguire and lead researcher Istvan Mody, both of the David Geffen School of Medicine at the University of California, Los Angeles, dysregulation of a particular class of proteins called GABA receptors on the surface of certain neurons in the brain may induce post-delivery mood disorders ranging from “baby blues” to postpartum psychosis.

The findings immediately suggest a possible therapeutic intervention, the authors noted. They also provided researchers with a new animal model for studying the biology and treatment of the disease—a valuable research tool that could accelerate the development of new treatments.

Yet the work was not performed in humans, stressed Dr. Bernard Carroll, scientific director of the Pacific Behavioral Research Foundation in California. Just because these animals appear to suffer from a disease akin to postpartum depression, he said, does not mean the two conditions are identical.

“We have to remember that the model is not the disease,” he said.

The results were published in the July 31 issue of Neuron.

The protein at the heart of this study, the GABA receptor (type A), serves an inhibitory role in the nervous system, dampening the effect of excitatory neurotransmitters in response to its substrate, GABA. These receptors can bind to more than one molecule, however, and one particular class of molecules called neurosteroids can modulate the receptors’ activity.

Neurosteroids are produced in the central nervous system from steroid hormones such as progesterone. During pregnancy, the levels of reproductive hormones (including progesterone) rise sharply, only to drop to pre-pregnancy levels shortly after delivery. As a result, neurosteroid levels also rise and fall.

Maguire and Mody wanted to see what happens to GABA receptors in the brains of mice undergoing the hormonal swings associated with pregnancy. By comparing virgin, pregnant and postpartum mice, the pair discovered that GABA receptor abundance (and function) falls during pregnancy and then returns to pre-pregnancy levels following birth.

That makes sense from a homeostatic point of view, Maguire explained. For the body to maintain a constant level of GABA receptor-derived inhibition, receptor abundance must stay more or less in synch with neurosteroid levels.

“If you want to maintain a constant level of inhibition, with more neurosteroids, you need fewer receptors,” she explained. “After pregnancy, when hormone levels drop off, you need more receptors to maintain that level. If you cannot maintain that level after pregnancy, that’s when the disorders manifest.”

She and Mody reached that conclusion using mice genetically engineered to lack a particular component of the GABA receptor — that is, mice that cannot adjust GABA receptor levels in response to changing hormone levels. By comparing these mutants to normal mice, the pair discovered that dysregulation of the normal changes in GABA receptor levels lead to mouse behaviors akin to postpartum depression, such as anxiety and depression, with a concomitant decrease in pup survival.

Treatment with THIP (Gaboxadol), a GABA receptor agonist originally intended to treat sleep disorders, ameliorated these effects in mice containing decreased levels of GABA receptors.

“Our thinking is that postpartum depression, and maybe premenstrual syndrome and premenstrual dysphoric disorder, may be due to impaired trafficking of these [GABA] receptors to the [neural] membrane,” Mody said.

The next step, he said, is to determine whether human postpartum depression is caused by a similar defect.

“We don’t know if this is the same mechanism in humans, but I think all indications are there,” Mody said. “The women that are affected by the disorder, the hormone levels are not changed, they are not different than in unaffected women. So, we are confident that it must be the receptor trafficking mechanism that is affected, because the changes in hormone levels are pretty normal.”

Dr. Julio Licinio, chairman of the department of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, praised the research as “very interesting,” particularly its development of a new animal model of postpartum depression, which can aid both research and drug development.

“This is probably the strongest [animal] model I have seen in a long time,” he said.

More information

For more on postpartum depression, visit womenshealth.gov.

SOURCES: Istvan Mody, Ph.D., Tony Coelho professor, neurology and physiology, department of neurology, David Geffen School of Medicine, UCLA; Jamie Maguire, Ph.D., assistant researcher, department of neurology, David Geffen School of Medicine, UCLA; Julio Licinio, M.D., professor and chairman, department of psychiatry and behavioral sciences, University of Miami Miller School of Medicine; Bernard Carroll, M.D., Ph.D., scientific director, Pacific Behavioral Research Foundation, Carmel, Calif.; July 31, 2008, Neuron

Last Updated: July 30, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

By Jeffrey Perkel
HealthDay Reporter

Ovarian Cancer Survival Linked to Two Key Proteins

2011-06-06T05:35:00.000-07:00

WEDNESDAY, Dec. 17, 2008 (Health.com) – The chances of surviving ovarian cancer appear to vary dramatically depending on the levels of two tumor proteins, suggesting that this type of cancer may have a more nuanced outlook than the grim statistics indicate.

Women who had ovarian tumors with high levels of the two proteins survived for a median of 11 years or more, while those with lower levels survived for a median of about 2.6 years, according to a study published Thursday in the New England Journal of Medicine.

The proteins, known as Dicer and Drosha, could help guide treatment or lead to new types of therapy. They are key players in RNA interference (RNAi), a naturally occurring system that turns genes on and off. The study is the largest to link RNAi with cancer survival rates, and the researchers also found that high Dicer levels are linked to survival in breast and lung cancer.

About 22,430 new cases of ovarian cancer were diagnosed in the United States in 2007, according to the American Cancer Society. Ovarian cancer is often called the “silent killer” because it can be difficult to catch early.

In the new study, Anil K. Sood, MD, of the University of Texas M.D. Anderson Cancer Center, in Houston, and colleagues analyzed tissue from 111 women with advanced epithelial ovarian cancer, specifically looking for Dicer and Drosha. They found 60% of the cancers had low levels of Dicer, 51% had low levels of Drosha, and 39% had low levels of both.

These two proteins are responsible for cutting and shaping tiny snippets of genetic material known as microRNAs, or miRNA. In the past decade, scientists have discovered that these naturally occurring snippets are important for turning genes on and off, controlling cell growth, and determining whether cells live or die. The entire process is known as RNAi, and when the system is damaged it can lead to disease. In fact, RNAi is abnormal in just about every cancer that researchers have examined.

“In the past, people used to think that miRNA might actually promote tumor growth, but there is some emerging thought that some of the miRNAs might keep tumors from growing and actually function as a tumor suppressor,” says Dr. Sood, who is an associate professor of cancer biology.

Many biotechnology companies are now trying to exploit this lock-and-key mechanism to fight other diseases. They have created synthetic molecules, called small interfering RNAs (siRNAs), which are being tested as a way to treat age-related macular degeneration, an eye disease, and many other conditions. “RNA interference is a way of shutting off or controlling genes,” Dr. Sood explains.

However, the research doesn’t have an immediate application for the treatment of women with ovarian cancer. “Should somebody go out and have this checked? No, not at this point,” says Dr. Sood. “‘But this is guiding us in developing appropriate therapies for the average person.”

The finding may eventually help doctors determine if an ovarian cancer patient needs more aggressive treatment. The researchers found that cells with inadequate levels of Dicer couldn’t turn genes off.

“We now know that ovarian cancer patients with low levels of these proteins tend to fare worse,” says Dr. Sood. “Now we can use this evidence to target treatment.”

The study may also help scientists create designer drugs to treat patients with cancers that have low levels of Dicer and Drosha. “This really helps us to understand more about the fine-tuning mechanisms that are going awry in cancer cells versus normal cells,” says Robert J. Morgan Jr., MD, codirector of the gynecological malignancy program at the City of Hope Cancer Center, in Duarte, Calif. “While this won’t influence patients right now, it will influence scientists developing these lifesaving drugs.”

But how long does that take? It’s difficult to estimate, but researchers have made significant leaps in cancer care over the past decade. “Ten years ago, there were no designer drugs. Now there are probably 25 or 30, with literally hundreds in the pipeline,” Dr. Morgan says. “I wouldn’t be surprised if we didn’t see some direct progress here in just a couple of years.”

Symptoms Plus Blood Test Boost Ovarian Cancer Detection

2011-06-06T05:33:00.000-07:00

MONDAY, June 23 (HealthDay News) — U.S. researchers boosted the level of early-stage ovarian cancer detection by 20 percent through use of a blood test to detect a tumor marker as well as a woman’s report of new-onset symptoms.

Using either test alone only uncovered about 60 percent of early-stage ovarian cancers in a high-risk group of women, while the two techniques together found 80 percent of early-stage tumors, according to finding published Monday in the online version of the journal Cancer.

“They appear to act complementary, and appear to be able to identify women who would not be identified by a blood sample alone, and conversely would not be identified by symptoms alone,” said the study’s lead author, M. Robyn Andersen, an associate member of the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center in Seattle.

More than 21,000 women are diagnosed with ovarian cancer annually, and more than 15,000 women die from the disease each year, according to the American Cancer Society (ACS). Currently, only about 20 percent of ovarian cancers are caught in their earliest, potentially curable stages, according to Andersen.

In 2006, Andersen’s colleague, Dr. Barbara Goff, director of gynecologic oncology at the University of Washington School of Medicine, published the ovarian cancer symptom-screening index tool, in an effort to help women and doctors clarify which women might have a heightened risk of ovarian cancer.

Important symptoms include pelvic or abdominal pain, bloating, increased abdominal size, difficulty eating, or feeling full quickly. These symptoms must occur more than 12 times per month, and have just recently begun occurring (within the past year), to be considered positive on the symptom-screening tool. For example, if a woman has had abdominal pain for the past 10 years, it’s probably not related to ovarian cancer, but to another disorder, such as irritable bowel syndrome.

For the current study, Andersen and her colleagues used the symptom-screening index and a blood test that looks for CA 125, a protein that is often elevated in ovarian cancer. However, CA 125 can sometimes be elevated in women who don’t have ovarian cancer, the researchers noted.

The study involved 254 healthy women at high-risk for ovarian cancer because of family history, as well as 75 women about to undergo surgery to remove an ovarian cancer. The women were asked to fill out a questionnaire about their symptoms. All of the women also gave a blood sample to have their levels of CA 125 measured.

The two methods together correctly identified almost 90 percent of the ovarian cancers—80.6 percent of the early cancers and 95.1 percent of the later-stage cancers.

About 14 percent of women who had symptoms and had elevated levels of CA 125 did not have ovarian cancer, according to Andersen. These women received transvaginal ultrasound tests for follow-up, according to Andersen.

“This study continues to add on to the work that’s been done, but we still have a long way to go with ovarian cancer,” commented Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

None of the current screening tools is as accurate as the ACS and other experts would like them to be, she explained. Any of the tests alone misses a significant number of cancers, and unnecessarily worries women who don’t have cancer. Saslow said transvaginal ultrasound can be a good test, but it has to be done by an experienced sonographer, and there are no current guidelines to define how much experience is enough.

Additionally, Saslow said that no research has been done to prove that early detection saves lives.

Andersen said the researchers recommend that if you have any of the symptoms of ovarian cancer, and they’re new-onset symptoms, that you should discuss them with your doctor. But, she added that, “even with this specific pattern of symptoms, most women probably don’t have ovarian cancer, just as most women with a breast lump don’t have breast cancer.”

More information

To read more about ovarian cancer detection, visit the American Cancer Society.

SOURCES: M. Robyn Andersen, Ph.D., associate member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Wash.; Debbie Saslow, Ph.D., director, breast and gynecologic cancer, American Cancer Society; June 23, 2008, Cancer online

By Serena Gordon
HealthDay Reporter

Last Updated: June 23, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Study Sees Link Between Low Salt Levels, Fracture Risk in Older Adults

2011-06-06T05:32:00.000-07:00

SATURDAY, Nov. 20 (HealthDay News) — New research links lower-than-normal levels of sodium (salt) in the blood to a higher risk of broken bones and falls in older adults.

Even mildly decreased levels of sodium can cause problems, the researchers contend.

“Screening for a low sodium concentration in the blood, and treating it when present, may be a new strategy to prevent fractures,” study co-author Dr. Ewout J. Hoorn, of Erasmus Medical Center in Rotterdam, the Netherlands, said in a news release from the American Society of Nephrology.

There’s still a mystery: There doesn’t appear to be a link between osteoporosis and low sodium levels, known as hyponatremia, so it’s not clear why lower sodium levels may lead to more fractures and falls, the study authors said.

The researchers examined the medical records for six years of more than 5,200 Dutch people over the age of 55. The study authors wanted to confirm findings in recent research that linked low sodium to falls, broken bones and osteoporosis, Hoorn said.

About 8 percent of the participants had low sodium levels, which often develop when the kidneys hold too much water. The 8 percent were also more likely to have diabetes and use diuretics (water pills).

About a quarter of the people with low sodium levels had falls, compared to 16 percent of the others in the study, and their risk of vertebral/vertebral compression fractures was 61 percent higher. The risk of non-spinal fractures, such as broken hips, was 39 percent higher.

Those with low sodium were also 21 percent more likely to die during the six-year period.

“Although the complications of hyponatremia are well-recognized in hospitalized patients, this is one of the first studies to show that mild hyponatremia also has important complications in the general population,” Hoorn said.

More research is needed to clarify the apparent link between low sodium levels and increased fracture risk. In the interim, “Screening older adults for and treatment of hyponatremia may be an important new strategy to prevent fractures,” Hoorn said.

The study findings were to be presented Friday at the American Society of Nephrology’s annual meeting, in Denver.

While the study found an association between low salt levels and risk of fractures, it did not prove a cause-and-effect. And research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

For more on kidney disease visit the U.S. National Library of Medicine.

– Randy Dotinga

SOURCE: American Society of Nephrology, press release, Nov. 19, 2010

Last Updated: Nov. 20, 2010

Copyright © 2010 HealthDay. All rights reserved.

Fewer Bone Screens May Be OK for Some Older Women

2011-06-06T05:31:00.000-07:00

MONDAY, Oct. 18 (HealthDay News) — Older women may be able to safely avoid getting bone density tests for 10 years if their previous screening scores didn’t show signs of problems, a new study suggests.

“If a woman’s bone density at age 67 is very good, then she doesn’t need to be re-screened in two years or three years, because we’re not likely to see much change,” study lead author Dr. Margaret L. Gourlay of the University of North Carolina at Chapel Hill School of Medicine, said in a university news release.

“Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it’s great news for this group of women,” Gourlay added.

In 2002, the U.S. Preventive Services Task Force began recommending that women aged 65 and older start routine screening for osteoporosis, but no time interval for screening was established.

In the new study, researchers studied the medical records of 5,035 women aged 67 and older, and found that it took an estimated 16 years for women in low-risk groups — based on their bone density scores — to develop osteoporosis, a progressive bone-thinning disease.

On the other hand, the researchers suggested that older women in the lowest bone density range could be screened annually.

Dr. Joan Neuner, an associate professor of medicine at the Medical College of Wisconsin who’s familiar with the study findings, said in an interview that the recommendations come from a detailed database “from which much of our current knowledge of U.S. fracture risk factors is gained” and is “consistent with some limited prior work.”

More information

For more on osteoporosis, try the American Academy of Orthopaedic Surgeons.

– Randy Dotinga

SOURCES: University of North Carolina School of Medicine, news release, Oct. 17, 2010; Joan Neuner, M.D., associate professor, medicine, Medical College of Wisconsin, Milwaukee

Last Updated: Oct. 18, 2010

Copyright © 2010 HealthDay. All rights reserved.

Hormone Replacement Might Relieve Arthritis

2011-06-03T04:30:00.000-07:00

TUESDAY, March 30 (HealthDay News) — Hormone replacement therapy directed to joint fluid may help regenerate damaged cartilage tissue in people with advanced osteoarthritis, according to German researchers.

Their study aimed to examine the regenerative potential of a type of cell — chondrogenic progenitor cells, or CPCS — that is present in the late stages of osteoarthritis. The researchers speculated that these cells might be influenced by the sex hormones estrogen, which has been shown to affect bone metabolism, and testosterone.

They analyzed tissue samples from 372 men and women with arthritis who’d had a total knee replacement. Most were in their early 70s.

In the joint fluid of the participants, they found 17 beta-estradiol, a form of estrogen, which they said increases calcium deposition in both sexes. And, in the osteoarthritic tissue, they found CPCs positive for estrogen receptors and androgen receptors.

The researchers, also found that unique CPCs were present in the cartilage of people with late-stage osteoarthritis (OA).

“We were able to isolate CPCs in 95.48 percent of female patients and 96.97 percent of male patients, making these cells a good target for future therapeutic intervention for a very large number of OA patients,” Dr. Nicolai Miosge, from August University in Goettingen, said in a news release from Wiley-Blackwell, which publishes Arthritis & Rheumatism.

The findings are reported in the journal’s April issue.

“Hormone replacement therapy in joint fluid may help mitigate the effects of OA,” Miosge concluded, adding that further investigation was needed.

More information

The Arthritis Foundation has more about osteoarthritis.

— Robert Preidt

SOURCE: Wiley-Blackwell, news release, March 30, 2010

Last Updated: March 30, 2010

Copyright © 2010 HealthDay. All rights reserved.

High-Impact Sports Might Not Harm Knee Replacements

2011-06-03T04:28:00.000-07:00

FRIDAY, March 12 (HealthDay News) — Patients who get a total knee replacement are usually advised to avoid high-impact sports to preserve their new body part. But a new study suggests sport participation is not only safe — it may even help people gain better knee function.

”Initially, we though high-impact sports were terrible for the prosthesis,” said Dr. Sebastien Parratte, a research collaborator at the Mayo Clinic in Rochester, Minn., and an assistant professor at the Aix-Marseille University Center for Arthritis Surgery at Hospital Sainte-Marguerite in Marseille, France.

“Our eight-year results have shown it is not the case,” he said.

He is the lead author of the study, scheduled for presentation Friday at the annual meeting of the American Academy of Orthopaedic Surgeons in New Orleans.

More than a half million total knee replacements are performed annually in the United States, according to the American Academy of Orthopaedic Surgeons. Parratte and his colleagues conducted the study knowing that patients routinely ignore their doctor’s advice to take it easy after receiving a knee replacement. In fact, about one of six patients engage in high-impact activities post-implantation, experts say.

Parratte’s team followed 535 patients in all. A total of 218 underwent knee replacement and then performed heavy manual labor or engaged in a non-recommended sport, such as high-impact aerobics, football, soccer, baseball, jogging or power lifting. The control group of 317 patients had knee replacement but did not engage in sports that were not recommended.

The researchers evaluated the patients clinically and with X-rays. About eight years after surgery, they found no significant radiological differences and no significant differences in the implant durability between groups.

In fact, the sport group had slightly higher knee function scores than the control group.

A first comparison found that the control group had a 20 percent higher need to repeat the operation because of mechanical failure of the knee (from wear, fracture or loosening) compared to the sport group. But when they took into account other health problems such as obesity or diabetes, the sport group had a 10 percent higher risk of mechanical failure compared to the control group, but the difference wasn’t statistically significant.

”The control group was more likely to have high blood pressure, obesity and diabetes,” Parratte added.

He said he doesn’t know why the sport group’s knees held up better.

Still, the study findings are no reason to tell patients with knee replacements to exercise in a high-impact way, said Dr. Christian Christensen, an orthopedic surgeon and head of adult reconstruction at the Lexington Clinic in Lexington, Ky.

“I think it’s a good study and certainly a worthwhile one,” he said. “Would it encourage me to tell my patients to play football? No way.”

More research is needed to evaluate what’s happening, he said. It’s possible that the people with the best results may be the ones engaging in high-impact sports. “People with the knees that feel great, who have excellent results,” are perhaps the ones who can engage in the high-impact sports without ill effect, he said.

Another possibility, he said, is that the follow-up may just not be long enough, that ill effects may show up later. Christensen said he’ll continue to tell his knee-replacement patients to avoid high-impact sports. “Implants aren’t meant to tolerate high-impact sports,” he said.

Dr. Benjamin Bengs, another expert, called the new study findings promising. It shows these devices are long-lasting, can lead to lifelong pain relief and excellent functioning and activity in patients, said Bengs, an orthopedic surgeon at Santa Monica-University of California Medical Center and Orthopaedic Hospital.

But more time and study are needed before we completely release people to all high-impact activities, he said.

”One study is not enough to change the recommendations,” Parratte agreed. He plans to study the topic further.

More information

To learn more about total knee replacement, visit the American Academy of Orthopaedic Surgeons.

By Kathleen Doheny
HealthDay Reporter

SOURCES: Sebastien Parratte, M.D., Ph.D., orthopedic surgeon, Mayo Clinic, Rochester, Minn., and Aix-Marseille University, Center for Arthritis Surgery, Hospital Sainte-Marguerite, Marseille, France; American Academy of Orthopaedic Surgeons annual meeting, March 12, 2010, New Orleans; Christian Christensen, M.D., head of adult reconstruction at the Lexington Clinic, Lexington, Ky.; Benjamin Bengs, M.D., orthopedic surgeon, Santa Monica–University of California Medical Center and Orthopaedic Hospital, Santa Monica, Calif., and assistant professor, orthopedic surgery, UCLA David Geffen School of Medicine, Los Angeles

Last Updated: March 12, 2010

Copyright © 2010 HealthDay. All rights reserved.

Low Vitamin D Levels Tied to Obesity in Kids

2011-06-03T04:25:00.000-07:00

FRIDAY, April 29 (HealthDay News) — Vitamin D deficiency is common in American children and linked with obesity and different types of fat distribution in white and black youngsters, new research shows.

Vitamin D is found in certain foods, but humans synthesize most of the nutrient they need via the action of sunlight on exposed skin. Supplements can also boost levels of vitamin D.

In the study, researchers checked vitamin D levels in 237 healthy obese and non-obese white and black children, aged 8 to 18. They found that most of them were vitamin D deficient. Low levels of vitamin D were associated with higher body mass index and fat levels, and lower levels of “good” high-density lipoprotein (HDL) cholesterol.

Among those with vitamin D deficiency, white children were more likely to have higher levels of fat between their internal organs (visceral adipose tissue), while black children were more likely to have higher levels of fat just under the skin (subcutaneous adipose tissue), the investigators found.

The study is published in the May issue of the Journal of Clinical Endocrinology & Metabolism.

“Vitamin D deficiency is rampant in American youth, and there is some suggestion in adults that low levels of vitamin D may be playing a role in the increasing rates of type 2 diabetes. It is possible the same may be true for youth with type 2 diabetes,” lead author Dr. Silva Arslanian, of the University of Pittsburgh, said in a news release from the Endocrine Society.

“Besides therapeutic interventions to correct the high rates of vitamin D deficiency in youth, benefits of vitamin D optimization on fat levels, lipid [blood fat] profile and risk of type 2 diabetes need to be explored,” Arslanian added.

More information

The American Academy of Pediatrics has more about children and vitamin D.

– Robert Preidt

SOURCE: The Endocrine Society, news release, April 27, 2011

Last Updated: April 29, 2011

Copyright © 2011 HealthDay. All rights reserved.

Tall, Obese Men More Prone to Leg Clots: Study

2011-06-03T04:22:00.000-07:00

By Randy Dotinga
HealthDay Reporter

THURSDAY, April 28 (HealthDay News) — Men who are both obese and tall face a much higher risk for developing potentially fatal blood clots, though overall the risk remains quite small, according to a new study.

The researchers report that extra weight and extra inches together seem to raise the risk more than either alone.

“Tall and obese men had more than a fivefold higher risk, compared to short and lean men,” said the study’s co-author, Sigrid K. Braekkan, who warns the vertically and horizontally gifted to avoid sitting in one place for too long.

Women also face a higher risk if they’re both obese and tall, but just being tall alone doesn’t seem to be a problem, the study found.

The clots lead to a condition known as deep vein thrombosis, which may be best known as an affliction that strikes passengers on long plane flights who don’t have much chance to move around. Immobilization of the legs can contribute to the condition.

Other causes include injury and a genetic condition that makes people’s blood more likely to clot. “And there are some people who seem to get clots when they don’t have any clear, obvious risk factors,” said Dr. Victor Tapson, director of the Center for Pulmonary Vascular Disease at Duke University.

Though the clots start in the leg, they can move to the lung, where they may cause a deadly pulmonary embolism. Venous thromboembolism is the term used to describe the two conditions — deep vein thrombosis and pulmonary embolism — together.

In the new study, published online April 28 in Arteriosclerosis, Thrombosis and Vascular Biology, researchers collected data on 26,714 people from 1994 to 2007, including 461 reports of venous thromboembolism.

Obese and tall men — those at least six feet tall — had more than five times the risk for a clot, compared with normal-weight men shorter than 5 feet 7 inches. The risk was three times higher for women who were obese and at least 5 feet 6 inches than for normal-weight women shorter than 5 feet 3 inches.

The higher risk for tall people appears to be related to their circulatory system. “The distance for blood to return to the heart and lungs is longer,” Braekkan said. “Since the blood must be pumped upwards against the force of gravity by the calf-muscle pump, the longer distance may cause reduced flow in the legs and, thereby, higher risk of clotting.”

He said that obesity causes pressure in the abdomen that may hinder the ability of the calf-muscle pump to send blood back up into the body.

The study found, however, that the risk for developing blood clots remained low, even for the tall and obese.

But what should obese and tall people do to lower their risk even more? Until pounds can be shed, the best thing to do is to avoid situations where you’re not moving for long periods of time, Tapson said.

Even in the cramped space of a plane, try “just moving your legs, shifting your legs, going up and down on your toes and flexing your feet back and forth to keep your calf muscles stimulated,” he said. It’s also a good idea to keep hydrated (and alcohol doesn’t help on that front). Some people use elastic socks, although Tapson said they may be troublesome if they crimp the legs.

More information

The U.S. National Heart, Lung and Blood Institute has more on deep vein thrombosis.

SOURCES: Sigrid K. Braekkan, Ph.D., researcher, Hematological Research Group, University of Tromso, Norway; Victor Tapson, M.D., professor, medicine, and director, Center for Pulmonary Vascular Disease, Duke University Medical Center, Durham, N.C.; April 28, 2011, Arteriosclerosis, Thrombosis and Vascular Biology, online

Last Updated: April 28, 2011

Copyright © 2011 HealthDay. All rights reserved.

Soaring Costs Deprive Some Children of Medical Care

2011-06-03T04:20:00.000-07:00

MONDAY, May 2 (HealthDay News) — Because of soaring health care costs in the United States, some parents are reluctant to take their children to the doctor or to buy prescription drugs, according to a new study.

Researchers examined data from 6,273 families with at least one child who took part in Medical Expenditure Panel Surveys between 2001 and 2006.

One thing that increased the chances that families would delay or go without care was excessive financial burden, defined as insurance premiums or out-of-pocket health care expenses exceeding 10 percent of family income.

Other factors were having a child with an ongoing activity limitation, and a parent with intermittent insurance.

The study also found significant racial/ethnic and income-related disparities. For example, white families were more likely than black families to report delayed or foregone care. Families with a household income below the federal poverty level were more likely to delay or go without care than those with incomes at or above 400 percent of the poverty level.

The study was to be presented Monday at the annual meeting of the Pediatric Academic Societies. Research presented at meetings is considered preliminary because it has not been subject to the scrutiny required for publication in a peer-reviewed journal.

“Every U.S. family has a finite amount of resources available to them, and every day they have to make decisions about how to allocate those resources. This is especially true in today’s economy where you hear people talk about ‘feeling the pinch,’” study leader Lauren E. Wisk, a doctoral student and graduate research assistant at the School of Medicine and Public Health, University of Wisconsin, Madison, said in an American Academy of Pediatrics news release.

“This study shows the unfortunate reality of the situation,” Wisk added. “Families aren’t choosing to spend their money on going to the doctor when someone is sick because of how much it cost them to see the doctor last time. They’re sacrificing their health because it costs too much to be healthy.”

More information

The U.S. Agency for Healthcare Research and Quality has more about health care costs.

— Robert Preidt

SOURCE: American Academy of Pediatrics, news release, May 2, 2011

Last Updated: May 02, 2011

Copyright © 2011 HealthDay. All rights reserved.

Blacks With Cancer More Inclined to Exhaust Funds to Prolong Life: Study

2011-06-03T04:18:00.000-07:00

TUESDAY, April 26 (HealthDay News) — White patients with lung or colorectal cancer are less willing than patients of other races or ethnicities to use up their personal financial resources to prolong their life, a new study finds.

U.S. researchers analyzed data from 4,214 participants in the Cancer Care Outcomes Research and Surveillance study of patients with newly diagnosed lung or colorectal cancer.

The patients were interviewed about various aspects of their care, including their willingness to deplete their personal financial resources for life-prolonging treatment rather than receive less costly treatment that would not extend their lives as long.

Those who said they would spend all their money to live longer included 80 percent of black patients, 72 percent of Asians, 69 percent of Hispanics and 54 percent of whites.

After researchers accounted for factors such as income, disease stage, quality of life, patients’ age, patients’ perceived time left to live and other medical illnesses, the researchers determined that black patients were 2.4 times more likely than whites to say they’d exhaust their personal finances to extend life.

Hispanic and Asian patients were also less inclined to spend all of their money than blacks, but more likely than whites to do so.

The study appears online April 26 in the journal Cancer.

Further research is needed to determine the reasons for these differences among the races, said Michelle Martin of the University of Alabama at Birmingham and colleagues in a journal news release. Learning more about this issue may lead to cancer care that consistently reflects patient values and preferences, they added.

More information

The U.S. National Cancer Institute offers fact sheets about coping with cancer.

— Robert Preidt

SOURCE: Cancer, news release, April 26, 2011

Last Updated: April 26, 2011

Copyright © 2011 HealthDay. All rights reserved

Early Adversity May Shorten Child’s Life

2011-06-03T04:15:00.000-07:00

WEDNESDAY, May 18 (HealthDay News) — Deprivation and neglect can cause premature aging of children’s chromosomes, a new study suggests.

Researchers examined DNA samples collected from institutionalized children (62 boys and 47 girls) in Romania taking part in a long-term study. Some of the children remained in the institution, while others were transferred to high-quality foster care at different ages.

Children who spent more time in an institution before age 5 had premature shortening of chromosome tips (telomeres) when they reached ages 6 to 10, the researchers found.

“The telomere is designed to protect the chromosome, so accelerating how early in life telomeres lose length correlates with shortened life span,” principal investigator Charles Nelson, director of the Laboratories of Cognitive Neuroscience at Children’s Hospital Boston, said in a hospital news release. “Children institutionalized early in life have shortened telomeres, which may lead to health consequences downstream, including premature aging.”

He and his colleagues found differences between girls and boys. The strongest predictor of telomere shortening for girls was the amount of time spent in the institution before 22 months of age. For boys, it was the amount of time spent in the institution before 54 months of age.

The study was published online May 17 in the journal Molecular Psychiatry.

Previous research has linked shorter telomere length in adults with cognitive defects and increased rates of cardiovascular disease and cancer.

“One question we are currently studying is whether telomere length can recover as a child spends more time in foster care, or whether the shortening we observed reflects a permanent change,” Nelson said.

More information

The University of Utah has more about telomeres.

– Robert Preidt

SOURCE: Children’s Hospital Boston, news release, May 17, 2011

Last Updated: May 18, 2011

Copyright © 2011 HealthDay. All rights reserved.

Skin Infestation a Delusion, Study Says

2011-06-03T04:13:00.000-07:00

By Anne Harding

MONDAY, May 16, 2011 (Health.com) — For years, dermatologists have been aware of—and baffled by—people who feel a constant creepy-crawly sensation beneath their skin, which they believe is due to bugs, worms, or eggs below the surface.

Now, in the largest study to date to examine skin samples from patients with these symptoms, doctors have firm proof that these infestations
—known as delusional parasitosis or delusional infestation—are not real. The researchers acknowledge, however, that the findings may not be enough convince many of these patients.

Patients often feel dismissed when doctors reassure them that the infestation is all in their head, and many continue to believe they are teeming with bugs even when skin biopsies come back negative.

“It’s almost impossible to get them to shake this belief, no matter how much evidence you produce to the contrary,” says Mark D. P. Davis, MD, a professor of dermatology at the Mayo Clinic, in Rochester, Minn.

Antipsychotic drugs are the standard treatment for delusional infestation. But, Dr. Davis says, “A lot of patients with this disorder don’t want to take these drugs because they don’t feel they have a delusional disorder.”

Some patients who experience this skin-crawling sensation believe it is caused by textile-like fibers produced by an unknown organism. Along with a group of sympathetic doctors and advocates, these patients have pushed for the condition to be officially recognized as Morgellons disease, and have lobbied—successfully—for the Centers for Disease Control and Prevention (CDC) to investigate it.

However, most doctors maintain that the condition is psychological rather than physical. In a new study, published this week in the Archives of Dermatology, Dr. Davis and his colleagues sought to confirm this view by presenting the results of skin biopsies taken from patients who were diagnosed with delusional infestation at the Mayo Clinic between 2001 and 2007.

The researchers performed 80 biopsies. As expected, none showed evidence of skin infestation, although 49 patients did have some skin inflammation, known as dermatitis. This inflammation might be due to some underlying cause, such as allergies, or it could have been caused by the patient’s efforts to remove the bugs or objects by digging them out or even trying to burn them, Dr. Davis says.

In addition, 80 of the study participants—including some who also had biopsies taken—supplied their own skin samples to the doctors. Ten of these specimens contained insects, such as a mite or tick, but only one such bug was actually capable of causing an infestation; it was a pubic louse, but the patient’s biopsy did not show any signs that his or her skin was infested with the lice.

The CDC recently completed its own study of the condition, which the agency refers to as unexplained dermopathy, but the results have not yet been published.

Teen Headaches Tied to Alcohol, Coffee

2011-06-01T04:43:00.000-07:00

MONDAY, June 7 (HealthDay News) — A new German study links drinking and smoking to higher rates of migraine and tension headaches among teens and young adults.

An estimated 5 to 15 percent of high school students surveyed reported suffering from migraines, and 15 to 25 percent said they have tension headaches. Migraines were more common among those who drank coffee and didn’t get much exercise.

Astrid Milde-Busch, a researcher at Ludwig-Maximilians-University in Munich, Germany, and colleagues surveyed 1,260 students aged 14 to 20 about headaches and their activities.

Of the students, 83 percent said they’d had a headache within the previous six months.

“Our study confirms that adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks,” Milde-Busch said. “In teens suffering from migraine, a low coffee consumption should also be suggested.”

Young adults who skipped meals weren’t at higher risk of headache, the researchers found.

The study was published online June 7 in the journal Headache.

More information

For more about headaches, see the U.S. National Library of Medicine.

– Randy Dotinga

SOURCE: Wiley, press release, June 7, 2010

Last Updated: June 07, 2010

Copyright © 2010 HealthDay. All rights reserved.

New Migraine Drug Might Be Safer for Some

2011-06-01T04:41:00.000-07:00

THURSDAY, April 22 (HealthDay News) — A drug under development could help patients with migraines, while an existing epilepsy drug might prevent the headaches from developing in the first place, new research suggests.

The report, published April 21 in The Lancet, examines the migraine drug telcagepant, which is not yet available, and topiramate (Topamax), an epilepsy drug sometimes used to treat migraines when they occur.

Telcagepant relieves pain in a similar way to the drugs known as triptans that are used to treat migraine. But it doesn’t cause blood vessels to constrict, a troublesome side effect for people with heart disease, the report says.

Triptans often don’t work, and they can cause side effects like dizziness, throat tightness, chest discomfort and numbness. For its part, telcagepant can cause side effects like dry mouth, dizziness, nausea and drowsiness.

Telcagepant is a “promising compound,” writing the study authors, but add that further investigation is needed.

Also in the report, the authors say topiramate is showing promise as a preventive treatment for migraines. It’s cost-effective and typically leads to weight loss instead of weight gain, they report.

The authors write that the drug “should especially be considered for adult patients who are overweight, or have epilepsy or a contraindication to beta blockers. It is generally safe and well-tolerated. Thus topiramate is an important drug for difficult cases.”

The report authors are Dr. Lars Edvinsson of University Hospital in Lund, Sweden, and Dr. Mattias Linde of the Norwegian University of Science and Technology in Trondheim, Norway.

More information

The U.S. National Library of Medicine has more about migraine headaches.

— Randy Dotinga

SOURCE: The Lancet, news release, April 21, 2010

Last Updated: April 22, 2010

Copyright © 2010 HealthDay. All rights reserved.

Early Menstruation Lowers Odds of Surviving Ovarian Cancer

2011-06-01T04:40:00.000-07:00

THURSDAY, July 9 (HealthDay News) — Among women with ovarian cancer, those who had their first menstrual period before the age of 12 and who had the most menstrual cycles over a lifetime are more likely to die of the cancer than those who had fewer ovulatory cycles, a new study shows.

U.S. researchers analyzed data on 410 women, aged 20 to 54, who had ovarian cancer and were enrolled in the Cancer and Steroid Hormone (CASH) study between 1980 and 1982.

Using data that included in-depth patient interviews, reproductive history, contraceptive use and personal and family medical history, the researchers divided the women into groups based on their total number of ovulatory cycles.

There were 212 deaths among the participants during a median follow-up of 9.2 years, the study authors noted.

Women in the group who had the highest number of lifetime ovulatory cycles had a 67 percent greater chance of dying during the study follow-up, which ranged up to about 17 years.

The findings were independent of a woman’s age at the time of the study, which would of course have a significant impact on the number of menstrual cycles a woman had had, said study author Cheryl Robbins, an epidemiologist at the U.S. Centers for Disease Control and Prevention.

Ovarian cancer patients whose age at menarche, or first menstrual cycle, was younger than 12 were 51 percent more likely to die from the cancer than those whose age at menarche was 14 or older, according to the study, published in the July issue of Cancer Epidemiology, Biomarkers & Prevention.

Ovarian cancer is the fifth-leading cause of cancer deaths among women. The high mortality is due, in part, because the disease is typically discovered after it has spread. Only about one-fifth of ovarian cancers are detected when the cancer is still localized, the study authors noted.

Previous research has linked age at first menstrual period and number of lifetime menstrual cycles with the risk of ovarian cancer, while use of oral contraceptives and hysterectomy or tubal ligation, which halt ovulation, have also been shown to reduce the risk of developing ovarian cancer.

Other studies have also found that having children earlier in life, having multiple children and breast-feeding provide protection, but the results are inconsistent, the researchers noted.

But less is known about the impact of those hormonal and reproductive factors on survival rates for women who already have the cancer.

“Although we have relatively good knowledge about the influence of reproductive factors on the risk of developing ovarian cancer, knowledge is rather limited regarding the reproductive factors that may influence survival after diagnosis with this serious disease,” Robbins said.

Though the exact mechanism isn’t understood, researchers believe that the surge of hormones brought on by ovulation, or the insult to the cells that occurs during ovulation, may be associated with more aggressive tumors, Robbins said.

In the current study, while age at first period and total lifetime menstrual cycles impacted survival, other factors, including number of pregnancies, breast-feeding and menopausal status did not show a statistically significant impact on survival rates.

Dr. Mary B. Daly, director of the Personalized Cancer Risk Assessment Program at the Fox Chase Cancer Center in Philadelphia, said the results shed more light on the role reproductive hormones play in ovarian cancer, potentially providing clues for developing new treatments for aggressive cancers.

Yet the study has its limitations, Daly added. Women’s recollections could have been flawed, and the study participants were younger than the typical ovarian cancer patient and so may not be truly representative. Additionally, the women in the study had ovarian cancer nearly 30 years ago and would not have been receiving today’s more advanced chemotherapy treatments.

Nor is the research definitive enough to suggest that women should go out and start taking contraceptive pills or having babies earlier to increase their chances of surviving ovarian cancer.

“The paper may suggest other avenues of research into what is it about the hormonal profile of women that could affect the biology of their ovarian cancer,” Daly said. “As of right now, it doesn’t translate into something you could clinically do differently.”

More information

The U.S. National Cancer Institute has more on ovarian cancer.

By Jennifer Thomas
HealthDay Reporter

SOURCES: Cheryl L. Robbins, Ph.D., epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; Mary B. Daly, M.D., Ph.D., director, Personalized Cancer Risk Assessment Program, Fox Chase Cancer Center, Philadelphia; July 2009 Cancer Epidemiology, Biomarkers & Prevention

Last Updated: July 09, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Childhood Sexual Abuse Might Spur Early Periods

2011-06-01T04:36:00.000-07:00

THURSDAY, May 21 (HealthDay News) — The younger they were when they started menstruating, the more likely black women were to have suffered childhood sexual abuse, U.S. researchers report.

The finding suggests childhood sexual abuse may increase the likelihood of early periods.

Researchers looked at more than 35,000 women,
aged 21 to 69, taking part in the Black Women’s Health Study and found that 43 percent reported physical abuse and 18 percent reported sexual abuse when they were children.

The study found that women who suffered one to three incidents of childhood sexual abuse were 26 percent more likely to have had menstrual periods before age 12, while those who experienced four or more incidents of childhood sexual abuse were 34 percent more likely to have had early periods.

There was a weaker association between early periods and childhood physical abuse, according to the study, published online in the American Journal of Public Health.

It’s biologically plausible that childhood sexual abuse could influence age of menstruation, said study author Lauren A. Wise, an epidemiologist at the Slone Epidemiology Center and an assistant professor of epidemiology at Boston University School of Public Health.

“A link between sexual abuse and early menarche [periods], if real, could have important public health implications, because early menarche is associated with earlier age at initiation of sexual activity and first pregnancy, and is a risk factor for several adult conditions, including gynecologic disorders, cardiovascular disease and cancer,” Wise said in a Boston University Medical Center news release.

More information

The American Academy of Child and Adolescent Psychiatry has more about childhood sexual abuse.

— Robert Preidt

SOURCE: Boston University Medical Center, news release, May 18, 2009

Last Updated: May 21, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Blood Test May Be Able to Predict Menopause

2011-06-01T04:33:00.000-07:00

MONDAY, June 28, 2010 (Health.com) — A simple doctor’s-office blood test may one day be able to predict when a woman will start menopause, possibly even in women in their 20s.

Pending validation in future studies, the test could help women make reproductive decisions, say the authors of a study that will be presented Monday at the annual meeting of the European Society of Human Reproduction and Embryology in Rome.

“Women may want to know if they’re OK waiting to start a family till they’re 41,” says Jennifer Wu, MD, an obstetrician/gynecologist at Lenox Hill Hospital, in New York City, who was not involved with the study. “If they know they’re going to start menopause at 45, they may not want to wait.”

But the test definitely isn’t ready for prime time and may not be used primarily to guide family planning decisions, even if it is eventually brought to market, other experts say.

“I’m not sure that this would help with family planning decisions [although] it’s a very interesting first, small, observational study,” says Steven Goldstein, MD, president-elect of the North American Menopause Society (NAMS). “It would be helpful to do a larger trial and see if it pans out and, if so, to what degree of accuracy.”

In the study, researchers from Shahid Beheshti University of Medical Sciences, in Tehran, Iran, measured blood levels of anti-mullerian hormone (AMH) in 266 women who were ages 20 to 49.

AMH is proportional to the number of viable eggs left in the ovaries, which produce the hormone, says James A. Grifo, MD, PhD, program director of the NYU Langone Fertility Center, in New York City.

Fertility Drug Shows Potential Against Hot Flashes

2011-06-01T04:30:00.000-07:00

WEDNESDAY, Sept. 16 (HealthDay News) — A powerful fertility drug may have another use for older women: stopping hot flashes.

In a letter to the editor in the Sept. 17 issue of the New England Journal of Medicine, researchers from the Netherlands report that in three cases, the injectable medication cetrorelix (Cetrotide) helped ease hot flash symptoms.

“It is a very exciting new approach for an extremely common problem with an enormous psychosocial impact that is often ignored or underestimated,” said the lead author of the letter, Dr. Hans de Boer, an endocrinologist at Rijnstate Hospital in Arnhem, the Netherlands.

Not everyone is convinced that this drug is a viable option for treating menopausal symptoms, however.

“This letter describes three cases and has no controls. This drug works on receptors in the brain and no one knows what the long-term consequences might be,” said Dr. Lila Nachtigall, director of the Women’s Wellness Program at the NYU Langone Medical Center, and a professor at the New York University School of Medicine in New York City.

Nachtigall said she would never recommend such a drug to her patients when there are other, often more well-studied options available to treat hot flashes.

Cetrorelix blocks the brain receptors for luteinizing hormone-releasing hormone (LHRH), which the letter’s authors suggest may be involved in the development of hot flashes. The medication is primarily used by doctors to stop premature ovulation in women taking fertility drugs but it is also being studied for use in women with hormone-sensitive cancers, such as breast, ovarian and endometrial cancer, as well as in endometriosis treatment.

Although they might not sound serious, hot flashes — sometimes called hot flushes — can greatly affect the quality of a woman’s life. A sudden sensation of increased heat is often accompanied by perfuse perspiration. The sweating can be severe enough that women need to change their clothes. Besides causing discomfort, hot flashes can seriously disturb sleep quality.

The three women that de Boer and his colleagues reported on all entered menopause as the result of the removal of their ovaries, which had occurred several years earlier. One patient was 65 years old and began having severe hot flashes after estrogen-replacement therapy was discontinued. The second patient was 49 years old and had survived breast cancer, while the third patient — 59 years old — had survived endometrial cancer.

All underwent daily injections of cetrorelix for at least 20 weeks, according to the letter. And, hot flash symptoms were reduced between 60 percent and 80 percent, according to de Boer, who added that they saw no serious adverse events associated with the use of cetrorelix. He also said that he didn’t expect any serious long-term side effects.

But, he cautioned that the “research in this area is very preliminary. It may take several years before everything is sorted out and therapy is available on a regular basis.”

Nachtigall said that one of her biggest issues with this case report is that other researchers, including the top researcher in the field, have come to believe that LHRH is not behind hot flashes. “We just don’t know the true cause,” she said.

And, more importantly, “we do have other options for treating hot flushes,” said Nachtigall.

She said that most women can safely take estrogen as they’re entering menopause for as long as a few years. And, she said, some antidepressant medications in the SSRI class have also been shown to be helpful in reducing hot flashes. There are also some alternative therapies that women have found effective.

“The bottom line is we do have ways to fight it. You don’t have to take a drug we know nothing about. For fertility, this is used for 10 days or so, maybe once or twice in a woman’s life. This drug works on receptors in the brain, and no one knows what effects long-term use might have,” she said.

More information

To learn more about treatments for menopausal symptoms, like hot flashes, visit the U.S. National Women’s Health Information Center.

By Serena Gordon

HealthDay Reporter

SOURCES: Hans de Boer, M.D., Ph.D., endocrinologist, Rijnstate Hospital, Arnhem, the Netherlands; Lila Nachtigall, M.D., director, Women’s Wellness Program, NYU Langone Medical Center, and professor, New York University School of Medicine, New York City; Sept. 17, 2009 New England Journal of Medicine

Last Updated: Sept. 16, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Birth Control Pills Linked to Lupus Risk

2011-06-01T04:27:00.000-07:00

THURSDAY, April 9 (HealthDay News) — Women taking birth control pills, especially those who have just started taking them, may face an increased risk of developing the autoimmune disease lupus, a new study suggests.

Although the link between lupus and oral contraceptives has been debated for some time, this new study adds weight to earlier studies — including the Nurses’ Health Study — that have shown a link between oral contraceptives and lupus, the study authors said.

The findings were published in the April issue of Arthritis Care & Research.

Lupus is characterized by acute and chronic inflammation of various tissues of the body. The immune system mistakenly attacks healthy cells and tissues, potentially damaging joints, skin, blood vessels and organs, according to the U.S. National Library of Medicine.

For the new study, a team led by Dr. Samy Suissa of the Centre for Clinical Epidemiology at Jewish General Hospital of McGill University in Montreal collected data on more than 1.7 million women whose medical records were in the U.K. General Practice Research Database. The women all had prescriptions for oral contraceptives.

During eight years of follow-up, 786 women developed lupus. The researchers matched each of these women with 10 women who did not have the disease.

Suissa’s team found that oral contraceptives were associated with a 1.5-fold increased risk of developing lupus. The risk was greatest during the first three months after starting “the Pill” — when there was a 2.5-fold increased risk.

The researchers speculated that increased estrogen from oral contraceptives could be responsible for the increased risk. Estrogen can affect the body’s immune response, which could trigger a genetic predisposition to the disease, the scientists said.

Suissa’s team also noted that newer oral contraceptives, which contain lower doses of estrogen, are substantially less likely to heighten the risk of lupus, compared to the second-generation contraceptives used in the study.

For most women, the increased risk of lupus is quite small, said Dr. Noel Rose, director of the Autoimmune Disease Research Center at Johns Hopkins University, who was not involved in the study. “One shouldn’t oversell this. Women taking oral contraceptives need to weigh the risk/benefit of unexpected pregnancy versus a very small increase in lupus.”

The increased risk isn’t the same for all women taking oral contraceptives, Rose said. “This is probably a risk that only people who are genetically predisposed are likely to ever encounter,” he said.

Dr. Bevra Hahn, chief of rheumatology and arthritis at the David Geffen School of Medicine at the University of California, Los Angeles, thinks the new study can be helpful in prescribing oral contraceptives.

“The higher the dose of estradiol in women who have been started on oral contraceptives in the past three months, the higher the risk for developing” lupus, Hahn said. “That’s the highest risk I’ve ever seen — meaning women have a little over three times the chance of developing lupus in the first three months of taking an oral contraceptive.”

“That is very useful information in terms of what oral contraceptive one prescribes,” she said.

Hahn agreed that women need to weigh the risk of developing lupus to the risk of getting pregnant. “There isn’t any effective treatment I know of that isn’t accompanied by some risk. So she just has to decide which risk she thinks is greater.”

More information

For more on lupus, visit the U.S. National Library of Medicine.

SOURCES: Noel Rose, M.D., Ph.D., director, Autoimmune Disease Research Center, Johns Hopkins University, Baltimore; Bevra Hahn, M.D., chief of rheumatology and arthritis, David Geffen School of Medicine, University of California, Los Angeles; April 2009, Arthritis Care & Research

By Steven Reinberg
HealthDay Reporter

Last Updated: April 09, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Blood Cancer Drug Shows Promise Against Lupus

2011-06-01T04:25:00.000-07:00

SUNDAY, June 8 (HealthDay News) — A drug used to treat multiple myeloma, a cancer of the white blood cells, may also be a treatment for the chronic autoimmune disease lupus, German researchers report.

The drug, Velcade (bortezomib), which is a proteasome inhibitor, worked against the disease and prolonged survival in mice with lupus. The finding could one day offer treatment options for other antibody-associated diseases, too, the researchers said.

“Autoantibody-mediated diseases such as autoimmune hemolytic anemia, immune thrombocytopenia, myasthenia gravis and systemic lupus erythematosus are often difficult to treat,” said lead researcher Dr. Reinhard Voll, of the University of Erlangen-Nuremberg.

A big problem is that plasma cells, which are the predominant producers of the disease-causing autoantibodies, can’t be efficiently attacked with current treatments, Voll said.

Lupus is a so-called autoimmune disease in which the immune system attacks healthy cells and tissues by mistake, leading to damage to joints, skin, blood vessels and organs. There are many kinds of lupus, with the most common type being systemic lupus erythematosus, which affects many parts of the body. There’s no one test to diagnose lupus, and it may take months or years to make the diagnosis. There’s also no cure, but medicines and lifestyle changes can help control the disease, according to the U.S. National Institutes of Health

For the new study, Voll’s team found that bortezomib efficiently eliminated the plasma cells in the mice, leading to a drastic decrease in autoantibodies and prolonged survival. And, the drug had no effect on other cells, he said.

“Proteasome inhibitors may be beneficial in refractory human diseases caused predominantly by autoantibodies,” Voll said. “Proteasome inhibitors can selectively deplete plasma cells, which are resistant to current treatments.”

Outside experts were divided on the findings, published in the June 8 online edition of Nature Medicine.

“This is a very exciting study that explores a novel mechanism for treating lupus erythematosus,” said Dr. Jennifer Grossman, an assistant professor of medicine at the University of California, Los Angeles.

“The fact that antibodies almost completely disappeared is encouraging. I look forward to hearing more about this treatment in the future,” she said.

But, another expert expressed concern that the treatment could adversely affect other cells in the human body.

“I think they’re onto something important, it looks as if it has a remarkable therapeutic effect,” said Dr. Noel Rose, director of the Autoimmune Disease Research Center at Johns Hopkins University. “The downside is that this is a proteasome inhibitor, and there is no reason to think that it would be specific for plasma cells. It does affect other rapidly proliferating cells.”

Rose noted that many drugs may appear safe during an initial trial. “I’m still really suspicious that if this is used clinically, there are going to be side effects like effects on intestinal or other rapidly dividing cells,” he said. “The question is, are the side effects going to be severe enough to prevent the use of this drug?”

More information

To learn more about lupus, the U.S. National Library of Medicine.

SOURCES: Reinhard Voll, M.D., University of Erlangen-Nuremberg, Erlangen, Germany; Jennifer Grossman, M.D., assistant professor of medicine, University of California, Los Angeles; Noel Rose, M.D., director, Autoimmune Disease Research Center, Johns Hopkins University, Baltimore; June 8, 2008, Nature Medicine, online

By Steven Reinberg
HealthDay Reporter

Last Updated: June 09, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Gene Sequencing Yields Picture of Human Gut

2011-05-31T02:54:00.000-07:00

THURSDAY, March 4 (HealthDay News) — Researchers have succeeded in sequencing 3.3 million genes from organisms residing in the human gut.

And it appears that each person harbors at least 160 species of bacteria in their gut, far more than originally estimated, according to a paper appearing in the March 4 issue of Nature. The research was led by researchers in China as part of the MetaHIT (Metagenomics of the Human Intestinal Tract) project.

Although this is just the first tiny dent in a mountain of work to be done, the findings should help experts understand both human health and human illness better.

“This is so rich. It could help in so many different ways. It could help us understand diseases like inflammatory bowel disease [IBD], Crohn’s and ulcerative colitis. It could help us with problems like malnutrition and obesity. It could help us understand many different metabolic problems from liver disease to kidney to heart disease,” said Dr. Martin Blaser, chairman of the department of medicine at New York University Langone Medical Center and a professor of microbiology at New York University School of Medicine in New York City. “This is really a landmark study.”

Humans coexist peacefully and sometimes not so peacefully with legions of microorganisms in their gut. An estimated 100 trillion cells make up these microbes. That’s 10 times the number of human cells in the body.

“There are symbiotic relationships with these bacteria,” explained Dr. Brian Currie, vice president and medical director for research at Montefiore Medical Center in New York City. “They make substances we need … and there’s a body of literature that suggests that the interaction with these bacteria may have something to do with immune modulation as well. It’s a largely unexplored area.”

Another expert, Jeffrey Cirillo, a professor of microbial and molecular pathogenesis at the Texas A&M Health Science Center College of Medicine in College Station, said that, “basically the gut functions properly because of the large amount of bacteria that are present within it.”

“In other words, rather than the gut being controlled by us, it’s actually controlled by the bacteria present in it,” he said. “There’s almost a limitless number of diseases and health characteristics that are affected by what we eat and how it gets digested, and the microflora that are present basically determine how that gets handled. It’s a critical component of health overall.”

This research team was able to identify and sequence 3.3 million microbe genes from fecal samples taken from 124 Europeans. This is 150 times more microbial genes than human genes.

The participants, from Spain and Denmark, were either healthy or had inflammatory bowel disease.

More than 99 percent of the genes were bacterial, representing up to 1,150 different bacterial species.

Although most of the 3.3 million genes must be shared among individuals, the study authors were only able to show that 38 percent of the genes seen in each individual were shared with at least half of the other individuals sampled.

And while much has been made of “good” bacteria vs. “bad” bacteria in people’s bodies, the organisms involved may not be either.

“This may have to do more with proportions. Maybe there is a certain ecological balance of certain kinds of organisms, and disease is not necessarily due to having bad bacteria but an imbalance,” Blaser said. “When you take a census and you have schoolteachers, policemen, insurance brokers, etc. That’s kind of healthy. But let’s say you took a census and everybody was a Wall Street stockbroker. That may be less healthy. The proportions of the different kinds of organisms that are present could be more important.”

For instance, patients with inflammatory bowel disease had, on average, 25 percent fewer genes than healthy individuals, indicating that patients suffering from IBD have less diversity in their guts.

“We know that some of these functions are critical for human health and well-being, and these are the first initial baby steps to fully characterize what those are, to get a handle on the diversity,” added Dale Hedges, an assistant professor at the John P. Hussman Institute for Human Genomics and assistant director of the Center for Genome Technology at the University of Miami Miller School of Medicine. “As we start to get a better grasp of the genetic diversity in our gut biome, we can start to ask questions about the relationship between the genetic diversity that’s existing in our microbiome internally and our susceptibility to different diseases and what the interaction is.”

Cirillo is enthusiastic. “A picture is worth a thousand words, and this gives us a picture of what’s going on in the gut,” he said.

More information

Visit the International Human Microbiome Consortium for more on this type of research.

By Amanda Gardner
HealthDay Reporter

SOURCES: Martin Blaser, chairman, department of medicine, Langone Medical Center, and professor, microbiology, New York University School of Medicine, New York City; Dale Hedges, Ph.D., assistant professor, John P. Hussman Institute for Human Genomics, and assistant director, Center for Genome Technology, University of Miami Miller School of Medicine; Brian Currie, M.D., vice president and medical director, research, Montefiore Medical Center, New York City; Jeffrey Cirillo, Ph.D., professor, microbial and molecular pathogenesis, Texas A&M Health Science Center College of Medicine, College Station; March 4, 2010, Nature

Last Updated: March 04, 2010

Copyright © 2010 HealthDay. All rights reserved.

Gut Bacteria May Spur Obesity, Research Suggests

2011-05-31T02:52:00.000-07:00

THURSDAY, March 4 (HealthDay News) — Intestinal bacteria may contribute to obesity and metabolic syndrome, a new study in mice suggests.

“It has been assumed that the obesity epidemic in the developed world is driven by an increasingly sedentary lifestyle and the abundance of low-cost, high-calorie foods. However, our results suggest that excess caloric consumption is not only a result of undisciplined eating but that intestinal
bacteria contribute to changes in appetite and metabolism,” senior study author Andrew Gewirtz, an associate professor of pathology and laboratory medicine at Emory University School of Medicine, said in a university news release.

He and his colleagues found that increased appetite and insulin resistance can be transferred from one mouse to another via intestinal bacteria. The findings are published online March 4 in the journal Science.

It’s believed that intestinal bacteria populations in people are acquired at birth from family members and are relatively stable. However, they can be affected by diet and antibiotics.

“Previous research has suggested that bacteria can influence how well energy is absorbed from food, but these [new] findings demonstrate that intestinal bacteria can actually influence appetite,” Gewirtz explained.

He said the findings from mice suggest “that it’s possible to ‘inherit’ metabolic syndrome through the environment, rather than genetically. Do obese children get that way because of bad parenting? Maybe bacteria that increase appetite are playing a part.”

A gene called toll-like receptor 5 (TLR5) plays an important role in controlling intestinal bacteria. Gewirtz and colleagues plan to investigate TLR5 variations in humans and how bacteria in TLR5-deficient mice influence appetite and metabolism.

More information

The American Academy of Family Physicians has more about metabolic syndrome.

— Robert Preidt

SOURCE: Emory University, news release, March 4, 2010

Last Updated: March 04, 2010

Copyright © 2010 HealthDay. All rights reserved.

Scientists Discover How Chemo Can Make Women Infertile

2011-05-31T02:48:00.000-07:00

MONDAY, Sept. 28 (HealthDay News) — Italian researchers say they have identified the mechanism by which chemotherapy can rob a woman of her ability to have children.

Intriguingly, the scientists also found that another anti-cancer drug might counteract the negative effects of the chemotherapy drug cisplatin.

The finding, demonstrated in mice and reported in the Sept. 27
online edition of Nature Medicine, raises the hope that there might be a way to protect a woman’s fertility while she undergoes treatment for cancer but, the authors stressed, this is still a long way off.

“The extension of these findings to patients and the design of clinical trials is likely to require the development of targeted drug delivery strategies to avoid any potential interference with anti-cancer systemic therapy,” explained study author Stefania Gonfloni, of the department of biology at the University of Rome.

“I think it’s a great idea. They found a pathway that can be used as a marker to detect which drug would produce cell death as a result of chemotherapy, and they found a repair effect of a drug,” said Dr. George Attia, an associate professor of reproductive endocrinology and infertility at the University of Miami Miller School of Medicine. “[But] it’s very basic science research. It’s still early.”

Because chemotherapy affects the egg cells of the ovary, women often end up with ovarian failure and infertility as a result of cancer treatment.

“We frequently deal with women of childbearing age, and there’s a lot of concern about fertility preservation although as women get older, the chemo induces menopause,” said Dr. Igor Astsaturov, an assistant professor of medical oncology at Fox Chase Cancer Center in Philadelphia. “The standard approach now is egg collection [storing eggs for later use].”

Chemotherapy can also cause genetic defects in offspring. In particular, cisplatin, which was studied in this trial, causes specific types of chromosomal damage.

Cisplatin is primarily usually used to treat ovarian cancer, Attia noted.

In this study, Gonfloni and her colleagues showed that cisplatin promotes the death of oocytes, or female germ cells, by way of the c-Abl enzyme, a protein that, when mutated, can also cause chronic myeloid leukemia (CML).

But targeting the enzyme with imatinib (Gleevec), a drug used to treat CML, protected the oocytes from the ill effects of cisplatin.

“These results raise the possibility of protecting ovarian function during cancer treatments, thereby preserving the fertility in female cancer survivors,” Gonfloni added.

But how to use one drug without compromising the other?

“First, we have to show that imatinib can be used to prevent chemotherapy-induced ovarian toxicity without interfering with anti-cancer treatments,” Gonfloni said. “In other words, we have to prove that tumor-bearing laboratory animals can be cured with a combined cisplatin and imatinib treatment, while at the same time preserving fertility,” she explained.

“Then, for any clinical implications, it will be very important to prove the same protective effect of a specific dosage of imatinib on human oocytes cultured and challenged with chemotherapeutic drugs in vitro,” she added.

And preserving fertility is not always the right thing, Astsaturov said.

“Chemotherapy induces menopause in some hormone-dependent cancers. It has a beneficial effect because it’s withdrawing the stimulants for the cancer cells. Menopause is contributing to the cure,” he said. “It’s still debated whether we should preserve menstrual function at all costs.”

More information

Visit Cancer Research UK for more on chemotherapy and fertility.

By Amanda Gardner
HealthDay Reporter

SOURCES: Stefania Gonfloni, Ph.D., department of biology, University of Rome, Italy; George Attia, M.D., associate professor, reproductive endocrinology and infertility, University of Miami Miller School of Medicine; Igor Astsaturov, M.D., assistant professor, medical oncology, Fox Chase Cancer Center, Philadelphia; Sept. 27, 2009, Nature Medicine, online

Last Updated: Sept. 28, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Stem Cells Spur New Eggs in Ovaries of Adult Mice

2011-05-31T02:47:00.000-07:00

SUNDAY, April 12 (HealthDay News) — Researchers in China have demonstrated that female ovaries may be capable of producing new eggs in adulthood and subsequently producing offspring.

That runs counter to the long-held belief that female mammals, including humans, are born with a finite number of the eggs (oocytes) needed to produce offspring.

According to study senior author Ji Wu, a professor at Shanghai Jiao
Tong University, the findings may lead to techniques for the “generation of new oocytes to postpone normal or premature ovarian failure or for the treatment of infertility.”

Paul Sanberg, a stem cell researcher and distinguished professor of neurosurgery and director of the University of South Florida Center for Aging and Brain Repair in Tampa, called the study “fascinating.”

“These stem cells are continuous,” explained Sanberg, who was not involved in the research. “They were still around through life and actually transformed to make oocytes. Then they were transplanted into infertile females and produced offspring.”

Could doctors someday use stem cells to help adult women produce brand-new oocytes? One reproductive medicine expert isn’t sure.

The new finding is “very, very exciting and opens up a big area of discussion,” said Dr. George Attia, associate professor of reproductive endocrinology and infertility at the University of Miami Miller school of Medicine. “If it would ever come to fruition in humans, I really don’t know. It’s far, far out there,” he said.

Another expert agreed.

“It’s a cute experiment, but I don’t think it’s going to have anything to do with humans,” said Dr. Darwin J. Prockop, director of the Texas A&M Health Science Center College of Medicine Institute for Regenerative Medicine at Scott & White. “There are too many steps, too many things could go wrong.”

But the findings, published online April 12 in Nature Cell Biology, could still have interesting implications for future stem cell and other research, Prockop added. “Any new kind of cell is interesting,” he said.

For years, scientists had believed that the capability to produce oocytes was lost in most mammalian species at birth.

That line of thought was tested with the recent discovery of actively dividing germ cells (those that give rise to sexual reproduction) in the ovaries of both juvenile and adult mice. The presence of these germ cells could indicate reproductive capability.

Still, researchers disagreed as to whether female germline stem cells (FGSCs) do exist in mammalian ovaries after birth.

So, the Chinese team isolated active female FGSCs from adult and five-day-old mice. They say that they were able to generate new FGSC lines that proliferated even after being cultured multiple times.

These FGSCs restored fertility (by producing new oocytes) when transplanted into the ovaries of female mice that were previously rendered infertile by chemotherapy.

The females then gave birth to normal, young mice.

Even if the breakthrough could apply to humans, it likely would only apply to younger women experiencing infertility, Attia said. “Pregnancy is a heavy load on the human body. A 60-year-old might not be able to be pregnant,” he noted.

In other stem cell news, researchers reporting Sunday in the journal Nature Biotechnology said that they were able to use bits of genetic material called microRNA to revert adult mouse cells back into embryonic cells.

These new embryonic cells are, like stem cells, capable of transforming into multiple different types of tissue.

Currently, retroviruses and genes are used to complete this transformation, but this carries the risk of cancer and other problems. Using microRNAs, which regulate gene expression, would be a potentially safer method, said researchers from the University of California, San Francisco.

More information

There’s more on stem cells at the U.S. National Institutes of Health.

SOURCES: Ji Wu, Ph.D., professor, Shanghai Jiao Tong University, Shanghai, China; Darwin J. Prockop, M.D., Ph.D., director, Texas A&M Health Science Center College of Medicine Institute for Regenerative Medicine at Scott & White, and Stearman Chair in Genomic Medicine and professor of molecular and cellular medicine, Texas A&M Health Science Center College of Medicine; George Attia, M.D., associate professor, reproductive endocrinology and infertility, University of Miami Miller School of Medicine; Paul Sanberg, Ph.D., D.Sc., distinguished professor, neurosurgery and director, University of South Florida Center for Aging and Brain Repair, Tampa; April 12, 2009, Nature Cell Biology, Nature Biotechnology

By Amanda Gardner
HealthDay Reporter

Last Updated: April 13, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Weight Loss Helps Incontinence

2011-05-31T02:45:00.000-07:00

WEDNESDAY, Jan. 28 (HealthDay News) — If you’re among the millions of women who suffer from urinary incontinence, losing weight might just ease your symptoms, a new study suggests.

Published in the Jan. 29 issue of the New England Journal of Medicine, the study found that when women lost about 8 percent of their body weight — an average of 17 pounds for this group — the frequency of incontinence episodes dropped by almost half.

“Weight is one of the biggest risk factors for developing incontinence and for worsening incontinence,” said study author Dr. Leslee Subak, an associate professor in the departments of obstetrics, gynecology, reproductive sciences, urology and epidemiology and biostatistics at the University of California, San Francisco.

More than 13 million American women have urinary incontinence problems, according to background information in the study. Observational studies have found an association between extra weight and incontinence, and other research has suggested that losing weight might be beneficial for relieving incontinence symptoms.

To confirm these findings, Subak and her colleagues recruited 338 women from Rhode Island and Alabama. The women had to be at least 30, with a body-mass index (BMI) between 25 and 50. A BMI over 25 is considered overweight and over 30 is obese, according to the National Institutes of Health. All of the women experienced at least 10 incontinence episodes in a seven-day period.

Two-thirds of the women were randomly assigned to the intervention group, which included diet, exercise and behavior modification, while the remaining one-third (the control group) received four educational sessions about weight loss, healthful eating and physical activity. All of the women received a self-help booklet with tips for improving their urinary incontinence.

The intervention group met for one hour every week for six months and were put on a structured protocol, including diet and exercise, designed to help them lose between 7 percent and 9 percent of their starting weight.

On average, the intervention group lost 8 percent of their body weight, or about 17 pounds each. The control group lost 1.6 percent of their body weight, or a little more than 3 pounds each.

After six months, the weekly number of incontinence episodes dropped by 47 percent for those in the intervention group compared to 28 percent in the control group. The intervention group also reported fewer episodes of stress incontinence — that’s incontinence that occurs due to extra pressure from laughing, coughing or sneezing. This group did not see improvement in urge incontinence — that’s the feeling of a sudden need to urinate.

“The reduced pressure from weight loss causes reduced pressure on the bladder,” Subak explained.

She said these findings confirm that weight loss can be considered a first-line treatment for women with incontinence.

“The weight we carry around affects our bodies in so many different ways,” said Dr. Janet Tomezsko, chief of the section of urogynecology at Northwestern Memorial Hospital in Chicago. “And, the more overweight you are, the more you have to lose to make an impact, but you can make an impact. It’s not an easy thing to do, but I think we’re going to see more and more programs that address weight loss, exercise and pelvic health.”

More information

To learn more about incontinence in women, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: Leslee Subak, M.D., associate professor, departments of obstetrics, gynecology, reproductive sciences, urology and epidemiology and biostatistics; University of California, San Francisco; Janet Tomezsko, M.D., chief, urogynecology and pelvic reconstructive surgery, department of obstetrics and gynecology, Northwestern Memorial Hospital, Chicago; Jan. 29, 2009, New England Journal of Medicine

By Serena Gordon
HealthDay Reporter

Last Updated: Jan. 28, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Female Incontinence a Prevalent Problem

2011-05-31T02:43:00.000-07:00

TUESDAY, Sept. 16 (HealthDay News) — Almost 25 percent of American women have a pelvic floor disorder, such as urinary incontinence, fecal incontinence or pelvic organ prolapse, according to new research.

“This study showed that pelvic floor disorders are exceedingly common in women in the United States,” said the study’s lead author, Dr. Ingrid Nygaard, a professor in the division of urogynecology and pelvic reconstructive surgery in the department of obstetrics and
gynecology at the University of Utah School of Medicine.

And, though these disorders are prevalent, women don’t always bring them up with their doctors, said Nygaard. “Pelvic floor disorders are not talked about often, and women are often too embarrassed to bring them up” with their doctors, she said.

Said Dr. Victor Nitti, vice chairman of urology at New York University Langone Medical Center: “I don’t think there’s any question that pelvic floor disorders are underreported. Some women are embarrassed, and some think they’re a normal part of aging. Either way, it’s not something women will often report spontaneously.”

The new study, published in the Sept. 17 issue of the Journal of the American Medical Association, reviewed data from almost 2,000 women over the age of 20 who had participated in the 2005-06 National Health and Nutrition Examination Survey. This study group is considered to be representative of the U.S. population. None of the women included in the data analysis was pregnant at the time of the study.

The women were interviewed at home and underwent a physical in a mobile examination center. Urinary incontinence was diagnosed based on scoring more than “three” on an incontinence severity index. Fecal incontinence was diagnosed if women reported having at least once monthly leakage of stool. And pelvic organ prolapse was diagnosed if women reported feeling a bulge inside or outside of the vagina. (Pelvic organ prolapse occurs when one of the pelvic organs, such as the uterus, drops and presses on the vagina.)

Overall, the researchers found that 23.7 percent of women experienced at least one pelvic floor disorder. Almost 16 percent of the women reported urinary incontinence, 9 percent experienced fecal incontinence, and 2.9 percent reported pelvic organ prolapse.

Nygaard pointed out that this study looked at moderate to severe incontinence. She said it’s quite common for women to leak small amounts of urine while laughing or sneezing, but that’s not what was studied here.

Older women were most likely to report a pelvic floor disorder, with almost 50 percent of those 80 and older reporting at least one pelvic floor disorder, compared to just 10 percent of women between 20 and 39 years old.

Having been pregnant increased the odds of pelvic floor disorders, and, with each pregnancy, the likelihood of incontinence or prolapse rose. Being overweight or obese also increased the risk of pelvic floor disorders, according to the study.

Both Nygaard and Nitti said that effective treatments are available for women with pelvic floor disorders. Nygaard recommended that women start with the most conservative treatment options, such as pelvic muscle strengthening and behavioral therapy. Surgery, which can be effective for certain problems, is usually reserved as a last option, she said.

“The most important thing women need to realize is that they’re not alone. Pelvic floor disorders aren’t dangerous and are treatable,” said Nygaard.

Nitti added: “If you have any symptoms related to any of these problems, and they bother you, you shouldn’t be embarrassed to bring it to the attention of your health-care providers. All are, in one way or another, treatable, particularly at the early stages.”

More information

Learn more about pelvic floor disorders from the National Institute of Child Health and Human Development.

SOURCES; Ingrid Nygaard, M.D., professor, division of urogynecology and pelvic reconstructive surgery, department of obstetrics and gynecology, University of Utah School of Medicine, Salt Lake City; Victor Nitti, M.D., vice chairman, urology, and professor, New York University Langone Medical Center, New York City; Sept. 17, 2008, Journal of the American Medical Association

By Serena Gordon
HealthDay Reporter

Last Updated: Sept. 16, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

New Guidelines Issued for Management of IBS

2011-05-31T02:42:00.000-07:00

THURSDAY, Dec. 18 (HealthDay News) — A leading organization of gastroenterologists has released new guidelines on the management of irritable bowel syndrome (IBS).

The guidelines, issued by the American College of Gastroenterology and published in the January issue of The American Journal of Gastroenterology, essentially replace a 2002 document.

“The world of IBS is changing quickly because of more therapies and an increased awareness. It is considered a ‘real disease,’
” said Dr. Lawrence Brandt, chairman of the group’s IBS task force and chief of gastroenterology at Montefiore Medical Center in New York City. “A lot of new drugs are being developed, and a lot of work still needs to be done, but there’s enough new information since the last time.”

“From the practitioner’s standpoint, this doesn’t change much about practice and there’s not that much information that’s new, although it is thorough and helpful,” said Dr. Benjamin D. Havemann, an assistant professor of internal medicine at the Texas A&M Health Science Center College of Medicine and director of gastroenterology for the Round Rock University Medical Campus of Scott & White Hospital. “It shows what little has transpired [in terms of new treatments] in the last few years. Some of the breakthroughs we had have been withdrawn or are under strict control.”

“One powerful piece of information is that extensive work-ups are unhelpful,” Havemann said. “It makes sense to me that in the absence of alarm symptoms, the benefit of even basic blood work and other tests is in doubt.”

An estimated 7 percent to 10 percent of people have IBS, which can involve abdominal pain, bloating and other discomfort, including constipation and diarrhea. IBS affects both quality of life and productivity for millions of people.

Most IBS treatments relieve symptoms rather than resolve the condition itself.

The new guidelines encompass existing evidence on conventional treatments for IBS as well as new therapies (probiotics, for example) and alternative therapies (acupuncture and more). In summary, the updated guidelines say:

    Fiber products — including psyllium, anti-spasmodic medications and peppermint oil — may be effective, at least in some people. “The evidence is poor, but some patients say they feel better,” Brandt said. He cautioned that fiber should be used carefully in people with narrowed colons.
    More data is needed on probiotics, live microorganisms (usually bacteria) similar to the “good” organisms found normally in the gut. “This is a very hot topic but an exceedingly complicated subject,” Brandt said. Researchers and practitioners need to consider the species of bacteria used, how many species, and dosages.
    Non-absorbable antibiotics — those targeted to the gut only, such as rifaximin (Xifaxan) — also seem to help some people, especially those who have “diarrhea-predominant IBS.” Brandt said that “the data is not great, but some patients swear they’re helping them dramatically.”
    Tricyclic antidepressants as well as the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) benefit a broad range of people with IBS. This is backed up by quality studies, although with small numbers of participants, and could change as research on larger numbers of people is evaluated. Psychological counseling may also provide some relief.
    Selective C-2 chloride channel activators, notably lubiprostone (Amitiza), are effective for “constipation-predominant IBS.”
    5HT 3 antagonists such as alosetron (Lotronex) relieve symptoms of diarrhea but can cause constipation and colon ischemia, a restriction of blood flow.
    5HT 4 agonists, though effective against constipation, are not available in North America because of a heightened risk of cardiovascular problems.
    There is yet to be conclusive evidence on Chinese herbal mixtures, and the mixtures run the risk of causing liver failure and other problems. Differences in the content of compounds and the purity of ingredients complicate evaluation of benefits.
    Similarly, the evidence on acupuncture remains inconclusive.
    There is no evidence at this point that testing for food allergies or following diets that exclude certain foods alleviates IBS symptoms.
    Routine diagnostic testing for IBS is not recommended, although some testing should be performed in certain subgroups of patients.

Though comprehensive, the guidelines were criticized for not explaining what outside funding was used for in the development process. The document does disclose that support was received from Takeda Pharmaceutical Co. and Salix Pharmaceuticals, which make products targeted to IBS.

Dr. Mark Ebell, deputy editor of American Family Physician, said he would feel more comfortable if the guidelines had been “very clear about what support was provided and what they needed the support for: paying for literature searches, for staff. … It’s common to have support for guidelines. … I think it’s generally unintentional, but when we have a relationship, it creates the potential for problems.”

Ebell said that Brandt had relationships with pharmaceutical companies.

Brandt had a different view. “I don’t have any ties to industry that would have any relevance to this publication,” he said. “I don’t receive money directly from any company. I own no stock and, nor does my family, so this is a totally unbiased thing. I have no conflict of interest whatsoever, and I think that does it.”

Anne-Louise B. Oliphant, a spokeswoman for the American College of Gastroenterology, said: “No company was involved in any way in either structuring or completing the meta-analysis that forms the basis for the College’s evidence-based recommendations on IBS. Furthermore, no company was in any way involved in deciding who served on the task force or in any of its work.”

More information

To learn more about IBS, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases online.

SOURCES: Lawrence J. Brandt, M.D., chief, division of gastroenterology, Montefiore Medical Center, and professor of medicine and surgery, Albert Einstein College of Medicine, New York City; Mark H. Ebell, M.D., deputy editor, American Family Physician; Anne-Louise B. Oliphant, spokeswoman, American College of Gastroenterology, Bethesda, Md.; Benjamin D. Havemann, M.D., assistant professor, internal medicine, Texas A&M Health Science Center College of Medicine, and director, gastroenterology, Round Rock University Medical Campus, Scott & White Hospital; January 2009 The American Journal of Gastroenterology

By Amanda Gardner
HealthDay Reporter

Last Updated: Dec. 18, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Gut Trouble? Peppermint Oil, Soluble Fiber Can Help Relieve IBS Symptoms

2011-05-31T02:40:00.000-07:00

THURSDAY, Nov. 13, 2008 (Health.com) — Peppermint oil, soluble fiber, and antispasmodic drugs can indeed help people with irritable bowel syndrome (IBS), according to an analysis of 25 years of research on the condition, which is characterized by bouts of diarrhea and constipation.

About 10% to 15% of people in North America have IBS, and it’s twice as common in women. However, only about one-third of people with the intestinal disorder seek treatment.

The exact cause of IBS remains unknown, and that lack of knowledge has led to the use of a variety of treatments, including fiber supplements, probiotics, antidepressants, behavioral-based therapies, psychotherapy, food modification, acupuncture, and laxatives. However, many treatments are controversial because study results have been mixed.

Newer and more expensive medications have been introduced to the public, but some were ineffective or withdrawn from the market due to side effects. The recent study sheds light on the cheap and readily available treatments that can help patients, says study coauthor Eamonn M. Quigley, MD, a professor of medicine and physiology at University College Cork in Ireland.

“Medical science has tended to ignore IBS; it wasn’t appreciated how much of an impact it can have on a patient’s quality of life,” he says.

In the new analysis, researchers systematically reviewed 38 studies from the last 25 years; more than 2,500 volunteers were involved. That research compared therapies—all relatively cheap, safe, and readily available—to a placebo or to no treatment at all.

The team looked at three treatments—soluble fiber, peppermint oil, and antispasmodics, which are drugs that relax the smooth muscle in the gut and relieve cramping—and found that they were all more effective than a placebo, according to the report in the British medical journal BMJ.

Thyroid Problems Boost Glaucoma Risk

2011-05-30T03:23:00.000-07:00

WEDNESDAY, Oct. 15 (HealthDay News) — People with a thyroid disorder run an increased risk of developing the eye disease glaucoma, a new study suggests.

In fact, those with glaucoma are 38 percent more likely to have had a thyroid condition at some point in their life, said the study authors, from the University of Alabama at Birmingham. Glaucoma is the leading cause of irreversible blindness worldwide.

“Studies like this are very useful in understanding what causes this disease,” said lead researcher Gerald McGwin, vice chairman of the Department of Ophthalmology at the university’s School of Medicine.

“If we can determine that thyroid problems are related to glaucoma, then we can make some hypotheses about what the mechanism behind that relationship might be and help us understand what might be the cause of glaucoma,” McGwin said. “And that may lead to more effective treatments or preventive measures.”

The findings were published online Oct. 16 in the British Journal of Ophthalmology.

For the study, McGwin’s team collected data on 12,376 people who participated in the 2002 National Health Interview Survey. They were asked if they’d ever been diagnosed with a thyroid problem or glaucoma. Slightly more than 4.5 percent said they had glaucoma, and 12 percent said they had been diagnosed with a thyroid problem.

Among people who had glaucoma, 6.5 percent said they had a thyroid problem, while 4.4 percent said they’d never had a thyroid condition.

People with thyroid problems should see an ophthalmologist or make their ophthalmologist aware of their thyroid condition, McGwin advised. “Somebody who has a history of thyroid problems and has not seen an ophthalmologist may have a heightened level of concern about their eyesight,” he said.

The thyroid produces hormones essential for the functioning of every cell in the body; these hormones help regulate growth and chemical reactions.

In glaucoma, the optic nerve becomes progressively damaged and, if not treated, leads to loss of vision and even blindness.

The study authors suggested that the link between glaucoma and thyroid disorders may owe to chemical deposits in the blood vessels that circulate blood to the eye, causing an increase in pressure within the eyeball. Increased pressure in the eyeball is the main feature of glaucoma.

Dr. Andrew Iwach, a spokesman for the American Academy of Ophthalmology and executive director of the Glaucoma Center of San Francisco, said the potential link between thyroid problems and glaucoma is interesting and should be taken into account, but it still needs to be proven. The best advice is to get your eyes checked, he said.

“If you haven’t seen an ophthalmologist by age 40, that’s a great time to get a baseline exam,” Iwach said.

“People may not know they are at risk for glaucoma. You are functioning fine, and yet slowly, this disease can chip away at the optic nerve, and by the time you have symptoms from glaucoma, oftentimes there’s not really much we can do,” he said.

In a related study, researchers at Rush University Medical Center in Chicago found that many elderly people have undiagnosed thyroid problems, including thyroid cancer. Older patients are twice as likely to be diagnosed with thyroid cancer as younger patients. Thyroid cancer was found in 41 percent of patients over 65, compared with 22 percent among younger patients, the researchers found.

Most thyroid cancer is treatable, and age should not be a barrier to treatment, noted the researchers, who were expected to present their findings Oct. 15 at the 2008 Clinical Congress of the American College of Surgeons, in San Francisco.

More information

For more on thyroid diseases, visit the U.S. National Library of Medicine.

SOURCES: Gerald McGwin, Ph.D., vice chairman, Department of Ophthalmology, University of Alabama at Birmingham School of Medicine; Andrew Iwach, M.D., spokesman, American Academy of Ophthalmology, and executive director, Glaucoma Center of San Francisco; Oct. 16, 2008, British Journal of Ophthalmology, online

By Steven Reinberg
HealthDay Reporter

Last Updated: Oct. 16, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Could Lowering Blood Pressure Help Stop Dementia?

2011-05-30T03:22:00.000-07:00

WEDNESDAY, March 17 (HealthDay News) — In the ongoing struggle to find treatments — and maybe one day even a cure — for dementia, researchers are focusing their attention on high blood pressure, long a culprit for a variety of other ills and an ailment for which many drugs are already available.

This coming fall, the U.S. National Institutes of Health will start enrolling participants in the largest trial thus far to see if lowering blood pressure even below current recommendations can reduce
not only the risk of age-related cognitive decline, but also the risk of cardiovascular and kidney diseases.

The Systolic Blood Pressure Intervention Trial (SPRINT) will involve 7,500 people aged 55 and over who will be followed for a minimum of four years. The NIH is investing $114 million in the endeavor.

“We have a number of effective and safe medications to lower blood pressure,” said Dr. Lawrence Fine, chief of the clinical applications and prevention branch in the division of cardiovascular sciences at the National Heart, Lung, and Blood Institute. “For the average person right now, the recommendation is a blood pressure of 140/90 or lower. SPRINT will compare that with a goal of 120 as the top number. Will the rate of dementia for people in the lower-goal arm be lower than standard?”

Current clinical guidelines recommend systolic pressure (the top number in a blood pressure reading) of less than 140 millimeters of mercury (mm Hg) for healthy adults, and 130 mm Hg for adults with kidney disease or diabetes.

“Hypertension is very easy to medicate and very easy to measure, so they want to see if just by modifying that simple thing they could reduce the incidence of dementia,” said Ian Murray, an assistant professor of neuroscience and experimental therapeutics at the Texas A&M Health Science Center College of Medicine in College Station.

The timing is critical, as over the next several decades huge numbers of aging Baby Boomers will develop Alzheimer’s disease and other forms of dementia.

Besides sparing thousands of Americans needless suffering, “if you could reduce that number by 10 percent, your cost savings would be immense,” said William Thies, chief medical and scientific officer for the Alzheimer’s Association in Chicago.

Although experts have long suspected a link between high blood pressure and dementia, without trial data those suspicions inevitably remain hypotheses.

“What we do know is that there’s an association between high blood pressure and a higher rate of dementia — it’s not a large increased risk but there is some increase,” Fine said.

“A whole bunch of epidemiologic data says there’s a link, and one trial actually showed that if you lowered people’s blood pressure it decreased the amount of dementia,” added Thies.

That particular trial used blood pressure drugs known as calcium-channel blockers, one in an extensive armamentarium of medications for the condition. Still, no one really knows why treating high blood pressure would lower the odds of dementia if, in fact, it really does.

“We’d really like to know the answer because it would give us our first confirmed pathway to modifying the amount of dementia by treating people with known agents,” Thies said. “That would be very important.”

The SPRINT trial will randomize participants — all of whom have systolic blood pressure of 130 mm Hg or higher — either to a group taking more intensive drug therapy (three or four medications) to try to get their blood pressure under 120, or a control group taking about two medications to maintain blood pressure at the currently recommended 140.

“We may discover lower blood pressure will not reduce the rate of dementia, but if the lower goal did reduce the rate of dementia by 10 or 20 or 30 percent, that would be an important observation because we don’t have other good treatments for dementia,” Fine said. “SPRINT should provide some additional science to inform us whether lowering blood pressure to the lower goal will, in fact, reduce the rate of developing dementia.”

“There are a lot of reasons why we ought to control blood pressure anyway, but this gives us another very important reason,” Thies added.

More information

There’s more on high blood pressure at the American Heart Association.

By Amanda Gardner
HealthDay Reporter

SOURCES: Ian Murray, Ph.D., assistant professor, neuroscience and experimental therapeutics, Texas A&M Health Science Center College of Medicine, College Station; Lawrence Fine, M.D., DrPH, chief, clinical applications and prevention branch, division of cardiovascular sciences, U.S. National Heart, Lung, and Blood Institute; William Thies, Ph.D., chief medical and scientific officer, Alzheimer’s Association, Chicago

Last Updated: March 17, 2010

Copyright © 2010 HealthDay. All rights reserved.

Report Calls High Blood Pressure a ‘Neglected Disease’

2011-05-30T03:20:00.001-07:00

MONDAY, Feb. 22 (HealthDay News) — Americans eat way too much salt and cutting down on that consumption should be a cornerstone of new public health efforts to curb hypertension.

That’s one of the key messages of an Institute of Medicine (IOM) report, commissioned by the U.S. Centers for Disease Control and Prevention and released Monday, that calls hypertension — or high blood pressure — a “neglected disease,” one that has fallen off the public health radar and needs to be put back on.

“High blood pressure and its consequences are too important to remain a neglected disease,” Dr. David Fleming, chairman of the committee that produced the report, said during a morning news conference. “It’s time to give our complete attention to take full advantage of known and promising interventions, and take concerted actions necessary to achieve prevention and control of hypertension.”

The public-health initiatives described by the report would refocus efforts from individual actions to so-called environmental considerations, such as stocking fresh produce in urban grocery stores, making streets safe to walk on, and enlisting the help of industry in manufacturing foods with lower salt content.

“Congress must give priority to adequate resources to implement a broad sweep of policy-based approaches at the state, local and federal levels,” said Fleming, who is director of public health for Seattle/King County, Washington.

According to the report, nearly one-third of U.S. adults have high blood pressure, and it accounts for about one in six adult deaths annually, a 25 percent increase from 1995 to 2005. High blood pressure usually has no symptoms: You can have it for years without knowing it, even though it can damage the heart, blood vessels, kidneys and other parts of the body, according to the U.S. National Institutes of Health.

“If you live long enough, you are almost guaranteed to get hypertension,” said Dr. Corinne Husten, a committee member who, at the time the report was being prepared, was executive vice president for program and policy at the Partnership for Prevention. She is now senior medical advisor at the U.S. Food and Drug Administration’s Center for Tobacco Products.

The report outlines several priorities.

The first would be to cut Americans’ salt intake — 80 percent of Americans currently eat more than the recommended amount and that number is growing. But given that 70 percent of Americans’ sodium comes from packaged foods and restaurants — not from the family salt shaker — the food industry needs to play a role here, Fleming said. “These efforts should be focused on making it easier for people to eat less salt,” he said.

Experts also need to better understand why many health-care providers fail to adhere to current treatment guidelines, despite knowing what the stakes are. Some people don’t even know they have high blood pressure, likely a failure of their doctor or other provider. “We are alarmed at the extent to which Americans have undiagnosed hypertension, equally the millions who have been diagnosed and are under the care of a provider but whose hypertension isn’t controlled,” Fleming said. Only one-third of people with the diagnosis have it under control.

The third area involves breaking down economic barriers that prevent patients from taking their medication. The committee recommended that the CDC work with the Centers for Medicare & Medicaid Services, pharmaceutical companies and businesses to help get medication to those who need it.

The committee also recommended that procedures be set up to measure performance in controlling hypertension and how much salt is actually being consumed. “There is really inadequate national data on trends,” said Dr. Walter Willett, chairman of nutrition and epidemiology at the Harvard School of Public Health.

American Heart Association President Dr. Clyde Yancy said in a prepared statement: “This Institute of Medicine report on hypertension now reinforces the need for a broad-based initiative in the science and public health spectrums to help individuals manage hypertension and perhaps even prevent the onset of hypertension.”

Yancy stated, “We support the IOM’s recommendations to make drug therapy more affordable for Medicaid and Medicare beneficiaries and boost funding for prevention programs that provide smoking-cessation counseling and screenings for high blood pressure and cholesterol for underserved populations.”

More information

View the full report at the Institute of Medicine.

By Amanda Gardner
HealthDay Reporter

SOURCES: Feb. 22, 2010, news release, American Heart Association; Feb. 22, 2010 teleconference with David W. Fleming, M.D., director, public health, Seattle/King County, Wash.; Corinne Husten, M.D., former executive vice president for program and policy, Partnership for Prevention, and currently senior medical advisor, Center for Tobacco Products, U.S. Food and Drug Administration; Walter Willett, M.D., Dr.P.H., Fredrick John Stare Professor of Epidemiology and Nutrition, and chair, department of nutrition and epidemiology, Harvard School of Public Health, Boston; A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension

Last Updated: Feb. 22, 2010

Copyright © 2010 HealthDay. All rights reserved.

New HPV Vaccine Might Stop Vulvar Cancer in its Tracks

2011-05-30T03:19:00.000-07:00

WEDNESDAY, Nov. 4 (HealthDay News) — A vaccine that targets human papillomavirus (HPV) is able to stop precancerous lesions in the vulva from progressing into full-blown malignancies, Dutch researchers report.

Two other vaccines — Gardasil and Cervarix — have been approved for young women to prevent infection with HPV, which is also thought to spur precancerous lesions in the cervix and cause 70 percent of cervical cancers.

But the vaccine used in this study, published in the Nov. 5 issue of the New England Journal of Medicine, is not the same as the two existing vaccines.

“This provides a therapeutic effect to a lesion that’s already there,” explained Dr. Eugene P. Toy, an associate professor of obstetrics and gynecology in the division of gynecologic oncology at the University of Rochester Medical Center.

“This shows that it is possible to vaccinate against chronic disease, as well as treat HPV-induced premalignance,” added study co-author Sjoerd H. van der Burg, of the experimental cancer immunology and therapy section at the Leiden University Medical Center in the Netherlands and ISA Pharmaceuticals, which helped fund the study and has licensed the patent for the vaccine from Leiden University Medical Center.

Eventually, clinicians hope the two HPV vaccines on the market will reduce the incidence of vulvar precancerous lesions.

Right now, though, said Dr. Kristine Zanotti, a gynecologic oncologist with University Hospitals Case Medical Center in Cleveland, “there are a lot of potential therapeutic challenges with HPV-related problems, especially vulvar dysplasia, which are multi-focal [they crop up in different places] and recurrent. [This vaccine] is a very exciting tool.”

The HPV-16 virus is implicated in 75 percent of cases of these vulvar lesions. A sexually transmitted pathogen, HPV has also been linked to rare cancers of the throat, genitals and anus, as well as genital warts.

For vulvar lesions, the existing treatments are unpleasant and not altogether effective.

“What we typically do is ablative therapies that destroy the lesion. That involves a surgical procedure or topical agents that essentially slough off the lining of the affected tissue,” Toy explained.

“Complete response rates [from these therapies] are disappointingly low, and we don’t know if they last,” added Zanotti.

For this study, 20 patients with vulvar dysplasia were vaccinated three or four times against certain cancer-related proteins associated with HPV-16.

Three months after the last vaccination, 60 percent of patients reported some kind of response along with fewer symptoms. For the same time period, five women (25 percent) saw their lesions disappear completely and four women had no more signs of HPV-16.

After a year, 79 percent of patients had experienced some kind of response while almost half had a complete response, which lasted at least 24 months, according to the report.

All of the patients showed immune responses to the vaccine.

Unlike Gardasil and Cervarix, which only affect the outside of the virus, the vaccine explored in this study was “trained to sense the proteins that are produced by the virus inside the cell. As such, they can recognize virally infected or virally transformed cells,” van der Burg explained.

Also exciting is the possibility, mentioned in the paper, that the new vaccine could be combined with imiquimod cream to completely erase all signs of the infection and tainted cells.

Next, the researchers want to figure out why the vaccine did not have a complete effect in all patients and they would also like to improve the vaccine so it works in patients with actual cancer or even other, non-HPV-related cancers, van der Burg said.

“In principle, this vaccine gives an enormous stimulation of the immune response against the HPV antigens expressed in infected and transformed cells. As such, it should do the same in patients with other types of HPV-16-induced (pre-)malignancies. However, in cancer patients, other forces may work against the efficacy of this vaccine. These need to be tackled, too, in order to make the vaccine do its job,” van der Burg added.

More information

The U.S. National Cancer Institute has more on human papillomavirus.

By Amanda Gardner
HealthDay Reporter

SOURCES: Eugene P. Toy, M.D., associate professor, obstetrics and gynecology, division of gynecologic oncology, University of Rochester Medical Center, Rochester, N.Y.; Sjoerd H. van der Burg, Ph.D., Experimental Cancer Immunology and Therapy, Leiden University Medical Center, Leiden, The Netherlands and ISA Pharmaceuticals; Kristine Zanotti, M.D., gynecologic oncologist, University Hospitals Case Medical Center, Cleveland; Nov. 5, 2009, New England Journal of Medicine

Last Updated: Nov. 04, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Increase in Thyroid Cancer Puzzles Experts

2011-05-30T03:17:00.000-07:00

TUESDAY, July 14 (HealthDay News) — Intensified screening doesn’t entirely explain the jump in thyroid cancers noted in the United States since 1980, and scientists now believe that other as-yet-unknown factors are to blame.

A new study finds that thyroid tumors of all sizes are being picked up, not just the smaller ones that more aggressive screening would be expected to detect.

“You cannot simply explain this by increased screening, there’s a real increased incidence,” said Dr. Amy Chen, lead author of a study published online July 13 in the journal Cancer.

Although, “some of this increased incidence is due to increased screening finding smaller tumors,” she added.

The findings surprised one expert.

“I wrote a chapter about this for a textbook about a year ago and I came away thinking this [rise in cancers] is a reflection of enhanced diagnostics,” said Dr. Bruce J. Davidson, professor and chairman of otolaryngology-head and neck surgery at Georgetown University Hospital in Washington, D.C. But, “it is more disturbing that it’s not just small tumors; it seems to be all tumors,” he said.

An estimated 37,200 new cases of thyroid cancer will be diagnosed this year, according to the U.S. National Cancer Institute. Fortunately, the cancer is considered highly curable, but the researchers said survival rates have not improved with better detection.

Until now, an uptick in cases seen over the past three decades was attributed to increased use of ultrasound and image-guided biopsy to detect tumors. Some researchers had found that thyroid cancer was diagnosed more often in areas with higher incomes and less in uninsured populations, adding further credence to this theory.

Looking at thyroid cancer cases from 1988 to 2005 reported in a large cancer database, Chen and her team found a higher incidence not just in small tumors, but across all sizes.

The most pronounced increase was seen in primary tumors under 1.0 centimeters — small ones for which many experts consider it safe to take a wait-and-see approach. The rate for these tumors rose almost 10 percent per year in men (1997 to 2005) and 8.6 percent per year in women (1988 to 2005).

But the authors also saw a 3.7 percent annual increase in tumors exceeding 4 centimeters in men and a 5.7 percent yearly rise in these tumors in women.

Cancers that had spread also increased in men by 3.7 percent annually and in women by 2.3 percent.

Thyroid cancer can be caused by exposure to radiation but there has been no evidence of increased exposure to radiation among Americans.

“People have looked at background radiation and nothing really has come of that that’s very useful. And certainly not useful to us in why there would be a bump in incidence in the last 15 years,” Davidson said.

Chen proposed in the study that environmental, dietary and genetic issues be explored.

More information

There’s more on thyroid cancer at the American Cancer Society.

By Amanda Gardner
HealthDay Reporter

SOURCES: Bruce J. Davidson, M.D., professor and chairman, otolaryngology-head and neck surgery, at Georgetown University Hospital, Washington, D.C.; Amy Chen, M.D., director of health services research, American Cancer Society and associate professor of otolaryngology-head and neck surgery, Emory University, Atlanta; online, July 13, 2009 Cancer

Last Updated: July 14, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Fewer Genital Warts Thanks to HPV Vaccine Program

2011-05-30T03:16:00.000-07:00

THURSDAY, Oct. 15 (HealthDay News) — New cases of genital warts have declined sharply since vaccination of teen girls and young women against the human papillomavirus (HPV) began in Australia in 2007, a new study has found.

Certain types of HPV are linked with the development of cervical cancer.

Researchers analyzed data on new clients receiving treatment for genital warts at the Melbourne Sexual Health Center between 2004 and 2008. During that time, the center had 36,055 clients, and genital warts were diagnosed in 10.6 percent of cases. The number of women under age 28 who were newly diagnosed with genital warts decreased by 25 percent each quarter throughout 2008, the researchers found.

Australia began providing free vaccinations with Gardasil for females ages 12 to 26 in 2007. In the period before the vaccinations began, new cases of genital warts rose by nearly 2 percent each quarter, the study authors noted.

The study also found that newly diagnosed cases of genital warts among young men fell by an average of 5 percent each quarter throughout 2008. Rates of newly diagnosed genital warts among older women and men didn’t decline.

The findings are published in the Oct. 15 online edition of the journal Sexually Transmitted Infections.

“The magnitude of the reduction in women [under] 28 years indicates a potential for substantial reductions in wart-associated morbidity and costs, and has important implications for countries deciding between the [Gardasil and Cervarix] vaccine,” the researchers wrote.

Gardasil protects against HPV types 6, 11, 16 and 18, while Cervarix protects against HPV types 16 and 18. Types 6 and 11 are associated with highly infectious genital warts, while types 16 and 18 are associated with cervical cancer.

More information

The U.S. Food and Drug Administration has more about HPV.

— Robert Preidt

SOURCE: Sexually Transmitted Infections, news release, Oct. 15, 2009

Last Updated: Oct. 15, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

U.S. Barred 33 TB-Infected People From Flying Over Past Year

2011-05-30T03:14:00.001-07:00

THURSDAY, Sept. 18 (HealthDay News) — Thirty-three would-be air travelers with suspected or confirmed infectious tuberculosis were placed on the U.S. government’s public health “Do Not Board” list in the first year of its existence, a federal report released Thursday showed.

Authorized under the Aviation and Transportation Security Act of 2001, the list was instituted on June 1, 2007 by the U.S Centers for Disease Control and Prevention
and the Department of Homeland Security, according to an article in the Sept. 19 issue of Morbidity and Mortality Weekly Report, a CDC publication.

“Before June 2007, we had a system to prevent travel which was mostly based on local action,” explained Dr. Francisco Alvarado-Ramy, co-author of the report and a CDC quarantine public health officer based in San Juan, Puerto Rico. “We have moved from predominantly a decentralized system to a centralized one We’re formally tapping all U.S. government resources which add additional layers of protection to prevent persons with serious communicable diseases which pose a serious public health threat from boarding the plane.”

In the year after institution of the list, U.S. state and local or territorial health departments asked the CDC to include 42 people on the list, all of whom had confirmed or suspected tuberculosis (TB), including multi-drug resistant (MDR) TB and extensively drug-resistant (XDR) TB. In the end, 33 individuals met the criteria to be placed on the list. The most requests (seven) came from Texas, followed by California (five).

The issue gained prominence in 2007 after a Georgia man who flew to Europe for his wedding was subsequently quarantined after it was discovered that he had XDR TB. That highly visible case “highlighted some of the vulnerabilities to the existing system,” said Dr. Martin Cetron, director of the CDC’s director of division of global migration and quarantine.

Almost half of those barred from flights over the past year were citizens of countries designated by the World Health Organization as TB “high-burden” countries. Two of the individuals on the list were known to have attempted to evade U.S. air travel restrictions, although it is unclear what, exactly, this meant.

The CDC reviews the list on a monthly basis, determining who is eligible for removal — once a person is deemed to be no longer contagious, his or her name is removed from the Do Not Board list within 24 hours, the report’s authors said. Between June 2007 and May 2008, 55 percent of the 33 people on the list were removed either because they were no longer contagious or did not have TB. Those removed had been on the list for a median of 26 days. Those persons not removed from the list had been on the list for a median of 72 days.

Officials said they are on the look-out for “diseases of consequence,” such as SARS, TB, a pandemic strain of influenza and hemorrhagic fevers such as Ebola, Cetron said.

Many experts were unaware of the existence of such a list and were divided in their reaction. (The agencies involved did not publicly announce the formation of the list, although it was discussed at a variety of open and professional organization meetings, Cetron said.)

Some public health experts found the very idea troubling.

“It’s slightly reassuring that the list hasn’t been used very much but I have grave reservations about this sort of collaboration between agencies who are charged with protecting the public from real disease threats and agencies — and here I’m talking about Homeland Security — that capitalize on people’s fears in the name of protecting the public from unnamed dangers,” said Philip Alcabes, an epidemiologist and associate professor at Hunter College’s School of Health Sciences in New York City.

“Is there a legitimate need to control tuberculosis? Absolutely. Is there a legitimate need to have a DNB list in order to do so? I don’t see how that adds to what the CDC already does,” continued Alcabes, who said he had not known of the existence of such a list. “The CDC knows very well how to control tuberculosis with existing rules and procedures. In fact, they have done a superb job.”

“I think the previous system did need bolstering,” countered Dr. Martin Blaser, chairman of medicine at New York University’s Langone Medical Center and former president of the Infectious Diseases Society of America. “The case from Atlanta . . . was a wake-up call,” he said. ” We live in a smaller world where air travel is very important and also carries the risk of moving contagious diseases from one part of the world to another very rapidly. This, in a sense, is just an extension of the concept of quarantine, which is an old concept and is well-established.”

More information

For a list of communicable diseases that fall under potential quarantine, head to the CDC.

SOURCES: Francisco Alvarado-Ramy, M.D., quarantine public health officer, U.S. Centers for Disease Control and Prevention, San Juan, Puerto Rico; Martin Cetron, director, division of global migration and quarantine, CDC; Philip Alcabes, Ph.D., epidemiologist and associate professor, School of Health Sciences, Hunter College, City University of New York, New York City; Martin Blaser, M.D., chairman, medicine, New York University Langone Medical Center, and former president, Infectious Diseases Society of America; Sept. 19, 2008, Morbidity & Mortality Weekly Report

By Amanda Gardner
HealthDay Reporter

Last Updated: Sept. 18, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Vaccine Skin Patch Prevents Travelers’ Diarrhea

2011-05-30T03:13:00.001-07:00

WEDNESDAY, June 11 (HealthDay News) — A new skin patch containing E. coli toxins seems to help prevent travelers’ diarrhea, researchers report.

Even when people developed diarrhea, the condition was less severe and the agonizing episode shorter, they added.

Consuming E. coli from contaminated food or drink is the main cause of travelers’ diarrhea, which affects some 27 million adult
travelers and 210 million children each year. The disease is responsible for some 380,000 child deaths. Travelers’ diarrhea usually lasts four to five days, and is associated with nausea, vomiting, abdominal cramps and dehydration.

“When people travel to Guatemala or Mexico, they have a 50 percent chance of having a bout of Montezuma’s revenge,” said Dr. Gregory Glenn, the head of IOMAI Corp., the Maryland company that developed the patch. “To date, there is no vaccine for this. People with the condition go to bed and are treated with antibiotics.”

“This is really a big breakthrough,” Glenn said. “For an infectious disease, this has been an extremely challenging area.”

To be effective, two doses of the vaccine are needed, Glenn said. The vaccine takes advantage of the skin’s potent immune system, which gives the vaccine its robust response, he added.

The vaccine is most effective when given two weeks before one travels abroad, Glenn said.

The report is published in the June 12 online issue of The Lancet.

In this phase II trial, 178 people planning trips to Mexico or Guatemala were randomly assigned to the vaccine patch or placebo patches.

Glenn and his study co-author, Dr. Herbert DuPont of the University of Texas School of Public Health in Houston, found that 24 of the 111 travelers who received placebo had travelers diarrhea, of these 11 had diarrhea caused by E. coli. Among the 59 travelers who received the vaccine, 12 had bouts of diarrhea, but only three had diarrhea caused by E. coli.

Among patients who received placebo, the rate of moderate to severe diarrhea was higher (21 percent) than among people who received the vaccine (5 percent). This means the patch was 75 percent effective for people who had moderate to severe diarrhea.

Moreover, the number of cases of severe diarrhea was higher amongst people who received placebo (11 percent), compared with those who received the vaccine (2 percent), Glenn’s group found. Among these patients, the patch was effective 84 percent of the time.

In addition, people who received the vaccine had shorter episodes of diarrhea—half a day, compared with more than two days for people who received the placebo patch.

The vaccine is delivered by a patch, because the active ingredient is too toxic to be delivered orally, nasally, or by injection, the researchers noted.

The vaccine still needs to go through a large, phase III trial, Glenn noted. He is hoping the vaccine will be available to the public by 2011.

One expert thinks the patch could be an important advance in preventing travelers’ diarrhea.

“This is an important advance in the prevention of travelers’ diarrhea. The vaccine is easy to store and administer, and is very well-tolerated,” said Dr. Pablo C. Okhuysen, an associate professor of medicine in the Division of Infectious Diseases at The University of Texas Medical School at Houston. “The patch vaccine approach is novel and opens the door for the future development of vaccines for the prevention of diarrheal disease.”

More information

For more on travelers’ diarrhea, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Gregory Glenn, M.D., IOMAI Corp., Gaithersburg, Md.; Pablo C. Okhuysen, M.D., associate professor, medicine, Division of Infectious Diseases, University of Texas Medical School at Houston; June 12, 2008, The Lancet, online

By Steven Reinberg
HealthDay Reporter

Last Updated: June 12, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Statins Might Help HIV Patients, Study Suggests

2011-05-28T04:29:00.000-07:00

By Randy Dotinga
HealthDay Reporter

THURSDAY, Feb. 24 (HealthDay News) — Preliminary research suggests that statins restrain the immune systems of HIV patients and may stave off progression of the AIDS-causing virus.

Although it’s too soon to recommend the drug for this purpose, the findings of this small study raise the possibility that “there might be drugs that can help adjust the immune response in HIV patients whether they’re taking AIDS medications or not,” said Dr. Brian Agan, director of HIV research with the Infectious Disease Clinical Research Program at the Uniformed Services University in Bethesda, Md. He works with some of the study’s authors.

It’s not unusual for HIV patients to take these cholesterol-lowering drugs, because the medications commonly used to combat HIV can cause cholesterol levels to skyrocket.

Scientists have wondered if statins’ anti-inflammatory properties might have benefits for HIV patients besides reducing the risk of cardiovascular disease. In the new study, which was funded by the National Institutes of Health, researchers recruited 24 participants to randomly take either a high dose of Lipitor (atorvastatin) or a placebo.

The participants took their pills for eight weeks, stopped for several weeks, and then took the other kind of pills. The patients took no AIDS medications, and their cholesterol levels weren’t high enough to require taking statins. Neither group knew which pills they were taking.

The findings were recently published online in the Journal of Infectious Diseases. The drugs didn’t affect levels of HIV in the 22 patients who remained in the study, but the medications did appear to curb their immune systems, reducing the inflammatory response.

Inflammation caused by the immune system is associated with HIV progression and death. “Persistent inflammation in patients with HIV, especially those on HIV treatment, has been associated with a worse clinical outcome. The cause of this inflammation remains unknown,” said Andrew Carr, a professor of medicine at the University of New South Wales in Sydney, Australia, who wrote a commentary accompanying the study.

Is it feasible to give cholesterol-lowering drugs to HIV patients? They’re definitely inexpensive, Agan said. And the side effects they cause may be mild and go away as time passes.

What comes next?

“For doctors, we should be studying the effects of statins over longer periods in patients with treated HIV disease whose virus is well-controlled but who still have excess inflammation to see if the anti-inflammatory effect of statins is still observed,” said Carr. “If so, we would then need to determine if this anti-inflammatory effect improved health outcomes, which would require a long and very large study.”

For now, both doctors said, physicians shouldn’t change how they prescribe anti-cholesterol drugs.

More information

The American Heart Association has more on anti-cholesterol drugs.

SOURCES: Brian Agan, M.D., director, HIV research, Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, Md.; Andrew Carr, M.D., M.B.B.S., head, HIV, Immunology and Infectious Diseases Unit, and head, Clinical Research Program, Center for Applied Medical Research, St. Vincent’s Hospital, and professor, medicine, University of New South Wales, Sydney, Australia; Jan. 25, 2011, online, The Journal of Infectious Diseases

Last Updated: Feb. 24, 2011

Copyright © 2011 HealthDay. All rights reserved.

Burden of HIV Highest for Blacks, CDC Reports

2011-05-28T04:28:00.000-07:00

By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 3 (HealthDay News) — Although blacks make up only 13.6 percent of the U.S. population, they account for 50.3 percent of all diagnosed cases of HIV, federal health officials reported Thursday.

The rate of HIV diagnosis among black men is eight times that of whites, and the rate for black women is 19 times that of whites, finds a new analysis of data from 37 states by the U.S. Centers for Disease Control and Prevention.

“What this study confirms is the severe and disproportionate burden of disease borne by African Americans when it comes to HIV,” said Dr. Kevin Fenton, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

Compared to Hispanic men, black men have twice the rate of HIV infection, and black women are four times as likely as Hispanic women to have an HIV diagnosis, according to the Feb. 4 edition of the CDC’s Morbidity and Mortality Weekly Report.

The reasons for these disparities are complex, Fenton said. “We are not looking at one core issue. There are many factors interacting with each other at different levels within the society,” he said.

For one thing, the background prevalence of the AIDS-causing virus is higher in the black community, he said.

“This higher background prevalence really continues to drive transmission within the community, because it increases the probability of someone coming into contact with HIV, even with low-risk behaviors,” Fenton said.

Sharing drug materials and having unprotected sex are key ways to spread HIV.

Fenton said there is also a higher rate of sexually transmitted diseases in the black community, noting other STDs facilitate the transmission of HIV.

Disparities in access to health care and poverty also contribute to the increased risk of HIV among blacks, Fenton explained.

High rates of male imprisonment are another factor, he added. “This leads to imbalances in male-to-female ratios in the community, which in turn result in sexual networks which facilitate transmission of HIV,” he said.

In a related report in the same edition, researchers said HIV diagnoses have skyrocketed among young black gay men in Milwaukee, Wis. Among 15- to 29-year-old black gay men in that city, HIV increased 144 percent from 2000 to 2008.

William Jeffries IV, a CDC Epidemic Intelligence Service Officer and co-author of the report, said this spike is not just the result of increased HIV screening, which would by itself uncover many new cases of HIV.

The number of syphilis cases also increased, which suggests a rise in HIV infection, Jeffries said.

The Milwaukee findings probably mirror similar HIV increases in some areas across the country, said the researchers, calling for new or better efforts to educate this group of males.

The CDC already is testing ways to expand HIV testing and referral services within the black community, Jeffries said.

These “intensive behavioral interventions,” he said, combine education, counseling, skills development and esteem building, as well as safer sex promotion.

Apathy about HIV is a problem, Fenton said. “We are really grappling with increased complacency as we enter the fourth decade of this epidemic,” he said. This is particularly true in the black community, where there are so many health and economic concerns that HIV becomes a back-burner issue, Fenton said.

Commenting on the report, Dr. Michael Kolber, professor and director of the Comprehensive AIDS Program at the University of Miami Miller School of Medicine, said that programs to reduce the spread of HIV need to target those communities where transmission rates are highest and take into account various cultural differences.

“In the African American community, we are working with faith-based organizations,” he said. “They really play a major role in daily living.”

The programs Kolber runs go into churches and provide HIV/AIDS education in the context of overall health issues.

“When you discuss these things, you need to do it in a manner which is sensitive to what they are willing to listen to,” Kolber said.

More information

For more information on HIV/AIDS, visit the U.S. Department of Health and Human Services.

SOURCES: Kevin Fenton, M.D., Ph.D., director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, and William Jeffries IV, Ph.D., Epidemic Intelligence Service Officer, both U.S. Centers for Disease Control and Prevention; Michael Kolber, M.D., professor and director, Comprehensive AIDS Program, University of Miami Miller School of Medicine; Feb. 4, 2011, Morbidity and Mortality Weekly Report

Last Updated: Feb. 03, 2011

Copyright © 2011 HealthDay. All rights reserved.

Noncardiac Chest Pain May Warrant More Management: Study

2011-05-28T04:26:00.000-07:00

SATURDAY, April 24 (HealthDay News) — People discharged from the hospital with noncardiac (not heart-related) chest pain may require more aggressive cardiovascular risk management than they typically receive, a new study has found.

Noncardiac chest pain can be caused by a number of problems, including panic attack, musculoskeletal pain, gastroesophageal reflux disease (GERD) and esophageal hypersensitivity.

The study included 320 patients who were admitted to the hospital with what was believed to be unstable angina, evaluated and discharged with a diagnosis of noncardiac chest pain. After the initial diagnosis of noncardiac chest pain, 49 percent of patients were re-evaluated in the emergency department and 42 percent underwent repeated cardiology evaluations.

Only 15 percent of the patients had gastrointestinal (GI) consultations. Of those, 38 percent had esophagogastroduodenoscopy, 4 percent had manometry (13 tests) and 2 percent had pH probes (six probes), the study authors reported.

“Patients in this study received few GI consultations and underwent even fewer GI tests. Further study is needed to determine whether patients with noncardiac chest pain would benefit from more frequent GI consultations and more diverse use of GI testing modalities,” study co-investigator Dr. Michael Leise, of the Mayo Clinic, said in a news release.

The study also found that patients with noncardiac chest pain didn’t have a significantly higher overall rate of death than expected, but a substantial number of cardiac deaths occurred in these patients.

“We speculate that cardiac death in patients with noncardiac chest pain may relate to overlapping risk factors for GERD and coronary artery disease, including obesity, obstructive sleep apnea, diabetes mellitus and smoking,” Leise said.

He said until more is known about cardiac death in patients with noncardiac chest pain, doctors should screen these patients for cardiac risk factors, such as high blood pressure, high cholesterol and diabetes, and aggressively manage these conditions.

The study is published in the April issue of Mayo Clinic Proceedings.

More information

The U.S. National Library of Medicine has more about chest pain.

— Robert Preidt

SOURCE: Mayo Clinic, news release, April 20, 2010

Last Updated: April 25, 2010

Copyright © 2010 HealthDay. All rights reserved.

Heartburn Drugs May Contribute to the Problem

2011-05-28T04:24:00.000-07:00

TUESDAY, July 7 (HealthDay News) — Drugs commonly used to treat heartburn and acid reflux may actually cause heartburn.

A new study in the July issue of Gastroenterology found that treatment with a proton pump inhibitor (PPI) actually produced heartburn, acid reflux and indigestion in healthy volunteers who took the medication for eight weeks.

Although the findings don’t necessarily mean that PPIs don’t have a valid place in the gastrointestinal armamentarium, they do strongly suggest that overprescribing may be causing harm, the study authors said.

“It is beyond any doubt that subjects with reflux disease benefit from and need treatment with acid suppressive drugs,” said study lead author Dr. Cristina Reimer of Copenhagen University in Denmark. “But it is equally beyond doubt that PPIs are prescribed more or less uncritically for a wide variety of symptoms where the initial effect of the drug is doubtful.

“The findings in our study [indicate that] this liberal prescribing is likely to create the disease the drugs are designed to treat,” she continued. “Patients who are treated on uncertain indication thus risk developing a true need for continued therapy. Our findings challenge the very liberal prescribing of these drugs, and this study should lead to careful consideration about possible changes in prescribing habits.”

According to an accompanying editorial in the journal, about 5 percent of the developed world’s population now uses PPIs.

And more people are using the drugs long-term, although this should only occur when a person has severe gastroesophageal reflux disease (GERD) or to prevent problems in people taking nonsteroidal anti-inflammatory medications, such as aspirin, which can be hard on the stomach, the researchers said.

But according to the study authors, about one-third of patients who take PPIs renew their prescriptions without one of these indications. And the editorial stated that the drugs are being prescribed without hard evidence that acid is involved with the problem. PPIs work by reducing acid production.

For this study, 120 healthy people were randomly assigned to receive 12 weeks of a placebo or eight weeks of Nexium (esomeprazole, 40 milligrams a day), followed by four weeks of placebo.

Forty-four percent of individuals receiving the PPI reported acid-related symptoms after stopping the medication, compared with 15 percent in the placebo group.

The study authors speculated that the post-treatment effect comes from an acid “rebound” after the period of inhibition. If this does turn out to be the case, the process could end up causing dependency on PPIs, the researchers said.

“Patients need to be informed about the potential effects of the rebound acid hypersecretion and the symptoms it can cause when therapy is initiated,” said Reimer, adding that more research into the phenomenon is needed.

“If both patients and their physicians are aware of this temporary period of time after discontinuation [that might include] aggravation or induction of acid-related symptoms, it is possible that withdrawal of therapy is easier to achieve,” she added.

Blair Hains, a spokesman for AstraZeneca, which makes Nexium, said: “This study was conducted with healthy volunteers, and the authors acknowledge that they can’t be sure that the conclusion can be carried over to patients who have started PPI therapy because of dyspeptic symptoms. A previous systematic review of rebound acid hypersecretion after discontinuation of PPIs concludes that there is no strong evidence for a clinically relevant increased acid production after withdrawal of PPI therapy.”

More information

Visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases for more on GERD.

By Amanda Gardner
HealthDay Reporter

SOURCES: Christina Reimer, M.D., department of medical gastroenterology, Koge University Hospital, Copenhagen University, Denmark; Blair Hains, spokesman, AstraZeneca; July 2009, Gastroenterology

Last Updated: July 07, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Fewer Medicare Patients Hospitalized for Heart Trouble

2011-05-28T04:22:00.000-07:00

WEDNESDAY, May 11 (HealthDay News) — Over the last decade, the number of Medicare patients hospitalized for cardiac issues dropped, accounting for a smaller slice of the 10-year hospitalization rate than non-heart related issues, new research indicates.

The finding stems from the largest effort launched in the past decade (1998 to 2008) to gauge Medicare hospitalization patterns. In the latest year, Medicare hospitalizations totaled about 13 million patients, the study authors said.

The research is scheduled to be presented Thursday at the American Heart Association’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke meeting, in Washington D.C.

“We’re seeing that common cardiac diseases are accounting for a smaller proportion of hospitalizations within the United States,” study lead author Amit H. Sachdev, a fourth-year medical student at New York University School of Medicine, said in a heart association news release. “We believe this may reflect an improvement in medical care and preventive efforts and in delivering health care in the United States over the last decade.”

Sachdev and his colleagues found that while six of the eight major causes for hospital admission have been on a downward trajectory over the past decade, heart disease hospitalization rates have fallen more quickly than those attributed to other causes.

Among heart health issues, they found that coronary artery disease hospitalizations among Medicare patients dropped the most (32 percent), followed by those prompted by heart attacks (down about 22 percent). Heart failure hospitalizations also fell by nearly 17 percent, the report found.

Conversely, hospitalizations because of an irregular heartbeat (cardiac arrhythmia) bucked the trend, going up by more than 10 percent.

The researchers also found that a number of non-heart related issues fell as causes for Medicare hospitalizations, including pneumonia, fluid and electrolyte disorders, and hip fractures.

The researchers speculated that a focused government effort to tackle heart disease may account for the observed drop in related hospitalizations.

“Heart disease is the leading cause of hospitalization in the United States, so you see a lot of government money focused at cardiac conditions,” Sachdev said.

Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

More information

To learn more about heart disease visit the U.S. National Library of Medicine.

– Alan Mozes

SOURCE: American Heart Association, news release, May 11, 2011

Last Updated: May 11, 2011

Copyright © 2011 HealthDay. All rights reserved.

Research Suggests 1 in 7 Strokes Happen During Sleep

2011-05-28T04:21:00.000-07:00

TUESDAY, May 10 (HealthDay News) — About 14 percent of strokes happen while people are sleeping, lowering the chance that they’ll be able to get to the hospital in time for a potentially brain-saving treatment, a new study suggests.

“Because the only treatment for ischemic stroke must be given within a few hours after the first symptoms begin, people who wake up with stroke symptoms
often can’t receive the treatment since we can’t determine when the symptoms started,” Dr. Jason Mackey, of the University of Cincinnati and a study co-author, said in a news release from the American Academy of Neurology. “Imaging studies are being conducted now to help us develop better methods to identify which people are most likely to benefit from the treatment, even if symptoms started during the night.”

In the study, published in the May 10 issue of Neurology, researchers examined the medical records of 1,854 adults who suffered from ischemic strokes in a one-year period and were treated at emergency rooms in the Cincinnati area. Ischemic stroke is caused by blocked blood flow in the brain, usually because of a clot.

In 14 percent of the cases, people woke up with symptoms of a stroke. Nationwide, that would account for 58,000 people who visit emergency rooms with stroke systems annually, the study authors pointed out.

Of 273 people who had so-called “wake-up strokes,” at least 98 would have been eligible for treatment with a blood clot-busting drug called tPA if doctors had known when the stroke had begun, the study reported.

“If a stroke started more than a few hours ago, tPA is not indicated because it can cause bleeding that will extend and enlarge the stroke,” explained Dr. Byron K. Lee, associate professor of medicine and director of the Electrophysiology Laboratories and Clinics at the University of California, San Francisco. “In wake-up strokes, it’s nearly impossible to know when the symptoms started [so] tPA is not an option and, therefore, the neurologic deficits have a higher chance of becoming permanent.”

If you wake up feeling strange symptoms, Lee said, don’t sit around. “People should not wait for any new neurologic deficits in the morning to pass or go away as they become less groggy,” he said. “They should seek medical attention immediately. Even though tPA may not be an option in wake-up strokes, there are many other treatments that can be given in an emergency room or hospital.”

According to the National Stroke Association, symptoms of a stroke include:

Sudden paralysis or weakness in the face or limbs, especially on one side of the body
Sudden problems with balance or walking
Sudden vision problems
Slurred speech
Sudden confusion or problems speaking or understanding simple statements
Sudden severe headache with no apparent cause

Stroke experts offer a simple way to help people remember what to look for if they think they are witnessing a stroke: Think FAST (Face, Arms, Speech, Time):

Face: See if the person is able to smile, or if one side of their face seems to droop.
Arms: Can the person raise both arms, or does one side drift downward?
Speech: See if the person is able to speak clearly or repeat a simple phrase.
Time: Call 9-1-1 immediately if the person exhibits any of these signs.

More information

For more about the signs of stroke, visit the U.S. National Institutes of Health.

– Randy Dotinga

SOURCES: Byron K. Lee, M.D., associate professor, medicine, and director, Electrophysiology Laboratories and Clinics, University of California, San Francisco; American Academy of Neurology, news release, May 9, 2011

Last Updated: May 10, 2011

Copyright © 2011 HealthDay. All rights reserved.

Experts Issue ‘Top 5′ List for Better Primary Care

2011-05-28T04:19:00.000-07:00

By Amanda Gardner
HealthDay Reporter

MONDAY, May 23 (HealthDay News) — Cutting back on unnecessary antibiotics, delaying wasteful imaging for lower back pain and foregoing annual ECG screenings for healthy, low-risk patients are among the actions that could help streamline primary care, experts say.

Perhaps taking a page from David Letterman’s Top 10 list, the authors of a new report came up with a “Top 5″ list of action items for each of the primary care disciplines — family medicine, internal medicine and pediatrics — to help save money and conserve health resources.

Many physicians are already behind the suggestions, according to the report, which appears online May 23 in the Archives of Internal Medicine.

“I have seen many instances where I thought clinicians were not making the right and wisest decisions in ways that were not good for patients’ health and not good for prudent use of finite resources,” said Dr. Stephen Smith, one of the report’s authors and professor emeritus of family medicine at the Warren Alpert School of Medicine at Brown University in Providence, RI.

Smith is also a member of the National Physicians’ Alliance (NPA), a group of 22,000 doctors promoting affordable and quality healthcare, which put together the lists.

None of the suggestions are particularly new, having been validated by scores of studies, yet few clinicians seem to be implementing them, Smith said.

Here are the Top Five recommendations for each discipline:

For family medicine:

Avoid imaging for lower back pain for six weeks unless red flags are present.
Cut back on prescribing antibiotics for sinus infections, since most are viral.
Avoid cardiac screening in patients who are low risk and have no symptoms.
Do not do Pap tests for cervical cancer in women under 21 or those who have had a hysterectomy for benign disease.
Confine bone density scans known as dual-energy X-ray absorptiometry (DEXA) for osteoporosis to women aged 65 and over and for men 70 and older who also have risk factors, such as those who have already had fractures .

For internal medicine:

Defer imaging for lower back pain.
Do not order blood chemistry panels (a set of 8 blood tests to assess kidney function, blood sugar and other health indicators) or urinalysis in healthy adults with no symptoms, since blood lipids (fats) tests alone yield most positive results.
Forego cardiac screening in healthy patients.
Prescribe generic statins (cholesterol-lowering drugs) before brand-name ones
Limit bone-density screening to older, at-risk patients .

In pediatrics:

Avoid giving antibiotics for sore throats unless a test definitely turns up the bacteria Streptococcus (strep throat)
Avoid imaging for minor head injuries without risk factors such as loss of consciousness.
Take a wait-and-see attitude towards middle-ear infections before referring the patient to a specialist.
Recommend that parents not give their children over-the-counter cough-and-cold medicines.
Make sure patients with asthma are using corticosteroid medicines properly, as this will cut down on episodes.

The report was funded by a grant from the American Board of Internal Medicine Foundation.

Several of the items — those involving cardiac screening, overuse of antibiotics, bone-density scans and lower-back imaging — appeared in more than one category.

But one item — not doing blood chemistry panels and urinalysis among healthy adults without symptoms — enjoyed only weak support from the practicing physicians who field-tested the suggestions.

The Top 5 lists will now be distributed to all NPA members. The researchers are also hoping to get funding to set up demonstration sites, creating training videos to help physicians hone their communication skills and finding ways to get patients on board, Smith said.

“These are certainly important issues,” said Dr. Lawrence C. Kleinman, a primary care physician and associate professor of pediatrics at Mount Sinai School of Medicine in New York City.

But he also pointed out that “the lists were done with some nuance, which [is] valuable and important to incorporate in the understanding of this.”

As the report authors point out, Kleinman noted, it’s not that all antibiotic use is bad, just that, in the case of sore throats, there should be a verification that the infection is really strep throat before prescribing them. Similarly, imaging for head injuries would need to be done for children with loss of consciousness or other risk factors.

More information

Find a primary doctor through the American Medical Association’s Doctor Finder.

SOURCES: Stephen R. Smith, M.D., professor emeritus of family medicine, Warren Alpert School of Medicine, Brown University, Providence, RI; Lawrence C. Kleinman, M.D., a primary care physician and associate professor of pediatrics at Mount Sinai School of Medicine in New York City; May 23, 2011 online edition, Archives of Internal Medicine

Last Updated: May 23, 2011

Copyright © 2011 HealthDay. All rights reserved.

Researchers Find Cousin of Hepatitis C Virus in Dogs

2011-05-28T04:16:00.000-07:00

MONDAY, May 23 (HealthDay News) — Researchers report that they’ve discovered a virus similar to the human hepatitis C virus in dogs, a finding that might provide insight into how the germ evolved in people and perhaps lead to better treatments.

About 200 million people around the world are thought to suffer from hepatitis C, including an estimated 3.2 million chronically infected people in the United States.
Many don’t know they’re infected with the liver-damaging virus that causes the disease, which means they can spread it to others without realizing it.

The new findings suggest that hepatitis C may have “jumped” from dogs to humans more than five centuries ago, the researchers said.

“Considering the origin of HIV, we expected to find the closest homologs, or genetic relatives, of [hepatitis C virus] in non-human primates,” study author Dr. Amit Kapoor, an investigator with Columbia University’s Mailman School of Public Health’s Center for Infection and Immunity, said in a news release.

“However,” Kapoor added, “while we were analyzing samples from dogs involved in outbreaks of respiratory disease, we came upon a virus that was more similar to HCV than other viruses of the same family. So far, we have only detected [the virus] in sick animals, a few of which had died of unknown causes. Because of its close genetic similarity to HCV, we suggested the name of canine hepacivirus.”

Study co-author Dr. Charles Rice, scientific and executive director of the Center for the Study of Hepatitis C at The Rockefeller University, said in the news release that the beginnings of hepatitis C “remain a mystery. These findings underscore the need to look beyond primates for clues to the origins.”

Scientists say there’s no risk of modern-day dogs infecting people with either human hepatitis C or the canine form.

Hepatitis C is a liver disease that’s typically spread through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth, according to the U.S. National Institutes of Health.

The study appears in this week’s issue of the Proceedings of the National Academy of Sciences.

More information

For more about hepatitis C, visit the U.S. National Library of Medicine.

– Randy Dotinga

SOURCE: PNAS, news release, May 23, 2011

Last Updated: May 23, 2011

Copyright © 2011 HealthDay. All rights reserved.

Soda and OJ May Increase Risk of Gout

2011-05-27T07:55:00.000-07:00

WEDNESDAY, November 10 (Health.com) — Drinking too much soda, orange juice, or other sugary drinks appears to increase the risk of developing gout, an especially painful form of arthritis, according to a new study in the Journal of the American Medical Association.

Women who consumed two cans or more of non-diet soda per day were more than twice as likely to develop gout as women who rarely drank soda, the study found.
(Diet soda had no apparent effect on risk.) Drinking 12 ounces or more of orange juice per day increased risk by roughly the same amount.

Women who had just one soda or 6-ounce glass of OJ per day were at 74% and 41% greater risk, respectively, compared to women who rarely drank either.

The culprit appears to be fructose, says the lead author of the study, Hyon Choi, MD, a professor of medicine at Boston University School of Medicine. A sugar found in oranges as well as the high-fructose corn syrup used to make many non-diet sodas, fructose increases levels of the chemical uric acid, which causes gout. When uric acid levels in the body get too high, the acid hardens into sharp crystals that are deposited in joints.

Cutting back on sugary drinks “would help you, particularly for gout patients or if you have high levels of uric acid,” says Dr. Choi, who presented his findings today at the annual meeting of the American College of Rheumatology, in Atlanta. (The findings corroborate a similar 2008 study in men, also led by Dr. Choi.)

The overall risk of developing gout is very low, however. Over a 22-year period, just 1% of the nearly 79,000 women included in the study developed gout, and the increased risk linked to soda and juice consumption was confined almost exclusively to women who had gone through menopause.

Estrogen appears to protect against gout, Dr. Choi says. As many as 98% of gout cases in women occur after menopause, when estrogen levels decline, he adds.

The study participants, who were part of a long-running, government-funded trial known as the Nurses’ Health Study, were mostly white and between the ages of 30 to 55. Gout rates tend to be higher among men and blacks than among white women, so the increased risk of gout associated with sugary drinks may be slightly higher in the population at large than in the study, the authors note.

Still, fructose may play a relatively small role in the development of gout. Although the researchers controlled for body mass index and a number of dietary factors that have been linked to gout (such as alcohol, meat, seafood, and dairy intake), fructose consumption is difficult to untangle from other factors that can contribute to the disease, says Karen Congro, RN, director of the Wellness for Life Program at the Brooklyn Hospital Center, in New York City.

“We can’t prove 100% that [fructose] is the one item that is causing gout when there are so many other issues,” Congro says. “Is it drinking beverages with high-fructose corn syrup, or is it the whole diet?”

Gout is a growing problem in the U.S. The percentage of adults affected by the condition rose from 2.7% in the late 80s and early ’90s to almost 4% in 2008, according to other research presented at the meeting.

Three Genes Raise Gout Risk

2011-05-27T07:53:00.000-07:00

TUESDAY, Sept. 30(HealthDay News) — Three genes may raise risks for painful gout by up to 40 times, researchers report.

The finding could help identify people at risk for the arthritic illness, long before symptoms start. One of the genes studied had already been associated with gout, but identifying all three genes could help develop new treatments.

Gout is a very painful form of arthritis caused by a buildup of uric acid. This causes uric acid crystals to be deposited on the cartilage of joints, tendons and other surrounding tissue, especially in the feet, causing an inflammatory reaction.

“We identified two novel loci [genes] for uric acid that were also associated with gout,” said lead researcher Dr. Caroline Fox, from the U.S. National Heart, Lung, and Blood Institute. These genes, “can potentially be used as novel drug targets” against the disease, she said.

The report was published in the Sept. 30 online edition of The Lancet.

For the study, Fox’s team looked at the genetic makeup of almost 7,700 people who participated in the Framingham Heart Study and more than 4,100 people from the Rotterdam Study. They found three genes associated with uric acid, a biomarker for gout.

To confirm their findings, Fox’s group replicated their study in more than 11,000 whites and 3,800 blacks who took part in the Atherosclerosis Risk in Communities study.

Fox’s group found an association with the gene involved in urate transport in the kidney– the SCLA29 gene, as well as two genes which are likely to be involved in urate transport– the ABCG2 and SLC17A3 genes.

Among people in the Framingham study, 2 percent to 13 percent had gout, as did 2 percent to 8 percent of those in the Rotterdam study and 1 percent to 18 percent of whites enrolled in the Atherosclerosis study, the researchers found.

The additive effect of having all three gene variants can increase the risk for gout 40-fold, the researchers reported. This increased risk is substantially higher than other factors that account for developing the disease.

“Small effects from multiple genes can be associated with substantial risk for disease,” Fox noted.

Dr. Martin Aringer, from the Division of Rheumatology at the University Clinical Centre Carl Gustav Carus in Dresden, Germany, and author of an accompanying journal editorial, believes the findings could have an impact on treating gout.

“The main problem in gout is a problem in renal excretion,” Aringer explained. “More than 90 percent of all gout patients are not able to get rid of uric acid the way they should,” he said.

“All these polymorphism [gene types] are pretty common. If you have several polymorphisms, then you are very likely to get gout,” he said.

By understanding the genetic components that increase the risk for gout, it might be possible to develop new medications that could target the disease more directly, Aringer said.

In addition, some of these genes could play a role in diabetes and other diseases, Aringer said. “New medications might change things we can’t even speculate about today,” he said.

More information

For more about gout, visit the U.S. National Library of Medicine.

SOURCES: Caroline Fox, M.D., Ph.D., U.S. National Heart, Lung, and Blood Institute, Bethesda, Md.; Martin Aringer, M.D., Division of Rheumatology, University Clinical Centre Carl Gustav Carus, Dresden, Germany; Sept. 30, 2008, early online release, The Lancet

By Steven Reinberg
HealthDay Reporter

Last Updated: Oct. 01, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Alzheimer’s Drug Might Help Prevent Esophageal Cancer

2011-05-27T07:47:00.000-07:00

TUESDAY, Jan. 12 (HealthDay News) — An experimental Alzheimer’s drug may help prevent esophageal cancer, a new study shows.

The drug, DBZ, currently in clinical trials for treatment of Alzheimer’s disease, is known to have side effects on the lining of the lower colon. The cells that line the colon are similar to those seen in Barrett’s esophagus, a condition that can progress to esophageal cancer. Barrett’s esophagus occurs when chronic heartburn damages the lining of the esophagus.

Researchers at the University of Utrecht in the Netherlands found that DBZ halted the growth of Barrett’s esophagus in rats and, in some cases, eliminated the damaged esophageal tissue.

Though the findings suggest that DBZ could be an effective way to treat Barrett’s esophagus and prevent esophageal cancer, the drug is still a long way from being tested in human clinical trials, the researchers said.

The study is in the January-February issue of Disease Models & Mechanisms.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about Barrett’s esophagus.

— Robert Preidt

SOURCE: Company of Biologists, news release, Jan. 12, 2010

Last Updated: Jan. 12, 2010

Copyright © 2010 ScoutNews, LLC. All rights reserved.

Reflux Drugs OK With Blood Thinners

2011-05-27T07:44:00.000-07:00

TUESDAY, Sept. 1 (HealthDay News) — Antacids don’t interfere with anti-clotting drugs such as Plavix and Effient in patients who have suffered a heart attack or unstable angina, a new study finds.

The results counter other studies that concluded that a class of antacids known as proton pump inhibitors (PPIs) could block the effect of anti-clotting drugs. Doctors often prescribe PPIs along with anti-clotting drugs to reduce the risk of gastrointestinal bleeding.

“The current findings provide some reassurance to clinicians that PPIs and clopidogrel [Plavix] can be safely combined in patients in whom there is a strong indication to use both drugs,” said lead researcher Dr. Michelle O’Donoghue, an investigator in the TIMI Study Group at Brigham and Women’s Hospital in Boston.

As to why the findings differ from earlier results, O’Donoghue said the answer may lie in the patients themselves and in the type of data analyzed.

“Patients who are treated with a PPI may differ quite markedly from other patients,” she said. “In particular, there is concern that PPIs are often administered to sicker patients and that this may help to explain why patients on a PPI seem to do more poorly than other patients.”

In the current study, the researchers adjusted for these differences, O’Donoghue said.

“Another advantage of the current study is that it was done within the confines of a clinical trial,” she said. “In a clinical trial, all endpoints are strictly defined and adjudicated so there may be less of a risk for bias.”

The report is published in the Sept. 1 online edition of The Lancet, to coincide with the presentation of the results Monday at the European Society of Cardiology Congress in Barcelona.

For the study, O’Donoghue’s group looked at the effects of PPIs like Prilosec in two trials, the TRITON-TIMI 38 trial and a smaller trial. In the TRITON-TIMI 38 trial, researchers randomly assigned 13,608 patients to clopidogrel (Plavix) or prasugrel (Effient) after having a heart attack or unstable angina.

Giving the PPIs in combination with anti-clotting drugs did not increase the risk of death, heart attack, or stroke, the researchers concluded.

“We did not find use of a PPI to be associated with a higher risk of cardiovascular events for patients taking either clopidogrel or prasugrel,” O’Donoghue said.

Dr. Dirk Sibbing, from the Technische Universitat Munchen in Germany and co-author of an accompanying commentary, said this study shows that PPIs affect the anti-clotting drugs, but not patient outcomes.

“It seems that patients who carry a risk profile comparable to that of patients enrolled in TRITON-TIMI 38 can be safe on PPI treatment as long as compliance to regular anti-platelet drug intake is well-controlled,” Sibbing said.

However, cautions should remain for high-risk patients and those who are less responsive to Plavix, Sibbing said. Also, he said he believes that for some patients taking Effient and PPIs, the combination may be harmful, he said.

“In any case, monitoring of compliance to anti-platelet treatment is mandatory in all patients, but specifically in the group of patients under concomitant PPI treatment,” Sibbing said.

“Specific studies, however, are warranted in this group of patients to clarify this issue,” he said.

O’Donoghue doesn’t disagree. “In the end, only a randomized clinical trial can definitively demonstrate the safety of combining these two classes of drugs,” she said.

More information

For more information on heart attacks, visit the U.S. National Heart, Lung, and Blood Institute.

By Steven Reinberg
HealthDay Reporter

SOURCES: Michelle O’Donoghue, M.D., investigator, TIMI Study Group, Brigham and Women’s Hospital, Boston; Dirk Sibbing, M.D., Technische Universitat Munchen, Munich, Germany; Sept. 1, 2009, The Lancet, online

Last Updated: Sept. 01, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

New Guidelines Make It Easy to Get Fit

2011-05-27T07:43:00.000-07:00

THURSDAY, Oct. 9 (HealthDay News) — In an effort to help harried Americans fit exercise into their hectic lives, new government guidelines released this week recommend slightly more than two hours of physical activity a week to stay fit.

The recommendation tweaks existing guidelines that suggested a daily workout was best.

“Being physically active is one of the most important things Americans of all ages can do to protect and improve their health,” said Rear Adm. Penelope Slade Royall, Deputy Assistant Secretary for Health at the U.S. Department of Health and Human Services. For most people, all it takes is 2 1/2 hours a week to stay healthy, she noted.

“The previous recommendation for moderate-intensity physical activity was 30 minutes a day five days a week. This is now just one way to meet the minimum guideline,” Royall said. “The same health benefits accrue to people who exercise vigorously for half the time.”

Being physically active helps reduce the risk of dying early from heart disease, stroke, high blood pressure, type 2 diabetes, colon and breast cancer, and depression — and it also helps you think better, according to the guidelines.

“We are trying to reach out to our sedentary nation and encourage people and help people find ways to become physically active,” Royall said. “We were meant and made to move. In the past, human beings spent their days running around looking for something to eat or running as fast as they could away from something that wanted to eat them.”

Now people have to find ways to integrate exercise into their lives, she added, because, over time, the amount of physical activity people get has been “engineered out” of society.

The new Physical Activity Guidelines for Americans are based on the latest scientific evidence about the health benefits of physical activity. It’s the first such review in a decade, Royall noted.

The guidelines recommend a minimum amount of physical activity to promote health, but the more exercise you get the greater the health benefit, Royall said.

Aerobic exercise should be done for at least 10 minutes. To get even more health benefits, adults should get at least five hours a week of moderate exercise or 2 1/2 hours a week of intensive exercise, the guidelines recommend.

Pregnant women can also benefit from 2 1/2 hours a week of moderately intensive aerobic exercise. This activity should be spread throughout the week, the guidelines recommend. Pregnant women who previously engaged in vigorous exercise should check with their doctor about how their routine should be modified.

Children and adolescents need even more exercise then adults. They should try to get at least one hour of moderate or vigorous exercise a day, and at engage in intense exercise at least three days a week. For children and adolescents, exercise improves hearts, lungs, muscles and bones, and improves body image.

For adults with disabilities, the guidelines recommend at least 2 1/2 hours of moderate aerobic activity a week, or one hour and 15 minutes of vigorous aerobic activity a week. If they can’t do that much exercise, they should do what they can to remain physically active.

People with chronic medical conditions should also be physically active, but they should do so with the advice of their doctor, the guidelines say.

Many professional groups such as the American Society for Nutrition and the American Heart Association support the new guidelines.

“The development of U.S. physical activity guidelines is a positive step forward for the country,” James O. Hill, president of the American Society for Nutrition, said in a statement. “We hope this effort can be integrated with the development of new dietary guidelines to help Americans achieve healthier lifestyles,” he added.

But one expert warns that guidelines, while welcome, aren’t enough.

“Guidelines are no panacea,” said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine. “Despite clear guidance on tobacco, many people still smoke. We’ve had detailed dietary guidelines for years, and the typical American diet still fails to resemble them. Physical activity guidelines are the starting line, not the finish line.”

“We now need policies and programs that provide various ways for most of us to meet these guidelines during a standard day or week. And we need the will to make meeting these guidelines a priority for ourselves, and our families,” Katz added.

More information

To see the guidelines, visit the U.S. Department of Health and Human Services.
What Works Best for You?

Here are some examples of what types of exercise work for different people, according to the new government guidelines.

Moderate activities for adults include a brisk walk, water aerobics, ballroom dancing and general gardening.
Vigorous activity for adults include racewalking, jogging or running, swimming laps, jumping rope and hiking uphill or with a heavy backpack.
In addition to aerobic exercise, build muscle with weight training push-ups, sit-ups, carrying heavy loads or heavy gardening, at least two days a week.
Moderate exercise for kids and teens include hiking, skateboarding, bicycle riding and brisk walking.
Vigorous activities for kids and teens include jumping rope, running and sports such as soccer, basketball, and ice or field hockey.
Kids and teens should also do muscle-strengthening exercises, such as rope climbing, sit-ups, and tug-of war, three days a week and bone-strengthening exercise, such as jumping rope, running and skipping, at least three days a week.

SOURCES: Rear Adm. Penelope Slade Royall, P.T., M.S.W., Deputy Assistant Secretary for Health, Director, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, D.C.; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.;

By Steven Reinberg
HealthDay Reporter

Last Updated: Oct. 09, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Pill Could Boost Sports Performance

2011-05-27T07:41:00.000-07:00

THURSDAY, July 31 (HealthDay News) — A simple pill, combined with exercise training, might enhance speed and endurance in athletes.

Researchers reporting in the July 31 issue of Cell discovered that young adult mice that exercised and took a drug originally developed to treat metabolic diseases ran considerably farther compared with mice who only exercised. Adding yet another compound increased endurance even more, basically “tricking” the muscle into thinking it was being worked daily.

Even harder than tricking muscles, however, is translating animal findings into benefits for humans.

“It’s an animal study, and it’s a relatively small sample,” said Malachy McHugh, director of research at the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York City. “It’s very interesting, but putting genetic-type research like this into context is quite difficult at the early stage. It can offer up great potential but, when you then go to humans and when you then go to trained humans, the potential may not be there.”

The advantages of exercise are well known: By reducing obesity and keeping body within normal weight, physical activity reduces the risk for cancer, diabetes, heart diseases and a myriad of other diseases.

But getting individuals to actually engage in 30 minutes or 40 minutes of exercise a day is another story.

In 2004, these researchers, from the Salk Institute and the Howard Hughes Medical Institute in La Jolla, Calif., altered the PPAR-delta gene to produce mice with altered muscle composition and increased endurance. These mice were able to run twice as far as their “normal” brethren and also tended not to gain weight, even when eating a fat-heavy diet.

PPAR-delta regulates other genes. By altering its function, researchers basically tilted the scales for muscle cells to burn more fat than sugar.

But this experiment took place in younger, developing mice. In other words, they were “pre-programmed.”

Could a drug “reprogram” adult mice?

The researchers gave a drug called GW1516, which increases the activity of PPAR-delta, to young adult mice for five weeks. The result: nothing.

So, they added another element: four weeks of exercise training. The drug combined with the training increased the rodents’ running time by 68 percent and distance by 70 percent compared with mice receiving exercise training alone.

The muscles of the mice receiving both the drug and the training also showed evidence of new patterns of gene activity not seen in mice taking the drug alone or exercise training alone. The pattern was similar to the one seen in the earlier, genetically engineered mice.

Adding another compound, AICAR, which affects the activity of an enzyme called AMP kinase (AMPK) not only replenished energy in the cells, but also helped PPAR-delta activate its genetic targets.

The findings, released on the eve of the Beijing Olympics, also have a troubling side: the potential for abuse by athletes.

Aware of this problem, the study authors have already consulted the World Anti-Doping Agency and are also developing a test to detect the use of GW1516.

More information

The U.S. Centers for Disease Control and Prevention have more on recommended exercise levels.

SOURCES: Malachy McHugh, Ph.D., director, research, Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York City; July 31, 2008, Cell

Last Updated: July 31, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

By Amanda Gardner
HealthDay Reporter

Bad Behavior in Youth Linked to Chronic Pain Later in Life

2011-05-27T07:36:00.000-07:00

FRIDAY, March 12 (HealthDay News) — Children with behavioral problems are at increased risk for chronic pain when they reach adulthood, new Scottish research has found.

The study of nearly 20,000 people born in 1958 found that those with “severe behavior disturbances” between the ages of 11 and 16 were about twice as likely to have chronic widespread pain (CWP) by the time they were 45 as those who didn’t have behavioral problems as children.

The association between childhood behavior and CWP was not explained by social class, early reporting of symptoms, or adult psychological distress. The researchers believe a dysfunction in the interaction between the nervous system and hormones that occurs in childhood may have long-term consequences for adult health.

“We know already that severe adverse events in childhood such as hospitalization after a road traffic accident and separation from mothers are linked to CWP in adulthood. In addition, aspects of childhood behavior are strongly related to children reporting CWP. However, until now, it was unknown whether maladjusted behavior in children was a long-term marker for CWP in adulthood. Our study shows that it is,” study author Dr. Dong Pang, an epidemiologist at the University of Aberdeen, said in a news release.

“Early life experience, such as emotional stress due to past trauma, may have a lifelong impact on the neuroendocrine system [hypothalamic-pituitary-adrenal axis], which in turn leads to behavioral problems in childhood and CWP in adulthood as well as other mental problems. Further research at molecular and genetic levels are needed to clarify this,” Pang added.

The study findings are published in the March 10 online edition of the journal Rheumatology.

More information

The American Academy of Family Physicians has more about chronic pain.

— Robert Preidt

SOURCE: Rheumatology, news release, March 10, 2010

Last Updated: March 12, 2010

Copyright © 2010 HealthDay. All rights reserved.

Ibuprofen May Help Stave Off Parkinson’s

2011-05-27T07:31:00.000-07:00

WEDNESDAY, Feb. 17 (HealthDay News) — Regular use of ibuprofen, a common anti-inflammatory drug, significantly lowers the risk for developing Parkinson’s disease, Harvard researchers report.

People who took three or more tablets a week showed a 40 percent lower risk than those who didn’t take the common pain reliever, their study found.

Study author Dr. Xiang Gao, an instructor and
epidemiologist at Harvard Medical School and Brigham and Women’s Hospital in Boston, said the findings are important for anyone at increased risk for Parkinson’s because most people with the disease eventually become severely disabled.

“There is thus a need for better preventive interventions,” Gao said. “In this context, our findings regarding the potential neuroprotective effect of ibuprofen, one of the most commonly used analgesics, on Parkinson’s disease may have important public health and clinical implications.”

Parkinson’s is a disease that affects nerve cells in the brain that control the movement of muscles. It affects an estimated 1 million people in the United States, men far more often than women. The exact cause is unknown, but experts believe it’s a combination of genetic and environmental factors.

Gao said that though the drug levodopa is the current standard treatment for Parkinson’s, much more is needed. He is scheduled to present the findings in Toronto at the annual meeting of the American Academy of Neurology in April.

The findings came from an analysis of data on 136,474 people who did not have Parkinson’s at the start of the study. In a six-year span, 293 were diagnosed with the disease. Those who took the largest doses of ibuprofen were less likely to have developed Parkinson’s than were those who took smaller amounts of the drug, the study found.

No other pain reliever was found to lower the risk for Parkinson’s.

Dr. Michele Tagliati, an associate professor of neurology and director of the Parkinson’s Disease Center at the Mount Sinai School of Medicine in New York City, described the results as somewhat surprising and said they emphasized the need for further study.

“It’s intriguing [that the finding applied to] just ibuprofen and not aspirin or acetaminophen or other commonly prescribed medications for inflammation because it implies something more specific to ibuprofen that should be investigated,” Tagliati said. “So it narrows the focus to a subgroup of [anti-inflammatory drugs].”

Tagliati called the study “eye-opening.” Parkinson’s is not considered an inflammatory disease, he said, adding: “We might be missing something. There is more work to be done.”

But in the meantime, Tagliati said, he would “definitely discuss ibuprofen use” with his patients because, if it works to protect against the disease, it could very well benefit those who already have it.

He cautioned that persistent use of ibuprofen can lead to gastritis, or inflammation of the stomach lining, but said that, in comparison, “there is very little to lose when measuring its side effects against the effects of Parkinson’s,” which can include loss of balance, stiffness, hallucinations and dementia.

More information

The National Parkinson’s Foundation has more on Parkinson’s disease.

By Ellin Holohan

HealthDay Reporter

SOURCES: Xiang Gao, M.D., Ph.D., instructor, medicine, and associate epidemiologist, Harvard Medical School and Brigham and Women’s Hospital, Boston; Michele Tagliati, M.D., associate professor, neurology and director, Parkinson’s Disease Center, Mount Sinai School of Medicine, New York City; April 10-17, 2010, presentation, American Academy of Neurology annual meeting, Toronto

Last Updated: Feb. 17, 2010

Copyright © 2010 HealthDay. All rights reserved.

Consistent Bedtime May Give Kids Developmental Boost

2011-05-27T07:29:00.000-07:00

MONDAY, June 7 (HealthDay News) — Sticking to a regular bedtime and getting enough sleep may help young children score higher on tests of development, a new study suggests.

Kids who had a consistent bedtime at the age of 4 scored higher on a number of tests, including some that measured literacy and math abilities. Earlier bedtimes and parental rules about keeping bedtime routines also were associated with higher scores on developmental measures.

The American Academy of Sleep Medicine suggests that preschool children get at least 11 hours of sleep each night. Kids who got less than that had lower test scores, according to study author Erika Gaylor, a researcher with SRI International, a research institute in Menlo Park, Calif., and colleagues.

“Getting parents to set bedtime routines can be an important way to make a significant impact on children’s emergent literacy and language skills,” Gaylor said in a news release from the American Academy of Sleep Medicine. “Pediatricians can easily promote regular bedtimes with parents and children, behaviors which in turn lead to healthy sleep.”

The study is based on responses from phone interviews with the parents of about 8,000 kids. The parents were interviewed when the children were 9 months old and again when they were 4 years old.

The findings are scheduled to be released Monday at SLEEP 2010, the annual meeting of the Associated Professional Sleep Societies in San Antonio.

More information

The Nemours Foundation has tips for parents about kids and sleep.

– Randy Dotinga

SOURCE: American Academy of Sleep Medicine, news release, June 7, 2010

Last Updated: June 07, 2010

Copyright © 2010 HealthDay. All rights reserved.

Move Childhood Back Outdoors This Summer

2011-05-27T07:28:00.000-07:00

By Kathleen Doheny
HealthDay Reporter

FRIDAY, June 4 (HealthDay News) — For kids, summertime used to mean days spent at the beach or lake, afternoon bike rides and playing badminton in backyards.

These days, summer is more likely to be lived in the not-so-great indoors, with kids glued to computer screens and televisions with little “human” contact.

The indoor child phenomenon concerns health experts and environmentalists, who worry about the effects on health, development and relationships.

By the time most U.S. children enter kindergarten, they have spent more than 5,000 hours in front of a television, and that is enough time to earn a college degree, according to David Mizejewski, a naturalist with the National Wildlife Federation who uses those scary statistics in the federation’s “Be Out There” campaign to get children back outside.

Having kids stay indoors in the summer is the lazy way out, of course. “It’s easier for parents to say ‘Play video games,’ ‘Watch a show,’” he said. But all that indoor time isn’t healthy or good for development, he added.

Among the health benefits of more outdoor time, according to data gathered by the federation:

    Kids will get the 60 minutes a day of physical activity recommended by the American Academy of Pediatrics to improve physical and mental health.
    Obesity risk will decline — important since obesity rates have more than doubled in the past two decades.
    Kids may enjoy better distance vision — at least one study has found this in children who spend more time outdoors than kids who don’t.
    Children with attention-deficit symptoms have been found to show improvement when they are exposed to natural settings.

Besides the health benefits, the outdoors provides lessons in socializing and other life skills, said Dr. David Elkind, a professor emeritus of child development at Tufts University and author of The Power of Play.

“One of the consequences of childhood moving indoors is the culture of childhood, passed down for hundreds of years [is lost],” Elkind said. He recalls childhoods of the past, where outdoor play was plentiful, and kids learned to handle their own quarrels, negotiate their turn at games, and have other valuable learning experiences.

Even with that list of benefits, however, it can be difficult to get kids out of the house, Mizejewski and Elkind agreed.

So how to make it happen? “Parents need to make it a priority,” Mizejewski said.
Taking back control can make it easier. “Kids don’t control how they spend their time,” he said. “Adults do.”
Parents can also emphasize a balance between indoor and outdoor activities, Elkind said, such as “an hour of screen time, an hour of outdoor play, being with your friends.”

The screen time might include a nature show. Mizejewski has hosted on Animal Planet, for instance.

Some adults become convinced that outdoor time is crucial once they hear enough statistics. Today, 8- to 18-year-olds log an average of 53 hours a week using entertainment media, according to a Kaiser Family Foundation study released in January.

Only three of 10 respondents said they had any rules about media use.

The answer isn’t to simply tell your kids to go outside, Mizejewski and Elkind agreed.

A child’s appreciation of play and the outdoors “has to come from example,” Elkind said. “It can’t come from preaching. There has to be some adult guidance and direction.”

“Parents can carve out an hour in the evening,” Mizejewksi said, and plan something outdoors as a family. “You don’t have to be an early childhood educator or a naturalist to be able to give your kids these important nature activities,” he pointed out.

“Kids need unstructured play time, outside in nature, where they can look under a rock, set their own rules with peers,” Mizejewski said.

Even going for a walk is good, he added.

Planting a garden with your kids is another good idea, Mizejewski said. Or just have a camp out in the backyard. “You don’t have to get in the car and drive to Yellowstone to have a fun camping experience.”

The federation, in fact, is planning the 6th Great American Backyard Campout on June 26, urging people across the country to take part in the one-night event and reconnect with nature.

Parents should also be sensitive to the fact that different children will be attracted to different outdoor options, Elkind said. “Give the kids some choices — hiking, camping, the aquarium.”

More information

To find out more suggestions for helping your child spend more time outdoors, visit the National Wildlife Federation.

SOURCES: David Mizejewski, naturalist, National Wildlife Federation; David Elkind, professor emeritus, child development, Tufts University, Boston; National Wildlife Federation

Last Updated: June 04, 2010

Copyright © 2010 HealthDay. All rights reserved.

Hormone Helps You Sniff Out Food, Study Finds

2011-05-26T04:22:00.000-07:00

WEDNESDAY, April 13 (HealthDay News) — A hormone called ghrelin enhances the nose’s ability to sniff out food, researchers report.

It was already known that ghrelin promotes hunger and fat storage. The new study suggests that the hormone may increase the ability to use smell to detect food and link that input with the body’s natural regulation of metabolism and body weight, said University of Cincinnati scientists.

The study, which included experiments with humans and rats, appears in the April 13 issue of the Journal of Neuroscience. It was led by Dr. Jenny Tong and Dr. Matthias Tschop, both of the university’s endocrinology, diabetes and metabolism division.

“Smell is an integral part of feeding, and mammals frequently rely on smell to locate food and discriminate among food sources. Sniffing is the first stage of the smell process and can enhance odor detection and discrimination,” Tong said in a university news release.

“Other studies have shown that hunger can enhance odor detection and sniffing in animals,” Tschop added in the release. “Since ghrelin is a hunger-inducing stomach hormone that is secreted when the stomach is empty, this hormone pathway may also be responsible for the hunger-induced enhancement of sniffing and odor detection.”

The researchers plan further research to identify the exact molecular pathways through which ghrelin affects sniff behavior.

More information

The U.K.-based Social Issues Research Center has more about the sense of smell.

— Robert Preidt

SOURCE: University of Cincinnati, news release, April 12, 2011

Last Updated: April 13, 2011

Copyright © 2011 HealthDay. All rights reserved.

‘Organic’ Label Seems to Make Food Taste Better

2011-05-26T04:21:00.000-07:00

SUNDAY, April 10 (HealthDay News) — An “organic” label on foods is enough to make people believe the food items are healthier and tastier, new research suggests.

The study included 144 volunteers who were asked to compare what they believed were conventionally and organically produced chocolate sandwich cookies, plain yogurt and potato chips. All of the products were actually organic, but they were labeled as either “regular” or “organic.”

The participants used a scale of 1 to 9 to rate each of the products on 10 attributes, such as overall taste and perception of fat content. They were also asked to estimate the number of calories in each food item and how much they would be willing to pay for each product.

The investigators found that participants preferred almost all of the taste characteristics of the foods labeled as “organic,” even though they were identical to those labeled as “regular.”

The food items with “organic” labels were also perceived as being lower in fat, higher in fiber, significantly lower in calories and worth more money, according to study author Jenny Wan-chen Lee, a graduate student in Cornell University’s Dyson School of Applied Economics and Management.

In addition, chips and cookies labeled “organic” were judged to be more nutritious than those believed to be non-organic.

Lee conducted the study to test the theory that people are influenced by what is described as “the halo effect,” according to background information in a news release from the Federation of American Societies for Experimental Biology. In this case, the researchers set out to see if the “health halo” — the perception that an item that is labeled “organic” is therefore nutritious — would lead people to believe that the “organic” foods tasted better.

The study was slated for presentation Sunday at the Experimental Biology annual meeting, in Washington, D.C., of the American Society for Nutrition.

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

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— Robert Preidt

SOURCE: Federation of American Societies for Experimental Biology, news release, April 10, 2011

Last Updated: April 11, 2011

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