Share Your Health

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’

2011-05-30T03:20:00.000-07:00

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

2011-05-30T03:14:00.000-07:00

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

2011-05-30T03:13:00.000-07:00

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.

More information

The American Academy of Family Physicians offers nutrition advice.

— Robert Preidt

SOURCE: Federation of American Societies for Experimental Biology, news release, April 10, 2011

Last Updated: April 11, 2011

Copyright © 2011 HealthDay. All rights reserved.

Kids With Type 1 Diabetes Often Overweight

2011-05-26T04:19:00.000-07:00

THURSDAY, July 2 (HealthDay News) — Children with type 1 diabetes are more likely to be overweight than those without the disease, increasing their risk of serious health complications, researchers say.

The finding is from a major study that explored the weight problems faced by U.S. youngsters with type 1 diabetes, a less common form of the disease that usually shows up in childhood or in young adults. The study, part of the “Search for Diabetes in Youth Study Group,” was reported online in the journal Pediatric Diabetes.

“The links between type 2 diabetes and excess weight are well documented, but are less clear in type 1,” said lead researcher Dr. Lenna Liu of the Center for Child Health, Behavior and Development at Seattle Children’s Hospital, in a news release from the journal’s publisher.

“Knowing the prevalence of overweight and obesity in children and young people with type 1 and type 2 diabetes is very important as it helps us to identify those individuals — by age, gender or race/ethnicity — who face the greatest risk of the clinical complications associated with excess weight,” Liu added.

The researchers examined data from nearly 4,000 diabetic and more than 7,500 non-diabetic children and young people aged 3 to 19. The diabetic patients were evenly split between boys and girls and the group included various ethnic groups.

The study findings showed that, overall, approximately one in eight, or 13 percent, of type 1 diabetes patients were obese. Among black type 1 diabetes patients, 20 percent were obese, while roughly 17 percent of Hispanic and Asian/Pacific Islander patients were obese. White patients with type 1 diabetes had the lowest rate of obesity at 11 percent.

In type 1 diabetes, the body’s immune system attacks and destroys certain cells in the pancreas, an organ behind the stomach. Obese patients are at increased risk for heart disease and other serious complications.

More information

For more on diabetes, visit the American Diabetes Association.

— Peter West

SOURCE: Pediatric Diabetes, news release, June 22, 2009

Last Updated: July 02, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Stem Cell Transplant May Allow Type 1 Diabetics To Delay Insulin

2011-05-26T04:17:00.000-07:00

TUESDAY, April 14, 2009 (Health.com) — A handful of people with type 1 diabetes have been able to survive without insulin shots for more than 2-1/2 years, on average, after having their own blood stem cells removed and reimplanted through intravenous injection, U.S. and Brazilian researchers reported on Tuesday.

Overall, the technique has been tried in 23 people, mostly boys and young men, who were treated within six weeks of a new diagnosis of type 1 diabetes. People who have type 1 diabetes,
an autoimmune disease that destroys the insulin-producing cells in the pancreas, typically need insulin shots to survive. (People with type 1 make up only about 10% of all diabetics; most people have type 2, which can be controlled with diet, exercise, oral drugs, or insulin shots.)

After the transplant, 20 of the 23 patients became insulin free for at least a few months or even years. Twelve of them stayed free of insulin for an average of 31 months and eight patients had periods ranging from six to 47 months in which they were free from insulin.

One patient was free of daily insulin for more than four years before needing insulin shots, according to the report in the Journal of the American Medical Association. The stem cell transplants were performed at a single center in Brazil.

The new findings are “very encouraging,” says Richard K. Burt, MD, associate professor of medicine at Northwestern University’s Feinberg School of Medicine, who presented the findings at a Washington press briefing. Still, he said, more study is needed before it’s known whether the treatment truly alters the course of the disease. “I never use the word ‘cure,’” says Dr. Burt, who is also chief of the Division of Immunotherapy and Autoimmune Diseases at Northwestern Memorial Hospital in Chicago. “We just have to wait and see.”

Low Glucose Levels May Raise Death Risk Among Older People

2011-05-26T04:15:00.000-07:00

MONDAY, April 18 (HealthDay News) — New research finds that older diabetics with better control of their blood sugar face less chance of such diabetes-related complications as heart attacks, amputation and kidney disease.

However, there’s a twist: Those with the lowest blood sugar levels face a slightly higher chance of dying than do those whose blood sugar control is in a more normal range.

Researchers tracked more than 70,000 people with type 2 diabetes for four years. All were older than 60. “We saw increased mortality and complications, as anticipated, among those with very high blood sugars, but we also saw a modestly increased risk of death among those with very low levels of blood sugar,” Dr. Elbert Huang, an associate professor of medicine at the University of Chicago and the study’s co-lead author, said in a news release from the university.

People did the best if they had intermediate control of their blood sugar, the study found.

Guidelines typically recommend that those with diabetes keep their glucose levels low with a hemoglobin A1C level of less than 7 percent. “We need more evidence regarding how well the 7 percent guideline, which was based on a 1998 British trial that excluded older patients, applies to patients over the age of 60,” Andrew J. Karter of the Kaiser Permanente Division of Research, who led the study along with Huang, said in the news release.

A 2008 study found that older people with diabetes were more likely to die if they took treatments geared toward intensively lowering their glucose levels.

“In our study, we found the best overall outcomes among those with the intermediate levels of control, those with A1Cs below 8 percent but above 6 percent,” Huang said. “We observed similar patterns for those in their 60s, 70s and over 80.”

Why might lower levels be linked to risk for death? “We cannot say whether this unexpected finding is due to the very low blood sugar itself, the treatments used to control blood sugars or to some other factors not directly related to the care of diabetes,” Karter said. “It may be that the sickest patients at high risk of dying simply had low blood sugars to start with, rather than anything directly associated with the care of diabetes increasing the risk of death.”

The study is published in the June issue of Diabetes Care.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Disease has more about diabetes.

– Randy Dotinga

SOURCE: University of Chicago Medical Center, news release, April 18, 2011

Last Updated: April 18, 2011

Copyright © 2011 HealthDay. All rights reserved.

Do Immune System Ills Help Drive Type 2 Diabetes?

2011-05-26T04:14:00.000-07:00

By Serena Gordon
HealthDay Reporter

SUNDAY, April 17 (HealthDay News) — New research suggests that the development of insulin resistance and type 2 diabetes may be linked to an immune system reaction gone awry.

“The main point of this study is trying to shift the emphasis in thinking of type 2 diabetes as a purely metabolic disease, and instead emphasize the role of the immune system in type 2,”
said study co-author Dr. Daniel Winer, an endocrine pathologist at Toronto General Hospital in Canada. When the research began, Winer was a postdoctoral fellow at Stanford University in California.

The researchers have identified immune system antibodies in people who are obese and insulin-resistant that aren’t present in people who are obese without insulin resistance. They also tested a drug that modifies the immune system in mice fed a fatty diet, and found that the medication could help maintain normal blood sugar levels.

The findings were published online April 17 in the journal Nature Medicine. Funding for the study was provided by the U.S. National Institutes of Health.

Nearly 26 million Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention. Between 90 percent and 95 percent of these cases are type 2 diabetes, where the body doesn’t use insulin efficiently, so the pancreas must make increasing amounts of insulin. Eventually, the pancreas stops making enough insulin to meet the increased demand.

The less common form of the disease, type 1 diabetes, occurs when the immune system mistakenly destroys the insulin-producing beta cells in the pancreas. This type of diabetes is considered an autoimmune disease, and isn’t linked to how much a person weighs.

Although the causes of type 2 haven’t been clear, it’s known that the disease runs in families, suggesting a genetic component. Also, while type 2 is strongly linked to increased weight, not everyone who is overweight gets type 2 diabetes.

And, that’s what got the researchers searching for another factor. Winer explained that excess weight has been linked to inflammation, which can cause the immune system to react.

As visceral fat (abdominal fat) expands, it eventually runs out of room, explained Winer. At that point, the fat cells may become stressed and inflamed, and eventually the cells die. When that happens, immune system cells known as macrophages come to sweep up the mess.

Other immune system cells, known as T-cells and B-cells, also respond to the stressed or dying cells. But, these cells are the ones that create specific antibodies to remember a threat to the body. For example, these are the cells responsible for creating immunity when you’re exposed to a certain flu virus.

In this case, however, instead of creating antibodies against a foreign substance, immune system cells — especially the B cells — create antibodies against fat cells. Those antibodies then start attacking the fat cells, making them insulin resistant and hindering their ability to process fatty acids. In addition to type 2 diabetes, this onslaught against the fat cells is associated with fatty liver disease, high cholesterol and high blood pressure, according to the researchers.

In the current study, the researchers fed mice that weren’t yet insulin-resistant a high-fat diet (60 percent fat). At weeks six and seven, the researchers gave some of the mice a drug called anti-CD20 (in humans, the drug is known as rituximab), and the others received no treatment. Mice given the drug didn’t develop insulin resistance, and their blood sugar levels were normal. The control mice all became insulin-resistant, according to Winer.

The researchers also tested blood samples from 32 obese humans. Half had insulin resistance. Those who were insulin-resistant had a distinct set of antibodies compared to the antibodies found in those without insulin resistance. Winer said this suggests the possibility of developing a vaccine for type 2 diabetes based on what appear to be protective antibodies in those who are obese but not insulin-resistant.

Winer pointed out the mice and the human volunteers were all male, so it’s not clear if these findings are applicable to women.

Winer also noted that anti-CD20 is not benign. It dampens the immune system and can cause significant side effects, so he said he wasn’t sure if it would ever be used for type 2 diabetes because other treatments are available.

Dr. David Kendall, chief scientific and medical officer for the American Diabetes Association, agreed.

“This doesn’t change our current approach to type 2 diabetes therapy, but it’s important to understand that type 2 has multiple contributors to its onset. For some people, it may be an immune component, and if it is, we should be able to develop some better therapies,” Kendall said.

“People with type 2 diabetes are often blamed for bringing the disease on, but it’s a combination of genetic and physiological factors exposed to a certain environment. And, this study points out what may be another important biologic factor,” he added.

More information

To learn more about type 2 diabetes, visit the American Diabetes Association.

SOURCES: Daniel A. Winer, M.D., endocrine pathologist, Toronto General Hospital, Canada; David Kendall, M.D., chief scientific and medical officer, American Diabetes Association; April 17, 2011, Nature Medicine, online

Last Updated: April 18, 2011

Copyright © 2011 HealthDay. All rights reserved.

Depression Common After Brain Injury

2011-05-26T04:12:00.000-07:00

TUESDAY, April 19 (HealthDay News) — Nearly one-third of people who suffer a traumatic brain injury (TBI) will experience depression after the injury, a new study finds.

A team at Vanderbilt University Medical Center analyzed existing research on blunt force trauma head injuries suffered by civilians in traffic accidents, falls, sports and assaults.

“Any patient who has a traumatic brain injury is at a real risk for developing depression, short and long term,” study co-author Dr. Oscar Guillamondegui, an assistant professor in the trauma and surgical critical care division, said in a medical center news release.

“It doesn’t matter where on the timeline that you check the patient population — six months, 12 months, two years, five years — the prevalence is always around 30 percent across the board.”

The rate of depression in the general population is about 9 to 10 percent, Guillamondegui said.

Each year, U.S. hospital emergency departments treat 1.2 million cases of traumatic brain injury. These findings suggest that about 360,000 of those patients will suffer depression after their head injury.

The study authors said their findings about the high rate of post-injury depression are especially important considering the lack of research on whether antidepressants are a safe and effective treatment for brain-injured people.

“Even though it is possible that individuals with TBI and depression may warrant different approaches to treatment than the general population with depression, there were only two studies of treatment in this population,” co-author Melissa McPheeters, co-director of the Vanderbilt Evidence-based Practice Center, said in the news release.

“It’s unacceptable, with so many people sustaining TBIs — both in combat and civilian life — that we know so little about treating depression in this population,” she added.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about traumatic brain injury.

— Robert Preidt

SOURCE: Vanderbilt University Medical Center, news release, April 13, 2011

Last Updated: April 19, 2011

Copyright © 2011 HealthDay. All rights reserved.

Fish Oil Promising Against Postpartum Depression in Small Trial

2011-05-26T04:11:00.000-07:00

TUESDAY, April 12 (HealthDay News) — Consuming omega-3 fatty acids in fish oil capsules during pregnancy may reduce a woman’s risk of postpartum depression, according to a new study.

Researchers looked at 52 pregnant women who took either a placebo or a fish oil capsule containing 300 milligrams of docosahexaenoic acid (DHA) five days a week each week from weeks 24 to 40 of pregnancy. DHA is a prominent omega-3 fatty acid.

After the babies were born, the researchers assessed the women for postpartum depression symptoms, such as sleeping and eating problems, anxiety, emotional issues, confusion, guilt, loss of self and thoughts of suicide.

There weren’t enough women in the study to determine if consuming DHA resulted in a lower incidence of postpartum depression. But women who took the fish oil capsules had significantly fewer symptoms of postpartum depression than those who took the placebo, said Dr. Michelle Price Judge, of the University of Connecticut School of Nursing, and colleagues.

“DHA consumption during pregnancy at levels that are reasonably attained from foods has the potential to decrease symptoms of postpartum depression,” they concluded in a news release from the Federation of American Societies for Experimental Biology.

But one expert said the jury is still out on fish oil’s ability to curb postpartum blues.

“This study is interesting but must be replicated on a larger scale with proper controls for a number of medical and psychosocial factors before concluding that omega-3 fatty acid consumption lowers the risk of postpartum depression,” said Dr. Shari I. Lusskin, director of reproductive psychiatry at NYU Langone Medical Center in New York City.

“In the meanwhile,” she said, “following a healthy diet can only be a good thing for the pregnant woman and her developing baby.”

The study was to be presented Tuesday at a meeting of the federation in Washington, D.C. Research presented at meetings is considered preliminary until it is published in a peer-reviewed journal.

Postpartum depression affects up to 25 percent of new mothers, some experts estimate.

More information

The Nemours Foundation has more about postpartum depression.

— Robert Preidt

SOURCE: Shari I. Lusskin, MD, director, reproductive psychiatry, NYU Langone Medical Center, New York City; Federation of the American Societies for Experimental Biology, news release, April 12, 2011

Last Updated: April 12, 2011

Copyright © 2011 HealthDay. All rights reserved.

Dental Care Linked to Heart Health in Older Women

2011-05-26T04:10:00.000-07:00

TUESDAY, Oct. 5 (HealthDay News) — Older women who get regular dental care are about one-third less likely to suffer from heart disease than those who don’t, new findings suggest.

The study doesn’t prove that dental care directly improves the heart health of women by lowering the risk of conditions like heart attack and stroke, and dental care seemed to have no benefit for men at all in terms of heart disease, but even so, the study authors were still impressed by the findings.

The study, which was released online Sept. 29 in advance of publication in an upcoming print issue of Health Economics, analyzed the medical records of nearly 7,000 people aged 44 to 88 who had participated in another study. The data from that study had been collected between 1996 and 2004.

The authors of the new study came to their conclusions after reviewing the data and adjusting the numbers so they wouldn’t be thrown off by large or small numbers of people who were, among other things, overweight or users of alcohol and tobacco.

“We think the findings reflect differences in how men and women develop cardiovascular disease,” study co-author Dr. Stephen Brown, a obstetrician/gynecologist resident at West Virginia University, said in a news release from the University of California at Berkeley. “Other studies suggest that estrogen has a protective effect against heart disease because it helps prevent the development of atherosclerosis. It’s not until women hit menopause, around age 50 to 55, that they start catching up with men.”

Dr. Maria Emanuel Ryan, a professor of oral biology and pathology at Stony Brook University in Stony Brook, N.Y., said she has seen signs of a link between dental care and heart disease in her own practice. The study, she said, “confirms the findings of some of the studies conducted in the insurance industry, which suggest that the medical costs for cardiac care and diabetes are reduced in patients who have regular dental visits.”

There does appear to be a connection between gum disease, in particular, and heart disease. Research suggests that chronic inflammation causes heart disease, Ryan noted, and gum disease “is the most common chronic inflammatory condition in the world. Unfortunately, periodontitis — or gum disease — is often a silent disease that goes undetected and untreated.”

More information

The U.S. National Library of Medicine has more on dental health.

– Randy Dotinga

SOURCES: University of California at Berkeley, news release, Sept. 30, 2010; Maria Emanuel Ryan, D.D.S., professor, oral biology and pathology, Stony Brook University, Stony Brook, N.Y.

Last Updated: Oct. 05, 2010

Copyright © 2010 HealthDay. All rights reserved.

Gum Disease More Common in U.S. Than Previously Thought

2011-05-26T04:08:00.000-07:00

THURSDAY, Sept. 30 (HealthDay News) — Officials have underestimated the prevalence of gum disease in the United States by as much as 50 percent, new research suggests.

“This study shows that periodontal disease is a bigger problem than we all thought. It is a call to action for anyone who cares about his or her oral health,” Dr. Samuel Low, professor of periodontology at the
University of Florida College of Dentistry and president of the American Academy of Periodontology, said in a news release from the organization.

But the chronic inflammatory condition known as periodontal disease can do more than harm the gums and the structures that support the teeth. Without treatment, serious diseases that affect the entire body can develop, including diabetes, heart disease and rheumatoid arthritis, the authors of the news release explained.

“Given what we know about the relationship between gum disease and other diseases, taking care of your oral health isn’t just about a pretty smile. It has bigger implications for overall health, and is therefore a more significant public health problem,” Low added.

In the study by Paul Eke of the U.S. Centers for Disease Control and Prevention and colleagues, periodontists examined the mouths of more than 450 people older than 35 years of age. They found more cases of gum disease overall than previous research indicated people had, suggesting that the older studies had high levels of misclassification of periodontitis cases and thus have low validity for surveillance and research.

Low said the findings highlight the importance of gum health. “Not only should you take good care of your periodontal health with daily tooth brushing and flossing, you should expect to get a comprehensive periodontal evaluation every year,” he said.

The study, by researchers at the CDC and the American Academy of Periodontology, was published in the Sept. 21 online edition of the Journal of Dental Research.

More information

The U.S. National Library of Medicine has more on gum disease.

– Randy Dotinga

SOURCE: Academy of Periodontology, news release, Sept. 21, 2010

Last Updated: Sept. 30, 2010

Copyright © 2010 HealthDay. All rights reserved.

Increasingly, Other Ailments Prove Fatal for People With COPD

2011-05-25T05:22:00.000-07:00

MONDAY, Jan. 24 (HealthDay News) — People with chronic obstructive pulmonary disease are more likely today than in the past to die from cardiovascular disease or other conditions that are not respiratory ailments, a new Swedish study has found.

This suggests that doctors need to be more aware of these risks when treating people with COPD, as the condition is known.

In recent years, the average age of COPD patients beginning long-term oxygen therapy has grown in Sweden from 66 to 73 years, Dr. Magnus P. Ekstrom, respiratory medicine physician and researcher at Blekinge Hospital in Karlskrona, Sweden, said in a news release from the American Thoracic Society. The proportion of women starting the therapy also has increased, said Ekstrom, who worked on the study.

“We wanted to determine if these changes had resulted in a shift in the causes of death for COPD patients with long-term oxygen therapy,” he said of the study, published online Jan. 7 in the American Journal of Respiratory and Critical Care Medicine.

The researchers analyzed data on 7,628 adults who began long-term oxygen therapy for COPD between 1987 and 2004. During the study, which followed the participants for an average of 1.7 years, 5,497 of them died.

Lung cancer and respiratory disease became less common causes of death each year, but the risk for circulatory and digestive organ disease both grew, the study found. Overall, the risk for death from cardiovascular disease increased by almost 62 percent, according to the study.

The difference seemed to be due, at least in part, to the older age of people starting oxygen therapy, the study found. “Tobacco exposure has decreased overall in Sweden, resulting in a delay in the decline of lung function, which means patients are generally older when they require” oxygen therapy, Ekstrom said. “However, although smoking has decreased overall, the rate of decrease has been greater in men than in women.”

Because people are older when starting therapy for COPD, they “have a progressively higher burden of coexisting diseases and conditions, and become more vulnerable with increasing age,” he said. Because of this, Ekstrom added, doctors treating COPD with long-term oxygen therapy “need to be aware of these shifts and to monitor for other conditions that may influence the risk of death in these patients.”

More information

The U.S. National Heart, Lung and Blood Institute has more on COPD.

– Randy Dotinga

SOURCE: American Thoracic Society, news release, Jan. 20, 2011

Last Updated: Jan. 24, 2011

Copyright © 2011 HealthDay. All rights reserved.

HEPA Filter May Improve Air Near Wood-Burning Stoves

2011-05-25T05:21:00.000-07:00

FRIDAY, Jan. 21 (HealthDay News) — HEPA filters may help lower the risk of cardiovascular disease caused by exposure to indoor air pollution, a new study suggests.

Canadian researchers looked at 45 adults from 25 homes in a small community where wood-burning stoves were the main sources of pollution. HEPA (high-efficiency particle air)
filters were placed in each home’s main activity room and in each participant’s bedroom.

The HEPA filter was operated normally during one seven-day period and without the internal filters during another seven-day period. The participants did not know when the filters were being operated normally, the study authors noted.

Air sampling devices were installed in the homes, and the participants were asked to record their activities, locations and proximity to pollution sources every hour. Blood and urine samples were collected from the participants at the end of each seven-day period.

The researchers found that the HEPA filters reduced levels of airborne particulate matter, resulting in improved blood vessel health and reductions in blood markers associated with an increased risk of cardiovascular disease.

The study was published online Jan. 21 ahead of print in the American Journal of Respiratory and Critical Care Medicine.

“HEPA filters are a potentially useful intervention since they are relatively inexpensive to purchase and operate and can effectively remove tiny particles that can be inhaled, to improve air quality inside homes where the majority of time is spent,” study author Ryan Allen, an assistant professor at Simon Fraser University in Burnaby, British Columbia, said in a news release from the American Thoracic Society.

“The importance of residential wood smoke as a source of air pollution is likely to increase due to the rising costs of other fuels,” he added.

More information

The American Lung Association has more about indoor air quality.

– Robert Preidt

SOURCE: American Thoracic Society, news release, Jan. 21, 2011

Last Updated: Jan. 21, 2011

Copyright © 2011 HealthDay. All rights reserved.

‘Health Literacy’ Called Key for Heart Failure Patients

2011-05-25T05:18:00.000-07:00

TUESDAY, April 26 (HealthDay News) — Heart failure patients with low levels of “health literacy” are at increased risk of hospitalization and death, a new study finds.

Health literacy refers to the ability to acquire, process and understand basic health information and services required to make appropriate health decisions, according to the Institute of Medicine.
Because chronic heart failure involves a large amount of self-management, patients need an adequate level of health literacy, explained the authors of the report published in the April 27 issue of the Journal of the American Medical Association.

In their study of nearly 1,500 heart failure patients, Dr. Pamela N. Peterson, of the Denver Health Medical Center, and colleagues found that 17.5 percent had low health literacy. These patients tended to be older, poorer, less educated and more likely to have other illnesses such as diabetes, high blood pressure, chronic pulmonary disease and stroke.

During a median follow-up of 1.2 years, 124 study participants died. That included nearly 18 percent of patients with low health literacy and 6 percent of patients with adequate health literacy, the researchers found.

In addition, during the follow-up period, nearly 31 percent of patients with low health literacy were hospitalized compared to about 23 percent of patients with adequate health literacy.

Routine assessment of health literacy may help identify heart failure patients at increased risk for hospitalization and death, the researchers suggested.

“This study demonstrates that even among those with health insurance and access to health information, low health literacy as assessed by three brief screening questions is associated with higher mortality. This finding supports efforts to determine whether interventions to screen for and address low health literacy can improve important health outcomes in patients with heart failure,” Peterson and colleagues concluded.

More information

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

– Robert Preidt

SOURCE: Journal of the American Medical Association, news release, April 26, 2011

Last Updated: April 26, 2011

Copyright © 2011 HealthDay. All rights reserved.

Tai Chi May Help Heart Failure Patients

2011-05-25T05:16:00.000-07:00

By Steven Reinberg
HealthDay Reporter

MONDAY, April 25 (HealthDay News) — The ancient Chinese exercise of Tai chi may improve quality of life for people suffering from heart failure, Harvard researchers report.

Tai chi combines flowing circular movements, balance and weight-shifting,
breathing techniques and focused internal awareness. It has already been shown to be helpful with a number of medical conditions, including hypertension (high blood pressure), balance and musculoskeletal diseases, and fibromyalgia, the researchers noted.

“Tai chi training improved important parameters of quality of life, mood and confidence to perform exercise in patients with heart failure,” said lead researcher Dr. Gloria Yeh, from the division of general medicine and primary care at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School.

“Maintaining an exercise regimen is important in heart failure, and Tai chi may be a suitable alternative or adjunct exercise for these patients,” she said.

Tai chi incorporates low/moderate intensity aerobics with strength training, breathing techniques, relaxation and stress management, Yeh explained.

The report was published in the April 25 issue of the Archives of Internal Medicine.

For the study, Yeh’s team randomly assigned 100 heart failure patients to a 12-week Tai chi program or to educational sessions about heart failure.

The researchers found that although both groups had similar oxygen use during six-minute walks, those who practiced Tai chi showed greater improvements in quality of life, which was measured using the Minnesota Living with Heart Failure Questionnaire.

In addition, those taking part in Tai chi also showed improvement in mood and improvement in the number of calories burned each week, compared with those in the education program, the researchers added.

People with chronic heart failure suffer from the inability of the heart to pump blood efficiently to meet the body’s needs. The condition causes shortness of breath, coughing, chronic venous congestion, ankle swelling and difficulty exercising.

Dr. Gregg Fonarow, associate chief of cardiology at David Geffen School of Medicine at University of California Los Angeles, noted that “heart failure results in substantial impairment in functional capacity, quality of life and mood.”

“While traditional aerobic exercise may provide some benefits to patients with heart failure, many heart failure patients have difficulty in engaging and sustaining regular aerobic exercise,” he added.

There has been increasing interest in using mind-body exercises such as Tai chi for patients with heart failure, Fonarow said. “It may be more easily implemented, pleasant and have the additional benefit of meditation,” he added.

“As a complement to standard medical care, this study has demonstrated that Tai chi enhanced quality of life, mood and exercise self-efficacy,” Fonarow said. “Tai chi appears to be a safe alternative to low- to moderate-intensity conventional exercise training in patients with heart failure. Further studies are needed to compare Tai chi to aerobic exercise training, and to determine if participation in Tai chi will have a favorable impact on risk of hospitalization or survival in patients with heart failure.”

Another study in the same journal found that HIV patients may be at greater risk of developing heart failure.

In the study, Dr. Adeel A. Butt, from the University of Pittsburgh School of Medicine, and colleagues collected data on 8,486 veterans, 2,391 of whom were HIV-positive. Over 7.3 years of follow-up, the researchers found those who were HIV-positive had an 81 percent greater risk of developing heart failure than those who were not HIV-positive.

There could be several reasons for the connection between HIV and heart failure, including the infection itself, heavy alcohol use, side effects of antiretroviral therapy, nutritional deficiencies and damage to the heart muscle, Butt’s group speculated.

“HIV infection is associated with an increased risk of heart failure after adjusting for traditional risk factors for heart failure,” the researchers wrote. “This association persisted even after exclusion of patients with a baseline history of coronary heart disease, heart failure and angina, as well as a coronary heart disease event in the follow-up period prior to the diagnosis of heart failure and a history of alcohol abuse or dependence diagnosis. Ongoing viral replication is associated with a higher risk of heart failure.”

More information

For more information on heart failure, visit the American Heart Association.

SOURCES: Gloria Yeh, M.D., M.P.H., division of general medicine and primary care, Beth Israel Deaconess Medical Center, and assistant professor, medicine, Harvard Medical School, Boston; Gregg Fonarow, M.D., associate chief, cardiology, David Geffen School of Medicine, University of California, Los Angeles; April 25, 2011, Archives of Internal Medicine

Last Updated: April 25, 2011

Copyright © 2011 HealthDay. All rights reserved.

Gene Test Might Predict Colon Cancer’s Return

2011-05-25T05:14:00.000-07:00

By Amanda Gardner
HealthDay Reporter

TUESDAY, Jan. 18 (HealthDay News) — A genetic test seems able to identify which people with stage II colon cancer face a higher risk of recurrence, German researchers report.

This would be a huge help to doctors in determining which patients need follow-up
treatment after initial surgery and which do not, and it would be an improvement on existing ways to predict recurrence, according to cancer experts.

“Eighty percent of stage II colon cancers are cured by surgery alone,” said Dr. Jennifer Obel, an American Society of Clinical Oncology (ASCO) official and an assistant clinical professor of medicine at the University of Chicago, who spoke at a Tuesday news conference to announce the findings. “Only a small percentage develop metastases. We don’t want to treat everyone with chemotherapy that will only benefit a few and expose them to unnecessary side effects.”

“This is another example of trying to personalize treatment for cancer,” said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.

These results and others are scheduled to be presented this weekend at the 2011 Gastrointestinal Cancers Symposium, co-sponsored by ASCO, in San Francisco.

To develop the ColoPrint test, researchers scanned the entire human genome to identify 18 genes that were associated with the risk of a recurrence in patients diagnosed with stage II disease.

In the study, 233 patients who had already undergone surgery for stage II or stage III colon cancer underwent the test and were followed for an average of eight years.

Only 5 percent of patients with stage II cancer identified as low-risk by the test had a recurrence within five years, vs. 20 percent of those who were classified high-risk.

“Patients who ColoPrint identified as high-risk had a 4.1-fold increased risk of developing a distant metastasis compared with those patients who had been identified as low-risk,” said study author Dr. Robert Rosenberg, a surgeon and an assistant professor at University Hospital, Technical University, in Munich. “Our studies confirm previous studies. ColoPrint facilitates the identification of patients who might not need additional therapy.”

The results are similar to those found in earlier studies of the test, one of which was published in the Journal of Clinical Oncology last year; a larger, prospective trial is now underway.

Another test that looks at 12 genes, called Oncotype DX, is already licensed in the United States., said Brooks. “The question of which test is better is unknown at this time,” he added.

Oncotype DX costs upwards of $3,000, and Rosenberg was unable to provide any information on what the cost of the new test, if licensed, would be.

Although Rosenberg did not have any financial disclosures, other authors reported ties with Agendia, which makes the test.

In other news from the conference:

    A Phase II trial in 52 patients with stage II and stage III anal cancer found that chemotherapy with a more targeted mode of radiation (called intensity-modulated radiation therapy or IMRT) had the same benefit as conventional radiotherapy as far out as two years after treatment. IMRT has the advantage of fewer side effects.
    Another Phase II trial showed that the targeted therapy Nexavar (sorafenib) might be useful in patients with gastrointestinal stromal tumors (GIST) who have failed or become resistant to other therapies, particularly Gleevec, a similar targeted therapy; it halted cancer progression in two-thirds of the patients for up to three years. Nexavar did, however, have a number of side effects such as hypertension, which required 63 percent of patients to go to a lower dose of the drug.
    Using positron emission tomography (PET) imaging may help predict the prognosis and guide treatment of patients with locally advanced cancer of the esophagogastric junction. The researchers also found that patients who didn’t do well with chemotherapy didn’t respond to more radiation, either.

More information

The National Cancer Institute has more on colon cancer.

SOURCES: Jay Brooks, chairman, hematology/oncology, Ochsner Health System, Baton Rouge, La.; Jan. 18, 2011, teleconference with: Robert Rosenberg, M.D., Ph.D., assistant professor, University Hospital, Technical University, Munich, Germany; and Jennifer Obel, M.D., spokeswoman, American Society of Clinical Oncology

Last Updated: Jan. 19, 2011

Copyright © 2011 HealthDay. All rights reserved.

Many Americans Over 50 Fear Colonoscopy: Survey

2011-05-25T05:12:00.000-07:00

FRIDAY, Jan. 14 (HealthDay News) — Many Americans over the age of 50 ignore expert recommendations that they undergo a colonoscopy to screen for colorectal cancer, a new survey reveals.

Seventy percent of the survey respondents in the age group recommended to get screened admitted that they hadn’t done so primarily because of fear of the procedure.

The survey was conducted last fall by the Washington, D.C.-based Colon Cancer Alliance, and involved nearly 1,700 people. The poll was funded by Salix Pharmaceuticals, Inc., a drug manufacturer that specializes in gastrointestinal treatments.

“Colon cancer is the second leading cause of cancer death in the United States,” Andrew Spiegel, CEO of the Colon Cancer Alliance, said in an organization news release. “More than 142,000 Americans will be diagnosed with colon and rectal cancer this year, yet by getting tested, it could be prevented. The results from this survey reveal that Americans over the age of 50 forgo colonoscopies due in large part to fear.”

Survey results indicated that among those who had actually undergone a colonoscopy, 60 percent said they either didn’t get or don’t recall getting any pre-procedure explanatory information from their health care provider and would have preferred receiving such information.

The Internet was cited as the source of information regarding colonoscopies for six in 10 of those surveyed.

Half of those who had undergone a colonoscopy said that the actual procedure was the easiest aspect of the total experience, while about three-quarters said that the pre-procedure bowel preparation process was the hardest part of the screening endeavor.

The U.S. Centers for Disease Control and Prevention recommends colonoscopy every 10 years starting at age 50 until age 75, when patients should consult their doctor about screening.

More information

For more about colonoscopies and how to prepare, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

– Alan Mozes

SOURCE: Colon Cancer Alliance, news release, Jan. 12, 2011

Last Updated: Jan. 14, 2011

Copyright © 2011 HealthDay. All rights reserved.

Survey Shows Fewer Hispanic Seniors Getting Flu Shots

2011-05-24T03:31:00.000-07:00

WEDNESDAY, Jan. 26 (HealthDay News) — Hispanic seniors in the United States are less likely than their white counterparts to be vaccinated against flu and pneumonia, a new study has found.

Researchers from the nonprofit RAND Corp. analyzed data from more than 244,000 seniors who took part in a 2008 Medicare survey and found that lifetime immunization rates for pneumonia were 74 percent for whites, 56 percent for English-speaking Hispanics and 40 percent for Spanish-speaking Hispanics.

Vaccination rates for seasonal flu were 76 percent for whites, 68 percent for English-speaking Hispanics and 64 percent for Spanish-speaking Hispanics, the study reported.

“All Hispanic seniors are less likely to become immunized, and we found the problem seems to be the worst in new immigrant communities where Spanish is the predominant language,” lead author and statistician Amelia M. Haviland said in a RAND news release. “These findings suggest new strategies may be needed to target an important problem.”

She and her colleagues found that communities where there was a long-standing Hispanic population had significantly smaller disparities in flu vaccination rates. In addition, Hispanic seniors enrolled in Medicare Advantage Plans had higher pneumonia immunization rates than those in traditional fee-for-service Medicare plans, regardless of language preference.

The study was published in the Jan. 24 issue of the Archives of Internal Medicine.

More information

The U.S. National Institute on Aging has more about vaccinations for seniors.

— Robert Preidt

SOURCE: RAND Corp., news release, Jan. 24, 2011

Last Updated: Jan. 26, 2011

Copyright © 2011 HealthDay. All rights reserved.

How to Cope With Stomach Flu Symptoms

2011-05-24T03:28:00.000-07:00

WEDNESDAY, Jan. 12 (HealthDay News) — If you get the stomach flu (also known as viral gastroenteritis), there are a number of things you can do to cope with the illness, an expert suggests.

“This virus causes nausea, vomiting, diarrhea, fatigue, fever, and head and muscle aches. Although the virus itself most often is not a serious health threat, it can cause serious complications like
dehydration, which can be especially dangerous for young children and older adults,” Dr. Christopher Zipp, a family physician at the University of Medicine and Dentistry of New Jersey’s School of Osteopathic Medicine, said in a university news release.

Zipp offered the following tips for coping with stomach flu:

    Avoid dehydration by consuming plenty of fluids. The best choices are water or half-strength juices. It’s best to avoid sodas or sports drinks, but they can be given to people who can’t tolerate the recommended fluids.
    Relieve body aches and fever by taking over-the-counter, non-aspirin pain relievers such as acetaminophen, as directed.
    Rest as much as possible.
    Take steps to prevent spread of the virus. Throw away used tissues immediately and wash your hands often. Soiled bed linens or clothes should be washed separately from other laundry.
    Make sure you’re fully recovered before heading back to work or school. People with the stomach flu can still be contagious for up to 72 hours after they feel better.

“Keep in mind that this illness is caused by a virus. Antibiotics, which work against bacterial infections, will not help you to recover,” Zipp explained.

“Most people will begin to feel better after a couple of days, but don’t hesitate to contact your physician if you or a family member experiences extreme symptoms, such as uncontrolled vomiting or a high fever that persists and does not respond to over-the-counter medications,” he added.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about viral gastroenteritis.

– Robert Preidt

SOURCE: University of Medicine and Dentistry of New Jersey, news release, Jan. 7, 2011

Last Updated: Jan. 12, 2011

Copyright © 2011 HealthDay. All rights reserved.

1 in 5 Cancer Survivors Suffers Chronic Pain, Study Finds

2011-05-24T03:25:00.000-07:00

WEDNESDAY, Jan. 19 (HealthDay News) — More than 40 percent of cancer survivors experience pain, and the risk is highest among black and female patients, finds a new study.

Researchers at the University of Michigan Health System surveyed nearly 200 U.S. cancer survivors and found that 43 percent had experienced pain since their diagnosis, and 20 percent suffered chronic cancer-related pain at least two years later.

Among white patients, the most significant source of pain was cancer surgery (53.8 percent), and among black patients the greatest source of pain was cancer treatment (46.2 percent), according to the report.

In addition, the study found that compared to men, women had more pain, more pain flare-ups, more disability due to pain and were more depressed because of pain.

The authors also noted that black patients were more likely to report greater severity of pain and more pain-related disability, and also expressed more concern about harmful pain treatment side effects.

The study was released online in advance of publication in an upcoming print issue of the journal Cancer.

“All in all, the high prevalence of cancer and pain and now chronic cancer pain among these survivors, especially blacks and women, shows there’s more work to be done in improving the quality of care and research,” lead author and pain medicine specialist Dr. Carmen R. Green, a professor of anesthesiology, obstetrics and gynecology and health management and policy at the University of Michigan, said in a university news release.

Poor pain management may be the result of patient and physician attitudes and lack of knowledge, the researchers suggested. For example, patients and doctors may minimize pain complaints because they’re worried about the pain medication side effects, such as addiction, or fear that pain is a sign that the cancer has gotten worse.

“When necessary and appropriate there are a variety of therapies available to address pain and improve [patients'] well-being,” Green said.

More information

The U.S. Centers for Disease Control and Prevention has more about cancer survivorship.

– Robert Preidt

SOURCE: University of Michigan, news release, Jan. 12, 2011

Last Updated: Jan. 19, 2011

Copyright © 2011 HealthDay. All rights reserved.

Study Gauges Best Treatments for Chronic Pelvic Pain in Men

2011-05-24T03:23:00.000-07:00

By Ellin Holohan
HealthDay Reporter

TUESDAY, Jan. 4 (HealthDay News) — Three treatments for chronic pelvic pain syndrome in men — antibiotics, anti-inflammatories, and alpha-blockers or nerve inhibitors — were found to be effective in curing or reducing symptoms of the often puzzling condition, according to a recent analysis of published research.

The review, published in the Jan. 5 issue of the Journal of the American Medical Association, noted that about 9 percent of men in the United States suffer from different types of inflammation of the prostate gland, accounting for about 2 million medical visits annually. Symptoms include pain in the pelvis, urethra or penis, back pain, trouble urinating and frequent urination.

Up to 95 percent of these cases are caused by chronic pelvic pain syndrome triggered by chronic prostatitis, an inflammation of the prostate gland that surrounds the male urethra. The condition — usually caused by a chronic bacterial infection — is most likely to affect men between the ages of 35 and 45, according to government statistics.

Not enough research has been done on effective treatments for this condition, one expert said, noting that only 23 studies met the researchers’ criteria for inclusion.

“This is a very ambitious study, and it appears to shed some light on a very challenging condition,” said Dr. Paul C. Cook, a urologist at the Memorial Hermann Memorial City Medical Center in Houston, who was not connected to the study. “The fact that they distilled it down to only 23 studies in all the literature that met their criteria exemplifies that there [are so few] really good controlled studies out there.”

The most effective treatment for chronic pelvic pain syndrome was the combination of antibiotics and alpha-blockers, particularly when the main symptom was pain while urinating, but “anti-inflammatory medications remain an option for patients” who seek help for pain, according to the authors of the report.

The researchers noted that the role of antibiotics was unclear, since infection has to be ruled out before a man is diagnosed with chronic pelvic pain syndrome. They speculated that the antibiotics might work against unrecognized germs and noted that antibiotics such as quinolones also have anti-inflammatory properties.

Chronic pelvic pain, or pain lasting three of the previous six months, can be a very debilitating condition, said Cook. Symptoms of chronic pelvic pain syndrome include pain in the pelvis, urethra or penis, back pain, trouble voiding, sexual difficulties and frequent urination.

Alpha-blockers, used to block the nerves going into the muscles of the prostate, are often prescribed along with antibiotics for the condition. If that doesn’t work another antibiotic is tried. But a man with chronic pelvic pain shouldn’t just keep switching around “from one antibiotic to another,” Cook said.

“If the patient comes back and the treatment isn’t working, it’s time to rethink the diagnosis,” he suggested. “It’s time to start thinking outside the box.”

Other conditions that can cause chronic pelvic pain include pudendal nerve entrapment (when nerves get trapped in bony canals) and compression of blood vessels in the pelvis, sometimes caused by long distance bicycle riding, Cook noted.

Calling chronic pelvic pain a “poorly understood condition,” Cook said patients need to become proactive.

“It’s very important that the patient be a partner with their physician,” he said. “I always encourage patients to do independent research on their condition.” This sometimes results in a patient helping to pinpoint what is wrong, said Cook.

As men get older the prostate grows naturally, but men sometimes develop an enlarged prostate that presses on the urethra, causing pain and interfering with urination. An enlarged prostate can be treated (shrunken) with medication.

In the study, an international team looked at research published between 1949 and 2010 that compared numerous treatments and their impact on pain, voiding, quality of life and total symptom scores. More than 1,500 subjects were included in the analysis.

Other treatments included steroids, phytotherapy (plant-based alternative medicines), finasteride (also used to treat enlarged prostate) and gabapentinoids, which are used to treat nerve pain. The researchers found that phytotherapies and finasteride might benefit some patients, but added that more research was needed.

Another expert said the study was important because chronic pelvic pain syndrome can cause “enormous frustration” and can interfere with sexual function and overall quality of life.

“For the most part they [patients] fare well,” said Dr. David Samadi, vice chairman of urology at Mount Sinai Medical Center in New York City. “Everyone’s regimen is a little different. But there are patients who go on for years [with symptoms] and end up trying alternative medicines because they become desperate.”

And, he added, 20 to 25 percent of patients with chronic pelvic pain fail to find effective treatment.

A very stubborn bacteria may sometimes be the cause, said Samadi, also chief of robotics and minimally invasive surgery at Mount Sinai.

“We have tried injecting antibiotics directly into the prostate” in such cases, said Samadi, “with some success.” He cautioned against overusing alpha-blockers because they can cause drowsiness, headaches and low blood pressure.

Factors that predispose men to the pelvic pain syndrome include infection, hormone imbalance, allergic and immune system triggers, and psychological and hereditary traits, according to the researchers. Samadi also noted that men who are not sexually active for a long time may be a bit more prone to the syndrome.

More information

The U.S. National Library of Medicine has more about prostatitis.

SOURCES: Paul C. Cook, M.D., M.B.A., urologist, Memorial Hermann Memorial City Medical Center and Texas Urology Specialists, Houston; David Samadi, M.D., vice-chairman of urology, chief of robotics and minimally invasive surgery, Mount Sinai Medical Center, New York City; Jan. 5, 2011, Journal of the American Medical Association

Last Updated: Jan. 04, 2011

Copyright © 2011 HealthDay. All rights reserved.

Two-Drug Combo Reduces Diabetic Kidney Damage

2011-05-23T13:44:00.000-07:00

WEDNESDAY, June 4 (HealthDay News) — A combination of two drugs used to combat some of the damaging effects of type 2 diabetes may also reduce the risk of diabetic kidney failure, a new Danish study has found.

But the researchers warn that testing the combination of losartan (Cozaar) and aliskiren (Tekturna) to block the activity of a molecule that damages renal arteries is still in the early stages.

Losartan is often prescribed for high blood pressure in diabetes. Aliskiren blocks the pathways that allow the vessel-damaging molecule—angiotensin II—to grow and expand.

The study, published in the June 5 issue of the New England Journal of Medicine, used 599 people with type 2 diabetes, the kind that generally develops in adults. In the six-month trial, half took losartan and aliskiren, while the others took losartan and a placebo. The double-dose treatment reduced the amount of protein in the urine by 50 percent or more in 24.7 percent of participants, compared to 12.5 percent of those who got the placebo.

“This is clearly a very exciting thing,” said Dr. Matthew Weir, director of the division of nephrology at the University of Maryland School of Medicine. Kidney failure is a major problem in diabetes, and reducing the rate of failure would be a major achievement, he noted.

However, the results won’t officially mean anything to the U.S. government. Weir said the U.S. Food and Drug Administration doesn’t officially recognize reduction of proteinurea as a biomarker of success in preserving kidney function. And the trial lasted only six months, which means more studies are required, he added.

“The ultimate plan now would be to do a full renal [kidney] protection trial over, say, three years to show that this is a better strategy to prevent kidney failure,” he said.

Weir himself is not waiting for such a trial to use the two-drug therapy. “I have been doing it for a while, because I have been aware of this study for a while,” he said.

“Exciting” was a word also used by Dr. Robert Zimmerman, interim director of the Cleveland Clinic endocrinology department. “Certainly, this is pointing in the direction you want to see,” he said.

Diabetes is probably the leading cause of kidney failure that leads to dialysis, Zimmerman added. “About 50 percent of dialysis is probably due to diabetes.”

But he agreed with Weir that more work is necessary. “We clearly need to have more long-term data,” Zimmerman said. “That would be the next stage, to see whether this truly proves to be a treatment that ought to be used more frequently.”

Drugs such as ACE inhibitors, as well as losartan, now are used to help prevent kidney damage in diabetes, he said. “What this study seems to indicate is that using a renin inhibitor is another way of blocking the pathway that is associated with the increased risk of renal disease,” Zimmerman said.

“This is an important study that is likely to change my practice,” said Dr. Ajay K. Singh, an associate professor of medicine at Harvard Medical School and director of dialysis at Brigham and Womens Hospital. “Based on the results of this study, I am much more likely to use a direct renin inhibitor in addition to an angiotensin blocker in patients with Type 2 diabetes with kidney disease.”

More information

Learn about diabetic kidney disease from the American Diabetes Association.

SOURCES: Matthew Weir, M.D., director, nephrology, University of Maryland School of Medicine, Baltimore; Robert Zimmerman, M.D., interim director, endocrinology department, Cleveland Clinic; Ajay K. Singh, M.D., associate professor, medicine, Harvard Medical School, and director, dialysis, Brigham and Women’s Hospital, Boston; June 5, 2008, New England Journal of Medicine

By Ed Edelson
HealthDay Reporter

Last Updated: June 04, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Supervised Exercise May Relieve Fatigue During Chemotherapy

2011-05-23T09:05:00.000-07:00

WEDNESDAY, Oct. 14 (HealthDay News) — Supervised exercise programs for cancer patients undergoing chemotherapy can reduce fatigue and boost muscle strength, aerobic capacity and emotional well-being, a new study suggests.

Fatigue is one of the most frequent and troublesome side effects of chemotherapy, the study authors noted.

The new study included 269 cancer patients, aged 20 to 65, at two hospitals in Copenhagen, Denmark. The patients had been diagnosed with 21 types of cancer.

Some patients took part in an exercise program that included high- and low-intensity cardiovascular and resistance training, relaxation and body awareness, and massage. They received nine hours of weekly training over six weeks in addition to standard care.

The patients in the exercise group experienced significantly less fatigue than those who didn’t undergo exercise training. Even patients with advanced cancer benefited from the exercise program, the researchers found.

Exercise didn’t improve overall quality of life. Even so, “there is a considerable rationale for promoting multimodal exercise interventions to improve physical capacity, vitality, physical and mental well-being and relieving fatigue during chemotherapy; thereby supporting cancer patients’ daily living activities,” wrote Lis Adamsen, of Copenhagen University Hospitals, and colleagues.

The study was published Oct. 14 in the online edition of the BMJ.

More information

The American Cancer Society has more about exercise and cancer patients.

— Robert Preidt
SOURCE: BMJ, news release, Oct. 13, 2009

Last Updated: Oct. 14, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Childhood Trauma Tied to Chronic Fatigue Syndrome

2011-05-23T09:03:00.000-07:00

TUESDAY, Jan. 6 (HealthDay News) — Children who are traumatized by sexual, physical or psychological abuse are more likely to develop chronic fatigue syndrome as adults, new research suggests.

The study also states that the increased risk for chronic fatigue syndrome (CFS) might be based in biology. The reason: There appears to be a connection between the nervous system and endocrine system abnormalities, called neuroendocrine dysfunction, in people with CFS who suffered childhood trauma, the researchers said.

“About 60 percent of the people who have CFS have been badly abused as children,” said lead researcher Dr. William C. Reeves, chief of the U.S. Centers for Disease Control and Prevention’s Chronic Viral Diseases Branch. “They also have a diminished salivary cortisol response to stress.”

The same researchers found similar results in an earlier study of patients in Kansas, Reeves noted. “CFS does involve a diminished response to stress,” he said.

An estimated 4 million people in the United States are thought to struggle with CFS, costing the nation some $9 billion annually, and each patient’s family $20,000 a year in lost revenue, Reeves said.

The condition, which is more common in women 40 to 59 years old, is marked by a cluster of debilitating symptoms, including unexplained fatigue, problems sleeping, problems with memory and concentration, and pain.

The illness was first recognized in the late 1980s and initially dubbed the “yuppie flu,” causing it to suffer from a credibility problem.

“CFS is quite common,” Reeves said. “It is a real illness. If you have the symptoms of CFS, see a provider. It’s not all in your head — it’s not a crock.”

For the study, published in the January issue of Archives of General Psychiatry, Reeves’s team collected data on 113 people with CFS and 124 people without the condition. The participants were asked whether they had experienced such childhood trauma as sexual, physical or emotional abuse or emotional and physical neglect.

The researchers also screened the participants for depression, anxiety and post-traumatic stress disorder. They were also tested for saliva levels of the hormone cortisol; low cortisol levels can indicate reduced function of the body’s neuroendocrine stress response system.

The researchers found that people who had experienced a childhood trauma were six times more likely to develop chronic fatigue syndrome, compared with non-traumatized individuals.

Among people with CFS who’d suffered childhood trauma, cortisol levels were lower. That was not the case among those with CFS who had not had a childhood trauma. The researchers said this finding indicates that stress early in life might cause a biological susceptibility to CFS.

Reeves’s group hopes to extend the findings to new treatments for the condition.

Dr. Anthony L. Komaroff, a professor of medicine at Harvard Medical School and an expert on CFS, doesn’t think childhood trauma causes CFS but, rather, might contribute to its development.

“Since a substantial fraction of people with CFS report no childhood abuse, and since none of the control subjects [in the new study] with childhood abuse had CFS, childhood abuse is not the cause of CFS,” Komaroff said. “However, childhood abuse may alter brain chemistry in such a way that people are subsequently more vulnerable to developing CFS.”

More information

To learn more about chronic fatigue syndrome, visit the CFIDS Association of America.

SOURCES: William C. Reeves, M.D., chief, Chronic Viral Diseases Branch, U.S. Centers for Disease Control and Prevention, Atlanta; Anthony L. Komaroff, M.D., professor, medicine, Harvard Medical School, Boston; January 2009, Archives of General Psychiatry

By Steven Reinberg
HealthDay Reporter

Last Updated: Jan. 06, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

High Level of ‘Good’ Cholesterol Alone May Not Protect Heart

2011-05-23T04:15:00.000-07:00

By Jenifer Goodwin
HealthDay Reporter

WEDNESDAY, Jan. 12 (HealthDay News) — High levels of HDL cholesterol — the “good” kind — have long been thought to help protect against heart disease. But new research finds that having high levels of HDL cholesterol may matter less than how well the good cholesterol functions — that is, how well it works to rid the body of excess cholesterol.

HDL (high-density lipoprotein) cholesterol performs this clean-up by acting as a boat, removing unwanted cholesterol from cells called macrophages and transporting it to the liver, where the body can get rid of it. That helps prevent the cholesterol from getting stuck in the arterial walls, leading to the plaques that are a hallmark of heart disease, explained Dr. Daniel Rader, director of Preventive Cardiology at the University of Pennsylvania.

Low levels of HDL are strongly associated with an increased risk of heart disease, but the converse isn’t always the case. For years, experts were perplexed at why some of those with high levels of HDL cholesterol were still at high risk of heart attacks. In fact, a trial for torcetrapib, a drug that raised levels of HDL cholesterol, was halted in 2006 when it emerged that people taking the drug were at heightened risk of heart attacks and death.

That led researchers to surmise there might be something about the way in which a person’s HDL functioned that mattered more than HDL levels.

In the study, Rader and his colleagues took blood samples and measured the thickness of the blood vessel walls in the carotid artery of the necks of 203 healthy adults. The carotid thickness indicates arterial plaque and heart disease risk, Rader noted.

Researchers then took the HDL from the blood and applied it to macrophages derived from mouse cell lines. In humans and mice, macrophages are white blood cells that swallow invading microbes as a front line of defense; they also engulf cholesterol, thus contributing to the formation of plaques and inflammation in the walls of the arteries.

Participants whose HDL cholesterol was less able to remove cholesterol from the macrophages tended to have a thicker carotid artery.

“The function of the HDL was an even better predictor of the thickness of the carotid wall than the HDL level itself,” said Rader, the senior study author. The researchers term this function “cholesterol efflux capacity.”

The study is published in the Jan. 13 issue of the New England Journal of Medicine.

In a second experiment, the researchers measured the HDL function of 442 people who had undergone bypass surgery due to a blocked artery and 351 people without heart disease.

Those with heart disease had poorer HDL function than those without it, even after adjusting for traditional risk factors, the investigators found.

“We found the people who had blockages had significantly less ability to promote cholesterol removal than those who had no blockages,” Rader said. “The measure of HDL function was a much better predictor of the likelihood of having blocked arteries than the measure of HDL cholesterol itself.”

That doesn’t mean high HDL is of no help, noted Dr. Robert Eckel, past president of the American Heart Association and a professor of medicine at University of Colorado. Generally, people with higher levels of HDL also have better function, Eckel said.

But the findings may help explain why some people with high HDL are still found to have heart disease.

“I see plenty of people who have heart disease but who also have high levels of HDL. So what is going on there? Why aren’t they protected? This study may suggest their HDL isn’t working properly to carry out its function,” Eckel said.

The converse may also be true: even someone with low levels of HDL may never develop heart disease because their HDL may work very well.

“Just because someone’s HDL level was high, doesn’t necessarily predict their function is going to be high,” Rader said. “And just because their HDL is low, doesn’t mean their HDL function, or their ability to remove cholesterol, is low.”

Statins, a popular cholesterol-lowering medication, lowers levels of LDL, or “bad” cholesterol. When LDL is engulfed by macrophages, it generally gets stuck in the arterial walls, accumulates and forms plaques.

Statins do not effect HDL cholesterol levels, Rader said.

There is no test available to the public for HDL function, nor is there likely to be one soon, Rader noted. He pointed out that researchers also don’t know what causes HDL cholesterol to function poorly in removing excess cholesterol, something that will be the subject of future research.

More information

The American Heart Association has more on cholesterol.

SOURCES: Daniel J. Rader, M.D., director, preventive cardiology, University of Pennsylvania, Philadelphia; Robert Eckel, M.D., professor, medicine, University of Colorado, Denver; Jan. 13, 2011, New England Journal of Medicine

Last Updated: Jan. 12, 2011

Copyright © 2011 HealthDay. All rights reserved.

Healthy Habits in Youth Tied to Better Adult Cholesterol Levels

2011-05-23T04:13:00.000-07:00

MONDAY, Jan. 3 (HealthDay News) — A new study links cholesterol levels in young adults to changes in lifestyle between childhood and adulthood.

Previous research had looked at whether blood fat levels, such as cholesterol and triglyceride levels, remain steady from childhood to adulthood.

“Although these [previous] studies found that youth levels correlate well with adult levels, they have shown that a substantial proportion of youth with high-risk levels will not have high-risk levels in adulthood and that a substantial proportion of adults with high-risk levels had normal levels as youth,” the authors of the new report wrote.

The new study is published in the January issue of the Archives of Pediatrics & Adolescent Medicine.

For the new research, Costan G. Magnussen, of the University of Tasmania in Australia, and colleagues looked at the cholesterol and triglyceride levels in 539 people both in childhood and as young adults: levels were measured in 1985 when the participants were 9, 12 or 15, and again between 2004 and 2006, when they were in their 20s and 30s.

“Using established cut points, we found that substantial proportions of individuals with high-risk blood lipid and lipoprotein levels at baseline no longer had high-risk levels at follow-up,” the authors wrote. Those who continued to have high levels were more likely to have gained body fat and either started or continued to smoke.

Those who went from low risk in childhood to high risk as adults were also more likely to have gained body fat and become less fit, the investigators found.

“Our findings are important for two reasons. First, they suggest that beneficial changes in modifiable risk factors (smoking and adiposity) in the time between youth and adulthood have the potential to shift those with high-risk blood lipid and lipoprotein levels in youth to low-risk levels in adulthood,” Magnussen and colleagues explained. “Second, they emphasize that preventive programs aimed at those who do not have high-risk blood lipid and lipoprotein levels in youth are equally important if the proportion of adults with high-risk levels is to be reduced.”

More information

For more about children’s nutrition, try the U.S. National Library of Medicine.

– Randy Dotinga

SOURCE: American Medical Association, news release, Jan. 3, 2011

Last Updated: Jan. 03, 2011

Copyright © 2011 HealthDay. All rights reserved.

Quick Action Can Restore Hearing After Meningitis-Induced Deafness

2011-05-23T04:08:00.000-07:00

MONDAY, Oct. 18 (HealthDay News) — Health-care providers should move quickly to try to restore hearing in children who become deaf after developing pneumococcal meningitis, a small new study finds.

The number of cases of meningitis and related diseases have dropped sharply since a vaccine for meningitis — the 7-valent pneumococcal conjugate vaccine (PCV7) — became available in 2001.

“However, pneumococcal meningitis continues to occur, even in healthy children who receive the recommended PCV7 vaccination series in early childhood,” Drs. Tina Tan and Nancy Young. from Children’s Memorial Hospital and Feinberg School of Medicine at Northwestern University in Chicago, said in a news release from the journal in which the study was published.

In children left deaf by the disease, the cochlea tends to harden into bone over time, making it difficult to install an electronic hearing device known as a cochlear implant, Tan and Young explained. (The cochlea is the structure in the ear where sound vibrations are converted into nerve impulses.)

For this reason, the two physicians wrote, it’s important for cochlear implant programs to proceed quickly to install the hearing device in children recently deafened by meningitis.

Their small case series study included five PCV7-vaccinated children, aged 15 months to 10 years, who lost hearing in both ears after being ill with pneumococcal meningitis. They received immediate evaluation and treatment, and all successfully underwent cochlear implantation in both ears to restore hearing. The average time between meningitis diagnosis and cochlear implantation was 36.8 days.

Although children being evaluated for a cochlear implant in the authors’ clinic usually undergo a hearing aid trial for two to three months, Tan and Young felt more more rapid treatment was needed in three of the post-meningitis patients to ensure that the implants took place before the cochlea hardened.

The study appears in the October issue of the journal Archives of Otolaryngology — Head & Neck Surgery.

More information

The Meningitis Research Foundation of Canada has more about pneumococcal meningitis.

— Robert Preidt

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

Last Updated: Oct. 18, 2010

Copyright © 2010 HealthDay. All rights reserved.

Too Few Adults Vaccinated Against Whooping Cough: CDC

2011-05-23T04:05:00.000-07:00

By Steven Reinberg
HealthDay Reporter

THURSDAY, Oct. 14 (HealthDay News) — Recent outbreaks of whooping cough highlight the need for adults to be vaccinated against this highly contagious disease, U.S. health officials said Thursday.

Not only does vaccination protect adults against the disease, it reduces the odds that they will pass on an illness that can be life-threatening to those most at risk: infants who haven’t finished their full vaccination series, according to the U.S. Centers for Disease Control and Prevention (CDC).

A whooping cough outbreak this year in California has already sickened more than 5,270 infants and killed nine, the agency reported. That rate of illness is the highest recorded in the state since 1955, according to the California Department of Public Health.

The best way to protect yourself and the infants you come into contact from getting whooping cough — also known as pertussis — is the tetanus, diphtheria, and pertussis (Tdap) vaccine, the CDC advises.

“A pertussis booster shot is essential to prevent the spread of pertussis to infants,” said infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University in New York City, who was not involved in the report.

“This vaccine wears off, and if you don’t get a booster you are putting babies at risk because the spread of pertussis is on the increase, with 17,000 cases reported in 2009,” he said. Most infants that have not had their full vaccination series are under six months of age.

If you take care of an infant or have contact with an infant, you have to get a booster, Siegel said. “That booster is best done by getting Tdap, because you need a tetanus booster anyway, so Tdap makes total sense,” he said.

The CDC recommends that all adults 18-64 in contact with infants or working in healthcare receive a Tdap within two years of their last tetanus vaccination, and that other adults in the same age range be offered the vaccine 10 years or more after their last tetanus shot.

However, in the event of outbreaks or a jump in cases of whooping cough in the community, these adults can be vaccinated even when they got last tetanus shot less than 10 years ago, the agency said.

Tdap, which was first introduced in 2005, offers protection from tetanus, diphtheria, and pertussis.

However, in 2008, only 5.9 percent of U.S. adults received the Tdap vaccine, and 13, 278 cases of whooping cough were reported — a figure that is likely an underestimate, according to the report in the Oct. 15 issue of the CDC’s Morbidity and Mortality Weekly Report.

The survey was limited in that vaccination data was self-reported and possibly inaccurate; also, many respondents were excluded because they were unsure whether they got a regular tetanus shot or Tdap. This means that as many as 14.6 percent of U.S. adults may actually have gotten the Tdap vaccine, the agency reported, but they added that even that figure was “suboptimal.”

The Tdap is totally safe and everyone should be vaccinated, Siegel said. But there may not be enough awareness of the need for these boosters, and there is a lot of anti-vaccine propaganda out there, he said. “We need a pro-vaccine campaign to combat the anti-vaccine campaign,” he concluded.

More information

For more information on Tdap vaccine, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Marc Siegel, M.D., associate professor, medicine, New York University, New York City; Oct. 15, 2010, CDC, Morbidity and Mortality Weekly Report

Last Updated: Oct. 14, 2010

Copyright © 2010 HealthDay. All rights reserved.

Did Steve Jobs’s Money Buy Him A Faster Liver Transplant?

2011-05-23T04:03:00.000-07:00

TUESDAY, June 23, 2009 (Health.com) — This week it was reported that Steven Jobs, the CEO and cofounder of Apple, underwent a liver transplant two months ago. One detail concerning Jobs’s transplant seemed odd: The surgery took place at a hospital in Tennessee, some 2,000 miles from Jobs’s home in northern California. Why Tennessee?

The answer sheds light on the intricacies of the organ transplant system, as well as why it’s sometimes easier for people with significant financial resources to get an organ transplant. (Jobs’s estimated net worth: $5.7 billion.)

Livers are a scarce resource. In any given year, only about one-third of the people on the national transplant waiting list receive one, and as of late June, more than 16,000 people were on the list.

Yet it sometimes seems that celebrities in need end up at the front of the line when they need a transplants, and people often assume they get preferential treatment. (Rumors about special treatment circulated after baseball player Mickey Mantle’s liver transplant in 1995, for example.)

The truth is more complicated. No one can actually buy an organ in the United States (legally, that is). But getting a liver transplant, it turns out, is a lot like getting into college. Once you’re on the waiting list, your chances of getting off it depend largely on your personal circumstances—how sick you are and whether you are a good donor match. But getting on the list in the first place—or more than one list, as the case may be—requires resources and know-how that most people don’t have.

George Lopez’s Kidney Transplant: a Life-Saving Gift From His Wife

2011-05-23T04:02:00.000-07:00

THURSDAY, March 12, 2009 (Health.com) — It’s barely past 8 a.m. on World Kidney Day, but funnyman and actor George Lopez is in overdrive, bouncing back and forth from television interviewers to radio remotes to Internet and print reporters, trying to spread the word about the importance of screening for kidney disease.

Nearby, his wife Ann, who donated her kidney when Lopez needed a transplant in 2005, is keeping pace with her own interviews, often stopping to hug a friend or wave hello across the room in between sound bites.

Both are quick with the quip, blending humor with education about the importance of kidney health and screening for kidney disease. Says Ann: “Be nice to your spouse. You never know when you’ll need spare parts.”
On an early-morning radio interview a few moments earlier, George had urged listeners to come down, get screened, and, he added, have a drink, too.

World Kidney Day took place all around the world today, but this Hollywood version sponsored by the National Kidney Foundation of Southern California had its own unique twist. It was actually held at a bar—Guy’s North, a trendy watering hole in Studio City just upstairs from a bowling alley called Pinz, where the din of bowling pins can be heard over the clinking of glasses.

Ann and George Lopez are national spokespeople for the National Kidney Foundation. And dozens of celebrities attended the day’s event—called KEEP (Kidney Early Evaluation Program) it Hollywood—which included free mini-screenings for kidney disease.

New Diagnostic Guidelines for Mental Illnesses Proposed

2011-05-23T04:00:00.000-07:00

WEDNESDAY, Feb. 10 (HealthDay News) — For the first time in more than a decade, the American Psychiatric Association has announced proposed changes to the Diagnostic and Statistical Manual of Mental Disorders (DSM), long considered the “Bible” of psychiatry.

Unlike its predecessor, DSM-4, the new DSM-5 would not formally recognize sex and Internet addictions; would create a new category for “risk” disorders for people possibly heading towards developing full psychosis or dementia; and would create a new disorder, “temper dysregulation with dysphoria” (TDD) to incorporate both mood and behavioral disturbances, partly a response to current overdiagnosis of juvenile bipolar disorder.

Other issues were also addressed, including creating an overarching category known as “autism spectrum disorders” to encompass autism, Asperger’s syndrome and other similar conditions. This term is already widely used. And “mental retardation” would become “intellectually challenged.”

DSM is the tome used by psychiatrists and other mental health professionals to diagnose different conditions and to guide research.

The proposed draft will be available for public comment until April 20. The final document, which has already been 10 years in the making, is expected to be released in 2013. The DSM-4 was published in 1994.

One of the major changes in the proposed volume will be a move toward “dimensional assessments” for mental disorders, meaning that strict, immutable categories will be replaced by a reliance on continuums and that “cross-cutting” symptoms — those that span several different disorders — will be included in the criteria.

“There’s no measure in the [DSM-4] to account for the severity of the disorder and therefore no way to measure if a patient, on quantitative measures, is improving with treatment,” Dr. Darrel Regier, vice chair of the DSM-5 Task Force and director of research for the American Psychiatric Association, said during a Tuesday teleconference announcing the proposed changes. “We’re trying to address this with more quantitative measures on a continuum with a cut-off to decide mild, severe, very severe.”

This time around, experts say they are giving “careful consideration” to how mental health disorders might vary according to race, gender and ethnicity.

Some of the other proposed changes:

    A diagnosis of autism spectrum disorders would compress into a single category several disorders that used to be considered separately. Also, one diagnosis for intellectual disability would replace separate categories of profound retardation and a new, overarching category of learning disabilities that merge dyslexia (related to reading) and dyscalculia (related to mathematics).
    The diagnoses “substance abuse” and “substance dependence” will now become “addiction and related disorders,” including “substance use disorders” such as “alcohol use disorder” and “cocaine use disorder.” A new category, “miscellaneous discontinuation syndrome” covers instances of “normal” responses of withdrawal from a drug. “This also fits the category of caffeine,” said Dr. Charles P. O’Brien, chair of the Substance-Related Disorders Work Group and a professor of psychiatry at the University of Pennsylvania School of Medicine.
    A new category of “behavioral addictions” has been created which, at this point, includes only gambling. Internet and sex addiction so far merit only inclusion in the appendix. “We couldn’t find enough scientific evidence for the existence of sex addiction, but we did feel that gambling merited inclusion and we seriously considered Internet addiction,” O’Brien said. Both sex and Internet addictions are included in the appendix “to stimulate research,” he explained.
    The DSM-5, as proposed, would also include a “risk syndrome,” to identify people at risk for certain disorders such as psychosis and dementia, which now becomes minor neurocognitive impairment and major neurocognitive impairment. This controversial feature (critics have said this practice unfairly labels and stigmatizes people) would allow for early intervention in people fitting the criteria.
    Experts recommended using two different scales to assess suicide risk, one for adults and one for adolescents, intended to better identify at-risk individuals.
    The new disorder, “temper dysregulation with dysphoria,” would be added to the mood disorders section. TDD would include both behavioral and mood problems and, hopefully, will avoid overdiagnosis of juvenile bipolar disorder. “The diagnosis of juvenile bipolar disorder is being given rather too frequently,” said Dr. David Shaffer, a member of the Disorders in Childhood and Adolescence Work Group and a professor of child psychiatry and of pediatrics at Columbia University. “The new diagnosis captures both the behavioral disturbance and the mood upset. We hope people contemplating a diagnosis of bipolar disorder will think again.”
    Binge eating would become the newest eating disorder. “We’re quite confident that, compared to other folks, these people are more distressed, have more symptoms of anxiety and mood disturbance, indications that their treatment may be better provided if it’s done in a somewhat different way than with other folks with similar weight problems,” said Dr. B. Timothy Walsh, chair of the Eating Disorders Work Group and a professor of pediatric psychopharmacology at New York State Psychiatric Institute. The DSM-5 would also include better criteria for diagnosing anorexia nervosa and bulimia nervosa.

The DSM-4 was widely criticized for “overpathologizing” ordinary and expected human experiences and emotions.

“Every time the DSM is revised it gets bigger and there seem to be more and more disorders, and new ones seem to be invented,” said James Maddux, a professor of psychology at George Mason University in Fairfax, Va. “There has been a gradual psychopathologizing of everyday problems in living.”

The DSM-5, however, might escape such criticisms, Maddux conceded.

“Any movement towards a dimensional model is a move in the direction of being consistent with the research,” he said. “Any change that reduces the probability that someone with a normal, expected problem in living is going to be said to have a mental disorder is also a move in the right direction.”

More information

View and comment on the proposed changes by visiting the American Psychiatric Association.

By Amanda Gardner
HealthDay Reporter

SOURCES: James Maddux, Ph.D., professor, psychology, George Mason University, Fairfax, Va.; Feb. 9, 2010, teleconference with: Darrel A. Regier, M.D., vice chair, DSM-5 Task Force, and director, research, American Psychiatric Association; Charles P. O’Brien, M.D., Ph.D., chair, Substance-Related Disorders Work Group, and professor, psychiatry, University of Pennsylvania School of Medicine, Philadelphia; David Shaffer, M.D., member, Disorders in Childhood and Adolescence Work Group, and Irving Philips Professor of Child Psychiatry and professor of pediatrics, Columbia University, New York City; and B. Timothy Walsh, M.D., chair, Eating Disorders Work Group and W&J Ruane Professor of Pediatric Psychopharmacology (in Psychiatry), New York State Psychiatric Institute

Last Updated: Feb. 10, 2010

Copyright © 2010 HealthDay. All rights reserved.

Study Suggests Sugar May Be Addictive

2011-05-23T03:58:00.000-07:00

WEDNESDAY, Dec. 10 (HealthDay News) — Science is verifying what many overeaters have suspected for a long time: sugar can be addictive.

In fact, the sweetener seems to prompt the same chemical changes in the brain seen in people who abuse drugs such as cocaine and heroin.

The findings were to be presented Wednesday at the American College of Neuropsychopharmacology’s annual meeting, in Nashville.

“Our evidence from an animal model suggests that bingeing on sugar can act in the brain in ways very similar to drugs of abuse,” lead researcher Bart Hoebel, a professor of psychology at Princeton University, said during a Dec. 4 teleconference.

“Drinking large amounts of sugar water when hungry can cause behavioral changes and even neurochemical changes in the brain which resemble changes that are produced when animals or people take substances of abuse. These animals show signs of withdrawal and even long-lasting effects that might resemble craving,” he said.

Dr. Louis Aronne, director of the Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City, added: “The big question has been whether it’s just a behavioral thing or is it a metabolic chemical thing, and evidence like this supports the idea that something chemical is going on.”

A “sugar addiction” may even act as a “gateway” to later abuse of drugs such as alcohol, Hoebel said.

The stages of addiction, as defined by the American Psychiatric Association, include bingeing, withdrawal and craving.

For the new research, rats were denied food for 12 hours a day, then were given access to food and sugar (25 percent glucose and 10 percent sucrose, similar to a soft drink) for 12 hours a day, for three to four weeks.

The bingeing released a surge of the neurotransmitter dopamine each time in the part of the brain involved in reward, the nucleus accumbens. “It’s been known that drugs of abuse release or increase the levels of dopamine in that part of the brain,” Hoebel said.

But it wasn’t only the sugar that caused this effect, Hoebel explained — it was the sugar combined with the alternating schedule of deprivation and largesse. After three weeks, the rats showed signs of withdrawal similar to those seen when people stop smoking or drinking alcohol or using morphine.

The scientists next blocked the animals’ brain endorphins and found withdrawal symptoms, anxiety, behavioral depression and a drop in dopamine levels. In other words, they confirmed a neurochemical link with the rats’ behavior.

But longer periods of abstinence didn’t “cure” the rats. Instead, there were long-lasting effects with the animals: They ingested more sugar than before, as if they were craving the substance and, without sugar, they drank more alcohol.

The researchers speculated that some of these brain changes may also occur in people with eating disorders such as bulimia and anorexia, although more research needs to be done to confirm the effects in humans.

“Some say it’s easy to lose weight — you just have to shut your mouth, stop eating so much,” Aronne said. “I tell them a good way to overcome global warming is if people made less carbon dioxide by breathing less. Obviously, that’s absurd. You can’t do it because you feel uncomfortable.

“The same thing is true of eating,” he added. “Fattening food has an impact on the regulating mechanism that breaks down your sense of fullness, makes you feel an urge to go back and get that blast of sugar and this creates the vicious cycle of weight gain that we’re going through.”

More information

Visit Overeaters Anonymous for more on food addiction and eating disorders.

SOURCES: Louis Aronne, M.D., director, Comprehensive Weight Control Program, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City; Dec. 4, 2008, teleconference with Bart Hoebel, Ph.D., professor of psychology, Princeton University, Princeton, N.J.; Dec. 10, 2008, presentation, American College of Neuropsychopharmacology annual meeting, Nashville

By Amanda Gardner
HealthDay Reporter

Last Updated: Dec. 10, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Payment Rates May Affect Breast Cancer Treatment

2011-05-23T03:57:00.000-07:00

THURSDAY, April 28 (HealthDay News) — Use of a costly breast cancer therapy called intensity-modulated radiation therapy is strongly influenced by what Medicare will pay for the treatment and where radiation oncologists practice, according to a new study.

Researchers analyzed Medicare data for 26,163 women with localized breast cancer who had surgery and radiation therapy between 2001 and 2005. During that time, Medicare billing for the treatment, called IMRT, increased more than 10-fold (from 0.9 percent to 11.2 percent of patients).

The average cost for radiation treatment within the first year after breast cancer diagnosis was $7,179 without IMRT and $15,230 with it.

Billing for IMRT was five times higher in regions of the country where the treatment was covered by local Medicare carriers than it was in areas where it was not covered, the researchers said. They also found that billing for IMRT was more common among patients treated in freestanding radiation treatment centers (7.6 percent) than among those treated in hospital-based outpatient clinics (5.4 percent).

The findings “suggest that with respect to breast radiation therapy, much of the variation in cost can be directly attributed to inconsistent treatment definitions and reimbursement rates authorized by Medicare and its intermediaries,” concluded Dr. Benjamin D. Smith, of the M.D. Anderson Cancer Center in Houston, and his colleagues.

The study is published in the April 29 online edition of in the Journal of the National Cancer Institute.

The findings “confirm the suspicion of many, both within and outside of the health care industry, that medical decision making is too heavily influenced by reimbursement rather than medical necessity,” Dr. Lisa A. Kachnic, of Boston University School of Medicine, and Dr. Simon N. Powell, of Memorial Sloan-Kettering Cancer Center in New York, wrote in an accompanying editorial.

More information

The American College of Radiology and the Radiological Society of North America have more about IMRT.

– Robert Preidt

SOURCE: Journal of the National Cancer Institute, news release, April 29, 2011

Last Updated: April 28, 2011

Copyright © 2011 HealthDay. All rights reserved.

ACE Inhibitors Seem to Raise Risk of Breast Cancer Recurrence

2011-05-23T03:54:00.000-07:00

By Amanda Gardner
HealthDay Reporter

THURSDAY, April 21 (HealthDay News) — Two commonly used blood pressure medications seem to have opposite effects on the chances of breast cancer recurring in women with a personal history of the disease.

Preliminary findings show that ACE inhibitors increased the risk of recurrence, which surprised even the researchers, who published their study online in the journal Breast Cancer Research and Treatment.

On the other hand, beta blockers seemed to reduce the risk, which is in keeping with prior studies on the subject.

Fortunately, when the two drugs were combined, beta blockers seemed to mitigate the increased risk of recurrence linked with ACE inhibitors.

The study reflects the increasing interest among scientists in the effect the “microenvironment” — which can include chronically used medications in addition to alcohol, tobacco and physical activity — might have on the course of a particular woman’s breast cancer.

“Tumors may be living in the breast before we even known about it. The microenvironment may either facilitate or keep under control whether the cells disseminate,” said study first author Dr. Patricia A. Ganz, director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at University of California Los Angeles.

The study suggested that certain medications used to treat heart disease and high blood pressure might have an adverse effect on breast cancer survivors, she and the other researchers noted.

A 2010 study by Jonsson Comprehensive Cancer Center researchers on mice had already looked at beta blockers and cancer spread (or metastasis). That study began by documenting that stress can affect how fast and how widely a tumor spreads in rodents. The mice were confined in a small tube for a couple of hours a day, and the resulting stress prompted immune cells to gather in the tumor cells, enabling quicker metastasis and a 30-fold increase in cancer spread, deeper analysis revealed.

But in this animal model, beta blockers managed to block the signals that were recruiting the immune cells, explained Ganz.

That same year, a study of more than 400 women in England and Germany found that women on beta blockers also had a lower likelihood of breast cancer recurrence.

The UCLA researchers decided to delve deeper, working with other scientists on a database of 1,779 women with early-stage breast cancer who had been treated at a large health maintenance organization in northern California and followed for about eight years in a study called Life After Cancer Epidemiology (LACE).

The women in the group who were taking ACE inhibitors had a 56 percent increased risk of a recurrence, although they had no increased risk of death.

The 14 percent of women who were taking propanolol — the beta blocker considered most likely to have a protective effect — had a reduced risk of recurrence. Because the number of women in this group was so small, the findings did not reach statistical significance, Ganz said, although “it was going in the right direction in terms of being protective.”

The risk associated with taking both drugs together was somewhat in the middle.

The study was funded by the Jonsson Comprehensive Cancer Center Foundation, the Breast Cancer Research Foundation and the U.S. National Cancer Institute.

Noting the need for further studies, Ganz is working with researchers in Denmark and Canada to evaluate the same medications and their relationship to recurrence in much larger samples of breast cancer patients.

“We’ve always been addressing the treatment of the cancer itself but in this study [they were looking at whether] there is something in the host, in the milieu that makes us more susceptible to the development of a malignancy. Is there something we can actually change?” said Dr. Lauren Cassell, chief of breast surgery at Lenox Hill Hospital in New York City.

Still, the research is very preliminary. “People have to realize this is just a work-in-progress and shouldn’t stop their medicines if they happen to be on one of these medications,” said Dr. Nieca Goldberg, director of the Women’s Heart Program at NYU Langone Medical Center in New York City.

“If they are concerned because they have breast cancer or they’re at high risk for breast cancer,” Goldberg said, “they should really express this to their doctors because there are other options for medicines.”

More information

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

SOURCES: Patricia A. Ganz, M.D., director, cancer prevention and control research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Nieca Goldberg, M.D., director, Women’s Heart Program, NYU Langone Medical Center, New York City; Lauren Cassell, M.D., chief of breast surgery, Lenox Hill Hospital, New York City; April 10, 2011, Breast Cancer Research and Treatment, online

Last Updated: April 21, 2011

Copyright © 2011 HealthDay. All rights reserved.

Male Abusers Often Sabotage Birth Control With Partners

2011-05-23T03:52:00.000-07:00

MONDAY, Jan. 25 (HealthDay News) — A new report says that male partners of teenage girls and young women who engage in physical and sexual violence also often try to sabotage the birth control the women are using.

The study, which appears online in the January issue of Contraception, also finds that women who experience both birth-control sabotage and violence from their partner are twice as likely to have an unintended pregnancy.

“This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners,” study author Elizabeth Miller, an assistant professor of pediatrics in the University of California at Davis School of Medicine, said in a news release from the school. “Not only is reproductive coercion associated with violence from male partners, but when women report experiencing both reproductive coercion and partner violence, the risk for unintended pregnancy increases significantly.”

The study was conducted from 2008-2009 at five health clinics that deal with reproductive issues in Northern California. About 1,300 women aged 16 to 29 took part by responding to a computerized survey.

About 15 percent said they’d experienced birth-control sabotage, and more than half reported physical or sexual violence from a partner. More than one-third of those who said they had been the victim of partner violence also acknowledged experiencing either pregnancy coercion or birth-control sabotage, the researchers found.

“We have known about the association between partner violence and unintended pregnancy for many years,” study senior author Jay Silverman, an associate professor of society, human development and health in the Harvard School of Public Health, said in the news release. “What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens.”

More information

The National Women’s Health Network has more on birth-control sabotage.

— Randy Dotinga

SOURCE: University of California at Davis, news release, Jan. 25, 2010

Last Updated: Jan. 25, 2010

Copyright © 2010 HealthDay. All rights reserved.

Birth Control Pills Might Alter Mate Selection: Study

2011-05-23T03:51:00.000-07:00

WEDNESDAY, Oct. 7 (HealthDay News) — Could birth control pills be taking human evolution in a whole new, and possibly detrimental, direction?

A review of past research finds that, by altering hormonal cycles, the pill might affect choice of mates among members of both genders in a way that could hinder successful reproduction in the future.

“The use of the pill by women, by changing her mate preferences, might induce women to mate with otherwise less-preferred partners, which might have important consequences for mate choice and reproductive outcomes,” said Alexandra Alvergne, lead author of a study appearing in the October issue of Trends in Ecology & Evolution.

“One prediction is that offspring of pill users are more homozygous than expected, possibly related to impaired immune function and decreased perceived health and attractiveness,” according to the report by Alvergne, a postdoctoral research associate in the department of animal and plant sciences at the University of Sheffield in England, and colleague Virpi Lummaa.

But another expert thinks this new revelation on the pill, which did indeed revolutionize sex in the 1960s, may have been over-interpreted.

“The study was about female preferences in their relation to hormones in the cycle but that’s not the same as your mate selection for a long-term relationship,” said Dr. William Hurd, a reproductive endocrinologist at University Hospitals Case Medical Center in Cleveland. “If you don’t take into account society maybe we’re all animals, but in social situations I don’t think there are many women who change who they would mate with at different times of the month. It might change desires or perceptions but, gee whiz, that’s a long stretch to changing who you would date, or even who you would go to dinner with.”

Women who are ovulating tend to be attracted to so-called “manly men,” those with more masculine facial features and traits of dominance and competitiveness, according to background information in the study. They also tend to prefer the man who is not like them, genetically speaking.

And men, given a choice, will gravitate towards an ovulating female rather than a non-ovulating female.

But women on the pill are more consistently in a state that mimics pregnancy, the authors stated.

According to the study authors, who stress that “modern contraception has improved the quality of life worldwide,” 100 million women around the globe are on the pill.

Alvergne and Lummaa are hoping the paper will spur further research.

“There are important limitations from previous studies, due to the fact few of them have been addressing the question as their main focus,” Alvergne said.

Future research should focus on two questions in particular, she said: Does use of the pill affect marital relationship, satisfaction and durability; and does it affect the ability of couples to reproduce?

But Hurd thinks there are other trends changing how humans date, mate and reproduce far more radically than artificial hormone cycles.

“Probably the biggest change in my lifetime is how people meet each other: online and using programs that match them for compatibility,” he said. “That’s probably going to have a massive effect on how people end up dating and ultimately reproducing. Just because you like someone with a square jaw in the middle of your cycle probably doesn’t affect who you end up with.”

More information

For more on reproductive health and biology, visit the U.S. National Institutes of Health.

By Amanda Gardner
HealthDay Reporter

SOURCES: Alexandra Alvergne, Ph.D., postdoctoral research associate, department of animal and plant sciences, University of Sheffield, U.K.; William Hurd, M.D., reproductive endocrinologist, University Hospitals Case Medical Center, Cleveland, Ohio; October 2009, Trends in Ecology & Evolution

Last Updated: Oct. 07, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

U.S. Spending on Mental Health Care Soaring

2011-05-21T01:12:00.000-07:00

WEDNESDAY, Aug. 5 (HealthDay News) — U.S. spending on mental illness is soaring at a faster pace than spending on any other health care category, new government data released Wednesday shows.

The cost of treating mental disorders rose sharply between 1996 and 2006, from $35 billion (in 2006 dollars) to almost $58 billion, according to the report from the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services.

At the same time, the report showed, the number of Americans who sought treatment for depression, bipolar disorder and other mental health woes almost doubled, from 19 million to 36 million.

The new statistics come on the heels of a study, released Monday, that found antidepressant use among U.S. residents almost doubled between a similar time frame, 1996 and 2005.

Spending on mental illness showed a faster rate of growth over the 10-year period analyzed than costs for heart disease, cancer, trauma-linked disorders, and asthma.

According to the report, spending on heart disease rose from $72 billion in 1996 to $78 billion in 2006; cancer care rose from $47 billion to $58 billion; asthma costs climbed from $36 billion to $51 billion, and expenditures for trauma-related care rose from $46 billion to $68 billion.

In terms of per-patient costs, cancer led the way at $5,178 in 2006 (up slightly from $5,067 in 1996), while costs for trauma care and asthma rose sharply — from $1,220 to $1,953 and from $863 to $1,059, respectively.

On the other hand, average per-patient spending for heart conditions fell, from $4,333 to $3,964. And spending on mental disorders declined from $1,825 to $1,591.

In the Monday study, published in the Archives of General Psychiatry, researchers reported that 10.12 percent of U.S. residents aged 6 and over, or 27 million people, were using antidepressants in 2005, compared to 5.84 percent, or 13.3 million people, in 1996.

The increase seemed to span virtually all demographic groups.

“This is a 20-year trend and it’s very powerful,” remarked Dr. Eric Caine, chair of the department of psychiatry and co-director of the Center for the Study of Prevention of Suicide at the University of Rochester Medical Center.

More information

For information on mental health issues, head to the U.S. National Institute of Mental Health.

— E.J. Mundell

SOURCES: Aug. 5, 2009, news release, Agency for Healthcare Research and Quality; August 2009, Archives of General Psychiatry; Eric Caine, M.D., chair, department of psychiatry, and co-director, Center for the Study of Prevention of Suicide, University of Rochester Medical Center, N.Y.

Last Updated: Aug. 06, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

FDA Panel OKs Newer Antipsychotics for Children

2011-05-21T01:09:00.000-07:00

WEDNESDAY, June 10 (HealthDay News) — A U.S. Food and Drug Administration advisory panel on Wednesday voted overwhelmingly that Seroquel and Zyprexa, two powerful antipsychotic drugs, be approved to treat schizophrenia and bipolar disorder in children aged 13 to 17.

The panel also handed down a decision on Geodon, a third antipsychotic in the same class. They found that drug to be safe and effective for the treatment of bipolar mania in children aged 10 to 17.

All three drugs are part of the new-generation “atypical” antipsychotics, currently approved for adult use. The medications have been prescribed “off-label” by many doctors for years to treat schizophrenia and bipolar disorder in children ages 10 to 17, despite possible serious side effects, including diabetes and heart woes.

Seroquel is made by drug maker AstraZeneca. pharmaceutical giant Lilly makes Zyprexa, and Geodon is made by Pfizer.

There is a pressing need for effective antipsychotics for children, one expert noted.

“Schizophrenia and bipolar disorder are very real illnesses, which collectively affect between 1 percent and 3 percent of all young people,” noted Dr. David Fassler, a clinical professor of psychiatry at the University of Vermont College of Medicine, who testified before the panel Tuesday. “Without treatment, children have problems at school, at home, and with their friends. They’re also at increased risk of accidents, hospitalization, and death at an early age from multiple causes, including suicide.”

And yet safety concerns plague many of these drugs. In 2004, the FDA ordered AstraZeneca to add a special “black box” warning to Seroquel’s packaging, outlining increased risks of hyperglycemia, high blood pressure and diabetes associated with use of the drug. Also, older patients with dementia-related psychosis treated with Seroquel are at an increased risk of death, according to the FDA.

And in a unanimous vote in early April, an FDA advisory panel determined that Seroquel should not be approved as first-line therapy for adult depression, because of continued questions about its safety profile — most notably, a link to higher risk for sudden cardiac death. However, the drug was approved for use in patients for whom other antidepressants didn’t work.

The family of atypical antipsychotics has other well-documented potential side effects, including weight gain and high blood sugar, which can increase the risk of diabetes, as well as rapid heart beat, difficulty sleeping and trouble concentrating.

Ronald T. Brown, dean and professor of public health at Temple University Health Sciences Center, testified before the panel Tuesday. Speaking to HealthDay, he said there’s still too little known about the efficacy and side effects of these medications in children for the FDA to approve their use in kids.

“The problems are what we don’t know rather than what we do know,” Brown said. “We don’t know anything about the long-term effects of these medications; they have only been through a six-week trial.”

“I am not convinced about the long-term safety of these drugs,” he added.

“Particularly with children, when you don’t know, I don’t think you should approve it,” Brown said. “In this country, we are very over-zealous to approve drugs. I think we need to be more conservative, particularly because this is a pediatric population.”

Brown believes off-label use may be safe, because it is done for particular patients, with the family’s consent. “That’s a lot different than saying this drug has been approved for children and adolescents,” he said.

Prior studies have also found that these newer drugs are no more effective than older medications. Their main advantage is that they do not cause the tremors and muscle spasms associated with older agents.

Diana Zuckerman is president of the National Research Center for Women & Families, a Washington, DC advocacy group. She believes much more study is needed before good decisions can be made as to the use of these antipsychotics by youngsters.

According to Zuckerman, the small studies that are out there suggest that, while on these drugs, “between 20 to 30 percent of kids were gaining weight, heart rates were increased, many of the kids were so knocked out (‘sedated’) that they could barely function.”

Overall, the trials submitted to the FDA panel were small, Zuckerman added, noting there were “usually less than 100 at a specific dosage.”

“If you want to prove that the benefits outweigh the risks,” she said, “it is necessary to study thousands of kids for at least a year in double-blind studies, preferably longer. These studies don’t come close to doing that.”

Fassler took a more measured view.

“None of these medications should be used without careful consideration of the risks and benefits,” he said. “Children and adolescents taking these medications should be monitored closely for evidence of significant side effects or adverse reactions. Nonetheless, when used appropriately, these medications can be a helpful and effective component of treatment for children and adolescents with schizophrenia or bipolar disorder.”

In any case, drugs should never be viewed as the only therapeutic option open to young patients, according to Fassler.

“Medication, including the atypical antipsychotics, can be helpful to control some of the signs and symptoms associated with these disorders, but medication alone is rarely an adequate or sufficient intervention. It should only be used as part of a comprehensive treatment plan, individualized to the needs of the child and family,” Fassler said.

Although the FDA isn’t required to follow advisory committee recommendations, it usually does.

More information

For more information on atypical antipsychotics, visit the U.S. Food and Drug Administration .

By Steven Reinberg
HealthDay Reporter

SOURCES: David Fassler, M.D., clinical professor of psychiatry, University of Vermont College of Medicine, Burlington; Diana Zuckerman, Ph.D., president, National Research Center for Women & Families, Washington, DC; Ronald T. Brown, Ph.D., dean and professor of public health, Temple University Health Sciences Center, Philadelphia; June 10, 2009 statement, U.S. Food and Drug Administration

Last Updated: June 10, 2009

Copyright © 2009 ScoutNews, LLC. All rights reserved.

Think Before You Ink: Women More Likely Than Men to Regret, Remove Tattoos

2011-05-21T01:03:00.000-07:00

TUESDAY, July 22, 2008 — Jen Graham, 28, of Brooklyn, N.Y., has gone through three sessions so far to remove a band of stars she impulsively had tattooed around her ankle at age 19. A tattooed ex-boyfriend gave her one “homemade” star with a safety pin and ballpoint-pen ink, and she had the design touched up and completed at a tattoo parlor soon after.

“I didn’t immediately regret it, but certainly within a year,” she says. “I’d thought about getting it removed for a long time and then finally made an appointment when I got a much more professional job at a publishing company and moved to New York. Plus my aesthetics had changed; I think tattoos look trashy now.”

Getting a tattoo is historically a male-dominated activity—but in a society where celebrities like Angelina Jolie and Rihanna flaunt their latest inked designs, tattooing has become popular among females as well. However, women may still face more societal stigma than men about their tattoos, and are more likely to have them removed because of embarrassment, body image, or career concerns, according to a new study.

More social stigma for women
Women represent at least half of the 45 million Americans with tattoos today, according to the Food and Drug Administration (FDA). About one-fourth of adults age 18 to 30 have a tattoo, and 20% are estimated to be dissatisfied with their body art. Only about 6%, however, seek removal—a costly, painful, and time-consuming procedure that involves laser treatments, surgery, or chemical skin treatments.

In the recent study published in Archives of Dermatology, researchers from Texas Tech University surveyed a sample of 196 patients visiting dermatology clinics for tattoo removal. In contrast to a 1996 survey, study participants were more than twice as likely to be women (69% vs. 31% men), and were typically white, single, college-educated, and between the ages of 24 and 39. Previously, more men had requested tattoo removal.

Both men and women said they wanted to get their tattoos removed to leave their pasts behind them, and because they:

    Just decided to remove it (58%)
    Suffered embarrassment (57%)
    Had a lowered body image (38%)
    Were getting a new job or career (38%)
    Had problems with clothes (37%)
    Experienced stigma (25%)
    Were marking an occasion, such as a birthday, marriage, or newly found independence (21%)

While most women were pleased with their tattoos when they got them, their feelings changed over the next one to five years. “While men also reported some of these same tattoo problems leading to removal, there seemed to be more societal fallout for women,” the authors wrote.

Specifically, their tattoos had begun to cause embarrassment and no longer provided a feeling of uniqueness. More women than men said they were removing their tattoos because they often had to hide them (73% vs. 36%); they experienced stigma problems because of them (27% vs. 9%); and the tattoos elicited negative comments in public, the workplace, and/or in school (31% vs. 5%).

The decision to remove
Graham first visited a hair-removal clinic where a woman used a painful laser without an anesthetic. Since then, she’s had two treatments at a doctor’s office—much better, she says, because they numbed her first—for $400 each plus a $300 consulting fee. “Sadly, it’s not much lighter yet,” she says. “The edges are blurrier, though; right now it just looks like I have a bad tattoo.”

Though the removal process is expensive, Graham considers it a career investment. She’s waiting until the fall to have any more procedures—”It looks terrible right afterward; you get these huge blisters that stick around for over a week, and I’d rather hide it under pants or tights,” she says—and then plans to get one every four to six weeks until she’s satisfied.

When considering a tattoo, women especially should think twice about the location on their bodies, say the Texas Tech researchers. Compared with the earlier survey, more study participants had skin markings in visible locations such as arms and legs, suggesting that they may have felt more comfortable about getting a prominent tattoo at the time, but regretted it later in life.

What to think about
The FDA warns consumers to think of tattoos as permanent because removal doesn’t always work and some colors may never be entirely gone. Those considering getting inked are also urged to consider the following:

    Known health risks of getting a tattoo include infection from dirty needles, allergies to various ink pigments, and unwanted scarring or small bumps called granulomas, which may form around material that the body perceives as foreign.
    Tattoos can hide or obscure signs of skin cancer, French researchers reported in the same issue of Archives of Dermatology. Patients with a history of melanoma should avoid tattoos, and those with a family history of melanoma or atypical moles should choose small designs with light colors, the researchers concluded.
    The FDA has not approved any tattoo inks for injection into the skin, and many pigments used are industrial-strength colors suitable for printers’ ink or automobile paint.
    Do not buy or order do-it-yourself removal products online. These acid-based products are not FDA-approved and can cause bad skin reactions.
    If you want a tattoo removed, consult your health-care provider (not a spa, clinic, or tattoo parlor, where the procedure is not always FDA-approved); the American Society for Laser Medicine and Surgery can help you find an experienced and certified doctor.

By Amanda MacMillan