Daily news articles of interest to health care consumers.

June 2013 Archives

MONDAY, July 1 (HealthDay News) -- Temperatures topping 110 and even 120 degrees Fahrenheit have much of the American West sweltering, and health officials are warning that people must do what they can to stay cool as the heat wave continues.

Temperatures in California's Death Valley hit 128 degrees on Sunday, NBC News reported, tying the record for the hottest June day anywhere in the United States. Thermometers soared to 117 on Sunday in Las Vegas, only the third time that's happened since the National Weather Service has kept records. By 1 a.m. Monday morning, Las Vegas was still baking at 102 degrees.

Residents of Phoenix were faced with punishing 119 degree-heat on Saturday, a record according to Weather.com, and Salt Lake City sweltered under 105 degree-temperatures for two days in a row -- a record-breaker for that city in June), NBC said.

In Yarnell, Ariz., 19 firefighters perished battling a wildfire that experts say has been encouraged by high temperatures and windy conditions, CBS News/Associated Press reported. It's one of the deadliest wildfires involving firefighters in decades, and is still raging out of control.

One man in Las Vegas died due to heat-related causes and another was hospitalized Saturday, authorities said. In both cases, the men were found without working air conditioning.

The heat wave will ebb slowly but is expected to last for the next few days, meteorologists said.

Health experts said there are key steps everyone can take to minimize their risk from extreme heat.

One essential step: Check up on elderly or ill relatives living on their own.

"Due to various reasons, the elderly are prone to suffer from the extreme heat," said Dr. Salvatore Pardo, associate chairman of the emergency department at Long Island Jewish Medical Center in New Hyde Park, N.Y.

"It is vital for loved ones and friendly neighbors to enter the home and make sure they have functioning air conditioning or access to a cool environment -- for example, a cooling center, senior center, public shopping mall -- during extreme heat events," he said. "This should be done at the beginning, during and after the extreme heat event."

Dr. Michael Ammazzalorso, chief medical officer at Winthrop-University Hospital in Mineola, N.Y., offered up other potentially lifesaving tips.

Keeping the shades drawn in the daytime can keep homes cooler, he said, and "if you live in a split-level home, stay downstairs. Heat rises, so upstairs will always be hotter than your living room. Open windows upstairs if you have no air conditioning to keep the room cool and have a fan blowing."

Alcoholic beverages dehydrate, so stick to water or beverages without alcohol, sugar or caffeine, Ammazzalorso said. Wear light, light-colored and loose clothing to stay cooler.

"Let the children play outside in the early morning or early evening when the air quality is at a healthier level and the temperatures are cooler," he added. "Head to a local swimming pool or beach to cool off, but never swim alone and be sure to observe all posted swimming advisories."

According to Ammazzalorso, signs of heat exhaustion include skin that is cool, moist and pale but may look flushed at times. Dizziness or fainting, nausea or vomiting, fatigue and headaches are also potential signs of heat exhaustion.

Signs of an even more serious condition known as heat stroke include red, hot and dry skin, high body temperatures (105 degrees or above), a rapid and weak pulse, rapid and shallow breathing and changes in consciousness. In these cases, 911 should be dialed immediately, Ammazzalorso said.

More information

The U.S. Federal Emergency Management Agency has more about extreme heat.

-- E.J.Mundell

Health News Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, June 30 (HealthDay News) -- Children play a lot of sports and other outdoor activities during the summer and are at risk for accidents that can damage their teeth, an expert says.

"Collision injuries with a friend, the ground or the side of a swimming pool definitely increase during the summer," Dr. Stephen Mitchell, a pediatric dentist at the University of Alabama at Birmingham, said in a university news release.

"If something like this occurs, remember first and foremost to make sure your child does not have a head injury," he said. "If they have lost consciousness or are dizzy, or if they can't remember how the injury happened, get medical attention and worry about the teeth later."

Once you're certain there are no medical issues, here are some tips on what to do about damaged teeth:

  • If a tooth is broken, find the fragment and go immediately to the dentist, Mitchell said. This is especially important if the tooth appears to be bleeding from the middle and not just the gums.
  • If a tooth is knocked out, it's best to try to put it back in immediately. The gum site is normally numb immediately following an injury, so this shouldn't hurt. If the tooth can be put back in the mouth within a half-hour, a full recovery is much more likely.
  • If the tooth cannot be put back in the mouth, however, place it in milk and go straight to the dentist. Avoid touching the root of the tooth, and do not clean it beyond gently running it under water.
  • If a tooth has been moved out of its normal location, make sure your child sees a dentist immediately.

Mitchell also said summer is a good time to schedule dental check-ups for children.

"Don't wait until the last two weeks of summer because appointments can get very scarce," he said. "Plan ahead for the best flexibility in appointments."

More information

The Nemours Foundation offers tips to keep children's teeth healthy.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, June 30 (HealthDay News) -- Fireworks add sparkle to Independence Day festivities but they need to be handled with care -- and by adults, a prominent group of U.S. surgeons says.

"Many people consider consumer fireworks to be harmless fun, when in fact they can be extremely dangerous, especially when used by or near children and adolescents," Boston orthopedic surgeon Dr. Tamara Rozental, spokesperson for the American Academy of Orthopaedic Surgeons, said in an academy news release.

"If caution is not used and safety guidelines are not adhered to, fireworks can cause serious injuries to the hands and fingers as well as the eyes," Rozental said.

Americans bought more than 212 million pounds of fireworks in 2011, compared with 184 million pounds in 2010, the American Pyrotechnics Association says. In 2012, there were more than 18,700 injuries caused by fireworks, including more than 7,300 emergency department visits, according to the U.S. Consumer Product Safety Commission (CPSC).

The CPSC also says that 36 percent of the estimated emergency department-treated, fireworks-related injuries in 2011 involved people younger than age 20. The parts of the body most often injured by fireworks were hands and fingers (46 percent of injuries); eyes (17 percent); head, face and ears (17 percent); and legs (11 percent). Burns accounted for more than half of the emergency department-treated, fireworks-related injuries. There were 1,100 emergency department-treated injuries associated with sparklers and 300 with bottle rockets.

The following fireworks safety tips come from the orthopedic surgeons:

  • Check with your local police department to determine if fireworks can be discharged legally in your area. If so, determine which types are legal. Never buy or use illegal fireworks. Their quality cannot be assured.
  • Only adults should light fireworks. Never hold lighted fireworks with your hand or place them near the body. Read the caution label on fireworks' packaging before lighting them and always wear safety eyewear when using fireworks. Never try to relight a firework.
  • Always have water handy in case of a fire, such as a hose hooked to a faucet or a nearby bucket of water. Soak used fireworks in water before discarding.
  • If you or anyone else suffers a fireworks-related injury, seek immediate medical attention.
  • Never allow young children to play with or go near fireworks, including sparklers. They might seem harmless, but sparklers can reach temperatures of more than 1,000 degrees.
  • Never handle fireworks if you are under the influence of drugs or alcohol.

More information

The Nemours Foundation offers fireworks safety tips for parents.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, June 29 (HealthDay News) -- People who exercise or play sports outdoors during the summer need to take steps to avoid heat injury, especially heat stroke, an expert says.

"Not every case of heat stroke is fatal, but some cases are," Stacey Snelling, associate dean of American University's School of Education, Teaching and Health, said in a university news release. "Once you have experienced heat stroke, you need to be even more careful, as you are more susceptible to it because you have ruined your hypothalamus, the part of your brain that regulates body temperature."

She offered some tips for people who are physically active outdoors during the summer.

  • Exercise during the coolest time of the day. "Many people think the evening is the coolest time of day, but actually, it is early in the morning just before the sun rises. If your schedule will not accommodate an early morning workout, wait until at least 5 p.m.," Snelling said.
  • Choose the right type of clothing. "Clothing choice is important. Wear light colors as they reflect light, and items made from moisture-wicking material, not cotton, which absorbs sweat and feels heavy when saturated. Also, wear as little clothing as possible," Snelling recommended.
  • Ease into outdoor summer activity. "Acclimatization is how our bodies gradually adjust to the heat. Take it slow the first couple of weeks, gradually increasing the intensity of your workout -- but listen to your body. If you start feeling sick or dizzy, stop immediately to rest, cool down and hydrate," Snelling advised.
  • Stay hydrated. "Drink water while you are active, but also, weigh yourself before you exercise outdoors, then again after you are done. Drink enough water to replace what you lost during your activity -- one pint of water for every pound you lose," Snelling said.
  • Use sunscreen. "Numerous brands make light-feeling and sweat-resistant sport sunblock formulas that won't run in your eyes," Snelling said. "If you have long hair, wear it up so that the sweat on your neck can better evaporate to keep you cool."

More information

The U.S. Centers for Disease Control and Prevention offers tips for preventing heat-related illness.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, June 29 (HealthDay News) -- When children head off to outdoor camps this summer, they need to be protected from ticks and tick-borne illnesses such as Lyme disease, experts say.

Youngsters aged 5 to 14 have the highest incidence of Lyme disease in the United States, according to the Tick-Borne Disease Alliance (TBDA). Lyme disease is spread by deer ticks, which are found in many types of settings at outdoor summer camps, including woodlands, lawns and playing fields, tree stumps and picnic tables.

"Deer ticks are cesspools of disease, and they put your children at risk of contracting Lyme disease and many other potentially debilitating diseases such as babesiosis, anaplasmosis, bartonella, tularemia and mycoplasma," Bob Oley, a public health consultant with the group, said in an alliance news release.

"These microscopic bugs pose an enormous threat to our children, who are especially vulnerable during the summer months. It is imperative to educate ourselves about tick-borne diseases, and take the necessary precautions to protect our children from them."

The TBDA outlined steps parents can take to protect their summer camp-bound children from ticks and tick-borne diseases. Summer camps should have a tick management program in place to protect campers, and should also notify parents right away if an embedded tick is found on their child, as immediate medical treatment may be advisable.

Make sure your child has tick repellant that contains an Environmental Protection Agency-registered active ingredient. Children should wear light-colored clothing that makes it easier to spot ticks and all their outdoor clothes and shoes should be sprayed with permethrin.

If your children attend a day camp, put their outdoor clothes in a separate hamper in the mud room or garage. As soon as possible, put these clothes in the clothes dryer on high heat for 20 to 30 minutes. The heat will kill any ticks that may be on the clothes.

Teach your children about areas they should avoid, the tick-repellant clothes they should wear, how to properly use tick repellant on exposed skin, and how to conduct body checks for ticks after being outdoors and at night before they go to bed.

If your child is younger than 10, talk about tick prevention with a camp counselor and make sure that those in charge of the camp know about these precautions.

More information

The U.S. Centers for Disease Control and Prevention has more about tick safety.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- A potentially lifesaving body-cooling treatment is rarely used for hospital patients who suffer cardiac arrest, a new study finds.

Research shows that therapeutic hypothermia -- in which the body is cooled to about 89.6 degrees Fahrenheit -- protects the brain against damage caused by lack of blood flow and oxygenation. The treatment has also been shown to improve survival.

Therapeutic hypothermia is credited with saving the lives of a growing number of patients who suffer cardiac arrest outside hospitals.

"We know it's being used in patients who went into cardiac arrest in their homes, at work or anywhere else outside of a hospital, but little was known about how often it's used in patients who arrest in the hospital," study author Dr. Mark Mikkelsen, an assistant professor in the pulmonology, critical care and allergy division at the Perelman School of Medicine at the University of Pennsylvania, said in a school news release.

"We found that even though most hospitals have the capability to treat these patients with therapeutic hypothermia, it's not being used," Mikkelsen added. "And even when it was used, in nearly half the cases, the correct target temperature was not being achieved."

The researchers looked at data from more than 67,000 patients who went into cardiac arrest at more than 530 U.S. hospitals between 2003 and 2009. Only 2 percent of them received therapeutic hypothermia.

"Several factors could explain this," Mikkelsen said. "There is little data, which is often conflicting, to support its use for patients in the hospital, and we have national guidelines that only have clinicians considering its use, which may lead to hesitation and lack of institutional protocol."

Many of the 210,000 hospital patients who suffer cardiac arrest each year in the United States may not be candidates for therapeutic hypothermia because they have other serious conditions or are terminally ill.

The study was published in the June issue of the journal Critical Care Medicine.

More information

The American Heart Association has more about cardiac arrest.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Night Owls May Pack on More Pounds

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FRIDAY, June 28 (HealthDay News) -- Night owls are more likely to gain weight than people who get good sleep because they tend to graze the kitchen for junk food in the wee hours of the morning, a new study suggests.

Researchers at the University of Pennsylvania found that people who were kept up until 4 a.m. in a sleep lab ate more than 550 additional calories during the late-night hours.

"People consumed a substantial amount of calories during those late-night hours when they would normally be in bed," said study author Andrea Spaeth, a doctoral candidate in the psychology department at the University of Pennsylvania. "Those calories also were higher in fat compared to the calories consumed at other times of day."

As a result, subjects kept up late gained more weight during five days of sleep deprivation than people in a control group who were allowed to get good sleep, Spaeth said.

Late-night overeating is likely the result of hormonal changes that occur in people who are sleep-deprived, said Dr. W. Christopher Winter, medical director of the Martha Jefferson Sleep Medicine Center in Charlottesville, Va.

They tend to experience an increase in their levels of ghrelin, a hormone that stimulates hunger cravings, and a decrease in levels of leptin, a hormone that makes people feel full.

"Now you're in a situation where you are craving bad food and more of it, and your body feels less full when it gets that bad food," Winter said.

The research team monitored the eating habits of about 200 people who, for five days straight, were kept up until 4 a.m. and then allowed only four hours of sleep. They remained in the lab the whole time, going through in groups of four or five at a time.

Subjects were allowed to eat whenever they liked, and trained monitors in the sleep lab maintained a running tally of the amount consumed and the times at which they ate.

Researchers then compared their calorie intake and weight gain to that of a control group allowed a good night's sleep in the same lab with the same food availability.

"The only difference between the two groups was sleep," Spaeth said. "They lived in a suite, and in the suite there was a kitchen with a fridge and microwave."

The eating habits of the control group remained unchanged. The sleep-deprived group began eating additional calories between 10 p.m. and 4 a.m., and they tended to eat fattier foods during that time period. "That does kind of mimic the real world, when you're up late at night and you drift over to your fridge," Spaeth said.

There was one key difference between the lab and the real world. Since the study took place in a hospital, the suite's kitchen was stocked with hospital food. "I'm wondering if the effect would be stronger in the real world, where you have access to more calorically dense foods," Spaeth said.

The findings are published in the July issue of the journal Sleep.

Previous studies have shown a link between inadequate sleep and weight gain, Winter said, but this research is valuable because it provides precise observations in a laboratory setting.

"Anytime you're dealing with studies in the field, you're often relying on some sort of food diary or the recall of the patient," Winter said. "It's amazing how much food a person can eat and not remember. It's hard to keep track of people in terms of their eating and in terms of their sleep. When people are in a lab, they can perfectly control conditions and report them."

Blacks gained more weight than whites, and males gained more weight than females. Researchers currently are undertaking follow-up research involving detailed calorie counting to try to explain these differences, Spaeth said.

The study adds more weight to the growing mound of evidence suggesting that people who want to control their weight need to get seven to eight hours' sleep a night, Winter said.

People who can't get a good night's sleep -- such as people who are traveling or working late to meet a deadline -- need to pay extra attention to their food cravings, he added.

"God knows I'm aware of it," Winter said. "I'm usually traveling a lot, and I can feel myself craving food I don't really need and didn't know I wanted. I know when I'm going through an airport late at night and I see chocolate-covered pretzels, I know I'm not craving them because I'm hungry. I think if patients are more aware of those things, they're going to say, 'I'm not going to eat this because I'm not hungry, and it's not going to do me any good.'"

More information

For more on eating behaviors, go to the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- Most pregnant women who were hospitalized and treated for acute severe migraines had vaginal births of full-term babies, a small new study finds.

Nearly 76 percent of the patients had full-term vaginal deliveries and about 17 percent had preterm deliveries. The rate of preterm delivery in the general population is about 11 percent. Follow-up was not possible for about 7 percent of the patients.

Participants included 29 patients who were an average of 27.5 weeks pregnant when they were treated in a hospital for migraines. Treatments included: acetaminophen (Tylenol) by mouth (79 percent); intravenous metoclopramide (59 percent); a combination of the two (55 percent); oral or IV narcotic (34 percent); acetaminophen, butalbital and caffeine (24 percent); and IV magnesium sulfate (7 percent).

Ten percent of patients needed more pain relief and were treated with peripheral nerve blocks.

The study was scheduled for presentation Monday at the International Headache Congress, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Acute migraine during pregnancy is a challenging condition for physicians to treat due to fears of harming the fetus and limited clinical research in the area," Dr. Matthew Robbins, of the Montefiore Headache Center in New York City, said in a center news release.

"While these data show a positive result for most women treated for acute severe migraine, more research is needed to better understand the relationship between migraine, available treatments during pregnancy and birth outcomes," he added.

More information

The U.S. Office on Women's Health has more about migraines.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- The Obama administration on Friday issued what it called final rules that let religious organizations opt out of providing contraception coverage in their health insurance plans, as mandated by the 2010 Affordable Care Act.

The White House said employers at non-profit religious organizations such as houses of worship, hospitals and universities won't have to offer free access to birth control, but their insurance companies will be made directly responsible for doing so.

Women who request birth control will be able to get it free of co-pays or premiums, as required by the Affordable Care Act. But non-profit religious organizations can refuse to cover birth control, leaving the woman's insurance company with the responsibility of coverage.

"The health care law helps ensure that millions of women have coverage for critical preventive services without cost sharing," Chiquita Brooks-LaSure, deputy director of policy and regulation at the Center for Consumer Information, part of the U.S. Department of Health and Human Services, said during an afternoon news conference.

These services include contraception "because there are tremendous health benefits for women that come from using contraception," she said.

Friday's revised rules are similar to earlier proposed rules, in which houses of worship such as churches can exclude contraceptive coverage from their health plans for their employees and their dependents.

"Today's announcement reinforces our commitment to respect the concerns of houses of worship and other non-profit religious organizations that object to contraceptive coverage, while helping to ensure that women get the care they need, regardless of where they work," Secretary of Health and Human Services Kathleen Sebelius said in a statement.

The revised rule, scheduled to take effect Jan. 1, 2014, follows more than a year of protests and legal action from Roman Catholics, conservative Protestants and many employers who maintain that the contraception provision in the Affordable Care Act -- the Obama administration's sweeping 2010 health reform law -- violates their religious beliefs on birth control.

It's not clear if Friday's announcement will satisfy opponents of the contraception provision.

On Thursday, a federal appeals court in Denver ruled that Hobby Lobby, an Oklahoma City-based arts and crafts chain, can proceed with its challenge to the birth-control mandate and won't be subject to fines.

The changes offered Friday appear to be the Obama administration's attempt to satisfy both sides on the issue -- religious leaders who object to providing contraception to employees, and those who wish to see that all women retain free access to birth control.

The White House first found itself embroiled in a political fight with Catholic Church officials after a Jan. 20, 2012, announcement that all religious-affiliated employers, with the exception of churches and other houses of worship, would have to cover free birth control as part of routine preventive care for women. These institutions were given until August 2013 to comply with the rule.

More information

For more on birth control, visit the Alan Guttmacher Institute.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- Vietnam veterans with post-traumatic stress disorder (PTSD) are much more likely to develop heart disease, a new study finds.

Researchers looked at 562 middle-aged male twins (340 identical and 222 fraternal) who were veterans of the Vietnam War, and found that nearly 23 percent of the vets with PTSD had heart disease, compared with about 9 percent of the vets without PTSD.

When the researchers compared the 234 twins where one brother had PTSD and the other did not, 22 percent of those with PTSD had heart disease, compared with nearly 13 percent of those without PTSD.

The link between PTSD and heart disease remained strong even after the researchers accounted for lifestyle factors such as smoking, drinking and physical-activity levels, as well as for mental health problems such as depression.

The study was published online June 25 in the Journal of the American College of Cardiology and appears in the Sept. 10 print issue of the journal. The study was partially funded by the U.S. National Heart, Lung, and Blood Institute.

"This study suggests a link between PTSD and cardiovascular health," lead researcher Dr. Viola Vaccarino, a professor in the department of medicine at Emory University and chairwoman of the department of epidemiology at the Rollins School of Public Health, said in an institute news release.

"For example, repeated emotional triggers during everyday life in persons with PTSD could affect the heart by causing frequent increases in blood pressure, heart rate and heartbeat rhythm abnormalities that in susceptible individuals could lead to a heart attack," Vaccarino said.

"This study provides further evidence that PTSD may affect physical health," said Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute. "Future research to clarify the mechanisms underlying the link between PTSD and heart disease in Vietnam veterans and other groups will help to guide the development of effective prevention and treatment strategies for people with these serious conditions."

PTSD affects nearly 7.7 million U.S. adults.

More information

The U.S. National Institute of Mental Health has more about post-traumatic stress disorder.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- New research shows that melanoma can recur decades after initial treatment in roughly 9 percent of patients.

The findings show that people who have had melanoma require lifelong follow-up, the study authors said.

The investigators looked at over 4,700 melanoma patients and found that recurrence occurred in 408 patients who had been disease-free for 10 or more years. The recurrence rates were nearly 7 percent after 15 years and 11 percent after 25 years, according to the study in the July issue of the Journal of the American College of Surgeons.

But the researchers also found that patients whose melanoma recurred 10 or more years later were less likely to die than those whose melanoma recurred within three years of treatment. Those with late recurrence were about 40 percent less likely to die of melanoma than those with early recurrence, and those with late recurrence also had a better overall survival rate.

Patients whose melanoma did not come back until at least 10 years after treatment were younger on average than those with early recurrence (age 41 versus 51).

Also, patients with a later recurrence tended to have had an original melanoma with less dangerous characteristics, the researchers noted. They also found that men accounted for 66 percent of patients with early recurrence, compared with 57 percent of those with late recurrence.

"For patients with melanoma, survival beyond 10 years without a recurrence has been considered nearly synonymous with a cure," lead investigator Dr. Mark Faries, a professor of surgery at the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., said in a journal news release. "However, most studies do not follow-up patients longer than 10 years. Our study found that late melanoma recurrence is not rare and that it occurs more frequently in certain patient groups," he noted.

"It appears the risk of melanoma recurrence is never completely gone," Faries said. "One change that should result from our study is that people need to be followed-up for life with a physician after a diagnosis of melanoma," he pointed out.

"Fortunately, the vast majority of melanoma patients who remain disease-free longer than 10 years will not have a recurrence," Faries added. "However, patients should be aware that persistent or unexplained symptoms anywhere in the body might indicate a recurrence of their melanoma, and they should return to their physician to make sure the symptoms are not related."

Nearly 76,700 new cases of melanoma will be diagnosed in the United States this year, according to the American Cancer Society.

More information

The American Cancer Society has more about melanoma.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- Starting July 1, seniors with diabetes should be able to save some money when they buy the blood sugar testing supplies they need to monitor their disease.

That's when Medicare kicks off a new cost-saving program that will require beneficiaries to order these supplies through a national mail-order program or a Medicare-approved pharmacy.

Right now, Medicare pays about $77.90 per month for 100 blood sugar test strips and lancets (the needles used to prick the finger to draw a drop of blood), according to the Center for Medicare and Medicaid Services.

Medicare recipients currently pay 20 percent of that cost, which averages to $15.58 a month. Once the national mail-order program kicks in, the total cost will drop to $22.47, due to a competitive bidding process. That means the cost to the Medicare recipient will only be around $4.50.

Over a year, each person with diabetes on traditional Medicare will save $133.

"We're hopeful that approved providers for diabetic testing supplies will offer people a better value for their needed mail-order purchases and ensure that consumers and taxpayers are getting the best price for their supplies," said Ariel Gonzalez, director of federal health and family advocacy for AARP.

This change is expected to affect 2.3 million Medicare beneficiaries who are on traditional fee-for-service Medicare. This change doesn't apply to people on Medicare Advantage plans, such as an HMO or PPO, according to the CMS.

The program is part of a competitive bidding process initially set up in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The competitive bidding process applies not only to diabetic testing supplies, but also to other types of medical equipment, such as wheelchairs, walkers, hospital beds and oxygen equipment. It's expected to save taxpayers nearly $26 billion between 2013 and 2022, according to CMS. The program is also expected to save an additional $17.2 billion for Medicare beneficiaries during that same time period.

So, if you're on traditional Medicare and you need diabetic testing supplies, you may need to make some changes to how you order supplies. The first step is to find a national mail-order supplier. You can do this by visiting medicare.gov/supplier or by calling 800-MEDICARE (800-633-4227). They can give you a list of suppliers who are under contract with Medicare to provide the new prices.

If you prefer getting your supplies locally, you can also get your supplies from a pharmacy or store that accepts Medicare assignment, according to CMS. Ask your pharmacist if they accept Medicare assignment before getting your prescription filled. Any pharmacy or store that says it accepts Medicare assignment can only charge you for any unmet deductible (Medicare Part B) and your 20 percent coinsurance. Stores and pharmacies that don't accept Medicare assignment can charge you more.

The cost of diabetic supplies will be the same for mail-order suppliers and pharmacies or stores that accept Medicare assignment, according to CMS.

The national mail order program applies to people with both type 1 and type 2 diabetes. It covers blood sugar test strips, control solution for the test strips, lancets, the lancing device and batteries for your blood sugar monitor.

National mail-order suppliers have to include coverage for more than 50 percent of the currently available test strips on the market, according to CMS. If the supplier you've chosen doesn't offer your brand of test strips, ask your doctor if you can use an alternative brand. If there's a medical reason for you to use a particular test strip, your doctor can document this, and the supplier can either given you the exact brand you need, or help you find another supplier who will.

Unsolicited phone calls from mail order suppliers aren't allowed under CMS rules. If you get a call pressuring you to switch suppliers, report the call to Medicare at the phone number given above. In addition, CMS recommends never giving your Medicare number or personal information to anyone who calls you.

More information

Learn more about the national mail-order program from Medicare.gov.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- There are too few migraine headache specialists in the United States, a new study finds.

Migraines affect about 36 million Americans over age 12 (more than 11 percent of the population). That's more than the number affected by asthma and diabetes combined. However, only 416 specialists nationwide are certified by the United Council for Neurologic Subspecialties to diagnose and treat migraine, according to researchers.

States with the highest number of migraine specialists include New York (56), California and Ohio (29 each), Texas (25), Florida (24) and Pennsylvania (23). Six states have no migraine specialists, according to the study presented this week at the International Headache Congress meeting in Boston.

States with the worst specialist-to-patient ratios include Oregon, Mississippi, Arkansas and Kansas. The District of Columbia has the best ratio, followed by New Hampshire, New York and Nebraska.

"This is a troubling picture," study leader Dr. Noah Rosen, of the Pain and Headache Center of the North Shore-Long Island Jewish Health System, said in a congress news release. "Migraine is a highly disabling disorder -- the seventh most disabling in the world and the fourth most disabling among women. It's clear that many more specialists need to be trained and certified to meet the need."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Migraine costs the United States more than $29 billion a year in direct medical expenses such as doctor visits and medications, and indirect expenses such as missed work and lost productivity, the release noted.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- Cheerleading is definitely not your grandmother's pastime anymore, injury experts warn, but rather a highly competitive activity that's light on the pom-poms and heavy on risky daredevil acrobatics.

The not-surprising result: Cheerleading injuries are on the rise.

"Over the past few decades, cheerleading has evolved from leading the crowd in cheers at sporting events to a competitive, year-round activity featuring complex acrobatic stunts performed by a growing number of athletes," said Dr. Cynthia LaBella, medical director of the Institute for Sports Medicine at the Ann & Robert Lurie Children's Hospital of Chicago. "As a result, the number and severity of injuries from cheerleading has also surged."

"Relatively speaking, the overall injury rate is low compared to other girls' sports, such as soccer and basketball," LaBella said. "But despite the lower overall injury rate, cheerleading accounts for a disproportionate number -- 60 percent to 70 percent -- of all the catastrophic injuries in girls' high school sports. That is an area of concern and needs attention for improving safety."

LaBella, who is also an associate professor of pediatrics at the Northwestern University Steinberg School of Medicine, was scheduled to discuss the issue Thursday at the annual meeting of the National Athletic Trainers' Association, in Las Vegas.

According to a policy statement issued by the American Academy of Pediatrics (AAP) last fall, the number of students aged 6 and up who engaged in cheerleading either at school or as members of offsite competitive squads skyrocketed from just 600,000 students in 1990 to somewhere between 3 million and 3.6 million in 2003.

The vast majority of participants -- 96 percent -- are girls, according to the AAP, and what these girls are now asked to do goes far beyond the stereotypical image of fun-loving dance routines. Rather, girls must routinely execute taxing feats of gymnastic prowess, with sequences that involve tumbling, leaping, jumping, tossing and human-pyramid building.

What's more, "injury rates increase with age and skill level, due to more complex stunts being performed at these levels," LaBella said.

The result has been a notable increase in the frequency with which cheerleaders fall, sometimes from great heights. A range of limb, head, neck and trunk injuries, as well as sprains and strains, can ensue, with some -- such as concussions -- being serious enough to require medical attention.

It is no longer unheard of to see cheerleading participants leave the field of play having suffered permanently disabling or even fatal catastrophic injuries.

"For those who have not seen cheerleading in 20 years, it really would be an eye-opener," said Lisa Kluchorosky, a sports medicine administrator at Nationwide Children's Hospital in Columbus, Ohio. "So many [people] still think it's the world of Annette Funicello. But cheerleading has gone from a more recreational, more supportive kind of role to being very competitive and very athletic, which means that the demands placed on these kids are really enormous.

"And the skill level and the types of stunts they are doing have gone up tremendously, as they have with most sports over the years," Kluchorosky added.

With this new reality in mind, the AAP now takes the position that state athletic associations should move to classify cheerleading as a sport, in order to ensure that the activity is treated in the same manner as all other traditional contact athletics.

"Cheerleading is still not considered a sport in many states, and it very much should be," said Kluchorosky, who is the National Athletic Trainers' Association liaison to the AAP. "If it were designated as such, it would be subject to the rules of all other sports, which means participants would be afforded the same resources and health care, and held to the same regulations."

For example, under a sports designation, cheerleaders would have to engage in strength and conditioning programs during both competition and preseason periods. Practice time would be regulated, and training facilities certified as safe. Participants also would have access to onsite medical staff when needed, all of whom would be prepped with detailed emergency medical plans.

As part of a recognized sport, cheerleading coaches, in turn, would have to be certified as to their proficiency in teaching key cheerleading skills, such as spotting techniques.

Beyond that, the AAP further recommended placing specific boundaries on the kinds of activities cheerleaders can be asked to do, including limiting human pyramids to a certain height and banning tumbling on hard surfaces that lack appropriate landing matting.

"There's still some of the feeling out there that [cheerleading] is not a real sport," Kluchorosky said. "But it is. And we're talking about real risks, so we have to try to move the needle forward and deal with it appropriately."

More information

For more on the AAP's cheerleading recommendations, visit the American Academy of Pediatrics.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- As American women continue to delay parenthood, rates of teenage births and births for women in their early 20s are at all-time lows, federal health officials reported Friday.

U.S. women have their first baby at age 25.6 on average, according to 2011 figures released by the U.S. Centers for Disease Control and Prevention (CDC). This is up slightly from 2010 and significantly older than the 1970 average of 21.4 years.

Births to girls 15 to 19 declined 8 percent between 2010 and 2011, and births to women 20 to 24 years old dropped 3 percent to a record low, the CDC report stated.

"If this [trend] results in more births being planned and intended it is difficult to object to it," said Dr. Jeffrey Ecker, director of Obstetrical Clinical Research and Quality Assurance at Massachusetts General Hospital in Boston.

"If we are talking about a shift from early 20s to late 20s or early 30s, the expectation is that outcomes would be safe and healthy. The message isn't that it's fine to wait until a woman is in her late 30s or 40s to think about becoming pregnant," added Ecker, who is also chair of the American College of Obstetricians and Gynecologists' Committee on Obstetric Practice.

As women get older it is more difficult to become pregnant, Ecker said, adding that the likelihood of miscarriage and other complications also increases.

Overall, 3.9 million U.S. births were reported in 2011, representing the lowest general birth rate since 1998 -- 63.2 births per 1,000 women aged 15 to 44 -- and 1 percent less than in 2010, the CDC reported.

Birth rates were unchanged for women aged 30 to 34 but rose for women 35 to 44.

Births to unmarried women declined in 2011 for the third year in a row -- down another 2 percent from 2010.

Experts found good news in the report.

In terms of health, highlights are a leveling off of cesarean births and the continued decline in the preterm birth rate, said lead author Joyce Martin, an epidemiologist at CDC's National Center for Health Statistics, Division of Vital Statistics, Reproductive Statistics.

In 2011 the rate of cesarean delivery remained about the same as the year before -- nearly 33 percent of all births. Previously, the number of women undergoing C-sections had increased steadily, jumping 60 percent from 1996 to 2009.

Meanwhile, the rate of preterm deliveries (before 37 weeks) dropped in 2011 for the fifth straight year to 11.7 percent of all births, down 2 percent from 2010 and 8 percent from its high in 2006.

The rate of babies born at a low birth weight in 2011 was 8.10 percent -- down somewhat from 8.15 percent in 2010 and 2 percent lower than the 2006 peak of 8.26 percent.

Other notable findings: Multiple births were relatively unchanged in recent years. Twins accounted for 33.2 per 1,000 total births in 2011.

Births of triplets and more also remained unchanged at 137 per 100,000.

Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten Island University Hospital in New York City, said he expects that women will continue to postpone childbirth.

"More and more women are not only in the workforce, but more women are the primary breadwinner in the family," he said.

"So you are going to have more women who are delaying childbearing to enhance their careers. And you have amazing technology to enable them to accomplish that," Maiman said. "You are going to see older and older mothers."

More information

For more information on healthy mothers and babies, visit the March of Dimes.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- People with more genetic risks for asthma are not only more likely to develop the disease in childhood, but also more likely to continue to have asthma into adulthood, according to a new study.

Previous studies have linked several genes to increased asthma risk, so the researchers wanted to investigate the cumulative effect of those genes.

For the study, they analyzed data from 880 people in New Zealand who have been followed since they were born in 1972 or 1973. Those with more genetic risks for asthma developed asthma earlier in life than those with fewer genetic risks. Among study participants who developed asthma in childhood, asthma that persisted into adulthood was more likely in those with more genetic risks.

These patients also had more allergic reactions associated with severe and persistent asthma and developed lung function problems. Their quality of life also suffered because they missed work and school more often and were admitted to hospital more often due to asthma.

The study appears June 28 in The Lancet Respiratory Medicine.

"We've been able to look at how newly discovered genetic risks relate to the life course of asthma at an unprecedented level of resolution," Daniel Belsky, a postdoctoral fellow at the Duke Institute for Genome Sciences and Policy and the Center for the Study of Aging and Human Development, said in a university news release.

However, much more research is needed before it may be possible to use genetic risk scores for asthma in patients, he noted.

"It will be important to explore how these genetic risks play out in environments that differ in terms of air pollution or other important, modifiable factors," Belsky said.

He added that the study could lead to a better understanding of the biology of asthma and help efforts to develop new ways to prevent and treat asthma, which affects 26 million people in the United States.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- Lower fitness levels and higher amounts of body fat are major reasons why middle-aged men of South Asian origin living in Scotland have higher blood sugar levels and a greater risk of diabetes than white men, according to a new study.

The findings suggest that physical-activity guidelines may need to be changed to take people's ethnicity into account, the University of Glasgow researchers said.

The researchers measured blood sugar levels, insulin resistance and other diabetes risk factors in 100 South Asian and 100 white men, aged 40 to 70, without diabetes. The men's physical-fitness levels were measured using a treadmill test and their body size and body fat were calculated.

Lower fitness levels and greater body fat in South Asian men explained more than 80 percent of their increased insulin resistance compared to white men, the researchers concluded in the study, which was published in the June 27 issue of the journal Diabetologia.

The study also found that lower fitness levels among South Asian men could not be explained simply by lower activity levels. The South Asian men had lower fitness levels than white men at all levels of physical activity, which suggests natural differences in body makeup, the researchers said.

"The fact that South Asians' increased insulin resistance and blood sugar levels are strongly associated with their lower fitness levels, and that increasing physical activity is the only way to increase fitness, suggests that South Asians may need to engage in greater levels of physical activity than Europeans to achieve the same levels of fitness and minimize their diabetes risk," study co-leader Dr. Jason Gill said in a journal news release.

"This has potential implications for physical activity guidance, which, at present, does not take ethnicity into account," study co-leader and professor Naveed Sattar said in the news release.

More information

The U.S. Centers for Disease Control and Prevention outlines the benefits of physical activity.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 28 (HealthDay News) -- People who receive inadequate treatment for acute migraine headaches are more likely to develop chronic migraines, according to a new study.

Researchers looked at data from more than 4,600 people with episodic migraines (14 or fewer migraine days per month) and found that 48 percent of them received poor or very poor treatment.

These patients were more likely to progress to having chronic migraines (15 or more migraine days a month) than those who received better treatment, according to the study, which was presented this week at the International Headache Congress meeting in Boston.

Within a year, about 8 percent of patients who received very poor treatment progressed to chronic migraine, compared with 4.4 percent of those who received poor treatment, 2.9 percent of those who received moderate treatment and 2.5 percent of those who received the best treatment.

Migraines are debilitating headaches involving intense pulsing or throbbing pain, and often nausea, vomiting and hypersensitivity to light and sound.

The study was conducted by a team from the Montefiore Medical Center and Albert Einstein College of Medicine, in New York City, and Vedanta Research, in Chapel Hill, N.C.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"These findings are exciting as they provide clinical targets for intervention. When we discover factors that increase the risk of progression, health care providers can focus their efforts in those areas to improve care and outcomes," study co-author Dawn Buse said in an International Headache Congress news release.

"In this case, we have found several factors in acute migraine treatment which may likely improve outcomes, including using medications that work quickly and maintain pain-free results, which allows and empowers people who live with migraines the freedom and confidence to make plans and fully engage in their lives," Buse said.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 28, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Baby Aspirin Recalled After Acetaminophen Discovery

More than 16,000 bottles of baby aspirin are being recalled by Advance Pharmaceutical Inc. after one of the bottles was found to be filled with acetaminophen pills.

The recall covers 120-pill bottles labeled to contain 81-milligram aspirin pills. The bottle discovered by a CVS pharmacist contained 500-mg acetaminophen pills, ABC News reported.

No injuries have been reported, according to Advance Pharmaceutical spokesman Abu Amanatullah.

Doctors said that unknowningly taking acetaminophen instead of baby aspirin could lead to an overdose that results in liver failure, the need for a liver transplant or death, ABC News reported.

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3-Person Fertility Treatments Being Considered in Britain

A controversial technique that uses DNA from three people to create a baby may be approved in Britain, according to a top medical official.

This method would help women with faulty mitochondria -- the energy source in a cell -- from passing this problem to their children. Mitochondrial disorders can result in conditions such as epilepsy, muscular dystrophy, mental retardation and heart problems, the Associated Press reported.

In this procedure, healthy genetic material is taken from the egg or embryo of a woman with a mitochondrial disorder and transferred into a donor egg or embryo that still has its healthy mitochondria but has had the rest of its key DNA removed. The fertilized egg or embryo is then transferred into the mother's womb.

"Scientists have developed ground-breaking new procedures which could stop these diseases being passed on," Dr. Sally Davies, Britain's chief medical officer, said in a statement, the AP reported. "It's only right that we look to introduce this life-saving treatment as soon as we can."

Critics say such methods are unethical, but there is wide public support for them, according to the U.K.'s fertility regulator.

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Second Company Recalls Pomegranate Seeds

Another company has announced a recall of pomegranate seeds from Turkey that could be contaminated with hepatitis A, an infectious disease of the liver.

Scenic Fruit Company in Oregon is recalling more than 61,000 bags of Woodstock Frozen Organic Pomegranate Kernels shipped between February and May of this year, the ABC News reported. Investigators have not found any evidence of hepatitis A contamination in the kernels and no one has become sick from eating them, according to information on the U.S. Food and Drug Administration's website.

"The company's decision to voluntarily recall products is made from an abundance of caution in response to an ongoing outbreak investigation by the FDA and CDC," according to the recall notice.

A hepatitis A outbreak has been linked to pomegranate seeds from Turkey included in a frozen berry mix from Townsend Farms in Oregon. The outbreak has sickened 122 people in eight states and 54 of them have been hospitalized, according to the CDC, ABC News reported.

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Illegal Online Pharmacy Crackdown Closes 1,677 Websites

More than $41 million in illegal medicines have been confiscated and 1,677 websites have been shut down by American and international regulators in their ongoing battle against counterfeit drugs sold over the Internet, the U.S. Food and Drug Administration says.

Federal court warrants were used to seize website domain names and post messages to warn visitors that people who traffic in counterfeit drugs may face severe penalties under U.S. law, the Associated Press reported.

The message also provides visitors with a link to an FDA website that outlines the risks of fake online pharmacies.

The website closures and counterfeit drug seizures announced Thursday were part of a weeklong crackdown that was organized by the international police agency Interpol and ended Sunday. No arrests were made but the investigation is continuing, the AP reported.

A similar operation last year led to the closure of more than 18,000 illegal online pharmacies, the seizure of $10.5 million in medicines, and the arrests of about 80 people.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Before you agree to an oral piercing, experts say you should consider some of the possible health risks.

The American Dental Association's Mouthhealthy.org website warns against these potential risks of an oral piercing:

  • Swelling, pain and infection.
  • Cracked or scratched teeth, injury to the gums or damaged fillings.
  • Sensitivity to the metals used in piercings.
  • Damage to nearby nerves.
  • An increase in saliva production, which can lead to drooling.
  • Difficulty getting dental X-rays.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Drive Safely as You Age

By on

(HealthDay News) -- As we get older, our vision tends to worsen and our reflexes aren't what they used to be.

The American Optometric Association offers these safe-driving suggestions for seniors:

  • Use extra caution at intersections. Look in all directions to make sure it's safe to proceed. Turn your head often, in case your peripheral vision is affected.
  • Try to only drive during the day. Stay away from routes that are unfamiliar.
  • Don't drive wearing glasses with wide frames, which can interfere with vision.
  • Join a local driving class just for seniors.
  • Get an annual eye exam.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Children should be closely supervised at the playground to help reduce their risk of injury.

The Safe Kids Worldwide website offers these suggestions for parents:

  • Inspect the playground to be sure equipment is age-appropriate. Make sure there are no broken or sharp areas or dangerous surfaces.
  • Talk to your child about following safety rules, such as not pushing, shoving or crowding.
  • Make sure your child is appropriately dressed for the playground. Don't allow the child to wear necklaces, scarves, purses or drawstring clothing that may become caught in equipment.
  • Have children under age 5 to play at a separate area designed for that age group.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Regularly eating oily fish such as salmon, tuna or sardines may help reduce the risk of breast cancer, a new report suggests.

These fish contain a type of fatty acid known as n-3 polyunsaturated fatty acids (PUFAs).

"Increased n-3 PUFA intake has a protective effect for breast cancer," said researcher Duo Li, a professor of nutrition at Zhejiang University in Hangzhou, China.

Li and his team reviewed 21 different studies that looked at the intake of fish and PUFAs. The previously published research included more than 800,000 women in the United States, Europe and Asia, and 20,000 cases of breast cancer. The follow-up time varied, from four years to 20.

The new report is published online June 27 in the journal BMJ..

Fish include several types of PUFAs that are involved in chemical messaging in the brain, helping to regulate both blood vessel activity and the immune system. The fatty acids also have been linked with other health benefits, such as lower risk of heart problems.

Earlier studies have shown conflicting results about the protective effects of PUFAs that are found in fish and breast cancer risk. So Li decided to pool the results of the 21 studies and reanalyze them.

In his analysis, consumption of most types of PUFAs -- but not fish itself -- was linked with a lower risk. Women with a high intake of PUFAs had a 14 percent reduction in breast cancer risk. For every 0.1-gram-per-day increase in the intake of the fatty acids, there was a 5 percent lower risk of breast cancer, the study found.

So how much fish should you eat? "One to two servings of oily fish per person per week is suggested," Li said.

Li said he can't explain with certainty the association between PUFAs and lowered breast cancer risk. Among other possibilities, he speculated that the fatty acids may help regulate the activities of molecules involved in cell growth and in the spread of cancer cells.

Two U.S. experts who reviewed the new findings saw pros and cons to the report.

Although the number of women studied was large, the link found between fatty acid intake and breast cancer risk reduction "is not necessarily cause-and-effect," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

Dr. Joanne Mortimer, director of women's cancer programs at the City of Hope Comprehensive Cancer Center in Duarte, Calif., agreed. "My take on this is it may be more than just what they eat" that helps reduce breast cancer risk, she said. "To make an assumption that the lower risk is due entirely to diet may be a false one."

The women with a high intake of PUFAs also may be more apt to exercise and follow other healthy habits, Mortimer said.

Both Mortimer and Bernik cautioned against focusing too much on fish for risk reduction or on eating too much of it. "It's no cure-all," Bernik said. And, if eaten in excess, the mercury content of some fish can be unhealthy, she added.

Besides eating oily fish, Bernik tells patients to exercise regularly, eat plenty of fruits and vegetables, and not smoke to reduce the risk of breast and other cancers.

More information

To learn more about breast cancer risks, visit the American Cancer Society.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- A new review of data suggests than an old and inexpensive drug, lithium, may help lower suicide risk in people with mood disorders such as depression or bipolar disorder.

"The study provides further evidence that one of the most effective psychiatric medications for preventing suicide in patients with mood disorders is also one of our oldest," said one expert not connected to the research, Dr. Andrew Kolodny, chairman of psychiatry at Maimonides Medical Center in New York City.

According to background information from the researchers, people with mood disorders have a 30 times higher risk of suicide compared to the general population.

Treatment with mood-stabilizing drugs such as lithium, anticonvulsants or antipsychotics can help maintain mood within normal limits, but their role in suicide prevention has been unclear, according to background information in the review, which was published online June 27 in the journal BMJ.

The review was led by Andrea Cipriani, of the department of psychiatry at Oxford University in the United Kingdom. His team analyzed the results of 48 clinical trials involving more than 6,600 people.

The researchers found lithium to be linked with a 60 percent reduction in the risk of suicide and other causes of death compared with people who took a placebo.

They also found that lithium may reduce the risk of self-harm in people with mood disorders. "[The review] reinforces lithium as an effective agent to reduce the risk of suicide in people with mood disorders," the team said.

How the drug works to cut suicide risk remains unclear. Lithium may reduce relapses of mood disorders, but there also is "some evidence that lithium decreases aggression and possibly impulsivity, which might be another mechanism mediating the anti-suicidal effect," the researchers said.

The drug has many side effects, however, so the researchers said doctors "need to take a balanced view of the likely benefits and harm of lithium in the individual patient."

Dr. Robert Dicker, associate director of the Child/Adolescent Psychiatry Division at Zucker Hillside Hospital in Glen Oaks, N.Y., called the new study "a great reminder that lithium offers tremendous benefits in treating patients with mood disorders and suicide."

But Kolodny said the drug is not used as often as it could be. "Lithium, which is generic and not promoted by pharmaceutical companies, tends to be under-prescribed," he said. "Hopefully, this study will help change that."

More information

The U.S. Centers for Disease Control and Prevention has more about preventing suicide.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Parks and tree-lined streets may give city dwellers more than shade. They may also save some lives, a new study from the U.S. Forest Service suggests.

Researchers estimate that across 10 U.S. cities, "urban forests" prevent an average of one death per year, by helping to clear the air of fine particulate matter -- tiny particles released when fossil fuels are burned. Car exhaust, wood burning and industrial sources such as power plants all contribute.

Those fine particles can be inhaled deeply into the lungs, and they are a particular concern when it comes to people's health, said David Nowak, a Forest Service researcher who led the study.

The particles are thought to cause inflammation in the blood vessels and airways, which can be dangerous for people with existing heart or lung disease.

The new findings, reported in the July issue of the journal Environmental Pollution, suggest that trees play a role in protecting urban dwellers from the health effects of air pollution.

But, Nowak said, it's not just a simple matter of "let's plant more trees."

This study shows a "large-scale" correlation between tree coverage and human health. But researchers still have to figure out the nitty-gritty, Nowak said. "How do we best design to protect people from [fine particle pollution]? What configuration of plants do we need? What species of tree?" he said.

And all of that, Nowak added, has to be figured out at the local and regional levels.

Trees, he noted, do a lot more than clear fine particles from the air. They have many beneficial effects -- including reducing other air pollutants such as ozone, and keeping the temperature down during the summer. But certain other effects are not so good for human health: Trees release pollen, for example, which can exacerbate allergies and asthma.

"We need to make smart decisions about what we should plant, where we should plant and when we should plant, in order to improve people's quality of life," Nowak said.

The findings are based on daily air-quality data from 10 U.S. cities, along with information on the cities' tree coverage. To gauge how trees might be affecting city residents' health, Nowak's team used a computer program from the U.S. Environmental Protection Agency (EPA) that estimates the health impact of changes in air quality.

Overall, Atlanta was number one when it came to the amount of fine particle pollution removed by trees, at 64.5 metric tons -- owing to the city's relatively dense urban forest.

But as far as lives saved, New York City came in on top, with an average of eight lives saved per year. That, Nowak said, was partly due to the city's large population, but also to the "moderately high" removal of fine particles from the air -- thanks to trees.

No one is claiming that trees are the answer to air pollution, though.

Trees may be a smaller-scale way to give people extra protection from pollution, said Janice Nolen, assistant vice president of national policy for the American Lung Association.

"But they're not going to be the solution," Nolen said.

The "big tools," she said, are measures to reduce emissions from power plants, cars and other sources of pollutants.

One of those wide-scale measures got extra attention this week. The U.S. Supreme Court on Monday agreed to review a controversial decision by the D.C. Circuit Court of Appeals that reversed a major EPA air-quality policy -- dubbed the Cross-State Air Pollution Rule, the Washington Post reported.

The regulation would have cut emissions from coal-fired power plants across more than half of U.S. states. Last August, the D.C. Circuit Court said the EPA had overstepped its authority in issuing the rule.

"We're very pleased the Supreme Court will review this," Nolen said.

As for trees, she said they are a worthy pollution-fighting measure to keep studying -- including whether strategic planting along roadways might be beneficial.

More information

The U.S Environmental Protection Agency has more on fine particle air pollution.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Nearly 70 percent of Americans take prescription drugs, with antibiotics, antidepressants and painkillers being the most widely used, according to a new study.

Researchers also found that more than half of patients take two prescription drugs, while 20 percent take five or more prescription medications.

One other key finding: "As you get older you tend to get more prescriptions, and women tend to get more prescriptions than men," study author Dr. Jennifer St. Sauver, of the Mayo Clinic Center for the Science of Health Care Delivery, said in a Mayo news release.

The findings come from an analysis of 2009 statistics from people living in Olmsted County, Minn., near the Mayo Clinic. St. Sauver believes the findings are comparable to people living elsewhere in the United States.

According to the study, 17 percent of patients took antibiotics, 13 percent took antidepressants, 13 percent took opioids (painkillers that include Oxycontin and Vicodin), 11 percent used high blood pressure drugs and 11 percent got vaccines. Drugs were prescribed to both men and women in all age groups. The exception was high blood pressure drugs, which were seldom prescribed before age 30.

Vaccines, antibiotics and anti-asthma drugs were most commonly prescribed in people younger than 19, antidepressants and opioids were most common among young and middle-aged adults, and cardiovascular drugs were most common among older adults.

Women had more prescriptions than men across several drug groups, especially antidepressants. Nearly one in four women aged 50 to 64 took antidepressants, according to the study published online June 19 in the journal Mayo Clinic Proceedings.

"Often when people talk about health conditions they're talking about chronic conditions such as heart disease or diabetes," St. Sauver said. "However, the second most common prescription was for antidepressants -- that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature.

According to the Mayo Clinic, there has been a steady increase in prescription drug use in the United States over the past decade. The percentage of people who took at least one prescription drug in the past month rose from 44 percent in 1999-2000 to 48 percent in 2007-08. The nation's spending on prescription drugs was $250 billion in 2009 and accounted for 12 percent of total personal health care spending.

More information

The U.S. Food and Drug Administration explains how to manage the risks and benefits of medicines.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Magnetic stimulation of the brain appears to help speed recovery of speech and language in stroke survivors, a small new study finds.

The study, published June 27 in the journal Stroke, points to a new tool patients might use to regain lost function, the researchers said.

"For decades, skilled speech and language therapy has been the only therapeutic option for stroke survivors" who have lost some ability to communicate, study lead author Dr. Alexander Thiel said in a journal news release.

"We are entering exciting times where we might be able in the near future to combine speech and language therapy with noninvasive brain stimulation earlier in the recovery," said Thiel, who is associate professor of neurology and neurosurgery at McGill University in Montreal. "This could result in earlier and more efficient aphasia recovery and also have an economic impact."

The researchers said between 20 percent and 30 percent of stroke survivors suffer from aphasia (difficulties with speaking, understanding language, reading or writing).

The Canadian study included 24 stroke survivors with several types of aphasia. Thirteen of them received transcranial magnetic stimulation (TMS) and 11 received a "sham" brain stimulation.

The TMS device is a handheld magnetic coil that delivers low-intensity stimulation and causes muscle contractions when placed over the brain's motor cortex. In the sham stimulation, coil's intensity was too low to produce any real stimulation.

Each day for 10 days, the patients received 20 minutes of TMS or sham stimulation followed by 45 minutes of speech and language therapy. On average, patients in the TMS group showed three times greater improvement than those in the sham stimulation group, Thiel's team found.

TMS had the greatest impact on improvement in patients' ability to name objects, which is one of the most debilitating aphasia symptoms.

"We believe brain stimulation should be most effective early, within about five weeks after stroke, because genes controlling the recovery process are active during this window," Thiel said.

Two stroke rehabilitation experts were cautiously optimistic about the results.

"This is a small study, but it yielded interesting results," said Dr. Kristjan Ragnarsson, chairman of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai in New York City. "The findings indicate that transcranial magnetic stimulation is important to use early, but that's also when we see the greatest improvement in our patients both naturally and with the help of speech therapy. A larger, well-controlled study is needed to confirm any long-term benefits after the initial testing period."

Thiel's team said a larger study in TMS therapy is set to launch at four sites in Canada and one in Germany later this year.

Another expert agreed that the treatment shows promise, adding that TMS is just one of many new techniques that are helping stroke survivors.

"Stroke is the leading cause of permanent disability," said Dr. Bruce Volpe, an investigator at the Feinstein Institute for Medical Research in Manhasset, N.Y.

"[However], attempts to improve the recovery after stroke have quickened with the noninvasive technologies based on robots and magnetism and electricity," he said. In his experience, "patients with stroke and robot training sustain better outcomes than those with only standard treatment."

Volpe said many of these new methods are in use at his institution and "provide enhanced recovery for many patients with stroke, even for those who are weeks and months after the episode."

More information

The U.S. National Institute of Neurological Disorders and Stroke outlines what you can do to prevent stroke.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Rixubis (coagulation factor IX recombinant) has been approved by the U.S. Food and Drug Administration to prevent routine bleeding episodes in people aged 16 and older with hemophilia B, the agency said Thursday.

It's the first recombinant coagulation factor IX to be sanctioned by the FDA. People with hemophilia B, mostly males, have a genetic disorder that leads to a deficiency in factor IX. Affecting some 3,300 people in the United States, the disorder can cause serious bleeding episodes, most commonly affecting the joints, the agency said.

Rixubis is a purified protein supplied as a freeze-dried powder, the FDA said. It is injected twice weekly after being combined with sterilized water.

The treatment was evaluated in clinical studies involving 73 males between the ages of 12 and 65. Those who received the treatment had a 75 percent lower annual bleeding rate than those who had historically received on-demand treatment, the FDA said.

The treatment may lead to life-threatening allergic reactions in some recipients, the agency warned. More common clinical side effects included distorted taste, extremity pain and atypical blood test results.

Rixubis is produced by Baxter Healthcare, based in Westlake Village, Calif.

More information

To learn more about hemophilia, visit the U.S. Centers for Disease Control and Prevention.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Breast cancer patients in rural areas of the United States are less likely than those in cities to receive recommended radiation therapy after having a lumpectomy, a new study finds.

Lumpectomy is a breast-sparing surgery that removes only tumors and surrounding tissue.

"The lumpectomy findings are worrisome because lack of follow-up radiation therapy could lead to recurrence, another surgery, and another time period of concern for the woman and her family," Elizabeth Habermann, associate scientific director of surgical outcomes at the Mayo Clinic Center for the Science of Health Care Delivery, said in a Mayo news release.

The analysis of data from nearly 350,000 California breast cancer patients treated between 1996 and 2008 revealed other differences in diagnosis and treatment between rural and urban patients, the researchers said.

Rural women were less likely to have their estrogen-receptor status tested and their tumor graded, which are two important parts of the diagnostic work-up for breast cancer. Rural women were also more likely to choose mastectomy (complete removal of the breast) rather than lumpectomy.

The findings were presented at the AcademyHealth annual research meeting, held June 23-25 in Baltimore.

"These study results are concerning," Habermann said. "All women should receive guideline-recommended cancer care, regardless of where they live."

She and her colleagues said further research is needed to determine the reasons for the differences between rural and urban breast cancer patients, so that action can be taken to correct them.

Despite the deviation from recommended treatment, no significant difference in death rates was noted between rural and urban breast cancer patients.

The data and conclusions of research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- A combination of antidepressant therapy and counseling is an effective way to treat anxiety in older adults, a new study finds.

Together, these treatments keep seniors anxiety-free for a longer time than either medication or counseling alone, according to the researchers.

The investigators studied 73 people, aged 60 and older, with generalized anxiety disorder, a problem that affects about 5 percent of seniors. All the patients began the study by taking the antidepressant escitalopram (Lexapro) for three months.

After that time, the patients were randomly assigned to one of two groups. The first group simply continued taking the antidepressant for another 16 weeks, while the second group continued taking the drug but also received 16 weeks of cognitive behavioral therapy.

During cognitive behavioral therapy, patients learned about the nature of anxiety, worked on relaxation techniques, such as deep, slow breathing and progressive muscle relaxation, and were also taught problem-solving skills, the study authors explained in a Washington University School of Medicine news release.

After four months, participants were randomly divided again, with half continuing on the antidepressant for another seven months and half getting an inactive placebo. At the end of 13 months the researchers compared results.

"Those individuals who had both the drug and cognitive behavioral therapy also had a lower relapse rate, and if they did relapse, it happened later," Dr. Eric Lenze, a professor of psychiatry at Washington University School of Medicine in St. Louis, said in the news release.

Taking the antidepressant lowered anxiety levels, but the improvement was much greater in patients who also received cognitive behavioral therapy, according to the study, published online recently in the American Journal of Psychiatry.

However, not all older adults benefit from cognitive behavioral therapy, Lenze said.

"Antidepressant medication and cognitive behavioral therapy appear to work well in combination, but if an older adult has begun to develop dementia related to Alzheimer's disease or some other illness, it appears even small amounts of cognitive impairment from those disorders can interfere with the benefits this combination of therapies provides," Lenze explained.

More information

The U.S. National Institute of Mental Health has more about anxiety disorders.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- In a hidden health effect of terrorism, about 1 million former smokers in the United States started smoking again after the Sept. 11, 2001, terrorist attacks, a new study finds.

The research found that smoking increased 2.3 percent nationwide after the 9/11 attacks. The increase was maintained until the end of 2003, when the researchers' analysis of data ended.

The study also found especially high increases in stress levels after Sept. 11 in communities with higher percentages of active-duty and reserve members of the military, and among higher-educated people. The rise in stress levels accounted for all of the increase in smoking, said the researchers from the Weill Cornell Medical College in New York City.

"This study provides the first unbiased estimate of the effect of stress on smoking, and the finding that there was such a big increase in smoking nationwide, seemingly due to one event, is extraordinary and surprising," study author Michael Pesko, an instructor in the department of public health, said in a college news release. "It sheds light on a hidden cost of terrorism."

The findings were published online recently in the journal Contemporary Economic Policy.

"I was really surprised to find that former smokers across the nation resumed their old habit," Pesko said. "I was expecting to see impacts just in the New York City area or, at most, the tri-state area."

Pesko said the estimated cost to the government of increased smoking after Sept. 11 was between $530 million and $830 million, and may be higher if the smoking continued beyond 2003. The costs include Medicare and Medicaid expenses, productivity losses associated with smoking-related illnesses and decreased tax revenue from lost work.

The findings suggest a potential public health response to deal with stress caused by future terrorist attacks or disasters, Pesko said. One idea would be to offer free nicotine-replacement therapy soon after the event.

"Another strategy would be to alert health professionals to do more substance-abuse screening during regular medical appointments following terrorist attacks, or any such event that is likely to stress the nation," he said.

Pesko also looked at the aftermath of the 1995 Oklahoma City bombing but did not find an increase in smoking after that terrorist attack.

More information

The U.S. National Institute of Mental Health has more about stress.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Those who get migraines have to deal not only with the pain, which can be disabling, but the stigma caused by others who tend to discount the impact of the debilitating headaches, a new study shows.

"We were able to validate that people who have migraine are not mistaken that they feel they are stigmatized," said lead researcher Dr. Robert Shapiro, a professor of neurological sciences at the University of Vermont College of Medicine. "We have found those perceptions are well-grounded, and that the stigma that people with migraine experience is of a similar magnitude to the stigma people with epilepsy and panic attack experience," he noted.

"The general attitude is that migraine is not a serious or valid condition," he said. In the study, those with asthma experienced the least amount of stigma of the four conditions studied. Epilepsy patients can experience unpredictable seizures and the condition is known to carry a stigma. Panic attacks, where sufferers experience bouts of intense fear, are also unpredictable.

Shapiro is due to present the findings Sunday at the International Headache Congress in Boston.

About 29.5 million Americans are affected by migraine pain and symptoms, according to the U.S. Department of Health and Human Services. Symptoms can include severe headache, light sensitivity and nausea. Those who are affected may need bed rest and may be unable to work while they are experiencing a migraine.

Shapiro polled 765 people online. All were U.S. residents, with an average age of 28. When presented with vignettes that described people with asthma, migraine, panic attack and epilepsy, the survey participants answered questions on a well-known test used to assess stigma towards illness.

The questionnaire, Shapiro explained, "just provides insight into how someone wants to be associated with someone else." For instance, respondents told how likely they were to want to work with someone with one of the four conditions, and how comfortable they would be inviting them to a dinner party.

The lowest stigma score was for those with asthma. "What we found was the score for migraine versus epilepsy versus panic attack were quite close together and quite similar," Shapiro said.

The study was funded by the Canadian Institutes of Health Research. Peter Reiner, of the University of British Columbia, also conducted the research.

Some of Shapiro's findings echo those from another study, published earlier this year, in which researchers from Thomas Jefferson University Hospital's Headache Center found that chronic migraine patients experienced more stigma than did those with epilepsy, while those with episodic migraines experienced less stigma than those with chronic migraines.

The latest finding did not surprise Dr. Randall Berliner, a neurologist and psychiatrist specializing in headache disorders at Lenox Hill Hospital in New York City.

"This is a very common problem," said Berliner, who was not involved in the study.

"If you don't have migraines yourself, you may have a hard time understanding just how severe the headaches can be," Berliner explained.

Many people experience non-migraine headaches, he said, and don't consider them disabling. They may pop a pill and feel better, not missing any work. But migraines are different, he said.

Shapiro agreed. Those who haven't had a migraine often have the attitude that those with disabling migraines are simply not managing a problem that nearly everyone has, he said.

Migraines are also typically very unpredictable, Berliner added. "It makes it hard for a migraine sufferer to make plans and keep them," he said. "Some people may interpret that as flakiness or lack of consideration."

To combat that attitude at work, Berliner said, an employee with migraine might have a conversation with his boss, communicating that "It's not my intention to take away your productivity."

More information

To learn more about migraine, visit the U.S. Department of Health and Human Services.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Speeding is a factor in a third of fatal crashes involving teen drivers in the United States, according to a new report.

Speeding played a role in 33 percent (nearly 19,500) of fatal teen driver crashes in 2011, compared with 30 percent in 2000. During that same period, there was a dramatic decline in the total number of fatal teen driver crashes, according to the Governors Highway Safety Association (GHSA) report.

"Curbing teen speeding is vital since no other age group has a higher crash risk," report author Susan Ferguson said in a GHSA news release. "Speeding is a common factor in the fatal crashes of teen male and female drivers."

"Speeding is more prevalent among teen males, at night and in the presence of other teen passengers," she said. "When three or more teen passengers are in a vehicle driven by a 16-year-old male, almost half of their fatal crashes are speeding-related."

Despite its significant role in fatal teen driver crashes, speeding doesn't get the attention it deserves, the researchers said. Increased speed limits in many states and the general belief that speeding is acceptable worsen the problem.

"Unless speeding is recognized as a dangerous behavior, much the same as drunk driving, addressing it will be difficult," said Ferguson, former senior vice president of research for the Insurance Institute for Highway Safety.

Potential solutions in the report included wider use of graduated driver licensing laws that place nighttime and passenger restrictions on newly licensed drivers. These rules help limit situations in which teen drivers are likely to speed.

Parents play an important role in teens' driving behavior. The report offered the following tips for parents:

  • Talk to teens about the importance of observing all traffic laws, demonstrate by example and establish family rules and consequences for breaking laws.
  • Do not give teens primary access to a vehicle for at least the first year of independent driving.
  • When selecting a car, make safety the primary consideration.
  • Consider in-vehicle speed monitoring devices and participation in incentive-based insurance programs that monitor usage, braking and acceleration, and speed.

More information

The U.S. Centers for Disease Control and Prevention has more about teen drivers.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Many 8-year-olds in the United States have already tasted alcohol, according to a new study.

Researchers found that 37 percent of kids in one Pennsylvania county had sipped alcohol by second grade, and two-thirds had tasted it by age 12.

Childhood exposure to alcohol is concerning because other research has suggested that sipping or tasting at a young age leads to early drinking, said study leader John Donovan, an associate professor of psychiatry and epidemiology at the University of Pittsburgh Medical Center.

"Our earlier research found that childhood sipping predicts early initiation of drinking -- drinking by age 14 or younger," he said.

For the study, published online June 11 in the Journal of Adolescent Health, the researchers collected data at 14 time points from about 450 children living in Allegheny County from ages 8 through 18.

Children were asked how old they were when they first tasted or sipped alcohol, when they first had a drink, and when they first had three or more drinks on the same occasion or got drunk. They also were asked if they had experienced problems such as hangovers or passing out.

The results: By age 14, three-quarters said they had sipped alcohol, 19 percent reported drinking and 3 percent reported binge-drinking (downing three or more drinks on one occasion). Two percent said they had been drunk.

By age 18, nearly all -- 96 percent -- had sipped or tasted alcohol, while almost 78 percent reported drinking and nearly one-third reported two or more alcohol-related problems.

Whether a youngster who tastes his dad's beer is doomed to abuse alcohol isn't spelled out in this study, but the authors suggested that pediatricians might want to discourage parents from such practices.

Ethnic differences emerged in the study, which was supported by the National Institute on Alcohol Abuse and Alcoholism. Only 18 percent of black children had tried alcohol by age 8, while 44 percent of children of European-American descent had a taste by that age.

Donovan said that discrepancy has been found in other research. He believes that stronger parental disapproval and more emphasis on religion are two factors behind the lower sipping rate among black children.

The findings may not apply to the larger U.S. population, since only residents of one county were polled, and few Hispanic or Asian families were included, Donovan said. Also, the study relied on self-reported information, which might not be totally accurate.

Still, another expert expressed concern about the findings.

"The numbers are troubling but not that surprising," said Dr. Marc Galanter, director of the division of alcoholism and drug abuse at the NYU Langone Medical Center in New York City. Galanter was not involved in the study.

"Much of this is certainly cultural," he said of the early alcohol exposure. "Drinking in some families is normal, even for young kids, in certain ethnic and cultural groups." Those include southern European families, he said.

What's the best advice for parents based on the research?

"As a generality, it's better not to encourage the onset of drinking at an earlier age," Galanter said. "Later onset of exposure to alcohol is associated with less alcohol problems."

Donovan said more research is needed to better understand what effect tasting alcohol in childhood might have on later drinking habits.

"There are a number of longitudinal studies that have established that adolescents whose parents allowed them to drink at home were at significantly greater risk for binge drinking and alcohol problems later in adolescence," Donovan said.

"[However], we don't yet have that kind of evidence with respect to child sipping at home," he said.

"All we can say at present is that kids who have sipped by age 10 are nearly twice as likely to start drinking by age 14 or younger, and that such early drinking has been shown to increase their likelihood of involvement in other problem behaviors in adolescence and in young adulthood," he said.

More information

To learn more about underage drinking, visit the U.S. National Institute on Alcohol Abuse and Alcoholism.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- Cesarean deliveries in the United States have leveled off for the first time in 12 years, although they still account for almost one-third of live births, U.S. health officials report.

"It's about time," said Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten Island University Hospital in New York City, who was not involved in the report.

The trend toward C-sections, which increased 60 percent between 1996 and 2009, was worrisome, he said. "It was bad for mothers and babies, and now finally it seems we have been able to halt it or maybe even reverse it a tiny bit," Maiman said.

"But we have a long way to go because the C-section rate is way higher than it should be," he added.

After rising from 21 percent of births in 1996 to about 33 percent in 2009, the 2011 rate held steady at about 31 percent, according to figures released Thursday by the U.S. Centers for Disease Control and Prevention (CDC).

Guidelines from the American College of Obstetricians and Gynecologists (ACOG) and other medical groups have helped to curb elective surgical deliveries, Maiman said. Those guidelines discourage cesarean delivery before 39 weeks without a medical indication.

Staten Island University Hospital has followed such guidelines for more than 15 years, Maiman said. The C-section rate there is about 22 percent, well below the national average.

Some obstetricians welcomed the new findings. "It's great that the overall C-section rate has remained flat," said Dr. Jeffrey Ecker, director of obstetrical clinical research at Massachusetts General Hospital in Boston.

"It has been difficult to demonstrate that the rise of the C-section rate over the past decade has been associated with any meaningful improvement in babies' or mothers' health," said Ecker, who is also chair of ACOG's committee on obstetric practice.

Ecker would prefer to see even fewer cesarean deliveries, but "there is no perfect rate," he said. However, "there are opportunities to move the rate down safely," he added.

The report, based on information from the Natality Data File from the National Vital Statistics System, found that the decline wasn't uniform.

At 38 weeks' gestation, the cesarean delivery rate decreased 5 percent -- a trend seen in 30 states. However, at 39 weeks -- full term -- it rose 4 percent. Thirty-eight weeks is considered early term.

Lead author Michelle Osterman, a health statistician at CDC's National Center for Health Statistics, said it's not possible to pin down the reason for the increase at 39 weeks, which was noted in 23 states. Nor could she predict whether the numbers will continue to hold.

"You never know what's going to happen, and we don't make projections," she said. "But it's significant that [the rate of C-sections] hasn't increased in the past three years."

C-sections became more commonplace for several reasons, Maiman said. Some included convenience for doctors and patients who wanted to schedule a delivery and avoid potential complications of a vaginal delivery. Also, women were uninformed about the benefits of a vaginal delivery, he noted.

For mothers, more than one C-section significantly increases the risk of complications and death, Maiman said. Now, doctors may encourage women who have had a C-section to try a vaginal birth later.

For babies, the danger is the prematurity.

"Any prematurity, even slight prematurity, leads to increased complications for the baby," Maiman said. High rates of asthma and a risk for obesity are also associated with C-section births, he said.

According to the March of Dimes, elective C-sections likely contribute to the number of babies born "late preterm," between 34 and 36 weeks' gestation. Although these babies are usually considered healthy, they are more likely to have medical problems than babies born at full term.

Compared to a full-term baby, an infant born late preterm is more likely to have problems with breathing, feeding and maintaining body temperature, the March of Dimes states.

And a study published earlier this year by University of Michigan researchers found that birth at 39 to 41 weeks provides more developmental advantages compared to birth at 37 to 38 weeks.

"We need to leave mothers alone so that the infant can have a full-term delivery," Maiman said.

More information

For more information on cesarean delivery, visit the March of Dimes.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- People who think stress is affecting their health may be setting themselves up for a heart attack, a new study contends.

The researchers found that these people had double the risk of a heart attack compared with people who didn't think stress was harming their health.

"People's perceptions about the impact of stress on their health are likely to be correct," said study author Hermann Nabi, a senior research associate at the Centre for Research in Epidemiology and Population Health at INSERM in Villejuif, France.

"They may need to take actions when they feel that it is the case," he added.

These findings have both clinical and theoretical implications, Nabi said.

"From a clinical perspective, they suggest that complaints of adverse impact of stress on health should not be ignored in clinical settings as they may indicate increased risk of developing coronary heart disease," he said.

From a theoretical perspective, the findings imply that the perceived impact of stress on health is a valid concept that should be considered in future studies aimed at examining the association between stress and health outcomes, Nabi added.

The report was published June 27 in the online edition of the European Heart Journal.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "stress and reactions to stressful situations have been associated with increased risk of cardiovascular disease in many studies."

However, few studies have looked at whether an individual's perception of stress is associated with cardiovascular outcomes, he said.

And it's not clear if reducing stress would affect the risk for heart attack, Fonarow said.

"Further studies are needed to determine whether stress reduction or other risk reduction strategies can reduce cardiovascular events in men and women who perceive they are under stress that is adversely impacting their health," he said.

For the study, Nabi's team collected data on more than 7,000 men and women who took part in the Whitehall II study, which has followed London-based civil servants since 1985.

Participants were asked how much they felt that stress or pressure in their lives had affected their health. Based on their answers, they were placed into one of three groups: "not at all," "slightly or moderately," or "a lot or extremely."

Participants were also asked about their levels of stress and other lifestyle factors such as smoking, drinking, diet and physical activity.

The researchers also collected medical information, such as blood pressure, diabetes status and weight, and other data, including marital status, age, sex, ethnicity and socioeconomic status.

Over 18 years of follow-up, there were 352 heart attacks or deaths from heart attack.

After taking all of these factors into account, the investigators found those who said their health was a "lot or extremely" affected by stress had more than double the risk of a heart attack compared with those who said stress had no effect on their health.

After further adjustments for biological, behavioral and other psychological risk factors -- including stress levels and measures of social support -- the risk wasn't as high. But it was still a lot higher (49 percent higher) than among those who said stress didn't affect their health, the researchers noted.

While the study found an association between perceived levels of stress and heart attack, it did not prove cause-and-effect.

Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, offered some tips on dealing with stress.

The stress response is not only a mental reaction to a situation, but a physiological reaction, she explained.

"Acute and chronic stress over time can make us sick. Our perception of how that stress affects our health may be an additional stressor biochemically, psychologically and physiologically, creating a feedback loop that results in increased physical distress and disease," Heller said.

Managing stress does not mean ignoring it, she said. "Working with a qualified mental health professional who specializes in cognitive behavioral therapy can be very helpful. In lieu of that, there are some things you can do on your own."

  • Take several slow deep breaths periodically throughout the day. Deep breathing can shift the body out of the fight-or-flight response.
  • Exercise regularly. Cardiovascular exercise teaches the body how to handle the physiological effects of stress. It also helps reduce anxiety and depression.
  • Eat as healthfully as possible. Chronic or acute stress may trigger the desire to dive into high-calorie comfort foods. However, after an initial flash of relief, you will tend to feel lethargic, fatigued and possibly worse than you did before.
  • Identify stressful triggers, and create a plan to help you cope.
  • Instead of stressing about your health, be proactive and find ways to improve it. If you have high blood pressure, learn how to lower the sodium in your diet. Start walking a few days a week to strengthen your heart and help manage weight.

More information

For more on stress and your heart, visit the American Heart Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 27 (HealthDay News) -- The size, weight, shape and color of your cutlery can affect how food tastes, a new study suggests.

In the research, participants thought white yogurt tasted sweeter than pink-colored yogurt when eaten from a white spoon, but the reverse was true when a black spoon was used.

These findings could help people improve their eating habits by reducing portion sizes or the amount of salt they add to their food, the researchers said.

"How we experience food is a multisensory experience involving taste, the feel of the food in our mouths, aroma and the feasting of our eyes," said Vanessa Harrar and Charles Spence of the University of Oxford, in the United Kingdom. "Even before we put food into our mouths, our brains have made a judgment about it, which affects our overall experience."

They found that yogurt seemed denser and more expensive when eaten from a plastic spoon. White yogurt was rated sweeter, more liked and more expensive than pink-colored yogurt when they were eaten from a white spoon. These effects were reversed when the two colors of yogurt were eaten from a black spoon.

When participants were offered cheese on a knife, spoon, fork or toothpick, they said the cheese from the knife tasted saltiest, according to the study, which was published in the journal Flavour.

"Subtly changing eating implements and tableware can affect how pleasurable, or filling, food appears," Harrar said. "When serving a dish, one should keep in mind that the color of the food appears different depending on the background on which it is presented and, therefore, tastes different."

This may also be used to help control eating patterns such as portion size or how much salt is added to food. Alternatively, people may be able to make better food choices if their ingrained color associations are disrupted by less constant advertising and packaging.

Previous research has shown that the weight and color of a plate can alter peoples' perceptions of how dense, salty or sweet food tastes.

More information

The U.S. National Institute on Deafness and Other Communication Disorders has more about taste and taste disorders.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 27, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

New U.S. Nutrition Rules for School Foods

Lower limits on the amount of fat, calories, sugar and salt in all foods sold in U.S. schools were finalized this week by federal officials.

Included in the new Department of Agriculture restrictions are snacks sold around the school and items on the "a la carte" line in cafeterias, which have never been regulated before, the Associated Press reported.

The new rules, which apply to 100,000 schools nationwide, allow states to regulate student bake sales.

The regulations -- required under a child nutrition law passed by Congress in 2010 -- are meant to combat childhood obesity and could lead to major changes in what many children eat at school, according to the AP.

Some schools do provide healthier lunch menus and vending machine choices, but others still sell high-fat, high-calorie foods. The nutritional content of free and low-cost school breakfasts and lunches subsidized by the federal government are already regulated. However, many school lunchrooms also have "a la carte" lines that sell other foods, many of which are unhealthy.

Under the new rules, those "a la carte" lines will have to offer healthier choices, such as low-fat hamburgers, yogurt and fruit cups, the AP reported.

Another major change under the new rule will be a near-ban on high-calorie beverages. Only sports drinks and sodas that contain 60 calories or less per 12-ounce serving will be allowed in high schools. Many companies have already developed low-calorie sports drinks and many diet teas and diet sodas are available.

In elementary and middle schools, beverage choices will be limited to water, carbonated water, 100 percent fruit or vegetable juice, and low fat and fat-free milk, including fat-free flavored milks, the AP reported.

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Mandela Placed on Life Support: Official

Nelson Mandela is on life support, according to a South African official who was briefed on the anti-apartheid hero's condition.

Mandela, 94, has been in hospital since June 8 for treatment of a recurring lung infection. Government spokesman Mac Maharaj declined to comment on the situation, citing doctor-patient confidentiality, CNN reported.

Since Sunday, Mandela's condition has been described as critical. After visiting Mandela late Wednesday night, South African President Jacob Zuma canceled a visit to Mozambique.

Mandela's former physician and the nation's ex-surgeon general, Dr. Vejay Ramlakan, also visited the hospital Wednesday, according to the South African Press Association, CNN reported.

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Most Chimps to be Retired from Medical Research: NIH

Most of the chimpanzees who've spent their entire lives in research labs are going to be retired by the U.S. National Institutes of Health.

The agency said Wednesday that it will retire about 310 chimps from medical research over the next few years, saying they "deserve special respect," the Associated Press reported.

Only 50 chimps will be kept so that they will be available if needed for important medical research that could be performed no other way, the NIH said.

In 2011, the Institute of Medicine said that nearly all use of chimps for invasive medical research no longer can be justified, the AP reported. The NIH said more space in sanctuaries is needed in order to provide all the retiring chimps with homes.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- When you're packing your bags before the birth of your baby, don't forget to pack essentials for the new arrival.

The womenshealth.gov website offers this advice about what to bring for baby:

  • An undershirt.
  • A sweater set, stretch suit or some other outfit.
  • Something to keep the feet warm, such as a pair of booties or socks.
  • A receiving blanket. If the weather is cold, bring a heavy blanket.
  • A package of wipes and diapers.
  • An infant car seat that is properly installed in your vehicle.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Running in Hot Weather

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(HealthDay News) -- If you're planning to run in hot weather, the Road Runners Club of America offers these safety tips before you start:

  • Drink enough fluids, preferably water. Plan your route so you can refill your water bottle along the way.
  • If the temperature outside is above 98.6 degrees Fahrenheit and humidity is above 70 percent, run indoors.
  • Stop running if you feel dizzy or nauseated, if you stop sweating or you get the chills.
  • Run in the shade, avoiding direct sunlight and blacktop.
  • Talk to your doctor about running in the heat if you have any respiratory or cardiac condition.
  • Make sure children run in the early morning or late in the day, to avoid peak heat.
  • Wear lightweight, breathable, light-colored clothing, avoiding long sleeves and long pants.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Stroke Prevention Tips for Women

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WEDNESDAY, June 26 (HealthDay News) -- Nearly half a million women in the United States will have a stroke this year, but there are many ways for them to reduce their risk.

"Knowledge is power," said Dr. Natalia Rost, associate professor of neurology at Harvard Medical School. "If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk."

Two leading contributors to stroke are age and family history, which can't be controlled, but factors such as blood pressure and lifestyle behaviors are modifiable, Rost said in a Harvard news release.

Stroke -- sometimes called a brain attack -- occurs when blood flow to the brain is disrupted.

In the June issue of Harvard Women's Health Watch, Rost suggested the following ways to reduce stroke risk:

  • Manage your blood pressure. Uncontrolled high blood pressure doubles or even quadruples stroke risk. Monitoring blood pressure and treating high blood pressure is an important way to prevent stroke.
  • Watch your weight. Obesity and the complications linked to it -- such as high blood pressure and diabetes -- boost the risk of having a stroke. For overweight people, losing as little as 10 pounds can reduce stroke risk.
  • Be active. Exercise helps control weight and blood pressure, and is also an independent reducer of stroke risk. One study found that women who walked three hours a week were less likely to have a stroke than women who didn't walk.
  • Take baby aspirin. The Women's Health Initiative study found that women over age 65 who took a daily baby aspirin lowered their stroke risk. Aspirin helps reduce stroke risk by preventing blood clots from forming. But if you're considering daily aspirin use, talk to your doctor first.

More information

The Office on Women's Health has more about strokes.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Black Americans on Medicaid are far less likely to receive a living-donor kidney transplant than patients with private health insurance, a new study finds.

In this type of transplant, a living person donates a kidney or part of a kidney to another person.

"Living kidney transplantation is the optimal treatment for patients with end-stage renal disease, offering the best quality of life and longest survival," study lead author Dr. Amber Reeves-Daniel, an assistant professor of nephrology at Wake Forest Baptist Medical Center, said in a center news release.

Blacks comprise 12.6 percent of the U.S. population but about one-third of dialysis patients. Nevertheless, blacks received only 13.5 percent of living kidney transplants performed in 2011, the researchers said.

To determine the reasons for this gap, Reeves-Daniel's team examined data from about 450 white and black patients who received a living kidney transplant at Wake Forest from July 2008 through December 2010.

Patients of either race with private insurance were much more likely than those without private insurance to receive a transplant (22 percent vs. 7.6 percent). Among whites, 27.5 percent of those with private insurance received a transplant, compared to 12.4 percent without private insurance.

But the statistics were more striking among blacks. Those with private insurance were 14 times more likely to receive a transplant than those without private insurance, the study found, and blacks covered by Medicaid were unlikely to receive a living kidney transplant at all.

"An alarming finding is that despite apparent access to kidney transplantation, no African-American Medicaid recipients received a living-donor kidney transplant during the two-and-a-half-year study period," Reeves-Daniel said.

"[It makes sense that] insured patients would be more likely to have donors with sufficient resources to facilitate the processes of living donation," he said. "However, it is difficult to explain why individuals with Medicaid, particularly African-Americans, were so much less likely to receive living kidney transplants."

The study was published online June 20 in the journal Clinical Transplantation.

More information

The National Kidney Foundation has more about living kidney transplants.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Using a new method to promote nerve regeneration after spinal cord injury, researchers were able to restore bladder function in paralyzed rats.

This success may help future efforts to find ways to restore bladder and other body functions in people with spinal cord injuries, the researchers said.

Scientists have long experimented with nerve grafts as a way of reconnecting nerves at the spinal cord injury sites but coaxing the cells to grow and form connections capable of transmitting nerve signals has proved difficult.

In this study, U.S. researchers used a chemical that promotes cell growth along with a scar-busting enzyme to create a more hospitable environment for the nerve graft at the spinal injury site in adult rats.

Their results appear in the June 26 issue of the Journal of Neuroscience.

"Although animals did not regain the ability to walk, they did recover a remarkable measure of urinary control," study co-author Jerry Silver, of Case Western Reserve University School of Medicine, in Cleveland, said in a journal news release.

Bladder control is a basic function that many spinal cord injury patients rank as one of the most important to regain following their injury, according to the news release.

"This is the first time that significant bladder function has been restored via nerve regeneration after a devastating cord injury," study co-author Yu-Shang Lee, of the Cleveland Clinic, said in the release.

Although the findings of the new study are promising, scientists note that research involving animals often fails to produce similar results in humans.

Although much more research is required before this type of therapy can be tested in people, these findings offer "great hope for the future of restoring bladder function to spinal cord injury patients," Elizabeth Bradbury, a spinal cord injury researcher at King's College London, said in the news release. She was not involved in the study.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about spinal cord injury.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Using its newfound authority to regulate tobacco, the U.S. Food and Drug Administration has for the first time allowed two new cigarette brands to hit the market.

The agency also rejected requests to allow the marketing of four other new tobacco products it did not name.

The FDA first gained regulatory purview over tobacco products in 2009 under the Family Smoking Prevention and Tobacco Control Act. Therefore, "new tobacco products under FDA's authority cannot come to market without FDA's review," FDA commissioner Dr. Margaret Hamburg explained during an afternoon news conference Tuesday.

The cigarettes the FDA allowed are both Lorillard Tobacco Co. products -- Newport Non-Menthol Gold Box 100s and Newport Non-Menthol Gold Box.

Because these products are essentially "equivalent" to approved products already being marketed, they "do not raise new questions of public health" and can be sold to U.S. consumers, explained Mitchell Zeller, director of FDA's Center for Tobacco Products.

He stressed that allowing the sale of these cigarettes does not mean that they are safer or less harmful than cigarettes already on the market.

"An FDA product order is not a finding by the FDA that the product is considered safe or safer than its predicate product, or less harmful in general," he said. "In addition, the companies cannot say their products are 'FDA-approved.'"

The agency rejected four new tobacco products because they determined that they were not similar enough to existing products already on the market.

"The applicant [also] did not adequately show that the new product did not raise new questions of public health," Zeller said at the news briefing.

By law, the FDA cannot release the names of the manufacturers of the rejected products or what types of products they were, he added.

More information

For more on tobacco regulation, visit the U.S. Food and Drug Administration.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Only half of American youths get the recommended amount of exercise and less than one-third eat the suggested amount of fruits and vegetables each day, according to a federal government study.

Researchers surveyed nearly 10,000 students aged 11 to 16 in 39 states, and found that only half were physically active five or more days a week and fewer than one in three ate fruits and vegetables daily.

"The students showed a surprising variability in eating patterns," study author Ronald Iannotti, of the prevention research branch of the U.S. National Institute of Child Health and Human Development, said in an institute news release. "But most -- about 74 percent -- did not have a healthy pattern."

The students in the study also were asked to describe their body image, emotional health and general satisfaction with life. The researchers classified the participants' diet and exercise habits into three general categories: unhealthful (26 percent), healthful (27 percent) and typical (47 percent).

Youth in the typical group were least likely to exercise five or more days a week or to eat fruits and vegetables at least once a day. They were more likely to spend time watching television, playing video games or on a computer than those in the healthful group, but less likely to do so than those in the unhealthful group.

The participants in the typical group infrequently ate fruits and vegetables, but also infrequently consumed sweets, chips, french fries or soft drinks. They were more likely than those in the other two groups to be overweight or obese and to be unhappy with the appearance of their bodies.

Youth in the unhealthful group consumed the most sweets, chips, french fries and soft drinks, and also were more likely than the other groups to watch TV, play video games and use a computer more than two hours a day, according to the study, which was published in the Journal of Adolescent Health.

Despite the unhealthy foods they consumed, youth in the unhealthful group were more likely to be underweight and to report needing to put on weight. Youth in this group also were more likely to report symptoms of depression and poor physical health, such as backaches, stomachaches, headaches or feeling dizzy.

Nearly 65 percent of students in the healthful group exercised five or more days per week -- the highest rate of the three groups. They were least likely to spend time in front of a screen, most likely to report eating fruits and vegetables at least once a day, and least likely to consume sweets, soft drinks, chips and french fries. They had the lowest rates of depressive symptoms and the highest life satisfaction ratings.

All three groups could stand to improve their health habits, Iannotti said, whether by walking or biking between home and school or eating more fresh produce each day.

Children and teens should get one hour or more of moderate or vigorous aerobic physical activity a day, including vigorous-intensity physical activity at least three days a week, according to the U.S. Department of Health and Human Services' Physical Activity Guidelines for Americans.

More information

The Nemours Foundation has more about kids and exercise.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- The use of advanced prostate cancer treatments has increased among men who arguably will derive little benefit from the expensive new technologies, a new study suggests.

The use of intensity-modulated radiotherapy (IMRT) and robotic prostatectomy to treat prostate cancer patients at low risk of dying from the disease increased from 32 percent in 2004 to 44 percent in 2009, researchers found in reviewing Medicare patient data.

These technologies also were utilized more often to treat men with prostate cancer who were at high risk of dying for some reason other than their cancer, increasing from 36 percent in 2004 to 57 percent in 2009.

Use of advanced technology to treat those with both low-risk disease and a high risk of non-cancer mortality went from 25 percent in 2004 to 34 percent in 2009.

"The implementation of these technologies occurred in populations at a time when there was an increase in awareness that some prostate cancers might not warrant treatment," said study co-author Dr. Brent Hollenbeck, an associate professor of urology and director of the Herbert H. and Grace A. Dow Division of Health Services Research at the University of Michigan.

The findings were published in the June 26 issue of the Journal of the American Medical Association.

Doctors who treat prostate cancer are rethinking the options they should pursue with patients, said Dr. Durado Brooks, director of prostate and colorectal cancers for the American Cancer Society. Most prostate cancers are slow-growing, and the surgeries and therapies used to treat them can drastically affect a man's quality of life, causing incontinence and impotence.

"Many of these men have a variety of other health issues that are likely to shorten their lives," Brooks said.

What's more, new technologies like IMRT, robotic prostatectomy and proton beam therapy have not been shown to be any more effective in treating prostate cancer or avoiding side effects than established procedures like traditional external beam radiation treatment (EBRT) and open radical prostatectomy.

"The hope with these advanced treatments is that we would decrease these side effects, but it hasn't been borne out in clinical trials," Brooks said.

This has led to a movement toward observational approaches like watchful waiting, where the doctor only steps in when symptoms appear or worsen, or active surveillance, in which testing continues but no therapeutic action occurs.

"In both situations, no active treatment is applied until evidence shows the prostate cancer is progressing," Brooks said.

The research team, led by doctors at the University of Michigan, reviewed thousands of Medicare patient records, focusing on men who underwent treatment using IMRT, EBRT, robotic prostatectomy, open radical prostatectomy or observation.

IMRT uses multiple small radiation beams to precisely target a tumor, changing the intensity and shape of the beams to reduce exposure of healthy tissue and limit side effects. Robotic prostatectomy uses robot technology to create precise incisions that are more likely to spare the nerves surrounding the prostate.

The researchers found that the older, time-tested procedures are being shunted aside in favor of the more advanced technologies, which could have a huge impact on health care spending in the United States.

"Both treatments are considerably more expensive than the prior standards," the authors wrote. "Start-up costs for both approach $2 million. Further, IMRT is associated with higher total episode payments, which translate into an additional $1.4 billion in spending annually. Thus, the implications of any potential overtreatment with these advanced treatment technologies are amplified in financial terms."

Brooks said patient demand could be one explanation for the increasing use of advanced technology.

"Less than 10 percent of U.S. men who are diagnosed with prostate cancer opt for an observational approach, and the fact is about 30 percent to 40 percent have slow-growing prostate cancer or other health issues that would make them candidates for observation," he said.

That demand, however, is being driven in part by hospitals and treatment centers touting the potential benefits of new technologies. For example, a 2011 study found that nine out of every 10 hospitals with robotic prostate surgery facilities claimed on their websites that robotic prostatectomy is better than conventional surgery -- less pain, shorter recovery, less scarring and less blood loss.

"Aggressive direct-to-consumer marketing and incentives associated with fee-for-service payment may promote the use of these advanced treatment technologies," the study authors wrote. "The extent to which these advanced treatment technologies have disseminated among patients at low risk of dying from prostate cancer is uncertain."

More information

For more on prostate cancer, go to the U.S. National Cancer Institute.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Concussions appear to be a common injury for teenagers, with the risk higher not only for athletes but also for kids who drink or smoke marijuana, new research indicates.

Canadian researchers found that of nearly 9,000 Ontario adolescents, 20 percent said they'd previously had a concussion, and almost 6 percent had suffered at least one in the past year.

Sports accounted for more than half of those recent concussions, according to findings reported in a research letter in the June 26 issue of the Journal of the American Medical Association.

And teens who drank alcohol or smoked pot at least occasionally had three to five times the concussion risk of their peers who were drug- and alcohol-free.

The results give a broader idea of how common kids' concussions are, since past studies have focused on narrower groups -- such as athletes or kids who land in the hospital, said lead researcher Gabriela Ilie, of the injury prevention research office at St. Michael's Hospital in Toronto.

Experts have called concussion a "silent epidemic," Ilie said, but there is relatively little data on how common the traumatic head injuries are among teenagers. "We know it's a big public health problem, but we don't exactly how big is 'big,'" she said.

Her team's findings are based on a questionnaire of students in grades 7 to 12 -- average age 15 --from the general Ontario population. So the figures capture kids who are not on sports teams, or didn't go to the hospital for treatment.

"This is the first study I'm aware of that looked at the general population," said Kenneth Podell, co-director of the Methodist Concussion Center at the Methodist Hospital System in Houston.

Still, it's hard to know how accurate the figures are, he said, because kids reported on their own history. And any time studies rely on people's memories, that is a limitation, Podell noted.

He also saw an issue with how the study defined "concussion" -- a blow to the head that knocked the child out for at least five minutes or resulted in an overnight hospital stay.

But contrary to popular belief, most concussions do not knock people out. "We know that about 90 percent of sports-related concussions do not cause a loss of consciousness," Podell said.

So the 20 percent lifetime prevalence in this study could be an underestimate.

Podell and Ilie said it's not surprising that sports accounted for so many concussions. The study did not pinpoint which sports were the culprits, but it's known that football, ice hockey, soccer and basketball are among the riskiest activities. Even some non-contact sports, such as gymnastics and cheerleading, carry a concussion risk.

It's not clear why kids who drank or smoke pot showed a greater concussion risk, said Ilie. "All we know is, there was an association," she noted.

Podell said the finding is, again, not surprising. "We know that drinking and drug use is associated with a higher risk of injuries in general," he pointed out.

According to the U.S. Centers for Disease Control and Prevention, more than 173,000 U.S. children and teens are seen in emergency departments each year because of traumatic brain injuries, including concussion, sustained in sports or recreational activities, such as bike riding.

But the total number -- including kids not seen in the ER -- is probably much bigger: the CDC estimates that across age groups, up to 3.8 million Americans suffer a sports-related concussion each year.

Concussion symptoms include headache, dizziness, nausea, ringing in the ears, fatigue and confusion -- though these problems may not become noticeable until hours after the jolt to the head.

Ilie suggested that parents consult their doctor any time their child suffers a blow to the head. Typically, concussion symptoms improve within a few days, but if they do not -- or actually start to worsen -- parents should get medical help, Podell said.

In general, experts say kids with concussions should be symptom-free and get a doctor's OK before returning to sports. The biggest concern is that if they sustain another knock to the head while still recovering from the first concussion, they could suffer so-called second-impact syndrome -- which can cause potentially fatal bleeding inside the skull and brain swelling.

Experts are still unsure whether kids' concussions -- especially multiple concussions -- can raise their risk of degenerative brain conditions, such as Alzheimer's disease, later in life.

Podell noted that it's an important but difficult question to study. "You have to look at people over decades," he said, "and many other things happen in a person's life over those years."

More information

Learn more about concussions from the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Numerous studies have found that daily low-dose aspirin might help shield against colon cancer. But new research suggests that gene mutations found in different colon tumors may influence that relationship.

This study of data from more than 127,000 people in the Nurses' Health Study and the Health Professionals Follow-Up Study in the United States found that the benefits of aspirin used were affected by mutation of a gene called BRAF.

Specifically, regular aspirin use was associated with a lower risk of colorectal cancers characterized by the "typical" form of BRAF, but not with the risk of colon cancers with mutated forms of BRAF.

These findings suggest that BRAF-mutant colon tumor cells may be less sensitive to the effects of aspirin, according to the study in the June 26 issue of the Journal of the American Medical Association.

The researchers also found that taking a higher number of aspirin tablets a week -- more than 14 tablets -- was associated with a lower risk of colorectal cancer with typical BRAF, but this was not seen with BRAF-mutated cancers, according to a journal news release.

The research was led by Reiko Nishihara of the Dana-Farber Cancer Institute in Boston.

Importantly, regular aspirin use after a diagnosis of either type of colorectal cancer did not improve patients' survival, the team said.

"This suggests that the potential protective effect of aspirin may differ by BRAF status in the early phase of tumor evolution before clinical detection but not during later phases of tumor progression," the study authors wrote.

More information

The U.S. National Cancer Institute has more about colorectal cancer prevention.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

A Honey of a Heart Condition

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TUESDAY, June 25 (HealthDay News) -- It's a sweet treat, but too much of a certain type of honey triggered a dangerous irregular heartbeat in a Turkish father and son, according to a new report.

So-called "mad honey poisoning" is very rare but can happen, experts say. In this case, the pair consumed too much honey made from the pollen of rhododendrons, which can cause heart rhythm problems.

The case involved a 68-year-old man and his 27-year-old son in Turkey who were admitted to a hospital emergency department at the same time with symptoms of vomiting and dizziness. Doctors determined that both of them had heart rhythm problems.

Both men reported that their breakfasts over the previous three days had included large amounts of honey from the Black Sea region of Turkey. This led doctors to consider that the men could be suffering from "mad honey poisoning."

The condition can occur after people eat honey contaminated with grayanotoxin, a chemical contained in nectar from the Rhododendron species ponticum and luteum. Grayanotoxin has a harmful effect on the heart.

Mad honey poisoning typically lasts no more than 24 hours. The symptoms of the two men in the study resolved without the need for any medications. An analysis of the honey they consumed showed that it did contain pollen from the two Rhododendron species.

The study was to be presented Tuesday at the annual meeting of the European Society of Cardiology in Athens, Greece.

Mad honey poisoning occurs most frequently in people who have consumed honey from the Black Sea region of Turkey, a major beekeeping area that is also the native habitat of Rhododendron ponticum and luteum.

However, the possibility of mad honey poisoning should always be considered in any previously health person who arrives at hospital with unexplained heart rhythm problems, said study author Dr. Ugur Turk, of Central Hospital in Izmir, Turkey.

"The dissemination of honey around the world means that physicians anywhere may be faced with honey poisoning," Turk said in a cardiology society news release. He said that anyone who buys honey from Turkey should first consume a small amount and leave it a few days before eating any more in order to determine if they experience any problems.

More information

The U.S. Food and Drug Administration has more about grayanotoxin and mad honey poisoning.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Pedestrians are becoming more likely to be injured while using their cellphones and an estimated 1,500 were treated in U.S. emergency rooms in 2010 as a result, a new study finds.

It's impossible to know how many of the injuries could have been avoided if pedestrians weren't using their cellphones. The study also doesn't determine whether the injuries are on the rise simply because more people are using cellphones.

Whatever the case, study author Jack Nasar said the findings show that cellphone use isn't just a danger to drivers. It's also a hazard to those who are only strolling.

"Stop walking when you're going to take a cellphone call or text. Don't do two things at once," advised Nasar, a professor of city and regional planning at Ohio State University who studies cellphones and distraction.

Nasar and colleagues previously reported that pedestrians on public streets are more likely to have close calls with cars if they are using their cellphones. In the new study, the researchers sought to understand the risk on a national level by examining a federal database of emergency room visits from 2004 to 2010.

The investigators found that the estimated number of pedestrian injuries linked to cellphones -- including those that had nothing to do with cars, such as walking into something -- varied from as low as 256 to as high as 597 between 2004 and 2007. The numbers then jumped to 1,055 in 2008, 1,113 in 2009 and 1,506 in 2010.

Deaths are not included in the study. It also doesn't break out injuries by seriousness; some injuries were minor.

The study gives details about some injuries that have been reported. In one case, a 21-year-old male suffered a sprained elbow and spinal sprain when he was hit by a car while on his phone. In another, a 28-year-old man walked into a pole and lacerated his brow. And a 14-year-old boy fell several feet off a bridge into a ditch, bruising his chest.

People under 31 were among those most likely to be hurt while walking and using a cellphone, with those aged 21 to 25 sustaining the most injuries, followed by 16- to 20-year-olds. Men were slightly more likely (53 percent) than women to be pedestrian victims.

The estimated numbers of injuries to pedestrians on cellphones were roughly equal to those of drivers who were on cellphones. Even at the height in 2010, however, the estimated injuries accounted for fewer than 4 percent of all estimated injuries to pedestrians.

Nasar said the estimates in the study may greatly underestimate the risk of cellphone use to pedestrians.

John Lee, a professor with the department of industrial and systems engineering at the University of Wisconsin-Madison who studies distracted driving, said the new research has weaknesses. "It could be that cellphones are associated with a greater number of injuries simply because it is more likely that people are using a phone at the time," he said, "and it is hard to know if cellphone use actually causes these mishaps or is even associated with them."

Still, Lee said, "this research is consistent with other studies that show a cost of multitasking. Technology tempts us to try to do many things at once, but our ability is severely limited."

What should be done? Study lead author Nasar called for more awareness, but he doesn't support laws banning use of cellphones by pedestrians such as there are in some states for drivers.

The study appears in the August issue of the journal Accident Analysis and Prevention.

More information

For details about pedestrian safety, try the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Americans get an average of C+ on the proper use of medications, and one in seven even gets an F, a new report card shows.

Released by a pharmacists group on Tuesday, the report card was based on the findings of a national survey of more than 1,000 adults, aged 40 and older, who have received a prescription for a chronic medical condition.

The participants were asked nine questions: whether or not in the past 12 months they failed to fill a prescription; neglected to have a prescription refilled; missed a dose; took a lower dose than prescribed; took a higher dose than prescribed; stopped a prescription early; took an old medication for a new problem without consulting a doctor; took someone else's medicine; or forgot whether they'd taken a medication.

On average, the participants earned a C+ in terms of taking their medication properly. One in seven -- the equivalent of more than 10 million adults -- were given an F. Overall, one-third of respondents received either a D or F.

The report card grades may underestimate the problem because some people are unlikely to admit to improper use of medications, the National Community Pharmacists Association (NCPA) noted.

The degree of personal connection with a pharmacist or pharmacy staff was the biggest predictor of proper use of medications. Patients of independent community pharmacies had the highest level of personal connection (89 percent agreeing that pharmacist or staff 'knows you pretty well'), followed by large chains (67 percent) and mail order (36 percent).

Other factors associated with proper medication use were: whether medications were affordable; whether there was continuity in patients' health care usage; whether patients felt it was important to take their medication as prescribed; how well-informed patients felt about their health; and drug side effects.

"Proper prescription drug use can improve patient health outcomes and lower health care costs, so anything less than an A on medication adherence is concerning," B. Douglas Hoey, CEO of the NCPA, said in an association news release.

"Pharmacists can help patients and caregivers overcome barriers to effectively and consistently follow medication regimens. Indeed, independent community pharmacists in particular may be well-suited to boost patient adherence given their close connection with patients and their caregivers," Hoey added.

More information

The U.S. National Institute of General Medical Sciences has more about taking medicines.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Excessive soda consumption appeared to be the culprit in the case of a 31-year-old woman suffering from fainting spells and an irregular heartbeat after she spent more than half her life drinking only colas in place of water, a new study contends.

The reason behind her hospitalization was a dangerous drop in overall levels of potassium -- a key mineral whose absorption by the body is aided by water but crippled in the face of excess sugar or caffeine consumption, the case study authors said.

Colas are typically high in both high-fructose corn syrup and caffeine, the Monaco-based researchers noted.

"[So] the first thing to highlight is that the case we reported is exceptional," said study lead author Dr. Naima Zarqane, a cardiologist at Princess Grace Hospital Centre in Monaco. "The patient had only drunk colas from the age of 15, and this is quite unusual."

"What is positive," Zarqane added, "is that once she stopped consuming colas, everything became normal again. So, there are no grounds for consumers to panic. Nevertheless, parents should be vigilant about their children's intake of colas."

The research team is scheduled to present the findings this week at a European Society of Cardiology meeting in Athens, Greece.

In a review of previous studies, the researchers found six other reported cases highlighting the ill health effects of excess cola consumption, which ran the gamut from skeletal muscle damage to cardiovascular complications. In one instance, the patient died.

In the new study of the woman with repeating fainting spells -- officially known as "traumatic syncope" -- a physical exam turned up no obvious smoking gun. The patient had no previously identified health issues, nor a family background of sudden death, and she was not taking any chronic medications.

However, blood tests soon revealed extremely low potassium levels -- a condition called "hypokalemia" -- while an electrocardiogram (EKG) revealed problematic heart rate patterns.

When asked about her diet, the patient noted that she had stopped drinking water at the age of 15, at which point she instead began to consume about two liters of cola per day.

After cola consumption was completely eliminated from her diet, the patient's potassium levels returned to normal, while her heart reverted to a healthy routine rhythm.

Zarqane and her associates surmised that her health issues were a direct result of excessive cola consumption, given that high levels of sugar can stop water absorption in the gut, prompting diarrhea and massive potassium loss. What's more, caffeine can similarly impede potassium absorption by sending kidney function out of whack.

But though the team advised that cardiologists be aware of complications linked to soda consumption, they acknowledged that "there is clearly a need for more research on the topic, as currently we have only seven case reports on the subject."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

For his part, Dr. Kishore Gadde, director of the obesity clinical trials program at Duke University Medical Center, said that it's important to understand that ultimately the key culprit here is not too-low consumption of potassium but rather the diarrhea that causes a high degree of potassium loss.

"It is extremely rare that people develop hypokalemia due to inadequate dietary intake of potassium," he noted. "Mostly, hypokalemia is caused by excessive loss of potassium," which is brought on by diarrhea, excessive sweating and undue use of laxatives or prescription diuretics, he said.

And in that light, Gadde suggested that too much caffeine intake could be just as problematic as too much sugar.

"People who consume very large quantities of coffee and other caffeinated beverages, especially the so-called 'energy drinks,' may be at risk of drop in blood levels of potassium," he cautioned.

Athletes are particularly vulnerable, Gadde said, given the excess sweating that accompanies vigorous activity. "(And) people who are trying to lose weight often switch from sugary beverages to diet beverages, which can also increase risk for lowering of potassium levels when consumed in large quantities due to cumulative increase in daily caffeine consumption," he said.

Moderation, he concluded, "is the key to consumption of sodas and other caffeinated beverages."

That point was seconded by Lona Sandon, a registered dietitian and an assistant professor of clinical nutrition at the University of Texas Southwestern at Dallas.

"Common sense and critical thinking should tell us that relying solely on soda for fluid intake is not healthy," Sandon said. "Heavy reliance on any one single food or beverage is not recommended."

More information

For more about healthy hydration, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Children with attention-deficit hyperactivity disorder should be steered away from contact sports such as football or basketball because these kids may be at greater risk of long-lasting head injury than their peers, a new study recommends.

Scientists found that children with ADHD -- who are already prone to risk-taking behaviors -- were much more likely than kids without the disorder to suffer a moderate disability after sustaining a mild traumatic brain injury from events such as car accidents, falls and injuries from high-impact sports.

"This was a phenomenon that I had noticed in my own practice -- some children with ADHD didn't recover as well following a traumatic brain injury," said senior study author Dr. Stephanie Greene, an assistant professor of neurological surgery at Children's Hospital of Pittsburgh. Some of the symptoms of traumatic brain injury are also symptoms of ADHD -- disinhibited behavior and impaired memory, she noted. "The effects of the [traumatic brain injury] may be additive to those of ADHD," she explained.

Encouraging activities in which the chances of brain injury are lower -- for example, swimming or track instead of football or basketball -- is a way in which parents can provide an outlet for energy while protecting their child's brain, she added.

The study is published online June 25 in the Journal of Neurosurgery: Pediatrics.

About 8 percent of American children have ADHD, a neurological disorder characterized by problems focusing, being overactive and exhibiting poor impulse control, according to the U.S. Centers for Disease Control and Prevention. Traumatic brain injury results in more than 7,000 deaths, 60,000 hospitalizations and 600,000 emergency room visits annually in the United States, according to the study. Prior research has linked several aspects of ADHD and traumatic brain injury.

In the new study, Greene and her colleagues reviewed medical charts of all patients at Children's Hospital of Pittsburgh who had ADHD and were diagnosed with a mild traumatic brain injury between 2003 and 2010. Forty-eight of these children were compared with a control group of 45 children without ADHD who had also sustained a mild traumatic brain injury.

The researchers found that 25 percent of the ADHD group suffered a moderate disability, and 56 percent had completely recovered after a nearly six-month follow-up period. In contrast, among the patients without ADHD, only 2 percent suffered a moderate disability and 84 percent had completely recovered after a much shorter follow-up of seven weeks. Moderate disability was defined as needing supervision or help for physical or behavioral problems, or having residual problems with learning or functioning.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, praised the study's design and said the authors excelled at explaining the possible implications of the findings.

"As someone who specializes in the evaluation and care of children with ADHD, I know they are at increased risk of injury," he said. "I think this study is suggesting that if they do experience a significant head injury, they may have greater long-term problems from that. Why that's true is hard to know."

The study made several recommendations stemming from the results, including that doctors should counsel families of children with ADHD about expected outcomes after a head injury; that more intensive treatment and rehabilitation for these patients be initiated; and that parents perhaps discourage children with ADHD from sports or hobbies that carry higher risks of sustaining a traumatic brain injury.

"Part of the problem with children with ADHD is that they often have poor impulse control, which means that they are at higher risk of sustaining a [traumatic brain injury] by engaging in risk-taking behaviors in daily life, separate from sports," Greene said. "When risky sports are added to the already elevated risk of [traumatic brain injury], the chances of a child sustaining a [traumatic brain injury] with potentially lingering effects become unacceptably high."

But Adesman said the findings need to be replicated before he would agree with curtailing contact sports for children with ADHD.

"I would not steer all kids with ADHD away from contact sports based on single study," he said. "Certainly we know that kids can experience accidents thru a variety of means . . . sports accidents made up a very small percent of accidents" in this study.

More information

The U.S. Centers for Disease Control and Prevention has more information about traumatic brain injury.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Five newly identified genetic regions linked to the onset of migraine could boost scientists' understanding of what drives the painful headaches, researchers say.

"This study has greatly advanced our biological insight about the cause of migraine," Dr. Aarno Palotie, from the Wellcome Trust Sanger Institute in the United Kingdom, said in an institute news release. Migraine is difficult to study, he added, because "between episodes the patient is basically healthy, so it's extremely difficult to uncover biochemical clues."

In their research, Palotie's team pinpointed five genetic regions tied to migraine. They did so after analyzing the results of 29 different genetic studies involving more than 100,000 samples from people with and without migraines.

Some of the five regions are close to a network of genes that are sensitive to oxidative stress, a biochemical process that leads to improper functioning of cells. The researchers believe that many of the genes in regions associated with migraine are interconnected and may be disrupting the internal regulation of tissue and cells in the brain, resulting in some of the symptoms of migraine.

The researchers also identified another 134 genetic regions that are possibly associated with migraine susceptibility.

Migraine affects about 14 percent of adults, and according to the researchers this was the largest study of migraine genetics to date.

"We would not have made discoveries by studying smaller groups of individuals," study co-author Dr. Gisela Terwindt, of Leiden University Medical Centre in the Netherlands, said in the news release. Having such a large study population "means we can tease out the genes that are important suspects and follow them up in the lab."

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- If you have a baby who's learning to talk, you may feel the need to chatter incessantly to boost her vocabulary, but a new study says another factor is crucial: the ability to provide non-verbal clues that help an infant figure out what words mean.

In other words, it's vital to not only talk to babies but also connect the words you use to the world in which you are using them, the research suggests.

The good news is that anyone -- regardless of education or vocabulary level -- can use this approach to teach language to babies, said study co-author Lila Gleitman, a professor of psychology and linguistics at the University of Pennsylvania. "If you took the effort to talk to your kid about the here-and-now, you'd have an impact on how they learn the meaning of words," she added.

And a better vocabulary, she noted, often translates to more success in school and in life.

At issue is the way humans learn language, especially as babies when words or grammar don't make sense. At the very start, a parent needs to do some world-to-word pairing, linking objects like a cat or a spoon to the word for each, Gleitman explained.

But one expert added that it's not just a matter of pointing to something and saying it's a banana or a dog or a couch.

For example, if you point to the sky and say something is an "airplane," the child might not know if that's the plane or the cloud next to it or a bird flying above, said Skott Freedman, an assistant professor who studies vocabulary at Ithaca College in New York. That's where the teaching talent of parents comes in.

The new study tried to figure out how a parent's ability to provide context affects a child's vocabulary in the long run.

To do this, the researchers created an experiment aimed at helping them understand which parents provided more context for the words they spoke to their kids. They told 218 college students to look at a muted video of 50 parents talking to their babies, and asked the students to try to figure out the words the parents were using.

The theory is that the students would detect more words from the silent video if the parents provided more nonverbal context by, say, pointing at objects they're talking about to the child.

The researchers then waited three years and analyzed the vocabulary of the babies, who were initially between 14 to 18 months old.

The results: Kids had bigger vocabularies if the words of their parents were more decipherable by the college students. This trend wasn't affected by the education and income of the parents, suggesting that it's not a matter of the parents simply knowing more words.

What does this mean in the big picture? "There's definitely a message for parents," Freeman said. "The message is not how much you talk to your children, it's how you talk to your child."

Study co-author Gleitman put it this way: "Talk to them about the objects and things you bring to their attention: 'Look at this strawberry. I see you're eating your peas, what nice little peas.'"

This simple approach, she said, can make a world of difference.

The study appears in this week's issue of the Proceedings of the National Academy of Sciences.

More information

For more about child development, try the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 25 (HealthDay News) -- Exercise benefits people with type 2 diabetes even if they don't make any other lifestyle or diet changes, a new study says.

Dutch researchers conducted MRI exams of 12 patients with diabetes before and after they did six months of moderate-intensity exercise. Each week, the participants, who were an average age of 46, exercised between three and a half and six hours a week during two endurance and two resistance training sessions.

The six-month exercise program ended with a 12-day trekking expedition, according to the study published online in the journal Radiology.

There were no changes in the participants' heart function at the end of the exercise program. But they did have significant decreases in the amount of fat in the abdomen, liver and around the heart, all of which have been shown to be associated with increased risk of heart disease.

"In the present study, we observed that the second layer of fat around the heart -- the pericardial fat -- behaved similarly in response to exercise training as intra-abdominal, or visceral fat. The fat content in the liver also decreased substantially after exercise," study senior author Dr. Hildo Lamb, of the Leiden University Medical Center in the Netherlands, said in a journal news release.

He said these exercise-related fat reductions in the liver are particularly important to people with type 2 diabetes, many of whom are overweight or obese.

"The liver plays a central role in regulating total body fat distribution," Lamb said. "Therefore, reduction of liver fat content and visceral fat volume by physical exercise are very important to reverse the adverse effects of lipid accumulation elsewhere, such as the heart and arterial vessel wall."

More information

The American Academy of Family Physicians has more about diabetes and exercise.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 25, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Calif. Inmates Must be Moved Due to Fungus Threat: Judge

Thousands of inmates must be moved out of two California prisons because they are at high risk of being infected with a potentially deadly airborne fungus, a federal judge ruled Monday.

U.S. District Judge Thelton Henderson issued the order for mostly black, Filipino and medically at-risk inmates at Avenal and Pleasant Valley state prisons. They account for about 3,250 of the two prisons' 8,100 inmates, the Associated Press reported.

The judge made the ruling because these inmates face the greatest risk from valley fever, a fungal infection that originates in the soil of the San Joaquin Valley, where the two prisons are located.

Henderson gave the state 90 days to fully comply. The state is reviewing the judge's order, Department of Corrections and Rehabilitation spokeswoman Deborah Hoffman told the AP.

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Generic Drug Makers Not Responsible for Drug Design Defects: U.S. Supreme Court

Generic drug makers can't be sued by patients who claim that medicines they took were defectively designed, the U.S. Supreme Court ruled Monday.

The 5-4 decision overturned the 2010 verdict of a New Hampshire jury that awarded $21 million to a woman who developed a serious skin disease after taking a generic version of the pain medication sulindac, The New York Times reported.

The generic drug maker in the case, the Mutual Pharmaceutical Company, was required by federal law to make a copy of the brand name drug Clinoril and could not be held responsible for claims that the generic drug was unsafe, the court said.

While the ruling is a major victory for the generic drug industry, it limits the legal options for people who are injured by generic drugs.

"Now, presumably, a patient harmed by those drugs has no remedy, either through a defective warning or a defective design argument," Bill Curtis, a Houston lawyer who specializes in pharmaceutical cases, told The Times.

-----

No Further Cancer Treatment Required for Former Quarterback Jim Kelly

Former Buffalo Bills quarterback Jim Kelly has confirmed that he does not require chemotherapy or radiation to further treat the cancer found in his jaw.

Earlier this month, Kelly underwent surgery to remove part of the jaw. Speaking to reporters at the opening of his football camp Monday, Kelly said his doctors told him the surgery was successful in removing all traces of cancer, NBC News reported.

Kelly said he will continue to be monitored every couple of months to guard against a return of the cancer.

The support of people in Buffalo during his struggle with cancer meant a lot to him, Kelly said, NBC News reported.

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Get Active!

By on

(HealthDay News) -- Keeping a log of your physical activity can help motivate you to get enough exercise and track your progress.

The Weight-Control Information Network says you should include the following information in your activity log:

  • Date of your activity.
  • Time spent on each activity.
  • Type of activity (ie., walking or gardening).
  • Your goal for each activity.
  • How you felt during and after each activity.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Dealing With Dandruff

By on

(HealthDay News) -- Dandruff, medically called seborrheic dermatitis, is characterized by dry, flaky skin on the scalp. Though it can be embarrassing, especially to folks who wear black, there's no evidence that it's harmful.

The American Academy of Family Physicians offers these treatment suggestions:

  • Look for a dandruff shampoo that includes salicylic acid, selenium sulfide or zinc pyrithione.
  • When dandruff is present, use this shampoo daily until symptoms are controlled, then switch to two to three times per week.
  • When shampooing, lather and let sit for five minutes before rinsing out.
  • If a dandruff shampoo doesn't control symptoms, talk to your doctor about adding a prescription steroid lotion.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Weight loss accomplished from diet and exercise does not appear to cut the risk of heart problems for people with diabetes, a new study finds.

Lifestyle changes have long been the bedrock of treatment for type 2 diabetes. Doctors advise patients to eat carefully and stay active to help control blood sugar and cut the risk of long-term complications, which include at least a doubling in the risk for heart attacks and strokes.

But the new study, published online June 24 in the New England Journal of Medicine, suggests that the benefits of diet and exercise may be more limited than previously believed.

Even so, researchers say, people with diabetes shouldn't give up on their efforts to eat less and move more. Additional findings from the study being presented at an American Diabetes Association meeting in Chicago show that lifestyle changes may have benefits beyond the heart, including lowering the risks for kidney failure and eye damage that may lead to blindness.

For the trial, researchers split more than 5,000 adults with type 2 diabetes into two groups. The first group was assigned to lose weight by exercising and cutting calories. They were given a goal to eat between 1,200 and 1,800 calories a day and to complete at least 175 minutes of moderate-intensity exercise each week.

To speed weight loss, participants used shakes and snack bars to substitute for as many as two meals each day. If they hadn't lost 10 percent of their initial weight by six months, they could also take the fat-blocking drug orlistat, which is sold over the counter as Alli, for a short time.

The other comparison group met three times each year for group counseling sessions. They were given lessons about the importance of using exercise, diet and social support to help manage the condition.

All participants were overweight and between 45 and 75 years of age. Their average starting weight was about 220 pounds. Most had been living with diabetes for at least five years.

Both groups lost weight, and, for the most part, managed to keep it off.

But the weight loss was modest. After one year, people in the diet-and-exercise group had lost about 8 percent of their starting weight, or about 18 pounds. Although they regained some of that over the next eight years, they still managed to keep off a 6 percent loss, or about 14 pounds on average. The comparison group shed about 10 pounds during the study, a difference of about 2.5 percent between the two groups.

But the group that ate less and moved more had just as many heart attacks, strokes, heart-related deaths and hospitalizations for chest pain as those in the comparison group.

The results between the two groups were so similar that last fall researchers stopped the trial about four years earlier than originally planned for "futility."

The researchers said there may be several reasons they didn't see a difference in heart problems between the two groups. One was the relatively modest weight loss.

"And perhaps that's not enough to see this difference," said study author Rena Wing. "Maybe you need larger weight losses." Wing is director of the Weight Control and Diabetes Research Center at Miriam Hospital, which is affiliated with Brown University in Providence, R.I.

Studies have shown that bariatric surgery, which typically leads to more dramatic weight loss as well as to significant changes in metabolic chemistry, may have more pronounced benefits for people with diabetes, though "it also has more risks," Wing said.

Participants in the new study were relatively healthy when it started. Their average hemoglobin A1C level, a measure of how well patients control their blood sugar over time, was 7.2 in the lifestyle-change group and 7.3 in the control group. The goal for most people with diabetes is an A1C level under 7, said Dr. Minisha Sood, who heads the diabetes committee at Lenox Hill Hospital in New York City. "These people were pretty near their goal A1C," Sood said.

She said diet and exercise may have bigger heart benefits in patients who aren't as well controlled.

In addition, the comparison group took more heart-protective medications, particularly cholesterol-lowering statins, than the diet-and-exercise group. The comparison group had lower average LDL, or "bad" cholesterol throughout the study, which may mean that diet and exercise works about as well as drugs to protect the heart, not that lifestyle changes don't work at all.

Indeed, the rate of heart events two years into the study was lower than the researchers had anticipated, leading them to adjust the main goals of the study to include a more controversial measure of heart disease -- episodes of chest pain serious enough to cause hospitalization. Chest pain episodes were similar between the two groups, and may have diminished the study's ability to detect differences in more serious events like heart attacks and strokes.

One expert said stopping the study early may have had an impact on the results.

"My impression is that the trial was stopped too soon," said Dr. Frank Sacks, a professor of cardiovascular disease prevention at the Harvard School of Public Health. Sacks has seen the study, but was not involved in the research. "This can produce an underestimate of the effect of treatment."

The bottom line is that weight loss may not be enough to protect people with diabetes from heart disease, although it may have important benefits that go beyond the heart.

Study author Wing, however, said researchers found many other reasons doctors should continue to recommend diet and exercise for their patients. These findings were not part of the main outcomes of the NEJM study but were presented at the diabetes meeting.

Some of the most important improvements were related to the havoc diabetes can inflict on the smallest blood vessels in the body. These microvascular complications of diabetes can damage the kidneys, which often leads to dialysis, and damage to the retina of the eye, which can cause blindness.

"Intensive lifestyle intervention reduced the risk of chronic kidney disease by 31 percent," Wing said. "So we had a very, very marked effect on the development of high-risk chronic kidney disease. We also showed a benefit in terms of self-reported eye disease."

People who made lifestyle changes also had less serious depression, and they had better physical function than people in the comparison group. Because they needed fewer medications and went to the hospital less often than people in the control group, they saved money on their medical care -- about $600 a year, or $5,000 over the course of the study.

"That's pretty remarkable," said Sood at Lenox Hill Hospital, who will continue to recommend lifestyle changes that lead to weight loss, although her reasons for doing so will shift slightly. "Now we have data to show that quality of life, depression and other complications will improve."

More information

To learn more about managing diabetes, head to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Breast-feeding, a practice already linked with many health benefits, could help a child become more upwardly mobile as an adult, British researchers report.

"Breast-feeding has lifelong benefits," said study author Amanda Sacker, a researcher at the University College London. "Breast-feeding not only gives children a good start in life, but also boosts chances of a healthy and successful adulthood. For most women, breast-feeding offers them a simple way to improve their child's life chances."

The study was published online June 24 in the Archives of Disease in Childhood.

Sacker and her team looked at data from the British Cohort Studies, comparing two groups of children: One included more than 17,000 babies born in 1958; the other included more than 16,000 infants born in 1970.

While 68 percent of the mothers breast-fed the children born in 1958, only 36 percent of the mothers who gave birth in 1970 did. The children were grouped into three categories: never breast-fed, breast-fed for less than four weeks; and breast-fed for at least four weeks.

All the children were tracked into adulthood and, at multiple time points, were interviewed, tested for brain development and given medical exams.

For this analysis, Sacker said, the researchers weighed many factors, including a parents' social class when the child was born. Social class was defined on a scale ranging from unskilled or semi-skilled manual to professional and managerial. They also took into account the fact that some groups of women may be less likely to breast-fed and some may have different levels of education.

Then, they looked at those children who became upwardly mobile adults. Upward mobility was defined as a social class higher than what the father's social class was when the child was 10 or 11. Downwardly mobile was the opposite.

According to their findings, breast-feeding increased the odds of upward mobility by 24 percent, Sacker said, and reduced the odds of downward mobility by about 20 percent for both those born in 1958 and in 1970.

It did seem, she added, that the longer children were breast-fed, the higher the odds of upward social mobility.

The study does not prove cause-and-effect, Sacker noted, and it is not clear which aspect of breast-feeding is most beneficial, physical contact or the nutrients in breast milk. The nutrients aid growth and brain development, she said, which in turn can lead to better thinking and reasoning skills and eventually more success in life as an adult. The contact promotes bonding, also healthy for the child.

The new study echoes results found in British research that was published in 2007. In that study, researchers followed 1,400 babies born in 1937 to 1939 for 60 years, and also found breast-fed babies were more likely to move up in social class.

The findings from the new study make sense, said Dr. Dennis Woo, former chair of pediatrics at the UCLA Medical Center, in Santa Monica, Calif.

Other studies have shown multiple health benefits for breast-fed children, he said, including intellectual benefits.

However, he cautioned that parents shouldn't think breast-feeding is a guarantee of upward social mobility for their baby. "It would be simplistic to think that one factor is responsible for success in life," he said.

More information

To learn more about the benefits of breast-feeding, visit U.S. Department of Health and Human Services.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- All adults born between 1945 and 1965 -- the baby boom generation -- should be screened for the hepatitis C virus along with injection-drug users and anyone transfused before 1992, according to new recommendations from the U.S. Preventive Services Task Force.

The guidelines, released Monday, mirror recommendations from the U.S. Centers for Disease Control and Prevention and provide a long-awaited policy from the task force, an independent panel of experts.

"For everyone born between 1945 and 1965 we recommend a one-time screening," said task force member Dr. Kirsten Bibbins-Domingo, an associate professor in residence at the University of California, San Francisco, School of Medicine.

People in this age group account for three-quarters of all hepatitis C cases in the United States, Bibbins-Domingo said. Many contracted the disease decades ago but don't know it.

Hepatitis C -- a leading cause of liver damage and liver disease in the United States -- is considered a silent killer because it progresses without any indications of illness. More than 30 percent of U.S. patients needing liver transplants have end-stage liver disease related to hepatitis C.

"The challenge is that many people have hepatitis C and don't have signs and symptoms of the disease," Bibbins-Domingo said. "Those people should be identified and consider treatment."

An estimated 3.9 million people are infected with hepatitis C in the United States, the task force said. Unlike other types of hepatitis, there is no vaccine for hepatitis C.

In its 2004 statement, the task force advised against routine screening of adults without symptoms and high risk of infection. It also said it had too little evidence to recommend for or against routine screening for adults with high risk of infection.

It became apparent, however, that two-thirds of infected people weren't getting screened, while treatment was becoming more successful.

"Many people appear to benefit from treatment," Bibbins-Domingo said. "That is what led the task force to conclude that it is beneficial for people to find out they have hepatitis C in order to seek treatment."

Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said he welcomes the new guidelines, which were published June 25 in the Annals of Internal Medicine.

"I am absolutely thrilled that the U.S. Preventive Services Task Force, which has had a head-in-the-sand approach toward screening, has come out for a one-time screening for hepatitis C," Siegel said.

Siegel encourages everyone at risk to get tested.

Screening for hepatitis C involves a simple, inexpensive blood test. Those who test positive usually receive a course of antiviral medication over several months. Most people have no detectable virus following treatment, Bibbins-Domingo said.

"Treatment is effective in preventing the complications of hepatitis C," Bibbins-Domingo said. "Treatments have gotten better, and I suspect treatments will continue to get better."

Many people who test positive for the virus have no signs of active infection. Whether they should be treated should be discussed with their doctor, she said.

Although baby boomers should have a one-time screening, those who continue to be at risk for the infection should be screened more often, Bibbins-Domingo said.

Past or current injection-drug use is the greatest risk for hepatitis C infection. Also at high risk are people with a history of blood transfusions before widespread adoption of screening and infection-control measures in 1992; people who have undergone long-term dialysis treatment; and those with exposure to hepatitis C in health care settings. People with HIV/AIDS, a history of intranasal drug use or tattoos from unregulated or unsafe parlors also are at greater risk than the general population.

This expanded screening may identify millions of Americans who were unaware of their infection, the task force said.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Borrowers who struggle with math are more likely to fall behind on their mortgage payments and face foreclosure than those who have stronger financial skills, new research suggests.

The study results offer a provocative new reason for the 2008 subprime mortgage crisis: Borrowers who got into trouble weren't simply the victims of tricky or unfair loans. It could have been that they also didn't have the math skills to manage their personal finances through difficult economic times.

"I think this is a very important paper," says Annamaria Lusardi, a professor of economics and accountancy at George Washington University in Washington, D.C.

"We have to make a lot more financial decisions than in the past, and we have to be equipped to make those decisions," said Lusardi, an expert on financial literacy who was not involved in the research. "Financial literacy is missing in our schools, and I think as a result, we're not equipped to make decisions about complex financial products."

For the study, which is published in this week's issue of the journal Proceedings of the National Academy of Sciences, researchers used proprietary data collected on subprime mortgage borrowers in New England in 2006 and 2007 to examine the details of the types of loans they took out on their homes and their payment histories.

They then called about 300 of those borrowers and asked questions about their financial situations, including their household income, age, education, marital status and credit score. They asked a set of questions designed to assess general intelligence. Finally, in a test that might strike fear in the hearts of arithmophobes everywhere, they threw in a set of word problems designed to test a person's ability to do basic calculations.

"There were five questions, and they got more and more complicated," said study author Stephan Meier, an associate professor at Columbia Business School. "The simplest one was: There is a sofa that costs $300 when it's full price, and it's on sale for half the price. How much is it on sale?"

Next up: There's a disease, and the probability of getting the disease is 10 percent. How many people out of 1,000 got the disease?

The researchers found that people with less mathematical ability were more likely to fall behind on their mortgages than those who were better at math. Only 7 percent of people with the highest scores on numerical ability ended up in foreclosure, compared to 20 percent of those who were not as good with numbers.

That was true even when the researchers took into account other factors that might impact a person's ability to pay their bills, such as total income and credit score. In fact, a person's credit score when they took out their mortgage wasn't related to later default.

In the second phase of the study, researchers tried to understand why numerical ability was tied to mortgage default.

"We had this hypothesis that people who are not so good with numbers will have problems with decisions that involve a lot of numbers, which are mortgage choices, which we all know are terribly complicated," Meier said. For example: "Something went wrong when they bought their mortgage. They had too big of a mortgage, they leveraged too much."

But that wasn't what happened.

People with high numerical ability appeared to have the same mortgage terms as those with low numerical ability.

Researchers think borrowers with low numerical skills got into trouble after they took out their mortgages because they weren't able to manage other aspects of their personal finances as well as people who were more comfortable with numbers.

"Say you have a mortgage and suddenly you get hit by an income shock. How you can weather such a shock is that maybe you have some savings on the side ... or you need to re-budget," Meier said. "People who are not so good with numbers may be bad at doing that, and it's really outside the mortgage choice."

That's just an educated guess, however. The study wasn't designed to prove that low numerical ability caused people to default on their home loans. It just suggests a relationship between the two. There could be other variables that weren't measured by the study that could have impacted the results.

People who are bad at math can at least take comfort in one finding from the study: Struggling with math doesn't indicate lower intelligence. Numerical ability doesn't seem to be tied to IQ.

Still, the study adds to a growing body of evidence suggesting that the ability to make sound financial decisions is linked to the ability to understand math and be comfortable with certain calculations.

"There's evidence that financial literacy affects behavior in other dimensions, very similar to this one," said Lusardi, who is campaigning to get more schools to add financial literacy to their curricula. "It's important for savings for retirement and for paying off credit cards, and we see the links to financial literacy in those behaviors as well. These things really do matter."

More information

For more on financial literacy and why it matters, head to the U.S. Department of the Treasury.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- There's a right way and a wrong way to persuade your adolescent to eat healthy and help avoid obesity, a new study suggests.

Pointedly connecting food with fatness or talking about needed weight loss is the wrong way and could even encourage unhealthy eating habits, researchers report.

Instead, discussions that focus on simply eating healthfully are less likely to send kids down this road, a new study shows.

"A lot of parents are aware of the obesity problem in the U.S -- it's everywhere you turn -- but they wonder how to talk about it with their children," said study lead author Dr. Jerica Berge of the University of Minnesota Medical School in Minneapolis.

She advises that parents "tell kids to eat more fruits and vegetables because eating them will make them healthy and strong. Don't connect these conversations to weight and size."

The study is published online June 24 in JAMA Pediatrics.

Childhood obesity has more than tripled in adolescents in the United States over the past 30 years, according to the Centers for Disease Control and Prevention. This has had a profound effect on children's health, with condition formerly only seen in adults, such as type 2 diabetes and high blood pressure, now being diagnosed in children.

The new study included survey data from more than 2,300 adolescents with an average age of about 14 and more than 3,500 parents.

Overall, the data showed, conversations about eating that focused on a child's supposed need to lose excess weight were linked to a higher risk of problem dieting and other unhealthy eating behaviors among adolescents.

On the other hand, parents who talked about healthy eating and living but did not focus on weight and size were less likely to have children who dieted or engaged in other unhealthy eating behaviors such as anorexia, binge eating or bulimia.

These benefits were seen in both overweight and normal weight teens, the study showed.

Overall, about 28 percent of moms and 23 percent of dads of kids who were not overweight said they had conversations that focused on healthy eating, while only 15 percent of moms and 14 percent of dads who had overweight children said they talked about health.

About 33 percent of moms and 32 percent of dads of non-overweight kids said they discussed weight and the need to lose weight; for overweight kids, that number rose to 60 percent of moms and 59 percent of dads.

Berge stressed that even when parents say all the right things about eating, it doesn't matter much if children see Mom and Dad ignoring their own advice.

It's "do as I do," she said. "Modeling does have a big role in showing kids the type of behavior that you want them to take on."

Also, Berge added, "these conversations have to happen way more than at dinner. They are not in-the-moment conversations, but ongoing ones."

Outside experts were quick to agree that focusing on health is more valuable than nagging kids about their weight and size.

"Telling people that they are fat or overweight is not in the best interest of the adolescent," said Dr. Ronald Feinstein, an adolescent medicine specialist at Cohen Children's Medical Center in New Hyde Park, N.Y. "We need to focus on healthy lifestyle, and parents need to lead by example," he said. This includes appropriate meal planning and having healthy food available.

Sometimes this involves a little troubleshooting, Feinstein added.

"At a restaurant, quietly ask the server not to put the bread basket out, or hand out one slice to everyone and then have it removed, so it's the family making the decision and no one feels left out," he said. "Set an example and avoid putting kids in a position where they have to make poor choices."

Dr. Scott Kahan, director of the National Center for Weight and Wellness, in Washington, D.C., agreed that weight is not always an easy subject to broach with adolescents.

"Some parents would rather talk about sex and drugs than weight," he said.

"I always try to focus on health, not appearance," Kahan added. The new findings "lend further weight to the importance of finding careful loving, supportive and appropriate ways of discussing health with kids," he said.

More information

First Lady Michelle Obama's Let's Move initiative is aimed at promoting healthy behaviors for kids.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Women aged 50 to 55 who take hormone therapy to relieve the symptoms of menopause can expect no benefit or risk to their memory or other thinking skills due to the treatment, according to new research.

The study was done to evaluate more closely the effect of the hormone treatment on women during the years menopause typically begins.

An earlier study, the Women's Health Initiative Memory Study, found that the hormone treatment produced deficits in thinking ability when given to women 65 years old and older. And other WHI research has found that hormone therapy can increase the risk of breast cancer, heart disease and stroke but protect against osteoporosis, the brittle bone disease.

Based on that research, many experts now suggest that the hormone therapy be taken, if needed, to relieve menopausal symptoms on a short-term basis.

In the new study, the focus was on women who begin hormone therapy between ages 50 and 55, the time period during which menopause typically begins, and evaluate the effect on thinking skills.

"We found no long-term harm on cognition when these drugs were prescribed when women were 50 to 55," said Mark Espeland, a professor of public health sciences at Wake Forest School of Medicine in Winston-Salem, N.C.

The study was published online June 24 in the journal JAMA Internal Medicine.

Espeland and his team compared women who were given either combination estrogen and progesterone treatment or estrogen alone (which is given in women who have had a hysterectomy). About half of the more than 1,300 women assessed were randomly assigned to take hormone therapy, while the other half were on placebo therapy.

During the follow-up period of about seven years, the women took tests of memory, verbal fluency and other skills during telephone interviews. Nearly 1,200 completed the second and final assessment.

Overall, Espeland said, no sustained benefit or risk to brain functioning was found. Test scores of the women on hormone therapy were similar to the scores of those on placebo. For women on estrogen alone, verbal fluency was affected, he said, but that may be a chance finding.

Deciding whether to prescribe hormone therapy always involves weighing benefits and risks, said Dr. Jennifer Leighdon Wu, a gynecologists at Lenox Hill Hospital in New York City. She was not involved in the study but reviewed the findings.

"For women 50 to 55, we can probably take cognition out of the equation when weighing risks and benefits," Wu said. "In the past, we used to think hormones would keep brains young and [help women] continue to have better brain function," she said. However, later research disputed that thinking.

Now, Wu said, the new research suggests that for women aged 50 to 55, hormone therapy "is not going to preserve or worsen cognition."

The bottom line? Preserving memory and other thinking skills, Wu said, "is not a reason to start hormone therapy or avoid hormone therapy."

Francine Grodstein, associate professor of medicine at Brigham and Women's Hospital and Harvard Medical School, who wrote a commentary accompanying the study, said, "I think the primary message here is reassurance."

It probably won't be the last study to examine the issue, Grodstein said. Even so, she said, "To me the most important finding of this study is to reassure younger women if they need to take hormone therapy to treat menopausal symptoms there is no obvious harm to brain health."

The study was primarily supported by the U.S. National Institute on Aging. One researcher reported research grants to her institution from a variety of pharmaceutical makers.

More information

To learn more about hormone therapy, visit the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- A new study suggests that an increase in blood transfusions for patients with sickle cell disease may have caused a drop in the number of black children suffering from ischemic strokes -- attacks brought about by a blockage in an artery.

Black children, however, still have a much greater risk of death from hemorrhagic (bleeding) strokes than white children, the new study finds.

Sickle cell disease gets its name from the shape of the red blood cells in someone who has it. They're crescent-shaped, similar to a farm tool called a sickle. These abnormally shaped red blood cells become hard and sticky and can clog the blood vessels, creating pain, according to the U.S. Centers for Disease Control and Prevention.

In the new study, researchers led by Dr. Laura Lehman of Boston Children's Hospital analyzed U.S. death certificate data for all children who died from 1988 through 2007. There were more than 4,400 deaths attributed to stroke, an average of 221 per year.

Twenty percent of the stroke deaths were caused by ischemic stroke, 67 percent by hemorrhagic stroke and 12 percent were unspecified, according to the study, which was published online June 26 in the journal JAMA Pediatrics.

In the period between 1988 and 1997, black children were 74 percent more likely to die from an ischemic stroke compared to white children, but that relative risk fell to 27 percent during the period from 1998 to 2007, the researchers found.

The relative risk for hemorrhagic stroke death, however, rose slightly over the same time period. From 1988 to 1997, black children were 90 percent more likely than whites to die from this type of "bleeding" stroke, and that number rose to 97 percent from 1998 to 2007.

"The excess risk of death from ischemic, but not hemorrhagic, stroke in U.S. black children has decreased over the past decade," the study authors wrote. "The only major change in childhood stroke care during this period was the initiation of long-term blood transfusion therapy for primary stroke prevention in sickle cell disease."

Two experts agreed that the change in the frequency of blood transfusions for children with sickle cell disease -- which predominantly affects blacks -- is driving the trend toward fewer ischemic strokes in black children.

The practice of giving sickle cell patients blood transfusions "occurred as a result of the STOP study, published in 1998," said Dr. Winfred Wang, a sickle cell expert at St. Jude Children's Research Hospital in Memphis, Tenn. "In this trial, ischemic stroke was reduced by 90 percent by placing children on chronic transfusion if they were at high risk for stroke, based on [ultrasound] screening of blood flow in cerebral arteries."

"This intervention has had a profound effect on the welfare of children with this condition," Wang said.

Dr. Rafael Alexander Ortiz, director of neuro-endovascular surgery and stroke at Lenox Hill Hospital in New York City, agreed with Wang that the new study "demonstrated the long-term effectiveness and results after implementation of blood transfusions as a preventive measure for children with sickle cell disease."

More information

The Nemours Foundation has more about strokes and children.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Homes that are close to fracking sites are at higher risk of having their drinking water contaminated by combustible gases, according to a new study.

Researchers from Duke University in Durham, N.C., analyzed drinking water samples from 141 private water wells in the Marcellus shale basin in northeastern Pennsylvania, where companies are using hydraulic fracturing to tap hard-to-access pockets of natural gas.

They detected methane in 82 percent of the drinking water samples, with the average concentrations six times higher for homes less than one kilometer -- about six-tenths of a mile -- from a natural gas well, according to findings published online June 24 in the Proceedings of the National Academy of Sciences.

In the study, which was strongly disputed by the oil and gas industry, the scientists also found higher concentrations of ethane and propane in drinking water wells less than six-tenths of a mile from shale gas drilling. Ethane concentrations were 23 times higher in water wells located near gas drilling, while propane was found in 10 wells all within a kilometer of a drill site.

"We were surprised to find such high concentrations, but we were also surprised to see such a strong effect of proximity to gas wells," said Robert Jackson, a professor of environmental sciences at Duke's Nicholas School of the Environment.

Jackson added that there is no biological source of ethane and propane in the region, which makes the Marcellus wells the chief suspect for the contamination.

The risk of fire and explosion is the main public health risk from the presence of these gases in drinking water, said Dr. Georges Benjamin, executive director of the American Public Health Association in Washington, D.C.

"These are volatile gases and in particular concentrations, they burn," Benjamin said. "If they leak into your home and build up, particularly in enclosed spaces, there's an explosive risk."

Based on what is now known, there seems to be no risk involved in ingesting the gases by drinking the water. "I just can't imagine how anyone would drink enough to make them sick," Benjamin said.

Hydraulic fracturing, also called fracking, is a controversial process that involves pumping water, sand and chemicals deep underground at high pressure to crack open hydrocarbon-rich shale and extract natural gas. Prior studies have raised concerns that such drilling techniques could lead to contamination of drinking water supplies.

Jackson believes the contamination is the result of faulty well construction, with gases escaping from flaws in either the steel tubing or the concrete seal that surrounds the tubing.

"We don't think the gases are migrating up through thousands of feet of rock to contaminate ground water," he said. "If the well isn't sealed properly with cement, you can have gas from thousands of feet down move up the outside of the well and into people's drinking water without ever seeing natural gas leak out from the Marcellus."

Industry spokesman Jim Smith criticized what he called key flaws in the Duke study. For example, he noted that the water samples were not taken randomly, but from wells chosen by the researchers in cooperation with homeowners' associations and other local contacts.

Smith, a spokesman for the Independent Oil and Gas Association of New York, added that the researchers found no fracking fluid in the contaminated wells.

"If the methane that was found in the water was a result of fracking, then certainly frack water would be found in those wells as well, and they found no evidence of that," he said.

Smith also doubted that poor well construction would be involved in the contamination, citing the stringent regulations adopted by the state of Pennsylvania to regulate gas drilling.

Jackson argues that flaws in the concrete seal would allow gas to migrate while still preventing leakage of fracking fluid.

He also noted that his team has researched potential well contamination from fracking in five states, most recently from the Fayetteville shale formation in Arkansas. His team believes faulty well construction is involved in Pennsylvania because other locations have revealed no contamination at all.

"We don't see any evidence of contamination in the homes there," he said of the Arkansas study. "We don't see the same problems everywhere we look."

More information

The U.S. Geological Survey offers a primer on water quality.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- A new study adds to growing evidence of a link between a common liver disease associated with obesity and high risk for heart disease.

People with non-alcoholic fatty liver disease have an accumulation of fat in the liver that is not caused by drinking alcohol. The fat can cause inflammation and scarring in the liver and progress to life-threatening illness.

The new findings "suggest that patients with coronary artery disease should be screened for liver disease, and likewise [patients with non-alcoholic fatty liver disease] should be evaluated for coronary artery disease," said Dr. Rajiv Chhabra, a gastroenterologist at Saint Luke's Health System's Liver Disease Management Center in Kansas City, Mo.

Researchers looked at upper-abdominal CT scans of nearly 400 patients and found that those with non-alcoholic fatty liver disease were more likely to have coronary artery disease. The effect of non-alcoholic fatty liver disease was stronger than other more traditional risk factors for heart disease, such as smoking, high blood pressure, diabetes, high cholesterol, metabolic syndrome and being male.

Chhabra conducted the study with a colleague, Dr. John Helzberg. Their findings were presented at the American Gastroenterological Association's recent annual meeting.

Current treatments for non-alcoholic fatty liver disease include diet changes, exercise and increased monitoring.

Non-alcoholic fatty liver disease is the most common liver disorder in Western countries, and is of growing concern among doctors due to rising rates of obesity and diabetes.

"If current trends continue, the prevalence of [non-alcoholic fatty liver disease] is expected to increase to 40 percent of the population by 2020," Helzberg said in a Saint Luke's Health System news release.

Data and conclusions presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The American Liver Foundation has more about non-alcoholic fatty liver disease.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- A new website and toll-free call center to help Americans navigate the new health insurance marketplace -- a key component of the Affordable Care Act -- were announced Monday by the federal government.

The Healthcare.gov website and the 24-hour-a-day call center will help people understand their choices and select the coverage that best suits their needs when open enrollment in the Health Insurance Marketplace begins Oct. 1, according to the U.S. Department of Health and Human Services.

"The new website and toll-free number have a simple mission: to make sure every American who needs health coverage has the information they need to make choices that are right for themselves and their families -- or their businesses," HHS Secretary Kathleen Sebelius said in a news release.

The website currently offers people information about what they can do to get ready for open enrollment in the fall. Over the summer, new functions will be added to the website so that, by October, people will be able to create accounts, complete an online application, and shop for qualified health plans, according to the news release.

For Spanish-speaking consumers, CuidadoDeSalud.gov will be updated to match Healthcare.gov's features.

Between now and the start of open enrollment, the call center will provide educational information. Beginning Oct. 1, the call center will help consumers select plans and complete applications. In addition to English and Spanish, the call center provides assistance in more than 150 languages through an interpretation and translation service.

The call center's number is 1-800-318-2596. Hearing-impaired callers using TTY/TDD technology can dial 1-855-889-4325.

More information

Click here to visit the Healthcare.gov website.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Preventable emergency room visits and hospitalizations are only a small part of the cost of caring for Medicare patients with the highest overall health expenses, a new study shows.

The findings suggest that providing these patients with better outpatient care would do little to lower their total health care costs, the researchers noted.

"High and increasing health care costs are arguably the single biggest threat to the long-term fiscal solvency of federal and state governments in the United States," according to background information in the study in the June 26 issue of the Journal of the American Medical Association.

"One compelling strategy for cost containment is focusing on the small proportion of patients in the Medicare programs who account for the vast majority of health care spending. We know from prior work that Medicare spending is highly concentrated; 10 percent of the Medicare population accounts for more than half of the costs to the program," the study authors wrote.

"As a result, many interventions targeting high-cost patients have focused on case management and care coordination, aiming to prevent emergency department visits and hospitalizations for conditions thought amenable to improvement through high-quality outpatient management programs," the researchers explained.

"The premise behind these and related interventions is that high-quality outpatient care should reduce unnecessary hospitalizations for high-cost patients. However, there are few data on the proportion of inpatient hospitalizations among high-cost patients that are potentially preventable," wrote Dr. Karen Joynt, of the Harvard School of Public Health, and colleagues.

Their analysis of 2009 and 2010 data from 1.1 million Medicare patients found that the 10 percent of patients with the highest costs were older, more often male and more often black. This group of patients accounted for 33 percent of emergency department costs and 79 percent of hospitalization costs, according to a journal news release.

Within this high-cost group of patients, 42 percent of emergency department visits and nearly 10 percent of hospitalizations were deemed preventable. The most common reasons for preventable hospitalization in high-cost patients were congestive heart failure, bacterial pneumonia and chronic obstructive pulmonary disease (COPD), the investigators found.

The study was released early to coincide with the planned Monday presentation of the research at the AcademyHealth annual research meeting in Baltimore.

"The biggest drivers of inpatient spending for high-cost patients were catastrophic events such as sepsis, stroke and myocardial infarction, as well as cancer and expensive orthopedic procedures such as spine surgery and hip replacement. These findings suggest that strategies focused on enhanced outpatient management of chronic disease, while critically important, may not be focused on the biggest and most expensive problems plaguing Medicare's high-cost patients," Joynt and colleagues concluded.

But even though "improvements to quality are not always substantial cost savers . . . [they] still may be worthwhile," the authors of an accompanying editorial pointed out.

"These findings certainly do not suggest abandoning efforts to reduce preventable emergency department use and hospitalizations," according to Dr. Aaron Carroll, of the Indiana University School of Medicine, and Austin Frakt, of the VA Boston Healthcare System, Boston University Schools of Medicine and Public Health.

"Even though avoiding some emergency department use and hospital admissions might not save much money -- and certainly not enough to declare victory in controlling health spending -- preventing such use when possible would be of substantial benefit to patients, both those who would otherwise use these services and those who have their care delayed because of overburdened emergency department and hospital resources," the editorial authors noted.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- The antibiotic Vibativ (telavancin) has been approved by the U.S. Food and Drug Administration to treat pneumonia caused by Staphylococcus aureus bacteria when other treatments aren't suitable.

Pneumonia, a lung infection, can be caused by different bacteria and viruses. S. aureus infection often affects people in hospitals, notably those on ventilators. Such infections can be serious, since people on a ventilator often have a weakened immune system and are unable to fight an infection, the FDA said in a news release.

Vibativ's safety and effectiveness were evaluated clinically among 1,532 people. The studies found the drug was about as effective in treating S. aureus pneumonia as another approved antibiotic, vancomycin.

However, the studies found that more people treated with Vibativ died if they also had kidney problems, compared to kidney patients who took vancomycin. The FDA said it would add this information to Vibativ's label. The most common clinical side effect of Vibativ is diarrhea.

Vibativ was first approved in 2009 to treat skin infections. The drug is marketed by San Francisco-based Theravance Inc.

More information

The FDA has more about this approval.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Minority children are significantly less likely than their white peers to be diagnosed or treated for attention-deficit/hyperactivity disorder (ADHD), new research shows.

The study, which is published online June 24 and in the July print issue of the journal Pediatrics, followed more than 17,000 children across the nation from kindergarten to eighth grade. Researchers regularly asked parents if their children had been diagnosed with ADHD.

Even after taking into account a host of factors that may influence behavior, attention and access to health care, researchers found that Hispanic and Asian children and those of other races were about half as likely to receive a diagnosis as whites. Blacks were about two-thirds less likely to be recognized as having problems with attention or hyperactivity as whites.

In addition, when minority children were diagnosed, they were less likely to receive medication than white kids with ADHD, the investigators found.

The study can't say, however, whether the differences mean that ADHD is being underdiagnosed in minorities or overdiagnosed in whites. Previous research has raised both possibilities.

A study published in the journal Clinical Psychology Review in 2009, for example, found that despite having more symptoms of distractibility and hyperactivity, black children were diagnosed with ADHD less often than whites.

On the other hand, a study published in April 2012 in the Canadian Medical Association Journal found that the youngest children in their school class were more likely to be diagnosed compared to the oldest children in those grades, suggesting that some doctors and teachers may mistake immaturity for ADHD, leading to overdiagnosis.

One expert suggested that socioeconomic and cultural differences may be at work.

Doctors still don't know if one or both problems may be driving the rates of lower diagnoses in minorities seen in the current study, said Dr. Tanya Froehlich, a pediatrician at Cincinnati Children's Hospital in Ohio.

"It does seem to be clear that there are some cultural differences at work, and also probably some differences in access to health care and access to health care information," said Froehlich, who was not involved in the research.

For example, the study noted that children without health insurance were less likely to be diagnosed with ADHD than children who had coverage. Kids from lower-income families were also less likely to be diagnosed.

Yet, children with older mothers, who tend to be more highly educated, and those with parents who spoke to doctors in English were more likely to be diagnosed with the condition. Both those factors are signs that access to health care and awareness of the problem may also be playing a role.

Several risk factors for ADHD occur more often in minority children than in whites. Those include a lower household income, less educated parents and low birth weight.

"What that suggests in our study is that there are children who are likely deserving of a diagnosis, but who aren't receiving a diagnosis, which raises the question of a lack of treatment," said study author Paul Morgan, director of the educational risk initiative at Pennsylvania State University in University Park, Pa.

The consequences of ADHD can be serious if the condition is left untreated.

"We know that people with ADHD have higher rates of failing a grade in school, lower academic achievement, lower achievement in their jobs, higher rates of incarceration, higher rates of substance abuse, more problems with relationships, and higher rates of depression and anxiety," Froehlich said. "It is extensive."

There's some evidence that treatment, either with behavioral therapies or medication, can improve the outlook for affected children.

"Definitely, we want all kids to be treated and to have the best chance possible for success in life," Froehlich said. "So if people truly have ADHD and they're not identified, that's going to hold them back."

More information

For more on ADHD, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Doctors don't have to automatically prescribe an antibiotic to treat children who appear to have acute sinus infections, according to new guidelines issued by a leading group of pediatricians.

Instead, they can take a "watch and wait" approach if it appears the infection might clear on its own, according to the new American Academy of Pediatrics guidelines.

"The practitioner can either treat immediately or consider waiting for a couple of days," said Dr. Ellen Wald, chairwoman of the academy's subcommittee on acute sinusitis. "If the kid doesn't look dramatically ill, you can wait an extra couple of days to see if they improve on their own."

The previous guidelines, passed in 2001, recommended antibiotic therapy for all children diagnosed with acute bacterial sinusitis, which is defined as persistent signs of sinus infection lasting more than 10 days.

Doctors now can observe kids for up to an additional three days past that 10-day period to see if their symptoms will ease without antibiotic treatment.

"There's nothing absolutely sacred about 10 days. It could be 11 days. It could be 12 days," said Wald, chairwoman of pediatrics at the University of Wisconsin School of Medicine and Public Health, in Madison. "In the child who looks sicker, we wouldn't do that. We would start on antibiotics immediately."

The new guidelines, published online June 24 in the journal Pediatrics, are driven primarily by concern over antibiotic resistance, she said. There is a lot of overlap between the common cold and acute sinusitis, and some children who are not suffering from a bacterial infection may be receiving antibiotics.

"If we prescribe fewer antibiotics, then the problem of antibiotic resistance is controlled," Wald said. "If you can avoid the use of antibiotics, then that is reasonable."

Between 6 percent and 7 percent of children who visit doctors seeking care for a respiratory condition have acute sinusitis, according to the report.

Most cases of acute sinusitis develop from a common cold. Colds usually last five to seven days and peak within two or three days, Wald said.

Acute sinusitis does not often develop into a life-threatening illness, but it can be very uncomfortable and even painful. Symptoms of sinusitis include a runny nose, a persistent daytime cough, headache and fever.

"I think cases of acute sinusitis resolve on their own, by and by," Wald said. "There are not children who are dying left and right from sinusitis. But there is a quality-of-life issue too. You get better more quickly with treatment."

The revised guidelines further underline the need for parents to seek out pediatricians who are adept at diagnosing and monitoring sinusitis, said Dr. Jordan Josephson, a sinus and allergy specialist at Lenox Hill Hospital in New York City and author of the book Sinus Relief Now.

This is especially true for children with ongoing sinus problems, he said.

"Treatment of chronic sinusitis is not simple, and I think it's important that patients get to a doctor who really understands the disease," Josephson said. "Guidelines are guidelines. The ultimate thing is to get to a physician who is a really good diagnostician who can determine whether antibiotics are needed."

The new guidelines for acute sinusitis also discourage the use of imaging tests to help diagnose the condition in uncomplicated cases.

More information

The U.S. Centers for Disease Control and Prevention has more about antibiotic resistance.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 24 (HealthDay News) -- Chinese health officials say health care workers should prepare for the possible re-emergence later this year of the deadly H7N9 bird flu, which has killed one-third of patients hospitalized with the virus.

"The warm season has now begun in China, and only one new laboratory-confirmed case of H7N9 in human beings has been identified since May 8, 2013," said researchers from the Chinese Center for Disease Control and Prevention and the University of Hong Kong. "If H7N9 follows a similar pattern to H5N1, the epidemic could reappear in the autumn." H5N1 is another bird virus that appeared in 2003.

"This potential lull should be an opportunity for discussion of definitive preventive public health measures, optimization of clinical management and capacity building in the region in view of the possibility that H7N9 could spread beyond China's borders," the researchers reported June 23 in the journal The Lancet.

Their research suggests that H7N9 has a lower death rate than H5N1, which killed about 60 percent of patients admitted to the hospital, but is deadlier than the 2009 H1N1 swine flu virus that killed 21 percent of patients admitted to the hospital, according to a second report by the same team in The Lancet.

The researchers also calculated that between 0.16 percent and 2.8 percent of all people who are infected with H7N9 and develop symptoms are at risk of dying. The wide variation in the estimate is due to the difficulty of accurately measuring how many people are infected with H7N9 but experience only mild symptoms.

"Assessing the severity profile of human infections is vitally important in the management and treatment of any infectious disease outbreak," the researchers wrote in a Hong Kong University news release. "Although previous clinical case series have focused on the potential for avian influenza H7N9 virus infection to cause severe illness, we have estimated that mild cases might have occurred."

Many of the people who contracted H7N9 had contact with poultry. No cases of H7N9 outside of China have been reported thus far.

The researchers said their results suggest a need for continued vigilance and sustained intensive control efforts against the virus to minimize the risk of human infection, which is greater than previously recognized.

More information

The U.S. Centers for Disease Control and Prevention has more about H7N9 bird flu.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 24, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Mandela in Critical Condition

Nelson Mandela's health deteriorated over the weekend and he is in critical condition in hospital, South African President Jacob Zuma said late Sunday.

Zuma didn't provide more details about the anti-apartheid hero and former president, the Wall Street Journal reported.

"Madiba is critical in hospital. This is the father of democracy. This is the man who fought and sacrificed his life. All of us as a country should accept that Madiba is old as he ages his health will trouble him," Zuma told reporters.

"Doctors are doing everything to ensure his well being and comfort," he noted.

Mandela was admitted to hospital on June 8 for treatment of a lung infection. He has had a number of respiratory ailments since contracting tuberculosis during the 27 years he spent in prison for his anti-apartheid activities, WSJ reported.

-----

10-Year-Old Lung Transplant Patient Awake

The 10-year-old girl who underwent a lung transplant last week after her family won a court battle is out of a coma and responsive.

Sarah Murnaghan woke up Friday night. She remains on a ventilator and is unable to talk, but is nodding and shaking her head in response to questions, according to family spokeswoman Tracy Simon, CNN reported.

Sarah, who has cystic fibrosis, was put in a medically induced coma before her transplant surgery to give her body time to rest before the procedure on June 12 in which she received lungs from an adult donor.

The transplant was conducted after Sarah's family won a court challenge against a rule that prevented her from receiving adult lungs. In response the case, the Organ Procurement and Transplant Network's executive committee recently approved a one-year change that makes children younger than 12 eligible for priority on adult lung transplant lists, CNN reported.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Hand sanitizers are a convenient method of cleaning hands and getting rid of germs, but it's important to use them properly.

The New York State Department of Health and Mental Hygiene offers this advice:

  • Squirt some sanitizer into the palm of one hand, and rub hands together and thoroughly rub sanitizer into both hands.
  • Let hands air dry; don't wipe them.
  • Use a sanitizer even when your hands are not visibly dirty, such as when you have sneezed or coughed, or you have been near a sick person.
  • Follow all label instructions.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Home-grown herbs can spice up your cooking with plenty of health benefits.

The Academy of Nutrition and Dietetics offers these herb care suggestions:

  • Just before using, wash herbs and gently pat dry with a paper towel.
  • Toss any leaves that are damaged.
  • Use stems of herbs that are soft and pliable to add flavor.
  • Pick herbs just before they bloom, when flavor is at its peak.
  • For more flavor, add herbs toward the end of cooking time to hot dishes. Add herbs hours before eating to cold dishes that don't require cooking.
  • Chop fresh herbs into fine pieces to release more flavor and aroma.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, June 23 (HealthDay News) -- Despite the introduction of pitching limits in youth baseball, throwing injuries requiring surgery are increasing at a dramatic rate in the United States. Now, a new study identifies the major reasons behind this continuing rise.

According to one estimate, serious throwing injuries now occur 16 times more often than 30 years ago.

This three-year national study of more than 750 pitchers, ages 9-18, identified several factors contributing to the problem, according to study leader Dr. Joseph Guettler, an orthopedic surgeon and sports medicine specialist with the Beaumont Health System in Royal Oak, Mich.

"It became very clear that dangerous pitching behavior is occurring among pitchers as young as Little League all the way through their high school years. And, the blame doesn't usually lie with the leagues or coaches. Most were found to be adhering to nationally recognized guidelines for pitch limits and rest. It seems much of the blame lies with behavior of parents and their kids," Guettler said in a health system news release.

Contrary to national guidelines limiting pitches thrown, about 13 percent of pitchers pitched competitively for more than eight months of the year, 40 percent pitched in a league without pitch counts or limits, nearly 57 percent pitched on back-to-back days, and 19 percent pitched more than one game in the same day.

The study also found that nearly one-third of pitchers pitched for more than one team during the same season, one-third played only baseball, and 10 percent also played catcher on the same team. Catcher is another position that requires a lot of throwing.

"The most prevalent reasons for arm pain and tiredness can be boiled down to five major issues," Guettler said. "The following behaviors can lead to arm pain and tiredness which can then lead to the most significant shoulder and elbow injuries."

These are:

  • Pitching for more than one team during the same season.
  • Pitching more than one game during the same day.
  • Pitching on back-to-back days.
  • Pitching in a league without pitch counts or playing year-round.
  • Throwing curve balls before high school.

The first step in reducing the number of pitching injuries can be remembered with a simple, newly coined "Rule of Ones," Guettler said.

It means one game a day, one day of pitching then rest, one position at a time during a pitched game, one team at a time, only one pitch before high school, and at least one season of some other organized sport. If a young pitcher says his or her arm is sore or tired, parents need to make sure the youngster takes some time off. One complaint of arm soreness or tiredness equals one week off.

More information

The Nemours Foundation offers youth baseball safety tips.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, June 23 (HealthDay News) -- A study out of Delaware suggests that injuries to beachgoers caused by ocean waves are more common and severe than previously suspected, and people need to be aware of the ocean's power -- even in shallow water.

To keep safe, it's important to swim at beaches with lifeguards, ask them about surf conditions and never turn your back to the waves, one study author suggested.

Over the past three summers, more than 1,100 ocean-wave-related injuries that required emergency room treatment were reported among Delaware beachgoers. The injuries ranged from sprains and strains to broken bones, blunt organ trauma and neck fractures. There were three deaths.

The most common types of injuries were broken collarbones, dislocated and separated shoulders, neck pain, and ankle and knee sprains.

The injuries occurred in an area called the surf zone, where many people play in the waves. This is the stretch of shoreline between the water's edge and where the waves break. In this area, waves can hit people and slam them into the sand. Most of the injuries in this study occurred in less than two feet of water.

"Historically, the magnitude of these injuries is largely underreported," study co-leader Paul Cowan, chief of emergency medicine at the Beebe Medical Center in Lewes, said in a University of Delaware news release. "This is the first study that documents and tracks the number of significant injuries occurring in the surf zone."

Lifeguards at three popular Delaware beach communities -- Bethany, Dewey and Rehoboth -- and several state park beaches provided researchers with information on beach conditions.

Although injuries to the neck and spinal cord accounted for less than 5 percent of all cases, these patients suffered some of the most complex and life-altering injuries, Cowan said.

Overall, the findings seemed to indicate "that a lot of these folks simply don't understand the power of the ocean, or they don't know how to swim in ocean waves and currents," study co-leader Wendy Carey, of the Delaware Sea Grant College Program, said in the news release.

More information

The U.S. National Oceanic and Atmospheric Administration outlines seven dangers at the beach.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, June 22 (HealthDay News) -- A new sensor attached to an insulin pump helps prevent dangerously low blood sugar levels in patients with type 1 diabetes while they sleep, a new study finds.

The new pump automatically stops delivering insulin when the sensor finds blood sugar levels have reached a pre-set low level, and it reduced overnight episodes of low blood sugar (hypoglycemia) by a third, the researchers report.

"After years of hoping for a way to achieve our goal of getting good blood sugar control without a lot of low blood sugar, we are finally, with this new technology, getting close to our goal," said study lead author Dr. Richard Bergenstal, executive director of the International Diabetes Center at Park Nicollet in Minneapolis.

"Hypoglycemia has all of a sudden become an important topic," he said. "Now that we are able to keep blood sugar down, we are running up against hypoglycemia as being our biggest barrier to achieving the blood sugar control we want to get to prevent eye disease, kidney disease and amputations and heart disease."

The effects of hypoglycemia can range from dizziness to seizures to coma and death, according to Bergenstal. "Patients are scared to death saying, 'Am I going to go to sleep tonight and am I going to wake up tomorrow morning, or am I going to have a major problem in the night,'" he said.

This may also be another step to creating a so-called "artificial pancreas" for people with type 1 diabetes, who cannot make insulin on their own, Bergenstal added. "This is the first step that shows that the artificial pancreas can actually work," he said.

Although this device has been used in Europe, the new study is a move toward getting the device approved by the U.S. Food and Drug Administration.

The study was funded by Medtronic Inc., the maker of the device. The results of the study were published June 22 online in the New England Journal of Medicine, to coincide with a scheduled presentation at the American Diabetes Association annual meeting in Chicago.

"This is a very real difference for people with type 1 diabetes, because these patients often go to bed in fear of low blood sugar," said Dr. Ronald Tamler, director of the Mount Sinai Diabetes Center in New York City. He was not involved in the new study.

But he added that it remains to be seen whether patients are agreeable to wearing a sensor along with an insulin pump and whether they can trust the technology.

"Some patients may not be willing to wear a sensor in addition to an insulin pump and entrust themselves to devices that need to work accurately and in harmony to succeed," he said. "It's a matter of practically and trust."

For the study, 247 patients with type 1 diabetes who were subject to hypoglycemia during the night were randomly assigned to the new device or a standard insulin pump for three months.

Patients wore a sensor along with an insulin pump. When the sensor sensed that blood sugar was getting too low overnight, the software was programmed to stop the pump for a short while.

The researchers found that the new device cut the times patients experienced hypoglycemia by 37.5 percent, compared with patients who didn't have the new device.

In addition, patients using the new device had about 32 percent fewer bouts of hypoglycemia during the night and 31.4 percent fewer hypoglycemia events during the day, the researchers found.

Moreover, the device had no effect on blood sugar levels, which were controlled in both groups.

Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, agreed that with the sensor, "we are one step closer to the artificial pancreas."

"This is an upgrade of the insulin pump and patients can avoid night-time low blood sugar, by using this technology," he said.

More information

For more on diabetes, visit the American Diabetes Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, JUNE 22 (HealthDay News) -- Pools can provide lots of fun and exercise for children, but a fun day can turn dangerous if proper safety precautions aren't followed, an expert warns.

Never leave children alone in or near a pool and be sure that they are always supervised by an adult who can swim, said Dr. Natalie Lane, medical director of the emergency department at Children's Hospital of Georgia.

In addition, don't use inflatable rafts or other flotation devices as substitutes for approved life vests, and keep children away from pool drains, pipes and other openings.

Teach children how to swim or at least make sure they know basic water-safety tips, Lane advised in a hospital news release. Parents and caregivers should learn CPR and rescue breathing. It is a good idea to create an emergency action plan with your family and rehearse each member's role.

And keeping a phone at poolside can also be a life-saver in the event of an emergency, she added.

A fence at least 4-feet high should surround the pool area and gates should be self-closing and self-latching. Place a safety cover over the pool when it's not in use and install a pool alarm to alert you when children are near the water.

Pool owners should also have a qualified professional inspect drain suction fittings and covers regularly to make sure they meet safety standards, Lane said.

Drowning is the leading cause of death among American children under age 5, with youngsters aged 1 to 4 more likely to drown in a residential pool than in any other body of water. Parents should not install a swimming pool until their children are over age 5, the American Academy of Pediatrics recommends.

More information

The Nemours Foundation has more about protecting children from drowning.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Vitamin D Levels Vary by Season

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THURSDAY, June 20 (HealthDay News) -- Americans' vitamin D levels vary throughout the year, peaking in August and bottoming out in February, a new study shows.

The findings will contribute to understanding the vitamin's role in seasonal illnesses, according to the researchers from the University of California, Irvine, and the Mayo Clinic.

Vitamin D, which is produced by the skin when exposed to sunlight, helps bones absorb calcium and can protect against osteoporosis. It's also believed to play a role in seasonal illnesses such as the flu.

For this study, the researchers measured vitamin D levels in 3.4 million blood samples collected weekly in the United States between July 2006 and December 2011. The results appear in the journal PLoS One.

"Even with food fortification, vitamin D levels in the population show a high level of seasonality due to the influence of sunlight," study first author Amy Kasahara, a UC Irvine graduate student in public health, said in a university news release.

"In this study, we have shown that vitamin D levels lag the solar cycle, peaking in August and troughing in February," she said.

The connection between seasons and vitamin D levels has been known for some time, but this study provides more precise data about vitamin D levels at different times of the year.

"Our analysis, combined with other data, will help contribute to understanding the role of vitamin D in all seasonal diseases, where the simple winter/spring/summer/fall categories are not sufficient," study senior author Andrew Noymer, an associate professor of public health at UC Irvine, said in the news release.

Vitamin D is found in foods such as egg yolks and oil-rich fish such as mackerel, salmon, sardines and herring. Milk and cereal often are fortified with vitamin D. Another option to boost your vitamin D intake is to take supplements.

More information

The Harvard School of Public Health has more about vitamin D and health.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Fewer children go to emergency rooms when their primary-care doctors have longer office hours, a new study finds.

Researchers examined data from a national survey of U.S. parents and found that children had half as many emergency-room visits if their primary-care doctor had evening office hours five or more days a week.

Many parents, however, didn't know if their child's primary-care provider had extended office hours, according to the study, which was published online June 7 in the Journal of Pediatrics. The findings also are scheduled for presentation at the AcademyHealth annual research meeting, which will be held June 23 to 25 in Baltimore.

"These findings are an important step in understanding where primary-care practices and medical home programs can be most effective in making changes to enhance access," study lead author Dr. Joe Zickafoose, a University of Michigan pediatrician, said in a university news release.

Zickafoose said primary-care practices nationwide are working on ways to make it easier for families to get advice and make appointments. A key goal of these efforts is to help parents avoid the stress and expense of unnecessary emergency-room visits. Extending primary-care office hours might be a good way to do this, Zickafoose said.

Other options include 24-hour phone advice; email or patient portal communication; same-day sick visits; and evening and weekend office hours.

Changes intended to improve access can be costly and time consuming for primary-care providers, so information about the most effective ways to achieve this could help them decide where to commit their resources, Zickafoose said.

The study found that changes other than extended office hours were not associated with a reduced number of emergency-room visits.

"We hope that our study encourages parents and primary-care practices to communicate more about when the office is open and when they can call for advice," Zickafoose said.

More information

The American Academy of Pediatrics outlines when parents should call their child's doctor.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Every time you try to mimic the speech of a friend or celebrity, the act switches on specific parts of your brain, new research suggests.

In the study, investigators had amateur impressionists recite the opening lines of nursery rhymes using either their normal voice, a foreign or regional accent, or an impersonation of another person's voice.

"The voice is a powerful channel for the expression of our identity -- it conveys information such as gender, age and place of birth, but crucially, it also expresses who we want to be," study author Carolyn McGettigan, of the department of psychology at Royal Holloway University, London, said in a university news release.

"Our aim is to find out more about how the brain controls this very flexible communicative tool, which could potentially lead to new treatments for those looking to recover their own vocal identity following brain injury or a stroke," she said.

McGettigan's team used an fMRI scanner to track the brain's activity in real time. They found that when the impressionists deliberately changed their voice, two regions of the brain -- the left anterior insula and inferior frontal gyrus -- were brought into play.

Compared to simply trying on accents, impersonations also triggered greater responses in two other brain regions -- the posterior superior temporal/inferior parietal cortex and the right middle/anterior superior temporal sulcus.

"Consider the difference between talking to a friend on the phone, talking to a police officer who's cautioning you for parking violation, or speaking to a young infant," noted McGettigan. "While the words we use might be different across these settings, another dramatic difference is the tone and style with which we deliver the words we say. We wanted to find out more about this process and how the brain controls it."

The study was published recently in The Journal of Cognitive Neuroscience.

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on the brain and how it works.

-- Mary Elizabeth Dallas

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- In some children with autism, levels of immune system antibodies to gluten proteins are elevated, a new study shows.

The finding may have implications for the cause and treatment of gastrointestinal troubles that often accompany autism spectrum disorders. Diets excluding gluten have become popular in the autism community, but the effectiveness of such diets has not been confirmed.

However, according to the new study, "there appears to be an increased immune reactivity to gluten in children with autism, which is associated with gastrointestinal symptoms," said lead researcher Armin Alaedini, an assistant professor of medical sciences at Columbia University Medical Center in New York City.

The study did not find any link between autism and celiac disease, an autoimmune disorder that is triggered by gluten.

Gluten is found in many wheat and related grain products.

In the study, Alaedini's team reviewed the medical records and blood samples of 140 children, 37 of whom had autism. Researchers tested the blood samples for antibodies to a marker of celiac disease and antibodies to gliadin, a marker of gluten. In addition, patients also were tested for genes associated with celiac disease.

Alaedini stressed that the study is preliminary and "the increased antibody response to gluten [found among patients] does not necessarily indicate sensitivity to gluten or any disease-causing role for the antibodies in the context of autism."

Instead, the higher levels of antibodies to gluten could point to immune and/or intestinal abnormalities in the affected children, he said.

More research into the immune response of people with autism to gluten might bring clues to the condition or highlight "a subset of patients that would respond to certain treatment strategies," Alaedini said.

Importantly, the findings do not suggest that putting a child with autism on a gluten-free diet has any benefit, he added.

"Such a conclusion cannot be drawn from this particular study," Alaedini said. "By itself, the increased antibody response to gluten does not necessarily indicate sensitivity to gluten or any pathogenic [disease-causing] role for the antibodies."

The report was published in the June online issue of PLoS One.

Another expert agreed that the study findings are preliminary.

"By themselves, anti-gluten antibodies do not mean disease," explained Dr. Daniel Coury, medical director of Autism Speaks' Autism Treatment Network and chief of developmental & behavioral pediatrics at Nationwide Children's Hospital in Columbus, Ohio.

"They are part of the whole puzzle. When they occur with other abnormalities and with symptoms, we begin to get a clearer picture. It may be that this will help identify a subgroup of individuals with autism who may benefit from a specific treatment someday when we have a better understanding of just what is going on here," Coury said.

Dr. Andrew Adesman, chief of developmental & behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center of New York in New Hyde Park, added that "this study could appear like some vindication to the many people who think that gluten is somehow involved in autism and dietary changes might be helpful. But that is not an accurate take-home message," Adesman said.

"Although increased gluten antibodies are present in children with autism and it appears they are involved in gastrointestinal problems, at this point it's hard to know what role, if any, these antibodies have in autism," he said.

Adesman noted that research into gluten-free diets for children with autism hasn't shown any benefit. "And this study doesn't reinforce any basis for dietary intervention for autistic children," he stressed.

More information

For more on autism, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

Mind Over Diet?

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FRIDAY, June 21 (HealthDay News) -- People's views about what causes obesity may influence both their eating habits and their weight, new research shows.

The finding suggests that public health campaigns may need to factor that into the equation to be effective, the study authors noted.

To examine the issue, the researchers conducted a series of surveys across five countries on three continents. Published recently in the journal Psychological Science, the study found people in Korea, the United States and France all held similar beliefs that either poor diet or lack of exercise was the leading cause of obesity.

And those who linked obesity to unhealthy eating habits had lower body mass indexes (BMIs) than those who blamed lack of physical activity. BMI is a measurement of body fat based on height and weight.

"There was a clear demarcation," study author Brent McFerran, of the Ross School of Business at the University of Michigan, said in a news release from the Association for Psychological Science. "Some people overwhelmingly implicated poor diet, and a roughly equal number implicated lack of exercise. Genetics, to our surprise, was a far distant third."

However, "what surprised me the most was the fact that we found lay theories to have an effect on BMI over and above other known factors, such as socioeconomic status, age, education, various medical conditions and sleep habits," McFerran pointed out.

The study authors noted that the link between views on obesity and exercise may also be associated with how much people eat. They found Canadian participants who felt obesity was the result of physical inactivity ate many more chocolates than those who saw diet as the main culprit. Meanwhile, people in Hong Kong who stressed the importance of exercise also ate more chocolate than those who saw diet as the main cause of obesity.

The researchers concluded that people's beliefs about obesity play a role in eating habits and BMI.

Anirban Mukhopadhyay, of Hong Kong University of Science and Technology, concluded in the news release that this is "the first research that has drawn a link between people's beliefs and the obesity crisis, which is growing as fast as people's waistlines are."

Studies show that two-thirds of U.S. adults are overweight or obese. Obesity is also a growing problem in many developed nations.

More information

The U.S. National Library of Medicine provides more information on obesity.

-- Mary Elizabeth Dallas

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Incorrectly toilet training children can lead to problems ranging from bed-wetting and daytime accidents to urinary tract infections, so it's important to get it right, an expert says.

There are a number of common mistakes that parents make when toilet training their children, said Dr. Steve Hodges, a pediatric urology specialist at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

Training too early is one mistake. Children younger than 3 don't have the mental maturity to make good toileting decisions. "They don't understand how essential it is to get themselves to a bathroom when nature calls," Hodges said in a Wake Forest news release. "Instead, they hold their urine and feces, which can lead to numerous problems, including bed-wetting."

Holding urine also leads to smaller bladder capacity, Hodges said.

Some parents potty-train their children but don't follow up with their toileting habits. Parents should have children urinate on a schedule, about every two hours, he suggested. To help make the bathroom trips successful, have the child count to 10 while on the potty and have some favorite books and puzzles nearby. Hodges also said that a high-fiber diet can make defecation less painful, so children are less likely to try to avoid it.

Up to 30 percent of children aged 2 to 10 have chronic constipation, but some parents miss the signs of constipation in their children. "Many parents mistakenly believe that if their child has daily bowel movements, they are not constipated," Hodges said. "But in kids, there's a different definition of constipation known as 'poop burden.' It refers to poop backed up in their rectum that can press on the bladder and cause bed-wetting and other problems."

Symptoms of constipation in children include having extra-large bowel movements or bowel movements that are very firm, rather than mushy; poop accidents; poop-stained underwear; and mild belly pain with no obvious cause, Hodges said.

He also said parents should never ignore signs of bladder trouble, which include painful and frequent urination and blood in the urine. These symptoms could be due to an infection or other problems that should be evaluated by a doctor.

Accidents of urine or stool should not be considered normal and ignored.

"Often, parents have the impression that wetting, like throwing temper tantrums, is just something kids do," Hodges said. "But accidents aren't normal and potty-trained kids shouldn't have accidents any more often than adults do."

More information

The Nemours Foundation has more about toilet training.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Swimming pools are a major reason why children's eye injuries increase in the summer, according to an expert.

Eye injuries among youngsters start to rise in May and June before peaking in July. They then fall off in September after school begins, according to Gerald McGwin Jr., a professor in the epidemiology and ophthalmology departments at the University of Alabama at Birmingham.

"Overall, the leading cause of eye injury in children 15 and younger is sports, specifically swimming," he said in a university news release.

Pool chemicals, which can cause eye irritation, are a common cause of eye injuries.

"Ensuring that a pool's pH level is within normal range is one way to reduce these injuries," McGwin said. "Goggles and swim masks are another way by providing a barrier between eyes and water."

Other causes of pool-related eye injuries include being hit by water toys or by elbows and feet.

Household chemicals and cleaners are another cause for concern and account for 30 percent of eye injuries suffered by children younger than age 2. "The obvious solution for parents and caregivers is to keep dangerous chemicals and substances locked up or out of the reach of children at all times," McGwin said.

Other ways to reduce eye injuries include having children of all ages wear eye protection when playing sports and keeping children away from sparklers, firecrackers or any other types of fireworks.

The good news is that the number of eye injuries among children 15 and younger in the United States is declining, McGwin said. Reported eye injuries fell from a high of more than 80,000 in 1992 to a low of about 50,000 in 2010.

More information

The American Academy of Ophthalmology has more about the prevention and care of eye injuries in children.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Babies who gained weight and head circumference more rapidly during the first month of life scored slightly higher on intelligence tests when they were 6 years old, according to a large new study.

But a baby's early rate of growth didn't influence the child's behavior later in life, according to the study.

"We found that faster growth in the first four weeks following birth was linked to a small increase in intelligence quotient scores at 6.5 years, but there were no clear effects on children's behavior," said the study's lead author, Lisa Smithers, a postdoctoral research fellow in early life nutrition at the University of Adelaide, in Australia.

She added that these findings suggest that "it is important that parents seek help for any concerns they might have about their baby's growth or feeding quite quickly so that any problems can be addressed early."

"[However], we cannot say that faster growth causes a higher IQ," Smithers said. "It is possible that a phenomenon called 'reverse causality' may be at play, for example, if children with lower IQs had poorer growth."

The study results appeared online June 17 and in the July print issue of the journal Pediatrics.

The study included about 17,000 mothers and their babies from Belarus. Only mothers who delivered a single, healthy baby were included in the study. In addition, the babies were all born at or after 37 weeks of gestation.

Researchers measured the babies' weights and head circumferences over the first four weeks of life. Intelligence was measured using several IQ scales that were combined to yield a full-scale IQ score at 6.5 years. The full-scale IQ scores can range from 50 to 150, Smithers said, and the average score is 100. To assess behavior, parents and teachers completed behavior questionnaires.

Babies with the highest growth in weight and head circumference scored 1.5 points higher on the IQ scale compared to babies with the lowest growth. The researchers found no statistically significant differences in children's later behavior based on early growth.

"Our study involved thousands of healthy babies, so our findings reflect a wide range of growth patterns that might be expected within a healthy population," Smithers said.

Researchers accounted for other important factors, such as family income and parental education, in their analysis.

"The size of the effect we found on children's IQ would not be noticeable to individuals," Smithers said.

But the results may be important in the bigger picture, a U.S. expert said.

"A 1.5-point difference would be meaningless in an individual child and that child's success in life, but on a population level, such a difference may matter," said Dr. Lisa Thornton, medical director of pediatric rehabilitation at LaRabida Children's Hospital in Chicago.

"It's clear, though, that brain growth equals [thinking ability] growth, and it's interesting to see that really early brain growth correlates to intelligence at 6 years," she said. "It shows that it's important that early feeding difficulties shouldn't linger."

Thornton said women who are having breast-feeding trouble should seek help sooner rather than later. "Breast milk is God's perfect food, but this study suggests that it's better to get nutrition early," Thornton said.

Both Thornton and Smithers said this study's findings don't suggest that parents should overfeed their babies.

"Babies should never be forced to eat," Smithers said. "Babies should be fed on demand. Overfeeding may raise other problems over the longer term, as there is some evidence to suggest that more rapid growth in infancy is linked to poorer health outcomes, such as obesity and high blood pressure. Our study draws attention to the importance of balance."

Thornton agreed. "Make sure the baby is getting enough food for optimal growth, but don't overfeed to try to make the baby smarter," she said.

More information

To learn about overcoming breast-feeding problems that could interfere with early nutrition, visit the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Older women who have depression or take antidepressants may be at increased risk for diabetes and cardiovascular disease, a new study finds.

Researchers looked at about eight years of data from a few thousand postmenopausal women in the United States. Those who had depression or were using antidepressants were more likely to have a higher body-mass index (BMI), a measurement of body fat based on height and weight; larger waist size and signs of inflammation than those who did not have depression and were not taking antidepressants.

These measurements are all associated with increased risk for diabetes and cardiovascular disease, noted the authors of the study in the June 13 issue of the American Journal of Public Health.

"It may be prudent to monitor postmenopausal women who have elevated depression symptoms or are taking antidepressant medication to prevent diabetes and cardiovascular disease," study leader Dr. Yunsheng Ma, an associate professor of medicine at the University of Massachusetts Medical School, said in a school news release.

This makes sense "given that diabetes and cardiovascular disease can be effectively prevented or delayed in high-risk individuals with lifestyle modifications or pharmacological interventions," study co-author Dr. Simin Liu, a professor of epidemiology and medicine at Brown University, said in the release.

While the study found an association between depression or antidepressant use and certain risk factors for heart disease and diabetes, it did not establish a cause-and-effect link.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart disease in women.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Think "skin cancer" and blame immediately goes to the sun. Justifiably so -- though not totally, skin doctors say.

"Hands down, sun exposure is the biggest risk factor for skin cancer," said Dr. Sherrif Ibrahim, an assistant professor of dermatology at the University of Rochester Medical Center in New York. "And it's a cumulative risk. The more exposure you've gotten, the bigger the risk. The skin doesn't know if you're out one time for an hour or 12 times for 5 minutes at a time. Your skin keeps a running meter."

That's important to know as summer officially begins, according to skin health experts at the American Academy of Dermatology.

Each year, more than 3.5 million basal and squamous cell skin cancers, known as non-melanoma cancers, are diagnosed in the United States, according to the American Cancer Society. These types of skin cancer aren't as deadly as melanoma, which affects about 75,000 U.S. residents annually. About 9,000 people die from melanomas and 2,000 from non-melanoma skin cancers each year, according to the society.

However, the sun isn't the only thing that can be problematic. Tattoos, certain chemicals, other diseases and possibly even those better-for-the-environment light bulbs all have been linked to skin cancer.

And people who think tanning beds are safer than soaking up the sun should think again, Ibrahim suggested.

"There's an unquestionable link between tanning booths and skin cancer," Ibrahim said. "There's been an enormous surge in the popularity of tanning booths, and with it the average age of people with melanomas is much lower. I had a 22-year-old patient just the other day."

This is because it doesn't matter if the ultraviolet light comes from the sun or from an artificial source. Dr. Alan Fleischer, a dermatology professor at Wake Forest Baptist Medical Center in Winston-Salem, N.C., explained that "the kind of light produced by tanning beds isn't better or worse than natural sunshine, but people may get more and longer exposure, especially in areas where outside, they might display more modesty."

Even getting a manicure can expose you to ultraviolet light.

"Ultraviolet nail treatment units do produce UV light, but the risk is quite small," said Fleischer. The lights are used to help gel or regular polishes set or harden.

Despite the low risk, the American Academy of Dermatology still recommends putting sunscreen on your hands before you get a manicure.

Even things that seem unrelated to UV light -- such as getting an organ transplant or a tattoo, or having an autoimmune disease -- have been linked to skin cancer diagnoses.

People who've had an organ transplant have an extremely elevated risk for skin cancer -- up to 200 times higher than others, according to Ibrahim.

This stems from the medications that must be taken after a transplant to suppress the immune system. As a result, the immune system, which normally fights off growing cancer cells, may not be strong enough to do its job.

Organ transplant recipients should talk to a dermatologist to get an idea of their baseline risk for skin cancer and find out how often they need to be screened. Ibrahim said that some high-risk people who've had organ transplants need screening every three to four weeks.

Although tattoos aren't known to increase the risk for skin cancer, tattoos can make it harder to detect cancer-related changes in moles. If you're considering a tattoo, make sure there aren't any moles in the area you're thinking about inking, according to experts from the American Academy of Dermatology.

Like people who've had an organ transplant, those with autoimmune diseases often take medications that suppress their immune system. These drugs can also increase their chances of developing skin cancer, Fleischer said.

The experts also pointed out other potential sources of skin cancer risk, including:

  • Compact fluorescent bulbs: These "eco-friendly" lightbulbs emit ultraviolet light, which normally isn't a problem because of a coating on the bulbs. However, if there's a crack in the coating, UV light can come through. A study in the journal Photochemistry and Photobiology showed that these bulbs can emit some UV light, but no one has yet shown a link to skin cancer.
  • Previous radiation: Areas of skin that have been exposed to radiation, such as that used for treatment of other types of cancer, have an increased risk for skin cancer, according to the American Cancer Society.
  • Parkinson's disease: A study in the Archives of Neurology found an increased risk for melanoma in people with Parkinson's disease. The authors, whose research was published in September 2012, suspect that some of the genes that cause Parkinson's disease may also give rise to skin cancers.
  • Smoking: Researchers also suspect a link between cigarette smoking and skin cancer. Two studies -- one published in June 2012 in the Archives of Dermatology and the other in December 2011 in the journal Cancer Causes and Control -- found that squamous cell cancer was more common in smokers than in nonsmokers.
  • Chemical exposure: Workplace exposure to certain chemicals can increase the risk of non-melanoma skin cancers, according to the American Cancer Society. These chemicals include arsenic, which is found naturally in well water and is used in the manufacture of some pesticides, as well as tar, coal, paraffin, and some types of oil.
  • Driving: Fleischer said that in the United States, skin cancers are much more common on the left side of the body because of the time spent driving. In Europe, more cancers occur on the right side. And, though he said he hasn't seen any studies on it, he suspects that people who regularly drive convertibles probably have higher rates of skin cancer because of increased exposure.

Both Fleischer and Ibrahim recommended wearing sunscreen regularly (applying liberally and reapplying often), avoiding the midday sun, seeking shade, wearing a wide-brimmed hat outside and covering up as much of your body as possible to lessen your sun exposure.

Though other factors can and do increase risk, "there's no question that the sun is the biggest risk factor for all types of skin cancer," Fleischer said.

More information

The American Academy of Dermatology has more about skin cancer.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- The Plan B "emergency" contraceptive (levonorgestrel) has been approved by the U.S. Food and Drug Administration for any female of child-bearing potential.

Thursday's agency announcement followed an April ruling by the U.S. District Court in New York that the product had to be made available without restriction, including age.

Plan B is meant to reduce the chances of pregnancy if taken within 72 hours of unprotected sex or suspected contraceptive failure. The product was first approved in 2009 as an over-the-counter option for women 17 and older, and as a prescription option for younger females.

The product will not end the pregnancy of a female who is already pregnant, and there is no evidence that it will harm a developing fetus, the FDA said in a news release. It will not prevent any sexually transmitted disease, including HIV/AIDS, the agency added.

Some females who have taken Plan B have reported these side effects: nausea, vomiting, stomach pain, headache, dizziness and breast tenderness. These adverse reactions are similar to those reported after use of other birth control products, the FDA said.

Plan B is produced by Teva Women's Health, a unit of the Israeli drug maker Teva Pharmaceutical Industries.

More information

The FDA has more about this approval.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Katie Wilkes was just 23 years old when she noticed a strange spot on her right breast.

"It was darker than many of my other freckles or moles -- not quite black, but it was dark," said Wilkes, who lives in Portland, Ore. "I asked my boyfriend at the time if I should have it removed. He told me it was 'cute' and that I shouldn't worry about it, so I didn't."

At least not at first. But Wilkes eventually decided to have the unusual spot checked out.

"I made an appointment with a dermatologist for a routine skin check," she said. "I had recently quit using tanning beds, and I felt like I could sleep better at night knowing that a doctor had looked me over and everything was OK."

However, everything wasn't OK. She said that her doctor thought the spot looked slightly abnormal but didn't seem too concerned and sent some tissue to the lab for further examination.

"I was pretty shocked when I got the call that it was malignant," Wilkes said.

So-called "malignant melanoma" is the most dangerous form of skin cancer. If it isn't caught early it can quickly spread to other parts of the body. When melanoma spreads, it can be deadly, according to the American Academy of Dermatology.

Wilkes was lucky she'd decided to go in when she did as the cancer was still at a treatable stage. "Fortunately, my melanoma was relatively shallow and it hadn't spread to my lymph nodes," she said. Treatment took just one surgery to remove the melanoma, but it required a 3-inch-wide, eye-shaped incision.

Although it's impossible to know the exact cause of her melanoma, Wilkes and her doctors suspect that her multiyear tanning bed habit while a teenager contributed to the cancer. The cancer developed in an area that is normally covered by a bathing suit or other clothing but is often exposed when using a tanning bed.

"I recently went for a checkup, and one of the residents said, 'Wow, you had a melanoma when you were 23? Did you use tanning beds a lot as a teenager?'" Wilkes said.

"You couldn't pay me to use a tanning bed now," she noted. Nonetheless, it took some time for that belief to settle in. "I was teased a lot as a kid for having very pale skin, so it's taken a while for me to become comfortable with and eventually embrace my natural skin color," Wilkes said.

Now 26, Wilkes blogs about her melanoma experience and about coming to terms with her pale skin. "I used to hate it when people would preach to me about using tanning beds, so I try to tackle the subject in a down-to-earth, non-preachy way," she explained.

Because she's already had melanoma, Wilkes has an increased risk for developing another melanoma. "I love spending time outdoors, and I'm still a little jealous of my friends who may not need to be as cautious about burning, but I know tanning isn't an option for me anymore," she said. "Once you've had melanoma, you're more likely to get it again, so I do everything I can to avoid sunburns."

She also visits her dermatologist regularly and checks her skin once a month to look for any new growths.

"Melanoma is not just the type of skin cancer you can cut off and forget about," Wilkes said. "It can grow from stage I to stage IV in a heartbeat, and it's incredibly hard to treat when it's not caught early."

More information

The U.S. National Cancer Institute has more about melanoma.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Men who are infertile because they produce no sperm may have a higher-than-average risk of developing cancer, a new study finds.

Researchers found that of more than 2,000 men with fertility problems, those with no sperm production had an increased risk of developing cancer over the next six years.

The men were young going into the study (about age 36, on average), so few did develop cancer. Among men with no sperm -- what doctors call azoospermia -- just over 2 percent were diagnosed with cancer.

Still, their risk was three times higher than that of the average man their age.

"They have the cancer risk of a man about 10 years older," said lead researcher Dr. Michael Eisenberg, an assistant professor of urology at Stanford University School of Medicine.

About 15 percent of infertile men are azoospermic, according to the study, which was published June 20 in the journal Fertility and Sterility.

This isn't the first work to connect male infertility to cancer risk, but it suggests the link may be concentrated among men with the most severe type of infertility.

"This suggests that it's not male infertility in general, but azoospermia in particular," Eisenberg said.

That's an important piece of information, said a male-infertility expert not involved in the study. If the link between male infertility and cancer is real, you would expect that more severe infertility would be tied to a greater cancer risk, said Dr. Thomas Walsh, of the University of Washington in Seattle.

"This reinforces the idea that this is a real relationship," Walsh said.

He said he doubts anyone would say that infertility is causing cancer. But he and Eisenberg said it's possible that some common genetic factors contribute to both azoospermia and a greater vulnerability to cancer.

"When we see a man with azoospermia, we usually assume there's a genetic cause," Eisenberg said. There are certain gene mutations already tied to the condition, but a minority of azoospermic men turn out to have one of them when they are tested. That means there are likely other, as yet unknown, gene defects involved in azoospermia, Eisenberg said.

And some of those genetic flaws might be involved in cancer susceptibility, he said.

Another infertility expert was cautious about interpreting the findings because of the small numbers: only 10 cases of cancer among the 451 men with azoospermia, and 19 cases among nearly 1,800 men with other types of infertility.

The idea that genetic abnormalities might underlie both azoospermia and cancer risk has merit, said Dr. Frederick Licciardi of NYU Langone Medical Center in New York City. But, he said, "while this is important reasoning and is based in basic science studies, I do not feel they have enough evidence in this paper to bolster this theory."

Another question is whether azoospermia is linked only to certain cancers. Past studies, including one Walsh worked on, have found that infertile men show a higher than average risk of testicular cancer -- a highly curable disease usually diagnosed in young men.

Of the 10 cancers in azoospermic men in this study, two were testicular tumors. The others included brain cancer, prostate cancer, lymphoma and melanoma.

Eisenberg said there were too few cases of each cancer to see whether men with azoospermia were at particular risk for any one type.

For now, he recommended that men with the condition "be aware of the possible risk, and pay attention to your health." That includes not only maintaining a healthy lifestyle, he said, but also doing what most younger men do not -- seeing your doctor for a regular check-up.

"It's too early to make any recommendations about cancer screening," he said. But a routine visit to your doctor for a physical exam -- which can detect testicular cancer, for example -- is wise, Eisenberg said.

Licciardi agreed. "Any man -- very low sperm count or not -- should have regular physical examinations."

Walsh said much more research is needed to dig into the connection between male infertility and cancer, including studies that follow men over a long period since cancer rates climb with age, as well as basic lab research to try to uncover the reasons for the link.

More information

Learn more about male infertility from the American Society for Reproductive Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Despite having more serious injuries, patients taken to the hospital by helicopter ambulance had a higher survival rate than those taken by ground ambulance, according to a new study.

Researchers examined data from 13,000 patients taken by ambulance to more than 300 European medical centers. Of those patients, one-third were transported to the hospital by helicopter. Such patients generally had more serious problems, including chest and abdominal injuries that required extensive treatment at the scene of the accident.

The helicopter-transported patients also were more likely to suffer complications -- such as blood infections and multiple organ failure -- and to require more time in the hospital before being released home, the investigators found. These patients, however, still had a better survival rate than those transported by ground ambulances.

The findings were published in the current online edition of the journal Critical Care.

Because patient diagnosis and quality of hospital care appeared to be the same whether patients arrived by helicopter or ground ambulance, the study's authors thought there must be another reason for the difference in survival rates.

"These patients tend to be the most severely injured; nevertheless, the care they receive from medical staff at the scene and during transport, plus speed of transport, means that patients are more likely to survive," Dr. Hagen Andruszkow, of the University Hospital Aachen in Germany, said in a journal news release. "This needs to be taken into account when deciding to start or continue with air ambulance services."

Helicopters have been used as ambulances for many decades, and for much of that time there has been debate about the cost of the service compared to the benefit in saving lives. These findings suggest that air ambulances are effective and worth the investment, the researchers said.

More information

The American College of Emergency Physicians provides facts about medical emergencies.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 21 (HealthDay News) -- Taking iron supplements during pregnancy reduces women's risk of anemia and is linked with an increase in birth weight and a reduced risk of low birth weight, a new analysis finds.

Researchers examined more than 90 studies that included a total of nearly 2 million pregnant women and found that daily iron supplements significantly reduced women's risk of anemia during pregnancy.

Anemia during the first or second trimester was associated with a significantly higher risk of low birth weight and preterm birth, according to the study, which was published online June 20 in the journal BMJ.

In addition, the investigators found that for every 10 milligram increase in iron dose per day (up to 66 mg), mothers had a 12 percent lower risk of anemia, birth weight increased by 15 grams and the risk of low birth weight fell by 3 percent.

The World Health Organization recommends that pregnant women take 60 mg of iron per day, the study authors noted in a journal news release.

They also said iron deficiency is the most common nutritional deficiency in the world, and the most common cause of anemia during pregnancy, particularly in low- and middle-income countries. It is estimated that iron deficiency affected 32 million pregnant women worldwide in 2011.

"Our findings suggest that use of iron in women during pregnancy may be used as a preventive strategy to improve maternal [blood] status and birth weight," Batool Haider, of the departments of epidemiology and nutrition at Harvard School of Public Health in Boston, and colleagues wrote.

More information

The March of Dimes has more about anemia during pregnancy.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 21, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

USDA OKs Label for Meat from Animals Not Given Gene-Modified Feed

A label for meat from animals that have not been given genetically-modified feed has been approved by the U.S. Department of Agriculture.

The label is the first of its kind and says that meat certified by the Non-GMO Project is from livestock that never ate genetically-modified ingredients such as soy, corn and alfalfa, The New York Times reported.

This "allows companies to demonstrate on their labels that they meet a third-party certifying organization's standards, provided that the third-party organization and the company can show that the claims are truthful, accurate and not misleading," USDA spokeswoman Cathy Cochran said in a statement.

She said the approval of the label was not an indication of "any new policy regarding non-G.E. or non-G.M.O. products," The Times reported.

-----

Flu Shot Approved for Those With Egg Allergies

A new flu vaccine that is produced without eggs was approved by a federal advisory panel Thursday.

The unanimous vote of recommendation from the Advisory Committee on Immunization Practices will give adults with egg allergies a way to protect themselves in the coming flu season.

Called FluBlock, the vaccine was licensed by the U.S. Food and Drug Administration last January.

Using an insect virus and recombinant DNA technology, FluBlock is made by Protein Sciences Corp. of Meriden, Conn. The method used to produce the vaccine is also used in the manufacture of other vaccines, according to the U.S. Centers for Disease Control and Prevention.

Although officials do not know how many people might be allergic to eggs, an estimated one in every 66 children has the allergy. However, the new vaccine is currently only approved for use in people aged 18 to 49, the CDC added.

Side effects with FluBlock are similar to those seen with other flu vaccines, and include pain at the injection site, headache, fatigue and muscle aches, the CDC said.

FluBlock has a shorter shelf life than other flu vaccines, and doctors should check the expiration date before giving it to patients, the CDC said.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- If you spend most days trying to keep your eyes open, you may have a deeper problem than ordinary lack of sleep.

The National Sleep Foundation mentions these possible causes of excessive sleepiness:

  • Self-imposed sleep deprivation.
  • Performing shift work, causing you to sleep during the day and work at night.
  • Sleep disorders, such as sleep apnea.
  • Other disorders, such as insomnia, narcolepsy or restless leg syndrome.
  • Certain medications.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Women can help the men in their lives stay well by encouraging a healthy lifestyle.

The U.S. Centers for Disease Control and Prevention mentions these suggestions for women:

  • Support the men in your life by urging them to seek medical attention when necessary.
  • Enlist the help of other male friends who live a healthier lifestyle.
  • Talk to men about the influence that their habits will have on their children and grandchildren.
  • Develop an enjoyable exercise routine that you and your male partner can perform together.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- The so-called morning-after pill is about to go over-the-counter, with the U.S. Food and Drug Administration announcing Thursday that it has approved unrestricted sales of Plan B One-Step.

The move follows a decision earlier this month by the Obama administration to drop its effort to fight a court order that would make the emergency contraceptive pill available over-the-counter to all women and girls, regardless of age.

After fighting for an age threshold on the nonprescription use of the Plan B One-Step pill for months, the FDA said June 10 that it would heed the ruling of Judge Edward Korman, of the United States District Court for the Eastern District of New York. The drug prevents conception if taken within 72 hours of sexual intercourse.

Korman first issued his order April 5, igniting a battle over whether young girls could gain access to emergency contraception without a prescription. Soon after, on April 30, the FDA lowered to 15 the age at which people could purchase the Plan B One-Step pill over-the-counter -- two years younger than the prior age limit of 17.

A day later, on May 1, the Obama administration stepped in to appeal the Korman decision.

At the time of the FDA's move to lower the age limit, agency Commissioner Dr. Margaret Hamburg said that "research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States.

"The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly and that it does not prevent the transmission of a sexually transmitted disease," she said.

Plan B prevents implantation of a fertilized egg in a woman's uterus through the use of levonorgestrel, a synthetic form of the hormone progesterone used for decades in birth control pills. Plan B contains 1.5 milligrams of levonorgestrel, more than the pill contains. It is considered a form of birth control, not abortion.

The Associated Press reported that the FDA's announcement Thursday only applied to Plan B One-Step. Other brands of emergency contraception include Next Choice and Ella.

Planned Parenthood has long pushed for wider access to emergency contraception. But conservative groups have objected to such a move.

More information

There's more on emergency contraception at the World Health Organization.

-- E.J. Mundell

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- The common belief that rheumatoid arthritis patients don't benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists.

Researchers from the Hospital for Special Surgery also found, however, that rheumatoid arthritis patients who underwent a total hip replacement didn't fare as well as those with osteoarthritis, though they did experience improvements in pain and function.

"One thing that we can clearly pull out of this research is that the levels of pain and function among those with rheumatoid arthritis were so much worse preoperatively at the point they approached joint replacement," explained rheumatologist Dr. Susan Goodman, the lead author of both studies. "They may be postponing or not getting to surgery until they're really in a much worse state. Perhaps that's one of the explanations for the results . . . perhaps it's their generalized disease. We really just don't know yet."

Goodman presented the research last week at the European League Against Rheumatism's annual meeting in Madrid, Spain. Research presented at scientific conferences has typically not been peer-reviewed or published and is considered preliminary.

Affecting one of every five adults, along with 300,000 children, arthritis is the leading cause of disability in the United States, according to the Arthritis Foundation. Osteoarthritis, the most prevalent form, progressively breaks down cartilage in the joints due to wear and tear, while rheumatoid arthritis is an autoimmune disease marked by inflammation of the membranes surrounding joints. Along with bringing chronic pain, both types can result in joint destruction.

Historically, rheumatoid arthritis patients have had worse outcomes after joint replacement surgeries than osteoarthritis patients, according to the study authors, but more effective drugs developed over the last two decades have helped them to better control their disease.

In the first study, Goodman and her team analyzed joint replacement registry data to identify 178 rheumatoid arthritis patients and more than 5,200 osteoarthritis patients who underwent knee replacement surgery. Though rheumatoid arthritis patients had worse pain and function before surgery, patients in both groups had similar satisfaction rates after surgery.

The second study compared outcomes of 202 rheumatoid arthritis patients and more than 5,800 osteoarthritis patients who underwent hip replacement, finding that those with rheumatoid arthritis started out with worse function before surgery and also had worse pain and function scores after surgery. However, rheumatoid arthritis patients were as likely as those with osteoarthritis to experience an overall improvement after hip replacement, though the gains didn't erase the disparity between the two groups.

"The advice to rheumatoid arthritis patients is, really, that you will have significant pain relief [from joint replacement surgery]," Goodman said. "It is an area that needs more study. We're looking forward to assessing more rheumatoid-specific factors."

The research, which looked at participants with active rheumatoid arthritis, is consistent with what Dr. Olivia Ghaw, an assistant professor of medicine in rheumatology at Mount Sinai Medical Center in New York City, sees in her practice.

But Ghaw said she felt the study's two-year follow-up period was perhaps not long enough to confirm if the joint replacement outcomes remained positive for rheumatoid arthritis patients.

"For some of my patients, if their joint is severely destructed, I still do recommend joint replacement," she said. "Ideally, we would love to get their underlying disease under better control. If we can bring their inflammation down, perhaps they can have better results with joint replacement."

More information

More facts about rheumatoid arthritis are available from the Arthritis Foundation.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Large doses of intravenous iron increase kidney dialysis patients' chances of developing a serious infection, but smaller doses given less frequently do not raise the risk, a new study shows.

Dialysis patients often develop anemia and must be given intravenous treatments of iron to correct the condition. Intravenous iron, however, can promote bacterial growth and weaken the immune system, putting patients at increased risk for infections.

This is the first large study to examine how different intravenous iron dosing regimens might affect this risk.

Researchers analyzed data from more than 117,000 dialysis patients who were followed for three months. Of these patients, 12 percent received a large amount of iron over a short period of time (bolus dosing); 49 percent received smaller, less frequent amounts of iron (maintenance dosing); and 38 percent received no iron.

Bolus dosing was associated with an increased risk of serious infection and infection-related death. There were 25 additional infections per 1,000 patient-years among patients who received bolus dosing, compared with those who received maintenance dosing.

These risks were particularly high among patients who used a catheter for dialysis (73 additional infections per 1,000 patient-years) and for those with a history of recent infection (57 additional infections per 1,000 patient-years).

Patients who received maintenance dosing did not have a greater risk of infection than those who received no iron, according to the study, which was published online June 20 in the Journal of the American Society of Nephrology.

"Although administration of iron is necessary to manage anemia in hemodialysis patients, our results suggest that providing a large amount of iron over a short time may increase the risk of serious infections in dialysis patients," study author Maurice Alan Brookhart, from the University of North Carolina at Chapel Hill, said in a journal news release. "Smaller, less frequent doses of iron appear to be safer."

More information

The National Kidney Foundation has more about dialysis.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- An international team of scientists report they've assembled the first three-dimensional model of the human brain that maps its anatomy on a cellular level.

Previously, doctors had been able to locate areas in the brain using imaging technologies such as MRI and CT scans. But the new model, called BigBrain, will allow researchers to peer at the organ's structures in much greater detail, producing images that are about 50 times more finely grained than the resolution of the best available MRI brain atlases.

The research is published in the June 21 issue of the journal Science.

"Reference brains have become an important tool for neuroscience, and especially for human brain research," Science senior editor Dr. Peter Stern said during a Wednesday news conference on BigBrain. "For a better understanding of the structural organization of something as complex as the human central nervous system, we really need a much, much closer look."

To make the model, the scientists carefully sliced a human brain that had been dipped in wax. Each slice was about 20 micrometers thick, about the same width as the finest human hair.

Researchers stained the delicate tissue slices -- there were more than 7,400 altogether -- with special dye to highlight cells, and then scanned them. The digitized images were then cleaned up and reassembled with the help of a super computer that could process the large volumes of data required to store and integrate the pictures.

The brain was donated to the project by a 65-year-old woman. Little is known about her, researchers said, except that she was free of any neurological or psychiatric problems. The team hopes to repeat the process in a sample of brains so they can see differences between brains that are young and old, male and female.

The first BigBrain model is freely available for anyone who wants to use it.

"It is a common basis for scientific discussions because everybody can work with this brain model and speak about the same basic findings," said study author Dr. Karl Zilles, director of the Institute of Neuroscience and Medicine, Julich Aachen Research Center, in Germany.

Researchers said the images would help surgeons who need to precisely place electrical probes when they need to stimulate brain tissue to treat disease.

"When patients, for instance, with Parkinson's are getting electrodes to decrease their tremors, these electrodes are placed using atlases that are more or less 2-D schematic drawings, so it's a big problem to place electrodes into new positions because [the current] atlas does not allow them to do it," explained lead researcher Dr. Katrin Amunts, director of the Cecile and Oskar Vogt Institute for Brain Research at the Heinrich Heine University Dusseldorf, in Germany.

The maps could also help doctors understand what happens to the brain when different parts become diseased or injured.

Experts who were not involved in the work praised the effort.

Michael Hawrylycz, an investigator at the Allen Institute for Brain Science in Seattle, said the effort to collect and image the data was a "massive undertaking."

The dataset that contains the BigBrain is a terabyte in size, or about 1,000 gigabytes. That's enough room to store about 435,000 photos snapped with an iPhone camera.

And it's about 100,000 times larger than the volume of data used by MRI brain maps.

Researchers say they'd like to make the resolution of the BigBrain even better, but they'll need more advanced computers than are currently available to do it.

Experts said the BigBrain will be an important framework for efforts such as the BRAIN initiative that was recently announced by President Obama and the European counterpart, The Big Brain Project.

Those studies aim to map brain's connectivity and function, and the new model could help give both projects a common point of reference.

Other researchers said they weren't sure how useful the BigBrain would be, however.

"From what I've read, it looks like the difference between the iPhone 3 and the iPhone 5," said Donald Stein, director of The Brain Lab at Emory University in Atlanta. "People have been mapping the circuits of the brain since the turn of the 20th century," he noted.

"It's a much better, cleaner, nicer, maybe a little more detailed picture," Stein said. "This is really looking at structure from dead tissue. Brain dynamics are really much more complicated than that. This is just one part of the story."

More information

For more information on the BRAIN initiative, head to the U.S. National Institutes of Health.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Add another hazard to the long list of reasons not to smoke during pregnancy: Children exposed to tobacco smoke in the womb may be at higher risk for hearing loss.

Researchers examined data from almost 1,000 children aged 12 to 15 who took part in the 2005 to 2006 U.S. National Health Examination Survey. They found that about 16 percent of them had been exposed to tobacco smoke while in the womb.

These adolescents had evidence of some overall hearing loss and were nearly three times more likely to have one-sided, low-frequency hearing loss compared to youngsters without such exposures, according to the study published online June 20 in the journal JAMA Otolaryngology -- Head & Neck Surgery.

The level of hearing impairment associated with fetal exposure to tobacco smoke was "relatively modest" at less than three decibels, wrote a team led by Dr. Michael Weitzman, of the NYU School of Medicine in New York City. "[However], an almost three-fold increased odds of unilateral hearing loss in adolescents with prenatal smoke exposure is worrisome," they wrote.

The study could not prove a cause-and-effect relationship between smoking during pregnancy and hearing outcomes in offspring, only an association. Two hearing experts, however, said they weren't surprised by the findings.

"This is an effect which has been described previously for the adult population, so it is logical that it would also apply to children of smokers," said Dr. Ian Storper, director of otology at the Center for Hearing and Balance Disorders at Lenox Hill Hospital in New York City.

Storper said the study "provides more reason to eliminate tobacco usage across our population and to continue research in the area to understand the mechanism of damage to the auditory system."

Dr. Martin Chavez, director of Maternal Fetal Medicine at Winthrop University Hospital in Mineola, N.Y., agreed, noting that fetal exposure to toxins "can have lifelong consequences."

The new study "proves that not smoking or avoiding being around others who smoke can [not only] increase the likelihood of a healthy newborn, but also decrease the chances of other diseases later on," Chavez said.

More information

The March of Dimes outlines the risks of smoking during pregnancy.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Aspirin and related drugs may fight cancer by lowering rates of DNA mutation, a small new study suggests.

It's known that aspirin reduces the risk for some cancers, and these findings point to a possible explanation, according to the researchers from the University of California, San Francisco.

They analyzed tissue samples from 13 patients with a condition called Barrett's esophagus, which can lead to esophageal cancer. The patients were followed for between six and 19 years. Patients took aspirin at different times during the study.

Mutations in tissue samples collected while patients were on aspirin had accumulated an average of 10 times more slowly than in samples obtained when patients were not taking aspirin, according to the study, which was published online June 13 in the journal PLoS Genetics. The study did not, however, prove a cause-and-effect link between aspirin and slower rates of gene mutations.

"Aspirin and other non-steroidal anti-inflammatory drugs, which are commonly available and cost-effective medications, may exert cancer-preventing effects by lowering mutation rates," researcher Carlo Maley, a member of the UCSF Helen Diller Family Comprehensive Cancer Center, said in a university news release.

"This is the first study to measure genome-wide mutation rates of a pre-malignant tissue within patients for more than a decade, and the first to evaluate how aspirin affects those rates," he added.

Maley said aspirin may lower DNA mutation rates by reducing inflammation, and plans to further investigate this theory.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

New Test IDs Genotype of Hepatitis C

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THURSDAY, June 20 (HealthDay News) -- A new test to help doctors identify the genotype of a person's hepatitis C infection has been approved by the U.S. Food and Drug Administration.

The Abbott RealTime HCV Genotype II can distinguish between genotypes 1, 1a, 1b, 2, 3, 4, and 5, using an infected person's blood sample. Knowing the virus's genotype can help doctors determine the best treatment, the agency said Thursday in a news release.

Hepatitis C is the most common chronic blood-borne infection in the United States, and the leading cause of liver transplant, the FDA said, citing the U.S. Centers for Disease Control and Prevention (CDC). Some 3.2 million people are infected with the virus, and about 15,000 people die from the infection every year.

Untreated, hepatitis C can lead to liver cancer and liver failure, the agency warned. The virus is transmitted via blood and other bodily fluids, and intravenous drug users are at greatest risk of acquiring the infection.

The new test is approved for people who are known to have the infection. It is not meant as a way to diagnose hepatitis C, or as a way to screen for the virus's presence in the blood, the FDA said.

The test has not been evaluated in children or in people with compromised immune systems, the agency said. It is manufactured by Abbott Molecular, Inc., based in Des Plaines, Ill.

More information

The CDC has more about hepatitis C.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- The death of Emmy Award-winning actor James Gandolfini at age 51, apparently from cardiac arrest, has shocked the nation, given his relatively young age.

But cardiac experts say they are seeing more middle-aged Americans suffer heart problems, mainly due to lifestyle risks like poor diet, obesity and lack of exercise.

"While 51 years old is considered relatively young for having a heart attack, unfortunately we are seeing many more patients coming in with heart disease at younger ages," said Dr. Reena Pande, a cardiologist at Brigham and Women's Hospital in Boston. "This is, in part, because of the increased rate of risk factors for heart disease, such as obesity, physical inactivity, high blood pressure and diabetes, among others, occurring at younger ages in the U.S. population."

Gandolfini, who was best known for his Emmy-winning portrayal of mob boss Tony Soprano in the HBO series "The Sopranos," died Wednesday evening while vacationing in Rome. He reportedly collapsed in his hotel bathroom, and hospital officials said Thursday the cause of death was cardiac arrest, the Associated Press reported.

Donna Arnett, president of the American Heart Association, said, "It is not uncommon to have a sudden cardiac death at his age." She added, however, that much is still unknown about Gandolfini's health problems and heart risks.

Still, the actor seemed to have several major risk factors that could contribute to heart trouble. He enjoyed food and cigars, and was a big man who carried around excess weight.

The American Heart Association explains that cardiac arrest is the sudden loss of heart function in someone who may or may not have been diagnosed with heart disease. It's caused when the heart's electrical system malfunctions, prompting the heart to stop suddenly. Death usually occurs within minutes. However, cardiopulmonary resuscitation (CPR) and use of a defibrillator to shock the heart and restore a normal rhythm can sometimes prevent death if performed within a few minutes.

Cardiac arrest isn't the same as a heart attack, although the term "heart attack" is often mistakenly used to describe cardiac arrest. Heart attacks are caused by a blockage that stops blood flow to the heart, according to the heart association.

Pande said there are "many reasons why people develop cardiac arrest, which is a generic term for when the heart stops beating. The most common cause of cardiac arrest is having a heart attack, which means that there is a sudden blockage leading to the heart muscle not getting enough oxygen and nutrients.

"There are other causes of cardiac arrest, including having an abnormal heart rhythm, a weakened heart muscle, or scar in the heart muscle from a prior heart attack," she added. "Because having a heart attack is the most common cause of cardiac arrest, the risk factors for developing cardiac arrest are largely the same as those for developing heart disease."

An estimated 265,000 American men aged 45 to 64 suffer a diagnosed heart attack or fatal coronary heart disease each year, according to the heart association. By comparison, heart attack and fatal heart disease strike an average 180,000 men aged 65 to 74, and 235,000 men aged 75 and older.

Men have a higher risk than women of suffering from heart problems, and the risk increases with age. People with a family history of heart disease also are at greater risk of sudden coronary death, according to the heart association.

"The majority of the risk of heart disease can be attributed to lifestyle factors, such as smoking, lack of exercise, poor diet, diabetes, high blood pressure and high cholesterol," Pande said. "The good news is that these are modifiable risk factors, which means that they are factors that you have the power to change. If you smoke, you can quit. If you don't exercise, you can get more active. If you have diabetes or high blood pressure or high cholesterol, you can talk to your doctor and get these treated."

People who take steps to improve their heart health through diet and exercise will enjoy immediate benefits, even if they continue to have risk factors such as obesity or diabetes, said Dr. Jeffrey Berger, director of cardiovascular thrombosis at NYU Langone Medical Center in New York City.

"There's really nice data that if you are obese and you exercise, you do well," Berger said. "If you eat well and you exercise, your risk is not that of an obese person or even a normal weight person who doesn't do that," he added.

"We have such a tremendous influence on how likely or unlikely we are to develop a cardiovascular disease or have a cardiovascular event," he continued. "Unfortunately, we don't realize how much control we have."

The U.S. Centers for Disease Control and Prevention offers a number of things that people can do to reduce their risk of heart trouble, including:

  • Eat a healthy diet,
  • Maintain a healthy weight,
  • Exercise regularly,
  • Don't smoke, and limit alcohol consumption,
  • Monitor your blood pressure and cholesterol,
  • Manage your diabetes and take your heart medications.

More information

For more on heart health, visit the American Heart Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Listening to music while driving doesn't seem to curb response time and might even boost your focus in certain conditions, new Dutch research suggests.

For younger but experienced drivers, loud music from a CD or radio is not a safety concern on par with talking on a cellphone behind the wheel, a simulated-driving study of about 50 college-aged students found.

"Speaking on a cellphone or listening to passengers talking is quite different than listening to music, as the former types are examples of a more engaging listening situation," said study author Ayca Berfu Unal, an environmental and traffic psychologist who was a doctoral student at the University of Groningen when she embarked on the research.

"Listening to music, however, is not necessarily engaging all the time, and it seems like music or the radio might stay in the background, especially when the driving task needs full attention of the driver," Unal said.

She acknowledged, however, that her observations are in many ways preliminary and still await publication in a peer-reviewed journal.

Distracted driving is a serious public health issue. Each day in the United States, more than nine people are killed and more than 1,000 are injured in crashes that involve a distracted driver, according to the U.S. Centers for Disease Control and Prevention.

To study music's influence on driving performance, Unal enlisted 47 university students between 19 and 25 years old to engage in a series of simulated road tests. Participants had more than two and a half years' driving experience on average.

First, they were asked to create their own playlist, to make sure the music they listened to was familiar and well-liked.

Computerized driving simulations then surrounded the motorists with four large screens to create a 240-degree view of traffic. Conditions included driving with loud music, driving with moderate-volume music and driving with no music. No sound adjustments were allowed while the tests were under way.

Participants took the virtual wheel for about a half-hour twice in two weeks along a monotonous, non-threatening and predictable drive in two-way traffic.

Unal monitored heart rate changes at five-minute intervals and assessed the drivers' car-following behavior as they adjusted to the changing speed of vehicles ahead of them. Drivers also were asked to report levels of arousal (feeling energized, bored, fatigued or sleepy) while on the road.

The result: Neither the presence of music nor its volume had any ill effect on the drivers' ability to properly follow the car ahead of them.

What's more, those who drove with music responded faster to changes in the speed of the car ahead than those driving without music. And the louder the music, the faster the response, Unal said.

Music also seemed to enhance drivers' energy and arousal, helping to alleviate boredom without siphoning off critical driver focus, she found. Louder music prompted more energy than moderate-volume music, the research showed.

Nonetheless, Unal cautioned that music may have a different impact under more strenuous driving conditions and might even be distracting in a hectic environment. "Yet we see that drivers try to prioritize the driving task in such settings by, for instance, blocking out radio content and trying to focus their attention only to driving-related tasks," she said.

Also, older drivers might react differently than the young adults she tested, and trips longer than 30 minutes might elicit different responses, she said.

Dr. Karen Sheehan, an attending physician in the department of pediatric emergency medicine at the Lurie Children's Hospital of Chicago, said the findings are inconclusive regarding music's impact on driving safety.

"From an injury-prevention point of view, I'm not sure if the study answers the question as to whether it's good or bad to listen to music when driving," said Sheehan, who also is medical director of the Injury Free Coalition for Kids of Chicago.

"There are some limitations to the study. It's a driver simulation versus driving in the real world, so I'm not sure how well these findings would translate into a real-life situation," she said. "And, overall, I'm just not sure that there is enough information here to recommend listening to music when you drive."

U.S. National Highway Traffic Safety Administration spokesman Derrell Lyles said the agency could not comment on Unal's conclusions, given that "the agency has not studied the issue."

More information

For more on driving safety, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Black and Hispanic Americans have a greater age-related decrease in their sense of smell than whites, a new study says.

Losing the ability to smell can lead to poor nutrition because food smells play a major role in how foods taste, the researchers noted. A declining sense of smell may also be an early warning sign of degenerative brain diseases such as Alzheimer's or Parkinson's, and can be associated with an increased risk of early death.

About 24 percent of Americans aged 55 and older have a measurable problem with their sense of smell, according to the U.S. National Institute on Aging. That rises to about 30 percent for those aged 70 to 80 and more than 60 percent for those over age 80.

The new study included more than 3,000 older adults who were asked to identify five common odors. Only about half (49 percent) correctly identified all five odors, 78 percent got four or more right, 92 percent identified at least three, and 97 percent got two or more correct.

The ability to identify the odors declined with age. All five odors were identified by 64 percent of participants aged 57, but only 25 percent of those aged 85. Women did better than men, with scores equivalent to being five years younger, the investigators found.

In addition, non-white participants consistently scored 47 percent lower than whites, equivalent to a nine-year increase in age, according to the study published online recently in the Journal of Gerontology: Medical Sciences.

"We have long known that men begin to lose their sense of smell some years sooner than women, but this is the first study to point to racial or ethnic differences," study author Dr. Jayant Pinto, an associate professor of surgery at the University of Chicago, said in university news release. "What surprised us was the magnitude of the difference. The racial disparity was almost twice as large as the well-documented difference between men and women."

The cause of this racial/ethnic difference was unclear. Genetics could be a factor, as could exposure to nerve-damaging substances in the environment, or both, the researchers pointed out.

They explained that people's race/ethnicity may lead to different life experiences and environmental exposures that may interact with biological differences to affect age-related sensory loss.

More information

The U.S. National Institute on Aging has more about loss of sense of smell.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- The first major global review of violence against women finds that nearly one in three have been physically or sexually assaulted by a current or former partner.

And another study, published June 20 in The Lancet, finds that more than one-third of all female murder victims worldwide are killed by an intimate partner, a new study shows.

"Our results underscore that women are disproportionately vulnerable to violence and murder by an intimate partner, and their needs have been neglected for far too long," the author of one study , Dr. Heidi Stockl, from the London School of Hygiene & Tropical Medicine, said in a journal news release.

Meanwhile, data released by the World Health Organization (WHO) and others found that 30 percent of women experience physical or sexual abuse by a partner, the Associated Press reported. WHO defined physical violence as being slapped, pushed, punched, choked or being attacked using a weapon. Sexual violence was defined as feeling physically or mentally coerced into having sex and/or being compelled to engage in sexual acts that felt humiliating or degrading.

The new numbers were based on data from 1983 to 2010 from 86 countries worldwide. Rates of domestic violence were highest in Africa, the Middle East and Southeast Asia, the WHO found. The United Nations says that more than 600 million women live in countries where domestic violence is not considered a crime, the AP reported.

In another study, researchers analyzed data on more than 492,000 murders in 66 countries over 20 years. They found that 13.5 percent of murders are committed by an intimate partner, and that intimate partners are responsible for 38.6 percent of all female murders, compared with 6.3 percent of all male murders.

Nations with the highest rates of murder of women by intimate partners include those in southeast Asia (about 59 percent), the Americas (40.5 percent), and Africa (40 percent), as well as high-income countries (about 41 percent).

A woman's greatest risk of murder comes from a current or former intimate partner, and women are six times more likely to be killed by an intimate partner than men, Stockl noted.

Rates of murder of men by intimate partners are highest in high-income countries (6.3 percent), Africa (4 percent), and the low-income and middle-income European region (3.6 percent). In all other parts of the world, rates were lower than 2 percent.

The researchers said that a lack of data means that their findings likely underestimate the true size of the problem.

"More needs to be done, particularly to increase investment in intimate partner violence prevention, to support women experiencing intimate partner violence [most women killed by a partner have been in long-term abusive relationships], and to control gun ownership for people with a history of violence," Stockl said.

More information

The World Health Organization has more about violence against women.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Estrogen treatment delivered vaginally may help prevent repeat urinary tract infections in postmenopausal women, new laboratory research suggests.

Urinary tract infections are common among women, with one-quarter experiencing recurring infections. And age-related changes increase the likelihood of these infections developing after menopause, when estrogen production plummets.

Until now, taking antibiotics prophylactically -- to ward off recurrent urinary tract infections -- has been the gold standard for these women, said Thomas Hannan, a research instructor in pathology and immunology at Washington University School of Medicine in St. Louis. "But antibiotic resistance is increasing, and some women are resistant to everything we have," Hannan said. "We need other options. We need non-antibiotic options."

This study, published in the June 19 issue of the journal Science Translational Medicine, "suggests a more holistic approach by changing the way women respond to bacteria," said Hannan, co-author of an editorial accompanying the study in the journal.

The results support the use of vaginal estrogen as a preventive measure for postmenopausal women with recurrent urinary tract infections, he wrote in the editorial.

Working in the laboratory and with animal models, the researchers identified a number of ways that estrogen -- the female sex hormone -- helps keep recurrent urinary tract infections at bay.

"This study presents some underlying mechanisms for the beneficial effect of [topical estrogen formulations] after menopause and supports the application of estrogen in postmenopausal women suffering from recurrent UTIs," wrote the study's authors, from the Karolinska Institute in Stockholm, Sweden.

About half of all women will experience at least one urinary tract infection in their lifetime, according to the study. For about 25 percent of these women, the infection will come back again within six months.

Low estrogen levels have previously been linked to recurrent infections, and the new study sought to identify exactly how estrogen might affect a woman's risk of recurrent urinary tract infections.

For the study, the researchers used human cells from postmenopausal women who had used supplemental vaginal estrogen for two weeks. They also worked with mice that were given bacteria that would cause urinary tract infections like those in humans.

They found that estrogen encourages production of natural antimicrobial substances in the bladder. The hormone also makes the urinary tract tissue stronger by closing the gaps between cells that line the bladder. By gluing these gaps together, estrogen makes it harder for bacteria to penetrate the deeper layers of the bladder wall, the study authors said.

Estrogen also helps prevent too many cells from shedding from the top layers of the bladder wall.

"Normally, there's an innate response to infection and some cells die -- sort of taking one for the team -- and then these cells shed," Hannan said. "But shedding too much could allow bacteria to get into the deeper tissue, so this exfoliation is a double-edged sword."

According to the study, estrogen promotes the redistribution of cells and prevents excessive loss of cells during an infection.

One expert welcomed the findings.

"This study gives us more information about what we always had a sense was true: that women do get more [urinary tract infections] after menopause," said Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City.

Although taking estrogen in pill form is associated with an increased risk of breast cancer and cardiovascular disease, topical estrogen is much safer, Wu said. Topical estrogen formulations include creams, gels and vaginal suppositories.

"Only about 1 percent of estrogen cream or other topical delivery gets into the rest of the body's systems," she said.

Although commonplace, women shouldn't accept recurrent urinary tract infections as a normal part of aging, Wu said. "Talk to a gynecologist or urologist to find out what kinds of therapies are available," she said. "There are treatments besides antibiotics."

More information

To learn more about urinary tract infections, visit WomensHealth.gov.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- In addition to the well-known health risks of being overweight, a new study finds that obese teens may be at increased risk for hearing loss.

For the study, researchers analyzed data from nearly 1,500 adolescents, aged 12 to 19, who took part in the 2005 to 2006 U.S. National Health and Nutrition Examination Survey. Obese adolescents had greater hearing loss across all frequencies and were nearly twice as likely to have one-sided, low-frequency hearing loss, compared to their normal-weight peers.

The study was released online June 17 in advance of publication in an upcoming issue of the journal The Laryngoscope.

"This is the first paper to show that obesity is associated with hearing loss in adolescents," study first author Dr. Anil Lalwani, a professor and vice chairman for research in the department of otolaryngology/head & neck surgery at Columbia University Medical Center, said in a Columbia news release.

He and his colleagues theorized that obesity-caused inflammation may contribute to hearing loss. Nearly 17 percent of U.S. teens are obese.

"These results have several important public health implications," Lalwani said. "Because previous research found that 80 percent of adolescents with hearing loss were unaware of having hearing difficulty, adolescents with obesity should receive regular hearing screening so they can be treated appropriately to avoid [brain] and behavioral issues."

The nearly twofold increased risk of one-sided, low-frequency hearing loss in obese teens is particularly concerning because it suggests early, and possibly ongoing, injury to the inner ear that could progress as obese teens become obese adults, the researchers said in the news release.

Further research is needed to determine how hearing loss in obese teens affects their social development, school performance, behavior and thinking skills.

"Furthermore, hearing loss should be added to the growing list of the negative health consequences of obesity that affect both children and adults -- adding to the impetus to reduce obesity among people of all ages," Lalwani said.

Although the study found an association between obesity and hearing loss in teens, it did not prove a cause-and-effect relationship.

More information

The Nemours Foundation has more about overweight and obesity in children.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Fruits and vegetables in grocery stores are still alive and know what time of day it is, researchers report.

The findings suggest that the way produce is stored and eaten could have an impact on its nutritional value and health benefits, according to the study, which was published June 20 in the journal Current Biology.

"Vegetables and fruits, even after harvest, can respond to light signals and consequently change their biology in ways that may affect health value and insect resistance," study author Janet Braam, of Rice University, said in a journal news release. "Perhaps we should be storing our vegetables and fruits under light-dark cycles and timing when to cook and eat them to enhance their health value."

By remaining alive after being harvested, vegetables and fruits can alter levels of chemicals that protect them from being eaten by insects and other creatures, the researchers found. Some of these chemicals also have anti-cancer effects.

Braam and her colleagues made the initial discovery in cabbage and then found similar responses in lettuce, carrots, spinach, sweet potatoes, zucchini and blueberries.

By eating vegetables and fruits at certain times of day, you may gain the most benefit from them. But that may prove challenging, so the researchers suggested another approach to get the most out of your produce.

"It may be of interest to harvest crops and freeze or otherwise preserve them at specific times of day, when nutrients and valuable phytochemicals are at their peak," Braam said.

More information

The U.S. Centers for Disease Control and Prevention has more about fruits and vegetables.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- It's true that college students tend to pack on extra pounds, but women are more likely to be troubled by that weight gain than men, according to a new study.

"As women gained weight, their eating attitudes worsened and body dissatisfaction rose," said Laura Girz, a University of Toronto graduate student and lead author of the study, published online recently in the journal Appetite.

The "freshman 15" may be a misnomer, though. The study of nearly 500 students found undergrads add less than 10 pounds on average.

The researchers followed the incoming freshmen -- whose average age was about 18 -- from just before they entered college through the next four years. Besides charting weight, they assessed attitudes about eating, depression and body satisfaction, and charted how those attitudes changed as the scale shifted.

Gender differences were considerable, the researchers found.

Most students -- 303 -- gained some weight. Another 100 remained weight stable and 75 lost weight.

On average, the men gained about 9 pounds and the women about 7 over the entire study period.

Guys who porked up had the same attitudes about eating and well-being as the men who remained weight stable, Girz said. However, men who lost weight reported negative eating attitudes both at the study start and at the end.

The bottom line: Weight gain is linked with more preoccupation with weight and negative eating attitudes for women, but not men, while weight loss improves the negative eating attitudes only of women. Men who started out heavy and had negative attitudes about eating, Girz found, did not have better attitudes even if they lost weight.

Weight changes didn't have much effect on depression, she added.

Girz speculated that men who were underweight to begin with might have welcomed the additional pounds.

"The first year is a really stressful time and that can have an effect on eating behavior," Girz said. However, as students settle in, the weight control may become easier.

Students have told her that widespread availability of food on campus, large portions and school stress can undermine attempts to eat sensibly, Girz said. Stress can make some people stop eating, she noted, and prompt others to overeat.

Another expert indicated the findings were to be expected.

The gender differences "are probably not too surprising when you think about it," said Heidi Wengreen, associate professor of nutrition, dietetics and nutritional sciences at Utah State University in Logan, Utah, who was not involved with the study.

Many college-age men may want to put on muscle mass, so the weight gain does not concern them, she noted.

Also, the transition to college is a major life change, Wengreen said. In her own research, she has found weight gain more likely for students who said they were exercising less because of school pressures and time constraints.

Girz tells students not to obsess about weight gain. "We know the more you obsess, it's usually counterproductive," she said. Instead, she advises college students to listen to their body and recognize signals of fullness and hunger. Instead of chronic dieting, she suggests eating a balanced diet.

The Academy of Nutrition and Dietetics advises college students to eat breakfast, look for high-fiber foods, choose lean protein such as chicken and fish, and limit intake of alcohol and sugary drinks.

More information

To learn more about smart eating at college, visit the Academy of Nutrition and Dietetics.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- For transsexual people who seek hormonal therapy, a new study offers some welcome news: short-term use of the treatment is safe and effective.

Surgery and hormone therapy are options for transsexual (also called transgender) people who want to change their external appearance in order to match what they feel is their true gender. Hormone therapy involves taking large doses of male or female sex hormones, which has led to concerns about possible health risks.

The study assessed the effects of short-term hormone therapy among 45 transsexual men and 42 transsexual women at four European centers that specialize in such treatment. The female-to-male transsexuals received a form of the male sex hormone testosterone, and the male-to-female transsexuals received treatment to lower their male hormone levels along with a form of the female sex hormone estrogen.

Treatment lasted for 12 months and the researchers monitored patients' blood pressure, waist-to-hip ratio, and percentages of fat and lean tissue mass throughout the study.

The hormone therapy was safe and effective, according to the findings that were to be presented this week at the annual meeting of the Endocrine Society, in San Francisco.

"Although transsexualism remains a rare diagnosis, the number of trans persons seeking hormonal or surgical treatment has drastically increased in recent years, making a detailed multicenter description on the effects of cross-sex hormonal treatment timely," study lead author Dr. Katrien Wierckx, an endocrinologist at Ghent University Hospital in Belgium, said in a society news release.

"Our study gives valuable information about the effects of drastic changes in sex steroids on glucose [blood sugar] and lipid [blood fat] metabolism, cardiovascular and bone health, so that we can inform our future clients, their families and other caregivers more accurately on the desired effects, side effects and adverse events of cross-sex hormonal treatment," she added.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The Gay and Lesbian Medical Association offers health resources for transgender people.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 20 (HealthDay News) -- Illegal immigrants account for only 1.4 percent of health spending in the United States and have lower health care costs than legal residents or naturalized and U.S.-born citizens, according to a new study.

This suggests they have insufficient access to health care, concludes study author Jim Stimpson, director of the Center for Health Policy at the University of Nebraska Medical Center.

The researchers analyzed data from 2000 to 2009 and found that U.S.-born citizens spent $1 trillion on health care during that time. Spending by all immigrants -- legal and illegal -- was $96.7 billion and illegal immigrants accounted for $15.4 billion of that total, the researchers found.

"Today, undocumented immigrants and persons who immigrated less than five years ago have few options for health care access through public programs, leaving only the option to pay out of pocket or to secure private insurance," Stimpson said in a university news release.

About 6 percent of illegal immigrants received care for which providers were not reimbursed, compared with 2.8 percent of U.S.-born citizens. This may be because the immigrants are much more likely to have no health insurance, said Stimpson.

He said the findings, published in the June issue of the journal Health Affairs, reflect a history of policies that block access to care for unauthorized immigrants.

The safety net available for immigrants includes hospital emergency rooms and federally qualified health centers, but this type of limited access is insufficient, the researchers noted.

"These policies have merely shifted the financial burden of paying for the care of immigrants, and have potentially put the public's health at risk, when those who have infectious diseases defer treatment for illness," Stimpson said.

He said illegal immigrants should be given access to preventive and treatment services for infectious diseases and to the insurance marketplace.

More information

The U.S. Department of Homeland Security provides statistics on immigrants in the U.S..

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 20, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

'Sopranos' Star James Gandolfini Dies at Age 51

Actor James Gandolfini, who played mob boss Tony Soprano in the acclaimed HBO series "The Sopranos", died Wednesday in Italy of cardiac arrest. He was 51.

The Emmy Award-winning actor was traveling in Rome, where he was on vacation, and was scheduled to attend the Taormina Film Fest, The New York Times reported.

Hospital officials in Rome confirmed Thursday morning that Gandolfini died of cardiac arrest, according to the Associated Press.

HBO released a statement that said: "We're all in shock and feeling immeasurable sadness at the loss of a beloved member of our family. He was a special man, a great talent, but more importantly a gentle and loving person who treated everyone no matter their title or position with equal respect. He touched so many of us over the years with his humor, his warmth and his humility. Our hearts go out to his wife and children during this terrible time. He will be deeply missed by all of us."

The actor's body is in a hospital morgue in Rome. His remains can be returned to the United States after the U.S. Embassy issues a death certificate, CNN reported.

Gandolfini was born Sept. 18, 1961 in Westwood, N.J. He is survived by wife Deborah Lin, 8-month-old daughter Liliana and son Michael, from a previous marriage.

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Illness Outbreak at Yellowstone, Grand Teton National Park

A spike in cases of gastrointestinal illness among visitors at Yellowstone and Grand Teton national parks has led the National Park Service to tell people to make an extra effort when washing their hands.

In one case that occurred June 7, members of a tour group visiting Mammoth Hot Springs in Yellowstone began complaining of stomach and other issues. Park employees who had contact with the group reported similar symptoms within 48 hours, CNN reported.

Tests revealed that the cause of the illnesses was highly-contagious norovirus.

In addition to visitors, suspected cases of norovirus have occurred among more than 100 Yellowstone employees and 50 Grand Teton workers, according to the National Park Service.

In response to the situation, the park service and businesses that operate in the parks are taking special measures, including more frequent cleaning and disinfection of public areas. Park workers who show signs of infection must be symptom-free for 72 hours before returning to their duties, CNN reported.

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Restrict Use of Food Stamps to Buy Sugary Beverages: Mayors

The mayors of major U.S. cities want the federal government to examine ways to limit people's use of food stamps to buy soda and other sugary drinks.

In a letter sent to congressional leaders on Tuesday, the mayors of New York, Los Angeles, Chicago and 15 other cities said this would be a way to fight obesity and related diseases, CBS News/Associated Press reported.

"More than one third of American adults are now obese, costing approximately $147 billion per year in associated medical expenses," the letter stated. "As a result of obesity, this generation of American children is the first to face the possibility of a shorter life expectancy than their parents. It is time to test and evaluate approaches limiting SNAP's (Supplemental Nutrition Assistance Program's) subsidization of products, such as sugar-sweetened beverages, that are contributing to obesity."

"We need to find ways to strengthen the program and promote good nutrition while limiting the use of these resources for items with no nutritional value, like sugary drinks, that are actually harming the health of participants," New York Mayor Michael Bloomberg, whose office released the letter, said in a statement, CBS/AP reported. "Why should we continue supporting unhealthy purchases in the false name of nutrition assistance?"

The food stamp program is run by the U.S. Department of Agriculture, which declined to comment on the letter, which was addressed to Republican House Speaker John Boehner and House Democratic leader Nancy Pelosi.

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Keep Food Safe

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(HealthDay News) -- If you've packed food and snacks for your hiking or camping trip, don't forget these food safety rules to make sure food poisoning doesn't ruin your plans.

The U.S. Food Safety and Inspection Service offers these suggestions:

  • Make sure you choose foods that are light enough to carry and won't spoil easily.
  • For cold foods, freeze them overnight and bring them frozen.
  • Wash your hands, and keep all raw meats and juices away from other foods.
  • Make sure your water source is safe by boiling or using water purification tablets.
  • Pack nonperishable foods, such as dried fruits, beef jerky, nuts, peanut butter and canned foods.
  • Use a food thermometer to make sure all foods are thoroughly cooked.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- When a tornado is headed for your home, it's important to take shelter immediately in the safest possible spot.

The U.S. Centers for Disease Control and Prevention offers these tornado safety tips:

  • Stay away from all windows.
  • The safest place in any home is a basement.
  • If you do not have a basement, go to the lowest floor, away from any windows. This space may be a bathroom, closet or hallway.
  • Position yourself under a sturdy piece of furniture, such as a table or bench.
  • Cover your body with a blanket or mattress and use something to protect your head.
  • Avoid having a very heavy object, such as a piano or refrigerator, directly above you. The object could fall through the floor.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Many of those lucky enough to survive a stroke find that they're soon faced with another serious challenge. Nearly one-quarter will develop symptoms of post-traumatic stress disorder, according to a new study.

The data show that experiencing a life-threatening health crisis can pose serious psychological challenges, said study lead author Donald Edmondson, an assistant professor of behavioral medicine at Columbia University Medical Center in New York City.

Although post-traumatic stress disorder (PTSD) typically is associated with combat veterans and sexual assault survivors, the researchers discovered that patients who develop a serious health condition followed by intense treatment may have mental problems that frequently go unrecognized by physicians and family members.

The study, published online June 19 in the journal PLoS ONE, also found that people who develop PTSD after a stroke could have a greater risk for heart problems or another stroke because of the psychological issues they endure.

PTSD is an intense physical and emotional response to a life-threatening or traumatic event. The symptoms fall into three broad types: reliving the event, avoiding usual activities and hyperarousal, according to the U.S. Centers for Disease Control and Prevention.

For Peter Cornelis, 62, the trauma of enduring a series of strokes followed by brain surgery left him unable to move for months. He remembers lying in bed mentally designing paintings to help him occupy endless hours with nothing to do.

Over the past four years, he has been slowly rehabilitated, and he now walks with a cane. Although he leads an art class at the local community center in Wantagh, N.Y., he avoids going outside as much as possible, because he suffers from PTSD.

Cornelis said he has little control over his emotions -- from crying when he reads a sentimental greeting card to laughing at nothing at all. Sometimes he blows up without knowing why. He is anxious around people, worrying about how he'll react and how others will respond to him. "And I'm afraid," he said. "Could I have another stroke? Can I make plans for the future?"

But people think he has recovered, Cornelis said. "I look fine, talk perfectly," he said.

Cornelis is not alone. Each year, nearly 300,000 stroke survivors will develop PTSD symptoms because of their health scare, the researchers said. Twenty-three percent will develop PTSD symptoms, and for about 11 percent, the condition will become chronic.

For the study, the researchers analyzed nine prior studies of stroke or transient ischemic attacks (TIAs), which are blood vessel blockages that break up quickly and dissolve without lasting damage. Together, the studies included more than 1,100 survivors who were either interviewed or given questionnaires.

PTSD is triggered in people who have strokes and TIAs by a variety of sequential factors, Edmondson said. First, there is a significant, terrifying, life-threatening event that is often accompanied by internal cues, such as a rapid heart rate and high blood pressure. "It's called the fight or flight response, and it's our innate response to fear," he said. An emotional ambulance ride, invasive tests, hospitalization and sometimes surgery follow.

Next, people must adjust to the shock of what has just happened, Edmondson said. "We walk through our lives with the naive belief that we're invulnerable," he said. "Often what is traumatic [about a stroke or heart attack] is that such unspoken assumptions are broken."

And once home, physical and environmental cues can stimulate the fear response all over again. Unlike a soldier who can leave the battlefield, stroke patients typically return to the place where the crisis occurred. Many patients may simply see the living room chair where they had the stroke and immediately feel PTSD symptoms.

Flashbacks, nightmares, palpitations, chills, and elevated heart rate and blood pressure may occur for months or years after their return home, Edmondson said. Severe anxiety, headaches and outbursts of anger also are likely for patients with PTSD.

"PTSD is a huge detriment to quality of life, a debilitating disorder in its own right, and deserves to be treated," said Edmondson.

Edmondson said that although the research does not show that strokes cause PTSD, he thinks it comes close. "You can't develop PTSD without a life-threatening event," he said. "Having PTSD can't cause a stroke a month ago, so this research is some of the strongest causal evidence we have."

Dr. Rafael Ortiz, director of the division of neuroendovascular disease and stroke at Lenox Hill Hospital in New York City, said he thinks this is the first time PTSD has been so closely associated with strokes and TIAs. "It's important that after suffering from a stroke, people are taken care of by a comprehensive team of doctors and other specialists, including psychologists and nurses who are very well-trained," he said.

Edmondson encouraged patients and family to talk with their physicians about PTSD. "I really hope this research lets survivors and their family members know it's not weird and it's nothing to be ashamed of," he said. "It's treatable. Tell somebody."

More information

Learn more about PTSD from the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- The new respiratory virus responsible for an ongoing outbreak in the Middle East poses a serious risk to hospitals because it is easily transmitted in health care facilities, according to a new study.

A team of infectious-disease experts traveled to Saudi Arabia to investigate the spread of the Middle East respiratory syndrome coronavirus (MERS-CoV) in four Saudi hospitals in May. They concluded that the new virus was even more deadly than the related SARS (severe acute respiratory syndrome) virus that caused an outbreak in Toronto hospitals in 2003.

Not only is MERS-CoV easily transmitted from patient to patient, but also from hospital to hospital when sick patients are transferred, according to the study, which was published online June 19 in the New England Journal of Medicine.

"Our investigation showed some surprising similarities between MERS and SARS. Both are very deadly viruses and easily transferred between people, and even between health care facilities," team member Dr. Trish Perl, senior hospital epidemiologist for Johns Hopkins Medicine and a professor at the Johns Hopkins University School of Medicine, said in a Johns Hopkins news release.

At the time of the investigation, 23 people in Saudi Arabia had been infected with MERS-CoV and 11 had died of the virus. The death toll in that country now stands at 32, with 49 people infected, according to the most recent report from the U.S. Centers for Disease Control and Prevention.

In Saudi Arabia, swift action by local health officials to monitor the disease -- including rapid detection, isolation and treatment of infected patients -- has largely helped stem the outbreak, Perl said.

In addition, hospitals have ramped up infection control by introducing stronger disinfectants, requiring health care workers to follow strict procedures (such as wearing masks, gowns and gloves), giving infected patients private rooms and providing masks for uninfected patients in the vicinity.

The investigators also found that the death rate for MERS was much higher than for SARS: 48 percent versus 8 percent, respectively. But the MERS death rate may decrease if more cases -- including patients with mild symptoms -- are identified, the experts said.

The time from MERS exposure to the first signs of infection is about a little more than five days. Symptoms include coughing, shortness of breath, fever and vomiting. It took an average of about eight days for the virus to spread from one person to another, the findings showed.

"The story of how this outbreak occurred and how this virus was transmitted became very clear once we started to lay out the evidence and saw that one infected patient had been in the hospital at the same time as another infected patient, and this patient was transferred to another hospital, where another patient became infected shortly thereafter," Perl said in the news release.

Knowing this information is critical to halting future MERS outbreaks because it reveals how long health officials have to act before a person exposed to the virus begins to show symptoms and when people they infect also start to show symptoms, the researchers said.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Happy? Mad? Afraid? Scientists have now developed the first computer model of brain activity that can be used to identify people's emotions, according to a new study.

The technique was developed using 10 actors who were asked to randomly and repeatedly go into nine emotional states -- anger, disgust, fear, happiness, lust, pride, envy, sadness and shame -- while their brains were monitored by functional MRI.

To identify the emotions within the brain, the researchers used the participants' neural activation patterns in early scans to identify the emotions experienced in later scans.

Research on emotions has been difficult due to the lack of reliable methods to evaluate them, mostly because people tend to be reluctant to honestly divulge their feelings. Attempts are further complicated by the fact that people may not be conscious of many of their emotional responses, according to the team at Carnegie Mellon University.

"This research introduces a new method with potential to identify emotions without relying on people's ability to self-report," study lead author Karim Kassam, an assistant professor of social and decision sciences, said in a university news release.

"It could be used to assess an individual's emotional response to almost any kind of stimulus; for example, a flag, a brand name or a political candidate," Kassam explained.

The study appears in the June 19 issue of the journal PLoS One.

Study co-author Amanda Markey, a graduate student in the department of social and decision sciences, said "Despite manifest differences between people's psychology, different people tend to neurally encode emotions in remarkably similar ways."

The researchers plan to use the new computer model to tackle a number of challenging problems in emotion research, including identifying feelings that people are actively trying to suppress and multiple emotions experienced at the same time, like the blend of joy and envy you might feel when you hear about a friend's good fortune.

The research was funded by the U.S. National Institute of Mental Health.

More information

Helpguide.org explains the importance of emotional health.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Flu shots likely prevented 13 million illnesses and more than 110,000 hospitalizations in the United States between 2005 and 2011, according to a new study.

The impact of flu vaccination was greatest during 2010-2011, when 5 million flu cases, 2.1 million medical visits and 40,400 hospitalizations were avoided, according to researchers from the U.S. Centers for Disease Control and Prevention.

The findings, published June 19 in the journal PLoS One, are based on a calculation of the health-care burden of flu cases that would have occurred in the absence of vaccination. Factors such as illness and hospitalization rates during the flu season, vaccination coverage and vaccine effectiveness were considered in the calculation.

"These results confirm the value of influenza vaccination, but highlight the need for more people to get vaccinated and the imperative for vaccines with greater efficacy, especially in the elderly," study senior author Joseph Bresee, chief of epidemiology and prevention in the CDC's influenza division, said in a journal news release.

The United States is the only country with universal influenza vaccine recommendations that suggest everyone aged 6 months and older should receive an annual flu vaccination, the researchers said. They added that previous studies have not provided ways to reliably assess the number of flu cases or hospitalizations prevented by vaccination each year.

More information

The U.S. Centers for Disease Control and Prevention has more about seasonal flu vaccination.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Young children of depressed mothers may develop fewer emotional problems if they spend time in some kind of day care, a new study suggests.

The Canadian research doesn't definitively prove that kids gain benefits from getting care from people other than their troubled mothers, and it doesn't examine the potentially high costs of alternative types of care. Nor does the study look at the role of fathers in caring for the kids.

However, experts said the study provides strong evidence of the value of day care when a mom is struggling with depression.

"The main message is that day care looks like it makes a huge difference in the long term," said Alan Kazdin, a child psychiatry professor at Yale University. "It's not trivial, and it's not just babysitting."

At issue are the children of mothers with depression, a condition that's estimated to strike 30 percent to 40 percent of mothers of childbearing age at some point. While it's difficult to fully understand how these kids are affected, "depressed mothers are likely to be more disengaged, inconsistent, negative and unresponsive, and less likely to be warm and supportive," explained Susan Campbell, a psychology professor at the University of Pittsburgh.

In the new study, the Canadian researchers followed 1,759 children between the ages of 5 months and 5 years. The investigators tracked the children's emotional problems (such as separation anxiety and inability to socialize with others) after the age of 17 months.

The researchers also followed their mothers, looking for signs of depression. And they monitored whether the kids were regularly cared for by relatives, outside babysitters or in day-care centers.

After adjusting statistics so they wouldn't be thrown off by various factors, the investigators found that about 12 percent of kids of non-depressed mothers showed signs of emotional problems, said study author Catherine Herba, an assistant professor of psychology at the University of Quebec at Montreal. But that number jumped to 32 percent among children of mothers who were depressed and didn't receive regular child care from anyone other than their mothers.

However, that number fell to 7 percent among kids whose mothers were depressed and were in day care; it fell to between 15 percent and 18 percent for those whose mothers were depressed and were cared for by a relative or babysitter, Herba said.

What's going on? Campbell said group child care can provide structure, toys and activities, and opportunities to socialize with others kids while giving stressed-out mothers a break.

Herba said future research should explore other aspects of how child care influences the lives of kids, such as how the quality of care affects the outcome. For now, she said, "we need to think about how we can better support mothers and families."

The study was published online June 19 in the journal JAMA Psychiatry.

More information

For more about child care, try the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- There's more evidence that routine colonoscopy confers life-extending benefits.

A new study that included almost 1,100 patients found that those whose cancer was spotted by colonoscopy tended to have an earlier stage of disease at the time of their diagnosis, as well as better survival.

In contrast, patients whose colorectal cancer was not diagnosed through colonoscopy were at higher risk of having more invasive tumors, as well as cancers that had already spread to other areas of the body.

The findings provide "yet another compelling reason for asymptomatic, average-risk individuals over the age of 50 to get screened by colonoscopy," said Dr. David Carr-Locke, chief of the division of digestive diseases at Beth Israel Medical Center in New York City. Carr-Locke was not involved in the study.

The findings were published online June 19 in the journal JAMA Surgery.

In the study, researchers led by Ramzi Amri, of Massachusetts General Hospital and Harvard Medical School in Boston, looked at outcomes for nearly 1,100 patients treated for colon cancer. In 217 cases, the cancer had been spotted in a screening colonoscopy.

At the time of their diagnosis, patients whose cancers had not been spotted via colonoscopy had nearly double the odds of having an invasive tumor compared to those whose tumor had been found through a colonoscopy. They also had more than three times the odds for a metastatic tumor that had spread to other parts of the body, the researchers reported.

During follow-up, patients not diagnosed through colonoscopy screening had higher death rates, higher cancer recurrence rates, shorter survival and shorter lengths of time during which they were cancer-free, the team found.

"Compliance to screening colonoscopy guidelines can play an important role in prolonging longevity, improving quality of life, and reducing health care costs through early detection of colon cancer," Amri and colleagues wrote.

Since they were introduced in 2000, colonoscopy guidelines recommended by the U.S. National Institutes of Health appear to have decreased overall rates of colorectal cancer, the researchers said.

Dr. Maurice Cerulli, program director in the division of gastroenterology, hepatology and nutrition at North Shore-LIJ Health System in New Hyde Park, N.Y., agreed that the adoption of routine colonoscopy has "resulted in a decrease in the number of people dying from colon cancer over the past decade."

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- People who experience stroke-like symptoms -- so-called "silent strokes" -- but do not have full-blown strokes are still at higher risk for memory and thinking problems, a new study finds.

Researchers reporting June 19 in the journal Neurology said the findings emphasize the need to be vigilant when any sign of stroke occurs.

"Our study highlights the importance of discussing stroke-like symptoms with your family doctor, even if they don't last long," study author Dr. Brendan Kelley, of the University of Cincinnati, said in a journal news release. "These symptoms can be a warning sign that a person is at increased risk of stroke or problems with thinking or memory."

Kelley's team's study involved nearly 24,000 people, average age 64, who completed stroke-symptom questionnaires at the start of the study and every six months after that for at least two years. Their memory and thinking skills were also tested yearly.

During the study, 30 percent of the participants experienced stroke-like symptoms but did not suffer a stroke. Those people were more likely to develop memory and thinking problems than those without such symptoms.

Memory and thinking problems were much more likely to occur in both whites and blacks with stroke-like symptoms (11 percent and 16 percent, respectively) than in people without such symptoms (5 percent and 10 percent).

"Silent strokes that cause small areas of brain damage have been tied to memory and thinking problems, but it has been difficult to study these 'silent strokes' due to the cost and inconvenience of obtaining brain MRIs," Kelley said. "With this study, we found that a quick, seven-question test can be a cost-effective tool to help identify people at increased risk of developing dementia."

Another expert said knowing the symptoms of stroke is key.

"It is important that people who experience an inability to speak, slurred speech, weakness, double vision, dizziness or numbness on one side of the body undergo [emergency care] for treatment of stroke," said Dr. Rafael Alexander Ortiz, director of Neuro-Endovascular Surgery and Stroke at Lenox Hill Hospital in New York City. He was not involved in the new study.

"Some strokes can be 'silent' or asymptomatic because of the location within the brain," Ortiz said. Health care workers should ask questions regarding a potential history of silent strokes in patients, he added, so therapies might be initiated that could "decrease the chance of memory problems and, more importantly, to decrease the chance of a life-threatening stroke."

More information

The U.S. National Institute of Neurological Disorders and Stroke outlines the symptoms of a stroke.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Vaccination against the cancer-causing human papillomavirus (HPV) is proving highly effective in reducing the spread of the sexually transmitted virus among young women, new research shows.

The rate of new infections with strains of HPV targeted by the vaccine have dropped by 56 percent among females aged 14 to 19 since the first vaccine was approved in 2006, report researchers at the U.S. Centers for Disease Control and Prevention.

According to the CDC, HPV infection is known to be the major cause of cervical cancer, and has also been strongly linked to vulvar, vaginal, penile, anal, and certain throat/oral cancers.

The new findings "are striking results, and I think they should be a wake-up call that we should increase vaccination rates, because we can protect the next generation of adolescents and young girls against cancer," CDC director Dr. Tom Frieden said in a press conference held Wednesday.

The findings are published in the June issue of The Journal of Infectious Diseases.

Each year in the United States about 19,000 cancers caused by HPV occur in women, with cervical cancer being the most common. Virtually all cases of cervical cancer are caused by HPV, and just two HPV subtypes, 16 and 18, are responsible for seven out of every 10 cervical cancers.

About 8,000 cancers caused by HPV occur each year in men in the United States, most commonly being throat cancer.

The decline in HPV infections among girls is actually higher than had been expected, indicating that "herd immunity" may have taken effect as more girls receive the vaccine, study lead author Dr. Lauri Markowitz said at the press conference.

Herd immunity occurs when widespread vaccination shrinks the pool of infected people to the point that it becomes less likely that a person can catch the disease from someone else. In this type of scenario, "even people who aren't vaccinated will have some protection due to the vaccination program," Markowitz said.

Another possible reason for the better-than-expected results could be that the vaccine is so effective that a girl receives protection from HPV even if she receives only one or two shots out of the full recommended three-dose series of vaccination.

Whatever the reason, the new statistics are "great news," according to Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "I think every young woman should have the opportunity to have this vaccine. That's what I've been telling people for however long the vaccine has been available."

HPV is highly infectious. In fact, about 79 million Americans, most in their late teens and early 20s, are thought to be currently infected with HPV, and each year about 14 million people become newly infected.

The study was based on data from the CDC's National Health and Nutrition Examination Survey. It compared HPV infections in teenage girls from 2003 to 2006 (before the start of the United States' HPV vaccination program) against infections that occurred from 2007 to 2010, after girls began receiving the vaccine.

The CDC team showed that infections by the HPV types covered by the vaccine fell dramatically -- from 11.5 percent in the pre-vaccine era to 5.1 percent post-vaccine.

There has been some public resistance to the HPV vaccine, of which there are now two versions, Gardasil (approved in 2006) and Cervarix (approved in 2009). The CDC currently recommends routine immunization at ages 11 to 12 for both boys and girls -- before most young people become sexually active.

A series of three shots is recommended over six months for both girls and boys. HPV vaccination is also recommended for older teens and young adults who were not vaccinated when younger.

"Unfortunately, only one-third of [U.S.] girls aged 13 to 17 have received the full three-dose series of the HPV vaccine," Frieden pointed out. In contrast, "countries such as Rwanda have vaccinated more than 80 percent of their teen girls. [The U.S. rate] is simply unacceptable. Our low vaccination rates represent 50,000 preventable tragedies; 50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we had reached our goal of 80 percent vaccination rates. For every year we delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes."

Brooks believes resistance to vaccination stems from a couple of factors, one being the difficulty in explaining to people how the vaccine works. "It's a conceptually difficult thing for people to recognize -- that a virus causes a cancer," he said. "That's a major, major issue."

Parents also have been reluctant to have their adolescent girls and boys receive a vaccine against a sexually transmitted disease, said Dr. Jill Rabin, head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

"This is the tack that I take with patients and with families: the reason we give it to younger women is that they will build up the best antibody response," Rabin said. "It's not that we're giving it now because we expect them to have sex in their teenage years. We're giving it because they will make the best antibody response so when they do become sexually active, they will have protection at that point.

"If you give it to a 26 year old, they aren't going to mount as good an antibody response as someone who is 11 or 12 years old," she continued. "You're going to be giving better protection if you give it younger. It's not permission for them to go out and have intercourse."

Doctors also play a role in the failure to achieve widespread HPV vaccination, Frieden added.

"Providers are not consistently giving strong recommendations for the vaccine, and they are not encouraging vaccination at every encounter," he said.

Frieden said the vaccine has a safe track record, with no serious long-term complications associated with it even though more than 56 million doses have been distributed in the United States.

"The time has come to ramp up our efforts to vaccinate the next generation against cancer," he concluded. "This is an anti-cancer vaccine."

More information

For a helpful Q & A on the HPV vaccine, head to the American Cancer Society.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Researchers interested in learning how certain rodents manage to live long, cancer-free lives have stumbled upon a potentially valuable clue: a substance outside their cells seems to help stop malignancies from spreading.

Most research has focused on how cancer occurs inside cells. Studying the area outside the cell, in what is called the "extracellular matrix," is new territory, explained study co-author Vera Gorbunova, a professor of biology and oncology at the University of Rochester, in Rochester, N.Y.

The substance the team studied is a molecule called hyaluronan. The rodents, naked mole rats that are the size of mice, live about eight times longer than rats and mice do. Unlike other mammals, they also have never been known to develop cancer. As it turned out, naked mole rats have tissue rich in hyaluronan.

The potentially good news for humans?

Hyaluronan is also a natural component of human tissues, and it is already used to treat arthritis, cover skin in burn victims and as an ingredient in anti-wrinkle creams, according to Gorbunova.

Hyaluronan works by binding to certain receptors that control cell behavior. Short forms of the molecule are associated with inflammation and cell growth, while the longer form (the kind the naked mole rats possess) are not linked to inflammation and prevent cell proliferation, Gorbunova explained.

In other words, for cancer cells to spread, they have to break out of the tissue. Luckily for naked mole rats, their long molecules of hyaluronan prevent that from happening.

Should the connection between the naked mole rat's form of hyaluronan and cancer prevention be proven through further research, it's likely that humans could get injections or pills that increase the amount of the molecule in their bodies, said Gorbunova. The next step is to test the ability of hyaluronan to stop the spread of cancer in mice, she added.

For the research, which was published June 19 in the journal Nature, the scientists began by looking at naked mole rat cells in a growth medium in the laboratory. They noticed that their cells seemed to grow differently than did others, allowing more space between other cells than expected, said Gorbunova.

The investigators also realized that the growth medium was somehow becoming unusually "gooey" after a couple of days. They knew that growth media with cells from humans, guinea pigs and mice did not become thick and sticky.

But the scientists had no idea what could be transforming the consistency of the growth medium. "When we saw the gooey media, I was pessimistic and thought we'd never find out what it was," noted Gorbunova. But a graduate student working on the research decided to simply "google" a description of what they had found, and learned it was hyaluronan, she added.

Next, the researchers tested what would happen if they removed the hyaluronan, and discovered that the cells then became susceptible to tumors, confirming the role the molecule plays in "cancer-proofing" naked mole rats. The scientists went on to identify the gene responsible for making hyaluronan, and learned that it was not the same as it is in other mammals.

Hyaluronan, which makes tissue more elastic and facilitates the healing process, is found in high concentrations in naked mole rats. The researchers think the rodents may have developed high levels of the substance to make it easier to squeeze through underground tunnels.

Gorbunova said scientists have been focusing on what was going on inside cells, and now they may start studying the extracellular matrix. "Now there may be a shift to understanding the extracellular environment as a key component in cancer development," she said.

Vadim Gladyshev, director of the Center for Redox Medicine at Brigham and Women's Hospital and Harvard Medical School, agreed. The discovery is "a little bit unexpected because it's not the typical type of cancer research -- studying the outside of cells -- rather than focusing on cell mechanisms and tumor suppressors," he said.

Gladyshev has something in common with Gorbunova: He's been studying naked mole rats, too. He published research two years ago that showed how he sequenced the full genome of the rodents, looking for clues to their exceptionally long, cancer-free lives. He thinks her findings should now be examined at the genomic level to search for pathways associated with the function of hyaluronan. His hope is that he can pursue that effort in cooperation with Gorbunova's team, he said.

More information

Learn more about cancer from the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Could screening for colon cancer someday be as easy as having a blood test? Researchers say just such a test is showing early promise in trials.

The screening checks for levels of miR-21 -- a piece of DNA known as microRNA. Researchers in the gastrointestinal cancer research lab at the Baylor Research Institute in Dallas studied several hundred patients with either colorectal polyps (noncancerous growths that often precede cancer) or full-blown cancer.

They found that measuring levels of miR-21 in the blood accurately spotted up to 92 percent of patients with colorectal cancer.

The test also accurately identified up to 82 percent of patients with advanced colorectal polyps -- growths that put people at high risk of developing colorectal cancer.

The study was published June 19 in the Journal of the National Cancer Institute.

"This blood-based test could be transformative in how we screen patients for colorectal cancer; it would save lives and could result in major savings of health care dollars," Dr. Michael Ramsay, president of Baylor Research Institute, said in an institute news release.

Other experts were cautiously optimistic.

"These results are very promising for the future of cancer screening and treatment," said Dr. Jerald Wishner, director of colorectal surgery at Northern Westchester Hospital in Mount Kisco, N.Y.

"Colonoscopy screening is the current gold standard to detect colon cancer. However, less than 50 percent of Americans who should be screened get screened," Wishner said. "The blood test is a less invasive screening method that will eliminate barriers to colonoscopies, including embarrassment and possible discomfort in preparation for the test."

Dr. David Robbins, associate chief of endoscopy at Lenox Hill Hospital in New York City, agreed that it is "only a matter of time before we can screen for the most common, and most lethal, cancers using a simple blood test."

"This well-designed study brings us one step closer to the holy grail of colon cancer eradication by identifying those at high risk for developing colon cancer by measuring a pretty straightforward genetic signature," Robbins said.

According to the American Cancer Society, colon cancer is the second leading cancer killer, after lung cancer. More than 102,000 new cases of the disease will be diagnosed among Americans this year, and almost 51,000 people will die from the disease in 2013.

More information

The American Cancer Society has more about colorectal cancer.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- A higher dose of cholesterol-lowering statin drugs did not increase the risk of kidney injury in heart attack survivors, according to preliminary study findings.

Statins have been shown to reduce the risk of a first heart attack or repeat ones, but some recent studies have suggested that higher doses of the drugs may be linked to a higher incidence of kidney injury.

To investigate the issue, researchers analyzed data from two large clinical trials in which thousands of heart attack survivors received either high- or low-dose statins. The investigators found that higher doses did not increase the risk of hospitalization for treatment of kidney injury.

The study also found that concentrations of a blood protein called creatinine -- an indicator of kidney function -- were comparable between the high- and low-dose statin groups during follow-up.

The findings were presented Wednesday on the American Heart Association's Emerging Science Series webinar.

"These findings provide important reassurance to clinicians that the use of some high-potency statins will not increase the risk of kidney injury," study lead author Dr. Amy Sarma, a resident physician in internal medicine at Brigham and Women's Hospital in Boston, said in an AHA news release.

The data and conclusions of unpublished research should be considered preliminary until published in a peer-reviewed journal.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- In an effort to focus greater attention on the weight-gain epidemic plaguing the United States, the American Medical Association has now classified obesity as a disease.

The decision will hopefully pave the way for more attention by doctors on obesity and its dangerous complications, and may even increase insurance coverage for treatments, experts said.

"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans," AMA board member Dr. Patrice Harris said in a statement Tuesday. "The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity."

One expert thinks the AMA's decision, approved Tuesday at the group's annual meeting, could lead to greater coverage by insurance companies of treatments for obesity.

"We already treat obesity as a chronic illness," said Dr. Esa Matius Davis, an assistant professor of medicine at the University of Pittsburgh. "But this decision will bring more resources into the picture because it will, hopefully, allow for more insurance coverage and that really has been the issue of getting people the help that they need," she said.

Treatments for obesity -- including drugs, nutritional counseling and surgery, if needed -- often don't get reimbursed by insurance companies, Davis said. That means many patients aren't getting the care they need because they can't afford to pay the out-of-pocket costs, she said.

If insurance covered these services "it would increase referrals and treatment and that would be a huge step in the right direction," Davis said.

Right now, Davis gets insurance coverage for her obese patients by diagnosing them with high blood pressure or high cholesterol or diabetes, or other obesity-related conditions. But, that still leaves many obese patients out in the cold, she said.

The Obesity Society, which calls itself the leading scientific society dedicated to the study of obesity, applauded the AMA's decision. "The passage of a new American Medical Association policy classifying obesity as a disease reinforces the science behind obesity prevention and treatment," Theodore Kyle, advocacy chair, said in a statement.

"This vital recognition of obesity as a disease can help to ensure more resources are dedicated to needed research, prevention and treatment; encourage health care professionals to recognize obesity treatment as a needed and respected vocation; and, reduce the stigma and discrimination experienced by the millions affected," he said.

Kyle said the AMA has now joined a number of organizations that have previously made this classification, including the U.S. National Institutes of Health, the Social Security Administration, and the Centers for Medicare and Medicaid Services.

Not everyone thinks the AMA's decision was the right one, however. In fact, the move was opposed by many in the doctors' group, including a committee that had been charged with exploring the issue. It had voted not to recognize obesity as a disease.

One of the objections to labeling obesity as a disease hinges on the way obesity is determined, using the so-called body mass index -- a ratio of weight to height -- that some health experts think is inexact.

That's not the only objection.

"I have never liked the idea of characterizing obesity as a disease, because disease occurs when the body is malfunctioning," said Dr. David Katz, director of the Yale University Prevention Research Center. "Turning surplus calories into a fat reserve is not malfunction, it is normal physiology."

Katz said obesity is largely a societal problem caused by too much food and too little physical activity. While obesity certainly needs to be treated, the aspects of culture that have led to the obesity epidemic need to be changed, he said.

"Obesity is rampant in the modern world not because of changes in our bodies, but because of changes in the modern world. We are drowning in excess calories and labor-saving technologies," he said.

He thinks obesity treatments deserve insurance coverage.

During the past 20 years, there has been a dramatic increase in obesity in the United States, with more than one-third of adults (35.7 percent) and approximately 17 percent (or 12.5 million) of children and teens considered obese, according to the U.S. Centers for Disease Control and Prevention.

Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death.

In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs for people who are obese were $1,429 higher than those of normal weight, the CDC said.

Blacks have the highest age-adjusted rates of obesity -- 49.5 percent -- followed by Mexican Americans (40.4 percent), all Hispanics (39 percent) and whites (34 percent).

Among children and teens, the obesity prevalence since 1980 has almost tripled. There are significant racial and ethnic disparities in obesity rates among children. Hispanic boys are significantly more likely to be obese than white boys, and black girls are significantly more likely to be obese than white girls, the CDC said.

Obesity and overweight are labels for ranges of weight that are greater than what are considered healthy for a given height.

For adults, obesity and overweight are determined by using weight and height to calculate your body mass index, or BMI. An adult with a BMI between 25 and 29.9 is considered overweight, while someone with a BMI of 30 or higher is considered obese.

Someone who is 5 feet, 9 inches tall and weighs between 125 pounds and 168 pounds has a BMI between 18.5 and 24.9, which is considered healthy. That same person who weighs between 169 and 202 pounds has a BMI between 25.0 and 29.9, which is considered overweight. And if he or she weighs more than 203 pounds, they have a BMI of 30 or higher -- considered obese.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Some people say they would refuse an organ or blood donation that came from a murderer or thief, a new study shows.

Many people believe behaviors and personality traits are tied to something deep within a person. As a result, patients are often worried they will become more like their donors following a transplant or transfusion, the researchers explained. For this reason, these patients prefer to receive organs or blood from people who are a lot like them, the University of Michigan study found.

"This suggests an interesting intuitive belief -- that behaviors and personalities are inherent, unchanging aspects of who they are," study co-author Susan Gelman, a professor of psychology, said in a University of Michigan news release.

Study author Meredith Meyer, a research fellow in psychology, added: "People dislike the prospect of any change in their essence -- positive or negative -- and so any salient difference between the donor and recipient leads to increased resistance to the transplant [despite the fact] there is no scientific model to account for why transplants might lead to transference of features."

For the study, the researchers showed the study participants a list of possible human donors. They were asked to judge whether they wanted a donor who was the same gender and sexual orientation and came from a similar background. The participants also considered possible donors' ages and positive or negative characteristics, such as high IQ, kind person, philanthropist, thief, gambler or murderer.

The participants were also asked how they felt about being a donor, and if they believed a transplant would cause a recipient to adopt the personality and behaviors of their donor.

The study, published in the May/June issue of Cognitive Science, revealed that the participants cared more about having a donor with a personality and behaviors similar to their own than a donor's positive or negative qualities. Organs or blood from a pig or chimpanzee were particularly unpleasant for people to consider, the findings indicated.

Feelings about blood transfusions were just as strong as views on heart transplants, the study authors pointed out.

"Since blood transfusions are so common and relatively straightforward, we had expected people might think that they have very little effect," Meyer noted.

The study participants included people from the United States as well as people from India, where some subcultures hold deep-seated beliefs about contamination from transplants. Those from India had stronger ideas on how transplants would affect their behavior than Americans did, the results showed.

"From the medical point of view, this is beginning to look like a promising way of addressing donor shortages," study co-author Sarah-Jane Leslie, an assistant professor of philosophy at Princeton University, said in the news release. "But these results indicate that potential recipients could struggle with the belief that accepting such a donation will profoundly change who they are."

More information

The U.S. National Library of Medicine has more about organ donation.

-- Mary Elizabeth Dallas

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 19, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Restrict Use of Food Stamps to Buy Sugary Beverages: Mayors

The mayors of major U.S. cities want the federal government to examine ways to limit people's use of food stamps to buy soda and other sugary drinks.

In a letter sent to congressional leaders on Tuesday, the mayors of New York, Los Angeles, Chicago and 15 other cities said this would be a way to fight obesity and related diseases, CBS News/Associated Press reported.

"More than one third of American adults are now obese, costing approximately $147 billion per year in associated medical expenses," the letter stated. "As a result of obesity, this generation of American children is the first to face the possibility of a shorter life expectancy than their parents. It is time to test and evaluate approaches limiting SNAP's (Supplemental Nutrition Assistance Program's) subsidization of products, such as sugar-sweetened beverages, that are contributing to obesity."

"We need to find ways to strengthen the program and promote good nutrition while limiting the use of these resources for items with no nutritional value, like sugary drinks, that are actually harming the health of participants," New York Mayor Michael Bloomberg, whose office released the letter, said in a statement, CBS/AP reported. "Why should we continue supporting unhealthy purchases in the false name of nutrition assistance?"

The food stamp program is run by the U.S. Department of Agriculture, which declined to comment on the letter, which was addressed to Republican House Speaker John Boehner and House Democratic leader Nancy Pelosi.

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Doctors' Group Supports Ban on Energy Drink Ads for Kids

The marketing of energy drinks to young people should be banned, the American Medical Association said in a policy endorsed Tuesday at its annual policy meeting.

The new policy calls for limiting how the caffeinated drinks are sold to consumers younger than 18. In highlighting the dangers, the AMA made note of research linking the products to heart problems and reports about emergency room visits made by youngsters after consuming the beverages, Bloomberg News reported.

The group, which represents 225,000 U.S. doctors, called for a temporary ban on youth marketing of energy drinks "until such time as the scientific evidence regarding the possible adverse medical affects that stimulant drinks may have on children and adolescents is determined."

"Energy drinks contain massive and excessive amounts of caffeine that may lead to a host of health problems in young people, including heart problems," Alexander Ding, a physician and AMA board member, said in an e-mailed statement to Bloomberg. "Banning companies from marketing these products to adolescents is a common sense action that we can take to protect the health of American kids."

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Natura Pet Products Recalled Over Salmonella Concerns

Natura Pet Products is recalling a wide range of dry pet foods and treats due to possible salmonella contamination.

The recall covers all of the following products with expiration dates prior to June 10, 2014: Innova Dry dog and cat food and biscuits/bars/treats; EVO dry dog, cat and ferret food and biscuits/bars/treats; California Natural dry dog and cat foods and biscuits/bars/treats; Healthwise dry dog and cat foods; Karma dry dog foods; Mother Nature biscuits/bars/treats.

Salmonella can cause illness in pets that eat contaminated products and in people who handle the products, the U.S. Food and Drug Administration said. There haven't been any reports of pet or human illnesses related to the recalled products.

The Natura pet food and treats were sold in bags at veterinary clinics, select pet stores, and online in the United States and Canada. People with the recalled products should throw them out.

For more information or to ask for a product replacement or refund, call Natura toll-free at 800-224-6123.

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Blood Test May Provide Early Alert of HPV-Related Throat Cancer

A new study suggests that a blood test may be able to predict throat cancers caused by the human papillomavirus (HPV) more than 10 years before the disease appears.

Researchers looked at the results of blood tests from 135 throat cancer patients and found that about one-third of them had HPV antibodies in their blood a decade before they were diagnosed with cancer, CNN reported. Antibodies are produced by the immune system when it's fighting infections.

About a third of throat cancers worldwide are said to be HPV-related, according to the study in the Journal of Clinical Oncology.

"Until now, there were no accurate markers for early detection of this cancer," said study author Paul Brennan with the International Agency for Research on Cancer in Lyon, France, CNN reported.

Further studies need to be done and it would likely be years before the test is available for patients.

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U.S. Adult Smoking Rate Falls

The number of American adults who smoke fell to 18 percent in 2011, according to the Centers for Disease Control and Prevention.

The adult smoking rate had been declining for decades but then seemed to level off at about 20 to 21 percent before falling to 19 percent in 2011, the Associated Press reported.

The latest findings are from a survey of about 35,000 adults. The smoking rate was 9 percent among people ages 65 and older but about 20 percent for younger adults. Men had a higher smoking rate than women.

The survey did not include teens, but a previous CDC study found that about 16 percent of high school students were smokers in 2011, the AP reported.

Factors that may have contributed to this latest decline in adult smoking include more public smoking bans, higher state and federal tobacco taxes, and increased spending on prevention and cessation programs, according to Patrick Reynolds, executive director of the Foundation for a SmokeFree America.

"This is a real decline in smoking in America. I'm ecstatic about it. It's proof that we are winning the battle against tobacco," he told the AP.

Smoking is the leading cause of preventable illness and death in the U.S.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Whooping cough cases are escalating in the United States, and many American adults are unknowingly exposing vulnerable babies to the potentially deadly disease because their vaccinations are not up to date, a new survey finds.

"[Whooping cough] is a very preventable disease, but many adults may think their childhood vaccinations still are protecting them against it," said Dr. Matthew Davis, director of the new University of Michigan National Poll on Children's Health. "Findings from this poll show that few adults have received a booster shot within the recommended 10-year time frame and, in fact, two-thirds told us they were not aware of their vaccination status."

Just 20 percent of adults said they'd received the whooping cough (pertussis) vaccine less than 10 years ago, while 19 percent said they were vaccinated more than 10 years ago and 61 percent said they did not know when they were last vaccinated.

The poll also found that 72 percent of respondents strongly agreed or agreed that parents have the right to insist that visitors receive the whooping cough vaccine before visiting a newborn in the hospital. And 61 percent of survey participants strongly agreed or agreed that parents should make sure all adults receive the vaccine before visiting a newborn at home.

Whooping cough easily spreads within households, day care facilities, schools and neighborhoods. Most deaths from whooping cough occur in children younger than 3 months old, and most infants who get whooping cough are infected by an older child or adult with the illness.

"Teens and adults who have received the [whooping cough] vaccine are less likely to get whooping cough themselves, and therefore less likely to spread whooping cough to other people, including infants who have not yet been protected by the recommended [whooping cough] vaccinations," Davis said.

The poll results are encouraging because they indicate some awareness that visitors need to be protected against this disease, Davis said in a university news release.

"Expectant parents should have a conversation about [whooping cough] vaccine with their family and close friends before the baby is born, to allow time for them to get their [whooping cough] vaccine up to date," he said. "If parents begin to take this approach, it may have a very positive impact decreasing the number of newborns who become severely ill or die as a result of [whooping cough]."

Whooping cough recently reached its highest level in the United States in 50 years. The disease can be serious or fatal in unvaccinated newborns.

More information

The U.S. Centers for Disease Control and Prevention has more about whooping cough.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 19 (HealthDay News) -- Addie Parker was a happy 4-year-old who appeared to have the flu. But within hours she was in a coma.

Tragically, her parents weren't familiar with the signs of type 1 diabetes -- extreme fatigue, thirst and sweet-smelling breath, among others -- in time to save their little girl. Soon after she was diagnosed, Addie's brain hemorrhaged. She died six days later, about a month shy of her fifth birthday.

Experts say a lack of awareness of the signs of type 1 diabetes is all too common. Just this month, a Wisconsin toddler died apparently because of undiagnosed type 1 diabetes.

"Addie had flu symptoms," recalled her mother, Micki Parker, who works in the operating room at a nearby hospital but was unfamiliar with type 1 diabetes.

"By the next morning, she was throwing up every hour," Parker said. Addie didn't have a fever, but later that day, she couldn't get up from the bathroom floor because she was so dizzy.

Eventually, the Parkers learned that Addie's blood sugar level was 543 milligrams per deciliter (mg/dL) -- more than four times higher than normal, according to the American Diabetes Association.

Most people have heard of type 2 diabetes, but type 1 diabetes is far less common. It can strike at any age -- even though it used to be known as juvenile diabetes -- and it always requires treatment with injected insulin or insulin delivered through a pump. People with type 1 diabetes don't produce insulin, a hormone needed to convert the food you eat into fuel for the body. Without insulin, glucose (blood sugar) rises to unhealthy levels.

Untreated, type 1 diabetes causes serious complications and even death. But it's often mistaken for other illnesses -- even by doctors.

"There's an underawareness of type 1 diabetes in the public, and in the healthcare system," said Dr. Richard Insel, chief scientific officer for JDRF (formerly the Juvenile Diabetes Research Foundation). "Missed diagnoses even occur in emergency rooms; people don't always think of it."

Every day, about 80 Americans are diagnosed with type 1 diabetes, and the total number rose 23 percent between 2000 and 2009 in children under 20. Currently, about 3 million Americans -- most of them adults -- are living with type 1 diabetes, according to the JDRF.

One of them is 20-year-old Amanda Di Lella, who was 13 when she knew something was seriously wrong.

"I was losing weight, but I was always hungry. I was always tired. My symptoms weren't extreme at first, but they quickly got worse," she said. "I went from being tired to not being able to get out of bed, from being thirsty to drinking 10 bottles of water in the middle of the night. I had lost 15 pounds, and only weighed 75 pounds when I begged my mother to take me to the doctor."

Her pediatrician told her mother that Di Lella probably had an eating disorder and he prescribed protein shakes.

Within a few days Di Lella wasn't waking up. Her mother took her to the hospital, at about the same time the doctor got blood work back showing that she had type 1 diabetes.

Her blood sugar level was over 400, and she was in diabetic ketoacidosis, or DKA. When your body doesn't get the glucose it needs for fuel (and when there's no insulin, glucose doesn't get into the body's cells), it burns fats for energy. This produces an acidic substance called ketones, which can build up in the blood, causing DKA.

"Once you're in DKA, you're set up for some major complications, and approximately 30 percent of people diagnosed with type 1 diabetes still present with DKA," Insel said.

After a week in the intensive care unit, Di Lella recovered. Her doctor apologized for the error and said he had never had a case of type 1 diabetes, so it wasn't something he normally looked for.

Insel said it's important to compare a child's changes in behavior to the other children in the family. Is the child drinking excessively compared to a sibling? Is a child who has mastered nighttime bladder control suddenly wetting the bed again?

The good news is that it's easy to test for type 1 diabetes. A urine test can detect whether there's sugar in the blood. If that test is positive, then a simple test drawing a drop of blood from the fingertip can confirm whether you have diabetes.

Di Lella, now a student at the University of Florida, said she would advise others to "not ignore symptoms that seem so basic. Even small symptoms can be a sign of something much bigger."

Parker said she wants other parents to know that a child with type 1 diabetes "doesn't necessarily look sick. Trust your gut instinct, and push to have your child tested."

The signs and symptoms of type 1 diabetes that everyone should know include:

  • Increased thirst
  • Frequent urination
  • Wetting the bed in a child who has previously had good nighttime bladder control
  • Unintended weight loss
  • Extreme fatigue
  • Sudden changes in vision
  • Unusual irritability
  • Increased appetite
  • A fruity odor on the breath
  • Heavy or labored breathing

More information

Learn more about the warning signs of type 1 diabetes from the JDRF.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Surviving With Cancer

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(HealthDay News) -- After you've finished cancer treatment, you may be anxious for life to return to "normal." But "normal" may be far different than it was before cancer.

CancerCare.org offers this advice:

  • Take time to reflect on what you've been through.
  • Identify any changes that you'd like to make in your life.
  • Accept what has changed, and think about what you've learned.
  • Re-evaluate your relationships and work-related goals.
  • Figure out new ways to feel fulfilled and find meaning in your life.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- It's important to create and practice a fire escape plan at home, and to teach it to every member of the family.

The U.S. Fire Administration offers these guidelines:

  • Draw a diagram of your home, marking all doors and windows. Devise two escape routes from each room.
  • Make sure all exits are clear of clutter.
  • Keep your child's bedroom door closed to help keep smoke from overtaking the room.
  • Talk to young children about firefighters, encouraging the children not to be afraid and explaining that firefighters will offer help in an emergency.
  • Teach children how to crawl low on the floor if there is smoke. Kids should also learn to feel closed doors for heat before opening them.
  • Designate a safe meeting place outside the home, and make sure children understand that they are never to go back inside.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- State websites that report the costs of health care services aren't much use to patients who want to compare prices, according to a new U.S. study.

"There's growing enthusiasm for improving transparency of prices for health services to help people be well-informed consumers and make better decisions about their care. The problem is that most of the information that's out there isn't particularly useful to the patients themselves," study lead author Dr. Jeffrey Kullgren, health services researcher in the VA Center for Clinical Management Research and the division of general medicine in the University of Michigan Medical School, said in a U-M Health System news release.

"As more Americans face high levels of cost-sharing in their insurance plans, it's even more important to improve access to data that help them anticipate their out-of-pocket expenses and evaluate their options," he added.

The federal government recently released hospitals' charges for procedures and services, but that kind of data won't provide much help to patients trying to assess their health care options, according to the study, published June 18 in the Journal of the American Medical Association.

The researchers analyzed 62 state websites meant to help patients estimate or compare prices for health care services. But most of the sites only reported billed charges, not what patients were actually expected to pay.

Among the other findings:

  • Most of the websites focused on prices for in-hospital care, which is often urgent and something for which many patients can't plan ahead.
  • Websites rarely included prices for outpatient services, such as laboratory and radiology tests that are often predictable or less urgent, and therefore good candidates for comparison shopping.
  • Most websites didn't provide information about quality alongside prices for services where price could be tied to differences in quality.

More information

The U.S. Agency for Healthcare Quality and Research offers tips for choosing quality health care.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- A diagnosis of type 1 diabetes often seems to come out of the blue. But German researchers say they can predict who will likely develop the chronic disease.

Blood samples taken from children at increased genetic risk of type 1 diabetes reveal significant "preclinical" clues, the researchers found. The strongest predictor is the presence of two diabetes-related autoantibodies, they reported in the June 18 issue of the Journal of the American Medical Association.

"If you have two or more autoantibodies, it's nearly inevitable that you will develop the disease. Most people -- even physicians -- don't appreciate this risk," said Dr. Jay Skyler, deputy director for clinical research at the Diabetes Research Institute and a professor at the University of Miami Miller School of Medicine. Skyler was not involved in the research.

Nearly 70 percent of youngsters with two diabetes-related autoantibodies developed type 1 diabetes over a 10-year period compared to less than 15 percent of kids with just one autoantibody, the researchers found.

Skyler, co-author of an accompanying journal editorial, said this study highlights the need for effective prevention strategies for type 1 diabetes.

Type 1 diabetes is believed to be an autoimmune disease in which the body's immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Insulin is a hormone needed to turn the carbohydrates from food into fuel for the body.

To survive, people with type 1 diabetes must monitor their food intake and replace the lost insulin through injections or an insulin pump.

Type 1 diabetes can occur at any age, and there's currently no known way to prevent or cure it, according to the JDRF (formerly the Juvenile Diabetes Research Association). And unlike its more common counterpart, type 2 diabetes, the development of type 1 diabetes isn't linked to lifestyle choices.

The current study included children from Colorado, Finland and Germany who were followed from birth for as long as 15 years. Children in the Colorado and Finland study groups were included in the study if they had a specific genotype that indicated a genetic predisposition to developing type 1 diabetes. Children in the German study had to have a parent with type 1 diabetes to be included in the study.

More than 13,000 youngsters were recruited in all. During the study follow-up, the researchers found that nearly 1,100 children -- or about 8 percent of the total group -- developed one or more autoantibodies, which are markers for the destruction of the insulin-producing beta cells in the pancreas.

The vast majority of the children, despite their higher risk, remained free of type 1 diabetes and free of signs that the disease might develop.

"Autoantibodies are a marker for the risk of diabetes. [But] they are just markers; they are not causing the disease," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

Of the children who developed autoantibodies, 585 developed two or more. The remaining 474 children had just one autoantibody, according to the study.

In children with multiple autoantibodies, 43.5 percent developed type 1 diabetes within five years, about 70 percent had diabetes after 10 years and about 84 percent had the condition after 15 years. At the 10-year mark, just 14.5 percent of children with a single autoantibody had developed type 1 diabetes.

The researchers also found that children who had multiple autoantibodies before age 3 were more likely to quickly develop type 1 diabetes. Children with certain genotypes -- the HLA genotype DR3/DR4-DQ8 -- were more likely to develop type 1 diabetes faster. And girls were more likely to progress to type 1 diabetes faster than boys if they had multiple autoantibodies, according to the study.

"Findings from this study suggest there should be a greater emphasis for [people with multiple autoantibodies] to be enrolled in studies that could delay or prevent type 1 diabetes," Skyler said.

Zonszein said these findings can help better predict who is at high risk for type 1 diabetes. "[However], we're still a long way from stopping the development of type 1 diabetes," he added.

He also noted that the children in the studies were almost all white, so these findings might not translate to other populations, such as blacks or Hispanics.

More information

Learn more about type 1 diabetes from the Diabetes Research Institute.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- The number of young adults without health care coverage in the United States has declined significantly over the past few years, according to a new government report released Tuesday.

That's the good news.

Not-so-good are the findings that: 45.5 million people, 14.7 percent of the American population, still don't have health care coverage, and 4.9 million kids under the age of 18 also lack health insurance.

The U.S. Centers for Disease Control and Prevention's National Center for Health Statistics used data on 108,131 people contacted for the 2012 National Health Interview Survey to compile the latest profile on health insurance coverage.

Of immediate interest was the apparent impact of the Affordable Care Act, President Obama's landmark health reform law passed in 2010.

The new report found that 27 percent of young adults between the ages of 19 and 25 had no health care coverage in 2012, down from more than 35 percent in 2010, according to report co-author Robin Cohen, a CDC health statistician.

At the same time, the number of young adults covered by a private health plan increased, from 49 percent in 2010 to 58 percent in 2012.

Health policy experts said the increase is most likely due to a provision in the Affordable Care Act (ACA) that allows young adults to remain on their parents' health insurance plan up to age 26.

"You see a significant decline in uninsurance among young adults and a corresponding uptick in private health insurance coverage," said Kathleen Stoll, director of health policy at Families USA, a national nonprofit health reform organization. "That is clearly due to the provisions in the ACA that allowed young adults to stay on their parents' health coverage. That's a positive change you can directly tie to the ACA."

By comparison, the number of uninsured adults aged 26 to 35 remained the same at 27 percent between 2010 and 2012. There also was no big difference in private coverage for this age group, which was about 59 percent in both 2010 and 2012.

The effectiveness of this single provision of the Affordable Care Act should give hope to the 45.5 million Americans still without health insurance in 2012, said Sara Collins, vice president for affordable health insurance at the Commonwealth Fund, a health policy think tank.

That's because most of the major provisions of the ACA take effect in 2014, including the opening of the health insurance exchanges and a major expansion of Medicaid, she noted.

"Going forward, starting next year, we're probably going to start seeing the same thing across the age spectrum," Collins said. "Next year we're likely to see a new trajectory of uninsured rates across the whole population."

The continuing need for health reform is reflected in another part of the CDC report, which found that enrollment in high-deductible health plans increased from 29 percent in 2011 to 31.1 percent in 2012, Stoll said.

"That doesn't sound like a huge increase, but it reflects a steady pattern of increasingly high deductibles in private health insurance," she said. "The trend is higher and higher out-of-pocket costs, and less coverage for your premium dollars."

In addition, the report found, more than 50 percent of those who had private health insurance not offered through employment were enrolled in a high-deductible plan.

The Affordable Care Act includes protection against high deductibles and copayments, particularly for low-income families. "I think we'll see some help from the ACA regarding out-of-pocket costs," Stoll said. "One of the policies ACA addresses is to make sure that people don't get hit with higher and higher out-of-pocket costs."

The report also showed:

  • While there were 45.5 million people uninsured at the time of the interviews in 2012, 57.7 million (18.6 percent) had been uninsured for at least part of the year prior to interview, and 34.1 million (11.1 percent) had been uninsured for more than a year at the time of interview.
  • Hispanics were more likely than whites, blacks or Asian Americans to be uninsured. More than one-quarter of Hispanics who were interviewed were uninsured at the time, and one-third had been uninsured for at least part of the year before that.
  • Among the 43 states included in this report, the percentage of uninsured individuals ranged from 4.8 percent in Massachusetts to 20.9 percent in Oklahoma, South Carolina and Texas.

More information

The U.S. Department of Health and Human Services has more about the Affordable Care Act.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Armed with MRI imaging tests, Michigan doctors have detected spinal infections in patients who received tainted steroid injections for back pain but were showing no signs of illness.

The effort to identify patients with "hidden" infection was developed in the wake of last year's multi-state outbreak of fungal meningitis stemming from the contaminated steroid shots.

"The use of MRI screening detected spine and near-spine infection earlier in these patients, allowing us to provide medical and surgical care earlier," said lead researcher Dr. Anurag Malani, an infectious disease doctor at St. Joseph Mercy Hospital in Ann Arbor.

Infections showed up in 21 percent of 172 patients screened, according to the report, which was published in the June 19 issue of the Journal of the American Medical Association. Many of these people were unaware they were infected, Malani said.

The contaminated drugs, administered to alleviate back pain, sickened 745 people in 20 states and killed 58, according to the U.S. Centers for Disease Control and Prevention. Michigan was particularly hard hit, with 264 reported infections and 17 deaths.

Early in the outbreak, patients were developing meningitis and signs of stroke. Later, doctors noticed a "steady stream" of less obvious spinal or near-spinal infections surfacing months after patients received the injections.

"We need a proactive outreach to patients who have been exposed to these injections," Malani said. "If they haven't had an MRI, they need to have an MRI." This is especially true for patients experiencing worsening back pain, he said.

Because patients got the injection for constant chronic pain, they might accept new or worsening pain as part of their condition and not realize they have an infection, Malani said.

The infections -- first reported last September -- were caused by the fungus Exserohilum rostratum (basically a common black mold) found in vials of the steroid methylprednisolone, produced by the now-shuttered New England Compounding Center in Massachusetts.

The researchers identified 172 patients who had received injections at a pain center from what was later determined to be a highly contaminated drug lot. The patients had not needed any medical treatment up to that point. All underwent MRIs of the injection site, and probable or confirmed spinal or near-spinal fungal infection was subsequently diagnosed in 35 of the patients.

All the infected patients were treated with antifungal medications, and 24 patients needed surgery to clean out the infection, the researchers said.

Additionally, data on 115 of the patients indicated that 35 patients had at least one symptom, including new or worsening back or neck pain, nerve pain, or weakness in their legs.

Malani said he believes new cases of fungal infection will appear in the coming months. People who received a shot from a contaminated lot were notified at the time of the initial outbreak, and Malani recommended MRIs for those who haven't yet had medical treatment.

Roughly 14,000 people got the shots, according to the CDC, and not everyone thinks widespread MRI screening is the solution.

"We agree that patients who did not have changes in their symptoms were identified, but it would be hard to institute that process on a widespread basis," said Dr. Thomas Patterson, of the infectious diseases division at the University of Texas Health Science Center in San Antonio.

Such screening would be costly and possibly harmful to some patients, said Patterson, co-author of an accompanying journal editorial.

Another proposal -- providing antifungal therapy to everyone who received the tainted steroid -- isn't feasible either, Patterson said. "That gets into a risk-benefit sort of setting where toxicity and cost probably outweigh the benefit," he said.

He admitted, however, that symptoms can be subtle "and in some patients doing additional tests might be beneficial."

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- For stroke victims, 15 minutes can mean the difference between life and death, a new study finds.

Rapid treatment with a clot-dissolving drug reduces stroke patients' risk of in-hospital death and increases their chances of being able to walk and return home when they leave the hospital, according to the study, published in the June 19 issue of the Journal of the American Medical Association.

"These findings support intensive efforts to accelerate patient presentation and to streamline regional and hospital systems of acute stroke care to compress [onset to treatment] times," Dr. Jeffrey Saver, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues said in a journal news release.

Researchers examined data from more than 58,000 patients who suffered an ischemic stroke (in which blood flow to the brain is blocked) and were treated with clot-dissolving tissue plasminogen activators (tPA) within four and a half hours of the onset of stroke symptoms. The patients were treated at nearly 1,400 U.S. hospitals between 2003 and 2012.

The median time between symptom onset and treatment was two hours and 24 minutes. Nine percent of patients were treated within 90 minutes of symptom onset; 77 percent were treated within 91 to 180 minutes of stroke symptoms; and about 14 percent went 181 to 270 minutes between the start of symptoms and treatment.

Factors most strongly associated with shorter onset-to-treatment time included greater stroke severity, ambulance arrival and arrival at the hospital during regular hours.

Nearly 9 percent of the patients died in the hospital, 5 percent had bleeding inside the skull (intracranial hemorrhage), 33 percent could walk when they were released from the hospital and 38 percent were discharged to their home.

For every 15-minute faster start of tPA therapy, patients were less likely to die or have an intracranial hemorrhage, and were more likely to walk and be sent home when discharged from the hospital, according to the study.

For example, patients with an onset-to-treatment time of 90 minutes were 26 percent less likely to die, 28 percent less likely to have an intracranial hemorrhage, 51 percent more likely to be able to walk and 33 percent more likely to be discharged to home, compared to those with an onset-to-treatment time of 181 to 270 minutes.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Measles-mumps-rubella (MMR) booster vaccinations do not appear to worsen disease activity in children with juvenile arthritis, according to a new Dutch study.

"The safety of MMR vaccination has been questioned because disease flares have been described after MMR vaccination," wrote Dr. Marloes Heijstek, of the University Medical Center Utrecht in the Netherlands, and colleagues. "Our trial does not show an effect of vaccination on [juvenile arthritis] activity."

The study included 137 juvenile arthritis patients, aged 4 to 9, who had received primary MMR vaccinations and were randomly assigned either to receive an MMR booster shot or not receive a booster. During follow-up, juvenile arthritis disease activity was about the same for both groups, according to the study, which was published in the June 19 issue of the Journal of the American Medical Association.

The average number of disease flares per patient was 0.44 in the booster shot group and 0.34 in the non-booster group, and both groups had a similar percentage of patients with one or more flares.

Juvenile arthritis is the most common childhood rheumatic disease, and affects between 16 and 150 children per 100,000. Patients with juvenile arthritis are at increased risk for infections due to weakened immune systems caused by the disease or its treatment. Preventing infections in these patients requires safe and effective vaccinations that do not increase disease activity, the researchers noted in a journal news release.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about juvenile arthritis.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Researchers have identified 45 genetic genetic variants in overweight newborns that are known to occur in obese adults and hope their findings could someday help combat the global obesity epidemic.

"Allowing earlier identification of high-risk newborns may allow for earlier interventions to take place to possibly prevent obesity later in life," study lead author Dr. Reeti Chawla, a fellow in pediatric endocrinology at Lurie Children's Hospital of Chicago and the Northwestern University Feinberg School of Medicine, said in an Endocrine Society news release.

Chawla and colleagues analyzed genetic data from more than 4,400 ethnically diverse newborns in the United States and found 45 genetic variants associated with higher fat levels. These variants were already known to occur in obese adults.

The researchers are now using the 45 genetic variants to develop a genetic risk score to determine whether having a large number of these genetic variants predicts whether newborns are at risk for having increased fat at birth and for obesity later in life.

The study was scheduled for presentation Tuesday at the Endocrine Society's annual meeting in San Francisco.

Being obese in childhood increases the risk of adult obesity and researchers are trying to identify risk factors to help predict who is at greater risk for weight gain.

More than one-third of American adults are obese, according to the U.S. Centers for Disease Control and Prevention. Being overweight and obese increases the risk of many types of health problems, including heart disease, diabetes, stroke and some cancers.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more about childhood overweight and obesity.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Catching up on your sleep on weekends may help protect you from developing diabetes, a small, early study suggests.

The study found significant improvements in insulin sensitivity -- the body's ability to clear sugar from the blood -- among sleep-deprived men after they had three nights of extra sleep.

"We all know we need to get adequate sleep, but that is often impossible because of work demands and busy lifestyles," Dr. Peter Liu, a researcher at the Los Angeles Biomedical Research Institute, said in an institute news release.

"Our study found extending the hours of sleep can improve the body's use of insulin, thereby reducing the risk of type 2 diabetes in adult men," Liu said. "Reducing the incidence of this chronic illness is critical for a nation where diabetes affects nearly 26 million people and costs an estimated $174 billion annually."

The study included 19 men without diabetes, whose average age was about 29. They slept only 6.2 hours per night during the week but regularly caught up on their sleep on the weekends by sleeping an extra 2.3 hours per night.

Participants spent three nights in a sleep lab on each of two separate weekends and were randomly assigned to varying sleep schedules. These included 10 hours of sleep; six hours of sleep; or 10 hours spent in bed, during which noises during deep sleep aroused them into shallow sleep without waking them.

The men's blood sugar and insulin levels were checked on the fourth morning to calculate their insulin sensitivity.

When the men had 10 hours of sleep for three consecutive nights, their insulin sensitivity was much better than when they got less sleep, according to the study, which is scheduled for presentation Tuesday at the annual meeting of the Endocrine Society in San Francisco.

The findings are important for people who don't get enough sleep during the week due to work and busy lifestyles, but catch up on their sleep on weekends, the news release suggested.

"The good news is that by extending the hours they sleep, adult men who over a long period of time do not get enough sleep during the working week can still improve their insulin sensitivity," Liu said.

Because this study 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 U.S. Department of Health and Human Services outlines ways to prevent diabetes.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Polluted Air Linked to Autism Risk

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TUESDAY, June 18 (HealthDay News) -- Pregnant women who live in smog-filled areas may be twice as likely to have children with autism, a new study suggests.

"The study does not prove that pollution increases risk for autism. It found an association," cautioned lead author Andrea Roberts, a research associate at the Harvard School of Public Health in Boston. "It adds to the weight of the evidence that there may be something in air pollution that increases risk for autism."

Researchers compared exposure to air pollution among 325 women who had a child with autism and 22,000 women who did not. The women were participants in the Nurses' Health Study II. Pollutants measured included diesel particulate matter, lead, manganese, mercury, methylene chloride, and a combined measure of metal exposure.

Twenty percent to 60 percent of the women lived in areas considered highly polluted. And the study showed that: those women who lived in the 20 percent of locations that had the highest levels of diesel particulates or mercury in the air were twice as likely to have a child with autism, compared to those who lived in the 20 percent of areas with the lowest levels of these pollutants.

In addition, those who lived in the 20 percent of locations with the highest levels of lead, manganese, methylene chloride, and combined metal exposure were about 50 percent more likely to have a child with autism than those who lived in the 20 percent of areas with the lowest concentrations.

The findings held even after the researchers took into account other factors known to affect autism risk, such as income, education and smoking during pregnancy. Overall, the association was stronger for boys than it was for girls, but the number of girls included in the new study was too low to draw any firm conclusions.

The findings, which were published June 18 online in Environmental Health Perspectives, do add to a growing body of research that suggests the air women breathe while pregnant is one of many factors linked to autism risk. Previous studies have shown that pregnant women who live in polluted areas or close to freeways are more likely to have a child with autism, but the studies were done regionally. The new data is nationwide.

Exactly how, or even if, air pollution affects the developing brain is murky. "By definition, pollution is stuff that is not good for us," Roberts said.

Still, the overall increase in autism risk that may be attributed to pollution is low. "Let's say a woman's risk for having a child with autism is one in 100, women who live in the most polluted cities have a risk that is about one in 50, which means that 49 children would not have autism," Roberts said.

"Even if the risk is doubled, it's still low," she explained.

The U.S. Centers for Disease Control and Prevention now estimates that about one in 50 children aged 6 to 17 in the United States has an autism spectrum disorder, the name for a larger group of disorders that can range from the mild to the severe, and affect social and communication skills.

Other experts also urged caution in interpreting the new findings.

"There many genes, probably hundreds, and many environmental factors, probably hundreds, that increase risk of autism," said Alycia Halladay, senior director for environmental and clinical sciences at the advocacy group Autism Speaks. "The real message is that a lot of things cause autism, namely genetics and the environment and their interaction."

Laura Anthony, the associate director of the Center for Autism Spectrum Disorders at Children's National Medical Center in Washington, D.C., said that these risks accrue during pregnancy, delivery and within the first month of a newborn's life. "Everything points to that as the critical period. This is the time when the brain is most sensitive because it is still developing," she said.

The new findings don't mean that pregnant women should head for the hills to avoid smog, Anthony added. "Even if you live someplace rural, you may be exposed to pollution while driving or you could live in a rural place right next to a plant [or factory]," she said. "We all need to campaign for cleaner air for a lot of reasons."

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center in Lake Success, N.Y., said that the new findings do add weight to previous studies that looked at the connection between prenatal exposure to airborn pollutants and later autism.

"While they do validate and affirm what other studies have found, there are many risk factors and genetic causes identified with autism," Adesman said. "Even with the strength of this study, parents can't presume that most cases of autism are due to airborne contaminants. It's easier said than done to suggest that she move or not breathe the air."

More information

Learn more about autism at the U.S. Department of Health and Human Services.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Overweight and obese people with rheumatoid arthritis are less likely to go into remission in the early stages of the disease and require much more drug treatment than people with normal weight, according to a new study.

The study included nearly 350 people with early rheumatoid arthritis (RA) who underwent a treatment meant to achieve remission of their disease. The strategy included strict follow-up visits, as well as treatment with steroids and the drug methotrexate, combined with anti-tumor necrosis factor (anti-TNF) therapy if a good response didn't occur. Anti-TNF drugs are used to reduce inflammation in a variety of conditions.

At six and 12 months of follow-up, overweight and obese patients had lower rates of remission. After 12 months, a higher percentage of overweight and obese patients were still on anti-TNF therapy, compared to normal-weight patients.

The researchers also said overweight and obese patients required 2.4 times more anti-TNF therapy throughout the study than normal-weight patients.

The study was presented Friday at the annual meeting of the European League Against Rheumatism in Madrid, Spain. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Obesity and rheumatoid arthritis are both on the rise, with devastating effects on individuals and society as a whole," study author Elisa Gremese said in an organization news release. "These data reinforce the link between obesity and inflammation, and establish that [weight] is one of the few modifiable variables influencing the major outcomes in RA."

"There is an urgent need to address the issues of overweight and obesity to improve patients' chances of successful remission," said Gremese, of the Institute of Rheumatology and Affine Sciences at the Catholic University of the Sacred Heart, in Rome.

Rheumatoid arthritis affects about one in 100 people worldwide. It can cause pain, stiffness, progressive joint destruction and deformity, and reduce physical function, quality of life, life expectancy and the ability to work.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about rheumatoid arthritis.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Children of women who drink moderate amounts of alcohol while pregnant don't appear to have any neurodevelopmental problems when it comes to balance, a new British study suggests.

Researchers assessed the long-term health impact of drinking while pregnant by testing roughly 7,000 10-year-olds on their balancing abilities, a method that offers a reliable reflection of fetal neurodevelopment. For the study, "moderate" alcohol consumption was defined as between three to seven glasses of alcohol a week.

The research team cautioned, however, that other variables, such as maternal wealth and education, might have influenced the findings.

The bottom line, according to study co-author John Mcleod, is that "[there's] certainly no evidence that moderate alcohol use by pregnant mums is good for their kids, and [there are] reasons to be cautious about other messages around 'benefits' of moderate alcohol use by pregnant mums. But equally, [there's] no strong evidence for important harmful effects."

Macleod, chair of clinical epidemiology and primary care with the School of Social and Community Medicine at the University of Bristol, and his colleagues discuss their findings in the June 17 online edition of BMJ Open.

The research comes on the heels of another British study, released in April, which reported no connection between "light" drinking (one to two drinks per week) during pregnancy and increased risk for mental defects among children at the age of 7.

For the new study, the researchers focused on 6,915 children from southwest England who had participated in the larger Avon Longitudinal Study of Parents and Children.

The team first analyzed maternal drinking habits self-reported at both the 18-week mark of pregnancy and then again when the children were 4 years old.

The vast majority of mothers -- 70 percent -- said they drank no alcohol during pregnancy, while 25 percent said they had consumed drinks in the range of "low" (one to two per week) to "moderate" amounts on a weekly basis. Among such drinkers, one in seven had actually engaged in "binge drinking," meaning at least four glasses of alcohol at a sitting.

By the time their children were 4 years of age, 50 percent of the mothers said they consumed three to seven glasses of alcohol weekly. The research team noted that those who drank moderately were older, more affluent and better educated.

At the age of 10, the children underwent two balance tests, which included walking across a balance beam (to assess so-called "dynamic balance"); standing heel-to-toe on a beam with eyes open and closed (to assess "static balance"); and standing on just one leg, eyes open and closed.

The result: moderate maternal (and paternal) drinking while pregnant, and maternal drinking after delivery appeared to be associated with better overall balance, particularly in terms of static balance.

Maternal genetic testing further revealed that the children of mothers who had a so-called "low alcohol" gene (known to reduce drinking behaviors) did not perform worse on the balance tests than those whose mothers didn't have the gene.

Dr. Francine Einstein, from the department of obstetrics & gynecology and women's health at Montefiore Medical Center in New York City, described the study as "interesting" while cautioning that self-reports about alcohol consumption "must be taken with a grain of salt."

"Some women may not recall how much they drank or may under-report use, particularly when there is a social stigma associated with what you are asking about," she noted. So "getting an accurate assessment of how much alcohol a child was exposed to is going to be difficult."

Reading and math skills should also be assessed, she added, as should the impact of other nondrinking factors -- such family wealth -- on a child's performance.

"For these reasons, I would be reluctant to tell my patients that drinking in pregnancy is a good idea," Einstein said.

More information

For more on alcohol and pregnancy, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Concussion can lead to damage in the white matter of the brain that resembles abnormalities found in people in the early stages of Alzheimer's disease, a new study suggests.

Researchers at the University of Pittsburgh School of Medicine said their findings should prompt a re-evaluation of the long-term effects of concussion, which affects more than 1.7 million people in the United States annually. About 15 percent of concussion patients suffer persistent neurological symptoms.

"The previous thinking before was you get a concussion, and that causes a certain damage from bopping your head and you get these symptoms," said study author Dr. Saeed Fakhran, an assistant professor of radiology at the University of Pittsburgh School of Medicine. "We found it acts as a kind of trigger, and lights a fuse that causes a neurodegenerative cascade that causes all these symptoms down the line. Once you've hit your head, the injury isn't done."

The findings are published online June 18 in the journal Radiology.

The study drew some criticism from concussion and Alzheimer's disease experts who said the findings, while provocative, should not be interpreted as drawing a clear link between a concussion suffered early in life with the development of Alzheimer's.

"I don't want a mom to pick this up and say, 'Oh my god, my 10-year-old is going to get Alzheimer's now,' because that is not the case," said Dr. Ken Podell, a neuropsychologist and co-director of the Methodist Concussion Center in Houston. "It's very inconclusive at this time, and there's no clinical application of this at this point of time."

White matter serves as the tissue through which messages pass between different areas of gray matter within the brain and spinal cord. Think of gray matter as the individual computers in a network, and white matter as the cables that connect the computer.

The researchers reviewed past brain scans of 64 people who had suffered a concussion, focusing on scans that used an advanced MRI technique called diffusion-tensor imaging, which spots microscopic changes in the brain's white matter.

The investigators then compared these brain scans to symptoms reported by concussed patients in a post-concussion questionnaire. They focused on symptoms shared with Alzheimer's patients, including memory problems, disturbances in sleep cycles and hearing problems.

The results showed a significant correlation between high concussion symptom scores and reduced water movement in the parts of the brain's white matter related to auditory processing and sleep-wake disturbances. Further, the researchers said, the distribution of white matter abnormalities in mildly concussed patients resembled the distribution of abnormalities in people with Alzheimer's disease.

"Basically, it looks a lot like Alzheimer's," said study co-author Dr. Lea Alhilali, an assistant professor of radiology at the University of Pittsburgh School of Medicine. "You get the same distribution of damage in the way that Alzheimer's disease affects the brain."

These abnormalities could spark a series of reactions that lead to long-term problems with thinking and memory. "The cascade is what is the important factor," Alhilali said. "It doesn't appear what you're symptomatic from is the injury itself. What you're symptomatic from is how the brain responds to that injury."

However, brain experts believe that researchers may be going too far in trying to draw a link between the concussion damage they found and the chronic damage found in Alzheimer's.

"It's an interesting observation, but I think they are making a leap that the pattern of changes they see on the scan are indicative of what we see in Alzheimer's disease," said Dr. Ron Petersen, director of the Mayo Alzheimer's Disease Research Center. "Their correlation between the scores on the concussion instrument and white matter changes, that's nice and good and makes sense. But then they go into a rather extensive anatomical explanation of how this might be similar to Alzheimer's disease, and I find that a bit tenuous."

Podell listed a number of concerns with the article, including:

  • The researchers' reliance on existing brain scans and symptom charts created by other people. "You don't know what questions were asked, who asked the questions, how they were asked," he said. "There are a lot of things you can't control for."
  • The inclusion of young patients in the pool of subjects, who ranged in age from 10 to 38. "White matter is not fully developed in people until they are adults," he said. "You have 10-year-olds in this study. It is highly, highly unusual to mix young kids with adults, because the brain is so different."
  • The use of sleep disturbance as a comparable symptom between concussion and Alzheimer's. "What's a common co-injury in concussion? Whiplash. You have neck pain, back pain," he said. "If you go to sleep, you don't think that pain wakes you up?"

"The issue is, does a single concussion in an individual mean they are at risk for developing Alzheimer's?" Podell said. "There are so many other factors involved, including genetic factors, management of a concussion and the general health and well-being of the individual throughout their life."

The study authors agreed that their findings are tentative.

"This is not a definitive study. This is not the end at all. This is the first step," Alhilali said. "We hope this will lead to more research that will further explore this potential link."

The researchers do believe their findings could lead to better treatments in the future, however.

"The first step in developing a treatment for any disease is understanding what causes it," Fakhran said. "If we can prove a link, or even a common pathway, between mild traumatic brain injury and Alzheimer's, this could potentially lead to treatment strategies that would be potentially efficacious in treating both diseases."

More information

For more on concussions, go to the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Plenty of Americans are eager to use their mobile phones and tablet computers to better manage their health care, a new poll finds -- though the nation has a way to go before we're all consulting Dr. Smartphone.

In a Harris Interactive/HealthDay survey released Tuesday, more than one-third of respondents who are online said they were "very" or "extremely" interested in using smartphones or tablets to ask their doctors questions, make appointments or get medical test results.

Similar numbers of respondents were eager to use mobile phones and tablets for actual health-care services -- such as monitoring blood pressure or blood sugar, or even getting a diagnosis. Such phone and tablet apps are, however, either just getting off the ground or not yet on the market.

The survey results show that the demand for digital assists to health care is "strong and likely to grow," said Humphrey Taylor, chairman of The Harris Poll.

But he added that big questions remain: What types of services will consumers be able to get with their mobile devices, and when?

"The devil will surely be in the details," Taylor said, "and these are very big details."

An expert in health-care information agreed. "Right now, we're looking at a patchwork system," said Titus Schleyer, who heads the Center for Biomedical Informatics at the Regenstrief Institute, based at Indiana University-Purdue University in Indianapolis.

Companies are developing a number of apps that, along with equipment attached to your phone or tablet, can help diagnose everything from ear infections and eye diseases to irregular heartbeats and malaria. One goal is to bring better health care to remote parts of the world.

But there are already apps out there designed for the masses -- including ones to manage your blood pressure or blood sugar readings, for example. You take the reading via a monitor that plugs into your smartphone, and the app records all the information, which can then be e-mailed to your doctor or sent to your electronic health record, Schleyer said.

Of course, your doctor has to have the systems in place to do something with that information. And, Schleyer added, depending on where you live, and what health system you're in, that may or may not be the reality.

Schleyer said he has first-hand experience with the obstacles. His wife found an app that let her record and organize her blood pressure readings, only to discover that her smartphone "couldn't talk" to their health-care system's portal.

She ended up just bringing her smartphone to her doctor's visit.

"This poll shows us that the public is interested in using these apps," Schleyer said. "But the health-care system has to make it easier for them to do it."

Taylor said that in some other countries, services like these are more widely used because they are required or doctors are compensated to employ them. "But in this country," he said, "most doctors and hospitals have little or no incentives to provide them. They are unlikely to offer them until it is in their interest to do so."

Another poll finding was that, not surprisingly, younger adults are more eager to use their smartphones and tablets than older adults. Only one-quarter of people aged 65 and older were very interested in using the devices to help manage their blood pressure, for instance -- compared to 38 percent of younger people.

On one hand, Schleyer noted, older adults could stand to benefit the most from such technology, because they're more likely to have chronic health conditions and need more contact with their doctors.

On the other hand, they may simply not be as comfortable with smartphones and tablets as younger generations are, he said.

Despite the interest in tapping into smartphones and tablets for health care, some poll respondents had some misgivings. They were less inclined to want e-mail or text "reminders" to exercise, quit smoking, or take medication, for example.

Schleyer said that may be because it's a bit like having your mom nag you electronically. Plus, many Americans are already inundated with e-mails and texts. "People may feel there's already too much digital information flying at them," he said.

Poll respondents were also worried about the security of their electronically transmitted medical information: 47 percent were "somewhat confident" it would be secure, while roughly 40 percent were "not very" or "not at all" confident.

That's a valid worry, Schleyer said. However, he also doubts that a hacker would have much interest in the blood pressure readings you're sending to your doctor. "They're probably more interested in your credit card number."

Schleyer thinks there's a lot of promise for technology to improve health care for Americans -- if, for instance, consumers can get not only test results sent to their phones, but also user-friendly information on what those results mean.

"But right now, none of this is mature yet," he said.

The poll results are based on an online survey of 2,050 Americans aged 18 and older, conducted between May 22-24.

More information

The U.S. Department of Health and Human Services has more on health information technology.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- Adding an organ donation option to the average Facebook user's profile prompted a dramatic rise in potential donors, researchers report.

In the day after the initiative launched last year, there was a 21-fold increase in donor registrations across the United States, according to the study in the American Journal of Transplantation.

Transplant experts collaborated with Facebook to alter the "timeline" platform on the social media giant's site so that users could change their profile status to indicate "organ donor." When they did so, they were given a link to their state's official donor registry and their friends were sent a message about their new organ donor status, the researchers said.

"The short-term response was incredibly dramatic, unlike anything we had ever seen before in campaigns to increase the organ donation rate," study leader Dr. Andrew Cameron, an associate professor of surgery at the Johns Hopkins University School of Medicine, Baltimore, said in a university news release.

"At the end of two weeks, the number of new organ donors was still climbing at twice the normal rate," he added.

On the first day of the initiative, there were more than 13,000 new registrations nationwide -- 21 times the normal daily average of 616. Increases ranged from about seven-fold in Michigan to nearly 109-fold in Georgia.

Registration rates remained elevated in the following 12 days but began to drop off after that. However, by the end of the study period, rates were still double the normal ones.

"The bump we saw did diminish over weeks, implying that more work is needed to assure sustainability or 'virality' in this case," Cameron noted in a journal news release.

According to background information from Hopkins, more than 118,000 Americans are currently on waiting lists for donor organs. The situation has gotten worse, not better: over the past two decades, donor numbers have been stagnant, while the need for donated organs has risen 10-fold. Each year, up to 10,000 people die with viable organs for transplant that cannot be used because the deceased did not give his or her consent.

Cameron, a transplant surgeon, said he got the idea for a Facebook link-up after discussing the issue with a fellow Harvard University classmate at their 20th college reunion in 2011. That former classmate happened to be current Facebook chief operating officer Sheryl Sandberg.

The initiative began May 1, 2012, and on that day more than 57,000 Facebook users updated their profiles to share their organ donor status with others.

"This was the first [online] effort like this designed to mobilize people for a public health cause," Cameron said. "Now we want to build on that. Studying the response to the organ donor effort is the next step in the process of using social media for social good."

The long-term significance of this effort will be known only when the use of social media and social networks is examined in terms of its impact on the nation's organ supply, he added.

More information

The U.S. Department of Health and Human Services has more about organ donation.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 18 (HealthDay News) -- People with a "hardening" of the abdominal aorta are at increased risk for heart attack and stroke, according to a new study.

Atherosclerosis is the medical term for a narrowing and hardening of the arteries caused by a buildup of plaque. The aorta is the largest artery in the body, carrying oxygen-rich blood from the heart; the section of the aorta in the abdomen is called the abdominal aorta.

Researchers used MRI to examine plaque accumulation and abdominal aortic wall thickness in more than 2,100 people in Dallas County, Texas. During a follow-up period of nearly eight years, 143 of the participants, whose average age was 44, had a cardiovascular event such as a heart attack or stroke. Thirty-four of those events were fatal.

Increased abdominal wall thickness was associated with an increased risk for all types of cardiovascular events. An increase in both wall thickness and plaque buildup was associated with a higher risk for nonfatal events in arteries outside of the heart, such as a stroke.

The study appears online June 18 in the journal Radiology.

"This is an important study, because it demonstrates that atherosclerosis in an artery outside the heart is an independent predictor of adverse cardiovascular events," lead author Dr. Christopher Maroules, a radiology resident at the University of Texas Southwestern Medical Center in Dallas, said in a journal news release. "MRI is a promising tool for quantifying atherosclerosis through plaque and arterial wall thickness measurements."

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 18, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

U.S. Adult Smoking Rate Falls

The number of American adults who smoke fell to 18 percent in 2011, according to the Centers for Disease Control and Prevention.

The adult smoking rate had been declining for decades but then seemed to level off at about 20 to 21 percent before falling to 19 percent in 2011, the Associated Press reported.

The latest findings are from a survey of about 35,000 adults. The smoking rate was 9 percent among people ages 65 and older but about 20 percent for younger adults. Men had a higher smoking rate than women.

The survey did not include teens, but a previous CDC study found that about 16 percent of high school students were smokers in 2011, the AP reported.

Factors that may have contributed to this latest decline in adult smoking include more public smoking bans, higher state and federal tobacco taxes, and increased spending on prevention and cessation programs, according to Patrick Reynolds, executive director of the Foundation for a SmokeFree America.

"This is a real decline in smoking in America. I'm ecstatic about it. It's proof that we are winning the battle against tobacco," he told the AP.

Smoking is the leading cause of preventable illness and death in the U.S.

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Swimmers Warned About Deadly Amoeba

Swimmers in Florida are being advised to avoid stagnant water that could contain a type of amoeba that can cause a potentially deadly brain infection.

Naegleria fowleri is invisible to the naked eye and can be found in warm, standing water, according to an alert issued by the Florida Department of Health. It said that the amoeba is usually harmless, but can cause a fatal brain infection if inhaled through the nose, ABC News reported.

"Wear nose clips, hold your nose shut or keep your head out of the water when swimming, jumping or diving in any freshwater," the health department advised. "Closing your nostrils may reduce your chance of becoming infected."

Infections caused by N. fowleri are extremely rare but almost always result in death. Between 1962 and 2012, 128 people in the United States were infected and only one survived, according to the Centers for Disease Control and Prevention.

The amoeba was linked to the death of a Minnesota child last summer and killed four people in Virginia, Florida, Kansas and Louisiana in 2011, ABC News reported.

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Spraying Begins in Dallas to Control West Nile Virus

Spraying is being conducted in North Texas after health officials detected a large increase in the type of mosquito that primarily carries West Nile virus.

The region was at the center of a national outbreak last year that resulted in the country's highest annual death toll from West Nile virus, the Associated Press reported.

In Dallas, trucks will spray through early Wednesday morning in neighborhoods where tests have revealed a rise in the species of mosquito most likely to transmit the virus.

There are no confirmed cases of West Nile in either Dallas or Dallas County and the spraying is being done to stem any outbreak, Crystal Woods, with the Dallas division manager for mosquito control, told the AP.

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Drug Makers Can be Sued Over Deals to Delay Generic Drug Sales: U.S. Supreme Court

Makers of brand-name drugs can be sued for violating U.S. antitrust laws if they pay a potential competitor to delay selling generic versions of the drugs, the Supreme Court ruled Monday in a 5-3 decision.

The court said that a "large and unjustified" payment to settle a patent dispute over generic drugs can trigger an antitrust claim against the maker of the brand-name drug, the Los Angeles Times reported.

So-called "pay-for-delay" deals between brand-name and generic drug makers cost consumers and health plans $3.5 billion a year, according to the Federal Trade Commission.

Monday's ruling is expected to lead to lower drug prices for consumers, the Times reported.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- To cut down on fat and calories without sacrificing dietary calcium, experts say you should cook with low-fat or fat-free dairy products.

The Joslin Diabetes Center mentions these examples:

  • Choose low-fat or nonfat yogurt, low-fat cheese and skim or low-fat milk.
  • When creating a cream sauce, use evaporated skim milk.
  • Flavor your coffee with fat-free half-and-half.
  • Instead of butter, use a bit of trans-fat-free margarine.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- When skin is dry, itchy and flaky, giving it some extra TLC can help restore its moisture and natural glow.

The Cleveland Clinic mentions these suggestions to help prevent or treat dry skin:

  • Take showers or baths with lukewarm water, not hot water.
  • Keep baths and showers to no more than 10 minutes.
  • Immediately after you bathe or wash hands, apply a rich moisturizer.
  • Use moisturizing hand soaps or body soaps.
  • Apply a light lotion during summer. Heavier creams and ointments may be used during winter.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Doctors should avoid ordering certain antibiotics for older patients who take cholesterol-lowering statin drugs, such as Lipitor, Canadian researchers say.

Statins, which are taken by many millions of people, don't mix well with the antibiotics clarithromycin or erythromycin, according to a study, published in the June 18 issue of the Annals of Internal Medicine.

These two commonly used antibiotics inhibit the metabolism of statins and increase statin concentration in the blood, which can cause muscle or kidney damage, and even death, the researchers said.

"These drugs do interact and cause difficulties for patients," said lead researcher Dr. Amit Garg, a professor in the department of epidemiology and biostatistics at the University of Western Ontario in London, Ontario.

These adverse reactions are rare, Garg added. "Most people will be fine," he said. "But at a population level, hundreds of preventable hospitalizations are occurring."

For someone taking a statin, the study suggests that substituting a different antibiotic -- azithromycin -- is safer because it doesn't interfere with the metabolism of statins.

Another strategy is to stop the statin until the antibiotic course is finished, Garg said.

The study of more than 144,000 statin users over the age of 65 compared those prescribed clarithromycin or erythromycin with those taking azithromycin.

In terms of absolute risk, the odds of kidney damage increased 26 percent among people who took clarithromycin or erythromycin and statins compared with patients who took azithromycin with statins.

Also, hospitalizations for muscle damage (a condition called rhabdomyolysis) and deaths were slightly higher -- 0.02 percent and 0.25 percent, respectively -- in the clarithromycin or erythromycin groups compared to the azithromycin group, the study authors found.

Dr. Gregg Fonarow, a spokesman for the American Heart Association, said patients should not stop taking statins, which are known to prevent heart disease. Instead, doctors should prescribe another antibiotic, he suggested.

"It is well documented that certain medications that inhibit the liver enzyme cytochrome P450 isoenzyme 3A4 can increase the drug level of statin medications," said Fonarow, a professor of cardiology at the University of California, Los Angeles. "Nevertheless, large-scale randomized clinical trials and clinical effectiveness studies have demonstrated [that] the benefits of statin therapy in reducing fatal and nonfatal cardiovascular events outweigh the potential risks."

The study data included more than 73,000 patients prescribed clarithromycin, about 3,200 prescribed erythromycin and more than 68,000 people who took azithromycin. Almost three-quarters of the statin users were taking atorvastatin (Lipitor). The other commonly used statins were simvastatin (Zocor) and lovastatin (Altoprev, Mevacor).

Clarithromycin and erythromycin are often prescribed for respiratory illness such as pneumonia. Previously, the U.S. Food and Drug Administration warned that statins don't interact well with these and certain other drugs used to treat HIV and hepatitis.

The study authors noted that younger patients are less likely than older adults to experience serious side effects from drug interactions.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Even after they leave the fields at the end of hot day, farmworkers still have to cope with high levels of heat and humidity in their living quarters, a new study shows.

"We found that a majority of the workers are not getting much respite from the heat in the evening," study author Sara Quandt, a professor of epidemiology and prevention at Wake Forest Baptist Medical Center, said in a center news release.

"While we didn't measure direct health outcomes, the research raises concern about worker's health related to dehydration and sleep quality, which can, in turn, impact safety and productivity," Quandt said.

She and her colleagues assessed heat levels -- ranging from no danger (less than 80 degrees Fahrenheit) to extreme danger (higher than 115 degrees) -- during the evenings in the common and sleeping rooms in barracks, trailers and houses at 170 farmworker camps in eastern North Carolina during the summer of 2010.

About 55 percent of the farmworkers in the study said they had no air conditioning in their dwelling, 38 percent said they had window air conditioning and 7 percent said they had central air conditioning. Eighty percent of the workers said there were electric fans in their sleeping rooms.

Heat levels exceeded the danger threshold in most of the common and sleeping rooms during the evening, according to the study published online June 13 in the American Journal of Public Health.

"If you sleep in a very hot room, you don't sleep well and you don't get rested so the quality of sleep is compromised," Quandt said. "For workers, the concern is what happens in the daytime during work hours while using tools and machinery. They're in situations where they have to make decisions that can affect safety, but if they're drowsy, this can be an issue."

She noted that this problem could get worse due to climate change.

"There is historical data to show that temperatures in the southern United States have risen, and over the long term, warmer temperatures are going to strain workers who do a lot of physical labor and affect their productivity," Quandt said.

More information

Farmworker Justice has more about workplace hazards faced by farmworkers.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- A diet high in saturated fat can quickly rob the brain of a key chemical that helps protect against Alzheimer's disease, according to new research.

In a small study published online Monday in the journal JAMA Neurology, researchers found that dietary saturated fat cut the body's levels of the chemical apolipoprotein E, also called ApoE, which helps "chaperone" amyloid beta proteins out of the brain.

"People who received a high-saturated-fat, high-sugar diet showed a change in their ApoE, such that the ApoE would be less able to help clear the amyloid," said research team member Suzanne Craft, a professor of medicine at Wake Forest School of Medicine.

Amyloid beta proteins left loose in the brain are more likely to form plaques that interfere with neuron function, the kind of plaques found in the brains of people with Alzheimer's disease.

Diet also directly affected the amount of loose amyloid beta found in cerebrospinal fluid, Craft said. Those on a high-saturated-fat diet had higher levels of amyloid beta in their spinal fluid, while people on a low-saturated-fat diet actually saw a decline in such levels, she said.

"An amyloid that is not cleared -- or attached to ApoE to get cleared -- has a greater likelihood of becoming this toxic form," Craft said.

The clinical trial, led by Dr. Angela Hanson of the Veterans Affairs Puget Sound Health Care System in Seattle, involved 20 seniors with normal cognition and 27 with mild thinking impairment, a precursor to Alzheimer's disease.

The patients, all in their late 60s, were randomly assigned to diets that contained the same amount of calories but were either high or low in saturated fat. The high-saturated-fat diets had 45 percent of total energy coming from fat, and more than a quarter of the total fat came from saturated fats. The low-saturated-fat diets had 25 percent of energy coming from fat, with saturated fat contributing less than 7 percent to total fat.

After just a month, the diets caused changes in the amounts of amyloid beta and ApoE in the study participants' cerebrospinal fluid, researchers said.

"Diet can really change levels of these toxic proteins and of these mediators that help clear these amyloids," Craft said. "Diets that are very high in bad cholesterol seem to interfere with ApoE's ability to clear amyloid."

One gerontology expert, who wrote an editorial accompanying the study in the journal, didn't think the link was quite that clear.

Although the study shows that diet can affect brain chemistry, it does not definitely tie diet to a person's risk for Alzheimer's disease, said Dr. Deborah Blacker, director of the Gerontology Research Unit at Massachusetts General Hospital in Boston.

"Is it plausible to say this could affect the risk of having Alzheimer's pathology in your brain? It's not showing that," said Blacker, who also is with the Harvard School of Public Health. "It's showing that some of the chemicals related to Alzheimer's pathology can shift in response to dietary factors."

The study does, however, offer important insight into the value of good nutrition, she said.

"The important lesson from the study is that dietary intervention can change brain amyloid chemistry in largely consistent and apparently meaningful ways, in a short period of time," Blacker wrote in the editorial. "Does this change clinical practice for those advising patients who want to avoid dementia? Probably not, but it adds another small piece to the growing evidence that taking good care of your heart is probably good for your brain too."

People focus on diet in terms of weight and heart health, but they overlook that nutrition can be key to cognitive function as well, Craft said.

"Diet is a very underappreciated factor in terms of brain function," she said. "It's quite well accepted for your heart and your cholesterol and your blood, but diet is critical for a healthy brain aging. Many of the things the brain needs to function properly -- fatty acids, certain amino acids -- come only from food."

More information

For more on a healthy diet for the brain, visit the Alzheimer's Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- People who eat a lot of red meat increase their risk of developing type 2 diabetes, while those who cut down on red meat cut their risk.

Those are the findings of a large new study out of Singapore involving 149,000 U.S. men and women.

The researchers found that increasing the consumption of red meat can increase the risk of developing type 2 diabetes by 48 percent.

"There is no need to have more red meat on your plate; it increases the risk of diabetes," said lead researcher An Pan, an assistant professor at the Saw Swee Hock School of Public Health at the National University of Singapore.

"It is better to reduce your red meat consumption by replacing it with other healthy food choices, like beans, legumes, soy products, nuts, fish, poultry and whole grains," he added.

The report was published in the June 17 online edition of the journal JAMA Internal Medicine.

For the study, Pan's team collected data on three Harvard group studies: the Health Professionals Follow-up Study, the Nurses' Health Study and the Nurses' Health Study II. All the participants answered questions about their diet every four years, resulting in more than 1.9 million person-years of follow-up.

There were more than 7,500 cases of type 2 diabetes, the researches found.

Comparing diet with the cases of diabetes, Pan's group found that people who increased their consumption of red meat by 0.5 servings per day during a four-year period were 48 percent more likely to develop type 2 diabetes, compared with people who ate less red meat.

Moreover, people who cut their red meat consumption were 14 percent less likely to develop type 2 diabetes, they found.

Outside experts, however, argued about the findings.

"Epidemiological studies made by questionnaires are not accurate, and they never prove causation, no matter how big and how good the statistics are," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

The interaction of the many genetic and lifestyle factors that cause obesity and type 2 diabetes is remarkably complex and is still being studied, Zonszein added. "Doing cross-sectional analysis or epidemiological analysis produces questions but not answers," he said.

Blaming red meat for diabetes is misleading, said William Evans, head of the Muscle Metabolism Discovery Performance Unit at GlaxoSmithKline and the author of an accompanying editorial in the journal.

The amount of saturated fat that is also found in many types of meat is the most likely cause for the association of red meat and risk of diabetes, he said.

"Red meat is not the bad food that it is touted to be," Evans said. "There are many cuts of beef that are red and have as much fat as a chicken breast, and the redness in meat provides the most available form of iron from any food that we eat."

But Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, countered that Americans are eating too much red meat.

"In 2012, Americans ate an estimated 166 pounds of meat per person," she said. "That is a titanic amount of unhealthy saturated fat and other compounds found in meat, such as iron, zinc or N-nitroso -- compounds that research suggests are linked with increased risks for diseases such as diabetes, cardiovascular disease and cancers."

"A plate loaded with meat also leaves less room for vegetables, whole grains and other healthy foods," Heller said.

Zonszein also doesn't put the blame for type 2 diabetes on red meat alone.

"The public health message should be to eat a heart healthy and balanced diet with balanced macronutrients, and low in saturated fat," he said.

He added, however, that "excessive caloric intake is not good, but I will eat a good steak and potatoes from time to time and enjoy it."

"If the cause of the associated risk is saturated and total fat content," Evans said, "the public health message should be to reduce intake from all sources, such as cheese, whole milk and meat that is rich in saturated fat, not to single out specific types of meat because of redness."

More information

For more information on diabetes, visit the American Diabetes Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- A new brain-imaging study could help explain why children with autism have difficulty with verbal communication: They may not get much pleasure from the human voice.

Researchers found that those with the disorder showed weaker connections between the brain's voice-processing areas and its "reward" centers compared to those without.

That suggests that kids with autism do not get the same pleasure from the human voice that typically developing children do, researchers said.

"When we speak, we don't only convey information, we convey emotion and social cues," said Daniel Abrams, a researcher at Stanford University in Palo Alto, Calif., who led the new study.

It's well known that children with autism have difficulty reading those cues and having conversations. And children with more severe autism may be completely indifferent to the sound of the human voice.

There are competing theories on why that is, Abrams said. "One theory is that, although these children have normal hearing, there's a problem in the brain's sound processing," he explained.

Another theory is that "social cues," including other people's speech, don't hit the brain's reward system in the typical way. "Our findings support this idea," Abrams said. "There may be some deficit in the brain circuitry related to reward."

The findings, published online Monday in the Proceedings of the National Academy of Sciences, are based on a type of brain imaging called functional MRI, which allows researchers to measure brain activity by watching changes in blood flow.

The investigators took scans of 20 children who were on average 10 years old and had "high-functioning" autism: all had normal IQs and speaking and reading skills, but had trouble conversing and grasping "emotional cues" in other people's voices. The researchers also scanned 19 kids without autism who were in the same age and IQ range.

The researchers found that the children with autism showed a weaker connection between an area of the brain that responds to the human voice and two other brain regions that release the "feel-good" chemical dopamine in response to rewards.

On top of that, there was a weaker link between the brain's voice processors and the amygdala -- a brain region involved in emotion, including the ability to perceive emotional cues from others.

An expert not involved in the work said the findings give more insight into the underpinnings of autism, which affects an estimated one in 50 U.S. kids aged 6 to 17, according to the U.S. Centers for Disease Control and Prevention.

"This is an elegant approach to using neuroimaging to better understand [autism]," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park.

What's unclear, Adesman added, is whether the impaired brain connectivity is actually a cause of the children's difficulties with conversations and socializing.

He noted that it's "likely" that weaker brain connections came first, but there's no way to tell for sure from this study.

"The natural next step," Adesman added, "is to try to replicate these findings in further studies, and to expand the research to include younger kids."

Adesman said he does not see the findings as being "immediately" useful in terms of autism therapies or diagnosis (such as using functional MRI scans to spot connectivity problems in the brain).

But, according to Abrams and colleagues, the findings lend some support to autism therapies already in use.

One example is known as pivotal-response training, which tries to motivate kids who can speak but do not usually converse with others, to engage in more "social" talk.

One limit of the study is that all of the children with autism were "high-functioning." But autism is considered a "spectrum" disorder whose effects range widely: Some people have mild problems socializing but have normal to above-normal intelligence; others have profound difficulties relating to others, and may have intellectual impairment as well.

It's not certain, Abrams said, that the same brain connectivity patterns would be seen across the autism spectrum.

More information

Learn more about autism from the U.S. National Institute of Child Health and Human Development.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- U.S. Hispanic children have high rates of obesity, and a new study suggests exposure to junk food ads on television might be one reason why.

According to the study based on 2010 data, Hispanic children under the age of 18 viewed an average of 12 food and beverage TV ads per day.

"Given higher rates of obesity and overweight for Hispanic youth, it is important to understand the amount and types of food advertising they view," said a team led by Frances Fleming-Milici of Yale University. The findings are published online June 17 in JAMA Pediatrics.

Their analysis estimates that Hispanic children saw a total of more than 4,200 food and beverage ads on television (both English- and Spanish-language TV) in 2010 alone.

Restricting their analysis to Spanish-language television only, the researchers say that Hispanic preschoolers viewed 1,038 food advertisements in 2010, the highest number for any age group, according to a journal news release.

Most of the food and beverage ads seen by the children and teens appeared on English-language TV, but fast food accounted for a higher percentage of food ads on Spanish-language TV, the study found. About half of the food ads on Spanish-language TV were for fast food, cereal or candy.

Exposure to such a large numbers of ads for foods and beverages with little or no nutritional value likely contributes to the high obesity rate among young Americans, the study authors said.

Taking note of "food companies' stated intentions to increase marketing to Hispanics, continued monitoring of food and beverage marketing to Hispanic youth is required," the Yale team added.

More information

The American Academy of Pediatrics has more about childhood nutrition.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- The younger you are, the less likely you are to realize you are infected with HIV or receive treatment for it, a new study finds.

Early diagnosis, prompt and continued care, and antiretroviral drug therapy are key to lowering the risk of illness and death among patients, and reducing transmission of HIV, the virus that causes AIDS.

However, this study of 2009 data from the National HIV Surveillance System found that people under the age of 45 who are infected with the virus are much less likely than their older peers to know they are infected or to be getting proper care.

The study also revealed that more than 200,000 of the more than 1.1 million Americans who are infected are unaware they carry the virus. The investigators also found that only about 37 percent of infected people received regular care, only one-third were prescribed HIV-suppressing medicines, and 25 percent had achieved a "suppressed viral load," meaning HIV was being kept to very low levels.

These results varied widely by age. For example, among HIV-infected people aged 13 to 24, only about 40 percent had received a diagnosis of HIV infection and only 30 percent had been referred for care.

Lower percentages of people aged 25 to 44 received regular care, were prescribed drug therapy and had a suppressed viral load, compared with those aged 55 to 64, the study found. For example, 28 percent of young adults with HIV were receiving treatment, compared with 46 percent of those aged 55 to 64.

The study was published online June 17 in the journal JAMA Internal Medicine.

Overall, more than 850,000 Americans with HIV had not achieved the treatment goal of viral suppression. This included 75 percent of men with HIV, 79 percent of blacks, 74 percent of Hispanics, and 70 percent of whites.

"Individuals, health care providers, health departments and government agencies must all work together to increase the numbers of people living with HIV who are aware of their status, linked to and retained in care, receiving treatment and adherent to treatment," concluded researchers led by H. Irene Hall of the U.S. Centers for Disease Control and Prevention.

"In 2011, the HIV field was shocked to learn that only about a quarter of individuals living with HIV were successfully receiving HIV treatment," Drs. Katerina Christopoulos and Diane Havlir, of the University of California, San Francisco, wrote in an accompanying commentary.

"The sobering numbers of those missing out on effective treatment because they did not know they were infected and those who knew their status but did not seek care spurred collaboration between the HIV treatment and prevention movements, two areas with different funding streams that often operated independently of one another," they noted.

"Already the HIV community has mobilized to further develop and study interventions that address bottlenecks in the cascade. Achieving an AIDS-free generation will be within reach if, and only if, these efforts succeed," Christopoulos and Havlir concluded.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV/AIDS.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Elderly people may gain as much benefit from having implantable cardioverter defibrillators as younger people, according to a new study.

An implantable cardioverter defibrillator, or ICD, is a device placed inside the chest to deliver electrical shocks to restore normal heartbeat if it detects a dangerous abnormal heart rhythm.

The findings indicate that overall health, not just a person's age, should be used to predict whether a patient will benefit from receiving this type of device and help determine who should receive one, according to the authors of the study, which was published June 17 in the journal Circulation.

"Whether elderly patients benefit from the devices has been controversial and research on the topic is lacking," lead author Dr. Douglas Lee, a scientist at the Institute for Clinical Evaluative Sciences and a cardiologist at the Peter Munk Cardiac Centre in Toronto, said in a journal news release. "The issue is important as the population ages and the number of elderly people living with heart disease grows."

Lee's team looked at nearly 5,400 patients who had the devices implanted. The patients had poor heart function due to heart failure or a prior heart attack, or after being resuscitated from cardiac arrest.

Among those who received the implanted device with heart failure or after heart attack, 38 percent were aged 70 or older and 7 percent were 80 or older. Among those who received the device after surviving a cardiac arrest, 42 percent were 70 or older and nearly 11 percent were in their 80s.

"Older patients were just as likely to experience an appropriate electrical shock from the device to treat a life-threatening heart rhythm," said Lee, who is also associate professor of medicine at the University of Toronto. "However, older patients experienced more noncardiac and cardiovascular hospitalizations and higher associated rates of death overall."

For example, among patients receiving an ICD to prevent cardiac arrest, the death rate among patients aged 18 to 49 was two per 100 patients, compared with 10 per 100 patients among those 80 and older.

More information

The U.S. National Heart, Lung, and Blood Institute has more about implantable cardioverter defibrillators.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Strict controls on the sale of cigarettes to youth may also reduce adult smoking, a new study suggests.

States with tighter restrictions on the sale of cigarettes to teens also had lower adult smoking rates, especially among women, researchers found. These states also tended to have fewer adult heavy smokers.

"In most states for many years, it has been illegal to sell cigarettes to people under 18, but few provisions are in place to prevent those sales," study first author Richard Grucza, an associate professor of psychiatry at Washington University School of Medicine in St. Louis, said in a university news release. "This study shows that more restrictive policies can prevent teen smoking and be beneficial down the road."

He and his colleagues examined 1998 to 2007 data from more than 105,000 people, aged 18 to 34, involved in an ongoing U.S. National Cancer Institute survey that monitors smoking behavior throughout the country. They looked at whether people had ever smoked, whether they were current smokers and, if they did smoke, whether they smoked more than 10 cigarettes a day.

The researchers focused on nine smoking-related policies. In states with stricter rules and enforcement, 17-year-olds had more difficulty buying cigarettes and were less likely to smoke when they were in their 20s and 30s, according to the study published online June 13 in the American Journal of Health.

"We estimated that if all states had effective policies in place, it would reduce the prevalence of smoking by about 14 percent and the rates of heavy smoking by 29 percent," Grucza said.

The study found that the following were the four most effective restrictions:

  • Eliminating cigarette vending machines or placing them in locations inaccessible to those under 18
  • ID requirements for purchasing cigarettes
  • Restrictions on repackaging cigarettes to prevent five or 10 being sold at a time, rather than the whole 20-cigarette pack
  • Banning distribution of free cigarettes at public events

"A lot of states still have not adopted all of these policies. In 2006, which is the last year for which we have data, only four states required a photo ID, and only 20 states had any kind of identification requirements at all. So there's still a lot of room for improvement," Grucza noted.

However, as more states implement and enforce more restrictive antismoking policies, there may be further reductions in smoking rates, he added.

More information

The U.S. Centers for Disease Control and Prevention has more about youth and tobacco.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Fetal exposure to the chemical bisphenol A (BPA) has been linked to low levels of a key developmental hormone in newborn boys with undescended testicles, according to an early new study.

The research adds to the list of growing health concerns related to BPA, which is widely used in food packaging. Government studies have shown that 92 percent of Americans have detectable levels of BPA in their bodies.

This study focused on boys with cryptorchidism, the medical term for undescended testicles. The condition occurs in 2 percent to 5 percent of newborn boys, according to the authors, and requires surgery to bring the testes out of the abdominal cavity. Boys born with cryptorchidism have an increased risk of fertility problems and testicular cancer in adulthood.

The researchers found that boys with cryptorchidism who had high levels of BPA in their fetal cord blood also had low levels of the hormone insulin-like 3, or INSL3, one of two hormones that regulate descent of the testicles.

The findings do not draw a direct link between BPA and cryptorchidism, as the newborns with undescended testicles did not have greatly increased levels of BPA compared with newborns without the birth defect.

Researchers found, however, that the BPA level in newborns' cord blood inversely correlated with the level of INSL3. That is, the higher the BPA level, the lower the level of the important testicular hormone.

The study was presented Sunday at the Endocrine Society's annual meeting in San Francisco. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Alone, our study cannot be considered as definitive evidence for an environmental cause of undescended testis," lead author Dr. Patrick Fenichel, professor and head of reproductive endocrinology at the University Hospital of Nice, in France, said in a society news release. "But it suggests, for the first time in humans, a link that could contribute to one co-factor of [unexplained] undescended testis, the most frequent congenital malformation in male newborns."

This appears to be the first study that shows a link between INSL3 levels and BPA, said Shanna Swan, a professor and vice chair for research and mentoring in the department of preventive medicine at the Icahn School of Medicine at Mount Sinai, in New York City.

"This hormone INSL3 has not been, to my knowledge, previously linked to any endocrine-disrupting chemicals," Swan said. "It's interesting, definitely, and it's an important step."

For the study, Fenichel and his colleagues studied 180 newborn boys between 2003 and 2005, including 52 boys born with one or two undescended testicles. They tested the infants' umbilical cord blood to measure levels of BPA and INSL3.

The infants with cryptorchidism had significantly lower levels of INSL3 compared to newborns without the birth defect, the authors reported. Fenichel speculated that BPA, considered a hormone disruptor, might repress expression of the gene that promotes production of INSL3.

The U.S. Food and Drug Administration has banned the use of BPA in products such as baby bottles and sippy cups, but the chemical continues to be used in many other consumer products.

The most prominent continuing use of BPA is in the lining of aluminum and tin cans, where it prevents corrosion. "The linings of tin cans is probably the biggest source of our exposure," Swan said. "There is almost no canned food that comes in BPA-free cans."

BPA also is found in cash register receipts. "To have a cash register receipt that doesn't require ink, it is coated in BPA," Swan said, noting that studies have found increased BPA levels in the urine of people who have touched a receipt.

Both Swan and Dr. Leonardo Trasande, an associate professor of pediatrics, environmental medicine and health policy at NYU Langone Medical Center in New York City, noted that there are limitations to the new study.

BPA typically is not measured in blood, Trasande and Swan said. In most cases, doctors use urine to measure BPA exposure.

Swan also said the study does not make a clear link between BPA and undescended testicles, since BPA levels appeared consistent in all the newborns regardless of whether they had the birth defect.

"That said, you have to [ask], What is INSL3 related to?" she added. "It is definitely related to descent of the testicles, and required for descent of the testicles."

Trasande said the study "certainly raises another set of health concerns that haven't been raised before about BPA exposure."

"While research is needed to study exposure to BPA during pregnancy and risk of birth defects to confirm this association, it also adds further concern about the ongoing decision by the Food and Drug Administration not to ban BPA in food uses," Trasande said.

More information

To learn more about BPA, visit the U.S. National Institute of Environmental Health Sciences.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Two new studies offer some solace to those who can't control their weight despite diet and exercise by providing more evidence that genetics may play a role in obesity.

One study offers unique insight because it finds genetic mutations in severely obese children that suggest their excess weight may be more connected to their DNA because they put on pounds at such a young age. The other study found that certain genetic traits boost the risk of obesity in families.

The exact connection between genes and weight remains elusive. Still, "it's very likely that many of the genetic variants that contribute to weight interact with our environment -- the food that we eat and the amount of exercise that we get," said Sadaf Farooqi, professor of metabolism and medicine at the University of Cambridge in the U.K. and co-author of the study on children. "In fact, some of these genes act by influencing our appetite and how much we like food."

Previous research has shown that certain genetic variations boost the risk of obesity, but not in everyone, said Daniel Belsky, a postdoctoral fellow at Duke University's Center for the Study of Aging and Human Development. "Many people who carry a high load of common genetic risks remain lean while others who carry a light load of common genetic risks develop obesity," he said.

The two new studies, both published in the June 17 issue of the Journal of Clinical Investigation, examine variations in the SIM1 gene that are very rare but may have a big effect on the people who have them, Belsky said. "The purpose of studying these variants is to learn something about obesity -- what systems are disrupted and how -- with the aim of guiding the development of new treatment and prevention strategies," he said.

In one study, researchers found several genetic mutations in 2 percent of 2,100 severely obese kids with an average age of 10, but in fewer than 0.1 percent of the others.

"When the genetic variations do occur, they play a major role in a person's weight," study co-author Farooqi said.

In the other study, researchers studied the DNA of hundreds of children and adults (many of them severely obese), as well as the DNA of children who seem to have a condition called Prader-Willi syndrome, which can lead to overeating and out-of-control obesity. Led by a researcher from the Lille Pasteur Institute in France, the study authors linked three genetic mutations -- related to those in the other study -- to a high risk of obesity in families.

Scientists suspect that the genetic variations in the studies affect hunger and the way the body handles energy.

What can people do if their genes put them at higher risk of obesity? For now, nothing beyond trying the usual weight-loss strategies, such as diet, exercise and surgery.

"Despite this new discovery, there are still many genes to be found and we still don't understand how some of these genes actually work to affect our weight over long periods of time," Farooqi said. "If we can find new genes and understand how they work, we may be able to find more appropriate treatments for people who struggle with their weight."

More information

For more about obesity, try the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 17, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Drug Makers Can be Sued Over Deals to Delay Generic Drug Sales: U.S. Supreme Court

Makers of brand-name drugs can be sued for violating U.S. antitrust laws if they pay a potential competitor to delay selling generic versions of the drugs, the Supreme Court ruled Monday in a 5-3 decision.

The court said that a "large and unjustified" payment to settle a patent dispute over generic drugs can trigger an antitrust claim against the maker of the brand-name drug, the Los Angeles Times reported.

So-called "pay-for-delay" deals between brand-name and generic drug makers cost consumers and health plans $3.5 billion a year, according to the Federal Trade Commission.

Monday's ruling is expected to lead to lower drug prices for consumers, the Times reported.

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Komen Breast Cancer Charity Announces New CEO

The new CEO of the Susan G. Komen for the Cure breast cancer charity is Judith Salerno, who most recently was executive director and chief operating officer of the Institute of Medicine.

Founder Nancy Brinker announced last summer that she would step down as CEO after Komen faced widespread criticism for announcing that it would stop giving grants to Planned Parenthood for breast cancer screenings. The group later reversed that decision, the Associated Press reported.

Brinker began the charity in honor of her sister, who died of breast cancer in 1980.

"Komen's commitment has helped countless numbers of low-income and medically underserved women and men get care they might otherwise have gone without, and Komen's research program is one of the most highly respected in the nation," Salerno, 61, said in a statement released by the charity, the AP reported.

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Four More MERS Deaths in Saudi Arabia

Four more people in Saudi Arabia have died from a new SARS-like virus, bringing to 32 the total number of deaths the respiratory disease has caused in the kingdom.

Overall, nearly 40 people have died from the MERS virus since September, mostly in the Middle East and Europe, according to the World Health Organization. According to the U.S. Centers for Disease Control and Prevention, cases have been reported in Saudi Arabia, France, Italy, Jordan, Qatar, Tunisia, United Arab Emirates and the U.K., CBS News/Associated Press reported.

On Monday, the Saudi Health Ministry also said that it had confirmed three more cases of the virus, including a 2-year-old child. Health officials are still trying to determine how easily the virus spreads between humans.

The MERS virus is related to SARS, which killed about 800 people worldwide in 2003. The WHO continues to monitor the situation but has issued no recommendations about travel or trade restrictions, CBS News/AP reported.

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Children's Hand Transplant Program Announced by U.S. Hospital

The world's first hand transplant program for children is being launched by Boston Children's Hospital.

Patients will include children born without hands, those who lose hands in accidents, and youngsters with infections that require damaged hands to be amputated, the Associated Press reported.

Only one child in the world is known to have had a hand transplant. The case involved a baby girl in Malaysia in 2000 who received a hand from a twin who died at birth.

"We feel that this is justifiable," Dr. Amir Taghinia, who will lead the new transplant program, told the AP. "Children will potentially benefit even more from this procedure than adults" because they regrow nerves more quickly and have more problems with prosthetic hands, he explained.

The main risk facing children who have hand transplants comes from immune suppressing drugs used to prevent rejection of the new hand. These drugs cause side effects and may increase the child's long-term risk of cancer.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Black and Hispanic children with autism are markedly less likely than children from white families to receive specialty care for complications tied to the disorder, a new study finds.

Researchers from Massachusetts General Hospital for Children in Boston found that the rates at which minority children accessed specialists such as gastroenterologists, neurologists and psychiatrists, as well as the tests these specialists use, ran well below those of white children.

"I was surprised not by the trends, but by how significant they were," said study author Dr. Sarabeth Broder-Fingert, a fellow in the department of pediatrics at MassGeneral and Harvard Medical School. "Based on my own clinical experience and some of the literature that exists on this, I thought we'd probably see some differences between white and non-white children in getting specialty care . . . but some of these differences were really large, especially gastrointestinal services."

The study is published online June 17 in the journal Pediatrics.

According to the U.S. Centers for Disease Control and Prevention, about one in 50 school-age children has been diagnosed with an autism spectrum disorder, a group of neurodevelopmental problems marked by impairments in social interaction, communication and restricted interests and behaviors. Research has indicated that children with an autism spectrum disorder have higher odds of other medical complications such as seizures, sleep disorders, attention-deficit/hyperactivity disorder (ADHD), anxiety and digestive issues.

In the new study, Broder-Fingert and her team examined data from more than 3,600 autism patients aged 2 to 21 over a 10-year span. The vast majority of patients were white, while 5 percent were black and 7 percent were Hispanic. About 1,500 of the autism patients had received specialty care.

Most notably, almost 14 percent of white children used gastroenterology or nutrition services, compared to only 9 percent of blacks and 10 percent of Hispanics. Tests such as colonoscopies and endoscopies were received far more by white children, while psychiatric evaluations were also more sought-after by whites, and Hispanics used fewer neurologic studies, sleep studies and neuropsychiatric tests.

Broder-Fingert said that many children with autism have gastrointestinal or sleep problems, which can lead to additional behavioral issues if they aren't properly diagnosed or treated.

"I do worry because autism is such a complicated disorder," she said. "The children have some sort of communication difficulty, so if they have stomach problems or sleep problems they may have difficulty expressing that. I always worry these kids are not getting all the care they need in general, and minority kids are more at [risk] of not getting the care they need."

The research offered several possible reasons for the disparity, but Broder-Fingert felt the most likely scenario is that doctors don't necessarily know when to refer these patients to specialty care, or to whom.

"And if some families are advocating more for services than others, doctors are more likely to be aware of it," she added. "So I worry that families of white children are more likely to come in and say, 'my kid needs a colonoscopy because he has a stomach ache.' I think it's a combination of parents' advocacy and physicians' lack of knowledge."

The findings offer hard data to back up some assumptions doctors already had about how different populations are served, added Dr. Patricia Manning-Courtney, associate professor of clinical pediatrics and medical director of the Kelly O'Leary Center for Autism Spectrum Disorders at Cincinnati Children's Hospital Medical Center.

"If non-white children use services less, then we need better outreach to the minority community," Manning-Courtney said. On the other hand, "if white people are receiving unnecessary referrals and procedures, we need better education about what's needed," she added.

"There are no guidelines about how to proceed with evaluating [specialty care needs], which puts a lot back into the hands of parents," she said. "We allocate care for people who go after it the most, versus those who may need it the most."

More information

Find out more about autism at the U.S. National Institute of Neurological Disorders and Stroke.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 17 (HealthDay News) -- Being picked on by your brother or sister may seem like a normal part of growing up, but for some kids the bullying may be a source of depression and anxiety, a new study suggests.

Researchers found that among 3,600 kids in a U.S. survey, those who were pushed around by a sibling -- physically or verbally -- had higher scores on a measure of depression and anxiety symptoms.

"Historically, sibling aggression has been dismissed as normal," said lead researcher Corinna Jenkins Tucker, an associate professor of family studies at the University of New Hampshire. "It's been seen as benign, or even good for kids because it teaches them something about dealing with the world."

In general, parents and other adults tend to be more tolerant when siblings smack or taunt each other -- even if they would never condone it among peers.

But Tucker said her findings suggest that parents should not turn a blind eye to their kids' fights and teasing.

The study, reported online June 17 in the journal Pediatrics, has a number of limitations, Tucker acknowledged. One is that the children and parents were interviewed at one point in time, so it's not clear that the sibling aggression actually led to the poorer mental health.

"We can't say it's the cause," Tucker said. "But we can say there's a link."

An expert not involved in the study agreed that the one-time interview is an issue. "If you're feeling bad on the day you're interviewed, you may remember more instances of aggression," said William Copeland, an assistant professor of psychiatry and behavioral sciences at Duke University School of Medicine, who studies bullying and kids' mental health.

On top of that, it's tough to disentangle the effects of sibling bullying from other parts of a child's life. "We don't know, for example, how parents in the study responded to the aggression," Copeland said. "I'd like to know more about the family dynamics."

Still, he said, the findings shed some light on an issue that has gotten little attention compared with schoolyard bullying. "I think this shows us we need to address aggression no matter where it happens," Copeland said.

The findings are based on telephone interviews with nearly 3,600 children and their parents. Tucker's team used standard questionnaires to gauge the kids' levels of anger, depression and anxiety, and asked them about episodes of bullying -- from siblings and peers -- in the past year.

Overall, one-third of kids said they'd been the target of one type of sibling bullying: physical; verbal abuse, such as name-calling; or having their things stolen or purposely ruined.

In general, those kids had more mental health symptoms than those who reported no sibling bullying. And that was true, Tucker said, even when the researchers compensated for things such as bullying at school, parents' education levels and kids' exposure to family violence in general.

The findings leave a lot of unanswered questions, such as how severe and lasting any mental health symptoms might be. "Is this a short-term thing, or do these problems last?" Copeland asked.

It's also not clear whether it makes a difference if the bullying comes from a sibling who is much older or around the same age -- or whether it's between sisters, brothers or sisters and brothers, Tucker said.

But she and Copeland both said it's safe to assume that parents' reactions to their kids' aggression matters. "Let your kids know this is something you won't tolerate," Copeland said. Even if the bullying doesn't stop, he noted, kids may get a lot of comfort knowing they can turn to their parents for help.

"If there's no real escape for kids," he said, "that could make it a lot worse."

More information

The American Academy of Pediatrics has advice on dealing with bullying.

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Overeating can be a sure ticket to gaining weight and eventually becoming obese.

There are other factors that also increase your risk. The American Academy of Family Physicians mentions these examples:

  • Getting insufficient exercise.
  • Having obese family members.
  • Sleeping poorly.
  • Being pregnant.
  • Quitting smoking.
  • Getting older.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: If You Have Braces

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(HealthDay News) -- Eating healthy is especially important when you have braces. That means avoiding sugary foods, which could lead to plaque build-up and tooth decay.

The American Dental Association's website offers this additional advice for people who wear braces:

  • Don't eat corn on the cob, popcorn and whole apples.
  • Avoid sticky foods, such as chewing gum and chewy candies.
  • Eat a nutritious, balanced diet.
  • Practice good oral hygiene and ask your orthodontist or dentist about any other foods you should avoid.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, June 16 (HealthDay News) -- Eating breakfast every day may help overweight women reduce their risk of diabetes, a small new study suggests.

When women skipped the morning meal, they experienced insulin resistance, a condition in which a person requires more insulin to bring their blood sugar into a normal range, explained lead researcher Dr. Elizabeth Thomas, an instructor of medicine at the University of Colorado.

This insulin resistance was short-term in the study, but when the condition is chronic, it is a risk factor for diabetes, Thomas said. She is due to present her findings this weekend at the Endocrine Society's annual meeting in San Francisco.

"Eating a healthy breakfast is probably beneficial," Thomas said. "It may not only help you control your weight but avoid diabetes."

Diabetes has been diagnosed in more than 18 million Americans, according to the American Diabetes Association. Most have type 2 diabetes, in which the body does not make enough insulin or does not use it effectively.

Excess weight is a risk factor for diabetes.

The new study included only nine women. Their average age was 29, and all were overweight or obese.

Thomas measured their levels of insulin and blood sugar on two different days after the women ate lunch. On one day, they had eaten breakfast; on the other day, they had skipped it.

Glucose levels normally rise after eating a meal, and that in turn triggers insulin production, which helps the cells take in the glucose and convert it to energy.

However, the women's insulin and glucose levels after lunch were much higher on the day they skipped breakfast than on the day they ate it.

On the day they did not eat breakfast, Thomas explained, "they required a higher level of insulin to handle the same meal."

"There was a 28 percent increase in the insulin response and a 12 percent increase in the glucose response after skipping breakfast," she said. That's a mild rise in glucose and a moderate rise in insulin, she noted.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Their study doesn't prove causation," said Dr. Joel Zonszein, a professor of clinical medicine at the Albert Einstein College of Medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, in New York City.

The study found only a link or association between breakfast skipping and higher insulin levels. More research is needed for confirmation, another expert said.

"This is a small, but very interesting, study," said Dr. Ping Wang, director of the University of California, Irvine, Health Diabetes Center. "The findings will have to be verified with larger studies."

Whether the effect is short-term or long-term is not known, Wang said.

Zonszein recommends against either skipping meals or eating very frequent meals, the so-called nibbling diet. "Studies done in Europe have shown that a large meal in the middle of the day is better than a large meal at dinner," he said.

However, he acknowledged that pattern is more of a habit in Europe than in the United States. Even so, he advises his patients to eat a good breakfast, a good lunch and a lighter dinner.

Other ways to reduce diabetes risk, according to the American Diabetes Association, are to control weight, blood pressure and cholesterol and to be physically active.

More information

To learn more about reducing diabetes risk, visit the American Diabetes Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, June 15 (HealthDay News) -- Sneezing, watery eyes, scratchy throat? What you think is a summer cold may actually be allergies, an expert says.

"Contrary to popular belief, seasonal allergies don't only strike in the spring and fall months," Dr. Richard Weber, president of the American College of Allergy, Asthma and Immunology (ACAAI), said in a college news release. "Allergies are also common in the summer and can even last year-round for some sufferers."

Grass pollens and mold spores are the most common allergy triggers during the summer, and mold can be more of a problem than pollen. Mold spores are everywhere and commonly outnumber pollen grains in the air even during peak pollen season, research has shown.

Summer allergies (or hay fever) can develop even in adults who have never had allergies. In such cases, it's easy to mistake allergies for a summer cold.

The ACAAI offers some tips on how to determine if you have a summer cold or allergies:

  • If symptoms last for two weeks or more, you likely have allergies.
  • If your symptoms become progressively worse, you likely have a cold.
  • Itchy eyes, throat and nose -- along with sneezing -- usually indicate allergies.
  • If you have asthma, you may be more likely to have an allergy than a cold. About 75 percent to 80 percent of people with asthma also have an allergy.

Although summer colds and allergies may not seem serious, both can progress and lead to other health problems, such as a sinus infection. If you have persistent symptoms, see an allergist for testing, diagnosis and treatment, the ACAAI advised.

There is no cure for seasonal allergies but avoiding triggers and getting treatment, such as medication or allergy shots, can provide relief and prevent progression.

More information

The U.S. National Institutes of Health has more about colds and seasonal allergies.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- U.S. veterans with Gulf War illness complain of different types of symptoms, and researchers now think they know why: There may be two distinct forms of the illness, depending on which areas of the brain have atrophied.

"Our findings help explain and validate what these veterans have long said about their illness," said study lead author Rakib Rayhan, a Georgetown University Medical Center researcher.

For the study, published online June 14 in the journal PLoS One, the research team conducted brain scans of 28 veterans with Gulf War illness before and after they underwent exercise stress tests. For 18 veterans, pain levels increased after exercise stress, and the scans showed a loss of brain matter in regions associated with pain regulation.

Before exercise, these 18 veterans showed increased use of a part of the brain called the basal ganglia when asked to do mental skills tasks. This increased use of the basal ganglia is also seen in people with degenerative brain disorders such as Alzheimer's disease. After exercise, these veterans lost the ability to increase the use of their basal ganglia.

The exercise stress test produced different results in the other 10 veterans. They had substantial increases in heart rate as well as deterioration in the brain stem, which regulates heart rate.

And in this group, brain scans performed during thinking tasks before exercise showed increased use of the brain's cerebellum, which is also seen in people with degenerative brain disorders. After exercise, they lost the ability to increase the use of their cerebellum.

"The use of other brain areas to compensate for a damaged area is seen in other disorders, such as Alzheimer's disease, which is why we believe our data show that these veterans are suffering from central nervous system dysfunction," Rayhan said in a Georgetown news release.

This does not mean, however, that veterans with Gulf War illness will progress to Alzheimer's or other brain diseases, he added.

Gulf War illness is believed to have affected more than 200,000 U.S. troops who served in Operation Desert Shield and Operation Desert Storm in 1990 and '91. Common symptoms, which can range from mild to debilitating, include pain; fatigue; mood and memory disruptions; and gastrointestinal, respiratory and skin problems. The causes of the illness are unclear.

More information

The University of Chicago Medical Center has more about Gulf War Syndrome.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- MemoryShape breast implants have been approved by the U.S. Food and Drug Administration for breast augmentation in women 22 and older, and for breast reconstruction, the FDA said Friday.

In a news release, the manufacturer, Mentor Worldwide LLC, said the implants have been approved outside of the United States for more than a decade. The product is available in a range of sizes and is tear-drop shaped to mimic the natural shape of a breast.

The product has been clinically studied among 955 augmentation and reconstruction patients participating in an ongoing 10-year study, Mentor said. After six years, the study has found a low rate of "adverse events" including rupture, the company added.

The FDA said in a news release that it's approval was based on six years of data from 955 women showing a reasonable assurance of safety and effectiveness for this implant. Mentor's MemoryShape Breast Implant showed similar rates of complications and outcomes as previously approved breast implants. These complications included tightening of the area around the implant, re-operation, implant removal, an uneven appearance (asymmetry), and wrinkling. Fissures or cracks were observed in the gel of some MemoryShape Breast Implants, a characteristic called gel fracture.

"It's important to remember that breast implants are not lifetime devices. Women should fully understand the risks associated with breast implants before considering augmentation or reconstruction surgery, and they should recognize that long-term monitoring is essential," Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said in the news release.

Breast implant surgery should not be performed on women with any active infection, untreated cancer or who are pregnant or nursing, Mentor said.

With Friday's approval, there are now five FDA-approved silicone gel-filled breast implants available in the United States manufactured by three companies: Allergan, Mentor and Sientra.

More information

The U.S. Food and Drug Administration has more about breast implants.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- About half of rheumatoid arthritis patients stopped taking their medications within two years after they started them, a new study finds.

Rheumatoid arthritis affects about one in 100 people worldwide and can cause progressive joint destruction, deformity, pain and stiffness. The disease can reduce physical function, quality of life and life expectancy.

The main reason about one-third of patients discontinued their medications was because the drugs lost their effectiveness, the study authors found. Other reasons included safety concerns (20 percent), doctor preference (nearly 28 percent), patient preference (about 18 percent) and access to treatment (9 percent), according to the study results, which were presented Thursday at the annual meeting of the European League Against Rheumatism (EULAR), in Madrid, Spain.

Rheumatoid arthritis "is a progressive disease, which, if left untreated, can significantly and permanently reduce joint function, patient mobility and quality of life," study lead author Dr. Vibeke Strand, a clinical professor at Stanford University School of Medicine, said in an EULAR news release.

"Studies have shown that patients sustain maximum benefit from [rheumatoid arthritis] treatment in the first two years -- yet our data highlight significant discontinuation rates during this time period," Strand said.

The study included more than 6,200 rheumatoid arthritis patients who started treatment by taking either tumor necrosis factor inhibitors (TNFi) or non-TNFi biologics. In the TNFi group, the percentages of patients who continued taking their medications were about 82 percent at six months, 68 percent at 12 months and 52 percent at 24 months. In the non-TNFi group, the percentages for those corresponding time periods were about 81 percent, 63 percent and 46 percent, respectively.

The average time to medication discontinuation was 26.5 months in the TNFi group and 20.5 months in the non-TNFi group, the investigators found.

"While there is no cure for [rheumatoid arthritis], initiating treatment early and improving adherence can enable patients to lead active and productive lives," Strand said in the news release.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about rheumatoid arthritis.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Fewer than 25 percent of new doctors in the United States go into primary care, and only about 5 percent open offices in rural areas, according to a new study.

There is a critical shortage of primary care doctors in the nation. These findings suggest that the number of new primary care doctors falls short of what's needed and will not solve the growing shortages in underserved areas in the near future, said the researchers at the George Washington University School of Public Health and Health Services.

"If residency programs do not ramp up the training of these physicians, the shortage in primary care, especially in remote areas, will get worse," study lead study author Dr. Candice Chen, an assistant research professor of health policy, said in a university news release.

"The study's findings raise questions about whether federally funded graduate medical education institutions are meeting the nation's need for more primary care physicians," she added.

The researchers examined the career choices of nearly 9,000 physicians who graduated from 759 medical residency institutions from 2006 to 2008. Three to five years after graduation, only 1 in 4 of the physicians worked in primary care. However, that figure is likely overestimated because it includes physicians who are hospitalists, Chen said.

She and her colleagues also found that 198 out of the 759 medical residency institutions produced no rural doctors during the study period, and that 283 of them produced no doctors practicing in Federally Qualified Health Centers. These clinics provide care to low-income patients and others and are often located in remote areas or poor urban neighborhoods.

The study appears online in the journal Academic Medicine.

In the United States, about 66 million people live in rural areas or urban neighborhoods with too few primary care doctors or a shortage of primary care in clinics. That means that about 1 in 5 Americans lacks access to this kind of essential care and could develop more serious health problems as a result, according to Chen.

More information

The MedlinePlus Medical Encyclopedia offers tips for choosing a primary care doctor.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Dogs may once again prove to be man's best friend, this time in new canine research findings that might help doctors get a better handle on obsessive-compulsive disorder (OCD) in humans.

Brain scans suggest that dogs who suffer from a comparably debilitating condition known as canine compulsive disorder (CCD) show similar structural brain abnormalities as those found in people diagnosed with OCD.

Alongside prior research that suggested OCD and CCD share the same genetic underpinnings, the same behaviors and the same responses to treatment, this latest study indicates that the disorder's biological progression among man's four-legged companions may offer valuable insight into a poorly understood human condition.

"This is an exciting finding because the current treatment options for OCD are less than satisfactory, with only about half of patients responding well, which means we need to develop new ones," said study co-author Nicholas Dodman, a veterinarian with the Cummings School of Veterinary Medicine at Tufts University in North Grafton, Mass. "So, one way to do that is by lifting up the hood on anxiety disorders among dogs. And by examining the mechanics of CCD, we hope to get a more complete picture of the physiology and anatomy of OCD."

Dodman, who is also the director of Tuft's Animal Behavior Program, and his team reported the findings online recently in the journal Progress in Neuro-Psychopharmacology & Biological Psychiatry.

The researchers pointed out that OCD strikes roughly 2 percent of the population, manifesting in a wide array of ways that can include continual hand washing or the uncontrollable hoarding of objects.

Although the physical and mental compulsion to engage in anxiety-relieving repetitive behaviors can be extremely detrimental to a patient's quality of life, many endure the disorder's relentless and intrusive stress for years before finally getting a proper diagnosis.

The International OCD Foundation estimates that, on average, OCD patients struggle with the disorder for 14 to 17 years before getting appropriate treatment.

Treatment typically involves selective serotonin reuptake inhibitors (SSRIs), which include well-known antidepressants such as Prozac, Paxil, Lexapro and Zoloft. Another option is cognitive behavioral therapy, which utilizes "exposure-and-response prevention" techniques, to acclimate patients to fearful stimulation and remove related anxieties.

The problem: a big swath do not seem to benefit from either approach; the OCD Foundation pegs that number at 30 percent of patients. What's more, among those taking medications, symptom reduction typically falls by only 40 percent to 60 percent, leaving many to continue to struggle with substantial compulsive behavior.

In the canine study, Dodman's team focused on 16 Doberman pinschers, a breed that appears to be particularly prone to developing CCD.

While half the dogs were healthy, the others had CCD. In dogs, Dodman explained, this can take the form of repetitive licking of their lower extremities; tail-chasing; irregular appetite; inappropriate nursing behaviors; or the compulsive gathering together of objects that mimics the kind of hoarding sometimes seen among OCD patients.

Using MRI scans and cutting-edge software, the team was able to map out detailed brain changes associated with CCD that were not seen among the healthy dogs. Differences included higher total brain and gray matter volume among the CCD dogs, as well as lower gray matter density in particular brain regions.

In turn, by comparing these abnormalities with those already seen in human OCD patients, Dodman said that even with the small sample size he and his colleagues determined the brain changes were "precisely identical."

However, Kiara Timpano, an assistant professor in the psychology department of the University of Miami, argued that the most effective approach to OCD treatment involves a combination of SSRI meds and cognitive therapy.

"We can even treat OCD with cognitive therapy alone," she added. "Pharmacological treatments are an option, but they don't necessarily need to be a component of therapy," Timpano explained.

"However, certainly medications are one of our treatment tools," she noted. "And obviously the more we can understand about the underlying mechanisms of OCD -- biological, cognitive or behavioral -- the better we will be able to develop more effective treatments, including medications. So, with respect to using an animal model such as this, I think it's great."

More information

For more on OCD, visit the International OCD Foundation.

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Certain proteins in saliva help protect seniors from influenza, according to a new study from China.

The findings improve understanding of why older people are better able to fight off the new strains of bird and swine flu than younger people, said researcher Zheng Li and colleagues.

As well as beginning the process of digesting foods, saliva also contains germ-fighting proteins that form a first-line defense against infections. It was already known that a person's age affects their saliva's levels of certain glycoproteins, which are proteins with a sugar coating that combat disease-causing germs.

In this study, investigators sought to learn more about how age-related differences in these saliva proteins affect people's susceptibility to influenza.

The researchers analyzed saliva samples from 180 men and women of various ages and found that glycoproteins in the saliva of people aged 65 and older were more efficient in binding to influenza viruses than those in children and young adults.

The study was published recently in the Journal of Proteome Research.

The researchers said their findings suggest that saliva testing may help improve understanding, prevention and diagnosis of some age-related diseases.

More information

The U.S. Office of Disease Prevention and Health Promotion explains how to protect yourself from seasonal flu.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- A previously undetected layer has been discovered in the cornea, which is the clear window at the front of the eye.

The finding could help improve results for people who undergo corneal grafts and transplants, according to the researchers at the University of Nottingham in England.

"This is a major discovery that will mean that ophthalmology textbooks will literally need to be rewritten," Harminder Dua, a professor of ophthalmology and visual sciences, said in a university news release. "Having identified this new and distinct layer deep in the tissue of the cornea, we can now exploit its presence to make operations much safer and simpler for patients."

Dua discovered the new layer, which is described in the journal Ophthalmology. In his honor, the new layer has been called Dua's Layer.

"From a clinical perspective, there are many diseases that affect the back of the cornea, which clinicians across the world are already beginning to relate to the presence, absence or tear in this layer," Dua said.

The cornea is the clear protective lens on the front of the eye. It was previously believed to have five layers. The new layer, which is located near the back of the cornea, is just 15 microns thick but it is incredibly tough, according to the study.

The researchers proved the existence of the new layer by simulating corneal transplants and grafts on eyes donated for research.

More information

The U.S. National Eye Institute has more about the cornea.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- In a new finding sure to be shared with some skeptical parents, it seems that the brains of video game enthusiasts make better and faster use of visual input.

"Gamers see the world differently," study author Greg Appelbaum, an assistant professor of psychiatry in the Duke University School of Medicine, said in a Duke news release. "They are able to extract more information from a visual scene."

The study included 125 college students who were either intensive video game players or nongamers. The participants took a visual memory test that flashed a circle of eight letters for one-tenth of a second. After a delay of between 13 milliseconds and 2.5 seconds, an arrow appeared and pointed to one spot where a specific letter had been. The participants had to try to recall the letter.

The gamers consistently outperformed the nongamers in recalling the letter, according to the study in the June issue of the journal Attention, Perception and Psychophysics.

The researchers said two possible reasons exist for the gamers' better recall: They may see more immediately, and they may be better at making correct decisions from available information.

Further investigation is needed to determine if gamers' brains have become trained to perform differently on visual tasks, compared to nongamers, the study authors said.

More information

The American Psychological Association has more about the potential brain benefits of video games.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Outcomes for people with transplanted organs who suffer a traumatic injury are no worse than for those without transplanted organs, a new study has found.

In addition, the investigators noted that transplanted organs are rarely damaged when patients suffer traumatic injuries.

For the study, researchers examined the outcomes of 50 people with transplanted organs who were treated for traumatic injury between 2007 and 2011, and compared them to more than 13,000 trauma patients who did not have transplanted organs.

"Trauma teams should be encouraged that patients with prior organ transplants don't do worse after injury, and that the transplanted organ (also known as a graft) is infrequently injured after trauma; however, our study did show that there may be an increased risk of graft rejection after trauma," lead author Dr. Joseph Scalea, a surgeon at the University of Maryland Medical Center, said in a center news release.

"We recommend that patients be assessed by a transplant surgeon as soon as possible, and graft function should be closely followed by a transplant team during hospitalization and after discharge from the trauma center," he added.

One patient had a direct injury to a transplanted organ and three others had possible injuries to a transplanted organ that did not affect organ function, according to the study in the June issue of The Journal of Trauma and Acute Care Surgery.

Within six months after their traumatic injury, 17 percent of 41 patients with transplanted organs developed acute organ rejection.

Transplant recipients take drugs to suppress their immune system in order to prevent rejection of the transplanted organ, and it's widely presumed that this puts them at increased risk for infection after traumatic injury. However, that was not the case in this study, the authors pointed out.

Instead, the researchers suggested, immune-suppressing drugs may help protect organs from inflammation after a person suffers traumatic injury.

More information

The U.S. Centers for Disease Control and Prevention has more about trauma care.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Although the role of father is often clear-cut, stepdads must negotiate the fine line between parent and friend with the children of their wives.

Now, new research, just in time for Father's Day on Sunday, suggests that open communication is the compass the family needs to survive the journey.

"There's a lot of evidence that moms expect the dads to take on the father role, but dads think their role is to be a friend to the stepchild," said study author Kevin Shafer, an assistant professor of social work at Brigham Young University in Provo, Utah.

Once a stepfamily is forged, everyone's roles need to be renegotiated, the researchers said, and mothers can play a key role in helping the children adjust to the new family dynamics.

One expert said it just takes time and a lot of talking.

"They're not going to look like the Brady Brunch right away. Creating a stepfamily is a major transition," said Markie Blumer, an assistant professor at the University of Nevada, Las Vegas. "It's important to sit down and say that we're all going to have to make adjustments and it isn't just the stepparent who has to do all the adjusting if this is going to work."

Blumer also recommends that parents be as flexible as possible and try to see things from the children's point of view. "Ask the kids if they want you to be at their baseball game, and tell them it's OK if they change their mind," she said. "Leaving the door open is really important [since things will likely change over time]".

Shafer said couples should discuss beforehand how they're going to parent the children together, and the kids also need to be involved in talking about how the family is going to function.

Although these findings may sound like common sense, Shafer said, many adults don't talk about their expectations beforehand.

It's not just the parenting issues the couple tends to avoid, he said. Sixty percent of men who owe child support and alimony to their ex-spouses never mention that to their new partners. "If they're not talking about their financial obligations, what else are they not talking about?" he said.

Blumer added that although there is a great deal of research on the effects of divorce on children, there aren't many studies that look at the issues associated with remarriage. But the impact on the kids can be significant.

Todd Jensen was a teenager when his father remarried, and he remembers the adjustment being difficult. "I felt my opinions weren't taken into account and my parents were so focused on their new marriage, the children took a back seat," he said.

From that experience, Jensen, now a research associate at Brigham Young University, became interested in studying how children perceive stepfamily relationships. He co-authored this latest research, published recently in the journal Social Work.

Nearly 10 percent of children in the United State live with a stepparent at any given time, and one-third will live in a stepfamily before they turn 18, the researchers said.

The study tapped data from the National Longitudinal Survey of Youth, a survey of people who were between 14 and 22 years old in 1979, and their children, aged 10 to 16 at the time they were surveyed. The participants have been followed yearly and asked questions about their marriages, children and family situations over time.

The study included about 1,000 respondents: children whose mothers were divorced and either remarried or living with someone other than the child's biological father. Among the respondents, the mother had been remarried or living with the stepfather for an average of five years.

Blumer was unsure whether the data remains relevant, noting that the respondents were primarily white Protestants, with parents born in the late 1950s. "You can't generalize the results to recent years," she said.

More information

Learn more about parenting from the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 14, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

U.S. Surgeon General Stepping Down

After four years in the post, U.S. Surgeon General Regina Benjamin will step down next month.

She made the announcement Wednesday in an e-mail to staff and thanked them for supporting her efforts, CNN reported.

"My goal was to create a grassroots movement, to change our health care system from one focused on sickness and disease to a system focused on wellness and prevention. With your help, that movement has begun," Benjamin wrote in the e-mail.

As surgeon general, the Alabama-native chaired the National Prevention, Health Promotion, and Public Health Council. It was created under the Affordable Care Act to find ways to improve access to care.

Deputy Surgeon General Boris Lushniak will serve as interim surgeon general until a new permanent Surgeon General is nominated, CNN reported.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Anyone who has ever been a volunteer knows that it feels good to help others, but researchers have found a less obvious benefit: volunteering can help reduce older adults' risk of high blood pressure.

The new study included more than 1,100 adults, aged 51 to 91, who were interviewed about their volunteering and had their blood pressure checked in 2006 and 2010. All of them had normal blood pressure at the time of the first interview.

The investigators found that participants who said during the first interview that they volunteered for at least 200 hours per year were 40 percent less likely to have high blood pressure four years later than those who did not volunteer.

It didn't matter what type of activity the volunteers performed. Only the amount of time spent helping others as a volunteer was associated with a reduced risk of high blood pressure, according to the study scheduled for publication in the journal Psychology and Aging.

The findings suggest that volunteering may be an effective medicine-free option to help prevent high blood pressure, which is a major contributor to cardiovascular disease -- the leading cause of death in the United States. High blood pressure, or hypertension, affects about 65 million Americans.

"Every day, we are learning more about how negative lifestyle factors like poor diet and lack of exercise increase hypertension risk," lead author Rodlescia Sneed, a Ph.D. candidate in psychology at Carnegie Mellon University, said in a university news release.

"Here, we wanted to determine if a positive lifestyle factor like volunteer work could actually reduce disease risk. And, the results give older adults an example of something that they can actively do to remain healthy and age successfully," Sneed explained.

"As people get older, social transitions like retirement, bereavement and the departure of children from the home often leave older adults with fewer natural opportunities for social interaction," Sneed noted. "Participating in volunteer activities may provide older adults with social connections that they might not have otherwise. There is strong evidence that having good social connections promotes healthy aging and reduces risk for a number of negative health outcomes."

While the study found an association between time spent volunteering and blood pressure levels, it did not prove a cause-and-effect relationship.

More information

The U.S. National Heart, Lung, and Blood Institute has more about preventing high blood pressure.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, June 14 (HealthDay News) -- Older adults who get steroid injections to ease lower back and leg pain may have increased odds of suffering a spine fracture, a new study suggests.

It's not clear, however, whether the treatment is to blame, according to experts. But they said the findings, which were published June 5 in the Journal of Bone and Joint Surgery, suggest that older patients with low bone density should be cautious about steroid injections.

The treatment involves injecting anti-inflammatory steroids into the area of the spine where a nerve is being compressed. The source of that compression could be a herniated disc, for instance, or spinal stenosis -- a condition common in older adults, in which the open spaces in the spinal column gradually narrow.

Steroid injections can bring temporary pain relief, but it's known that steroids in general can cause bone density to decrease over time. And a recent study found that older women given steroids for spine-related pain showed a quicker rate of bone loss than other women their age.

The new findings go a step further by showing an increased fracture risk in steroid patients, said Dr. Shlomo Mandel, the lead researcher on both studies.

Still, he said, the study, which was based on medical records, had "a lot of limitations."

"I want to be careful not to imply that people shouldn't get these injections," said Mandel, an orthopedic physician with the Henry Ford Health System in Detroit.

The findings are based on medical records from 3,000 Henry Ford patients who had steroid injections for spine-related pain, and another 3,000 who got other treatments. They were 66 years old, on average.

Overall, about 150 patients were later diagnosed with a vertebral fracture, Mandel said. Vertebral fractures are cracks in small bones of the spine, and in an older adult with low bone mass they can happen without any major trauma.

On average, Mandel's team found, steroid patients were at greater risk of a vertebral fracture -- with the risk climbing 21 percent with each round of injections.

The findings do not prove that the injections themselves caused the fractures, said Dr. Andrew Schoenfeld, who wrote a commentary published with the study.

But the results raise an important potential risk that needs to be weighed against the benefits. "This brings to light something that should be part of doctor-patient discussions," said Schoenfeld, who is based at William Beaumont Army Medical Center in El Paso, Texas.

He cautioned, however, that the findings may apply only to certain patients -- namely, older adults with waning bone mass. "We don't know if this would apply to elderly people with normal bone mass," Schoenfeld said.

Complicating matters, steroid injections seem to benefit only certain types of spine-related pain. The "best medical evidence" that they work is for cases of leg pain caused by a herniated disc compressing a nerve, Schoenfeld said.

Herniated discs are a common source of pain for younger people. "If you're 35 and have a herniated disc, these findings don't really apply to you at all," Schoenfeld said.

When it comes to spinal stenosis -- the most common source of problems for older adults -- steroid injections can aid leg pain and cramping. But there is "very sparse" evidence that the injections ease pain concentrated in the low back, Schoenfeld said.

If that's the primary problem for an older adult, the potential side effect of a vertebral fracture could outweigh the small chance of benefit.

Epidural steroids have been getting negative press of late. U.S. officials are currently investigating a deadly outbreak of fungal meningitis linked to epidural steroids produced by one Massachusetts pharmacy. And a study released in March found that steroid injections were less effective at relieving back pain than surgery and other treatments.

But both Schoenfeld and Mandel said the treatment still has a role in treating certain spine-related pain. They said older patients who have already found leg-pain relief from steroid injections may want to stick with them. But they should at least be aware of the potential fracture risk.

If they opt to continue the treatment, Mandel said, they may want to talk with their doctor about ways to preserve their bone mass -- such as calcium and vitamin D supplements.

"There are also a number of other options for spinal stenosis," Schoenfeld said. Normally, doctors would start conservatively, with physical therapy or medications such as nonsteroidal anti-inflammatory drugs or drugs that target nerve pain, including gabapentin (Neurontin) and pregabalin (Lyrica).

Steroid injections would be the middle ground for patients who don't respond to those treatments but want to put off surgery, Schoenfeld said. Surgery to relieve pressure on the nerves is often effective, said Schoenfeld, although someone with spinal stenosis may later develop the narrowing in another area of spine.

More information

Learn more about spinal stenosis from the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- If your child is tired of the same old sandwich, try spicing up lunch with more creative fare.

The Academy of Nutrition and Dietetics says fun alternatives to school-lunch sandwiches include:

  • Roll lunch meat inside a wrap, using pita bread or a tortilla in a fun color.
  • Wrap a slice of deli meat around a slice or stick of cheese.
  • Stack the usual sandwich toppings on crackers, instead of bread.
  • Create a salad with greens, cheese, nuts and beans.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Protect Kids' Eyes

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(HealthDay News) -- A flying object or injury could affect your child's vision for life.

The U.S. Department of Health and Human Services offers these suggestions to help protect your child's eyes:

  • Don't buy or acquire any toys with sharp points or edges.
  • Keep sharp and pointy objects, such as knives or scissors, out of your child's reach.
  • Equip your child with the appropriate eye protection for his or her sport.
  • Make sure your child wears sunglasses that block 100 percent of UVA and UVB rays.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- If you hear that a friend's beloved family member has joined a clinical trial for cancer treatment, don't assume the patient is human.

Cancer is the leading cause of death in older dogs and cats, and clinical trials offer hope that effective medications will be developed -- for humans and their four-legged friends, cancer experts say.

The new National Veterinary Cancer Registry, launched last month by a national team of animal and human cancer doctors, will point pet owners toward clinical trials that might benefit their beloved companions and speed up the development of life-saving therapies for humans.

"We will be able to decrease the cost and beat the time involved in drug discovery," said the registry's founder, Dr. Theresa Fossum, a professor of surgery at Texas A&M University's college of veterinary medicine.

Because many similar diseases affect people and their animals, veterinarians and physicians say a lot can be learned from studying how treatments work in cats and dogs.

The drug-assessment process could be accelerated by a simple fact: dogs age many times faster than humans, and their cancers progress more rapidly too. Also, many canine and feline cancers -- including sarcoma; non-Hodgkin lymphoma; leukemia; mesothelioma; and bone, ovarian, kidney, uterine and oral cancers -- are virtually the same cancers humans have.

Experts not involved with the registry said the concept of the database looks promising.

"These clinical trials would be more real-world than a lab experiment," said Dr. Peter Rabinowitz, associate professor of medicine at Yale School of Medicine and head of the Yale Human Animal Medicine Project, which studies clinical connections between human and animal medicine.

Dogs often are an interesting model for better understanding environmentally induced cancers, Rabinowitz said. "Asbestos causes cancer in humans 35 years [after exposure], but if you're a dog, you get it in four to five years, so we can see how the cancers develop more naturally," he said.

Fossum said she has always been bothered by the slow and cumbersome way drugs are tested. "If it's a cancer drug, they're going to put a human tumor in a mouse ... but it's not very predictive of how drugs will work in people," she said.

Then, after tests to see if the drugs might be toxic in humans, the drugs are evaluated in human clinical trials, which take more than a decade to conduct. "So the drugs that are coming out now were starting [to be evaluated] 12 years ago," she said.

Testing the drugs in pets speeds up the process, allowing researchers to determine if a medication works before taking it to human clinical trials, Fossum said. With a pet owner's informed consent, "we can try a new drug that seems promising a lot sooner," she said.

The concept of a cancer database for dogs and cats could expand to include other diseases, such as diabetes. About 800,000 dogs have type 1 diabetes in the United States, Fossum said. Other conditions that a veterinary registry could serve include endocrine, neurological and cardiac issues.

About 6 million dogs and 6 million cats in the United States receive a cancer diagnosis each year, according to the Animal Cancer Foundation, in Norwalk, Conn. If your dog or cat is one of them, you can register your pet with the National Veterinary Cancer Registry.

The registry was created by a consortium of animal and human cancer doctors, including specialists from the Baylor Healthcare System in Texas, the Texas Veterinary Oncology Group and the CARE Foundation, a Florida-based animal rescue and wildlife education organization.

Because the registry is new, it may take some time before effective clinical trial matchmaking can occur between animals and drug developers, Fossum said.

More information

Learn more about the connection between animal and human health from the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Can women blame men for menopause?

They may have a case, according to new research that suggests it was men's interest in mating with younger females that gave evolutionary rise to menopause by sidelining older women from reproduction.

Menopause -- when a woman stops getting menstrual periods and can't become pregnant -- is unique to humans and its cause is still unknown, explained study author and evolutionary biologist Rama Singh. "We accept as a given the idea that older women tend to be unable to reproduce," but Singh said this is actually an "evolutionary puzzle."

It has long been thought that menopause is what causes women, primarily in their early 50s, to stop being able to get pregnant, but the researchers found evidence that things could actually have occurred the other way around. In other words, infertility may have been the cause, not the effect, of menopause in early humans.

There are at least 10 theories of why menopause occurs, according to the researchers, including ideas based on the fact that women are living longer and depleting the number of eggs in their ovaries, to what is called the "grandmother hypothesis." That idea holds that menopause allows older women to provide childcare that contributes to the survival of their grandchildren, making them more fit or valuable to the human tribe.

But Singh's research, published online June 13 in the journal PLOS Computational Biology, suggests something altogether new.

"This paper is saying that men have played the major or dominant part in choosing mates," said Singh, who is a professor of population genetics and evolution at McMaster University, in Canada. "Somewhere along the line in our evolutionary history, males did not mate randomly but preferred young women because they are more attractive."

Going way back in human history, people reproduced all their lives, explained Singh. While it's possible that some women may have experienced menopause 30,000 years ago, now 100 percent of women experience it. "Menopause is an evolutionary phenomenon," he said.

The scientists found that the development of menopause seems to have done nothing to improve the chances of human survival over time, but rather occurred because women of a certain age weren't finding mates, and thus reproductive ability was unnecessary for them.

Yet Singh pointed out that if women long ago had been the ones choosing younger mates, older men would have been the ones losing their fertility, not women.

The process of natural selection favors the most fit, so women who are most likely to reproduce are protected, explained Singh. Natural selection is the gradual, non-random process through which biological traits become either more or less common, due to the way reproduction occurs, Singh explained.

The researchers used computational models and computer simulations to show how male mating preference for younger females could increase the number of mutations that stopped women's reproductive ability, creating menopause.

Singh said his research suggests that it might be possible for women who delay childbearing to also postpone menopause, allowing them to have a longer window in which to conceive. "We might be able to extend the time period in which you can have children, rather than rush it," he said.

Lynnette Leidy Sievert, a biological anthropologist and a professor at the University of Massachusetts, Amherst, raised questions about the study.

"The study showed that by the age of 50 or 60, 50 percent of the population was still living, but that just doesn't match what we know about human evolution," she said. "By the age of 50, the skeletal evidence shows that only 10 percent of Neanderthals lived beyond 50. Our own homo sapiens [humans] had about 17 percent living past the age of 40."

Sievert, a member of the board of trustees of the North American Menopause Society, also questioned whether the concept of men mating with younger women fully explains menopause.

"Because it's a human and mammalian pattern for men to die younger [than women], you have a younger female with an older male who is going to die," she explained. "I get mixed up about how that pulls a woman's lifespan across menopause."

Singh said he's planning to do more simulations based on a Canadian long-term study of aging that is following 50,000 men and women. He is interested in learning more about the relationship between menopause, reproduction and genetic markers. "I really want to see if you can do something to delay menopause," he explained.

More information

Learn more about menopause from the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Three of every 20 flexible endoscopes used to examine patients' gastrointestinal tracts and colons were improperly cleaned, a new study finds.

Those 15 percent of endoscopes had unacceptable levels of "bio dirt" -- cells and matter from a patient's body that could pose a potential infection risk to other patients, according to the researchers.

They examined 275 flexible duodenoscopes, gastroscopes, and colonoscopes used at five U.S. hospitals and found that 30 percent, 24 percent and 3 percent, respectively, did not pass a cleanliness rating.

The study findings were to be presented last weekend at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC).

"Three out of 20 is an unexpectedly high number of endoscopes failing a cleanliness criterion," lead investigator Marco Bommarito, lead research specialist at 3M Infection Prevention Division, said in an APIC news release. "Clearly, we'd like no endoscopes to fail a cleanliness rating."

In recent years, improperly cleaned endoscopes at medical facilities in the United States have resulted in thousands of patients having to be checked for HIV and hepatitis B and C, according to the news release. More health-care-associated outbreaks have been linked to contaminated endoscopes than to any other medical device, the U.S. Centers for Disease Control and Prevention has reported.

Each year in the United States, between 15 million and 20 million endoscopy procedures are conducted with reusable endoscope devices to screen various parts of patients' gastrointestinal tracts and look for problems such as cancer.

Duodenoscopes examine the duodenum (the first section of the small intestine), while gastroscopes examine the stomach and colonoscopes examine the colon.

"The cleaning protocols for flexible endoscopes need improvement, such as guidelines tailored to the type of scope or identifying if there is a critical step missing in the manual cleaning process, and documented quality-control measures," Bommarito said. "These types of improvements could have a positive impact on patient safety."

Because this study 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 Cancer Society has more about endoscopy.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- This past flu season started earlier, peaked earlier and led to more adult hospitalizations and child deaths than most flu seasons, U.S. health officials reported Thursday.

At least 149 children died, compared to the usual range of 34 to 123, according to the U.S. Centers for Disease Control and Prevention.

The predominant strain of flu circulating in 2012-13 -- H3N2 -- made the illness deadlier for children, explained Lynnette Brammer, an epidemiologist with the CDC.

"With children H3 viruses can be severe, but there was also a lot of influenza B viruses circulating . . . and for kids they can be bad, too," she said.

Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, added that H3N2 is easily transmitted from person to person and has a high rate of complications, which accounts for the increased hospitalizations.

"This is the kind of flu that enables other infections like pneumonia," he said. "Really what people need to know is that flu isn't the problem. The flu's effect on the immune system and fatigue is the problem."

The flu season started in September, which is unusually early, and peaked at the end of December, which is also unusual, Siegel said.

Flu season typically begins in December and peaks in late January or February.

Texas, New York and Florida had the most reported pediatric deaths. Except for the 2009-10 H1N1 flu pandemic, which killed at least 348 children, the past flu season was the deadliest since the CDC began collecting data on child flu deaths, according to the report, published in the June 14 issue of the Morbidity and Mortality Weekly Report.

Older adults were targeted heavily by the 2012-13 flu. Those aged 65 and older accounted for more than half of all reported flu-associated hospitalizations in the 2012-13 flu season -- the most since the CDC started collecting data on flu hospitalizations in 2005-06, the agency reported.

In addition, more Americans saw a doctor for flu than in recent flu seasons, the CDC noted.

The flu vaccine was well matched to the circulating strains, but less effective than health officials had hoped. In January, the CDC reported that the vaccine was about 60 percent effective, which meant it offered "moderate" protection from the flu.

Siegel said even a moderately effective vaccine is better than not getting vaccinated at all because flu symptoms will be milder, with a lower chance of complications.

According to Brammer, decisions about the vaccine for this coming season were made in February so manufacturers could make a sufficient supply for fall. The makeup will be basically the same as the 2012-13 vaccine with some tweaks to some of the strains so they better match changes in the viruses, she said.

The CDC recommends that everyone 6 months and older get vaccinated. The agency urges people at higher risk for severe disease -- including young children, pregnant women, anyone with a chronic health problem and the elderly -- to get the vaccine.

Don't make any assumptions about the course of next season's flu based on the recent past, these experts added.

"I wouldn't assume next year's flu season is going to be milder or that it's going to be early," Siegel said. "The flu is unpredictable."

Because the 2012-13 flu season started several months earlier than usual, the CDC also advised doctors to consider influenza as the source of respiratory illnesses that occur beyond the typical flu window.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- The world's population could reach nearly 11 billion by 2100, the United Nations predicts, which is about 800 million (8 percent) more than the previous projection of 10.1 billion issued in 2011.

The revised estimate is mostly due to a slower-than-expected decline of birth rates in Africa. The current African population is about 1.1 billion and that is now expected to reach 4.2 billion by the end of the century.

Fewer population changes are expected in other regions of the world. Europe may see a small decline in population due to birth rates that continue to be below replacement level, while some other areas may see slight population increases due to longer life expectancies, said Adrian Raftery, a professor of statistics and sociology at the University of Washington.

Raftery and colleagues at the University of Washington Center for Statistics and Social Sciences developed the statistical methods used in the new U.N. global population estimates.

The projected increase in global population will cause challenges but other pressing matters, such as poverty and climate change, have sidelined the topic. But both of these problems are linked to world population, Raftery said.

"These new findings show that we need to renew policies, such as increasing access to family planning and expanding education for girls, to address rapid population growth in Africa," he said in a university news release.

The world's population passed 6 billion in 1999 and reached 7 billion in 2011, according to the United Nations report, which was issued June 13.

More information

PopulationGrowth.org has more about the problems associated with population growth.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Some men who use finasteride (Propecia) to help battle baldness may also be drinking less alcohol, a new study suggests.

Among the potential side effects of the hair-restoring drug are a reduced sex drive, depression and suicidal thoughts. And it's men who have sexual side effects who also appear to want to drink less, the researchers report.

"In men experiencing persistent sexual side effects despite stopping finasteride, two-thirds have noticed drinking less alcohol than before taking finasteride," said study author Dr. Michael Irwig, an assistant professor of medicine at George Washington University School of Medicine and Health Sciences in Washington, D.C.

Although it isn't clear why the medication might have this effect, Irwig thinks the drug may alter the brain's chemistry.

"Finasteride interferes with the brain's ability to make certain hormones called neurosteroids, which are likely linked to drinking alcohol," he said.

"For younger men contemplating the use of finasteride for male pattern hair loss, they should carefully balance the modest cosmetic benefits of less hair loss versus some of the serious risks," Irwig said.

The report was published online June 13 in the journal Alcoholism: Clinical & Experimental Research.

"The biggest challenge with this finding is that it is naturalistic rather than a controlled study so cause-and-effect is hard to establish," said James Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill. "This is more of a cloud on the horizon than a clear-cut effect."

If these findings are confirmed it suggests there may be a subgroup of people, perhaps identifiable by their experience of sexual side effects, who will experience reductions in alcohol consumption, said Garbutt, who was not involved with the study.

"Based on the consumption levels reported in the paper, this population would be considered social drinkers and not problem drinkers," he added.

It is unclear if these people will begin to drink more again once they have stopped taking the drug for a long enough period of time, Garbutt noted.

But he did note a potential silver lining in the finding.

"There is interest in the neuroactive steroid system for development of new medications for problem drinking -- this study offers some support for that idea," Garbutt said.

In addition, "this highlights the importance of being aware that any medication one takes has the potential to cause side effects and many side effects are not known for medications until years after they have been on the market," Garbutt added.

This study also points out that a medication may have an effect that is not obvious based on initial understanding of how the medication works, Garbutt explained.

"For finasteride, the relationship between metabolism of [the hormone] progesterone, the production of neurosteroids and the relationship of neurosteroids to alcohol actions and consumption is still being sorted out," he said.

For the study, Irwig interviewed 83 men who had persistent sexual side effects from using finasteride, even three months after they stopped using the drug.

Irwig also collected information on the participant's medical histories, sexual function and alcohol consumption before and after taking finasteride.

Of the 63 men who had at least one drink a week before using finasteride, 41 men (65 percent) reduced their alcohol consumption after stopping finasteride, Irwig found.

In addition, 20 men (32 percent) reported no change in their alcohol consumption and two men (3 percent) reported drinking more, Irwig said.

There have been reports of finasteride's ability to reduce alcohol consumption in rodents, but this is the first study to show this pattern in humans, he added.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Middle-class men who take on a large share of childrearing and chores in the family home are often met with disrespect in the workplace, compared to men who follow more traditional gender roles, a new study finds.

The same holds true for mothers with "unconventional" childcare arrangements or women without children, say a team from the University of Toronto.

"Their hours are no different than other employees', but their co-workers appear to be picking up on their nontraditional caregiving roles and are treating them disrespectfully," study co-author Jennifer Berdahl, a professor at the Rotman School of Management said in a university news release.

The researchers surveyed unionized workers in female-dominated jobs and public service employees in a male-dominated workforce.

Overall, the investigators found that any worker who had a nontraditional gender role in the family was given a hard time by co-workers. Those who faced the least harassment included men who did less caregiving and household chores and women who did more of both.

The results suggest that people's adherence to traditional gender roles in the home has more influence on how they're treated at work than how well they do their job, which puts pressure on them to conform to traditional roles at home.

"They may choose not to have children if these traditional roles are not feasible for them, or get in the way of family or career goals," Berdahl said.

In addition, "both male and female employees suffer lower pay and fewer promotions after taking time off work to care for family, to extents that cannot be explained by possible skill loss, hours, performance or ambition," she noted.

"What we really need is a more flexible workplace and policies that protect employees who choose to use that flexibility or not, regardless of their gender," Berdahl concluded.

More information

The American Academy of Pediatrics has more about roles within the family.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Transplanting partial livers from deceased teen and adult donors to infants is less risky than in the past and helps save lives, according to a new study.

The risk of organ failure and death among infants who receive a partial liver transplant is now comparable to that of infants who receive whole livers, according to the study, which was published online in the June issue of the journal Liver Transplantation.

Size-matched livers for infants are in short supply and the use of partial grafts from deceased donors now accounts for almost one-third of liver transplants in children, the researchers said.

"Infants and young children have the highest waitlist mortality rates among all candidates for liver transplant," study senior author Dr. Heung Bae Kim, director of the Pediatric Transplant Center at Boston Children's Hospital, said in a journal news release.

"Extended time on the liver transplant waitlist also places children at greater risk for long-term health issues and growth delays, which is why it is so important to look for methods that shorten the waitlist time to reduce mortality and improve quality of life for pediatric patients," Kim said.

For the new study, Kim and his colleagues examined data from nearly 2,700 children younger than age 2 who underwent partial liver or whole liver transplants in the United States between 1995 and 2010.

Between 1995 and 2000, whole livers were much more likely than partial livers to survive after transplantation into infants. But the rates became similar between 2001 and 2010, which suggests that the use of partial livers became less risky over time, the researchers said.

The adjusted risk of transplant failure and death was similar for partial and whole organs between 2006 and 2010, according to the study.

There is evidence that partial organs donated from living donors are superior to those from deceased donors, but they accounted for less than 11 percent of liver transplants to children in 2010, according to the news release. Since 2002, there has been an eight-fold increase in the use of partial livers from deceased donors.

More information

The Nemours Foundation has more about liver transplants and children.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- A close look at some very old bones is shedding light on the elimination of leprosy in Europe, where it was a major scourge until medieval times.

Leprosy was common across medieval Europe and nearly one in 30 people are thought to have had the disease. However, while it is still endemic in many parts of the world today -- affecting over 200,000 people across the globe -- leprosy all but disappeared in Europe by the turn of the 16th century.

The reasons for this sudden change have been a mystery.

In this new study, researchers decoded the nearly complete genomes of five strains of Mycobacterium leprae, the bacterium that causes leprosy. The samples were collected from the bones of people buried in medieval graves across Europe.

The study seems to rule out sudden genetic changes as the reason for leprosy disappearing from Europe. That's because the genomes of the medieval strains are almost identical to those of modern strains of leprosy, and the mode of spreading the disease has not changed, researchers reported June 13 in the journal Science.

Therefore, "if the explanation of the drop in leprosy cases isn't in the pathogen, then it must be in the host, that is, in us; so that's where we need to look," study co-director Stewart Cole, head of the Global Health Institute at the Swiss Federal Institute of Technology in Lausanne, said in an institute news release.

There are many clues that people in medieval Europe developed resistance to the disease, according to Cole. But "natural selection" may also have been key, involving the social isolation of people with the disease.

"In certain conditions, victims could simply be pressured not to procreate," Cole reasoned. "In addition, other studies have identified genetic causes that made most Europeans more resistant than the rest of the world population, which also lends credence to this hypothesis."

The research also turned up an interesting correlation between leprosy in the Middle East and Europe. According to the researchers, a strain of the disease found in medieval bones from Sweden and the United Kingdom is very similar to that found today in the Middle East. "The pathogen could have been carried to Palestine during the Crusades. But the process could have operated in the opposite direction, as well," Cole said.

In addition to its historical significance, the study sheds new light on the workings of the leprosy pathogen and improve understanding of epidemics, according to the researchers.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Xgeva (denosumab) has been approved by the U.S. Food and Drug Administration to treat giant cell tumor of the bone (GCTB), a rare tumor that's most often non-cancerous.

The tumor usually affects adults between ages 20 and 40, although it may also develop in adolescents, the FDA said Thursday in a news release. It typically doesn't spread, although in rare cases it can become cancerous and travel to the lungs.

As a non-cancerous tumor, GCTB destroys bone as it becomes larger, causing pain, fractures and loss of mobility. Xgeva has been approved in cases where the tumor can't be surgically removed, or might lead to a severe outcome such as loss of a limb, the agency said.

Xgeva, approved under the FDA's expedited review program, was evaluated for this use in two clinical trials involving a total of 305 adults and adolescents. Common side effects included joint pain, headache, nausea, fatigue, back pain and extremity pain.

Women of childbearing potential should use "highly effective" contraception while taking Xgeva, since the drug can harm a fetus, the FDA warned.

The drug was first approved in 2010 to prevent fractures when cancer has spread to the bone. It's marketed by Amgen, based in Thousand Oaks, Calif.

More information

The FDA has more about this approval.

-- Scott Roberts

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- In a decision that could have far-reaching implications for medicine, the U.S. Supreme Court on Thursday ruled that human genes cannot be patented.

The ruling could be a blow to drug companies such as Myriad Genetics, whose effort to patent an isolated form of a gene that might foretell cancer risk was at the center of the case. The high court decided that, unlike drugs or medical devices, human genes are not "created" by companies and therefore cannot be patented, USA Today reported.

"Myriad did not create anything," Justice Clarence Thomas wrote in the unanimous decision. "To be sure, it found an important and useful gene, but separating that gene from its surrounding genetic material is not an act of invention."

Still, the justices did say that Myriad or companies like it might be able to patent forms of DNA that were not simply extracted from genes taken from the human body.

According to USA Today, the judges' nine-to-zero decision was in line with past decisions that have ruled that forces of nature are not patent-eligible, while products of human invention are.

The decision may have a profound impact on the bottom line of companies that sell genetic tests. According to USA Today, more than 40,000 patents linked to genetic material have been issued by the U.S. Patent and Trademark Office since 1984. Myriad's gene tests for breast and ovarian cancer risk have been used by almost 1 million women since the late 1990s.

But the newspaper noted that these tests aren't cheap: it costs $3,340 for the breast cancer gene analysis, for example.

As is usual in cases over patents, Myriad and industry representatives have long argued that losing patent protection would lead to less investment in research and development.

On the other side, doctors and patient advocacy groups say loss of patent protection for gene-based products would free up competition, drive prices down and lead to more research and development, not less.

In a statement released earlier this week, the National Society of Genetic Counselors, argued against the patenting of genes.

"Exclusive licenses on patents create barriers that could stifle the development of innovative tests by restricting the access of researchers to gene sequences," the group said, "or requiring researchers to pay exorbitant licensure costs that will ultimately be passed on to the consumer."

An advocacy group for patients with ovarian cancer agreed.

"Many women we work with are concerned about their genetic risk of developing ovarian cancer, especially in the wake of Angelina's Jolie's announcement that she carries the BRCA1 mutation," Calaneet Balas, CEO of the Ovarian Cancer National Alliance, said in a statement. "Myriad's patent limited women's options for learning about their genetic risk."

The Supreme Court agreed that a gene is a preexisting entity that is not subject to patent.

"In isolation, it has no value, it's just nature sitting there," Justice Sonia Sotamayor said, USA Today reported.

More information

To find out more about genes, head to the Human Genome Project.

-- E.J. Mundell

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- Newly identified genetic variations may help predict which women will respond to breast cancer prevention therapy, a new study suggests.

By determining who would and would not receive possible benefit from two preventive drugs, women who aren't likely to respond could be spared the treatment and its side effects, the study authors noted.

Researchers examined data on women enrolled in two large breast cancer prevention trials, including 592 women who had developed cancer along with 1,171 similar women who did not.

The investigators found that women with a favorable genetic variation (called a "single nucleotide polymorphism" or SNP) in the gene ZNF423 and another near the gene CTSO were more likely to respond to prevention therapy with tamoxifen and raloxifene.

Women with unfavorable variations of these SNPs may not benefit from prevention therapy and have a five-fold increased risk of developing breast cancer, according to the study published June 13 in the journal Cancer Discovery.

"The recent guidelines by the U.S. Preventive Services Task Force emphasize that ... therapy with tamoxifen and raloxifene can lower a woman's risk for developing breast cancer. But about 50 women have to be exposed to the treatment and side effects to prevent a single case of breast cancer," study author Dr. James Ingle, a professor of oncology at the Mayo Clinic in Rochester, Minn., said in a journal news release.

"Our findings are important, because for the first time, we discovered genetic factors that could be used to select women who should be offered the drugs for prevention. Also of substantial importance is that we have discovered new information on how tamoxifen and raloxifene work to prevent breast cancer," he added.

"Findings from our study provide clear direction as to which women are likely and which are unlikely to benefit from tamoxifen or raloxifene," Ingle explained. "The best chance we have of decreasing the burden of breast cancer is to prevent it in the first place. Our findings provide the basis for a reinvigoration of research efforts in breast cancer prevention."

More information

The U.S. National Cancer Institute has more about breast cancer prevention.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- The types of TV shows that families watch influences the amount of junk food that preschool children eat, a new study suggests.

Researchers found that children in homes where parents watch regular TV with commercials had higher levels of junk food consumption and were more likely to have distorted views about healthy eating than children in homes where parents watched commercial-free digitally recorded TV or other types of media without food advertising.

The link between TV viewing and junk food consumption was much stronger in "food-secure" homes than in those that were "food-insecure." A family is considered food-secure if they have ready access to food.

Since food insecurity is associated with limited income, it restricts how much people can spend on junk food. But food-secure people can afford to give into cravings when seeing junk food ads on TV, the University of Michigan researchers explained.

The findings -- based on interviews with more than 100 parents and their children -- are scheduled for presentation at the International Communication Association's annual meeting, held June 17 to 21 in London, England.

"Even though parents and other caregivers are the primary gatekeepers regarding young children's food intake, children are still learning about food as it relates to health from family, media and other sources, and may use this knowledge later on to inform their decisions when parents or other adults aren't there to supervise them," study co-author Kristen Harrison said in an association news release.

The preschool years are especially important in influencing whether a child will grow up to be obese, so it's important to learn as much as possible about the factors that can lead preschool children to develop eating habits that lead to obesity, Harrison said.

In the United States, about one in three children is overweight or obese, which puts them at greater risk of serious illness later in life.

Studies presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

More information

The American Academy of Pediatrics has more about childhood nutrition.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- For dads aiming at marital bliss, a new study suggests just two factors are especially important: being engaged with the kids, for sure -- but also doing a fair share of the household chores.

In other words, just taking the children outside for a game of catch won't cut it.

"In our study, the wives thought father involvement with the kids and participation in household work are all inter-related and worked together to improve marital quality," said Adam Galovan, lead author of the study and a researcher at the University of Missouri, in Columbia. "They think being a good father involves more than just doing things involved in the care of children."

Galovan found that wives feel more cared for when husbands are involved with their children, yet helping out with the day-to-day responsibilities of running the household also matters.

But Galovan was surprised to find that how husbands and wives specifically divide the work doesn't seem to matter much. Husbands and wives are happier when they share parenting and household responsibilities, but the chores don't have to be divided equally, according to the study. What matters is that both parents are actively participating in both chores and child-rearing.

Doing household chores and being engaged with the children seem to be important ways for husbands to connect with their wives, and that connection is related to better relationships, Galovan explained.

The research was recently published in the Journal of Family Issues.

For the study, the researchers tapped data from a 2005 study that pulled marriage licenses of couples married for less than one year from the Utah Department of Health. Researchers looked at every third or fourth marriage license over a six-month period.

From that data, Galovan surveyed 160 couples between 21 and 55 years old who were in a first marriage. The majority of participants -- 73 percent -- were between 25 and 30 years old. Almost 97 percent were white. Of participants, 98 percent of the husbands and 16 percent of the wives reported they were employed full time, while 24 percent worked part time. The average couple had been married for about five years, and the average income of the participants was between $50,000 and $60,000 a year.

Couples indicated which spouse was generally responsible for completing 20 common household tasks -- or if both or neither of them were responsible. Fathers rated their involvement in their children's lives and mothers noted how involved they felt their husbands were with the kids. Both spouses rated how happy they were with how they divided household tasks and with their marriage.

Men and women differed in how they reported marital quality. For wives, the father-child relationship and father involvement was most important, followed by satisfaction with how the household work was accomplished.

For husbands, satisfaction with the division of family work came first, followed by their wife's feelings about the father-child relationship, and then the degree of involvement the dad had with his children.

For her part, Laurie Gerber, president of Handel Group Life Coaching in New York City, said the study rings true. Women really appreciate getting hands-on help at home, but men don't realize this intuitively because they see things very differently, she said. "If a man wants to get into his wife's good graces he should do a chore," she said. "If a woman wants to get into a man's good graces, she should jump him."

A study published earlier this year in American Sociological Review showed that married men who spend more time doing traditional household tasks reported having less frequent sex than do husbands who stick to more traditional masculine jobs, such as gardening or home repair. While women like getting help, doing too many of the chores may inadvertently turn the husband into more of a helpmate than a lover, the research found.

Rather than basing the choice of chores on traditional roles, Gerber recommends that tasks be divided based on both who cares most about getting the particular job done and who is best at it. "My husband doesn't care if my kids have matching outfits on and I don't care about getting the oil changed," she said. Couples need to sit down and discuss who will be primarily responsible for what. "That stops fights and clears so much air."

For Gerber, it's critical to try not to be influenced by how you were raised, what your culture says you should do or what the gender stereotyping says, but rather, by what you think is right. "Marriage is all about being there for the other person and you work as a team to get the job of the family done," she said.

More information

Learn more about parenting from the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, June 13 (HealthDay News) -- For the first time, researchers have shown that implanting electrodes in the brain's "feeding center" can be safely done -- in a bid to develop a new treatment option for severely obese people who fail to shed pounds even after weight-loss surgery.

In a preliminary study with three patients, researchers found that they could safely use the therapy, known as deep brain stimulation (DBS). Over almost three years, none of the patients had any serious side effects, and two even lost some weight -- but it was temporary.

"The first thing we needed to do was to see if this is safe," said lead researcher Dr. Donald Whiting, vice chairman of neurosurgery at Allegheny General Hospital in Pittsburgh. "We're at the point now where it looks like it is."

The study, reported in the Journal of Neurosurgery and at a meeting this week of the International Neuromodulation Society in Berlin, Germany, was not meant to test effectiveness.

So the big remaining question is, can deep brain stimulation actually promote lasting weight loss?

"Nobody should get the idea that this has been shown to be effective," Whiting said. "This is not something you can go ask your doctor about."

Right now, deep brain stimulation is sometimes used for tough-to-treat cases of Parkinson's disease, a movement disorder that causes tremors, stiff muscles, and balance and coordination problems. A surgeon implants electrodes into specific movement-related areas of the brain, then attaches those electrodes to a neurostimulator placed under the skin near the collarbone.

The neurostimulator continually sends tiny electrical pulses to the brain, which in turn interferes with the abnormal activity that causes tremors and other symptoms.

What does that have to do with obesity? In theory, Whiting explained, deep brain stimulation might be able to "override" brain signaling involved in eating, metabolism or feelings of fullness. Research in animals has shown that electrical stimulation of a particular area of the brain -- the lateral hypothalamic area -- can spur weight loss even if calorie intake stays the same.

The new study marks the first time that deep brain stimulation has been tried in that brain region. And it's an important first step to show that not only could these three severely obese people get through the surgery, but they also seemed to have no serious effects from the brain stimulation, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania who was not involved in the research.

"That shows us this is a therapy that should be studied further in a larger trial," said Halpern, who has done animal research exploring the idea of using deep brain stimulation for obesity.

"Obesity is a major problem," Halpern said, "and current therapies, even gastric bypass surgery, don't always work. There is a medical need for new therapies."

The three patients in Whiting's study were examples of that medical need. All were severely obese and had failed to shed weight after gastric bypass surgery -- the current last-ditch treatment option.

During the study period, the patients did have some side effects from deep brain stimulation -- nausea, anxiety and feeling "too hot or flushed" -- but they were short-lived, the researchers said. And there was some evidence that the brain stimulation was having effects. In lab tests, Whiting's team found that the deep brain stimulation seemed to spur short-lived spikes in resting metabolism.

Then, after the deep brain stimulation was programmed to the settings that seemed to boost metabolism, two patients shed some pounds -- 12 percent to 16 percent of what they weighed before the DBS settings were "optimized."

"There was some weight loss, but it was transient," Whiting said. Now a key question is, what is the right setting for the deep brain stimulation to encourage lasting weight loss? Whiting said his team is continuing to follow these three patients to try to figure that out -- and to keep monitoring safety.

Although deep brain stimulation is considered a generally safe therapy for the right patients, it is a major undertaking that requires two surgeries -- one to implant electrodes in the brain and another to place the neurostimulator. The potential risks include infection, a blood clot or bleeding in the brain, or an allergic reaction to the DBS parts.

If deep brain stimulation ever does become an option for managing severe obesity, Whiting said, he would expect it only to be used when all else fails. "This would definitely be a last resort," he said.

"At first, it would absolutely be a last-ditch option," neurosurgeon Halpern said. But, he added, it's also possible that deep brain stimulation could become an add-on therapy, used after gastric bypass for some patients whose weight does not fall -- or even an alternative in certain cases where bypass surgery is too risky.

Medtronic provided the deep brain stimulation hardware for the study and funded the work. One of Whiting's co-researchers is employed by the company.

More information

Learn more about brain stimulation therapies from the U.S. National Institute of Mental Health.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 13, 2013

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

10-Year-Old Girl's Double-Lung Transplant Successful: Family

Sarah Murnaghan's double-lung transplant on Wednesday was successful, her family says. She's the 10-year-old girl with cystic fibrosis whose parents won a legal fight to get their daughter on the adult lung transplant waiting list.

The procedure to give Sarah new lungs from an adult donor was performed at the Children's Hospital of Philadelphia and lasted about six hours, the Associated Press reported.

"Her doctors are very pleased with both her progress during the procedure and her prognosis for recovery," the family said in a statement.

"The surgeons had no challenges resizing and transplanting the donor lungs -- the surgery went smoothly, and Sarah did extremely well," it said, the AP reported. "She is in the process of getting settled in the ICU and now her recovery begins. We expect it will be a long road, but we're not going for easy, we're going for possible."

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U.S. House Committee Passes Anti-Abortion Bill

A bill to ban nearly all abortions after the 22nd week of pregnancy was approved Wednesday by the U.S. House of Representatives Judiciary Committee.

The 20-12 vote on the Republican-sponsored Pain-Capable Unborn Child Protection Act was spilt along party lines, The New York Times reported.

A vote by the full House could take place as early as next week, but it's almost certain that the bill will go no further due to opposition in the Democratic-controlled Senate.

In response to criticism from Democrats that the bill contained no exception for rape victims, Republican Representative Trent Franks of Arizona said that instances of pregnancies from rape were "very low." Opponents said his remark is an example of Republican insensitivities to women's issues, The Times reported.

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Judge Clears Way for Sale of Morning-After Pills Without Prescription

A U.S. federal judge's ruling Wednesday clears the way for the Plan B One-Step emergency contraceptive pill and its generic versions to be available to girls of all ages without a prescription.

In his decision, Judge Edward Korman of the Eastern District Court of New York said the government's plan to make the morning-after drugs available over the counter was sufficient to comply with his order that the U.S. Food and Drug Administration remove all sales and age restrictions for these drugs, The New York Times reported.

His ruling came in a case in which plaintiffs represented by the Center for Reproductive Rights asked Korman to reject the federal government's proposal because it did not include the two-pill versions of the drug.

The two-pill versions are fast being replaced by one-pill versions, but the plaintiffs said the two-pill versions are cheaper and that there is no significant difference between the two- and one-pill versions, The Times reported.

However, the FDA has said there is not enough evidence to show that young women can responsibly take two separate doses instead of just one.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Power mowers may seem easy to operate, but they can be deadly if misused.

The American Academy of Pediatrics says you should follow these safety rules before you start mowing the lawn:

  • Ensure that underage children are inside the home or are at a safe distance from the mower.
  • Never allow kids under 12 to use a power mower, or people under 16 to use a riding mower.
  • Carefully read the mower's operating instructions.
  • Never mow during a thunderstorm, poor lighting or when the grass is wet.
  • Clear objects such as stones, sticks and toys that could be struck and projected by the mower blade.
  • Inspect your mower to make sure it is in good working condition and that all safety guards are in place.
  • If using an electric mower, reduce the risk of electric shock by using a ground fault circuit interrupter.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Building a Campfire?

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(HealthDay News) -- Creating a campfire can be fun and practical, but it can lead to disaster if you don't follow some basic safety rules.

The National Wildlife Federation offers this advice:

  • Use dead pieces of soft wood lying around to start the fire, including pine, cedar or fir. Make sure you keep the fire small.
  • Keep water close by, so you can extinguish the fire when necessary. Make sure there is no debris nearby that could ignite.
  • Build the fire inside a fireplace, stove or fire ring.
  • Always stay with the fire when it is lit.
  • To extinguish the fire, pour water, stir the ashes, and pour more water. Make sure the ashes are cold when you leave the fire.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- The more tobacco advertising teenagers see, the more likely they are to start smoking, according to a new study.

Every 10 tobacco ads that teens view increases their risk of starting to smoke by nearly 40 percent and boosts their chances of becoming a daily smoker by 30 percent, the German researchers found.

The findings, published online in the journal BMJ Open, support the total ban on tobacco advertising advocated by the World Health Organization, said Dr. Matthis Morgenstern, of the Institute for Therapy and Health Research in Kiel and colleagues.

"Data from this study support this measure, because only exposure to tobacco advertisements predicted smoking initiation, which cannot be attributed to a general receptiveness to marketing," they wrote in a journal news release.

For the study, researchers looked at more than 1,300 nonsmokers, aged 10 to 15, in Germany. Their exposure to tobacco ads and subsequent smoking behavior was monitored for 30 months.

At the end of the 30 months, one-third of the youngsters admitted to trying smoking and 10 percent said they had smoked within the previous month, according to the study.

Five percent said they had smoked more than 100 cigarettes and were classified as established smokers, while a similar percentage said they now smoked every day. One-third of the daily smokers were 14 or younger and one-quarter were 16 or older.

Youngsters who saw the most tobacco ads (11 to 55) during the 30 months were about twice as likely to become established smokers and daily smokers compared to those who saw the fewest ads.

For each additional 10 tobacco ads they saw, teens were 38 percent more likely to become established smokers and 30 percent more likely to become daily smokers. After taking into account other major smoking risk factors, the researchers concluded that the overall risk of becoming an established smoker was 3 percent to 7 percent greater, and the risk of becoming a daily smoker was 3 percent to 6 percent greater, depending on how many tobacco ads a teen had seen.

Although the study found an association between tobacco ads and the likelihood of smoking, it did not establish a cause-and-effect relationship.

More information

The American Lung Association explains how to prevent children and teens from smoking.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- There's fresh evidence that the chemical bisphenol A, or BPA, may play a part in childhood obesity.

BPA is a chemical that is widely used in food packaging. Government studies have shown that 92 percent of Americans have detectable levels of BPA in their bodies.

There's intense scientific interest in BPA because it is chemically similar to the hormone estrogen, and there's some concern that it may mimic estrogen's effects in the body, causing harm to the brain and reproductive organs, particularly in children.

Last year, the U.S. Food and Drug Administration formally banned BPA from baby bottles and sippy cups, though manufacturers had already stopped using it. The agency declined to ban it from other food containers, pending further research.

In a new study published online June 12 in the journal PLoS One, researchers measured BPA levels in the urine of more than 1,300 children in China and compared those levels to their body weights.

The study authors also asked the kids about other things that may influence body weight, such as how often they ate junk food, fruits and vegetables, how much exercise they got, whether their parents were overweight and how long they played video games, on average, each day.

After taking all those factors into account, the investigators found that girls aged 9 to 12 who had higher-than-average levels of BPA in their urine were about twice as likely to be obese as those with lower-than-average levels. The researchers didn't see the same association for boys or for older girls.

One explanation for the results may be that girls who are entering puberty are uniquely vulnerable to the effects of hormone-disrupting chemicals, said study author Dr. De-Kun Li, an epidemiologist at Kaiser Foundation Research Institute and the Stanford School of Medicine, in California.

"Human studies are starting to confirm animal studies that show BPA can disrupt energy storage and energy metabolism," said Li.

One of the most recent questions raised about BPA is whether or not it may be an obesogen, or a chemical that contributes to the development of obesity.

In laboratory studies, BPA produces many of the molecular hallmarks of obesity. It makes fat cells bigger, it blocks the function of a protein called adiponectin, which protects against heart disease, and it disrupts the balance of testosterone and estrogen -- hormones that are important for maintaining a healthy body mass.

One expert found the study results troubling.

"Clearly, unhealthy diet and physical activity are still the leading causes of the childhood obesity epidemic worldwide, but this study adds further concern to the notion that environmental chemicals may be independent contributors," said Dr. Leonardo Trasande, an associate professor of pediatrics, environmental medicine and health policy at NYU Langone Medical Center, in New York City.

In a study of more than 2,800 U.S. children published last year in the Journal of the American Medical Association, Trasande reported that boys and girls who were exposed to higher levels of BPA were more likely to be obese than those exposed to lower levels of the chemical. That was true even after they took into account how many calories kids ate, how much TV they watched and household income.

Still, he said, neither of these studies can prove that BPA causes children to become obese. One explanation could be that obese kids eat more packaged and processed foods, which in addition to having more fat and calories could also contain more BPA. Another explanation is that obese kids may have higher levels of BPA because the chemical is stored in body fat, Trasande said.

Other studies that follow children as they grow are needed to clarify the nature of the association.

The American Chemistry Council, a trade group that represents the interests of the chemicals industry, said in a statement that the new study did little to shed light on the true causes of childhood obesity.

"Attempts to link our national obesity problem to minute exposures to chemicals found in common, everyday products are a distraction from the real efforts underway to address this important national health issue," the statement from the council said. "Due to inherent, fundamental limitations in this study, it is incapable of establishing any meaningful connection between BPA and obesity. In particular, the study measures BPA exposure only after obesity has developed, which provides no information on what caused obesity to develop, a limitation noted by the study's authors."

More information

For more on BPA, head to the U.S. National Institute of Environmental Health Sciences.

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WEDNESDAY, June 12 (HealthDay News) -- Researchers have found a gene they say can help identify patients facing aggressive liver cancer, and may prove key to their future treatment.

This is good news in a field "that has not had big advances before this and has not been the beneficiary of genomic medicine," said Dr. Richard Goldberg, a professor of medicine at the Ohio State University Comprehensive Cancer Center.

The new laboratory study focused on hepatocellular carcinoma, a type of cancer that originates in the liver, particularly in people who have sustained liver damage from diseases such as hepatitis or cirrhosis, said Goldberg, who was not involved in the research. The findings open the possibility of targeted drugs that would outperform the standard drug treatment in use now, he said.

Some patients with hepatocellular carcinoma -- the most common form of liver cancer -- appear to have overactivity of a gene that is most often linked to embryonic stem cells and early human development, according to the study, published June 13 in the New England Journal of Medicine.

Those patients had a worse prognosis than other patients with hepatocellular carcinoma, wrote the lead authors from the National University of Singapore.

Further, blocking the gene -- called SALL4 -- appeared to help stop the cancer's spread, the researchers said.

Dr. Snorri Thorgeirsson, chief of the Laboratory of Experimental Carcinogenesis with the Center for Cancer Research at the U.S. National Cancer Institute, considers the new findings significant. "They found that if they inhibited SALL4, they were able to slow the growth of the cancer quite drastically," said Thorgeirsson. "They did this in lab cultures and in animal testing. It's pretty impressive they were able to show this."

Liver cancer is a leading cause of cancer-related deaths globally. More than 700,000 people are diagnosed with liver cancer each year throughout the world, and it accounts for more than 600,000 deaths annually, according to the American Cancer Society. Overall, the five-year survival rate from liver cancer is about 15 percent.

SALL4 has previously been linked to leukemia and other types of cancer, according to the study authors.

The researchers obtained specimens from 179 people with liver cancer and performed microscopic analysis to determine the number of cancer cells that appeared to contain the SALL4 gene.

Next, lab tests were performed to determine the effect of the SALL4 gene on liver cancer cells, using a peptide drug to block the gene's activity in mice and human samples. The cancer slowed as a result.

At this point, SALL4 will be most useful to help figure out liver cancer patients most in need of treatment, said Thorgierrson, co-author of an editorial that accompanied the new study.

"Now you can use SALL4 as a biomarker," he said. "If you find patients who overexpress this gene, you can focus treatment on them."

Most people are diagnosed with hepatocellular carcinoma when it's in an advanced stage. At that point the standard treatment option is a drug called sorafenib (Nexavar), and most patients don't respond to it, said Goldberg. "It's better than what we had before, but it doesn't affect the outcome for the majority of patients," he said. The current research suggests it may be possible to develop a new type of drug that would perform better, he said.

The gene also can be used to figure out which liver cancer patients might most benefit from experimental drugs that target the cancer's developmental signaling pathways, said Michael Melner, program director of molecular genetics and biochemistry of cancer for the American Cancer Society.

"I think more research needs to be done on their particular target and its effectiveness," Melner said. "It may be in the future that this SALL4 ends up being a good target, but it's a little early based on the evidence so far to make that jump. But this could be a very good biomarker for separating groups of patients that then could be treated with different classes of these newly developed classes of therapeutic drugs."

It is unlikely that the peptide used to block SALL4 in this study would be a viable drug for liver cancer patients, Melner said.

"A number of drug companies have tried peptide-based drugs," he said. "Although the drugs are effective, they need to be present in relatively high concentrations. It's been difficult to achieve those levels in humans."

However, clinical trials are under way involving targeted drugs that inhibit the expression of genes with stem-cell features, Thorgierrson noted.

"These will also affect SALL4, so there may already be available drugs that can be a potentially useful treatment," he said. "This needs to be expanded into proper medical trials, but the data set is very impressive."

More information

The American Cancer Society explains how liver cancer is found.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Men with restless legs syndrome now have another health concern: New research has just linked the condition to an increased risk of dying early.

In a study of nearly 20,000 men, Harvard researchers found that men with restless legs syndrome had a 39 percent higher risk of an early death than did men without the condition.

"This study suggests that individuals with restless legs syndrome are more likely to die early than other people," said study author Dr. Xiang Gao, an assistant professor at Harvard Medical School and an associate epidemiologist at Brigham and Women's Hospital in Boston. "This association was independent of other known risk factors."

"[However], this is an observational study," Gao said of the findings, which were published online June 12 in the journal Neurology. "We can only see an association that suggests a possible causal relationship."

Restless legs syndrome is a common condition that causes people to feel an uncomfortable sensation in their legs when lying down, according to the U.S. National Institute of Neurological Disorders and Stroke (NINDS). The feeling may be a throbbing, pulling or creeping sensation. Restless legs syndrome makes it hard to fall asleep and stay asleep.

The exact cause of restless legs syndrome is unknown. It does seem to run in families, suggesting a genetic component to the condition, according to the NINDS. Restless legs syndrome has also been linked to some medical conditions, such as kidney disease and the nerve disorder peripheral neuropathy. It's also associated with the use of certain medications, and may occur during pregnancy.

Gao said many people with restless legs syndrome have low iron levels, and taking iron supplements often can alleviate the symptoms of restless legs syndrome. But, he cautioned, too much iron can be dangerous, so be sure to have your doctor check your iron levels before taking any supplements.

The current study included nearly 18,500 American men who were followed for eight years. At the start of the study, none of the men had diabetes, arthritis or kidney failure. The average age at the start of the study was 67.

Almost 4 percent (690 men) of the study group was diagnosed with restless legs syndrome. Men with restless legs syndrome were more likely to take antidepressant drugs and have high blood pressure, cardiovascular disease or Parkinson's disease. Not surprisingly, men with restless legs syndrome had more frequent complaints of insomnia.

During the study follow-up, nearly 2,800 men died.

When the researchers compared those with restless legs syndrome to those without, they found that men who had the condition were 39 percent more likely to die during the study period than men without the condition. When they controlled for factors such as body mass, lifestyle factors, chronic conditions and sleep duration, the mortality risk for men with restless legs syndrome dropped to 30 percent.

After controlling the data for major chronic conditions, the researchers saw a linear relationship between the frequency of restless legs syndrome and the risk of death. The more frequent the symptoms, the higher the risk of death, Gao said.

Gao said the reason restless legs syndrome is associated with an increased risk of death isn't clear. He said it might have something to do with the sleep problems and lack of sleep quality in people with the condition. It could be related to cardiovascular risk factors, even though the researchers tried to control the data for those factors. What is clear, he said, is that more research is needed.

Gao and his team are studying a group of women with restless legs syndrome, but he said he doesn't know if the findings from the study of men will be similar in women.

Dr. Melissa Bernbaum, a neurologist at Lenox Hill Hospital in New York City, suspects the findings will be similar in women. "I don't see any reason why they wouldn't be," she said.

"I was surprised by these findings," Bernbaum added. "This is a pretty high increased risk."

"I think they did a good job of defining some of the reasons why this association exists, but what they don't mention is who was treated for restless legs and who wasn't," Bernbaum said. "If you could avoid the sleep disruption, would the mortality risk be the same?"

Both experts said the main message from the study is that anyone with symptoms of restless legs syndrome should see their doctor. If you have an iron deficiency, iron supplements can help. There are also other treatments available for people who don't have an iron deficiency.

More information

Learn more about restless legs syndrome from the National Institute of Neurological Disorders and Stroke.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- An antiviral drug may help protect injection drug users from HIV infection, a new study finds.

The study of more than 2,400 injection drug users recruited at 17 drug treatment clinics in Thailand found that daily tablets of tenofovir reduced the risk of HIV infection by nearly 49 percent, compared to inactive placebo pills.

One expert said an intervention to help shield injection drug users from HIV -- the virus that causes AIDS -- is much needed.

"This is an important study that opens up an additional option for preventing HIV in a hard-to-reach population," said Dr. Joseph McGowan, medical director at the Center for AIDS Research & Treatment at North Shore University Hospital in Manhasset, N.Y.

He noted that "HIV infections continue to occur at high rates, with over 2.5 million worldwide and 50,000 new infections in the U.S. each year. This is despite widespread knowledge about HIV infection and the way it is spread, through unprotected sex and sharing needles for injecting drugs."

The participants included in the new study were followed for an average of four years. During that time, 17 of the more than 1,200 patients taking tenofovir became infected with HIV, compared with 33 of an equal number of patients taking a placebo, according to the study published online June 12 in The Lancet.

Further analyses of the results showed that the protective effect of tenofovir was highest among those who most closely followed the drug's prescribed regimen. In this group, the risk of HIV infection was reduced by more than 70 percent, said study leaders Dr. Kachit Choopanya and Dr. Michael Martin, chief of clinical research for the Thailand Ministry of Public Health--U.S. Centers for Disease Control and Prevention Collaboration.

Prior research has shown that preventive use of antiviral drugs cuts the risk of sexual transmission of HIV in both heterosexual couples and men who have sex with men, and also reduces mother-to-child transmission of HIV. But this is the first study to show that this approach might also be effective among injection drug users.

Worldwide, injection drug use is believed to cause one in 10 new HIV infections. But rates of infection associated with injection drug use are far higher in some areas of the world, such as eastern Europe and central Asia. In these regions, up to 80 percent of new HIV infections are caused by injection drug use.

According to McGowan, tenofovir is no "silver bullet" that would, on its own, eliminate the risk of HIV infection for drug abusers. But it could be a key ingredient in reducing the odds.

"Adoption of this strategy, not as a stand-alone, but in conjunction with needle exchange, counseling, opiate substitution, social support and mental health therapy may enable us to get ahead of this expanding epidemic," McGowan said.

He added that the participants in the study were also provided with what's known as "directly observed therapy," where the drug is administered under the observance of a health care worker. Services like this, along with monthly HIV testing and condom distribution, might not occur in "real life" treatment situations, McGowan said, so outcomes might not be as good as in this clinical trial.

Another expert agreed that adherence to tenofovir therapy is key to success.

Tenofovir "accumulates slowly [in the body], making the case for adherence -- which is strongly associated with the efficacy of the drug," said Victoria Richards, assistant professor of medical sciences at the Frank H. Netter MD School of Medicine at Quinnipiac University, in Hamden, Conn.

More information

The U.S. Centers for Disease Control and Prevention has more about people at risk for HIV infection.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- People with genetic mutations that lead to inherited, early onset Alzheimer's disease overproduce a longer, stickier form of amyloid beta, the protein fragment that clumps into plaques in the brains of Alzheimer's patients, a small new study has found.

Researchers found that these people make about 20 percent more of a type of amyloid beta -- amyloid beta 42 -- than family members who do not carry the Alzheimer's mutation, according to research published in the June 12 edition of Science Translational Medicine.

Further, researchers Rachel Potter at Washington University School of Medicine in St. Louis and colleagues found that amyloid beta 42 disappears from cerebrospinal fluid much more quickly than other known forms of amyloid beta, possibly because it is being deposited on plaques in the brain.

Alzheimer's researchers have long believed that brain plaques created by amyloid beta cause the memory loss and thought impairment that comes with the disease.

This new study does not prove that amyloid plaques cause Alzheimer's, but it does provide more evidence regarding the way the disease develops and will guide future research into diagnosis and treatment, said Dr. Judy Willis, a neurologist and spokesperson for the American Academy of Neurology.

The mutation occurs in the presenilin gene and has previously been linked to increased production of amyloid beta 42 over amyloid beta 38 and 40, the other types of amyloid beta found in cerebrospinal fluid, the study said.

Earlier studies of the human brain after death and using animal research have suggested that amyloid beta 42 is the most important contributor to Alzheimer's.

The new study confirms that connection and also quantifies overproduction of amyloid beta 42 in living human brains. The investigators also found that amyloid beta 42 is exchanged and recycled in the body, slowing its exit from the brain.

"The amyloid protein buildup has been hypothesized to correlate with the symptoms of Alzheimer's by causing neuronal damage, but we do not know what causes the abnormalities of amyloid overproduction and decreased removal," Willis said.

The findings from the new study "are supportive of abnormal turnover of amyloid occurring in people with the genetic mutation decades before the onset of their symptoms," she said.

Researchers conducted the study by comparing 11 carriers of mutated presenilin genes with family members who do not have the mutation. They used advanced scanning technology that can "tag" and then track newly created proteins in the body. With this technology, they tracked the production and clearance of amyloid beta 40 and 42 in the participants' cerebrospinal fluid.

This research gives clinicians a potential "marker" to check when evaluating the Alzheimer's risk of a person with this genetic mutation, Willis said.

"It's an earlier way to identify the first associations of Alzheimer's," she said. "It appears looking at the spinal fluid may be the first way to diagnose this disease."

Even though the research focused on a genetic abnormality faced by a very small percentage of early onset Alzheimer's patients, its new insights into the way amyloid beta is produced and exchanged in the body will help investigations into both early and late onset forms of the disease, said Dean Hartley, director of science initiatives for the Alzheimer's Association.

"The disease pathology is almost identical, when you look at early Alzheimer's compared with the more common sporadic forms of Alzheimer's," Hartley said. "The plaques and tangles that form are nearly identical."

The study also identifies amyloid beta 42 as a potential target for future drug trials, he added.

"One of the reasons we've not made a shot on goal for clinical trials for Alzheimer's disease is we need to understand more about the disease mechanism for Alzheimer's," he said. "There actually have been trials to look at drugs that inhibit [the enzyme that causes the formation of amyloid beta]. They have failed because this particular enzyme doesn't just work on beta amyloid but on other proteins in the body as well. It wasn't really a target-specific drug.

"We're not that far away from clinical trials," Hartley continued. "The question is whether this target is going to turn out to be a safe target."

More information

Learn more about Alzheimer's disease at the Alzheimer's Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Taking high doses of iodine and kelp supplements can be hazardous to your health, warns the American Thyroid Association.

Adequate iodine intake is required for normal function of the thyroid, a gland in the neck that produces hormones that control the rate of many bodily activities. But too much iodine can lead to thyroid dysfunction.

Daily supplements containing more than 500 micrograms of iodine should be avoided, the association recommended. Many iodine, potassium iodide and kelp supplements contain iodine amounts that are up to several thousand times higher than the daily tolerable upper limit of 1,100 micrograms per day, they noted.

The recommended daily limit for iodine intake is 150 micrograms for men and non-pregnant women. The recommended daily intake is 220 to 250 micrograms for pregnant women and 250 to 290 micrograms for women who are breast-feeding.

Women should take multivitamins containing 150 micrograms of iodine daily before conceiving, during pregnancy and while breast-feeding, the experts said in an association news release.

"For other individuals, the U.S. diet generally contains enough iodine to meet nutritional needs, with common sources being iodized salt, dairy products, breads and seafood," Dr. Angela Leung, chair of the association's public health committee and an assistant professor of medicine at Boston University School of Medicine, said in the release.

There are only a few medical conditions in which the short-term use of high amounts of iodine is indicated, the association added.

More information

The U.S. Office of Dietary Supplements has more about iodine.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- A pregnant woman's exposure to environmental contaminants affects her unborn baby's heart rate and movement, a new study says.

"Both fetal motor activity and heart rate reveal how the fetus is maturing and give us a way to evaluate how exposures may be affecting the developing nervous system," study lead author Janet DiPietro, associate dean for research at the Johns Hopkins Bloomberg School of Public Health, said in a school news release.

The researchers analyzed blood samples from 50 high- and low-income pregnant women in and around Baltimore and found that they all had detectable levels of organochlorines, including DDT, PCBs and other pesticides that have been banned in the United States for more than 30 years.

High-income women had a greater concentration of chemicals than low-income women.

The blood samples were collected at 36 weeks of pregnancy, and measurements of fetal heart rate and movement also were taken at that time, according to the study, which was published online in the Journal of Exposure Science and Environmental Epidemiology.

The researchers found that higher levels of some common environmental pollutants were associated with more frequent and vigorous fetal movement. Some of the chemicals also were associated with fewer changes in fetal heart rate, which normally parallel fetal movements.

"Most studies of environmental contaminants and child development wait until children are much older to evaluate effects of things the mother may have been exposed to during pregnancy," DiPietro said. "Here we have observed effects in utero."

How the prenatal period sets the stage for later child development is a subject of tremendous interest, DiPietro said.

"These results show that the developing fetus is susceptible to environmental exposures and that we can detect this by measuring fetal neurobehavior," she said. "This is yet more evidence for the need to protect the vulnerable developing brain from effects of environmental contaminants both before and after birth."

More information

The MedlinePlus Medical Encyclopedia has more about fetal development.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Participants in one of the world's most grueling cross-country ski races are at increased risk of developing a heart rhythm disorder (arrhythmia), according to a new study.

Researchers looked at nearly 53,000 people who completed the 90-kilometer (56-mile) Vasaloppet in Sweden between 1989 and 1998 and were followed until 2005. The Vasaloppet is the world's oldest, longest and largest cross-country skiing race.

The risk of developing an irregular or abnormally fast heart beat (atrial fibrillation) or a too-slow heart beat (bradyarrhythmia) was highest among skiers who completed the most Vasaloppets and had faster finishing times than other contestants, according to the study, published online June 12 in the European Heart Journal.

"We found that those who completed five or more races in a period of 10 years had a 30 percent higher risk of developing any arrhythmia than those who did one race only. Similarly, skiers who had the fastest finishing time relative to the other participants also had a 30 percent higher risk of developing any arrhythmia in subsequent years," Dr. Kasper Andersen, a cardiologist at Uppsala University Hospital in Sweden, said in a journal news release.

He noted that previous research has examined the effects of endurance exercise on cardiovascular problems such as heart disease and stroke. But only a few, smaller studies have investigated its effect on heart rhythm problems, and these studies have tended to look at people who are less active.

"The present study investigates the higher end of the physical activity level scale and shows how very high physical activity level affects risk of arrhythmias," Andersen said. "The skiers in our study are as a group healthier than the general population. We have previously shown that besides higher leisure-time physical activity, the participants in Vasaloppet smoke less, have lower fat and higher fiber consumption, and better physical and mental health than the general population."

The findings suggest a dose-response relationship -- "the more races skiers complete and the faster they go, the greater their risk of subsequently developing arrhythmia," Andersen said. "However, it is important to stress that this study does not show that the exercise causes arrhythmias, only that it is associated with an increased risk," he added.

The racers have about half the death rate compared to the rest of the population, Andersen said. This is probably because of the training level of the participants, and also because they need to be healthy to even consider participating in the race, he added.

More information

The Cardiovascular Research Foundation has more about heart rhythm problems.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 12, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Mandela Responding Better To Treatment

After a "difficult few days," Nelson Mandela is responding better to treatment for a recurring lung infection, South African President Jacob Zuma said Wednesday.

"I am happy to report than Madiba is responding better to treatment from this morning," Zuma told lawmakers in Cape Town, Bloomberg News reported. "We are very happy with the progress that he is [having] now."

Madiba is Mandela's clan name.

Mandela, 94, is in "serious, but stable" condition, Zuma's office said Tuesday. The anti-apartheid hero and former South Africa president was hospitalized June 8. It was his fourth hospitalization since December, Bloomberg reported.

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Tighter Restrictions Proposed for Medical Research on Chimps

A proposal to bring captive chimpanzees in the United States under the protection of the Endangered Species Act would create another major barrier to using them for invasive medical research on human diseases.

Under the U.S. Fish and Wildlife Service proposal, permits would be required for any experiment that harms chimps, and researchers would have to prove that the experiment contributes to the survival of chimps in the wild, The New York Times reported.

The public has 60 days to comment on the proposal, which was announced Tuesday.

Wild chimps were declared endangered in 1990 but captive chimps have been unprotected under the law. This proposal would end that so-called split list, Fish and Wildlife Service Director Daniel Ashe told The Times.

The demand for chimps in medical research has declined and a U.S. National Institutes of Health committee has recommended that the NIH retire most of the about 450 chimps it owns or supports.

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Drug License Violations Lead to $80 Million Penalty for Walgreens

A record $80 million in fines will be paid by Walgreens for violating its U.S. Drug Enforcement Agency license to dispense controlled substances such as the highly addictive pain drug oxycodone.

It's the largest civil penalty paid under the Controlled Substances Act in DEA history, according to USA Today.

In September, the DEA accused Walgreens -- the nation's largest drug store chain -- of endangering public safety and forbid the company from shipping controlled drugs from its distribution center in Jupiter, Fla.

The company committed "an unprecedented number" of record-keeping violations that led to millions of oxycodone pills reaching the black market, U.S. Attorney Wilfredo Ferrer said Tuesday, USA Today reported.

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NYC Lawyer Faces Tough Questions About Soda Size Limit

A New York City lawyer faced tough questioning Tuesday from state appeals court members holding a hearing about a city health regulation that imposes a 16-ounce size limit on sugary beverages sold in fast food outlets, restaurants and sports stadiums.

The regulation -- introduced as a way to fight obesity and diabetes -- was struck down in March by a lower-court judge and the city appealed that decision.

During oral arguments Tuesday, the four state appeals court justices repeatedly asked city attorney Fay Ng to defend the regulation's scientific and legal foundations, the Associated Press reported.

One of the justices said the city seemed to be asking for unprecedented authority to regulate the portions of many types of foods, while another questioned the scientific reasoning behind the 16-oz. limit.

After Tuesday's session, City Health Commissioner Thomas Farley said he was still confident that the regulation would ultimately be upheld, the AP reported.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Drivers who think hands-free devices for talking or texting are safer than handheld cellphones are mistaken, a new report suggests.

Instead, devices such as speech-based technologies in cars can overload drivers, taking their attention from the road and making an accident more likely, experts say.

"Hands-free is not risk-free, even though three out of four motorists believe it is," said Peter Kissinger, president and CEO of the AAA Foundation for Traffic Safety. "We know now that devices like voice-detect or voice-to-email systems can create substantial mental distractions, which can lead to degradation of driving performance."

Each day in the United States, more than nine people are killed and more than 1,000 are injured in crashes that involve a distracted driver, according to the U.S. Centers for Disease Control and Prevention.

Brains aren't wired to multi-task, Kissinger said. "It's virtually impossible for the brain to do two complex things at the same time," he said.

Multi-tasking can lead to "inattention blindness," he said, which occurs when people are concentrating on one thing and don't see other things going on around them.

"You can literally look at something and not see it," he said. "We have seen that situation occur in the real world. We have seen people being engrossed in a cellphone conversation and run right through a red light and afterwards don't even remember seeing the red light."

Released Wednesday, the new report was prepared for AAA by researchers from the department of psychology at the University of Utah.

They tested drivers in a variety of ways with a range of distractions including listening to the radio, conversing with a passenger, talking on handheld phones and using hands-free devices. The researchers looked at reaction time, both in lab simulators and on the road, Kissinger said.

The researchers found that reaction time slows and brain function is compromised as mental workload and distractions increase. Drivers check the road less and miss cues that can result in not seeing things right in front of them, such as stop signs and pedestrians.

Behaviors like listening to the radio were a very mild mental distraction, which researchers classified as a level-one distraction, Kissinger said. Voice-activated technology, however, was very distracting at level three, which is considered the highest risk.

Another expert said inattentive driving existed before the era of electronic devices -- hands-free or otherwise.

"Distracted driving is a big problem on the road, but it has always been a big problem, even before cellphones and other electronic devices came along," said Russ Rader, a spokesman for the Insurance Institute for Highway Safety. "Even so, researchers expected to see a wave of crashes as electronic devices proliferated, but the opposite is happening on the road: Police-reported crashes have been on the decline."

"[However], this doesn't mean that electronic devices aren't distracting," Rader said. "Every study, including this new one, demonstrates that they are distracting. It does mean we need to better understand how drivers are integrating these systems into the driving task."

A CDC expert agreed that hands-free devices don't solve the problem of distracted driving.

"Hand-free devices may take away some of the visual and physical distractions that come with handling or dialing a phone, but we can't say that hands-free is risk-free, because there is still a mental distraction," said Rebecca Naumann, an epidemiologist at the CDC's Injury Center.

'"You still have the distraction that your mind is taken off of the driving," she said. "Anything that takes your hands off the wheel or your mind off the road poses a risk to safety."

"Drivers should commit to distraction-free driving," Naumann said.

Distracted driving "has real consequences," Kissinger said. "We should heed that and minimize all the distractions while driving. Keep our hands on the wheel and our eyes on the road and, most importantly, keep our mind on driving."

Despite the risks, AAA is not calling for a ban on these devices, but is starting to work with car makers to find ways to make in-car voice and text systems safer.

Jonathan Adkins, deputy executive director of the Governors Highway Safety Association, added that "our expectation is that in-vehicle systems will improve and thus become safer. Our advice to drivers is to not use any type of cellphone while driving."

More information

To find out more about distracted driving, visit the U.S. Centers for Disease Control and Prevention.

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Older adults at risk for getting diabetes who took a 15-minute walk after every meal improved their blood sugar levels, a new study shows.

Three short walks after eating worked better to control blood sugar levels than one 45-minute walk in the morning or evening, said lead researcher Loretta DiPietro, chairwoman of the George Washington University School of Public Health and Health Services in Washington, D.C.

"More importantly, the post-meal walking was significantly better than the other two exercise prescriptions at lowering the post-dinner glucose level," DiPietro added.

The after-dinner period is an especially vulnerable time for older people at risk of diabetes, DiPietro said. Insulin production decreases, and they may go to bed with extremely high blood glucose levels, increasing their chances of diabetes.

About 79 million Americans are at risk for type 2 diabetes, in which the body doesn't make enough insulin or doesn't use it effectively. Being overweight and sedentary increases the risk. DiPietro's new research, although tested in only 10 people, suggests that brief walks can lower that risk if they are taken at the right times.

The study did not, however, prove that it was the walks causing the improved blood sugar levels.

"This is among the first studies to really address the timing of the exercise with regard to its benefit for blood sugar control," she said. In the study, the walks began a half hour after finishing each meal.

The research is published June 12 in the journal Diabetes Care.

For the study, DiPietro and her colleagues asked the 10 older adults, who were 70 years old on average, to complete three different exercise routines spaced four weeks apart. At the study's start, the men and women had fasting blood sugar levels of between 105 and 125 milligrams per deciliter. A fasting blood glucose level of 70 to 100 is considered normal, according to the U.S. National Institutes of Health.

The men and women stayed at the research facility and were supervised closely. Their blood sugar levels were monitored the entire 48 hours.

On the first day, the men and women did not exercise. On the second day, they did, and those blood sugar levels were compared to those on the first day.

The men and women were classified as obese, on average, with a body-mass index (BMI) of 30. The men and women walked on a treadmill at a speed of about three miles an hour (a 20-minute mile, which DiPietro described as the lower end of moderate).

The walks after meals reduced the 24-hour glucose levels the most when comparing the sedentary day with the exercise day.

A 45-minute morning walk was next best.

Walking after dinner was much better in reducing blood glucose levels than the morning or afternoon walking, DiPietro found.

Walking a half hour after eating gives time for digestion first, DiPietro said. Within that half hour, she said, "the glucose starts flooding the blood. You are using the working muscles to help clear the glucose from the blood stream." The exercise "is helping a sluggish pancreas do its job, to secrete insulin to clear the glucose," she said.

The briefer, more frequent exercise may also sound more doable to sedentary older adults, she said. "Committing to do this with someone would work best," DiPietro said. "It can be coupled with things like walking the dog or running errands."

The findings make physiological sense, said Dr. Stephen Ross, attending physician at UCLA Medical Center in Santa Monica, Calif.

"If you are exercising right after you eat, that would cause blood sugar to decrease because more of the glucose would go to the muscles to help the muscles with their metabolism," he said.

The brief walks, Ross said, may also fit a person's schedule better.

DiPietro cautioned, however, that "you have to do it every day" to get the benefit. It's not a prescription for fitness, she said, but simply to reduce diabetes risk.

The study was funded by the U.S. National Institutes of Health, the U.S. National Institute on Aging and the Beltsville Human Nutrition Research Center of the U.S. Department of Agriculture.

More information

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

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- Restricting the sale of large sodas and other sugar-sweetened beverages in restaurants and other food-service outlets would affect 7.5 percent of Americans each day and have the greatest impact on overweight people, according to a new study.

In an effort to fight obesity, New York City's Board of Health approved a ban on the sale of sugary beverages larger than 16 ounces at eateries, but the law was struck down by the New York state Supreme Court in March. An appeal began this week.

In order to assess the effect that such a ban would have nationwide, researchers at Columbia University's Mailman School of Public Health analyzed the records of more than 19,000 people who took part in the U.S. National Health and Nutrition Examination Survey from 2007 to 2010.

The study found that about 60 percent of Americans consumed sugary drinks daily, but only 7.5 percent of them purchased "super-size" sugary drinks from an eatery on a given day. The rates, however, were somewhat higher for certain groups: 13.6 percent of overweight teens, 12.6 percent of overweight young adults aged 20 to 44 and 8.6 percent of overweight people in general.

The investigators also found that low-income and high-income people were equally likely to buy large sugary drinks from restaurants, which challenges the criticism that a ban on the sale of these drinks at eateries discriminates against the poor.

The researchers said this finding was a surprise because poorer people are more likely to drink sugary beverages than those with higher incomes. But although poor people tend to consume more sugary beverages, it's cheaper for them to buy these drinks at a store and consume them at home, the authors said.

The study, published online in the American Journal of Clinical Nutrition, used national data but shows that this type of ban would help fight obesity no matter where in the country it was implemented.

"Our findings are clear: A law like this would address one of the fundamental causes of obesity -- the growing portion size of sweetened drinks," lead author Dr. Y. Claire Wang, an assistant professor of health policy and management, said in a university news release.

For example, the study authors said, in 1955, a regular-size soda at McDonald's was 7 ounces. The sizes offered today range from a 12-ounce child-size drink to a 32-ounce drink. "Changing social norms is difficult, but as portion sizes have grown, it's useful to establish a new standard," Wang said.

Another expert, Dr. Sandro Galea, chairman of the department of epidemiology at the Mailman School, pointed out the importance of the study findings.

"[The study] provides critical foundational evidence that the proposed efforts to restrict marketing of large sodas in New York City and elsewhere can have a substantial impact on population health," said Galea, who is also a member of the New York City Board of Health.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, June 12 (HealthDay News) -- The big toe is not the biggest culprit in gout flare-ups, contrary to popular belief, a new study reports.

Researchers from the Mayo Clinic in Rochester, Minn., found that people with the highest risk of repeated cases of gout are those whose gout first appears in other joints, such as the knee or elbow, rather than in the joints of the big toe.

Gout is a painful form of arthritis caused by uric acid buildup in the body. Continuing to take medication is essential to prevent recurrences, the researchers said.

"Because patients often think that a gout flare-up means their medications are not working, they may stop medications like allopurinol. It is especially important for these patients to continue taking gout medication to prevent flare-ups," study co-author Dr. Eric Matteson, rheumatology chair, said in a Mayo news release.

The study was scheduled for presentation at the annual meeting of the European League Against Rheumatism, June 12 to 15, in Madrid.

Researchers followed 46 gout patients for about 13 years on average. Their first gout attack occurred at an average age of 66.

Mayo researchers presented other studies at the meeting. Among those findings:

  • Black American lupus patients with certain autoantibodies (anti-RNA-binding protein autoantibodies) have higher levels of interferon, a protein involved in inflammation. The finding may explain why black Americans have worse lupus than whites and could lead to improved treatments, the researchers say.
  • Rheumatoid arthritis patients have greater changes in their systolic blood pressure (the top number of a blood pressure measurement) from one health care visit to another than people without the disease. That erratic blood pressure was linked to heart disease, which means that doctors need to closely manage heart disease risk in these patients.
  • Another study may help explain why smoking doubles the risk of developing rheumatoid arthritis. In people with a genetic predisposition to a particular immune response, smoking triggers immune cells called dendritic cells, the researchers found. Unlike osteoarthritis, which is related to wear and tear, rheumatoid arthritis is an autoimmune disorder, meaning the body attacks its own cells.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

More information

The American College of Rheumatology has more about gout.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Babies and toddlers are at higher risk for suffocation while they're sleeping. Parents can help keep their infants safe by following these guidelines from the U.S. Centers for Disease Control and Prevention:

  • Place an infant in a crib or bassinet with a firm mattress, without blankets, pillows or stuffed animals.
  • Do not hang objects, such as mobiles, above baby's crib.
  • Break up or cut foods into bite-sized pieces. Always watch your child carefully while he or she is eating.
  • Make sure your child carefully chews food. Don't encourage laughing or talking during eating.
  • Don't allow your child to run or play while eating.
  • Make sure all toys are age-appropriate and do not pose a choking hazard.
  • Take a CPR class, and learn basic first aid.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Varicose veins are painful, swollen veins that usually affect the legs. While you may not be able to keep them from forming, you can take steps to prevent them from worsening.

The U.S. National Heart, Lung, and Blood Institute mentions these prevention tips:

  • Do not stand or sit for long periods without interruption.
  • Don't cross your legs while seated.
  • Elevate your legs when sitting or lying down, keeping them raised above your heart.
  • Get plenty of regular physical activity, strengthening the muscles in your legs.
  • Lose any extra weight to help improve blood flow.
  • Do not wear tight clothes, especially those that are constricting around the waist, groin or thighs.
  • If your doctor says it's a good idea, wear compression hose to help keep blood from pooling.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Newer, costlier treatment for rheumatoid arthritis appears no better than an older, less-expensive regimen for people who don't respond to the first-line drug methotrexate, a new study suggests.

"Newer isn't always better," said researcher Dr. Ted Mikuls, an associate professor in the rheumatology division at the University of Nebraska Medical Center, in Omaha. "Some of the older medications can be effective."

Rheumatoid arthritis causes inflammation in the joints, resulting in swelling, stiffness, pain and reduced joint function. It can also affect other parts of the body.

"We compared two different ways of treating rheumatoid arthritis -- one that included a new biologic [medication] with an older, more conventional oral medication," Mikuls explained. "We basically showed that at the end of the day patients, regardless of what they got, looked very similar in terms of pretty much every outcome we looked at in the study."

Patients whose arthritis didn't respond to methotrexate alone who were then given a combination of methotrexate, sulfasalazine (Azulfidine) and hydroxychloroquine (Plaquenil) did as well as patients given methotrexate and the new biologic drug etanercept (Enbrel) -- which is given by injection -- the researchers said.

"The treatments are very different in terms of costs," Mikuls said. If a patient had to pay out of pocket for etanercept it could cost around $20,000 a year, while the out-of-pocket costs for the other drugs is a few hundred to a few thousand dollars, he said.

The out-of-pocket cost of etanercept varies by insurance provider, including those covering the Medicare drug benefit program, Mikuls added.

The report was published online June 11 in the New England Journal of Medicine to coincide with presentation of the study at the Annual European Congress of Rheumatology meeting in Madrid, Spain.

"This study addresses a real-life scenario for rheumatologists where patients are often on methotrexate and are not doing well and the question is what to do next," said Dr. Soumya Reddy, an assistant professor in the rheumatology division of the dermatology department at NYU Langone Medical Center, in New York City.

About 20 percent to 40 percent of patients don't respond methotrexate or can't take the drug either because of side effects or it is not indicated for them, said Reddy, who was not involved in the study.

The findings are "reassuring," in that when a biologic is not an option, due to cost or other reasons, the older regimen is effective, she said.

Which regimen is best really needs to be tailored to each patient, Reddy said.

For the study, researchers randomly assigned 353 patients to methotrexate, sulfasalazine and hydroxychloroquine or to methotrexate and etanercept for 48 weeks. Some patients switched from one regimen to another midway through the study.

The researchers found that both groups improved significantly, with no difference between the two treatments.

In addition, improvements in both groups were similar with regard to pain, quality of life, progression of their arthritis as seen on X-rays or side effects of the drugs.

For her part, Dr. Diane Horowitz, a rheumatologist at North Shore University Hospital, in Manhasset, N.Y., said the trial wasn't long enough to really tell if treatment with etanercept is equal to the three-drug regimen.

"In other studies, people on biologics did better over the long term," said Horowitz, who is also with the LIJ Medical Center, in New Hyde Park, N.Y. "I want to see more long-term data."

For patients who don't do well on methotrexate alone "there is some significant evidence that doing methotrexate plus sulfasalazine plus hydroxychloroquine [gives] a good response, and you don't always have to jump to a biologic right away," she said.

More information

To learn more about rheumatoid arthritis, visit the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- While the number of women dying from breast cancer is decreasing, mammography screening can't take the credit, according to a new study from England that looked at 40 years of data.

"We find no effect of mammographic screening on population-based breast cancer mortality rates," said study author Toqir Mukhtar, a researcher at the University of Oxford.

"While this does not rule out an effect at the individual level of women," she said, "the key point is that these effects are not large enough to be detected at the population level."

In their study, published June 11 in the Journal of the Royal Society of Medicine, the researchers found the greatest reduction in breast cancer deaths over the nearly 40 years studied was in women under 40, an age group not routinely offered screening.

Improvements in treatments and other factors may explain the decline, she said. Or, the benefits of screening may take a longer period of time to show up, she added.

However, Robert Smith, senior director of cancer screening at the American Cancer Society, disagreed that mammography doesn't deserve the credit, and cited flaws in the new study.

Mukhtar's team analyzed death rate trends from breast cancer before and after the introduction of the United Kingdom's National Health Service Breast Screening Programme in 1988.

The researchers evaluated death statistics in the Oxford region. In that area, unlike the rest of the country, all causes of death are listed on the death certificate, not just the underlying cause. The investigators also compared that with death statistics for the whole of England.

The analysis in Oxford spanned the years 1979 to 2009. The analysis of national breast cancer death rates looked at the years 1971 to 2009.

Death rates began to decline before the 1988 introduction of screening, the findings indicated.

The researchers found no evidence that decreases in death rates were greater in women screened once, several times or not at all.

The new findings run counter to the results of other studies. For instance, the Marmot Report, commissioned by the English Department of Health and published in 2012, found a 20 percent relative reduction in breast cancer deaths in women offered screening.

Meanwhile, Smith and his colleagues reported in 2010 in the Journal of Medical Screening that screening was linked with a substantial reduction in breast cancer deaths in studies of Swedish and English women. That benefit in terms of lives saved is greater than the harm of overdiagnosis, with two or more lives saved for every overdiagnosis.

"We have more studies showing a benefit than those who don't," Smith said.

He also took issue with a statistical method used in the new study, in which researchers looked at breaks in patterns. "The researchers analyzed intervals that includes years before screening was offered and after," he said. Ideally, they should have compared death rates before screening launched and after, he said.

Another point: "Some of the women who died from breast cancer after the screening program started had been diagnosed before mammography was even available," Smith said, further complicating the analysis.

"We know mammography screening contributes to significant mortality reduction [from breast cancer] in the U.S.," he said.

While individual U.S. organizations differ in specific mammography guidelines, including whether to start at age 40 or later and which intervals are best, they do agree on one point, Smith said: "Regular screening is a good thing to reduce your risk of dying from breast cancer and your need for a mastectomy."

More information

To learn more about early detection of breast cancer, visit the American Cancer Society.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Clever food labeling can fool well-intentioned consumers into believing that foods labeled sugar-free, fat-free or whole-wheat are healthy choices, a dietitian says.

"Consumer food marketing can be extremely persuasive, and the right buzzword on a package can lure a shopper into making an unwise purchase," Kari Kooi, a registered dietitian at the Methodist Hospital in Houston, said in a hospital news release. "We need to educate consumers on how to read nutrition labels so they can avoid falling prey to the 'health halo' effect."

Studies have shown that this "health halo" effect leads some people to eat twice as much or more of these foods because they are marketed as healthy, she says.

Five foods Kooi recommends avoiding are:

  • Vegetable chips. These are marketed as healthy substitutes for vegetables but the nutrition labels on most brands read the same as potato chips. Many of the vegetables' nutrients are lost in the processing of these chips. Choose real vegetables instead.
  • Nutrient-enhanced waters. Most are nothing more than colored sugar water that contain empty calories that contribute to weight gain. Claims that some of these products are a healthy choice because of added vitamins are just marketing hype, Kooi said. Taking a daily multivitamin with a glass of water is a better option, she said.
  • Muffins. If they're sprinkled with a few oats or packed with blueberries, consumers think they're a healthier choice than donuts. But muffins are really nothing more than cupcakes without icing, said Kooi. She also noted that mega-size muffins sold in coffee shops can contain 500 to 600 calories.
  • Premade smoothies. Most commercial ready-made smoothies are loaded with sugar and calories. You're better off making your own smoothies with high-quality, nourishing ingredients such as low-fat Greek yogurt, skim milk and fresh or frozen fruits, Kooi says.
  • Frozen yogurt. Although made with low-fat or fat-free dairy ingredients, frozen yogurt typically contains high amounts of added sugar. Many of the live and active cultures added to frozen yogurt cannot survive freezing, so you won't get any probiotic benefits, Kooi said. Probiotics help maintain the balance between good and bacteria in the digestive tract.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- People with chronic obstructive pulmonary disease (COPD) who have signs of chronic inflammation in their blood are more likely to have flare-ups of the lung disease than those who do not, a large new study shows.

In addition to the slow, steady deterioration in lung function caused by COPD, patients can have sudden, distressing flare-ups. These so-called "exacerbations" are periods of worsening breathing problems that are typically triggered by infections or air pollution.

Patients who experience frequent flare-ups decline more quickly than those who do not; they also tend to have worse quality of life and poorer survival rates than those whose conditions are more stable, according to background information in the study.

Preventing flare-ups is a major goal of COPD treatment, but these episodes can be difficult to predict.

In a study of more than 61,000 people in Denmark, researchers found that COPD patients who had increased levels of certain proteins and cells in their blood were at greater risk for frequent flare-ups.

These particular proteins and cells -- C-reactive protein, fibrinogen and leukocytes -- increase in response to infections, tissue damage and inflammation.

People with higher levels of all three of these "markers" were more likely to experience frequent flare-ups than those with normal levels. That was true regardless of the stage or severity of their COPD.

But the risk was especially pronounced for patients in the study with the worst breathing problems. Among patients who had the highest grade of COPD symptoms, 24 percent with no elevated markers had frequent flare-ups compared to 62 percent of those who had high levels of all three markers.

Patients with frequent exacerbations had two or more flare-ups each year they were followed for the study.

The study is published in the June 12 issue of the Journal of the American Medical Association.

According to Dr. Elizabeth Regan, who is studying the genetics of COPD at National Jewish Health in Denver, the researchers "give compelling evidence that those are useful tests." Regan was not involved with the study.

"These are tests that are readily available. The practicing physician kind of has them at their fingertips. They're not unusual, they're not high-risk," said Regan. "If I were seeing patients, I'd be strongly attracted to doing it."

The price of each test varies, but in general, they're inexpensive, ranging between $10 and $40. Insurance often covers the cost. The only trouble with doing the tests now, Regan said, is that doctors still don't know exactly how to use the information.

"While these tests look like they're strong predictors, we don't have the next piece of this clearly in place," she noted.

The study wasn't able to prove that inflammation causes COPD exacerbations, or that lowering inflammation with medications could head off future flare-ups, Regan explained.

Other studies currently underway are testing whether antibiotics or newer medications can prevent such attacks, she noted.

Until more is known, the researchers say there is still one good reason for COPD patients to get the blood tests.

"Many patients with COPD aren't very adherent to their inhalation medication. Patients don't like to be sick, so they think 'it's doing well now, so let me stop,'" said study author Dr. Borge Nordestgaard, a clinical professor in the department of diagnostic sciences at the University of Copenhagen in Denmark.

"But if you're one of these patients with high biomarkers, then you should be even better at taking your daily inhalation medication," he said. "That's the best advice at present."

More information

For more on COPD, head to the U.S. National Heart, Lung, and Blood Institute.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Overweight or obese women who are pregnant are more likely to give birth prematurely, and the risk of preterm delivery increases with their amount of excess weight, according to a study of more than 1.5 million deliveries in Sweden.

Researchers speculate that the health problems associated with overweight and obesity -- high blood pressure, insulin resistance, high cholesterol, increased chance of infection -- have a direct impact on a woman's ability to carry their child to term, according to the study, which was published in the June 12 issue of the Journal of the American Medical Association.

Birth of an infant prior to 37 weeks of gestation is the leading cause of infant mortality, neonatal illness and long-term disability in children, said researchers led by Dr. Sven Cnattingius of the Karolinska Institute in Stockholm.

A U.S. expert not involved with the study said he wasn't surprised by the findings.

"This just reinforces the fact that the complications of obesity and additional weight gain are deleterious to both mother and fetus," said Dr. Raul Artal, a professor and chairman of the department of obstetrics, gynecology and women's health at the Saint Louis University School of Medicine.

Artal said this study, along with previous research, makes the case that overweight and obese women who are pregnant can protect the health of their unborn child by maintaining their current weight or even shedding some pounds.

"The concept that we propagated for years that pregnancy is not a good time for weight loss and physical activity is wrong," he said.

For the study, researchers analyzed the records of 1.59 million births between 1992 and 2010, reviewing the body-mass index (BMI) of the women at their first prenatal doctor's visit as well as information recorded following birth about health risks, maternal diseases and pregnancy complications.

BMI is a measure of body fat based on height and weight.

The statistics came from the Swedish Medical Birth Register, which maintains detailed data on all births in that nation and serves as a valuable resource for researchers, a U.S. expert said.

"There's a lot of good obstetric data that comes out of Sweden because of that register," said Dr. Russ Fothergill, vice chairman of the department of obstetrics and gynecology at Scott and White Healthcare in Temple, Texas.

The researchers found that the risk of extremely premature (22 to 27 weeks), very premature (28 to 31 weeks) and moderately premature (32 to 36 weeks) deliveries increased with a woman's BMI.

The authors said that even though the study is Swedish, the results can be generalized to other populations with similar or higher rates of maternal obesity or preterm delivery.

For example, the United States has preterm delivery rates twice as high as Sweden's. In the United States, slightly more than half of women are either overweight or obese in early pregnancy, and severe obesity is much more common than in Sweden. Extremely preterm births accounted for 25 percent of all U.S. infant deaths among single births, and extremely preterm birth is also the leading cause of long-term disability, according to study background information.

The study's results seem to suggest an interplay between health risks linked to overweight and obesity, said Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology, and head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

Earlier studies have found that women who suffer a spontaneous preterm delivery have increased levels of inflammatory proteins called cytokines, which are associated with neonatal health problems such as weakening of the membranes and preterm contractions.

Both obesity itself and the health problems that come with obesity increase the amount of inflammation in a woman's body, Rabin said. Obesity and the inflammation that accompanies it also make it more likely that a woman could suffer an intrauterine bacterial infection.

"Obese women have increased risk of urinary tract infections and vaginal infections," Rabin said. "These increase the risk of preterm delivery."

The study noted that a bacterial infection is considered the most important risk factor for spontaneous extremely preterm delivery.

The American Congress of Obstetricians and Gynecologists has issued a recommendation that it is OK for women who are overweight or obese to not gain weight during pregnancy, or even to lose weight, said Artal, of Saint Louis University.

"I consider pregnancy to be an ideal time for behavioral modification," Artal said. He noted that pregnant women have an improved chance to adopt healthy habits because they have better access to medical care than at any other time in their life, are more prone to comply with recommendations because they have the added responsibility of their unborn child, and are under close medical supervision.

Although the study found an association between maternal obesity and premature birth, it did not establish a cause-and-effect relationship.

For his part, Fothergill said the study cries out for follow-up research that will better elaborate upon the link between obesity and premature birth.

"There needs to some additional research that explains why these women are delivering early," he said. "What is it about obesity that's making these women go into labor early?"

More information

The March of Dimes has more about overweight and obesity during pregnancy.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Straining to catch the gist of conversations is frustrating enough, but a new study shows that seniors with hearing loss are also at increased risk for hospitalization, illness, injury and depression.

Researchers analyzed data from more than 1,100 American men and women aged 70 and older with hearing loss, and found that over a four-year period they were 32 percent more likely to have been admitted to the hospital than more than 500 adults with normal hearing.

Hearing-impaired seniors were also 36 percent more likely to have prolonged stretches (more than 10 days) of illness or injury and 57 percent more likely to have extended episodes (more than 10 days) of stress, depression or bad mood, according to the study, published online June 11 in the Journal of the American Medical Association.

"Hearing loss may have a profoundly detrimental effect on older people's physical and mental well-being, and even health care resources," said study senior investigator Dr. Frank Lin, an otologist and assistant professor at the Johns Hopkins University School of Medicine and Hopkins' Bloomberg School of Public Health.

"Our results underscore why hearing loss should not be considered an inconsequential part of aging, but an important issue for public health," Lin said in a Hopkins news release.

Hearing deficits can lead to social isolation, which in turn contribute to physical and mental declines, Lin said.

Hearing loss affects as many as 27 million Americans over age 50, including two-thirds of men and women aged 70 years and older, according to Lin.

The study doesn't prove that being hard of hearing directly leads to other health problems, but it does show an association between the two. And health policymakers need to consider the broader health impact of hearing loss when making decisions for older people, study lead investigator Dr. Dane Genther, a resident in otolaryngology/head and neck surgery, said in the news release.

Genther's recommendations: expanded Medicare and Medicaid reimbursement for hearing-related health care services, wider installation of hearing loops in various facilities, and more accessible and affordable approaches for treating hearing loss.

More information

The U.S. National Institute on Aging has more about hearing loss.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Nearly all adult survivors of childhood cancer have at least one chronic health problem, according to a new study.

Many of these health conditions are believed to be linked to treatments used to combat the survivors' childhood cancer, such as radiation therapy and chemotherapy.

Researchers examined data from more than 1,700 adults who were diagnosed with childhood cancer between 1962 and 2001 and underwent health assessments between 2007 and 2012. The analysis revealed that 98 percent of the patients had a chronic health condition.

About 95 percent of the patients had a chronic health problem by age 45, or 35 years after cancer diagnosis. More than three-quarters had a serious, disabling or life-threatening condition at age 45.

The most common problems involved the lungs (65 percent), hearing (62 percent), endocrine or reproductive systems (62 percent), heart (56 percent) or declining mental ability (48 percent).

Liver, skeletal, kidney and blood problems were less common, according to the study, which was published in the June 12 issue of the Journal of the American Medical Association.

"The percentage of survivors with one or more chronic health conditions prevalent in a young-adult population was extraordinarily high," Dr. Melissa Hudson, of St. Jude Children's Research Hospital and the University of Tennessee College of Medicine in Memphis, said in a hospital news release.

The researchers said their findings highlight the need to monitor childhood cancer survivors for conditions that can cause significant illness if not detected and treated early -- such as second cancers and heart disease -- as well as conditions that can be treated to improve quality of life, such as hearing and vision problems.

More information

The U.S. National Cancer Institute has more about the late effects of childhood cancer treatment.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Sleep apnea raises the risk of sudden cardiac death, according to a long-term study that strengthens a link doctors have suspected.

"The presence and severity of sleep apnea are associated with a significantly increased risk of sudden cardiac death," said study leader Dr. Apoor Gami, a cardiac electrophysiologist at Midwest Heart Specialists-Advocate Medical Group in Elmhurst, Ill.

The new research is published online June 11 in the Journal of the American College of Cardiology.

Sleep apnea -- in which a person stops breathing frequently during sleep -- affects about 12 million American adults, although many are not diagnosed. The diagnosis is made after sleep tests determine that a person stops breathing for 10 seconds or more at least five times hourly while sleeping.

Some research suggests that sleep apnea is on the rise, in part because of the current obesity epidemic.

Sudden cardiac death kills 450,000 people a year in the United States, according to study background information. It occurs when the heart unexpectedly and suddenly stops beating due to problems with the heart's electrical system. Those problems cause irregular heartbeats. The condition must be treated within minutes if the person is to survive.

Electrophysiologists are cardiologists who treat these heart rhythm problems.

In earlier research, Gami and his team had found that patients with sleep apnea who suffered sudden cardiac death often did so at night, a completely opposite pattern than found in others without sleep apnea who had sudden cardiac death.

"That was the first direct link [found] between sudden cardiac death and sleep apnea," Gami said.

In the new study, the researchers tracked more than 10,000 men and women, average age 53, who were referred for sleep studies at the Mayo Clinic Sleep Disorders Center, mostly due to suspected sleep apnea, from 1987 through 2003. After sleep tests, 78 percent were found to have sleep apnea.

During the follow-up of up to 15 years, they found that 142 had sudden cardiac arrest, either fatal or resuscitated.

Three measures strongly predicted the risk of sudden cardiac death, Gami said. These include being 60 or older, having 20 apnea episodes an hour or having low blood levels of oxygen.

This "oxygen saturation" drops when air doesn't flow into the lungs. "If the lowest oxygen saturation was 78 percent, or less, their risk of [sudden cardiac death] increased by 80 percent," Gami said. In a healthy person, 95 percent to 100 percent is normal.

Having 20 events an hour would be termed moderate sleep apnea, Gami said.

Gami found a link, not a cause-and-effect relationship, between sleep apnea and sudden cardiac death. He can't explain the connection with certainty, but said there are several possible explanations. For example, sleep apnea is related to the type of heart rhythm problem that causes sudden cardiac death, he said.

The study findings should be taken seriously by those who have sleep apnea or suspect they do, said Dr. Neil Sanghvi, an electrophysiologist at Lenox Hill Hospital, in New York City, who reviewed the findings.

People with sleep apnea are often but not always obese, and many have other heart risk factors such as heart failure or heart disease. Having these other risk factors already puts a person at risk of sudden cardiac death, Sanghvi said. "The sleep apnea may be the tipping point. Each of these factors adds a level of risk. When you add sleep apnea, you could have a worse outcome."

Anyone who suspects they have sleep apnea should ask their doctor about a sleep test, Sanghvi said. Daytime sleepiness and fatigue are frequent symptoms. Another tipoff is a bed partner who complains of snoring.

The study didn't address whether those who used sleep apnea treatments -- such as the CPAP machine (continuous positive airway pressure) prescribed during sleep to help breathing -- would reduce risk. "It would be fair to say we suspect it would," Gami said.

The U.S. National Institutes of Health funded the study. Gami has served as a consultant for Medtronic, Boston Scientific and St. Jude Medical, which make defibrillators and other heart devices. Other study authors have also worked for heart device manufacturers and CPAP makers.

More information

To learn more about sleep apnea, visit the National Sleep Foundation.

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- All those "status updates" and "tweets" that people post as they clamor to be part of the online social network may reflect a troubling trend toward self-absorbed behavior in the United States, a new study suggests.

The University of Michigan researchers examined whether narcissism was related to the number of daily Facebook and Twitter postings by 486 college students and 93 adults, and to the amount of time they spent on each site.

The college students' average age was 19, and three-quarters were women. The average age of the adults was 35, and most of them were white women.

"Among young adult college students, we found that those who scored higher in certain types of narcissism posted more often on Twitter," study author Elliot Panek, who recently completed his doctorate in communication studies, said in a university news release. "But among middle-aged adults from the general population, narcissists posted more frequent status updates on Facebook."

Facebook functions as a mirror for narcissistic adults, Panek explained.

"It's about curating your own image, how you are seen, and also checking on how others respond to this image," he explained. "Middle-aged adults usually have already formed their social selves, and they use social media to gain approval from those who are already in their social circles."

Twitter is the social media tool of choice for narcissistic college students.

"Young people may overevaluate the importance of their own opinions," Panek said. "Through Twitter, they're trying to broaden their social circles and broadcast their views about a wide range of topics and issues."

The findings, published online June 11 in the journal Computers in Human Behavior, suggest that narcissistic college students and adults use social media in different ways to inflate their egos and control other people's perceptions of them, according to Panek.

He and his colleagues weren't able to determine whether narcissism leads to increased use of social media, whether social media use leads to narcissism, or whether other factors explain the association.

More information

The American Psychological Association has more about narcissism.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- New research seems to support the theory that Otzi the Iceman was attacked and suffered some form of brain damage in the final moments of his life.

A team from the European Academy of Bolzano/Bozen (EURAC) extracted and analyzed tiny samples of brain tissue taken from Otzi. He died more than 5,000 years ago, and his frozen, mummified body was discovered in the Italian Alps in 1991.

Otzi had an arrow wound in his back and previous examination revealed two bruising-related dark spots at the back of his brain. This suggested that Otzi had received a blow to the forehead, which caused his brain to knock against the back of his skull.

In this new study, researchers found that the brain tissue samples contained clotted blood cells. Although this supports the theory that Otzi's brain possibly suffered bruising before his death, it remains unclear whether this was due to a blow to the forehead or from falling after being injured by an arrow.

The scientists also identified numerous brain proteins, blood cell proteins and well-preserved brain cell structures in the brain tissue samples, according to the study, which was published June 6 in the journal Cellular and Molecular Life Sciences.

For their study, the team used new methods of protein analysis that open up new possibilities for learning more about mummified bodies.

"Investigating mummified tissue can be very frustrating," study author Frank Maixner said in a EURAC news release. "The samples are often damaged or contaminated and do not necessarily yield results, even after several attempts and using a variety of investigative methods."

"When you think that we have succeeded in identifying actual tissue changes in a human who lived over 5,000 years ago, you can begin to understand how pleased we are as scientists that we persisted with our research after many unsuccessful attempts," said Maixner, a microbiologist. "It has definitely proved worthwhile."

More information

The South Tyrol Museum of Archeology has more about Otzi.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- The number of people sickened in a hepatitis A outbreak that may be tied to a frozen berry/pomegranate mix now stands at 87, U.S. health officials said Tuesday.

As of June 10, cases had been reported in eight states: Arizona, California, Colorado, Hawaii, Nevada, New Mexico, Utah and Washington. The number of cases is expected to rise as the investigation continues, according to the U.S. Centers for Disease Control and Prevention.

The CDC said the hepatitis A cases may be connected to Townsend Farms Organic Antioxidant Blend frozen berry and pomegranate mix.

The agency said 36 people who were sickened have been hospitalized, and no deaths have been reported. Forty-six of 68 ill people interviewed (70 percent) reported eating Townsend Farms Organic Antioxidant Blend frozen berry and pomegranate mix.

On June 4, Oregon-based Townsend Farms recalled the frozen berry mixes, which were sold to Costco and Harris Teeter stores. The mixes were sold under the Townsend Farms label at Costco and under the Harris Teeter brand at that chain of stores, the Associated Press reported.

All of those sickened said they'd purchased the product from Costco markets. No cases have been traced to product bought at Harris Teeter, the CDC said.

Costco has removed the product from its shelves and is notifying members who purchased the product since late February 2013, the CDC said.

Preliminary laboratory analyses of specimens from two states suggest the hepatitis A strain responsible for the outbreak is rare in North America but is common in Africa and the Middle East. The strain was pinpointed as the cause of a recent hepatitis A outbreak in Europe linked to frozen berries, and to a 2012 outbreak in British Columbia associated with a frozen berry blend with pomegranate seeds from Egypt. But, there's no evidence that these outbreaks are related, the CDC said.

The label on the Townsend Farms product says it contains products from the United States, Argentina, Chile and Turkey.

According to the World Health Organization, hepatitis A illnesses typically arise within 14 to 28 days of infection. Symptoms may include nausea, fever, lethargy, jaundice and loss of appetite. There's a vaccine against hepatitis A, and it may ease symptoms if given soon after exposure to the virus.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about hepatitis A.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- The next time you reach out to shake someone's hand, consider this finding: A recent study of hand-washing habits found only 5 percent of people who used the restroom scrubbed long enough to kill germs that can cause infections.

Thirty-three percent didn't use soap, and 10 percent didn't wash their hands at all, according to the study, based on Michigan State University researchers' observations of more than 3,700 people in a college town's public restrooms.

"These findings were surprising to us because past research suggested that proper hand washing is occurring at a much higher rate," lead investigator Carl Borchgrevink, an associate professor of hospitality business, said in a university news release.

Among the other findings:

  • Men were less likely than women to clean their hands. Fifteen percent of men and 7 percent of women didn't wash their hands at all. When they did wash their hands, only 50 percent of men used soap, compared with 78 percent of women.
  • People were less likely to wash their hands if the sink was dirty.
  • People were more likely to wash their hands earlier in the day. This may be because when people are out at night for a meal or drinks, they are relaxed and hand washing becomes less important, the researchers suggested.
  • People were more likely to wash their hands if they saw a sign encouraging them to do so.

Hand washing is the single most effective thing a person can do to reduce the spread of infectious diseases, according to the U.S. Centers for Disease Control and Prevention. Failure to sufficiently wash hands contributes to nearly 50 percent of all foodborne illness outbreaks, the agency says.

It takes 15 to 20 seconds of vigorous hand washing with soap and water to effectively kill germs, the CDC says, but people only wash their hands for an average of about 6 seconds, according to the study, published recently in the Journal of Environmental Health.

The findings have implications for consumers and restaurant and hotel owners, says Borchgrevink.

"Imagine you're a business owner and people come to your establishment and get foodborne illness through the fecal-oral route -- because people didn't wash their hands -- and then your reputation is on the line," he said. "You could lose your business."

More information

The U.S. Centers for Disease Control and Prevention has more about hand washing.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Breast-feeding is good for a baby's brain, a new study says.

Researchers used MRI scans to examine brain growth in 133 children ranging in age from 10 months to 4 years. By age 2, babies who were breast-fed exclusively for at least three months had greater levels of development in key parts of the brain than those who were fed formula only or a combination of formula and breast milk.

The extra growth was most evident in parts of the brain associated with things such as language, emotional function and thinking skills, according to the study published online May 28 in the journal NeuroImage.

"We're finding the difference [in white matter growth] is on the order of 20 to 30 percent, comparing the breast-fed and the non-breast-fed kids," study author Sean Deoni, an assistant professor of engineering at Brown University, said in a university news release. "I think it's astounding that you could have that much difference so early."

In addition to brain imaging, the researchers gave older children tests of thinking ability and found increased language and motor control performance, and increased visual perception in those who were breast-fed.

The researchers also found that babies who were breast-fed for more than a year had significantly more brain growth -- especially in areas of the brain that control motor skills -- than those who were breast-fed for less than a year.

This is not the first study to suggest that breast-feeding helps babies' brain development, but it is the first imaging study to examine breast-feeding-related differences in the brains of very young and healthy children, according to Deoni.

"We wanted to see how early these changes in brain development actually occur. We show that they're there almost right off the bat," he said.

The findings add to a substantial body of evidence that breast-feeding is good for children's brains.

"I think I would argue that combined with all the other evidence, it seems like breast-feeding is absolutely beneficial," Deoni said.

More information

The U.S. Office on Women's Health has more about breast-feeding.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- The U.S. government has dropped its effort to block a court order that would make the morning-after contraceptive pill available over-the-counter to all women and girls.

After fighting for an age threshold on the nonprescription use of the Plan B One-Step pill for months, the U.S. Food and Drug Administration said in a statement late Monday that it would heed the ruling of Judge Edward Korman, of the United States District Court for the Eastern District of New York. The drug prevents conception if taken within 72 hours of having sexual intercourse.

The Obama administration appears to have concluded that it could lose its case, and would have to weigh whether to request that the Supreme Court hear any appeal, the New York Times reported.

Women's reproductive rights groups, which had sued the government to clear the way for broader distribution of the drug were happy with the decision, the Times reported, but they still wanted to see the details of how the change would be implemented.

"We will not rest in this fight until the morning-after pill is made available without delay and obstruction," said Mara Verheyden-Hilliard, executive director of the Partnership for Civil Justice Fund, which represented the plaintiffs in the case, the newspaper reported.

"This is a huge breakthrough for access to birth control and a historic moment for women's health and equity," Planned Parenthood President Cecile Richards said in a news release. "The FDA's decision will make emergency contraception available on store shelves, just like condoms, and women of all ages will be able to get it quickly in order to prevent unintended pregnancy."

However, the decision is certain to anger abortion rights opponents, who oppose allowing young girls access to the drug without the consent or involvement of a parent or a doctor.

Korman first issued his order April 5, igniting a battle over whether young girls could gain access to emergency contraception without a prescription. Soon after, on April 30, the U.S. Food and Drug Administration lowered to 15 the age at which people could purchase the Plan B One-Step pill over-the-counter -- two years younger than the prior age limit of 17.

A day later, on May 1, the Obama Administration stepped in to appeal the Korman decision.

At the time of the FDA's move to lower the age limit, agency commissioner Dr. Margaret Hamburg said in a news release that, "research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States."

"The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly and that it does not prevent the transmission of a sexually transmitted disease," Hamburg said.

Plan B prevents implantation of a fertilized egg in a woman's uterus through the use of levonorgestrel, a synthetic form of the hormone progesterone used for decades in birth control pills. Plan B contains 1.5 milligrams of levonorgestrel, more than the pill contains. It is considered a form of birth control, not abortion.

Other brands of emergency contraception include Next Choice and Ella.

Planned Parenthood has long pushed for wider access to emergency contraception, with Richards calling it "an important step forward."

But conservative groups have objected to the move. In April, Janice Shaw Crouse, director of the Beverly LaHaye Institute, the think tank for the conservative women's group Concerned Women for America, called Korman's ruling "a political decision, made by those who stand to profit financially from an action that puts ideology ahead of the nation's girls and young women."

More information

There's more on emergency contraception at the World Health Organization.

-- E.J. Mundell

Health News Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, June 11 (HealthDay News) -- Sophisticated scans reveal that soccer players who head the ball a lot show changes in the white matter of their brain that mirror those seen in traumatic head injuries.

In addition, they face a higher risk of developing thinking and memory problems, the researchers report.

"We looked at the relationship between heading and changes in the brain and changes in cognitive functions [thinking and memory], and we found that the more heading people do, the more likely we are to find microscopic structural abnormalities in the brain, and they're more likely to do poorly on cognitive tests, particularly in terms of memory," said study author Dr. Michael Lipton, associate director of the Gruss Magnetic Resonance Research Center at Albert Einstein College of Medicine and medical director of magnetic resonance imaging at Montefiore Medical Center, both in New York City.

However, Lipton noted, "We cannot say heading caused these changes. We found an association, but in no way can we infer causation. You need a longitudinal study that follows people over time to prove causation."

Results of the study were released online June 11 in the journal Radiology.

Soccer is the world's most popular sport. More than 265 million people play the game worldwide, and heading is a common move in soccer. Heading a soccer ball means using your head instead of your feet to play the ball. In competitive games, players head the ball between an average of six and 12 times, according to background information in the study. In this elite level of play, the ball can travel at velocities of 50 miles per hour or more, according to the study.

This isn't the first study to link heading and changes in the white matter in the brain. In an issue of the Journal of the American Medical Association late last year, Harvard researchers compared soccer players to swimmers, and found changes in the white matter in soccer players.

White matter is the communication network in the brain; it sends messages between neurons (gray matter).

For the current study, Lipton and his colleagues recruited 37 adult amateur soccer players. Their ages ranged from 21 to 44 years old, and the average age was nearly 31. Twenty-eight of the volunteers were men. They played at least one competitive game of soccer each week, and practiced an average of two times a week, according to Lipton. Most had been playing since they were kids.

All underwent a special imaging technique called diffusion tensor magnetic resonance imaging that produces detailed images that show microscopic changes in the white matter of the brain.

The players also filled out a questionnaire about such factors as frequency of heading and prior concussions, and completed a number of tests to measure their thinking and memory skills.

The researchers found that there appears to be a threshold for harm from heading. Below that threshold, there wasn't as much risk, but there was significantly more risk of brain changes above it. In this study, the threshold was between 885 and 1,550 headers a year for brain changes, and higher than 1,800 headings a year for changes in memory scores.

Lipton said these findings were independent of past concussions.

"People can take some degree of trauma. Not everyone who bumps their head on a cabinet will have concussion symptoms. The question is how much does it take to have a lasting injury? And, that remains an open question, especially in children," said Lipton.

Because kids' brains are developing, they might be more susceptible to injuries, noted Lipton. But, on the other hand, he pointed out, children's brains are also quite adaptable and can recover more easily from conditions such as stroke than adult brains can.

One expert noted that the study showed that even minor insults to the brain can have lasting effects.

"This study shows that even if you don't have a concussion or a noticeable injury, if you look close enough at the brain, you can see changes. The evidence from these adults seems reasonably compelling that these minor heading events accumulate over time," said Dr. Michael Bell, director of pediatric neurocritical care at Children's Hospital of Pittsburgh.

For parents who may be wondering if they should keep their kids from heading soccer balls, Lipton said the evidence isn't clear-cut enough yet to make a firm recommendation one way or the other.

"Parents have to weigh the evidence and make their own decisions. Our study provides very preliminary evidence that lines up with many of the concerns that parents have, but that needs to be balanced against the fact that this isn't yet a closed book," Lipton said.

Bell agreed, and added a counterpoint.

"The data is evolving, and any sort of mild traumatic brain injury may have consequences we don't understand yet," Bell said, adding that parents also have to remember that they don't want to discourage their children from being physically active, because a sedentary lifestyle has other health risks.

More information

Learn more about mild brain injuries from the Brain Injury Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 11, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Transplant Network Creates Appeal/Review System for Young Lung Patients

A special appeal and review system for children under age 12 on the U.S. lung transplant waiting list was announced Monday by the Organ Procurement and Transplantation Network, but the group decided not to make emergency rule changes for this group of patients.

The teleconference was triggered by the cases of two children -- a 10-year-old girl and an 11-year-old boy -- who have end-stage cystic fibrosis and are waiting for lung transplants, the Associated Press reported.

The children's families challenged a national policy that requires patients under 12 to wait for lungs from children or to be given lungs from adults only after the lungs have first been offered to all teens and adults on the waiting list. Last week, a federal judge ruled that the two children should be eligible for adult lungs.

While trying to acknowledge the concerns raised by the judge, the transplant network was also sending a message with its decision Monday, according to a transplant ethics expert.

"I think what they're trying to tell the judge is, 'We have a system. It's working. Let us decide, not you,'" Dr. Arthur Caplan, a bioethicist at New York University Langone Medical Center, told the AP.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Kids seem to climb everywhere, including on the furniture. To keep children safe, parents should make sure that furniture and TVs are securely anchored.

The Safekids.org website offers these suggestions:

  • Inspect every TV in your home for stability.
  • If you have a flat-screen, mount it to the wall (following manufacturer's instructions) instead of using a TV stand.
  • If you have an older-style TV, make sure it is on a sturdy, low piece of furniture.
  • Secure top-heavy furniture to the wall using wall straps, braces or brackets.
  • Fit your dresser drawers with drawer stops so they cannot be pulled all the way out; keep the heaviest items in the lowest drawers and shelves.
  • Don't place toys, food or remote controls on higher areas where children are tempted to climb to reach them.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Your daughter's prime bone-building years are between ages 9 and 18. And the U.S. Office of Women's Health says it's never too early to start teaching her healthy bone habits.

The agency's "Best Bones Forever!" website offers these tips for the parents of young girls:

  • Set a good example by getting plenty of regular exercise and eating healthy foods.
  • Teach your daughter about the importance of a healthy lifestyle and building healthy bones.
  • Suggest that she participate in bone-building activities such as martial arts classes, sports and dancing.
  • Build your daughter's confidence and encourage her to try new activities.

-- Diana Kohnle

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Hurricane season is here, and pregnant women need to take extra precautions to ensure their health and safety during a storm, an expert says.

Pregnant women who are close to their delivery date and those with high-risk pregnancies need to let their health care provider know where they will be during a hurricane. They should also ask their health care provider if it's safe for them to leave before a storm strikes, said Dr. Alfred Robichaux, chairman of obstetrics and gynecology at the Ochsner Medical Center in New Orleans.

Here are some other tips:

  • Plan an alternate birth location in case of evacuation or problems with road travel.
  • Have phone numbers and locations for local obstetricians and midwives in case you cannot reach your regular health care provider during evacuation.
  • Women in late pregnancy who are evacuating should bring a copy of their prenatal care record and immunizations, as well as their birth bag. They should also bring a two weeks' supply of any medications, including prenatal vitamins and prescriptions.
  • Pregnant women who go to an evacuation center should immediately notify officials and get information about the location of hospitals in the area.
  • Do everything you can to reduce stress, which is a major factor in preterm labor. By planning and preparing early, you can help reduce stress levels.
  • Create a family communication plan so everyone knows what needs to be done before and during evacuation.

Floodwaters after a storm may be polluted with infectious agents and toxic chemicals, which can harm both mother and baby. "If you are in a flood-prone area, it's probably a good idea to again fall back on your plan and evacuate so you avoid being put in that situation," Robichaux said in a medical center news release.

Robichaux also offered advice for new mothers, including creating a hurricane food kit for the entire family that can be used either at home or during a car ride to a safer location.

"Make sure mom has enough high-protein snacks and clean water to drink to prevent dehydration," Robichaux said.

He said breast milk is the sole source of recommended nutrition for babies less than 6 months old, and new mothers should pack a hand- or battery-operated pump and clean storage bottles or bags, and have a method of freezing or cold storage for pumped breast milk.

More information

The U.S. Centers for Disease Control and Prevention has more about hurricane readiness.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- A lack of research makes it impossible to recommend how primary care doctors can prevent abuse and neglect of children who show no signs or symptoms of maltreatment, according to a new U.S. Preventive Services Task Force statement.

"We know there are children suffering abuse who don't show obvious signs of mistreatment, and the task force wanted to learn more about what primary care practices can do to help them," task force member Dr. David Grossman said in a task force news release.

Child abuse and neglect affects more than half a million American children each year, according to the release. About 680,000 children in the United States were abused or neglected in 2011 and more than 1,500 of these children died. Children aged 5 and under are at the most risk for abuse and death from abuse.

The task force analyzed studies released since 2004 and concluded that although child abuse and neglect is a serious problem, there is very little evidence to determine how primary care doctors can protect young victims who show no obvious signs or symptoms of maltreatment.

Due to the lack of information, the task force said it cannot make a specific recommendation for or against primary care doctors taking action to help these children. The statement appears online June 11 in the journal Annals of Internal Medicine.

"We critically need more research on how primary care clinicians can prevent maltreatment and protect their young patients when symptoms of abuse or neglect are not apparent," Grossman said.

The task force said areas where more research is needed include: how health care providers can help support families to prevent abuse and neglect; how to identify children who are being mistreated; ways to prevent abuse of older children; and whether interventions to prevent child abuse could cause unintended harm.

"It will take action from every part of society, including families, schools and health care professionals, to build a future where every child can grow up healthy and safe from abuse and neglect," task force chair Dr. Virginia Moyer said in the news release. "While we learn more about what primary care professionals can do to help children, all health care professionals must continue to remain vigilant for signs of abuse and neglect, and respond appropriately when they identify problems."

More information

The U.S. Children's Bureau outlines ways to prevent child abuse and neglect.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Men with prostate cancer may boost their survival chances if they replace animal fats and carbohydrates in their diet with healthy fats such as olive oils, nuts and avocados, new research suggests.

Men who substituted 10 percent of their daily calories from animal fats and carbs with such healthy fats as olive oil, canola oil, nuts, seeds and avocados were 29 percent less likely to die from spreading prostate cancer and 26 percent less likely to die from any other disease when compared to men who did not make this healthy swap, the study found.

And a little bit seems to go a long way. Specifically, adding just one daily tablespoon of an oil-based salad dressing resulted in a 29 percent lower risk of dying from prostate cancer and a 13 percent lower risk of dying from any other cause, the study contended.

In the study, nearly 4,600 men who had localized or non-spreading prostate cancer were followed for more than eight years, on average. During the study, 1,064 men died. Of these, 31 percent died from heart disease, slightly more than 21 percent died as a result of prostate cancer and slightly less than 21 percent died as a result of another type of cancer.

The findings appeared online June 10 in JAMA Internal Medicine.

The study can't say for sure that including healthy fats in the diet was responsible for the survival edge seen among men. "The main take-home message is that consuming healthy fats and nuts may have a protective role," said study author Erin Richman, a postdoctoral scholar in the department of epidemiology and biostatistics at the University of California, San Francisco.

In 2013, there will be nearly 239,000 men diagnosed with prostate cancer and nearly 30,000 men will die from the disease, according to estimates from the U.S. National Cancer Institute.

"The next step is to plan a randomized controlled trial of these healthier fats and see whether and how they affect the prostate," Richman said. "The novel finding in this study seems to be a benefit on prostate cancer survival." She noted that there is already a large body of evidence suggesting that healthy fats help reduce heart disease risks.

An editorial by Dr. Stephen Freedland of Duke University Medical Center accompanied the new study.

"We can say for sure that being obese increases the risk of dying of prostate cancer," Freedland said. "The new study gives us some more clues. It suggests that cutting out saturated fats and carbohydrates and replacing them with healthy fats can also lower the risk of dying from prostate cancer."

Another expert praised the new study while noting that the findings aren't conclusive.

"This study is well-designed and offers some evidence that a diet higher in vegetable fat and lower in carbohydrates might reduce risk of premature death from prostate cancer in men with prostate cancer that has not spread to other parts of the body," said Eric Jacobs, an epidemiologist at the American Cancer Society. "While these results are exciting, there have been few other studies in this area and more are needed before conclusions can be made about the effect of vegetable fat or other dietary factors on prostate cancer progression."

Moreover, Jacobs said, "there is stronger evidence that smoking and obesity increase risk of prostate cancer recurrence and death from prostate cancer, giving prostate cancer survivors one more reason to avoid smoking and maintain a healthy weight."

More information

Learn more about prostate cancer and prevention at the U.S. National Cancer Institute.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Low blood sugar in older adults with type 2 diabetes may increase their risk of dementia, a new study suggests.

While it's important for diabetics to control blood sugar levels, that control "shouldn't be so aggressive that you get hypoglycemia," said study author Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.

The study of nearly 800 people, published online June 10 in JAMA Internal Medicine, found that people with episodes of significant hypoglycemia -- low blood sugar -- had twice the chance of developing dementia, Yaffe said. Conversely, "if you had dementia you were also at a greater risk of getting hypoglycemic, compared with people with diabetes who didn't have dementia," she said.

People with type 2 diabetes, by far the most common form of the disease, either don't make or don't properly use the hormone insulin. Without insulin, which the body needs to convert food into fuel, blood sugar rises to dangerously high levels. Over time, this leads to serious health problems, which is why diabetes treatment focuses on lowering blood sugar. But sometimes blood sugar drops to abnormally low levels, which is known as hypoglycemia.

Exactly why hypoglycemia may increase the risk for dementia isn't known, Yaffe said. Hypoglycemia may reduce the brain's supply of sugar to a point that causes some brain damage, Yaffe said. "That's the most likely explanation," she added.

Moreover, someone with diabetes who has thinking and memory problems is at particularly high risk of developing hypoglycemia, she said, possibly because they can't manage their medications well or perhaps because the brain isn't able to monitor sugar levels.

Whether preventing diabetes in the first place reduces the risk for dementia isn't clear, although it's a "very hot area" of research, Yaffe said.

But the findings do suggest that patients' mental status needs to be considered in the management of diabetes, Yaffe said.

Other experts agreed.

"This does raise concern about low blood sugar causing future problems with dementia and dementia causing problems with low blood sugar," said Dr. Stuart Weinerman, an endocrinologist at North Shore-LIJ in Great Neck, N.Y.

Weinerman isn't convinced that the association between hypoglycemia and dementia is cause-and-effect, however. "This is not a definitive study. It raises questions, but it doesn't answer them," he added.

But hypoglycemia is a serious problem for diabetics, Weinerman said. "Sooner or later, everyone is going to have some hypoglycemia," he said.

Episodes of hypoglycemia increase with age, perhaps because of changes in kidney function and drug metabolism, according to an accompanying journal commentary.

Anyone taking drugs that lower blood sugar should be aware of the signs of hypoglycemia, and be prepared to deal with it, Weinerman said. Symptoms can include confusion, jitteriness, fainting, heart palpitations and blurred vision.

For the study, Yaffe's team collected data on 783 diabetic patients who were aged 70 to 79 and free of dementia at the start of the study in 1997.

Over 12 years of follow-up on average, participants were periodically given tests of mental ability.

The researchers found people who were hospitalized for severe hypoglycemia had twice the risk of developing dementia compared with those who didn't have bouts of hypoglycemia.

And patients with dementia were also more than twice as likely to have severe hypoglycemia, they found.

Based on the findings, Dr. Marc Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y., said he thinks trying to control blood sugar too aggressively might be ill-advised.

"There has been a concern about the association between diabetes and dementia, Gordon said. "Patients need to be careful that they are not either undertreated or over treated and that they monitor their blood sugar," he said.

More information

For more on hypoglycemia, visit the American Diabetes Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- People suffering from cardiovascular disease who have lower-than-normal blood pressure may face a higher risk of brain atrophy -- the death of brain cells or connections between brain cells, Dutch researchers report.

Such brain atrophy can lead to Alzheimer's disease or dementia in these patients. In contrast, similar patients with high blood pressure can slow brain atrophy by lowering their blood pressure, the researchers added.

Blood pressure is measured using two readings. The top number, called systolic pressure, gauges the pressure of blood moving through arteries. The bottom number, called diastolic pressure, measures the pressure in the arteries between heartbeats. Normal blood pressure for adults is less than 120/80, according to the U.S. National Heart, Lung, and Blood Institute.

For the study, 70 to 90 was considered normal diastolic blood pressure, while under 70 was considered low.

"Our data might suggest that patients with cardiovascular disease represent a subgroup within the general population in whom low diastolic blood pressure might be harmful," said researcher Dr. Majon Muller, an epidemiologist and geriatrician at VU University Medical Center in Amsterdam.

On the other hand, lowering blood pressure in people with high blood pressure might slow brain atrophy, she said.

"Our findings could imply that blood pressure lowering is beneficial in patients with higher blood pressure levels, but one should be cautious with further blood pressure lowering in patients who already have low diastolic blood pressure," Muller added.

The report was published in the June 10 online edition of JAMA Neurology.

A U.S. expert noted the complex effects of blood pressure levels on the brain.

"High blood pressure has been shown to increase the risk of vascular brain lesions and brain atrophy. Trials of blood pressure lowering in patients with hypertension have shown reduced risk of brain lesions," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.

However, in patients with hypertension, the relationship between the levels of systolic and diastolic blood pressure and brain atrophy has been less clear, he said.

This new study suggests that low diastolic blood pressure levels were associated with brain atrophy regardless of blood pressure levels after patients developed dementia, Fonarow said.

"These findings suggest that while treatment and control of high blood pressure is very important for brain and cardiovascular health, caution is needed in patients who have low diastolic blood pressure levels," he said.

To see what changes blood pressure would make in the progression of brain atrophy, Muller's group studied 663 patients who suffered from heart disease, cardiovascular disease, peripheral artery disease or abdominal aortic aneurysm. The average age of participants was 57 and most were men.

People whose diastolic blood pressure was below 70 had more brain atrophy over time, the study found. For people with higher-than-normal blood pressure, brain atrophy decreased when their blood pressure did. When blood pressure rose, however, atrophy increased.

Another expert, Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City, said that the finding "is an important cautionary tale."

"This implies that one must adapt the approach to the individual patient. Correction of hypertension is helpful, but reducing blood pressure in patients with normal blood pressure is risky and complicated," Gandy said.

Although the study found an association between low diastolic blood pressure and the risk of developing brain atrophy for people with artery disease, it did not establish a cause-and-effect relationship.

More information

To learn more about blood pressure, visit the American Heart Association.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Elementary schools are less likely to sell unhealthy snack foods and drinks if school districts or states have rules that limit the sale of such products, a new study finds.

However, more than three-quarters of public elementary schools in the United States are located in a state or school district that does not limit the sale of items such as sugary drinks, salty snacks, candy or high-fat milk, according to the research published June 10 in the journal JAMA Pediatrics.

For the study, researchers examined the types of foods and drinks offered by schools nationwide between 2008-2009 and 2010-2011. Candy, ice cream, cookies and other sweets were sold by about 32 percent of schools in areas where both school district or state policies limited the sugar content of snack foods, compared with 43 percent of schools where there were no such policies.

Ice cream was sold by just over 10 percent of schools in areas where the state and school district limited the fat content of snack foods, compared with about 21 percent of schools where there was no such policy. Cookies, cakes and other high-fat baked goods were sold by nearly 12 percent of schools in areas with such a policy and by about 25 percent of schools in areas with no such policy, the investigators found.

In the case of sugary drinks, school district policies had more impact than state laws: Sugar-sweetened beverages were sold by close to 4 percent of schools when school districts banned them, compared with 13 percent of schools when there was no school district ban.

However, the sale of sugary beverages by schools was not affected by state bans -- especially in the South -- where sugary drinks were sold by one-quarter of schools in states that banned the sale of the drinks in schools.

The study was funded by the Robert Wood Johnson Foundation through its national research program, Bridging the Gap.

"We found that states and districts can influence the types of snacks and drinks sold at school," study lead author Jamie Chriqui, an investigator at Bridging the Gap, said in a foundation news release. "These policies can go a long way in helping kids have healthy choices during the school day, but more states and districts need to get strong policies on the books to have a meaningful impact nationally."

However, Chriqui and colleagues found that many states and school districts do not have specific nutritional rules for school snacks and drinks. Among U.S. elementary schools:

  • 78 percent were in a district and state that did not limit the sodium (salt) content of snacks or ban high-fat milk.
  • 77 percent were in a district and state that allowed the sale of candy.
  • 75 percent were in a district and state that did not prohibit the sale of sports drinks, sodas and sugar-sweetened fruit drinks.
  • 58 percent were in a district and state that did not limit the sugar content of snacks.

"Too many of our nation's schools are still selling junk foods and sugary drinks to young children," Chriqui said.

"But the good news is that this is the first generation of children to be enrolled in school at a time when educators and policymakers are focused on preventing childhood obesity -- that's why it's so critical to enact or change policies that make schools healthier places for students," she added in the news release.

More information

The American Academy of Pediatrics has more about childhood nutrition.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Reducing the number of unnecessary and high-dose CT scans given to children could cut their lifetime risk of associated cancers by as much as 62 percent, according to a new study.

CT (computed tomography), which uses X-rays to provide doctors with cross-sectional images of patients' bodies, is frequently used in young children who have suffered injuries.

Researchers concluded that the 4 million CT scans of the most commonly imaged organs conducted in children in the United States each year could lead to nearly 4,900 cancers in the future.

They also calculated that reducing the highest 25 percent of radiation doses could prevent nearly 2,100 (43 percent) of these future cancers, and that eliminating unnecessary CT scans could prevent about 3,000 (62 percent) of these future cancers.

The study was published online June 10 in the journal JAMA Pediatrics.

"There are potential harms from CT, meaning that there is a cancer risk -- albeit very small in individual children -- so it's important to reduce this risk in two ways," study lead author Diana Miglioretti, a professor of biostatistics in the department of public health sciences at the UC Davis Health System, in California, said in a health system news release.

"The first is to only do a CT when it's medically necessary, and use alternative imaging when possible," she said. "The second is to dose CT appropriately for children."

The researchers examined data on the use of CT in children at a number of health care systems in the United States between 1996 and 2010. Among children under 5 years old, CT use nearly doubled from 11 per 1,000 in 1996 to 20 per 1,000 between 2005 and 2007, and then decreased to about 16 per 1,000 in 2010.

Among children aged 5 to 14, CT use nearly tripled, from 10.5 per 1,000 in 1996 to a peak of 27 per 1,000 in 2005, before falling to about 24 per 1,000 in 2010.

Researchers examined 744 random CTs of the head, abdomen/pelvis, chest and spine conducted on children between 2001 and 2011 at five of the health systems to calculate radiation exposure levels and estimated cancer risk. These areas of the body account for more than 95 percent of all CT scans, the researchers said.

Head CT -- the most commonly performed CT in children -- poses the highest risk of radiation-induced leukemia and brain cancers, according to the study. Meanwhile, CTs of the abdomen and pelvis -- which had the most dramatic increase in use, especially among older children -- pose the highest risk of radiation-induced solid cancer. Leukemia and breast, thyroid and lung cancers account for 68 percent of estimated future cancers in girls who have had CTs, while leukemia and brain, lung and colon cancers account for 51 percent of future cancers in boys who have had CTs.

More information

The American College of Radiology/Radiological Society of North America has more about CT scans and children.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- As they attempt to open clogged heart arteries, more U.S. doctors are taking a new route and threading a catheter through the wrist, rather than the groin, a new study finds.

This is because entering the radial artery in the wrist is linked to fewer bleeding complications than the traditional route through the femoral artery in the groin, according to the study, published June 10 in the journal Circulation. The artery-opening procedure is called percutaneous coronary intervention (PCI) or coronary angioplasty.

"Traditionally, femoral access has been taught and used in the United States for PCI, whereas the radial approach is frequently used in Europe," study lead author Dr. Dmitriy Feldman, an assistant professor of medicine at Weill Cornell Medical College, New York Presbyterian Hospital department of medicine, said in a journal news release.

He and his colleagues studied data on nearly 3 million artery-opening procedures and found that bleeding complications occurred in about 3 percent of the radial artery procedures, compared with about 6 percent of the femoral artery procedures.

Wider use of the wrist-route procedure could improve safety of the artery-opening operations, the study authors said in the news release. Bleeding complications are an important concern in these procedures because patients are often taking blood thinners that make it harder to stop bleeding after the procedure.

The radial artery is smaller and located closer to the skin's surface than the femoral artery, which makes it easier to prevent or stop bleeding, the researchers explained.

The research team analyzed artery-opening procedures conducted at nearly 1,400 U.S. centers between 2007 and 2012. By the end of 2012, nearly one of every six procedures was performed through the wrist's radial artery. That's a 13-fold increase from 2004-2007, when less than one of every 50 PCIs was performed through the radial artery.

The greatest benefits of wrist artery PCI were seen in high-risk patients, such as those over age 75, women and patients with acute coronary syndromes, the investigators found. However, these patients are least likely to undergo the wrist-route procedure, the study authors said.

The researchers also found that the use of radial PCI is much higher at academic institutions and centers in New England than at other centers in the United States.

More information

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

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Offering flu shots at elementary schools could reduce the number of flu cases and deaths among children, a new study suggests.

Vaccination is the most effective way to protect children aged 6 months and older against seasonal flu, but vaccination rates among American children are low. Only about 40 percent of children received a 2012-2013 flu vaccine, according to the U.S. Centers for Disease Control and Prevention.

About 90 percent of children who died from flu during 2012-2013 were not vaccinated, the CDC noted.

The study, conducted in late 2009, included 32 elementary schools in the Rochester, N.Y., area. Two flu vaccination clinics were held four weeks apart at 21 of the schools, while no vaccination clinics were held at the 11 other schools.

The flu vaccination rate among students at the schools where vaccination clinics were held was 13 percent higher than among students at the schools that did not have vaccination clinics, the investigators reported in a recent issue of the journal Vaccine.

"The flu is a disease with high probability of reaching epidemic levels even though we have an effective vaccine. Our goal is to find ways to ensure that the best prevention is as accessible as possible," study author Byung-Kwang Yoo, an associate professor of public health sciences at the University of California, Davis, said in a university news release. Yoo was with the University of Rochester when the study was conducted.

Children's flu shots are typically given in primary care doctors' offices, but they "may not have the capacity to vaccinate all U.S. children against seasonal influenza," Yoo said. "If the CDC's recommendations were followed, primary-care offices would have to accommodate 42 million additional patient visits during the five-month window for each flu season."

That's why it's important to find ways to expand children's access to flu shots, he added.

More information

The U.S. Centers for Disease Control and Prevention has more about children, the flu and the flu vaccine.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Certain brain changes may help explain why many older adults become clumsier as time goes by, a new study says.

Age-related declines in vision, agility and other physical abilities can lead to an increase in problems such as knocking over a glass while reaching for the salt shaker or fumbling while trying to slide a key into a lock.

But some of the increased clumsiness may be due to changes in the mental frame of reference that older adults use to visualize nearby objects, say researchers at Washington University in St. Louis.

"Reference frames help determine what in our environment we will pay attention to and they can affect how we interact with objects, such as controls for a car or dishes on a table," study co-author Richard Abrams, a professor of psychology in arts and sciences, said in a university news release.

"Our study shows that in addition to physical and perceptual changes, difficulties in interaction may also be caused by changes in how older adults mentally represent the objects near them," he explained.

The study, recently published in the journal Psychological Science, included young and older adults who were given a series of simple tasks involving hand movement. The young adults used an "action-centered" reference frame when picking up an object. This means that they remained aware of and sensitive to potential obstacles along their hand's path of movement.

But older adults used a "body-centered" reference frame, which means they devoted more attention to objects that were closer to their bodies, whether or not they were along their hand's path of movement. As a result, they were less able to adjust their hand movements to avoid obstacles, the researchers said.

More information

The U.S. National Institute on Aging has more about health and aging.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- For many people, once-a-year dental cleaning may be enough to prevent gum disease that leads to tooth loss, according to a new study.

"Twice-yearly cleanings have been recommended for over 50 years without supporting evidence," study author William Giannobile, a professor of dentistry and biomedical engineering at the University of Michigan, said in a university news release.

But the results of this study "showed that one yearly cleaning is likely to be enough for patients with no risk factors," he said. "Patients with one or more risk factors, which represent over half of the population, should visit at least twice a year and likely more in some cases."

For the study, which was published online June 10 in the Journal of Dental Research, Giannobile and colleagues looked at data from more than 5,100 adults who visited the dentist regularly for 16 straight years, had no history of gum disease and received one or two cleanings each year.

The researchers examined the link between the frequency of teeth cleanings and long-term tooth loss in the participants, as well as three key gum disease risk factors: smoking, diabetes and genetics.

Two dental cleanings a year provided significant benefits to people with one or more of the three risk factors, while people with two or three of the risk factors may require more than two cleanings a year. But one cleaning per year appears sufficient for people with none of the risk factors, according to the study.

"The future of health care is personalized medicine," Giannobile said. "This study represents an important step toward making it a reality, and in a disease that is widespread, costly and preventable."

"We have long known that some individuals are at greater risk of [gum] disease, but tools haven't been available to adequately identify those at increased risk and prevent disease progression," he said.

More information

The U.S. National Institutes of Health has more about preventing gum disease.

-- Robert Preidt

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Kids who suffer a concussion may have a substantially slower recovery if they've sustained one or more blows to the head in the past, a new study finds.

Researchers report that among 280 kids and young adults who sustained a concussion over one year, those who'd suffered one in the past took twice as long to recover -- typically 24 days, versus 12 days for kids with no history of concussion.

What's more, the number of past concussions, and the timeframe of kids' head injuries, appeared key. Young people who'd sustained a concussion in the past year had a prolonged recovery from the current one -- typically 35 days.

Recovery was also slower for those who'd had two or more concussions in the past, at any time. It typically took 28 days for their symptoms to fully resolve.

Experts said the findings, reported online June 10 and in the July print issue of Pediatrics, have implications for managing kids' head injuries.

When they have had multiple concussions, or a relatively recent one, parents and doctors should probably be "extra cautious" about letting them back into sports, said lead researcher Dr. Matthew Eisenberg, of Boston Children's Hospital.

Sports are a major cause of young people's concussions -- and accounted for almost two-thirds of those in this study. In general, experts say those kids should not get back into the game until all of their symptoms have resolved, and a health professional gives them the OK.

So be even more patient when a youngster has a history of concussions, Eisenberg said. That means not only waiting until any symptoms go away to get active again, but gradually moving back into the normal routine.

"You do not want them to go from zero to 60," Eisenberg said.

That gradual return is important any time an athlete has had a concussion. But it's probably even more vital with repeat concussions, agreed Keith Yeates, chief of pediatric psychology and neuropsychology at Nationwide Children's Hospital in Columbus, Ohio.

"It's been part of the medical lore, this idea that multiple concussions are 'bad,' and having a repeat concussion within a short amount of time is bad," Yeates said. But this study, he added, helps confirm that.

One of the big remaining questions, though, is whether kids with repeat concussions suffer any long-term consequences, Yeates said.

"We don't know if there are any effects on long-term cognition or memory," study author Eisenberg agreed. There have been reports that professional athletes who suffer blows to the head may be at heightened risk of degenerative brain diseases later on. A recent study found increased risks of Alzheimer's and Lou Gehrig's disease in retired pro football players, for example.

But Eisenberg pointed out that those athletes are routinely exposed to high-impact collisions. No one knows if kids' concussions, even repeat ones, would translate to health effects down the road.

According the U.S. Centers for Disease Control and Prevention, more than 173,000 U.S. children and teens land in the ER each year because of a concussion sustained in sports or recreational activities, like bike riding.

Concussion symptoms include headache, dizziness, nausea, ringing in the ears, fatigue and confusion -- though these problems may not become noticeable until hours after the jolt to the head. And contrary to popular belief, concussions usually do not involve loss of consciousness.

The current findings are based on 280 11- to 22-year-olds treated at the Boston Children's ER for a concussion. Of these, 21 patients had a concussion within the past year; and typically, Eisenberg's team found, their recovery from the current injury was three times longer, versus the recovery times of kids who'd never had a concussion before.

It's not clear, though, whether that high-risk time window actually lasts a whole year. "We need to figure out, more specifically, what the vulnerable window is," Eisenberg said. "Is it one month? Is it three months? We don't know."

Both Eisenberg and Yeates said they are big supporters of sports and exercise, and they would not want parents to keep their kids out of activities over concussion fears.

But both also said that if your child has suffered more than one concussion in a particular sport, it may be time to think about changing to a different activity.

"We don't know what the long-term risks might be," Yeates said. "But since we don't know, it seems best to be conservative and assume it's not good for kids to have multiple concussions."

More information

The U.S. Centers for Disease Control and Prevention has about concussions and sports.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- Having a designated driver sounds like a great idea, but a new study found that more than one-third of those who were supposed to drive their pals home safely had been boozing it up themselves.

And some were legally drunk.

The study has limitations that prevent it from being definitive, and researchers aren't sure how much danger lurks in designated drivers who have a drink or two. But the message is clear, said study author Adam Barry, an assistant professor at the University of Florida: Some designated drivers are drinking when they should be abstaining.

"While more of the designated drivers didn't drink than did drink, which is a good thing, you have people being selected because they're the least drunk, or the least intoxicated or they've driven drunk before," Barry said. "The only real safe option is to completely abstain."

The researchers, all from the University of Florida, Gainesville, went to an unidentified college-area town and talked to almost 1,100 bar patrons, mostly white, male and college-aged. They then gave blood alcohol tests to 165 people who said they were serving as designated drivers -- those who are expected to take care of driving their friends home so the others can drink.

Sixty-five percent, or 108, of the designated drivers had zero alcohol in their systems. Another 17 percent, or 28, had a blood alcohol level of between 0.02 and 0.049 (grams of alcohol per 210 liters of breath). And 18 percent, or 29, were at 0.05 or more; the legal limit is 0.08 or higher.

It's not clear how many of the designated drivers actually drove after taking the blood alcohol tests, nor do researchers know if they were able to sober up before driving.

The researchers also didn't examine how many of the designated drivers were legally drunk at 0.08 or higher. Barry said the researchers chose to look at those above 0.05 because experts think drivers are significantly impaired at that level; some public health advocates want to lower the legal level for driving to 0.05.

People can be arrested for driving while intoxicated at levels under 0.08, but they must show signs that they're impaired.

Why does it matter if designated drivers have had only a bit of alcohol? Barry said they may have more trouble handling the task of driving with boozed-up passengers: "You've got roughhousing, unruly passengers, music -- so many competing factors on top of your ability to process information and brake and steer effectively," he explained.

Is it realistic to expect designated drivers to not drink at all? James Lange, an alcohol researcher and coordinator of Alcohol and Other Drug Initiatives at San Diego State University, said it is.

Because people's alcohol tolerance varies, "it would be difficult for me to make a blanket statement that a certain amount is OK," Lange said. "The easiest recommendation is that they don't drink at all."

E. Scott Geller, a professor who studies alcohol use at Virginia Tech, suggested that "we should not trust a designated driver to be sober." Instead, he said, there should be ways to guarantee that they don't drink, such as providing rewards at a party or bar if blood alcohol tests shows they've abstained.

The study appears in the July issue of the Journal of Studies on Alcohol and Drugs.

More information

For more about alcohol abuse, try the U.S. National Library of Medicine.

Health News Copyright © 2013 HealthDay. All rights reserved.

MONDAY, June 10 (HealthDay News) -- An implanted device that zaps the nerves at the nape of the neck -- shown effective in treating some people with migraines -- may also help ease the ache of fibromyalgia, an ailment that causes widespread body pain and tenderness.

A Belgian scientist treated small numbers of fibromyalgia patients with "occipital nerve stimulation," which rouses the occipital nerves just beneath the skin at the back of the neck using an implanted device. Dr. Mark Plazier found that pain scores dropped for 20 of 25 patients using this device over six months and their quality of life improved significantly.

"There are only a few treatment options [for fibromyalgia] right now and the response to treatment is far from 100 percent, which implies there are a lot of patients still looking for help to get a better life. This treatment might be an excellent option for them," said Plazier, a neurosurgeon at University Hospital Antwerp. But, "it is difficult to determine the impact of these findings on fibromyalgia patients, since larger trials ... are necessary."

Plazier is to present his research this week at a meeting of the International Neuromodulation Society, in Berlin. Neuromodulation is a group of therapies that use medical devices to relieve symptoms or restore abilities by altering nerve system function.

Research presented at scientific conferences has not typically been peer-reviewed or published and is considered preliminary.

Fibromyalgia is thought to affect about 5 million American adults -- most of them women -- according to the U.S. National Institutes of Health. The cause of the disorder, which can also involve sleep problems, anxiety and depression, is unknown and it can be difficult to treat.

Plazier also presented a separate study on six fibromyalgia patients using PET scan images to visualize brain changes from occipital nerve stimulation treatment. It suggested that the nerve stimulation changes activity in the limbic system, a brain region that helps determine pain perception.

"In fibromyalgia, we see that there is a hypervigilance to pain, so patients are more sensitive to pain and more aware of it," Plazier said. "They also have high scores on questionnaires concerning catastrophizing behavior, which implies the high impact of pain on their lives."

"During [occipital nerve] stimulation we see differences in brain activity on PET scans in regions involved in pain," he added. "This all might suggest that we are influencing a cerebral system and might even turn it back to 'normal' perception."

Study participants didn't find the nerve-zapping treatment to be painful, Plazier noted. The occipital nerve stimulation device is implanted during a brief surgery using general anesthesia, he said, and postoperative pain is normal but not extreme.

Dr. Patrick Wood, director of the fibromyalgia clinic at Madison River Oaks Medical Center in Canton, Miss., called the studied "interesting and promising" but said additional research is necessary before treatment with occipital nerve stimulation -- which may cost around $10,000 -- could become mainstream for fibromyalgia patients.

"It's mostly used in headaches, and even in the headache realm it's still considered experimental," Wood said. "It would be nice to have expanded data here that would indicate there's something worth banking on and putting our hopes on. It's promising, but more work needs to be done before the average patient can consider it."

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about fibromyalgia.

Health News Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: June 10, 2013

By on

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Mandela Remains in Hospital

South Africans are being told to pray for former President Nelson Mandela, who remained hospitalized Monday to treat a recurring lung infection.

"His condition is unchanged," according to a statement released Monday by the current president's office, " the Wall Street Journal reported. "President Jacob Zuma reiterates his call for South Africa to pray for Madiba and the family during this time."

Madiba is the clan name by which many South Africans refer to the anti-apartheid hero.

Mandela was taken to hospital early Saturday after doctors treating him for a lung infection at his home determined that there had been a significant decline in his condition, WSJ reported.

This is the fourth hospitalization in the past six months for Mandela, who will turn 95 next month. That includes a three-week stay in December to treat a lung infection and to remove gallstones and another stay that ended in early April, in which Mandela was treated for a lung infection.

-----

Fungus, Bacteria Found in Drugs From Tennessee Pharmacy: FDA

Fungus and bacteria have been found in drug vials from a Tennessee specialty pharmacy that recalled all of its injectable medicines last month, according to the U.S. Food and Drug Administration.

The growths were detected in two unopened vials of a steroid injection distributed by the Main Street Family Pharmacy of Newbern. The FDA said it is working with the Centers for Disease Control and Prevention to identify the exact species of fungus and bacteria, the Associated Press reported.

An investigation was launched last month after seven patients in North Carolina and Illinois said they developed skin abscesses after being injected with the steroid methylprednisolone acetate, which is used to treat joint pain, inflammation and respiratory problems.

This is the same steroid linked to a deadly fungal meningitis outbreak that began last year and has caused 58 deaths and sickened more than 740 other people, the AP reported. The FDA said it does not know of cases of meningitis associated with products from Main Street Family Pharmacy.

Copyright © 2013 HealthDay. All rights reserved.